Even when topics of obesity, nutrition, and food always show up in the news, still, for some reason, these topics are often misrepresented.
In this episode, Dr. Adrienne starts a new segment to review recent news about obesity, food, and nutrition. Here, she talks about a) the new FDA-approved medication for diabetes called tirzepatide which also has a positive impact on weight loss, b) pandemic weight gain, how it still affects us now, and what we can do about it, and c) the work that the Women’s Preventive Services Initiative does, especially on the prevention of weight gain in midlife for women.
What you will learn from this episode:
● Find out how the new medication for diabetes called tirzepatide helps not only in the treatment of type 2 diabetes but also in weight loss;
● Recognize that there is a true and clear physiological link between stress, anxiety, and difficult emotions and excess weight, which have greatly contributed to the increase in cases of weight gain during the pandemic; and
● Understand why women in midlife should start seeking counseling and guidance directed towards weight gain
“Let's not wait until we have gained weight or excessive weight in order to seek counseling and guidance to make the change. This is really important because prevention is key.”
– Dr. Adrienne Youdim
Valuable Free Resource:
Look at your weight as a data point. Just like blood pressure; just like temperature and heart rate.
● Don't have judgment about it.
● Don't use it as a character assassination.
● Instead, use that number in an actionable way, not to judge ourselves, not to discriminate against ourselves, but to use it as a tool towards motivating behavior change and greater health.
If you are a woman who is currently in your 40s to 60s, start seeking counseling, screening, and preventive services directed towards weight gain now.
● A little tip: food, movement, and sleep – all three of these are critical to maintaining healthy weight in the midlife.
00:54 – A Different Take: The start of Health Bite’s new segment – a monthly review of news around areas of obesity, food, and nutrition
01:16 – Lilly’s Mounjaro: What the new medication tirzepatide is all about, and how it helps in both weight loss and treatment of type 2 diabetes
03:58 – They’re All Related: The science behind pandemic weight gain and its relation to depression, anxiety, and stress, and how it still affects us today
06:20 – “Look at your weight as a data point”: Dr. Adrienne encourages you to use the number shown on the weighing scale as a tool for motivating behavior change and greater health
08:21 – The Women’s Preventive Services Initiative: “Women during their midlife should begin to have counseling, screening, and preventive services directed towards weight gain”
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Obesity, Nutrition, and Food in the News – Transcript
[Tirzepatide, Pandemic Weight Gain, and the Women’s Preventive Services Initiative]
Obesity, nutrition, and food in the news. These topics are so topical and always in the news, but also often misrepresented, so I decided to offer a segment on obesity, nutrition, and food in the news.
Welcome to Health Bite, the podcast dedicated to small, actionable bites towards healthy weight and weight maintenance through greater mental, emotional, and physical wellbeing. I'm your host, Dr. Adrienne Youdim, and I created this podcast as an alternative to the noise, to offer you knowledge-based guidance in the areas of nutrition, fitness, habit change, and mindset that I use in my medical practice every day to help my patients achieve healthy weight and health.
A DIFFERENT TAKE: THE START OF HEALTH BITE’S NEW SEGMENT – A MONTHLY REVIEW OF NEWS AROUND AREAS OF OBESITY, FOOD, AND NUTRITION
So I decided to have a different take on the Health Bite podcast and offer you a monthly review of these areas of obesity, food, and nutrition in the news. So let me know what you think about this, because I think it's important content.
LILLY’S MOUNJARO: WHAT THE NEW MEDICATION TIRZEPATIDE IS ALL ABOUT, AND HOW IT HELPS IN BOTH WEIGHT LOSS AND TREATMENT OF TYPE 2 DIABETES
So this month we saw the release of a new medication called Tirzepatide that goes by the trade name Mounjaro. Now, while this is a medication that's currently FDA-approved for diabetes, it is very relevant to weight loss, too. Maybe the name tipped you off.
So first off, what is it?
Tirzepatide is a combination drug that is an analog or a mimic of two commonly released hormones in the body – hormones by the name of GLP and GIP; there are longer names, but I'm not going to bore you with that. But essentially, these are hormones that are released by the gut in response to food and nutrient intake.
So imagine you eat a piece of pie or something; doesn't have to be a sugary food, but that food goes down, travels down into the intestines, the intestines and the gut receive this food, and then they need to send a signal to the brain to say, “Alright, we got food down here. You can shut off that hunger switch.” And so, these hormones literally shut off the hunger signal or signal to the brain that food has been received and therefore hunger can dissipate.
The second message they send is to the pancreas, because again, it's signaling the receival of food. So it sends a signal to the pancreas, “Hey there, we got food over here. Can you please send down some more insulin?” And so for that reason, this medication has been shown to improve blood sugar and therefore is being used now as a treatment for type 2 diabetes.
But in clinical trials, they showed that individuals on this drug also achieved really stellar weight loss results. In fact, people who were on the initial treatment dose that is of five milligrams lost 15% of their body weight, and lost over 20% of their body weight with 15 milligram doses. 20% of their total body weight; that's pretty darn good.
Now, once again, this is currently approved for type 2 diabetes, but the company, Lilly, is trying to get approval for this drug for obesity and many doctors are already prescribing it for this indication. So something to keep your eyes open to and something that may be available to you now, but is certainly also coming down the pipeline.
THEY’RE ALL RELATED: THE SCIENCE BEHIND PANDEMIC WEIGHT GAIN AND ITS RELATION TO DEPRESSION, ANXIETY, AND STRESS, AND HOW IT STILL AFFECTS US TODAY
Now, the second topic I wanted to talk about in the news is pandemic weight gain. So of course, stay at home orders are behind us, but the pandemic is somewhat slightly with us, and definitely, the repercussions are still with us and we're dealing with them, particularly pandemic-related weight gain.
