November 28, 2024 • 48 mins
In this episode of "The Middle with Jeremy Hobson," we're asking you: are drugs like Ozempic, Wegovy and Mounjaro changing everything we know about weight loss? Jeremy is joined by two leading obesity physicians - Dr. Fatima Cody Stanford at Massachusetts General Hospital and Dr. Disha Narang at Endeavor Health System in Illinois. The Middle's house DJ Tolliver joins as well, plus callers from around the country. #ozempic #wegovy #mounjaro #weightloss #health #wellness
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Welcome to the middle I'm Jeremy Hobson. Happy Thanksgiving, and
even though we're still more than a month away from
when you might need to start making any New Year's resolutions,
We're going to dip into our archives right now for
a show that brings you a conversation about ozempic, Manjaro
and other similar drugs that Americans have been using more
and more for weight loss. Back when we originally aired
(00:25):
this conversation in January, these drugs all part of the
umbrella of glp ones. We're just getting out of the
phase of designer drug. In fact, at the Oscars last year,
host Jimmy Kimmel even joked about them being used among
the rich and famous.
Speaker 2 (00:39):
Everybody looks so great when I look around this room,
I can't help but wonder is ozembic right for me?
Speaker 1 (00:45):
Since then, golp ones like ozempic have exploded in popularity
and have broken into the mainstream as a much more
common treatment for obesity. A Kaiser Family Foundation poll from
earlier this year found that more than fifteen million people
currently have a prescription for a golp one drug, and
that one in eight adults had used the drug at
least once. We've also seen stories about gyms across the
(01:08):
country reporting a downtiket membership because many customers are saying
these drugs are doing the job a lot better than
an hour on.
Speaker 3 (01:15):
The treadmill can.
Speaker 1 (01:16):
But golp ones were designed as treatments for diabetes, not
necessarily weight loss, and the high demand has led to shortages,
which is especially difficult for people who actually need them
to treat serious health problems. But one thing is certain,
golp one drugs have completely changed the conversation about health
and weight loss in America, and they're likely here to stay.
(01:37):
So this hour we're asking listeners what do you think
of these medications like ozepic, Mountjarro and we gov. Are
you using them for weight loss? Is this a revolution
for weight loss or just another fat Let's meete our panel.
Doctor Fatima Cody Stanford practices obesity medicine at Massachusetts General
Hospital and as a professor at Harvard University, and doctor
(01:58):
deshen Orang is direct of obesity Medicine at Endeavor Health
in Chicago.
Speaker 3 (02:03):
Welcome to both of you to the middle.
Speaker 4 (02:05):
Thank you for having me. It's a delight to be here.
Speaker 5 (02:08):
Thank you so much.
Speaker 6 (02:09):
For having me.
Speaker 1 (02:10):
Well, before we get to the phones, let's start with
the basics. Most of these drugs are slightly different from
one another, but they all seem to have the same effect,
which is pretty rapid weight loss, like fifteen or twenty
percent of body fat in some cases in a year.
Speaker 3 (02:23):
Doctor Stanford, How did they work? Briefly?
Speaker 7 (02:26):
Yeah, Well, actually, I want to just kind of get
rid of a little few myths that we've kind of
stated at the outset of the show.
Speaker 4 (02:31):
They actually are the same drugs.
Speaker 7 (02:33):
So some magnetide is the agent that is exactly the
same drug ozimpig and will go be there, identical drug.
They're the exact same drugs, so it's the exact same compound.
These are what we call GLP one receptor agonists, and
I know that some fancy language that we have to
throw out there, but that's exactly what they are. They're
called glucagon like peptide one receptor agonists, and they really
(02:54):
work on the brain and the gut. They work to
upregulate a part of the brain that tells us to
eat less, and they work to really help us store
us adipose or fat. So they do work in the
brain and the gut. To really regulate how our brains
think and how we store fat. There's a lot of
complicated science behind how they work, but it's really important
(03:16):
to recognize that in our bodies, our bodies already produce
gop one. A lot of people don't know that in
our bodies, we already produce gop one within our gut.
Some of us produce more of it than others. So
for those of us that produce more of it, we
already have in our bodies this ability to regulate how
our bodies, you know, have this sense of satiety, the
(03:39):
sense of fullness, better than those of us that don't
produce as much of it.
Speaker 4 (03:43):
So I just want to kind of throw that out
there right now.
Speaker 7 (03:46):
The FDA has approved ozepic for the for the purpose
of treating diabetest GOV for treating obesity, and.
Speaker 1 (03:56):
They're exactly the same thing. You say, they're exactly the
same thing.
Speaker 7 (04:00):
The exact identical, exact same drug. And then for mandoruro,
that's a dual agonist that has kind of two different
types of things in it, the gop one we just
talked about, and something called a GIP that's a glucose
insulinotropic polypeptide say that five times fast. And it's a
dual agonist, and it's a little bit of a you know,
(04:22):
kind of a step above what we see in that
kind of single agent. That's the manjuro that you talked about.
But it was approved by the FDA on November eighth
for the treatment of patients with obesity under the trade name.
Speaker 4 (04:34):
Of zet bound.
Speaker 7 (04:35):
So that is the same agent Mondorro and zet bound,
same drug approved by the FDA initially to treat diabetes,
then approved to treat patients with obesity.
Speaker 4 (04:45):
I don't like this idea of.
Speaker 7 (04:47):
Us taking one drug from one population to treat another population,
because many of the patients that have type two diabetes
also happen to have obesity. About actually eighty percent of
patients that have type two diabetes also have obese. So
's really taking one from one another to treat another population.
Both patients or both sets of patients actually happened it. Yeah,
(05:09):
it's not that one is better or worse than the other.
I think both warn't treatment, and so I don't like
for us to think of it that way, and so
I really want to kind of get rid of that dimorphism.
So I just want to throw those things out there
and I'll be quiet after.
Speaker 1 (05:23):
Well, let me just I'll just bring doctor during And
do you think that these drugs are as revolutionary as
so many people think, or are they comparable to any
other existing weight loss tool?
Speaker 5 (05:33):
So these are amazing resources and it has really changed
the landscape of weight management.
Speaker 4 (05:39):
Right.
Speaker 5 (05:39):
So, as weight management specialists, we have had medications in
the past approved for weight management, right and weight loss. However,
these medications in the trials have shown upwards of twenty
percent or more weight loss in the groups that have
been on the highest doses. So truly, yes, this has
really changed the landscape.
Speaker 6 (05:59):
Of metaal weight management.
Speaker 5 (06:01):
However, within this whole conversation about you know, these revolutionary medications,
we really need to emphasize that these are, at the
end of the day, resources for weight loss.
Speaker 8 (06:14):
Right.
Speaker 5 (06:14):
So, in the trials, patients went through rigorous lifestyle changes
in addition to taking these medications in order to achieve
that long term weight loss. So, you know, just from
a clinical standpoint, I have had patients on these medications
who have not lost weight. I've also had patients on
(06:35):
these medications who have changed their lives and lost a
very significant amount of weight. And you know, their entire
life is different than it was a few years ago.
And so, you know, we don't necessarily need to tout
these medications as magic bullets or revolutionary things.
Speaker 6 (06:50):
However, yes we are.
Speaker 5 (06:51):
They're excellent resources and we're excited to have them as
a resource.
Speaker 6 (06:56):
But they're not a magic bullet.
Speaker 1 (06:58):
Well, but anybody who has to lose weight for their
whole life and then suddenly does with one of these
drugs probably does feel like it's a bit of a
magic bullet.
Speaker 3 (07:05):
We have a lot of.
Speaker 1 (07:06):
People calling in on the phones. Let's get to one
of them. Wes is calling from soft Center, Minnesota. Wes,
welcome to the middle Go ahead.
Speaker 2 (07:15):
Yes, So I take ozempic myself, and I have for
three years, and my doctor had encouraged me to take
it against you know, my what I wanted to do,
but I started taking it. You know, I was sick
for about six to eight months just with you know,
you throw up, you know, you have terrible ball movements
(07:37):
and you kind of get through it, but you learn
what you can eat and what you can eat it,
and it changes your mind on what you put in
your body. Just because you don't want to be sick.
But I lost about one hundred and twenty pounds wow
after taking ozempic Yeah, and changed my life. I mean
I had to buy three wardrobes because I lost so
(07:57):
much weight, and you know, and I just changed my appetite.
It changed my mood. I came off of all my
blood pressure meds.
Speaker 9 (08:06):
Wo.
Speaker 2 (08:07):
I came off of all yeah, and it and it uh.
I mean I came off of I was on like
nine meds and I got down to three.
Speaker 1 (08:15):
And Wes, do you think that you're going to take
it for the rest of your life or do you
think you'll eventually wean yourself off of it?
Speaker 2 (08:21):
I think I would, you know, honestly, the way it's
changed my mind as far as what I eat and
how I eat, it's mentally made me think about Wow,
I used to eat a lot of this and I
don't anymore because I don't want to be sick. But
you know, the biggest problem I run into now is
that I can come off of it. I mean, I
know what I what my body needs. I know how
(08:42):
to how I feel. I don't have chronic foot pain.
I don't have I can run. I can run upstairs. Wow,
you know, And yeah, it's it's it's crazy to think
that's a drug could do that. And it's very you know,
and I listened to your show that it's very upsetting
to see like these celebrities have ozembic parties. Uh and
uh you know, and well, because they run out there's
(09:05):
such a short supply. I've had to wait a month
before uh giving a few quite a few times to
get the medication and the dose I need, and uh,
you know, then I have to start over again and
I get six for a few months again because you know,
not because of what I'm eating, but just because my
body's trying to re adjust again.
Speaker 10 (09:23):
Right.
Speaker 9 (09:23):
Well, so when yeah, Wes, celebrities and people miss using it, let.
Speaker 1 (09:27):
Me take that to the panel. Thank you so much
for the call, Doctor Stanford. He brought up a couple
of points I want to get to. Let's start with
one of them, the side effects.
Speaker 3 (09:33):
There are some.
Speaker 1 (09:34):
People have been reporting you know that some of the
things that Wes was talking about there.
Speaker 7 (09:38):
Yeah, so the key side effects from these medications. Number
one is the one that he brought up, which is nausea.
So forty to forty five percent of patients will experience
nausea on these medications, and it's usually a dose effect,
so you tight right up on the doses of these medicines.
If you're looking at somemaglutide, their five key doses for
somemaglutie point two, five miligram point five miligrams, one miligram,
(10:02):
one point seven and then two point four milligrams. What
he mentioned to you at the very end of his
call was that if he misses a dose or it's
missing several doses, he needs to restart and rety trade
up the dosing of what he's saying is and so
then he has to kind of restart his plan and
then that he has to go back up the dosing titration,
which then makes him have to go back through his
(10:23):
body getting adjusted to the medication. So he brought up
some really key points there. So nausea is by far
the number one side effect, and he brought that up
as a key side effect. He talked about diarrhea constipation.
Constipation is a key side effect, and so he thought
about these things. These are really the gi side effects
or the key side effects that we hear from these medications,
and that's what we saw in the trials.
Speaker 1 (10:44):
Well, and we'll see if we'll see if other listeners
bring that up as well. I want to just remind
our listeners we are available as a podcast in partnership
with iHeart Podcasts on the iHeart app or wherever you
listen to podcasts.
Speaker 11 (10:55):
Iano Jeremy. One industry that might be more than a
bit scared of these drugs is the weight loss industry.
Weight Watchers has been around for sixty years. Wow, here's
an ad from the nineteen eighties.
Speaker 3 (11:05):
Surprise, Jessica, I'm home.
Speaker 4 (11:09):
It's not what it looks like.
Speaker 3 (11:10):
It looks like Lasanya to me. I thought we were
on a diet.
Speaker 4 (11:13):
We still are.
