GLP-1s are transforming metabolic care—but what do they mean for people with eating disorders? Our new World Psychiatry consensus paper outlines practical clinical recommendations and key research priorities @MichaelMindrum @MWeintraubMD @cbulik @BevTchangMD

Congrats to @aaron_keshen on leading this project on developing consensus-based clinical and research recommendations on the use of obesity management medications in people with eating disorders. It's an area that needs more awareness among clinicians, and more research. Thanks for having me on the team! onlinelibrary.wiley.com/doi/…

GLP-1 medicines have revolutionized the pharmacologic treatment of obesity. "Mechanisms by which these therapies work overrides the pathophysiologic changes causing obesity rather than simply undoing them." GLP-1 signaling is not necessary for normal fat regulation. Animal knockout data and human genetic variants of GLP-1 is not associated with weight gain. So obesity treatment and prevention are different, but we don't yet understand the mechanisms. Obesity Science Endocrine Society Scientific Statement: doi.org/10.1210/endrev/bnag0…

Saturday thoughts 💭: many debates about "scientific" questions are really about identity and belonging (On social media, especially). We are social creatures, so the bias is natural; however, It clouds how we read the evidence. Perhaps it’s helpful to consider where a debate is landing: is this about data and evidence or is it about defending identity?

Returning to X after a break to refocus on what I want to share and how I want to engage. Today I completed my training in prep for a 5K race. There were some set backs and challenges along the way but I kept coming back. My fitness has improved remarkably the last 6 mos and am proud of that. This lays the foundation for my next challenge - a 10k!

Every so often I get nauseated when I open X. Something to do with excess speed, spin, and heat. It has been building for a couple of months now, to where I have trouble reading anything here and even a harder time posting. I have a feeling the world and perhaps more so myself, could stand to sit for a nice quiet moment and connect. So I'll see you back in a month or two or three... All the best :)

We wrote a thing on how oxidative stress causes hepatic insulin resistance based on a recent article @NatMetabolism link.springer.com/article/10…

FGF21 synergizes with leptin to counteract #obesity-related metabolic comorbidities by reversing hepatic leptin resistance @Cell_Metabolism cell.com/cell-metabolism/ful…

I treat metabolic disease. GLP-1s work. The complication is a culture that moralizes body weight instead of physiology.

A few more Zanzibar beach pictures

Photo of a woman wearing a hat. Zanzibar

My daughter on beach in Zanzibar 🏝️

I think products such as Hava and Diet Doctor could have had a viable role if it was integrated into evidence informed clinical pathways as opposed to viewing modalities like medication or surgery as unnecessary. There is a collapse of the diet - culture industry which views obesity solely as a choice and personal responsibility rather than a complex chronic and relapsing disease.

Combination treatment is the optimal treatment for obesity: #Bariatricsurgery #Tirzepatide #Semaglutide

A metabolic update and perspective on #MASLD #MASH @DiabetologiaJnl link.springer.com/article/10…

Metabolic surgery vs GLP-1 medication is a tradeoff: about 0.5% early mortality, but 32% lower long term mortality, around 12 life years gained per 100 patients, and fewer CV and renal events. onlinelibrary.wiley.com/doi/…

Higher BMI is linked to increased risk of at least 19 cancers across the body (and lower risk for a few). nature.com/articles/s42255-0…

🔬 Nueva revisión en @DiabetologiaJnl ➡️los motores metabólicos de MASLD y MASH ➡️ del desequilibrio hormonal a la fibrosis. 🔹 La disfunción del tejido adiposo y el desequilibrio insulina–glucagón son el eje central 🔹 La fibrosis (no la inflamación) predice el pronóstico… y puede regresar si mejora la disfunción metabólica 🔹 Dianas terapéuticas con base mecanística: resmetirom (THR-β), AR GLP-1, lanifibranor (pan-PPAR), análogos FGF21/19 Medicina de precisión para frenar la progresión hepática 👇 🔗 link.springer.com/article/10…