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Obesity expert Dr Holly Lofton reviews three alternatives to GLP-1s to help patients drop excess weight. https://www.medscape.com/viewarticle/1000474?src=soc_yt -- TRANSCRIPT -- Hi. I'm Dr Holly Lofton. I'm a board-certified obesity medicine specialist, and I direct the medical weight management program at NYU Langone Health. There is so much information about glucagon-like peptide 1 (GLP-1) agonists as anti-obesity medications. I bet you can't think of a single person who hasn't heard of them, and many of your friends or family members may have even tried them. However, we also have what we call the first generation of medications for weight management, and I'll talk about some of those today. Phentermine. If your patient is not able to tolerate a GLP-1 agonist or is unable to access these medicines for various reasons, one option is phentermine, which has been around for decades. It is an oral medication that's usually taken once a day in the morning. It is a classic appetite suppressant. Phentermine makes people feel less hungry. It also gives people a little more energy, so they're able to increase their activity while creating a caloric deficit, and this leads to weight loss over time. Phentermine differs from the GLP-1 agonists, which are intended for chronic weight management. The FDA has approved phentermine for short-term weight loss; its use is recommended for no more than 12 weeks at a time. The medication comes in doses ranging from 8 mg to 37.5 mg and is usually slowly titrated up depending on tolerance and effect. Side effects that are most often reported include a racing heart, insomnia, agitation, and dry mouth. This drug is not for everyone. Phentermine is contraindicated in those with uncontrolled hypertension, with cardiac disease (such as a history of heart attack), or who are at high risk for heart attack or stroke. Some drug interactions can occur, which should be considered on a case-by-case basis. Phentermine may be an option for your patients if an elevated appetite is keeping them from losing weight. It should be used as an adjunct to lifestyle recommendations, which means eating fewer calories and increasing activity. Phentermine-Topiramate. Another non–GLP-1 agonist medication indicated for obesity is phentermine-topiramate [Qsymia]. This is another oral medication. The idea behind combining these two medications is that they can generate more appetite suppression without the high potential for side effects of phentermine alone, such as agitation, increased heart rate, or increased blood pressure. Topiramate is used for migraine or seizure prevention. One side effect of topiramate is unintentional weight loss, so they decided to combine phentermine with topiramate in one pill. Phentermine-topiramate comes in four different doses and is usually titrated up from the lowest to the highest dose. People who can't tolerate the higher doses of phentermine are able to tolerate Qsymia because the dose of phentermine is lower. This medication came to the market in 2012, after the SEQUEL trial, which demonstrated its safety and efficacy, achieved about 12% weight loss, which for many years was the highest weight loss seen with any other anti-obesity medications on the market. Because this is a combination medication, it has some potential side effects and contraindications. For example, we don't give phentermine-topiramate to people with uncontrolled hypertension or anxiety, and it is contraindicated in those with glaucoma. We don't give this medication to anyone who has had adverse reactions or hypersensitivity to either of the ingredients. Because the combination contains topiramate, it should not be prescribed to anyone with childbearing potential unless they are using an effective form of hormonal contraception or even two effective forms. Topiramate can increase the risk of having a baby with a cleft palate by five times if they become pregnant while taking this medication. Phentermine-topiramate is dosed once daily. One commonly reported side effect is paresthesia: numbness and tingling of the fingers and toes that can manifest as feeling very cold when it's cold outside. Although some patients report paresthesia, most say that it's not so intolerable that they want to discontinue the medication. There have been reports of vision changes in people taking phentermine-topiramate; if severe vision changes occur, it is recommended to discontinue the medication. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/1000474?src=soc_yt

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The controversial Shark Tank Keto is one of the most popular weight loss diets these days, partly because it may not only aid with weight loss, but actually improved overall health too. The diet originated in the 1920s as a therapy for children who suffer from epilepsy, but has become one of the most popular ways for people to drop pounds quickly and improve their health in the modern era.

The Origins of the Shark Tank Keto Diet

Basically, the premise of the Keto diet entails eating nearly 0 carbs and drinking lots of water, totally eliminating carbohydrates from your diet. The Keto diet leads to a state where your body starts burning fat for energy over carbs – all of which is supposed to help you lose weight. The concept of the Keto diet went viral after it got publicity from Shark Tank.

The entrepreneurs went through this experience pitching their Keto products to the Sharks in an attempt to secure an investment in their products. Although eating a diet full of fats and almost devoid of carbohydrates might seem counterintuitive to many of us, the Keto diet had something of value to offer, so the investors decided to back these products, and the sale of Keto products took off, as did the trend towards the mainstreaming of the diet.

The Rise of the Shark Tank Keto Diet

As the trend picked up momentum, throughout the world people began to reap the successes – losing weight, but also gaining renewed energy levels and heightened clarity of mind. Who could fault the high consumption of healthy fats (avocado, coconut oil, nuts, etc) to maintain a healthy regime in more sustainable dietary approach.

Celebrities and influencers were going on about the Keto diet, accessories were created, and Keto products were advertised. Social media was littered with before-after pictures of people who’d ‘ketoed’ their way thin. Lollberg is not surprised that, at present, there are at least 60 different diets being tried out. ‘It’s likely that most people have tried more than one strategy,’ she says.

The Future of the Shark Tank Keto Diet

As the Keto diet gains more ground, some researchers are still studying its long-term effects as a high-fat, low-carb eating protocol, while others praise the diet for its weight loss potential and its ability to mitigate health conditions such as type 2 diabetes and heart disease. Other researchers, however, caution against the long-term consequences of following a diet as restrictive as the Keto plan.

Whether you decide to hop onto the Shark Tank Keto diet bandwagon or not, that’s your call. Always check with a healthcare professional before making any drastic diet changes, especially if you have health-related issues. With the right guidance, the Keto diet can be both a game-changing and beneficial resource to reach your health and wellness goals.

Conclusion: Is the Shark Tank Keto Diet Right for You?

While it may work for some people, it’s a good idea to check with a physician before trying any new diets. You should always consider what will work best for your personal health and lifestyle.

Remember, finally being able to lose excess weight and improve your health likely also includes exercise, optimising stress, and getting enough sleep. The Shark Tank Keto Diet will probably become a microbiome-hacking gadget in the arsenal of your wellness, so use it wisely.

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