WEBVTT - Should the taxpayer fund weight loss medications? 0:00:05.800 --> 0:00:06.200 Kyota. 0:00:06.280 --> 0:00:09.320 I'm Chelsea Daniels and this is the Front Page, a 0:00:09.400 --> 0:00:16.599 daily podcast presented by The New Zealand Herald. From Celery 0:00:16.760 --> 0:00:22.360 juice cleanses to infomercial ad busting gadgets, society has always 0:00:22.600 --> 0:00:26.800 been on a diet. It's a global, multi billion dollar 0:00:26.960 --> 0:00:31.080 powerhouse industry. The latest trend that you would have heard 0:00:31.120 --> 0:00:36.120 about are golp ones or weight loss injections. Far MAC 0:00:36.240 --> 0:00:39.199 is seeking advice on whether they should be funded for 0:00:39.360 --> 0:00:43.600 certain people. Australia is committed to it for certain patients, 0:00:43.720 --> 0:00:47.000 taking the cost to about twenty nine dollars per script. 0:00:47.360 --> 0:00:51.240 A drug like Wagovi, for instance here costs about four 0:00:51.320 --> 0:00:55.480 hundred and sixty dollars per script. But are they really 0:00:55.560 --> 0:00:59.960 beneficial or is it just the next get skinny quickplow. 0:01:00.320 --> 0:01:04.560 Today on the Front Page, obesity specialist doctor Gerrard mcquinlan 0:01:04.680 --> 0:01:07.640 is with us to explore whether these drugs should be 0:01:07.760 --> 0:01:12.840 funded or is diet and exercise really the only answer? 0:01:17.080 --> 0:01:20.400 First off, Gerard, can you give me a brief history 0:01:20.440 --> 0:01:23.600 of weight loss drugs, because it seems like you know 0:01:23.640 --> 0:01:27.839 they've been around for ages. Weren't the first iterations essentially 0:01:27.920 --> 0:01:28.600 just speed? 0:01:28.880 --> 0:01:31.760 Yeah, certainly back in the sixties and seventies. You know, 0:01:31.800 --> 0:01:34.800 the weight loss drugs were emphetamine based and they had 0:01:34.800 --> 0:01:39.160 that addictive component to the medication, so you know, the 0:01:39.240 --> 0:01:42.080 long term use back then sort of led to concerns 0:01:42.120 --> 0:01:46.839 about heart disease being a stimulant and sort of lost 0:01:46.880 --> 0:01:50.240 a lot of popularity when the heart issues came out. 0:01:51.640 --> 0:01:56.880 Then they reformulated that sort of appetite for presant drugs 0:01:56.920 --> 0:02:03.360 to take out the addictive part, and I guess for 0:02:03.520 --> 0:02:07.080 probably three or four decades there wasn't really much in 0:02:07.120 --> 0:02:10.679 the way of medications to treat obesity. They tried zenecaw, 0:02:10.840 --> 0:02:15.800 which was a drug that limited absorption of fat through 0:02:15.880 --> 0:02:19.440 the gut, but it wasn't very well tolerated. It work 0:02:19.520 --> 0:02:23.000 for some people, but most people didn't tolerate it. And 0:02:23.040 --> 0:02:27.880 then about two thousand and five, these new GLP medications 0:02:27.960 --> 0:02:33.359 came into existence to treat obesity. So that was they 0:02:33.360 --> 0:02:36.680 came about because of studies into gut hormones and the 0:02:36.760 --> 0:02:41.760 influence that that had on insulin and diabetes. And then 0:02:41.840 --> 0:02:44.519 the treatments for diabetes sort of came out in the 0:02:44.560 --> 0:02:50.119 twenty tens twenty fifteens, and what they noticed treating diabetic 0:02:50.160 --> 0:02:52.760 patients with these drugs is a lot of lost weight, 0:02:53.400 --> 0:02:57.639 which wasn't really seen with the diabetes treatments. So then 0:02:57.760 --> 0:03:01.720 that's how they became