Speaker 12 (11:15):
Weight watchers, Jessica, don't try to fool me. Finally, nineteen
new meals that are so much saucier, so much chunkier than,
so much zestier.
Speaker 1 (11:25):
You won't believe they're weight watchers. Well, if you can't
beat them, join them, I suppose. Rather than trying to
compete with ozempic and we go via Mountjarro. Weight Watchers
is now offering special plans for people on the drugs,
and even bought a telehealth company to prescribe the drugs themselves.
Don't go anywhere more ahead on the Middle. This is
the Middle. I'm Jeremy Hobson. If you're just tuning in
(11:45):
the Middle as a national call in show, we're focused
on elevating voices from the middle politically, geographically, and philosophically,
or maybe you just want to meet in the middle.
This hour, we're talking about the rise in popularity of
GLP one drugs like ozempic, montjar Ro, and wigov and
what kind of impact they've had on the people who've
been taking them. They've become massively popular for weight loss,
(12:06):
but were designed as treatments for diabetes, and in the
last year we've seen them completely transform the discussion surrounding
health and wellness. This program was previously recorded, so we're
not taking any more live calls, but you can leave
us a message at eight four to four four Middle.
We're joined this hour by doctor Fatima Cody Stanford, an
obesity physician at Massachusetts General Hospital, and doctor Deshon Orang,
(12:28):
director of OBCD Medicine at Endeavor Health in Chicago. I
continued our conversation by asking doctor Orang about a criticism
I've read about these weight loss drugs, which is that
people who've been trying their whole lives to lose weight
and not feel shame about their bodies. Now feel like
a whole movement toward body positivity has been upended.
Speaker 5 (12:48):
Yeah, you know, I think one of the things is
that anyone who may be coming into doctor Stanford's clinic
or mine, they've probably been shamed for decades at that
point for their weight, right, and so to have a
resource to be able to treat.
Speaker 6 (13:02):
That is immense, right.
Speaker 5 (13:05):
And so one thing is that you know, obesity nationally
is seen or just worldwide, is seen as a disease
of vanity, that it's your fault or it was your
will power that caused you to.
Speaker 6 (13:16):
Be at this certain weight.
Speaker 5 (13:18):
But that's not true there obesity and weight gain weight loss,
it's very much a neuro hormonally mediated disease. So your
hormones talk to your brain, talk to your gut. They
determine how full or you know and hungry you are
and your environment and that means you know, the food
around you, where you live, what your access to food
(13:40):
might be, may exacerbate that or may not affect that.
And so that's the environment that we live in. That's
the disease of obesity.
Speaker 6 (13:49):
And so when we.
Speaker 5 (13:50):
Add these medications in you know what doctor Stanford was
saying earlier, The medication works, you know, the GLP one agonist.
When we add the gip on, it works to suppress
the hunger hormone, so it shuts off the noise in
your head to you know, have those cravings for food.
So when someone is on these medications and loses that weight,
(14:11):
it's like one of those things where you know, people
are judged for being at a certain weight, then they
are judged for being on medication to lose that weight.
And I want to kind of turn that conversation to
say that, well, no one's judging you for having heart
disease or taking medication for that. We aren't, you know,
judging people for being on a cholesterol or blood pressure medication.
Speaker 6 (14:30):
This is no different.
Speaker 5 (14:32):
And so you know, it's great to have that body positivity,
but I feel like a lot of my patients who
are on these medications feel like they can't win because
they've been judged either way.
Speaker 1 (14:41):
Well, and by the way, the number one prescribed medication
in America is a tour of statin, which is a
cholesterol medication that so many people take, including me.
Speaker 3 (14:50):
Let's go to the phones.
Speaker 1 (14:51):
Diana in Michigan is with us. Diana, welcome to the middle.
Go ahead, Hi there, Hi, go ahead with your comment.
Speaker 13 (15:03):
Hi, so, and I apologize you got me right as
untime is hearing. So I have started taking I thought
out manjaro as a way to sort of combat fertility treatment.
I have intul and resistant PCOS and I continued to
(15:24):
hear from doctors that if I was just losed weight
that maybe I could get pregnant in a second pregnancy.
And so I sought out ozempic and my doctor said,
why don't we try monjaro instead as a better option,
And it's been a complete game changer for me. So
(15:45):
I think it's really important to look at the hormonal
and fertility aspect of these drugs, and it's not something
everybody's talking about.
Speaker 1 (15:53):
Diana, thank you for that call. Doctor Stanford. Your thoughts
on that well.
Speaker 7 (15:57):
First of all, thanks so much for calling in. I
think this is a very important, overlooked issue. I've published
widely on this issue. I think a lot of the
fertility conversation is missing this issue, the issue with hormone
and balance and how it's impacting fertility treatment and how
many of our fertility docs are really not trained to
look at this issue of hormone imbalance and how this
(16:20):
can be impacting infertility with either first or second or
even third or however many pregnancies that we're looking at,
and how this can play a major role. And I
thank her for calling in and bringing up this important
issue that is very much overlooked. I've but like I said,
I've published on this. I find that about a third
of my female patients that are of reproductive of age
or coming in with this exact issue, many of them
(16:43):
I am trying on medications, whether it be some maglutide,
whether it be truseeppetide or other of our more historic
agents that I've utilized, and I've gotten significant success among
these using these medications and helping them to achieve pregnancy
in the midst of being told that this was really
an impossible feat. So I thank her so much for
(17:04):
sharing her story, being brave enough to share this story.
I think it's an important overlooked conversation in the fertility world.
And like I said, I just want to thank her
for sharing her.
Speaker 1 (17:14):
Story, especially as the kids were crying in the background.
Speaker 7 (17:16):
Yeah, she was brave in that sense.
Speaker 4 (17:19):
So brave all around. Thank you so much for sharing
your story.
Speaker 1 (17:23):
Anthony is with us from Atlanta, Georgia. Anthony, go ahead,
Welcome to the middle.
Speaker 14 (17:29):
Thank you so yes, I just started taking Olympic in October.
Prior to that, I was on the highest vistage of
me foreman never you know, with not seeing results my
last agency, I had dropped you know, three or four
points within to three or four month period. So it's
(17:50):
been a game changer for me. I'm you know, thirty
nine active and just a combination of exercising in strength
training has helped tremendously.
Speaker 1 (18:02):
So you've been you've been taking it in collaboration with
also an exercise routine that's helpful.
Speaker 15 (18:10):
Absolutely.
Speaker 14 (18:11):
I play tennis, work out at a gym, and so
I think for me, I'm actually I feel like I'm
doubling the results, you know, with my all and c reducing.
I got like toad doctor next month and we're going
to see if we need to reduce the DOSA since
it's working so well in my body.
Speaker 1 (18:27):
Anthony, thank you for that call. Let's get to another one.
Will is with us from Houston. Will go ahead, Welcome
to the middle.
Speaker 16 (18:35):
Hi, good to be on Love the Show. So my
point is basically a little bit personal. But I've been
on ADHD meds for the majority of my life, and
with IDHD meds it really suppresses your hunger and I
haven't had the best relationship with food. You know, I
was not trouble losing weight, but gaining weight. And you know,
(18:58):
with that in mind, I don't I think relying upon
pills to gain or lose weight is a healthy way
at all. I think it's a tool, and by all means,
you can use tools to your advantage, but if you're
relying upon a wonder drug to help you lose all
this weight, it's not going to last. And you know, lately,
(19:19):
getting off of ADHD meds and being able to regain
a healthy relationship with food has been really helpful in
gaining muscle and gaining healthy weights. And that's really my
point that I wanted to make, because it's a tool,
not a crutch.
Speaker 1 (19:32):
I appreciate your comment, Doctor Nurng. Let me go to
you on that. What about that view? I'm sure you've
heard it before.
Speaker 6 (19:39):
Yeah, I actually completely agree with you.
Speaker 5 (19:41):
I think that it is a tool, and as I
said earlier, that it's an excellent resource, but it is
not the magic bullet. And so you know, the caller
before that, you know, is doing a regimented exercise program,
you know, has an entire lifestyle built around this.
Speaker 6 (19:58):
That's where you tend to see success.
Speaker 5 (20:00):
So you know, of course there's camps where people say,
you know, you only do lifestyle modifications. The other camps
may just you know, rely on medication. Well, we truly
see long term success when we marry the two, when
we marry lifestyle, when we and medication together, that's where
we see long term success. However, yes, I agree that
(20:20):
we cannot be using this as a crutch, and especially
in the setting of medication shortages and insurance denials. We
don't have you know, readily available medication for folks every
single month.
Speaker 6 (20:31):
I wish we did.
Speaker 14 (20:33):
We do not.
Speaker 6 (20:34):
And this this is.
Speaker 5 (20:35):
Also not a treatment for eating disorders, and this is
exactly where long term weight management becomes essential. We cannot
just dole out the medication like candy. There's a lot
of counseling.
Speaker 6 (20:46):
That goes into it.
Speaker 5 (20:48):
And you know, someone is struggling with an eating disorder,
whether that might be restrictive or you know, the opposite.
We really need to be able to make sure is
this patient a good candidate for medication to lose weight,
you know, is it going to trigger the eating disorder?
Speaker 6 (21:05):
My bigger concern.
Speaker 5 (21:06):
Is that are you going to continue to have a
positive relationship with food, because it really does come down to,
you know, we need to make sure that we have
a healthy relationship with food, and because think about the
next twenty five years of your life, right like, we
have to make sure that this is not, you know,
a temporary fix.
Speaker 6 (21:23):
And so that's where it really comes.
Speaker 5 (21:25):
Down to the food environment and how we're thinking about,
you know, day to day what we're eating.
Speaker 1 (21:30):
Yeah, Tolliver, we're getting some comments in online at listen
toothiddle dot com.
Speaker 11 (21:34):
Yeah, Christy and Hazlitt. Michigan says, as a pharmacist, I
see people struggling with weight and always looking for the
quick fix. These new drugs are working for people and
getting a lot of good press. They do work. However,
I hear from my patients that as soon as they
can get the medication, their former appetite and former habits
come right back. I'm not sure we have made it
clear that these are lifelong meds and not the quick
fix they're seeing in the media. Bottom line, if I
(21:54):
thought it was the magic bullet, I'd be using it
since I'm two hundred plus.
Speaker 3 (21:57):
Pounds, Doctor Stanford.
Speaker 1 (21:59):
What about that that these are drugs you'd have to
take your whole life.
Speaker 7 (22:03):
That is absolutely true. These are a lifetime commitment. I
tell my patients whenever they're starting any medication that we're
using to treat the chronic disease that is obesity, if
they do work, and notice I said, if they do work,
if you are a responder, this is a lifetime commitment
to these medications. For many of my patients, they've been
with me for at least ten years. So this isn't
(22:25):
a short term commitment. If you're looking for something that
you're going to just breeze on bube, start it, stop it,
and hope that everything is going to be solved, you
have picked the wrong thing. This is not something that
you're going to just start and stop. Like I said,
people have been with me for ten, fifteen, twenty plus
years and they're looking this is going to be a
(22:46):
long term commitment. If they work, you do need to
be on these for the rest of your life.
Speaker 17 (22:52):
So you've have had patients that they don't work for
for if they don't work, then we need to pick
another agent, something that works in a different pathway of
the brain, or maybe even look at other types of treatments.
Speaker 7 (23:04):
Metabolic and bariatric surgery is still the best treatment that
we have available, particularly for those with moderate to severe obesity.
And for many of my patients, they're in combination therapy.
What do I mean by that? They have undergone bariatric surgery,
They're on medications, they're doing lifestyle modifications, they're working with
psychiatrists and psychologists. They're truly using all of the forms
(23:26):
of therapy available for them to get the best possible outcome.
