Pennington Study Demonstrates Long-Term Weight Loss Efficacy of Semaglutide

The long term data is reassuring.  We now have more evidence for semaglutide weight loss efficacy in older, sicker individuals. Interview with:
Donna H. Ryan, MD
Professor Emerita
Pennington Biomedical Research Center
New Orleans, LA 70130  What is the background for this study? 

Response: This is the first of the sub-papers to the landmark SELECT study.  It has been peer review and published in a top-line journal.  While the primary outcome was the observation of 20% reduction in MI, stroke and CV death this new paper looks only at weight.   What are the main findings?

SIR24: Bariatric Arterial Embolization Safely Reduced BMI in Hopkins Study

The procedure resulted in a decrease in the mean BMI of the participants from initially being 43.6 to 41.2 one-year post-procedure. Interview with:
Clifford R. Weiss, MD
Professor of Radiology
Director, the Johns Hopkins HHT Center of ExcellenceRadiological Science and Biomedical Engineering
Johns Hopkins University  What is the background for this study? How would you describe the procedure?

Response: The purpose of this study was to evaluate the safety and efficacy of Bariatric Arterial Embolization (BAE) in patients who have a BMI greater than or equal to 35. BAE is a minimally invasive interventional radiology treatment that reduces the production of the hunger hormone ghrelin as a result of decreasing the blood flow to the stomach.

There were 10 participants recruited in this study. The participants were followed six weeks before BAE and a year following the procedure. After the procedure, the participants were admitted for routine supportive care for up to 48 hours. The participant’s BMI, weight, and body compensation were measured 1,3,6, and 12 months after the surgery.

ECO24: Ideal Weight For Patients with Diabetes May Vary with Age

For older individuals who are moderately overweight , maintaining rather than reducing weight may be a more practical goal. Interview with:
Dr Shaoyong Xu
Xiangyang Central Hospital
Affiliated Hospital of Hubei University of Arts and Science
Xiangyang, China  What is the background for this study? 

Response: In previous studies, the obesity paradox has been observed, where overweight and obese individuals with cardiovascular disease have better outcomes compared to their slim counterparts with the same disease. The global prevalence of diabetes is steadily increasing year by year.

In this era of population growth and aging, the question arises as to whether obesity or overweight can be beneficial in improving survival rates for older individuals with diabetes. This topic holds significant relevance due to the potential implications it has on weight management strategies for older adults. If overweight does not pose an increased risk of cardiovascular mortality, it may suggest that older individuals are not necessarily required to strive for weight loss in order to achieve so-called normal values. Moreover, inappropriate weight loss and being underweight could potentially elevate the risk of cardiovascular events, myocardial infarction, cerebral infarction, and all-cause mortality.

ECO24: Tirzepatide Found Effective for Weight Loss Despite Duration of Obesity

Tirzepatide is a once weekly GIP and GLP-1 receptor agonist while semaglutide was a once weekly GLP-1 receptor agonist Interview with:
Giovanna Muscogiuri, MD, PhD
Assistant Professor
Endocrinology Unit
University Federico II
Naples, Italy  What is the background for this study? 

Response: The study was a subgroup analysis of SURMOUNT 1-4 aiming to investigate if tirzepatide was effective in terms of percent body weight change, proportions achieving weight loss targets of 5, 10, 15, 20, and 25% and change in waist circumference in subjects with different duration of obesity.

Fasting Mimicking Diet: Five Days Per Month Demonstrated Improved Biomarkers for Aging and Disease Risk

The fasting mimicking diet is a five-day long meal program specifically designed to mimic the beneficial effects of fasting while allowing a person to eat and providing the necessary nutrients Interview with:
Valter D. Longo PhD
Edna M. Jones Professor of Gerontology and Biological Sciences
Director, Longevity Institute, Leonard Davis School of Gerontology
University of Southern California, Los Angeles, CA
AIRC Institute of Molecular Oncology
Italian Foundation for Cancer Research Institute of Molecular Oncolog
Milan, Italy

Sebastian Brandhorst PhD
Associate Professor Of Gerontology Co-Director
Aging Murine Phenotyping Core
University of Southern California,  Health Sciences  What is the background for this study? 

Response: In mice, periodic cycles of a fasting mimicking diet (FMD) protect normal cells while killing damaged cells including cancer and autoimmune cells, reduce inflammation, promote multi-system  regeneration, and extend longevity. We previously demonstrated that study participants who consumed the FMD for 5 consecutive days per month for 3 months, but otherwise ate their regular diet had reduced body weight, trunk and total body fat, blood pressure, and a favorable safety profile.