a weight loss strikes was because 0:03:01.760 --> 0:03:05.320 they saw the effect in diabetic patients losing weight. So 0:03:06.040 --> 0:03:12.120 now we've got this burgeoning attention in medicine about GLP 0:03:12.400 --> 0:03:16.799 medications and GAT hormones. So now we've got much more 0:03:16.800 --> 0:03:18.600 effective treatments for weight loss. 0:03:19.240 --> 0:03:22.399 So what do GLP ones actually do? 0:03:22.960 --> 0:03:29.919 Yeah, so these hormones control the sensation of satisfaction light, 0:03:31.919 --> 0:03:35.760 feeling satisfied with what you've eaten. So with a ba IF, 0:03:35.800 --> 0:03:39.200 I sort of reframe a BC as a disease because 0:03:39.400 --> 0:03:43.520 it hasn't been framed that way, but the Lancet Commission 0:03:44.080 --> 0:03:47.320 sort of looked at ABC. The World Health Organization also 0:03:47.920 --> 0:03:52.560 classified ABC as a disease back in twenty thirteen. So 0:03:53.640 --> 0:03:56.000 trying to cut through the stigma of a BC, lot 0:03:56.040 --> 0:03:59.440 of people thought it was to do a person's personality 0:03:59.600 --> 0:04:03.320 and there's a well powered failure, but it's not. It 0:04:03.360 --> 0:04:07.520 is a disease, and it used to be just tastified 0:04:07.520 --> 0:04:11.839 according to the BMI, the body mass index, but that's 0:04:11.960 --> 0:04:15.360 quite crude. So now we look at you know, we 0:04:15.400 --> 0:04:17.480 asked a couple of questions. You know, does a person 0:04:17.560 --> 0:04:21.880 have excess body tissue in their body? So that's the 0:04:21.920 --> 0:04:25.000 first question, and then the second question is is that 0:04:25.160 --> 0:04:29.240 excess back causing disease? So that's how we look at 0:04:29.240 --> 0:04:34.480 obesity now because we know that patients with obesity it's 0:04:34.680 --> 0:04:41.200 a difficult life. It affects everything day to day, movement, sleep, 0:04:41.800 --> 0:04:44.159 and it contributes to other diseases. You know, it's a 0:04:44.200 --> 0:04:49.520 direct modifiable risk factive for thirteen different canses. But it's 0:04:49.600 --> 0:04:54.320 also related to diabetes, it's related to heart disease about 0:04:54.360 --> 0:04:57.839 turns and thirteen different diseases are impacted by obesity. So 0:04:57.920 --> 0:05:01.000 that's the message that I've get through today is that 0:05:01.120 --> 0:05:04.600 obesi is a disease that needs long term care. 0:05:04.920 --> 0:05:07.719 Well, it's important to ask those other questions, hey, because 0:05:07.760 --> 0:05:10.360 the bear My scale has had its issues. I mean, 0:05:10.600 --> 0:05:12.880 you look at any of the all blacks, for instance, 0:05:12.920 --> 0:05:15.960 and they're probably all technically obese. 0:05:15.600 --> 0:05:20.640 Right, yes, based on that crude measure, But you have 0:05:20.680 --> 0:05:24.600 to ask the second question, you know, is the amount 0:05:24.680 --> 0:05:27.480 of fat in a person's body is it causing disease? 0:05:27.600 --> 0:05:30.159 So we have sort of two groups of patients. Now 0:05:30.720 --> 0:05:33.800 we have those with pre clinical obesity, so they do 0:05:33.880 --> 0:05:37.440 have excess fatty tissue, but they don't have any disease. 