Speaker 1 (23:30):
Let's go back to the phones. Beth is with us
from Nashville, Tennessee. Beth, Welcome to the middle. How is
ozempic working for you or one of the drugs like it?
Speaker 4 (23:41):
Well?
Speaker 15 (23:41):
I took Olympic for eighteen months through a program at
my work, and for me, it was really kind of
the brain piece that I was not expecting. And I
learned that semeglotide goes through the blood brain barrier. But
as someone who all my life has I say I
would secret eat and I binge ate and I know
(24:04):
one of the doctors mentioned about eating disorders and this
not necessarily being a great treatment for it. But for
the first time in my life, within a couple of
weeks of starting Ozimpic, I felt like I understood what
the majority of the population feels like about food. I
wasn't that food noise and food chatter was not always
(24:26):
in my head, and I was not just constantly trying
to think of, you know, what food's going to be available,
and is it food I'm going to want to eat
in front of people? And am I going to want
to eat before or after? And is there going to
be enough food or not enough? And not even just
like craving things, but just having a healthy outlook on
(24:46):
eating or you know, going to a restaurant and thinking
about what everyone else is going to order and just
feeling full. That was something I had never really even experienced.
I was like a bottomless pit. And when I started
taking the Ozimpic, it was like, oh, I don't have
to eat the entirety of that. I can have a
stopping point. And I just wasn't expecting that brain piece
(25:07):
to come into play so quickly.
Speaker 1 (25:09):
Let me ask you, let me ask you that question,
which is when you were taking it. When you started
taking Ozepe, did you tell other people that you were
taking it, because I've read a lot of people who've
been taking it they feel a little uncomfortable about talking
about taking it.
Speaker 15 (25:23):
Yeah. So I had several friends who were in the
same work weight loss program that we were in at
the same time. But there were people, even like close
friends and relatives who I still have never told because
they have said in the past. You know, well, if
you wanted to lose weight, you just you know, exercise
and eat, you know, eat some spinach and stop you know,
(25:44):
having junk food or whatever. And for me, it wasn't
even just a weight loss, like my body image issues
still exist, like we were talking about the body movement,
but it was it was that brain piece for me.
But for people who never experienced that brain piece, they
don't understand where I'm coming from.
Speaker 1 (26:03):
Well, let me take your comment to doctor Narrang your
thoughts on that.
Speaker 5 (26:08):
Yeah, you know, if it was as easy as eating
some salad and losing weight, we would have all been
able to do that.
Speaker 18 (26:15):
Right.
Speaker 5 (26:16):
As of twenty thirty, fifty percent of our population is
predicted to have obesity, So This is not just about
the fact that you may not have eaten enough salad
in the last you know, however, many decades of your life.
Speaker 6 (26:28):
This goes way way beyond that.
Speaker 5 (26:30):
And you know, as I said earlier, it's not a
question of willpower. This is very much our brain chemistry.
This is very much you know, the genetics we were
dealt and and part of it is, you know, we
can't change our genetics, but we can change the environment
around us. We can be on you know, therapeutic medications
that can alter part of that interaction of hormones between
(26:53):
our brain and our gut. And that's the situation that
we're in right now, right And I think people, you know,
like she was ment those who may not necessarily understand
that chatter going on in the brain, those people finally
feel seen because they have a resource to actually calm
that chatter down. Which and that's why you know, these
(27:14):
medications are remarkable because for the first time, and probably
you know, decades of dealing with this, they have something
that can you know, help them. Right And I'm telling
you everyone who may have come into my clinic, they've
tried every diet in the book. Right right there, there
is not a diet they have not tried, so that
it's not a question of eating more greens.
Speaker 1 (27:34):
Well, but just as it's not a question of eating
more greens. And you mentioned the amount of people that
may be obese. Almost three quarters of adults older than
twenty in the US are already living with obesity or overweight,
doctor Stanford. There are probably some listeners saying to themselves,
what about the food industry?
Speaker 3 (27:50):
Is this just?
Speaker 1 (27:51):
Is this just a way to counteract the kinds of
things that the food industry markets to us and has
for decades.
Speaker 7 (27:59):
Well, I mean, definitely think the food industry plays a role,
but I think that we make it just about the
food industry, and it's so much more complex than that.
It's about our sleep quality and duration. It's about other
issues that play a large role. I mean, let's look
at how our environment has changed over the last fifty years.
Let's look at the one demand ability to get food
(28:19):
at anytime, at any hour, at any minute of any day.
That's part of it. But let's look at how our
circadian rhythms have changed. Just the timing of when we
eat has plays a large role. Those things play a
large role. Medications that we take play a large role
in how much we weigh? Do you know that twenty
percent of our obesity has to do with medications that
we take for other issues? Did you know that that
(28:41):
twenty percent of obesity is caused by other medications? What
medications cause obesity? Medications like beta blockers, lithium depicode, medications
that are antipsychotics, insulin, these medications that we have to
take for other issues that lead to weigh gain. We
can't like not take those medications, but guess what they
(29:02):
cause weight gain? So there's a lot of other issues
that lead to obesity.
Speaker 1 (29:06):
All right, Well, stand by a reminder that The Middle
is also available as a podcast in partnership with iHeart
Podcasts on the iHeart app or wherever you listen to podcasts. Tlliver,
I have to say, when I first heard about ozembek,
I thought of Fenfenn, which was a hit weight loss
drug in the nineties, called a miracle drug at the.
Speaker 11 (29:21):
Time, yep, until it turned into a nightmare. Listen to
this nineteen ninety seven clip from the Fox affiliate in
my home city of Chicago.
Speaker 12 (29:27):
The first Illinois lawsuit's been filed against the makers of
fen Fenn. A Chicago law firm, filed a class action
suit today. It comes after the Food and Drug Administration
last week urged the recall of fen Fenn because of
studies that link it to heart problems.
Speaker 1 (29:41):
By the way, the drug combination that made fenfenn was
never approved by the FDA, whereas the drugs were talking
about today have been Stay with us.
Speaker 3 (29:48):
More of the Middle coming up. This is the Middle.
Speaker 1 (29:52):
I'm Jeremy Hobson. If you're just tuning in the Middle
as a national call in show, we're focused on elevating
voices from the middle politically, geographically, and philosophically, or maybe
you just want to meet in the middle. This hour,
we're talking about the rise in popularity of GLP one
drugs like ozempic, Mountjarro, and Wigovy and what kind of
impact they've made on the people who have been taking them.
They've become very popular for weight loss, but we're designed
(30:15):
as treatments for diabetes, and in the past year we've
seen them completely transform the discussion surrounding health and wellness.
This program was previously recorded, so we're not taking any
more live calls, but you can leave us a message
at eight four to four four Middle, or you can
reach out at listen toothmiddle dot com. We're joined this
hour by doctor Fatima Cody Stanford, an obesity physician at
Massachusetts General Hospital, and doctor Deshen Orang, director of obesity
(30:38):
medicine at Endeavor Health in Chicago. I continued our conversation
by asking doctor and Orang about the cost of these drugs.
If it's not covered by insurance, it's around one thousand
dollars a month and Medicare doesn't cover it, so for
most it is cost prohibitive.
Speaker 3 (30:52):
Here's what she had to say.
Speaker 5 (30:54):
I think one of the things is that there are
more agents in the pipeline coming out. So I do
think that potentially having multiple agents that are as powerful
as you know, the current agents that we have may
help to decrease the prices.
Speaker 6 (31:09):
That's just conjecture.
Speaker 5 (31:10):
Though we do have coupons available, you know, for all
of these medications. However, even after the coupons, they are
quite pricey. So in the near future, unfortunately, I do
not see the price coming.
Speaker 3 (31:22):
Down, Doctor Stamford.
Speaker 1 (31:24):
The other thing I'm wondering about, and we've heard about,
is that ozebic, what it does for cravings, addictions, and
desires goes beyond hunger. Can it be used for you know,
alcoholism or impulse shopping.
Speaker 7 (31:38):
Even so, those studies are being now conducted by the NIH,
so the data is still very preliminary. There are some
people that will anecdotally say that, you know, I do
feel that I'm not having those strong alcohol, you know,
cravings that I've had before. I've had some patients, although
just a few, that say that I no longer have
(31:59):
those issues. But the data is very scarce, and so
I would be a little bit pro you know, cautious
in terms of making these really sweeping statements to say
that those are what we're getting from these drugs, although
there are some patients that would tell you that definitively
they've seen major shifts in those One thing that I
do want to add, however, to what doctor Nrainge stated earlier,
(32:22):
is that one of the drugs that is a gop
one that's a daily injection, that was the first drug
approved that was a golp one. That's the ragletide. That
was Victosa, which was the one treat the treat diabetes
and sex cinda that is set to come off patent
in twenty twenty four. So when that does come off patent,
that will be a generic drug which will be available
to the public. Now, on average, the weight loss is
(32:44):
significantly less, but it still works in the same pathways
of the brain and was quite effective for many patients
and still quite effective for several patients. So that will
improve some of the equity issues that we've seen in
access issues when that comes off patent this year.
Speaker 4 (32:59):
And so I do think that that will help improve.
Speaker 7 (33:01):
Some of the equity and access issues when that comes
off patent in twenty twenty four this year.
Speaker 1 (33:06):
Let's go back to the phone. Sarah is joining us
from Pennsylvania. Sarah, Welcome to the Middle Go ahead, Hi.
Speaker 8 (33:13):
Thank you. I caught this show accidentally and it has
been so informative and great to hear, so thank you,
thank you. I heard one of the callers, a gentleman,
talking about how he's been on the medication for add
or ADHD, and his statement kind of challenged me about
(33:33):
you know, we're looking for the weight loss, the magic bullet,
the magic pill here, and I think that's the biggest thing,
one of the biggest things that gets me with this.
I too, have taken adderall for my add over the
years I've taken Fennermine. I actually took finfin before it
was banned for a short time, which helped me and
I was able to be off of it for a
(33:55):
number of years. And then I did revisit fentermine itself
years ago and it actually helped me more with my
add than the weight loss, so that was interesting. And
then here comes Lagovi and I started that earlier this year.
And the mental component, the brain com opponent, like one
of the other callers mentioned, it is amazing what it does,
(34:16):
and it's hard to put to words, and I just
wish that people would understand that. Nobody goes into the
store and says, you know what, I'll take a box
a add actually give me a double dose, and while
you're at it, why don't you add some obesity to
it and make that a triple dose. Nobody wants any
of this. Nobody's looking for an easy way out. It's
exactly like the doctor said that, you know, there's no
(34:39):
judgments because you're taking medication for your heart or insolence
or because of whatever. So it just really I guess
struck my NERB when he was like, you know, hey,
change your life. Stop I've done everything like like has
been mentioned on the show, I've I've done the lifestyle change,
I've done the eating change, and I still gain weight
and being a bottom most pit of hungry hungry all
(35:02):
the time. Yeah, to the point of being physically sick
is mind blowing of like what is going on with
my body and the WAGOVI it is a game changer
and and it was just like, yeah, whatever it did
to the mentalness, I was like, whoa wait a minute,
because I know what Funnerman does.
Speaker 13 (35:19):
Well, Sarah, I don't.
Speaker 3 (35:20):
We've got it.
Speaker 1 (35:21):
Let me take it to our panel, doctor Doury. Why
is there such judgment about about not just weight, but
about people trying to lose the weight.
Speaker 5 (35:31):
Yeah, So, going back to my earlier comment, obesity is
seen as the disease of vanity. It is seen as
a disease that was your fault because you ate too
much or whatever the situation may have been, that it
was your fault. We need to turn this conversation around.
This is a chronic disease. We're not seeing this conversation
around blood pressure, polesterol, heart disease, diabetes, sleep apnea, joint disease.
(35:55):
All of these are actually complications of obesity, and so
this conversation needs to change.
Speaker 6 (36:01):
Even our insurance.