Patients Who Stopped Tirzepatide (Mounjaro™) For Weight Control Gradually Regained Most of Lost Weight 

Obesity is a chronic disease, like diabetes and hypertension. If treatment is discontinued, it will relapse, though gradually. Interview with:
Louis J Aronne M.D.
Sanford I. Weill Professor of Metabolic Research
Department of Medicine
Weill Cornell Medicine  What is the background for this study? What are the main findings?

Response: The SURMOUNT -4 trial demonstrates that patients who discontinued tirzepatide after losing 20.9% over 36 weeks regained about half the weight in one year to an average 9.5% weight loss following discontinuation while those who continued lost an additional 5%.  

The metabolic parameters which had improved with weight loss returned towards their starting point, but did not completely regress.  

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Increased Risk of Dental Cavities after Bariatric Surgery for Obesity

The main findings are that dental caries were more common in those with the highest BMI before treatment and that surgical obesity treatment can increase the frequency of dental caries Interview with:
Anna-Lena Östberg, DDS PhD Assoc Professor
Director of Research, Public Dental Service Västra Götaland
Dept of behavioral and community dentistry
Inst of Odontology
Sahlgrenska Academy
University of Gothenburg, Sweden

NEGIN TAGHAT and ANNA-LENA ÖSTBERG  What is the background for this study? 

Response: The original background for the studies was the global obesity epidemic and its consequences. The implications for general health have been the focus of much research, but the impact on oral health has been studied very little.

In recent years, observations of oral health problems after bariatric surgery have been reported from both patients and dentists. However, these have been episodic observations and therefore scientific studies are required. At the same time, a larger medical study was started to follow patients undergoing obesity treatment, medical or surgical, and we were able to include examinations of the mouth and teeth.

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DIETFITS: Identifying Groups with Varying Weight Loss Success

the most successful subgroup (73% met threshold) had high outcome expectations for making health improvements coupled with high levels of family encouragement Interview with:
Matthew J. Landry, PhD, RDN, FAND, FAHA (he/him)
Assistant Professor 
Department of Population Health & Disease Prevention 
University of California, Irvine  What is the background for this study? 

Response: Lifestyle interventions are the first-line treatment for obesity; however, not all participants achieve clinically significant weight loss.

As researchers and clinicians, we want to minimize patient burden, maximize clinical outcomes, and conserve constraints (budget & personnel).

Using data from a 12-month diet and weight loss intervention (DIETFITS), we examined 52 demographic, clinical, & psychosocial variables among 436 participants (BMI 28-40) to see if there are distinct subgroups of participants who were more or less successful in losing 5% weight by 12 months?

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EASD: Analysis Finds More Weight Loss (and side effects) with Tirzepatide in Type 2 Diabetes

Our analysis can help healthcare professionals make informed choices for managing type 2 diabetes, especially for those patients for whom weight loss is an important goal. However, like any medication, it’s crucial to consider the entire profile of tirzepatide, including side effects. Interview with:

Dr Thomas Karagiannis MD
Aristotle University of Thessaloniki
Thessaloniki, Greece  What is the background for this study? What are the main findings?

Response: Previous individual studies have shown that both subcutaneous semaglutide and tirzepatide are very effective in managing blood sugar and reducing body weight in people with type 2 diabetes. However, direct comparisons between these medications have been limited.

In our study, we used a technique called a network meta-analysis to indirectly compare the two. This method allowed us to derive results by examining other trials that compared either of the drugs with placebo or another treatment.

Our findings indicated that tirzepatide had a stronger effect than semaglutide in controlling blood sugar and aiding weight loss. For example, those on the highest dose of tirzepatide lost, on average, 5.7 kg more than those on the highest dose of semaglutide. But, it’s worth mentioning that some side effects, especially related to the digestive system, were slightly more common with the high dose of tirzepatide.

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WeightControl: CalPoly Study Examines Factors Distinguishing Weight-Maintainers from Weight-Regainers Interview with:
Suzanne Phelan, PhD
Professor of Kinesiology & Public Health
Director, Center for Health Research
California Polytechnic State University  What is the background for this study? 

Response: Understanding the factors that promote long-term weight control is need to inform health interventions.  We know that self-monitoring, physical activity, and cognitive restraint are associated with success in long-term weight control.  The other behavioral, psychological, and environmental factors remain unclear, and very few studies have examined the factors related to long-term successful weight control in commercial weight management programs, which reach 10-15% of the US population.  

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