0:05:38.040 --> 0:05:40.400 And then you have the patients who do have excess 0:05:40.440 --> 0:05:45.400 fatty tissue and have a disease like osterearthritis, like pre 0:05:45.520 --> 0:05:49.960 diabetes or diabetes high pertension. So if they have those 0:05:50.000 --> 0:05:53.640 two things together, we should start treating that early because 0:05:54.680 --> 0:05:57.920 just take arthritis for instance. You know the arthritis, you 0:05:58.000 --> 0:06:01.279 know it's related to age, and it's related to weight. Now, 0:06:01.279 --> 0:06:04.920 if you can treat the weight part early on with 0:06:05.200 --> 0:06:09.560 orits often it goes away, so people don't need surgeries 0:06:09.680 --> 0:06:15.200 or excess painkillers or so I see that a lot 0:06:15.520 --> 0:06:18.799 people come in with knee pains, joint pains. We treat 0:06:18.839 --> 0:06:22.120 the obesity and then the pains go away and they're 0:06:22.200 --> 0:06:23.160 much more mobile. 0:06:23.360 --> 0:06:26.800 In terms of these drugs and the suppressing of appetite 0:06:27.200 --> 0:06:31.680 portion of it, What is the difference between suppressing your 0:06:31.720 --> 0:06:36.160 appetite and eating disorders, because in both you're limiting what 0:06:36.240 --> 0:06:40.839 you eat, right, but one is unhealthy and the other is, 0:06:41.600 --> 0:06:43.520 you know, being prescribed. 0:06:43.920 --> 0:06:47.920 So eating disorders is important, and that's why people with 0:06:47.960 --> 0:06:50.520 obesity need to have a consultation because some of it 0:06:50.560 --> 0:06:54.640 will be psychological. So we're talking about restrictive eating patterns 0:06:54.680 --> 0:06:59.440 and eurexia not so much, but binge eating disorder in 0:06:59.640 --> 0:07:03.240 disorder eating, So yeah, we want to sort out that 0:07:03.320 --> 0:07:07.200 because the treatments for those are different. We would say 0:07:07.320 --> 0:07:11.320 consider binge eating disorder, would use medications that can alter 0:07:12.240 --> 0:07:17.240 a person's psychology. But we have found that actually treating 0:07:18.200 --> 0:07:22.520 obesity and patients say with binge eating disorder, these treatments 0:07:22.560 --> 0:07:25.640 for OBSI are very effective because it cuts the noise. 0:07:25.800 --> 0:07:28.800 People don't think about food when they're on these medications. 0:07:29.880 --> 0:07:32.280 And I'll just come back to the point about appetite suppression. 0:07:33.040 --> 0:07:36.960 We don't use appetite suppression so that it's like those 0:07:37.280 --> 0:07:41.600 amphetamine stimulants. The glps are more about satiety, that feeling 0:07:41.640 --> 0:07:44.360 that you've had enough to eat. And that's the problem 0:07:44.360 --> 0:07:48.000 with ABC is that people don't feel full, so they 0:07:48.120 --> 0:07:50.640 overeat and that's what keeps the weight up. 0:07:56.520 --> 0:07:58.520 A friend of mine who is a very smart guy, 0:07:58.920 --> 0:08:04.200 very very rich, very powerful man actually, but he's very fat, 0:08:05.280 --> 0:08:07.440 and he took the fact I caught the fat drug. 0:08:07.480 --> 0:08:10.600 I won't give you which one. It was a z 0:08:10.600 --> 0:08:12.400 empic I won't tell you that. 0:08:13.520 --> 0:08:16.280 After I told him that the drug does not work 0:08:16.320 --> 0:08:18.720 on him, because I saw him recently he's actually fatter 0:08:18.840 --> 0:08:22.760 than ever. I said, the drug is not working on you. 0:08:22.880 --> 0:08:25.040 You're going to have to go to something else. But 0:08:25.120 --> 0:08:28.920 it does work on a lot of people. And he said, thanks, 0:08:28.960 --> 0:08:31.440 you make me feel good. I said, well, I got 0:08:31.480 --> 0:08:33.079 to be truthful. You always tell the truth. 