Speaker 5 (36:02):
Companies, you know, deny these medications left and right, or
if someone didn't lose enough weight on the medication, they'll
stop coverage for the medication. Well, they're putting blame on
the patient. They're making this disease their fault. And this
is precisely why we need to treat this as a
long term chronic illness that needs to be treated long
(36:22):
term with the medication potentially. And so this is exactly
you know what this caller was saying. She's tried all
these medications and you know this finally worked for her.
That mental chatter came down. She's doing well on it. Well,
that's what we want to see, right, because when we
do well on it, then all these other things get better.
Our diabetes, blood pressure, cholesterol, heart disease, sleep apnea, a
(36:44):
joint disease, risk of cancer, like you name it, right,
all of these things get better. So we need to
change this conversation.
Speaker 1 (36:54):
Let's go to Nick, who's calling from Michigan. Nick, Welcome
to the middle.
Speaker 10 (37:00):
Oh did he My question to your panel was? I
was just that Actually at my doctor recently and he
was commenting that they were seeing or maybe in the
lab animal aspect of when they test drugs, that they
were seeing increased rates of thyroid cancer. But I don't
(37:20):
know that that necessarily translated to the human I guess trials,
and now that it's been on market, if we've seen
an uptick in instances of thyroid.
Speaker 1 (37:30):
Cancer, well let me take that to doctor Stanford.
Speaker 3 (37:33):
Have you heard about that?
Speaker 7 (37:35):
So yeah, So I think that what he's saying is
that some of the earlier trop particularly in the wrap models,
did show a slight increase in thyroid cancer. We haven't
really seen this translate into the human models, and so
I appreciate Nick for bringing this to the attention. So
there has been some fear associated with this, but long
term studies have not seen this translate into human studies.
(37:57):
And what I want to also let the caller people
that are listening to the show know that gop ones
have been on the market here in the United States
for almost twenty years, so we have almost twenty years
of data to look at with regards to the gop ones,
and we just really haven't seen that play out in
the almost twenty years of data that we've seen in
terms of thyroid disease. There was one study that was
(38:19):
conducted in Europe that showed a slight increase in the
European population with regards to thyroid disease in one study
that was conducted there. We have not seen that were
out in the American population. So I have not been
cautious in that way within my patient population. I have
over treated over over three thousand patients with gop ones
(38:42):
in my own personal patient population, and so I can
tell you that I'm always very cautious of thinking about this.
I will say a contra indication to use of this medication.
If you have a personal or family history of meadullary
thyroid cancer, you cannot use this medication. This is completely
a contra indication to use or any fit patient that
has a history of multiple intercom theeoplasia type two complete
(39:05):
contraindication to the use of these medications. So those patient
populations completely excluded.
Speaker 4 (39:10):
From the use of medication. But thanks so much for
calling in with that concern.
Speaker 1 (39:15):
Let's go to Eva, who's in the Chicago area.
Speaker 14 (39:18):
Hi.
Speaker 3 (39:18):
Eva, welcome to the middle.
Speaker 19 (39:21):
Hi. I was beginning to lose hope.
Speaker 3 (39:27):
Your prayers have been answered go ahead.
Speaker 19 (39:30):
Yes, I never had weight problems.
Speaker 16 (39:33):
I'm blessed.
Speaker 9 (39:34):
I guess.
Speaker 18 (39:35):
My daughter, however, was born. Finn was thin through school
and through high school, went away to college and started
getting weight and then gaining more and more and more
and more, and she was clinically obese, which of course
worries her mother. But I wasn't allowed to talk about
(39:56):
it or ask her question.
Speaker 19 (39:57):
Because then I would be that shaming her.
Speaker 18 (40:01):
So all I could do is bite my lips and hope.
Speaker 19 (40:07):
She has used the medication and lost almost one hundred pounds.
And it's like, oh my god, she's that's the person
you know I saw growing up. That's and it's it's wonderful.
But I have three concerns. Number One, there was no
(40:27):
research being done for weight control for the medication because
it was for diabetics. Is the medica is research going
on now? Number two, are people who are taking it
for weight control taking a higher dosage or different dosage
when people are taking it for diabetes? And number three,
(40:48):
do we have any idea of what happens when people
stopped taking it?
Speaker 3 (40:52):
Okay, my life we've been Yeah, those are great questions.
Speaker 1 (40:56):
Let me take let me take that to our panel,
Doctor Murrang, your give answers to those questions.
Speaker 5 (41:02):
Yes, So the answer to the first question, whether there
has been research on long term weight management, I think
that was the question. We have research and so with
U samaglatide, we're seeing about twenty percent give or take
at the highest dose. With turzeppatide, we're seeing even more
than that, up to twenty five percent in patients who
(41:26):
have taken it for over a year. And so we
do have actually data to support you know, long term
weight maintenance and weight loss. Right now, remind me of.
Speaker 1 (41:36):
The ether do people have to take a higher dose
if they're using it.
Speaker 3 (41:39):
For weight loss?
Speaker 5 (41:40):
Well, so the way that the medications have been dose,
so samaglotide for diabetes goes up to two milligrams, samaglatide
for that is indicated for the for weight management goes
up to two point four milligrams. So there's not too
much of a difference, but it's a very slight difference
for turzeppatide for both diabetes management and weight management, it's
(42:01):
the exact same dosing. And so you know, when these
studies were done, there were studies done for people who
have obesity without diabetes and there are separate studies for
patients who do have diabetes. So we actually have very
concrete data on this, and as doctor Stanford said, we
have twenty years almost experience with these sorts of agents,
(42:23):
and so for long term management, now you know, we
have ongoing trials to understand if we go down on
the dose, do we maintain our weight? If we come
off of the dose, though, especially anecdotally, patients do you know,
regain some of that appetite, some of that food noise,
and some of that weight. And so when when we
say that obesity is a chronic disease, we're expecting patients
(42:45):
to be on these medications long term. And so the
trade off is that hopefully you know, your diabetes and
blood pressure issues, cholesterol issues, those all get better, so
hopefully you do get to come off of other medications
as a trade off.
Speaker 1 (43:00):
Let's get in another call here. Weston is joining us
from Boise, Idaho. Weston, go ahead.
Speaker 9 (43:11):
I guess to get my thesis. I think we're starting
to Sorry, I'm actually a lot of breaks to at
the gym. My thesis is ultimately nice. We're trying to
address a broken food system with pills and the reason
I say that is that our food systems designed to
(43:32):
be addictive, at least the commercialized food system. So people
from a very young age are eating food that's mentally
and physically addictive, and then as they grow up that's
all their body knows. They haven't gotten good eating habits
the wise. So then we're at a point where now
(43:52):
Eli Lilly can make billion bumping drug because of the
food system being brooking. And I guess we just I
think we need a radically look at health societies where
and how people are becoming unhealthy because of society.
Speaker 1 (44:05):
All Right, well, Wesson, thank you for that call, and
I think it's very appropriate that we got a call
from somebody who's at the gym clearly on a piece
of exercise equipment during this show about this. But doctor Stanford,
this is something we just talked about a few moments ago.
But the food industry and the food that we eat.
Speaker 7 (44:20):
Yeah, I think that Wesson brings up a certain point,
but I think that he's missing the fact that this
is a global pandemic. There's not one country in the
world that isn't affected by obesity, and there's been a
global increase in the rates of obesity in every single
country in the world. And so if we're talking about
this and we're looking at food and food systems throughout
(44:41):
the world, we've seen this as an increase even in
those countries that don't have the same food systems that
we have here in the US. And so, if we
think about this as a multi factorial disorder or genetics, development, environment,
and behavior all play a role in a person's likelihood
of developing this disease. Where food does play a role,
we have to look at the role of genetics, development, environment,
(45:03):
and behavior and all of those components playing a role
in the likelihood of a person's development of obesity. I
encourage him to watch my lecture that I recorded Obesity.
Speaker 4 (45:14):
It's much more complex than you think.
Speaker 7 (45:15):
It is one hour and eleven minutes, and you can
go watch it for free. It's available for you to watch,
and it is great. It's not behind a paywall. But
I think that if you go watch that, you'll recognize
that this is not just about the food system, and
while that does play a role, it is much more
complex than you think.
Speaker 1 (45:33):
And doctor Durang, you are a nutritionist as well, correct.
Speaker 5 (45:37):
I have a license in culinary medicine.
Speaker 1 (45:39):
Okay, do you have thoughts on this, you know, I do.
Speaker 5 (45:42):
I agree with doctor Stanford. Food is certainly a large
part of this. We are in a different world than
we were in nineteen fifty, right. We rely on our cars,
our physical activity is much different, you know, the way
we live, the way we work, the places we live
and work.
Speaker 6 (45:59):
It's just it's a different world.
Speaker 9 (46:01):
Right.
Speaker 5 (46:01):
And so when we I agree, right, when we add
in the processed food industry and and all of those things,
it all contributes. We're more stressed, we don't sleep enough.
Like it's a whole, you know, combination of issues.
Speaker 1 (46:18):
We have to leave it there in terms of the
calls for now, but Tolliver, we do have time for
a quiz.
Speaker 11 (46:23):
Shout out to Wesson for setting this question up perfectly. Okay, okay,
So the quiz question is what's the US food band
most in other countries? Some of the name for foods, Okay,
instant mashed potatoes, Skittles, twinkies, or pills Berry biscuits. Feel
free to jump in when you got it. It's instant
mashed potatoes, Skittles, twinkies, or Pillsberry biscuits.
Speaker 6 (46:45):
I say twinkies too, you know.
Speaker 11 (46:47):
I would have said the exact same thing. It's instant
mashed potatoes.
Speaker 4 (46:50):
Wow, that's kind of disgusting. I think there should be really.
Speaker 3 (46:54):
I just want the real mashed potatoes. They don't want
the inside. I love the issue.
Speaker 4 (47:00):
He's on it.
Speaker 10 (47:01):
I just the other third.
Speaker 3 (47:02):
Yeah.
Speaker 1 (47:03):
I want to thank my guest, doctor Fatima Cody Stanford,
an obesity medicine physician at Massachusetts General Hospital, professor at Harvard.
Speaker 3 (47:10):
Doctor Stanford, thank you so much for joining us.
Speaker 4 (47:12):
Thank you for having me, and.
Speaker 1 (47:14):
Doctor Tishen Iraang, incoming director of Obesity at Endeavor Health
in Chicago.
Speaker 3 (47:19):
Doctor Iran, thank you so much for joining us.
Speaker 6 (47:22):
Thank you so much, it was an honor.
Speaker 1 (47:24):
Well that's it for our Thanksgiving encore episode. I hope
it didn't keep you from eating your turkey.
Speaker 3 (47:28):
But on our next show, we are live.
Speaker 1 (47:29):
Again taking a look at the loneliness epidemic in America,
what's behind it, how it affects us on an individual level,
and how to reach out and find a better sense.
Speaker 3 (47:37):
Of community if you need.
Speaker 1 (47:39):
We're going to be joined by activist and author David
Jay whose new book is called Relationality, and Reno Nevada
Mayor Hillary sheevy. You can call us at eight four
four four Middle. That's eight four four four six four
three three five three, or write in at Listen to
the Middle dot com, and of course, sign up for
our weekly newsletter while you're there. The Middle is brought
to you by Long Nook Media, distributed by Illinois Public
Media in Urbana, Illinois, and produced by Harrison Patino, Danny Alexander,
(48:02):
John Barth, and Sam Burmus Dawes. Our technical director is
Jason Croft. Our intern is Anikadeshler. Our theme music was
composed by Andrew Haig. Thanks to our podcast audience, our
listeners on satellite radio, and the more than four hundred
and twenty public radio stations that are making it possible
for people across the country to listen to The Middle,
little trick, I'm gonna give you right here, Take that
(48:23):
turkey leftover and turn it into a New Mexico style
green chili turkey tortilla soup.