Now we experienced it, and a study that came out this month showed that almost 50% of the population gained weight during the pandemic. There's all of these different numbers out there, but significant numbers all across the board showing weight gain during the pandemic. People who reported being obese or overweight already before the pandemic were most likely to gain weight, but those individuals who are “normal weight”, 40% of them also experienced weight gain, too.
This is important because it is just adding to the already high levels of excess weight in our communities, in our society, and in our country. And of course, this is going to have repercussions in terms of our health.
The study also showed that weight gain was significantly higher in those with anxiety, depression, or symptoms of both. And again, this is not surprising either, but for reasons that you may not know. The image that comes to mind or might come to mind is that those who are depressed or anxious are self-soothing with food – and they are – but there's a physiologic reason behind that. A study showed that emotional discomfort or distress, stress and anxiety literally hijack our hunger hormones or increase the hormones that make us feel hungry. So there is a true, clear physiological link between stress, anxiety, and difficult emotions and excess weight.
I talk about all of this in my book,Hungry For More, so if you're interested in learning a little bit more about the science behind it, check it out, because I firmly believe that knowledge is power.
“LOOK AT YOUR WEIGHT AS A DATA POINT”: DR. ADRIENNE ENCOURAGES YOU TO USE THE NUMBER SHOWN ON THE WEIGHING SCALE AS A TOOL TOWARDS MOTIVATING BEHAVIOR CHANGE AND GREATER HEALTH
Now, I wanted to take this time to also point out another study that was published earlier this year that showed that those who were less likely to be weighed were more likely to gain weight. And in fact, that there was greater weight gain in those who had had the greatest time since their last weight. Meaning that people who had not weighed themselves for a prolonged period of time were more likely to have greater amounts of weight gain.
Now, I understand that getting on the scale is difficult. I understand that getting on the scale at a doctor's office can be difficult, because not only do we have judgment against ourselves, but unfortunately, there is judgment and bias in health care and in our health care workers. But this is not a place in which we need to keep our heads in the sand. We cannot bury our heads in the sand on this point because it is so directly related to our health. The less that we know, the less data we have, the more likely we are to experience significant weight gain.
And so I want you to look at it just as that. Look at your weight as a data point. Just like blood pressure; just like temperature and heart rate. Look at it as a data point. Don't have judgment about it. Don't use it as a character assassination. Let it be a guide, a tool to your next steps. If we can start thinking about our weight in this way, then we can use that number in an actionable way, not to judge ourselves, not to discriminate against ourselves, but to use it as a tool towards motivating behavior change and greater health.
THE WOMEN’S PREVENTIVE SERVICES INITIATIVE: “WOMEN DURING THEIR MIDLIFE SHOULD BEGIN TO HAVE COUNSELING, SCREENING, AND PREVENTIVE SERVICES DIRECTED TOWARDS WEIGHT GAIN”
Last but not least, theWomen's Preventive Services Initiative. It's a mouthful and a tongue twister. But it is a group of women – obstetricians and gynecologists – who have come together with other colleagues, internists, and the like to create standards and recommendations for women's health. And I really applaud this work because for so long, women's health has been made equivalent to men's health, and we know on so many levels and in so many areas the way women experience disease and pathology is so different than men. This has been shown most notably in cardiovascular disease, such that the way that women not only experience the symptoms of heart attack, but actually, the pathology that results in heart attacks in women is vastly different than the pathology in men. And this translates into a difference in imaging modalities as well, so that the imaging studies don't capture women's heart disease in the same way that it captures men. A totally different topic, which I do want to discuss more in a subsequent episode; I actually have an expert in mind that I'm going to bring on the show. But let's stay with the news of the month.
And actually, at the day of this recording, researchers showed that there may be a hormonal link that contributes to weight gain in the midlife. So we know that women tend to gain weight during menopause and during the transition; we also know that they're experiencing hormonal changes during this time. What we don't know is whether these hormonal changes are actually impacting women's weight gain, and so that is being studied right now.
We know that women during menopause have a reduction in estrogen, but other hormonal changes are occurring as well. For example, FSH – another hormone that is involved in stimulation of ovulation – is increased. And studies, in rats at least, have shown that blocking FSH reduces the risk of obesity. Researchers are looking to see if the same is true in women, and the results of this can be really important in terms of not only understanding weight gain during menopause, but also potentially having implications for medications and pharmacotherapy. So I digress.
Let's get back to the Women's Preventive Services Initiative, and this is, again, a group that is focused on prevention of disease in women. And what they have suggested is that counseling occur in women during the midlife; women aged 40 to 60 who are overweight or normal weight should begin to have counseling, screening, and preventive services directed towards weight gain.
Let's not wait until we have gained weight or excessive weight in order to seek counseling and guidance to make change. This is really important because prevention is key.
So if you are a woman in that transition period, in that midlife rage, which is pretty broad from our forties to our sixties, and is experiencing weight gain or maybe you were not – start to get the knowledge, the guidance, and the help now to prevent that from happening. And I'll give you a little tip: food, movement, and sleep – all three of these are critical to maintaining healthy weight in the midlife.
And I think that's it for today.
Our three big topics today, we talked about novel agents for diabetes and weight loss that are on the pipeline and currently approved for diabetes. We also talked about pandemic weight gain, how it still affects us now, and what you can do about it. And finally, recommendations about weight gain and prevention of weight gain in midlife for women.
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I hope you have a great week and I look forward to seeing you again next week on Health Bite. Until then.