0:08:35.400 --> 0:08:38.520 Obesity in New Zealand is obviously nothing new. We hear 0:08:38.559 --> 0:08:41.720 about how we're always one of the most overweight nations 0:08:41.760 --> 0:08:45.640 in the world. Tell me more about the common misconceptions 0:08:45.720 --> 0:08:48.880 about obesity. So number one is treating it obviously like 0:08:48.920 --> 0:08:51.199 a disease, But what are some other things? 0:08:51.520 --> 0:08:55.560 Probably the biggest misconception is that it's a failure of willpower. 0:08:55.559 --> 0:09:01.360 It's a failure of personal attribues. Highly is not a 0:09:01.400 --> 0:09:05.560 failure willpower. In fact, you know people who diet can 0:09:05.600 --> 0:09:08.880 make the obaesitly worse. So we know that diet and 0:09:08.920 --> 0:09:11.960 lifestyle just by themselves, they've worked for a short period 0:09:11.960 --> 0:09:15.000 of time, but only about one in twenty patients will 0:09:15.040 --> 0:09:19.360 actually succeed and keep the weight off. That means, you know, 0:09:19.559 --> 0:09:23.720 nineteen out of twenty patients that doesn't work. And they'll 0:09:23.720 --> 0:09:26.000 actually put on it even more weight. So a common 0:09:26.120 --> 0:09:29.080 story we get is people who've been on like three 0:09:29.600 --> 0:09:33.080 or five diets in their lifetime and over that time 0:09:33.160 --> 0:09:36.000 they just got bigger. And that's not a chance thing. 0:09:36.080 --> 0:09:40.839 That's due to the brain's hormone control of weight. So 0:09:41.040 --> 0:09:44.840 weights controlled by hormones in the brain that interact with 0:09:44.880 --> 0:09:45.240 the gate. 0:09:45.679 --> 0:09:48.880 Isn't that kind of like the fad diets though, you know, 0:09:48.920 --> 0:09:53.320 like the juice cleansers and the drinking citric acid or 0:09:53.320 --> 0:09:56.400 something and hot tea every morning, those kind of things. 0:09:56.400 --> 0:09:58.520 When you stop those we I think we all know 0:09:58.559 --> 0:10:01.800 that you do pile the weight back on. But in 0:10:01.880 --> 0:10:08.040 terms of making long, long term lifestyle changes, would that work, Yeah, I. 0:10:08.000 --> 0:10:13.040 Think if it's if it's if it's monitored by a doctor, 0:10:12.760 --> 0:10:16.800 or if the program even a dietician. So lifestyle and 0:10:17.360 --> 0:10:21.240 diet changes, we want those, but we know that just 0:10:21.320 --> 0:10:24.440 by themselves, they don't. People don't stick to them, and 0:10:24.760 --> 0:10:27.520 it's very hard to keep up with the diet. Keto 0:10:27.600 --> 0:10:30.600 diet has been quite popular. That cance diet. I've heard 0:10:30.640 --> 0:10:35.000 of diet Yeah, yeah, So diets tend to fail because 0:10:35.440 --> 0:10:41.079 the hormone control for dieting and it's overcome because people 0:10:41.160 --> 0:10:44.720 just eventually get hungry if they restrict their diet in 0:10:44.760 --> 0:10:47.680 the end. So you know, most people want a keto 0:10:47.720 --> 0:10:50.320 diet for instance, can maybe hack it for about six 0:10:50.400 --> 0:10:54.240 months before they revert back to their normal diet. 0:10:54.559 --> 0:10:56.719 In terms of I mean, there's a lot of talk 0:10:56.760 --> 0:11:02.000 about taxpayers funding drugs like over like these weight loss injections, 0:11:02.040 --> 0:11:07.000 these GLP ones. Would it be worth perhaps subsidizing gym 0:11:07.080 --> 0:11:11.640 memberships first before subsidizing something like a weight loss drug. 0:11:11.880 --> 0:11:14.880 Now I'd strongly disagree with that. I mean, if