Speaker 3 (48:29):
You're gonna love it. I'm Jeremy Hobson.
Speaker 1 (48:31):
Talk to you next week.
Welcome to the middle I'm Jeremy Hobson. Happy Thanksgiving, and
even though we're still more than a month away from
when you might need to start making any New Year's resolutions,
We're going to dip into our archives right now for
a show that brings you a conversation about ozempic, Manjaro
and other similar drugs that Americans have been using more
and more for weight loss. Back when we originally aired
(00:25):
this conversation in January, these drugs all part of the
umbrella of glp ones. We're just getting out of the
phase of designer drug. In fact, at the Oscars last year,
host Jimmy Kimmel even joked about them being used among
the rich and famous.
Speaker 2 (00:39):
Everybody looks so great when I look around this room,
I can't help but wonder is ozembic right for me?
Speaker 1 (00:45):
Since then, golp ones like ozempic have exploded in popularity
and have broken into the mainstream as a much more
common treatment for obesity. A Kaiser Family Foundation poll from
earlier this year found that more than fifteen million people
currently have a prescription for a golp one drug, and
that one in eight adults had used the drug at
least once. We've also seen stories about gyms across the
(01:08):
country reporting a downtiket membership because many customers are saying
these drugs are doing the job a lot better than
an hour on.
Speaker 3 (01:15):
The treadmill can.
Speaker 1 (01:16):
But golp ones were designed as treatments for diabetes, not
necessarily weight loss, and the high demand has led to shortages,
which is especially difficult for people who actually need them
to treat serious health problems. But one thing is certain,
golp one drugs have completely changed the conversation about health
and weight loss in America, and they're likely here to stay.
(01:37):
So this hour we're asking listeners what do you think
of these medications like ozepic, Mountjarro and we gov. Are
you using them for weight loss? Is this a revolution
for weight loss or just another fat Let's meete our panel.
Doctor Fatima Cody Stanford practices obesity medicine at Massachusetts General
Hospital and as a professor at Harvard University, and doctor
(01:58):
deshen Orang is direct of obesity Medicine at Endeavor Health
in Chicago.
Speaker 3 (02:03):
Welcome to both of you to the middle.
Speaker 4 (02:05):
Thank you for having me. It's a delight to be here.
Speaker 5 (02:08):
Thank you so much.
Speaker 6 (02:09):
For having me.
Speaker 1 (02:10):
Well, before we get to the phones, let's start with
the basics. Most of these drugs are slightly different from
one another, but they all seem to have the same effect,
which is pretty rapid weight loss, like fifteen or twenty
percent of body fat in some cases in a year.
Speaker 3 (02:23):
Doctor Stanford, How did they work? Briefly?
Speaker 7 (02:26):
Yeah, Well, actually, I want to just kind of get
rid of a little few myths that we've kind of
stated at the outset of the show.
Speaker 4 (02:31):
They actually are the same drugs.
Speaker 7 (02:33):
So some magnetide is the agent that is exactly the
same drug ozimpig and will go be there, identical drug.
They're the exact same drugs, so it's the exact same compound.
These are what we call GLP one receptor agonists, and
I know that some fancy language that we have to
throw out there, but that's exactly what they are. They're
called glucagon like peptide one receptor agonists, and they really
(02:54):
work on the brain and the gut. They work to
upregulate a part of the brain that tells us to
eat less, and they work to really help us store
us adipose or fat. So they do work in the
brain and the gut. To really regulate how our brains
think and how we store fat. There's a lot of
complicated science behind how they work, but it's really important
(03:16):
to recognize that in our bodies, our bodies already produce
gop one. A lot of people don't know that in
our bodies, we already produce gop one within our gut.
Some of us produce more of it than others. So
for those of us that produce more of it, we
already have in our bodies this ability to regulate how
our bodies, you know, have this sense of satiety, the
(03:39):
sense of fullness, better than those of us that don't
produce as much of it.
Speaker 4 (03:43):
So I just want to kind of throw that out
there right now.
Speaker 7 (03:46):
The FDA has approved ozepic for the for the purpose
of treating diabetest GOV for treating obesity, and.
Speaker 1 (03:56):
They're exactly the same thing. You say, they're exactly the
same thing.
Speaker 7 (04:00):
The exact identical, exact same drug. And then for mandoruro,
that's a dual agonist that has kind of two different
types of things in it, the gop one we just
talked about, and something called a GIP that's a glucose
insulinotropic polypeptide say that five times fast. And it's a
dual agonist, and it's a little bit of a you know,
(04:22):
kind of a step above what we see in that
kind of single agent. That's the manjuro that you talked about.
But it was approved by the FDA on November eighth
for the treatment of patients with obesity under the trade name.
Speaker 4 (04:34):
Of zet bound.
Speaker 7 (04:35):
So that is the same agent Mondorro and zet bound,
same drug approved by the FDA initially to treat diabetes,
then approved to treat patients with obesity.
Speaker 4 (04:45):
I don't like this idea of.
Speaker 7 (04:47):
Us taking one drug from one population to treat another population,
because many of the patients that have type two diabetes
also happen to have obesity. About actually eighty percent of
patients that have type two diabetes also have obese. So
's really taking one from one another to treat another population.
Both patients or both sets of patients actually happened it. Yeah,
(05:09):
it's not that one is better or worse than the other.
I think both warn't treatment, and so I don't like
for us to think of it that way, and so
I really want to kind of get rid of that dimorphism.
So I just want to throw those things out there
and I'll be quiet after.
Speaker 1 (05:23):
Well, let me just I'll just bring doctor during And
do you think that these drugs are as revolutionary as
so many people think, or are they comparable to any
other existing weight loss tool?
Speaker 5 (05:33):
So these are amazing resources and it has really changed
the landscape of weight management.
Speaker 4 (05:39):
Right.
Speaker 5 (05:39):
So, as weight management specialists, we have had medications in
the past approved for weight management, right and weight loss. However,
these medications in the trials have shown upwards of twenty
percent or more weight loss in the groups that have
been on the highest doses. So truly, yes, this has
really changed the landscape.
Speaker 6 (05:59):
Of metaal weight management.
Speaker 5 (06:01):
However, within this whole conversation about you know, these revolutionary medications,
we really need to emphasize that these are, at the
end of the day, resources for weight loss.
Speaker 8 (06:14):
Right.
Speaker 5 (06:14):
So, in the trials, patients went through rigorous lifestyle changes
in addition to taking these medications in order to achieve
that long term weight loss. So, you know, just from
a clinical standpoint, I have had patients on these medications
who have not lost weight. I've also had patients on
(06:35):
these medications who have changed their lives and lost a
very significant amount of weight. And you know, their entire
life is different than it was a few years ago.
And so, you know, we don't necessarily need to tout
these medications as magic bullets or revolutionary things.
Speaker 6 (06:50):
However, yes we are.
Speaker 5 (06:51):
They're excellent resources and we're excited to have them as
a resource.
Speaker 6 (06:56):
But they're not a magic bullet.
Speaker 1 (06:58):
Well, but anybody who has to lose weight for their
whole life and then suddenly does with one of these
drugs probably does feel like it's a bit of a
magic bullet.
Speaker 3 (07:05):
We have a lot of.
Speaker 1 (07:06):
People calling in on the phones. Let's get to one
of them. Wes is calling from soft Center, Minnesota. Wes,
welcome to the middle Go ahead.
Speaker 2 (07:15):
Yes, So I take ozempic myself, and I have for
three years, and my doctor had encouraged me to take
it against you know, my what I wanted to do,
but I started taking it. You know, I was sick
for about six to eight months just with you know,
you throw up, you know, you have terrible ball movements
(07:37):
and you kind of get through it, but you learn
what you can eat and what you can eat it,
and it changes your mind on what you put in
your body. Just because you don't want to be sick.
But I lost about one hundred and twenty pounds wow
after taking ozempic Yeah, and changed my life. I mean
I had to buy three wardrobes because I lost so
(07:57):
much weight, and you know, and I just changed my appetite.
It changed my mood. I came off of all my
blood pressure meds.
Speaker 9 (08:06):
Wo.
Speaker 2 (08:07):
I came off of all yeah, and it and it uh.
I mean I came off of I was on like
nine meds and I got down to three.
Speaker 1 (08:15):
And Wes, do you think that you're going to take
it for the rest of your life or do you
think you'll eventually wean yourself off of it?
Speaker 2 (08:21):
I think I would, you know, honestly, the way it's
changed my mind as far as what I eat and
how I eat, it's mentally made me think about Wow,
I used to eat a lot of this and I
don't anymore because I don't want to be sick. But
you know, the biggest problem I run into now is
that I can come off of it. I mean, I
know what I what my body needs. I know how
(08:42):
to how I feel. I don't have chronic foot pain.
I don't have I can run. I can run upstairs. Wow,
you know, And yeah, it's it's it's crazy to think
that's a drug could do that. And it's very you know,
and I listened to your show that it's very upsetting
to see like these celebrities have ozembic parties. Uh and
uh you know, and well, because they run out there's
(09:05):
such a short supply. I've had to wait a month
before uh giving a few quite a few times to
get the medication and the dose I need, and uh,
you know, then I have to start over again and
I get six for a few months again because you know,
not because of what I'm eating, but just because my
body's trying to re adjust again.
Speaker 10 (09:23):
Right.
Speaker 9 (09:23):
Well, so when yeah, Wes, celebrities and people miss using it, let.
Speaker 1 (09:27):
Me take that to the panel. Thank you so much
for the call, Doctor Stanford. He brought up a couple
of points I want to get to. Let's start with
one of them, the side effects.
Speaker 3 (09:33):
There are some.
Speaker 1 (09:34):
People have been reporting you know that some of the
things that Wes was talking about there.
Speaker 7 (09:38):
Yeah, so the key side effects from these medications. Number
one is the one that he brought up, which is nausea.
So forty to forty five percent of patients will experience
nausea on these medications, and it's usually a dose effect,
so you tight right up on the doses of these medicines.
If you're looking at somemaglutide, their five key doses for
somemaglutie point two, five miligram point five miligrams, one miligram,
(10:02):
one point seven and then two point four milligrams. What
he mentioned to you at the very end of his
call was that if he misses a dose or it's
missing several doses, he needs to restart and rety trade
up the dosing of what he's saying is and so
then he has to kind of restart his plan and
then that he has to go back up the dosing titration,
which then makes him have to go back through his
(10:23):
body getting adjusted to the medication. So he brought up
some really key points there. So nausea is by far
the number one side effect, and he brought that up
as a key side effect. He talked about diarrhea constipation.
Constipation is a key side effect, and so he thought
about these things. These are really the gi side effects
or the key side effects that we hear from these medications,
and that's what we saw in the trials.
Speaker 1 (10:44):
Well, and we'll see if we'll see if other listeners
bring that up as well. I want to just remind
our listeners we are available as a podcast in partnership
with iHeart Podcasts on the iHeart app or wherever you
listen to podcasts.
Speaker 11 (10:55):
Iano Jeremy. One industry that might be more than a
bit scared of these drugs is the weight loss industry.
Weight Watchers has been around for sixty years. Wow, here's
an ad from the nineteen eighties.
Speaker 3 (11:05):
Surprise, Jessica, I'm home.
Speaker 4 (11:09):
It's not what it looks like.
Speaker 3 (11:10):
It looks like Lasanya to me. I thought we were
on a diet.
Speaker 4 (11:13):
We still are.
Speaker 12 (11:15):
Weight watchers, Jessica, don't try to fool me. Finally, nineteen
new meals that are so much saucier, so much chunkier than,
so much zestier.