you 0:11:15.120 --> 0:11:18.560 take just say one disease related to a busy just 0:11:18.640 --> 0:11:22.880 say ostearthritis. About five hundred thousand people in New Zealand 0:11:22.920 --> 0:11:27.839 lived with some degree of osterearthropis. Probably about one hundred 0:11:27.880 --> 0:11:32.480 thousand people need a joint replacement because of osterearthritis, and 0:11:32.520 --> 0:11:36.640 we only do about fifteen thousand operations per year. Now, 0:11:36.840 --> 0:11:40.119 if you treated the obesity that's present in that population, 0:11:40.480 --> 0:11:44.800 half of the arthritis goes away. Now you also put 0:11:44.880 --> 0:11:50.040 those same group of people into gym memberships, that's really 0:11:50.280 --> 0:11:52.840 not going to help with their weight. It's not really 0:11:52.880 --> 0:11:55.360 going to help with the rights. Well to a degree, 0:11:55.440 --> 0:12:01.000 but not quite losing weight. So I see people getting 0:12:01.240 --> 0:12:05.280 much how they're much better quickly once they start on 0:12:05.360 --> 0:12:08.920 these glps, but it is a lifetime treatment. I think 0:12:08.920 --> 0:12:13.040 if the government, like Australian government, who's invested in subsidizing 0:12:13.080 --> 0:12:16.080 these medications, I think they see the benefits, the economic 0:12:16.120 --> 0:12:21.199 benefits because it reduces the harm from other co morbid 0:12:21.320 --> 0:12:23.600 diseases that a lot of people are the best that 0:12:23.600 --> 0:12:27.000 you have. So I think, you know, they've taken the 0:12:27.040 --> 0:12:29.680 bolt step to fund it. I think our government will 0:12:29.679 --> 0:12:33.400 probably follow so hopefully because they'll see that the benefits 0:12:33.440 --> 0:12:38.600 outweigh the costs. But you know, these medications are expensive, 0:12:39.000 --> 0:12:42.680 and I don't know. I think there could be more competition. 0:12:43.080 --> 0:12:46.160 I think Monjarro is coming to New Zealand and we 0:12:46.240 --> 0:12:47.040 expect that to be. 0:12:47.080 --> 0:12:49.680 Cheaper in terms of I mean, I'm just going to 0:12:49.679 --> 0:12:55.040 play Devil's advocate here. You are an obesity specialist, right, 0:12:55.559 --> 0:13:00.480 and you will get more business if these presumably do 0:13:01.200 --> 0:13:06.680 our taxpayer funded. If you strip all of that away, 0:13:07.000 --> 0:13:09.520 would you still do you reckon? Would you still go 0:13:09.600 --> 0:13:13.080 with this route as opposed to say, getting outside and 0:13:13.120 --> 0:13:14.320 going for walks and stuff? 0:13:14.480 --> 0:13:17.559 Oh? Yes, one hundred percent. Even if it was all funded. 0:13:17.600 --> 0:13:21.040 I mean probably the limiting step for patients to get 0:13:21.080 --> 0:13:23.960 access to the medications, not only the costs, but also 0:13:24.240 --> 0:13:27.440 doctors who are prepared to treat obesity as a long 0:13:27.520 --> 0:13:30.480 term disease. So my clinic, yeah, I'm prepared to trigger 0:13:30.520 --> 0:13:33.800 these patients for life. So well, just like you would 0:13:33.920 --> 0:13:38.120 with any chronic disease, whether it's high blood pressure, you 0:13:38.200 --> 0:13:46.720 need doctors who are skilled in using these medications, that 0:13:46.760 --> 0:13:49.960 are prepared to put on the effort to follow these 0:13:49.960 --> 0:13:53.560 patients long term. So I follow them long term. We 0:13:53.640 --> 0:13:56.560 do cholesterol tests, we do blood pressure tests, and I 0:13:56.600 --> 0:14:00.520 see a lot of reversal of even pre diabetes can 0:14:00.559 --> 0:14:03.920 reverse with weight loss. So yeah, I'm measuring, you know, 0:14:04.480 --> 0:14:08.440 and managing other does the other conditions that patients have. 0:14:08.640 --> 0:14:12.200 So that'll be a right limiting step is actually are 0:14:12.240 --> 0:14:17.120 there enough doctors to actually treat the population. There's about 0:14:17.120 --> 0:14:20.000 one point five million people in the Zelan have a 0:14:20.080 --> 0:14:23.480 BE study, and I would say probably half of those 0:14:23.520 --> 0:14:27.240 patients probably have significant other diseases that go with a BESTY. 0:14:33.160 --> 0:14:36.440 I read that you were initially skeptical of the GLP one. 0:14:36.560 --> 0:14:39.400 Absolutely yes, because it's like this guinea shot and like 0:14:39.440 --> 0:14:41.760 it's a shortcut, and so for years I didn't well, 0:14:41.880 --> 0:14:43.440 not for years, but for a long time I didn't 0:14:43.480 --> 0:14:45.040 do it, and I didn't want to do it. Yeah, 0:14:45.120 --> 0:14:47.880 and I thought like, I'm not going to take the shortcut, 0:14:48.000 --> 0:14:50.240 you know, I'm going to work harder. But then eventually 0:14:50.360 --> 0:14:53.720 I was like, I've tried everything. I've tried every diet, 0:14:53.880 --> 0:14:57.000 I've tried every workout. I've tried walking for hour. I 0:14:57.000 --> 0:14:59.040 would go to Europe in Paris and I would just 0:14:59.080 --> 0:15:02.560 walk for hours, the twenty thousand steps a day, like 0:15:02.800 --> 0:15:06.040 every single thing, you know, and nothing was working well. 0:15:06.040 --> 0:15:08.880 I would so this was killing me. Backstage, I would 0:15:08.920 --> 0:15:11.000 lose the weight, but my body liked to be at 0:15:11.000 --> 0:15:14.120 a certain way. So eye opening for me. 0:15:16.560 --> 0:15:18.680 Do you reckon there are still doctors out there though, Like, 0:15:18.800 --> 0:15:22.560 for example, if I use the example of going to 0:15:22.600 --> 0:15:27.480 the doctor and the doctor saying not prescribing anti antibiotics 0:15:27.520 --> 0:15:30.680 because of you know, your immune system and we need 0:15:30.720 --> 0:15:32.320 to build that up, et cetera. You know, you've got 0:15:32.360 --> 0:15:36.640 those doctors out there who are very hesitant to prescribe medications. 0:15:36.960 --> 0:15:38.680 Do you think there are still a lot of doctors 0:15:38.680 --> 0:15:41.400 out there who would be hesitant to just prescribe these 0:15:41.440 --> 0:15:44.960 medications and instead maybe sign you up to go see 0:15:44.960 --> 0:15:46.120 a nature path or something. 0:15:47.280 --> 0:15:51.320 Oh, most definitely, And we doctors need to have education 0:15:51.640 --> 0:15:54.840 to see ABC as a disease because the stigma about 0:15:54.960 --> 0:15:57.920 BC is that it's your faults, the patient's fault and 0:15:57.960 --> 0:16:00.920 if only they could diet and exercise and do those things, 0:16:00.920 --> 0:16:04.480 that that will get better. But if it's a hormone condition, 0:16:04.880 --> 0:16:07.600 if you accept that it's a disease of hormones that 0:16:07.720 --> 0:16:11.920 control weight, you know you're fighting a losing battle. You 0:16:12.120 --> 0:16:14.880 die and their size will work for some people, maybe 0:16:14.880 --> 0:16:16.960 for some of the time, but it won't work for 0:16:17.000 --> 0:16:21.280 the long term for most patients. So yeah, I do 0:16:21.560 --> 0:16:24.800 