Speaker 1 (11:25):
You won't believe they're weight watchers. Well, if you can't
beat them, join them, I suppose. Rather than trying to
compete with ozempic and we go via Mountjarro. Weight Watchers
is now offering special plans for people on the drugs,
and even bought a telehealth company to prescribe the drugs themselves.
Don't go anywhere more ahead on the Middle. This is
the Middle. I'm Jeremy Hobson. If you're just tuning in
(11:45):
the Middle as a national call in show, we're focused
on elevating voices from the middle politically, geographically, and philosophically,
or maybe you just want to meet in the middle.
This hour, we're talking about the rise in popularity of
GLP one drugs like ozempic, montjar Ro, and wigov and
what kind of impact they've had on the people who've
been taking them. They've become massively popular for weight loss,
(12:06):
but were designed as treatments for diabetes, and in the
last year we've seen them completely transform the discussion surrounding
health and wellness. This program was previously recorded, so we're
not taking any more live calls, but you can leave
us a message at eight four to four four Middle.
We're joined this hour by doctor Fatima Cody Stanford, an
obesity physician at Massachusetts General Hospital, and doctor Deshon Orang,
(12:28):
director of OBCD Medicine at Endeavor Health in Chicago. I
continued our conversation by asking doctor Orang about a criticism
I've read about these weight loss drugs, which is that
people who've been trying their whole lives to lose weight
and not feel shame about their bodies. Now feel like
a whole movement toward body positivity has been upended.
Speaker 5 (12:48):
Yeah, you know, I think one of the things is
that anyone who may be coming into doctor Stanford's clinic
or mine, they've probably been shamed for decades at that
point for their weight, right, and so to have a
resource to be able to treat.
Speaker 6 (13:02):
That is immense, right.
Speaker 5 (13:05):
And so one thing is that you know, obesity nationally
is seen or just worldwide, is seen as a disease
of vanity, that it's your fault or it was your
will power that caused you to.
Speaker 6 (13:16):
Be at this certain weight.
Speaker 5 (13:18):
But that's not true there obesity and weight gain weight loss,
it's very much a neuro hormonally mediated disease. So your
hormones talk to your brain, talk to your gut. They
determine how full or you know and hungry you are
and your environment and that means you know, the food
around you, where you live, what your access to food
(13:40):
might be, may exacerbate that or may not affect that.
And so that's the environment that we live in. That's
the disease of obesity.
Speaker 6 (13:49):
And so when we.
Speaker 5 (13:50):
Add these medications in you know what doctor Stanford was
saying earlier, The medication works, you know, the GLP one agonist.
When we add the gip on, it works to suppress
the hunger hormone, so it shuts off the noise in
your head to you know, have those cravings for food.
So when someone is on these medications and loses that weight,
(14:11):
it's like one of those things where you know, people
are judged for being at a certain weight, then they
are judged for being on medication to lose that weight.
And I want to kind of turn that conversation to
say that, well, no one's judging you for having heart
disease or taking medication for that. We aren't, you know,
judging people for being on a cholesterol or blood pressure medication.
Speaker 6 (14:30):
This is no different.
Speaker 5 (14:32):
And so you know, it's great to have that body positivity,
but I feel like a lot of my patients who
are on these medications feel like they can't win because
they've been judged either way.
Speaker 1 (14:41):
Well, and by the way, the number one prescribed medication
in America is a tour of statin, which is a
cholesterol medication that so many people take, including me.
Speaker 3 (14:50):
Let's go to the phones.
Speaker 1 (14:51):
Diana in Michigan is with us. Diana, welcome to the middle.
Go ahead, Hi there, Hi, go ahead with your comment.
Speaker 13 (15:03):
Hi, so, and I apologize you got me right as
untime is hearing. So I have started taking I thought
out manjaro as a way to sort of combat fertility treatment.
I have intul and resistant PCOS and I continued to
(15:24):
hear from doctors that if I was just losed weight
that maybe I could get pregnant in a second pregnancy.
And so I sought out ozempic and my doctor said,
why don't we try monjaro instead as a better option,
And it's been a complete game changer for me. So
(15:45):
I think it's really important to look at the hormonal
and fertility aspect of these drugs, and it's not something
everybody's talking about.
Speaker 1 (15:53):
Diana, thank you for that call. Doctor Stanford. Your thoughts
on that well.
Speaker 7 (15:57):
First of all, thanks so much for calling in. I
think this is a very important, overlooked issue. I've published
widely on this issue. I think a lot of the
fertility conversation is missing this issue, the issue with hormone
and balance and how it's impacting fertility treatment and how
many of our fertility docs are really not trained to
look at this issue of hormone imbalance and how this
(16:20):
can be impacting infertility with either first or second or
even third or however many pregnancies that we're looking at,
and how this can play a major role. And I
thank her for calling in and bringing up this important
issue that is very much overlooked. I've but like I said,
I've published on this. I find that about a third
of my female patients that are of reproductive of age
or coming in with this exact issue, many of them
(16:43):
I am trying on medications, whether it be some maglutide,
whether it be truseeppetide or other of our more historic
agents that I've utilized, and I've gotten significant success among
these using these medications and helping them to achieve pregnancy
in the midst of being told that this was really
an impossible feat. So I thank her so much for
(17:04):
sharing her story, being brave enough to share this story.
I think it's an important overlooked conversation in the fertility world.
And like I said, I just want to thank her
for sharing her.
Speaker 1 (17:14):
Story, especially as the kids were crying in the background.
Speaker 7 (17:16):
Yeah, she was brave in that sense.
Speaker 4 (17:19):
So brave all around. Thank you so much for sharing
your story.
Speaker 1 (17:23):
Anthony is with us from Atlanta, Georgia. Anthony, go ahead,
Welcome to the middle.
Speaker 14 (17:29):
Thank you so yes, I just started taking Olympic in October.
Prior to that, I was on the highest vistage of
me foreman never you know, with not seeing results my
last agency, I had dropped you know, three or four
points within to three or four month period. So it's
(17:50):
been a game changer for me. I'm you know, thirty
nine active and just a combination of exercising in strength
training has helped tremendously.
Speaker 1 (18:02):
So you've been you've been taking it in collaboration with
also an exercise routine that's helpful.
Speaker 15 (18:10):
Absolutely.
Speaker 14 (18:11):
I play tennis, work out at a gym, and so
I think for me, I'm actually I feel like I'm
doubling the results, you know, with my all and c reducing.
I got like toad doctor next month and we're going
to see if we need to reduce the DOSA since
it's working so well in my body.
Speaker 1 (18:27):
Anthony, thank you for that call. Let's get to another one.
Will is with us from Houston. Will go ahead, Welcome
to the middle.
Speaker 16 (18:35):
Hi, good to be on Love the Show. So my
point is basically a little bit personal. But I've been
on ADHD meds for the majority of my life, and
with IDHD meds it really suppresses your hunger and I
haven't had the best relationship with food. You know, I
was not trouble losing weight, but gaining weight. And you know,
(18:58):
with that in mind, I don't I think relying upon
pills to gain or lose weight is a healthy way
at all. I think it's a tool, and by all means,
you can use tools to your advantage, but if you're
relying upon a wonder drug to help you lose all
this weight, it's not going to last. And you know, lately,
(19:19):
getting off of ADHD meds and being able to regain
a healthy relationship with food has been really helpful in
gaining muscle and gaining healthy weights. And that's really my
point that I wanted to make, because it's a tool,
not a crutch.
Speaker 1 (19:32):
I appreciate your comment, Doctor Nurng. Let me go to
you on that. What about that view? I'm sure you've
heard it before.
Speaker 6 (19:39):
Yeah, I actually completely agree with you.
Speaker 5 (19:41):
I think that it is a tool, and as I
said earlier, that it's an excellent resource, but it is
not the magic bullet. And so you know, the caller
before that, you know, is doing a regimented exercise program,
you know, has an entire lifestyle built around this.
Speaker 6 (19:58):
That's where you tend to see success.
Speaker 5 (20:00):
So you know, of course there's camps where people say,
you know, you only do lifestyle modifications. The other camps
may just you know, rely on medication. Well, we truly
see long term success when we marry the two, when
we marry lifestyle, when we and medication together, that's where
we see long term success. However, yes, I agree that
(20:20):
we cannot be using this as a crutch, and especially
in the setting of medication shortages and insurance denials. We
don't have you know, readily available medication for folks every
single month.
Speaker 6 (20:31):
I wish we did.
Speaker 14 (20:33):
We do not.
Speaker 6 (20:34):
And this this is.
Speaker 5 (20:35):
Also not a treatment for eating disorders, and this is
exactly where long term weight management becomes essential. We cannot
just dole out the medication like candy. There's a lot
of counseling.
Speaker 6 (20:46):
That goes into it.
Speaker 5 (20:48):
And you know, someone is struggling with an eating disorder,
whether that might be restrictive or you know, the opposite.
We really need to be able to make sure is
this patient a good candidate for medication to lose weight,
you know, is it going to trigger the eating disorder?
Speaker 6 (21:05):
My bigger concern.
Speaker 5 (21:06):
Is that are you going to continue to have a
positive relationship with food, because it really does come down to,
you know, we need to make sure that we have
a healthy relationship with food, and because think about the
next twenty five years of your life, right like, we
have to make sure that this is not, you know,
a temporary fix.
Speaker 6 (21:23):
And so that's where it really comes.
Speaker 5 (21:25):
Down to the food environment and how we're thinking about,
you know, day to day what we're eating.
Speaker 1 (21:30):
Yeah, Tolliver, we're getting some comments in online at listen
toothiddle dot com.
Speaker 11 (21:34):
Yeah, Christy and Hazlitt. Michigan says, as a pharmacist, I
see people struggling with weight and always looking for the
quick fix. These new drugs are working for people and
getting a lot of good press. They do work. However,
I hear from my patients that as soon as they
can get the medication, their former appetite and former habits
come right back. I'm not sure we have made it
clear that these are lifelong meds and not the quick
fix they're seeing in the media. Bottom line, if I
(21:54):
thought it was the magic bullet, I'd be using it
since I'm two hundred plus.
Speaker 3 (21:57):
Pounds, Doctor Stanford.
Speaker 1 (21:59):
What about that that these are drugs you'd have to
take your whole life.
Speaker 7 (22:03):
That is absolutely true. These are a lifetime commitment. I
tell my patients whenever they're starting any medication that we're
using to treat the chronic disease that is obesity, if
they do work, and notice I said, if they do work,
if you are a responder, this is a lifetime commitment
to these medications. For many of my patients, they've been
with me for at least ten years. So this isn't
(22:25):
a short term commitment. If you're looking for something that
you're going to just breeze on bube, start it, stop it,
and hope that everything is going to be solved, you
have picked the wrong thing. This is not something that
you're going to just start and stop. Like I said,
people have been with me for ten, fifteen, twenty plus
years and they're looking this is going to be a
(22:46):
long term commitment. If they work, you do need to
be on these for the rest of your life.
Speaker 17 (22:52):
So you've have had patients that they don't work for
for if they don't work, then we need to pick
another agent, something that works in a different pathway of
the brain, or maybe even look at other types of treatments.
Speaker 7 (23:04):
Metabolic and bariatric surgery is still the best treatment that
we have available, particularly for those with moderate to severe obesity.
And for many of my patients, they're in combination therapy.
What do I mean by that? They have undergone bariatric surgery,
They're on medications, they're doing lifestyle modifications, they're working with
psychiatrists and psychologists. They're truly using all of the forms
(23:26):
of therapy available for them to get the best possible outcome.
Speaker 1 (23:30):
Let's go back to the phones. Beth is with us
from Nashville, Tennessee. Beth, Welcome to the middle. How is
ozempic working for you or one of the drugs like it?
Speaker 4 (23:41):
Well?