get patients who've come from doctors said no way, you know, 0:16:25.440 --> 0:16:29.360 And I think that's just really an education thing and 0:16:29.440 --> 0:16:34.000 having statements from the Lance that Commission on Obesity, they 0:16:34.080 --> 0:16:37.280 will falter through. I think students in med school will 0:16:37.280 --> 0:16:40.080 start learning about OBC and treating as a disease, and 0:16:40.160 --> 0:16:41.040 same for GPS. 0:16:41.600 --> 0:16:44.000 So there are going to be some people listening to 0:16:44.040 --> 0:16:46.520 this and they're going to be angry that their taxes 0:16:46.640 --> 0:16:51.240 might be going towards funding these in the future. How 0:16:51.440 --> 0:16:56.160 does it though, compare to funding obesity. In the long term, 0:16:56.640 --> 0:16:57.560 I think. 0:16:57.640 --> 0:17:00.840 If it's tracked well, I think the government could probably 0:17:00.880 --> 0:17:05.800 see savings less liver transplants, less patients with diabetes who 0:17:05.800 --> 0:17:12.000 then have other significant operations, less ostere arthritis, less disability, 0:17:12.480 --> 0:17:15.359 And don't forget that people with obesity, you know, their 0:17:15.680 --> 0:17:19.080 quality of life, like getting a job, performing a job, 0:17:19.520 --> 0:17:21.840 they are all quite reduced. And I'll tell you that 0:17:22.040 --> 0:17:24.800 when I treat patients with obesity, you know, I don't 0:17:24.840 --> 0:17:28.040 imagine their productivity goes up because they tell me I 0:17:28.080 --> 0:17:30.360 can walk up the steps, I can move better. When 0:17:30.400 --> 0:17:32.520 I wake up, I feel like I've had a good sweap. 0:17:33.200 --> 0:17:36.000 So it's quite life changing. Losing weight, I think the 0:17:36.040 --> 0:17:40.760 cost benefit of just treating the BC itself is key 0:17:40.840 --> 0:17:46.160 because it reduces the occurrence of other diseases like osteoarthritis, 0:17:46.560 --> 0:17:50.080 like diabetes, even high blood pressure gets better as people 0:17:50.160 --> 0:17:50.680 lose weight. 0:17:51.119 --> 0:17:54.200 Are these weight loss medications kind of like the silver 0:17:54.280 --> 0:17:57.880 bullet through obesity? Or am I just looking up too 0:17:57.920 --> 0:17:59.600 many social media profiles? 0:18:00.080 --> 0:18:03.359 Yeah, definitely not a silver bullet. It's helpful, so you know, 0:18:03.400 --> 0:18:06.320 there's a limit to what medications can do, and it 0:18:06.400 --> 0:18:11.040 sits alongside say weight loss surgery, so you know, some 0:18:11.080 --> 0:18:14.880 people surgery will be a better option than weight loss medications. 0:18:15.280 --> 0:18:18.040 And then there's other patients. We have lifestyle and diet 0:18:18.119 --> 0:18:21.119 if managed, and people need to coach for this stuff. 0:18:21.200 --> 0:18:24.280 So if they can do that and lose weight, the 0:18:24.320 --> 0:18:26.959 goal should be to reduce our weights of obesity. You know, 0:18:27.280 --> 0:18:29.920 in the last six years, you know, we've gone from 0:18:30.560 --> 0:18:33.960 thirty one percent of the population having obesity to about 0:18:33.960 --> 0:18:37.480 thirty five percent, so just in a short space of 0:18:37.600 --> 0:18:43.879 six eggs, So there's an avalanche of pre diabetes diabetes coming. 