Speaker 15 (23:41):
I took Olympic for eighteen months through a program at
my work, and for me, it was really kind of
the brain piece that I was not expecting. And I
learned that semeglotide goes through the blood brain barrier. But
as someone who all my life has I say I
would secret eat and I binge ate and I know
(24:04):
one of the doctors mentioned about eating disorders and this
not necessarily being a great treatment for it. But for
the first time in my life, within a couple of
weeks of starting Ozimpic, I felt like I understood what
the majority of the population feels like about food. I
wasn't that food noise and food chatter was not always
(24:26):
in my head, and I was not just constantly trying
to think of, you know, what food's going to be available,
and is it food I'm going to want to eat
in front of people? And am I going to want
to eat before or after? And is there going to
be enough food or not enough? And not even just
like craving things, but just having a healthy outlook on
(24:46):
eating or you know, going to a restaurant and thinking
about what everyone else is going to order and just
feeling full. That was something I had never really even experienced.
I was like a bottomless pit. And when I started
taking the Ozimpic, it was like, oh, I don't have
to eat the entirety of that. I can have a
stopping point. And I just wasn't expecting that brain piece
(25:07):
to come into play so quickly.
Speaker 1 (25:09):
Let me ask you, let me ask you that question,
which is when you were taking it. When you started
taking Ozepe, did you tell other people that you were
taking it, because I've read a lot of people who've
been taking it they feel a little uncomfortable about talking
about taking it.
Speaker 15 (25:23):
Yeah. So I had several friends who were in the
same work weight loss program that we were in at
the same time. But there were people, even like close
friends and relatives who I still have never told because
they have said in the past. You know, well, if
you wanted to lose weight, you just you know, exercise
and eat, you know, eat some spinach and stop you know,
(25:44):
having junk food or whatever. And for me, it wasn't
even just a weight loss, like my body image issues
still exist, like we were talking about the body movement,
but it was it was that brain piece for me.
But for people who never experienced that brain piece, they
don't understand where I'm coming from.
Speaker 1 (26:03):
Well, let me take your comment to doctor Narrang your
thoughts on that.
Speaker 5 (26:08):
Yeah, you know, if it was as easy as eating
some salad and losing weight, we would have all been
able to do that.
Speaker 18 (26:15):
Right.
Speaker 5 (26:16):
As of twenty thirty, fifty percent of our population is
predicted to have obesity, So This is not just about
the fact that you may not have eaten enough salad
in the last you know, however, many decades of your life.
Speaker 6 (26:28):
This goes way way beyond that.
Speaker 5 (26:30):
And you know, as I said earlier, it's not a
question of willpower. This is very much our brain chemistry.
This is very much you know, the genetics we were
dealt and and part of it is, you know, we
can't change our genetics, but we can change the environment
around us. We can be on you know, therapeutic medications
that can alter part of that interaction of hormones between
(26:53):
our brain and our gut. And that's the situation that
we're in right now, right And I think people, you know,
like she was ment those who may not necessarily understand
that chatter going on in the brain, those people finally
feel seen because they have a resource to actually calm
that chatter down. Which and that's why you know, these
(27:14):
medications are remarkable because for the first time, and probably
you know, decades of dealing with this, they have something
that can you know, help them. Right And I'm telling
you everyone who may have come into my clinic, they've
tried every diet in the book. Right right there, there
is not a diet they have not tried, so that
it's not a question of eating more greens.
Speaker 1 (27:34):
Well, but just as it's not a question of eating
more greens. And you mentioned the amount of people that
may be obese. Almost three quarters of adults older than
twenty in the US are already living with obesity or overweight,
doctor Stanford. There are probably some listeners saying to themselves,
what about the food industry?
Speaker 3 (27:50):
Is this just?
Speaker 1 (27:51):
Is this just a way to counteract the kinds of
things that the food industry markets to us and has
for decades.
Speaker 7 (27:59):
Well, I mean, definitely think the food industry plays a role,
but I think that we make it just about the
food industry, and it's so much more complex than that.
It's about our sleep quality and duration. It's about other
issues that play a large role. I mean, let's look
at how our environment has changed over the last fifty years.
Let's look at the one demand ability to get food
(28:19):
at anytime, at any hour, at any minute of any day.
That's part of it. But let's look at how our
circadian rhythms have changed. Just the timing of when we
eat has plays a large role. Those things play a
large role. Medications that we take play a large role
in how much we weigh? Do you know that twenty
percent of our obesity has to do with medications that
we take for other issues? Did you know that that
(28:41):
twenty percent of obesity is caused by other medications? What
medications cause obesity? Medications like beta blockers, lithium depicode, medications
that are antipsychotics, insulin, these medications that we have to
take for other issues that lead to weigh gain. We
can't like not take those medications, but guess what they
(29:02):
cause weight gain? So there's a lot of other issues
that lead to obesity.
Speaker 1 (29:06):
All right, Well, stand by a reminder that The Middle
is also available as a podcast in partnership with iHeart
Podcasts on the iHeart app or wherever you listen to podcasts. Tlliver,
I have to say, when I first heard about ozembek,
I thought of Fenfenn, which was a hit weight loss
drug in the nineties, called a miracle drug at the.
Speaker 11 (29:21):
Time, yep, until it turned into a nightmare. Listen to
this nineteen ninety seven clip from the Fox affiliate in
my home city of Chicago.
Speaker 12 (29:27):
The first Illinois lawsuit's been filed against the makers of
fen Fenn. A Chicago law firm, filed a class action
suit today. It comes after the Food and Drug Administration
last week urged the recall of fen Fenn because of
studies that link it to heart problems.
Speaker 1 (29:41):
By the way, the drug combination that made fenfenn was
never approved by the FDA, whereas the drugs were talking
about today have been Stay with us.
Speaker 3 (29:48):
More of the Middle coming up. This is the Middle.
Speaker 1 (29:52):
I'm Jeremy Hobson. If you're just tuning in the Middle
as a national call in show, we're focused on elevating
voices from the middle politically, geographically, and philosophically, or maybe
you just want to meet in the middle. This hour,
we're talking about the rise in popularity of GLP one
drugs like ozempic, Mountjarro, and Wigovy and what kind of
impact they've made on the people who have been taking them.
They've become very popular for weight loss, but we're designed
(30:15):
as treatments for diabetes, and in the past year we've
seen them completely transform the discussion surrounding health and wellness.
This program was previously recorded, so we're not taking any
more live calls, but you can leave us a message
at eight four to four four Middle, or you can
reach out at listen toothmiddle dot com. We're joined this
hour by doctor Fatima Cody Stanford, an obesity physician at
Massachusetts General Hospital, and doctor Deshen Orang, director of obesity
(30:38):
medicine at Endeavor Health in Chicago. I continued our conversation
by asking doctor and Orang about the cost of these drugs.
If it's not covered by insurance, it's around one thousand
dollars a month and Medicare doesn't cover it, so for
most it is cost prohibitive.
Speaker 3 (30:52):
Here's what she had to say.
Speaker 5 (30:54):
I think one of the things is that there are
more agents in the pipeline coming out. So I do
think that potentially having multiple agents that are as powerful
as you know, the current agents that we have may
help to decrease the prices.
Speaker 6 (31:09):
That's just conjecture.
Speaker 5 (31:10):
Though we do have coupons available, you know, for all
of these medications. However, even after the coupons, they are
quite pricey. So in the near future, unfortunately, I do
not see the price coming.
Speaker 3 (31:22):
Down, Doctor Stamford.
Speaker 1 (31:24):
The other thing I'm wondering about, and we've heard about,
is that ozebic, what it does for cravings, addictions, and
desires goes beyond hunger. Can it be used for you know,
alcoholism or impulse shopping.
Speaker 7 (31:38):
Even so, those studies are being now conducted by the NIH,
so the data is still very preliminary. There are some
people that will anecdotally say that, you know, I do
feel that I'm not having those strong alcohol, you know,
cravings that I've had before. I've had some patients, although
just a few, that say that I no longer have
(31:59):
those issues. But the data is very scarce, and so
I would be a little bit pro you know, cautious
in terms of making these really sweeping statements to say
that those are what we're getting from these drugs, although
there are some patients that would tell you that definitively
they've seen major shifts in those One thing that I
do want to add, however, to what doctor Nrainge stated earlier,
(32:22):
is that one of the drugs that is a gop
one that's a daily injection, that was the first drug
approved that was a golp one. That's the ragletide. That
was Victosa, which was the one treat the treat diabetes
and sex cinda that is set to come off patent
in twenty twenty four. So when that does come off patent,
that will be a generic drug which will be available
to the public. Now, on average, the weight loss is
(32:44):
significantly less, but it still works in the same pathways
of the brain and was quite effective for many patients
and still quite effective for several patients. So that will
improve some of the equity issues that we've seen in
access issues when that comes off patent this year.
Speaker 4 (32:59):
And so I do think that that will help improve.
Speaker 7 (33:01):
Some of the equity and access issues when that comes
off patent in twenty twenty four this year.
Speaker 1 (33:06):
Let's go back to the phone. Sarah is joining us
from Pennsylvania. Sarah, Welcome to the Middle Go ahead, Hi.
Speaker 8 (33:13):
Thank you. I caught this show accidentally and it has
been so informative and great to hear, so thank you,
thank you. I heard one of the callers, a gentleman,
talking about how he's been on the medication for add
or ADHD, and his statement kind of challenged me about
(33:33):
you know, we're looking for the weight loss, the magic bullet,
the magic pill here, and I think that's the biggest thing,
one of the biggest things that gets me with this.
I too, have taken adderall for my add over the
years I've taken Fennermine. I actually took finfin before it
was banned for a short time, which helped me and
I was able to be off of it for a
(33:55):
number of years. And then I did revisit fentermine itself
years ago and it actually helped me more with my
add than the weight loss, so that was interesting. And
then here comes Lagovi and I started that earlier this year.
And the mental component, the brain com opponent, like one
of the other callers mentioned, it is amazing what it does,
(34:16):
and it's hard to put to words, and I just
wish that people would understand that. Nobody goes into the
store and says, you know what, I'll take a box
a add actually give me a double dose, and while
you're at it, why don't you add some obesity to
it and make that a triple dose. Nobody wants any
of this. Nobody's looking for an easy way out. It's
exactly like the doctor said that, you know, there's no
(34:39):
judgments because you're taking medication for your heart or insolence
or because of whatever. So it just really I guess
struck my NERB when he was like, you know, hey,
change your life. Stop I've done everything like like has
been mentioned on the show, I've I've done the lifestyle change,
I've done the eating change, and I still gain weight
and being a bottom most pit of hungry hungry all
(35:02):
the time. Yeah, to the point of being physically sick
is mind blowing of like what is going on with
my body and the WAGOVI it is a game changer
and and it was just like, yeah, whatever it did
to the mentalness, I was like, whoa wait a minute,
because I know what Funnerman does.
Speaker 13 (35:19):
Well, Sarah, I don't.
Speaker 3 (35:20):
We've got it.
Speaker 1 (35:21):
Let me take it to our panel, doctor Doury. Why
is there such judgment about about not just weight, but
about people trying to lose the weight.
Speaker 5 (35:31):
Yeah, So, going back to my earlier comment, obesity is
seen as the disease of vanity. It is seen as
a disease that was your fault because you ate too
much or whatever the situation may have been, that it
was your fault. We need to turn this conversation around.
This is a chronic disease. We're not seeing this conversation
around blood pressure, polesterol, heart disease, diabetes, sleep apnea, joint disease.
(35:55):
All of these are actually complications of obesity, and so
this conversation needs to change.
Speaker 6 (36:01):
Even our insurance.
Speaker 5 (36:02):
Companies, you know, deny these medications left and right, or
if someone didn't lose enough weight on the medication, they'll
stop coverage for the medication. Well, they're putting blame on
the patient. They're making this disease their fault. And this
is precisely why we need to treat this as a
long term chronic illness that needs to be treated long
(36:22):
term with the medication potentially. And so this is exactly
you know what this caller was saying. She's tried all
these medications and you know this finally worked for her.
That mental chatter came down. She's doing well on it. Well,
that's what we want to see, right, because when we
do well on it, then all these other things get better.
Our diabetes, blood pressure, cholesterol, heart disease, sleep apnea, a
(36:44):
joint disease, risk of cancer, like you name it, right,
all of these things get better. So we need to
change this conversation.
Speaker 1 (36:54):
Let's go to Nick, who's calling from Michigan. Nick, Welcome
to the middle.
Speaker 10 (37:00):
Oh did he My question to your panel was? I
was just that Actually at my doctor recently and he
was commenting that they were seeing or maybe in the
lab animal aspect of when they test drugs, that they
were seeing increased rates of thyroid cancer. But I don't
(37:20):
know that that necessarily translated to the human I guess trials,
and now that it's been on market, if we've seen
an uptick in instances of thyroid.
Speaker 1 (37:30):
Cancer, well let me take that to doctor Stanford.
Speaker 3 (37:33):
Have you heard about that?
Speaker 7 (37:35):
So yeah, So I think that what he's saying is
that some of the earlier trop particularly in the wrap models,
did show a slight increase in thyroid cancer. We haven't
really seen this translate into the human models, and so
I appreciate Nick for bringing this to the attention. So
there has been some fear associated with this, but long
term studies have not seen this translate into human studies.
(37:57):
And what I want to also let the caller people
that are listening to the show know that gop ones
have been on the market here in the United States
for almost twenty years, so we have almost twenty years
of data to look at with regards to the gop ones,
and we just really haven't seen that play out in
the almost twenty years of data that we've seen in
terms of thyroid disease. There was one study that was
(38:19):
conducted in Europe that showed a slight increase in the
European population with regards to thyroid disease in one study
that was conducted there. We have not seen that were
out in the American population. So I have not been
cautious in that way within my patient population. I have
over treated over over three thousand patients with gop ones
(38:42):
in my own personal patient population, and so I can
tell you that I'm always very cautious of thinking about this.
I will say a contra indication to use of this medication.
If you have a personal or family history of meadullary
thyroid cancer, you cannot use this medication. This is completely
a contra indication to use or any fit patient that
has a history of multiple intercom theeoplasia type two complete
(39:05):
contraindication to the use of these medications. So those patient
populations completely excluded.
Speaker 4 (39:10):
From the use of medication. But thanks so much for
calling in with that concern.
Speaker 1 (39:15):
Let's go to Eva, who's in the Chicago area.
Speaker 14 (39:18):
Hi.
Speaker 3 (39:18):
Eva, welcome to the middle.
Speaker 19 (39:21):
Hi. I was beginning to lose hope.
Speaker 3 (39:27):
Your prayers have been answered go ahead.
Speaker 19 (39:30):
Yes, I never had weight problems.
Speaker 16 (39:33):
I'm blessed.
Speaker 9 (39:34):
I guess.
Speaker 18 (39:35):
My daughter, however, was born. Finn was thin through school
and through high school, went away to college and started
getting weight and then gaining more and more and more
and more, and she was clinically obese, which of course
worries her mother. But I wasn't allowed to talk about
(39:56):
it or ask her question.
Speaker 19 (39:57):
Because then I would be that shaming her.
Speaker 18 (40:01):
So all I could do is bite my lips and hope.
Speaker 19 (40:07):
She has used the medication and lost almost one hundred pounds.
And it's like, oh my god, she's that's the person
you know I saw growing up. That's and it's it's wonderful.
But I have three concerns. Number One, there was no
(40:27):
research being done for weight control for the medication because
it was for diabetics. Is the medica is research going
on now? Number two, are people who are taking it
for weight control taking a higher dosage or different dosage
when people are taking it for diabetes? And number three,
(40:48):
do we have any idea of what happens when people
stopped taking it?
Speaker 3 (40:52):
Okay, my life we've been Yeah, those are great questions.
Speaker 1 (40:56):
Let me take let me take that to our panel,
Doctor Murrang, your give answers to those questions.
Speaker 5 (41:02):
Yes, So the answer to the first question, whether there
has been research on long term weight management, I think
that was the question. We have research and so with
U samaglatide, we're seeing about twenty percent give or take
at the highest dose. With turzeppatide, we're seeing even more
than that, up to twenty five percent in patients who
(41:26):
have taken it for over a year. And so we
do have actually data to support you know, long term
weight maintenance and weight loss. Right now, remind me of.
Speaker 1 (41:36):
The ether do people have to take a higher dose
if they're using it.
Speaker 3 (41:39):
For weight loss?
Speaker 5 (41:40):
Well, so the way that the medications have been dose,
so samaglotide for diabetes goes up to two milligrams, samaglatide
for that is indicated for the for weight management goes
up to two point four milligrams. So there's not too
much of a difference, but it's a very slight difference
for turzeppatide for both diabetes management and weight management, it's
(42:01):
the exact same dosing. And so you know, when these
studies were done, there were studies done for people who
have obesity without diabetes and there are separate studies for
patients who do have diabetes. So we actually have very
concrete data on this, and as doctor Stanford said, we
have twenty years almost experience with these sorts of agents,
(42:23):
and so for long term management, now you know, we
have ongoing trials to understand if we go down on
the dose, do we maintain our weight? If we come
off of the dose, though, especially anecdotally, patients do you know,
regain some of that appetite, some of that food noise,
and some of that weight. And so when when we
say that obesity is a chronic disease, we're expecting patients
(42:45):
to be on these medications long term. And so the
trade off is that hopefully you know, your diabetes and
blood pressure issues, cholesterol issues, those all get better, so
hopefully you do get to come off of other medications
as a trade off.
Speaker 1 (43:00):
Let's get in another call here. Weston is joining us
from Boise, Idaho. Weston, go ahead.
Speaker 9 (43:11):
I guess to get my thesis. I think we're starting
to Sorry, I'm actually a lot of breaks to at
the gym. My thesis is ultimately nice. We're trying to
address a broken food system with pills and the reason
I say that is that our food systems designed to
(43:32):
be addictive, at least the commercialized food system. So people
from a very young age are eating food that's mentally
and physically addictive, and then as they grow up that's
all their body knows. They haven't gotten good eating habits
the wise. So then we're at a point where now
(43:52):
Eli Lilly can make billion bumping drug because of the
food system being brooking. And I guess we just I
think we need a radically look at health societies where
and how people are becoming unhealthy because of society.
Speaker 1 (44:05):
All Right, well, Wesson, thank you for that call, and
I think it's very appropriate that we got a call
from somebody who's at the gym clearly on a piece
of exercise equipment during this show about this. But doctor Stanford,
this is something we just talked about a few moments ago.
But the food industry and the food that we eat.
Speaker 7 (44:20):
Yeah, I think that Wesson brings up a certain point,
but I think that he's missing the fact that this
is a global pandemic. There's not one country in the
world that isn't affected by obesity, and there's been a
global increase in the rates of obesity in every single
country in the world. And so if we're talking about
this and we're looking at food and food systems throughout
(44:41):
the world, we've seen this as an increase even in
those countries that don't have the same food systems that
we have here in the US. And so, if we
think about this as a multi factorial disorder or genetics, development, environment,
and behavior all play a role in a person's likelihood
of developing this disease. Where food does play a role,
we have to look at the role of genetics, development, environment,
(45:03):
and behavior and all of those components playing a role
in the likelihood of a person's development of obesity. I
encourage him to watch my lecture that I recorded Obesity.
Speaker 4 (45:14):
It's much more complex than you think.
Speaker 7 (45:15):
It is one hour and eleven minutes, and you can
go watch it for free. It's available for you to watch,
and it is great. It's not behind a paywall. But
I think that if you go watch that, you'll recognize
that this is not just about the food system, and
while that does play a role, it is much more
complex than you think.
Speaker 1 (45:33):
And doctor Durang, you are a nutritionist as well, correct.
Speaker 5 (45:37):
I have a license in culinary medicine.
Speaker 1 (45:39):
Okay, do you have thoughts on this, you know, I do.
Speaker 5 (45:42):
I agree with doctor Stanford. Food is certainly a large
part of this. We are in a different world than
we were in nineteen fifty, right. We rely on our cars,
our physical activity is much different, you know, the way
we live, the way we work, the places we live
and work.
Speaker 6 (45:59):
It's just it's a different world.
Speaker 9 (46:01):
Right.
Speaker 5 (46:01):
And so when we I agree, right, when we add
in the processed food industry and and all of those things,
it all contributes. We're more stressed, we don't sleep enough.
Like it's a whole, you know, combination of issues.
Speaker 1 (46:18):
We have to leave it there in terms of the
calls for now, but Tolliver, we do have time for
a quiz.
Speaker 11 (46:23):
Shout out to Wesson for setting this question up perfectly. Okay, okay,
So the quiz question is what's the US food band
most in other countries? Some of the name for foods, Okay,
instant mashed potatoes, Skittles, twinkies, or pills Berry biscuits. Feel
free to jump in when you got it. It's instant
mashed potatoes, Skittles, twinkies, or Pillsberry biscuits.
Speaker 6 (46:45):
I say twinkies too, you know.
Speaker 11 (46:47):
I would have said the exact same thing. It's instant
mashed potatoes.
Speaker 4 (46:50):
Wow, that's kind of disgusting. I think there should be really.
Speaker 3 (46:54):
I just want the real mashed potatoes. They don't want
the inside. I love the issue.
Speaker 4 (47:00):
He's on it.
Speaker 10 (47:01):
I just the other third.
Speaker 3 (47:02):
Yeah.
Speaker 1 (47:03):
I want to thank my guest, doctor Fatima Cody Stanford,
an obesity medicine physician at Massachusetts General Hospital, professor at Harvard.
Speaker 3 (47:10):
Doctor Stanford, thank you so much for joining us.
Speaker 4 (47:12):
Thank you for having me, and.
Speaker 1 (47:14):
Doctor Tishen Iraang, incoming director of Obesity at Endeavor Health
in Chicago.
Speaker 3 (47:19):
Doctor Iran, thank you so much for joining us.
Speaker 6 (47:22):
Thank you so much, it was an honor.
Speaker 1 (47:24):
Well that's it for our Thanksgiving encore episode. I hope
it didn't keep you from eating your turkey.
Speaker 3 (47:28):
But on our next show, we are live.
Speaker 1 (47:29):
Again taking a look at the loneliness epidemic in America,
what's behind it, how it affects us on an individual level,
and how to reach out and find a better sense.
Speaker 3 (47:37):
Of community if you need.
Speaker 1 (47:39):
We're going to be joined by activist and author David
Jay whose new book is called Relationality, and Reno Nevada
Mayor Hillary sheevy. You can call us at eight four
four four Middle. That's eight four four four six four
three three five three, or write in at Listen to
the Middle dot com, and of course, sign up for
our weekly newsletter while you're there. The Middle is brought
to you by Long Nook Media, distributed by Illinois Public
Media in Urbana, Illinois, and produced by Harrison Patino, Danny Alexander,
(48:02):
John Barth, and Sam Burmus Dawes. Our technical director is
Jason Croft. Our intern is Anikadeshler. Our theme music was
composed by Andrew Haig. Thanks to our podcast audience, our
listeners on satellite radio, and the more than four hundred
and twenty public radio stations that are making it possible
for people across the country to listen to The Middle,
little trick, I'm gonna give you right here, Take that
(48:23):
turkey leftover and turn it into a New Mexico style
green chili turkey tortilla soup.
Speaker 3 (48:29):
You're gonna love it. I'm Jeremy Hobson.
Speaker 1 (48:31):
Talk to you next week.
Host
Jeremy Hobson
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