0:18:44.960 --> 0:18:48.200 That's what the epidemic's all about, is all the ill 0:18:48.240 --> 0:18:51.399 health from that stems from obesity. So we need to 0:18:51.400 --> 0:18:54.920 do something right now, sort of like on the front 0:18:55.000 --> 0:18:59.840 lines as well as public health policy. So it's really 0:19:00.160 --> 0:19:04.399 the tool for us to treat obasily right now. 0:19:04.840 --> 0:19:07.640 And in terms of I mean, I've seen these articles 0:19:07.680 --> 0:19:10.400 about you know, if you go on the weight loss drugs, 0:19:10.400 --> 0:19:12.800 you're on them for life. If you ever stop them, 0:19:12.840 --> 0:19:16.360 you're just going to pile everything back on. Is there 0:19:16.480 --> 0:19:20.480 enough research anyway to suggest that I do have. 0:19:20.400 --> 0:19:24.639 Patients who've been on these GLP medications and then stop 0:19:24.760 --> 0:19:28.800 for whatever reason, Maybe it's financial, maybe it's other Yeah, 0:19:28.800 --> 0:19:32.040 and the weight does come back on, so we understand that. 0:19:32.119 --> 0:19:35.440 We know that even with surgery. We see patients who've 0:19:35.440 --> 0:19:39.840 had bariatric surgery, so they've had most of their stomach 0:19:39.960 --> 0:19:44.240 bypassed or removed. Even those patients put on weight, So 0:19:44.320 --> 0:19:49.960 it's not just a mechanical physical part. It's really again 0:19:50.000 --> 0:19:52.880 to do with those hormones that control how much people eat, 0:19:53.320 --> 0:19:56.720 how much they think about food, whether they're satisfied with 0:19:56.800 --> 0:20:00.960 how much they've eaten. But there's always a pressure on 0:20:01.040 --> 0:20:04.000 people to put on weight. And one of the biggest 0:20:04.000 --> 0:20:06.919 triggers for gaining weight, believe it or not, is actually 0:20:06.920 --> 0:20:10.119 losing weight, and it's mediated through hormones that work in 0:20:10.160 --> 0:20:14.840 the brain, hunger hormones, the appetite hormones, and obviously these 0:20:14.880 --> 0:20:18.960 society hormones. So when I talk to patiency, I spell 0:20:19.000 --> 0:20:21.640 that out at the beginning, that these medications are for life. 0:20:21.680 --> 0:20:23.520 We need to manage your obesity for life. 0:20:23.920 --> 0:20:24.480 It might not. 0:20:24.600 --> 0:20:28.919 Be an injection. There's new tablets coming into the market. 0:20:29.000 --> 0:20:31.879 We gave these in a tablet form now, so I 0:20:31.920 --> 0:20:34.600 think with new developments, new research will be able to 0:20:34.640 --> 0:20:40.280 manage long term obsy, just like we would manage blood 0:20:40.320 --> 0:20:45.080 pressure or hypertension diabees, we manage that with medication. So 0:20:45.640 --> 0:20:48.639 I see a future where we would manage obesity with medication. 0:20:48.800 --> 0:20:52.639 Because whatever we're doing, it's the current date. It's not 0:20:52.760 --> 0:20:54.880 working right because the rates are going out. 0:20:55.800 --> 0:21:02.720 Thanks for joining us, Jared, my pleasure. That's it for 0:21:02.800 --> 0:21:06.000 this episode of the Front Page. You can read more 0:21:06.000 --> 0:21:10.520 about today's stories and extensive news coverage at enzidherld dot 0:21:10.520 --> 0:21:13.920 co dot enz The Front Page is hosted and produced 0:21:13.920 --> 0:21:18.200 by me Chelsea daniels Kine. Dickie is our studio operator, 0:21:18.440 --> 0:21:22.320 Richard Martin, our producer and editor, and our executive producer 0:21:22.480 --> 0:21:25.879 is Jane Ye. Follow the Front Page on the iHeart 0:21:25.920 --> 0:21:29.040 app or wherever you get your podcasts, and join us 0:21:29.240 --> 0:21:32.360 next time for another look beyond the headlines.