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Obesity has emerged as a global health epidemic, with its prevalence reaching alarming levels in many parts of the world. The complex interplay of genetic, environmental, and lifestyle factors contributes to the development of obesity, making it a challenging condition to manage. While traditional approaches such as diet and exercise remain fundamental, recent years have witnessed a groundbreaking development in obesity treatment - the advent of GLP-1 agonists. GLP-1 Agonists: An Overview GLP-1 (Glucagon-Like Peptide-1) is a hormone the intestine produces in response to food intake. Its primary role is stimulating insulin release and inhibiting glucagon secretion, thereby regulating blood sugar levels. Additionally, GLP-1 reduces appetite, slows gastric emptying, and promotes a feeling of satiety. Harnessing the therapeutic potential of GLP-1, researchers have developed a class of drugs known as GLP-1 agonists, which mimic the effects of the natural hormone. Mechanism of Action GLP-1 agonists bind to the GLP-1 receptors on pancreatic beta cells, enhancing insulin secretion in a glucose-dependent manner. This mechanism helps improve glucose control in individuals with type 2 diabetes, a condition often associated with obesity. Furthermore, GLP-1 agonists act on the brain to reduce appetite and food intake, promoting weight loss. Breakthrough Clinical Trials The outcomes of several pivotal clinical trials underscore the groundbreaking nature of GLP-1 agonists in obesity treatment. Trials such as the SCALE (Satiety and Clinical Adiposity – Liraglutide Evidence) program demonstrated the efficacy of GLP-1 agonists in achieving significant weight loss among participants. Liraglutide, a widely studied GLP-1 agonist, showcased remarkable results, leading to its approval for obesity treatment in various countries. Dual Benefit: Diabetes Management and Weight Loss One of the unique aspects of GLP-1 agonists is their dual benefit in managing obesity and type 2 diabetes. Individuals with obesity often have comorbidities, and the ability of GLP-1 agonists to address both conditions simultaneously is a notable advancement in therapeutic options. This dual-action approach not only simplifies treatment regimens but also offers a comprehensive solution to the complex metabolic challenges associated with obesity. Safety Profile and Tolerability GLP-1 agonists have demonstrated a favorable safety profile in clinical trials, with side effects typically being mild and transient. Common adverse events include nausea, vomiting, and transient increases in heart rate. Importantly, the benefits of significant weight loss and improved glycemic control outweigh the manageable side effects for many individuals, making GLP-1 agonists a promising option in the obesity treatment landscape. Future Implications and Challenges The development and success of GLP-1 agonists mark a significant milestone in the quest for effective and safe obesity treatments. As research in this field continues, there is potential for further refinements in drug formulations, dosing regimens, and the exploration of combination therapies. Challenges such as long-term adherence, cost, and accessibility must be addressed to ensure widespread adoption and sustained impact on the obesity epidemic. Conclusion The groundbreaking invention of GLP-1 agonists represents a transformative moment in obesity treatment. By leveraging the body's natural mechanisms for glucose regulation and appetite control, these drugs offer a novel and practical approach to weight management. As we continue to navigate the complexities of obesity, GLP-1 agonists stand out as a beacon of hope, offering a promising path towards healthier and more sustainable solutions for individuals grappling with this pervasive health issue. Lixisenatide (Adlyxin): Approved for the treatment of type 2 diabetes. It's essential to note that the availability and approval status of medications can change, and new drugs may have been introduced since my last update. Always consult with a healthcare professional or refer to the latest medical sources for the most current information on GLP-1 agonists and other medications. #ObesityTreatment #GLP1Agonists #WeightLossInnovation #MedicalBreakthrough #HealthcareAdvancements #MetabolicHealth #GLP1Receptors #DiabetesManagement #ClinicalTrials #SustainableHealth #InnovationInMedicine #GlobalHealth #HealthyLiving #DualActionTherapy #FutureOfObesityTreatment #ResearchProgress #WellnessJourney #MedicalScience #HealthTech #TransformativeMedicine #Exenatide #Byetta #Bydureon #Liraglutide #Victoza #Saxenda #Dulaglutide #Trulicity #Albiglutide #Tanzeum #Semaglutide #Ozempic #Rybelsus #Wegovy

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Hims & Hers Health: Timeline 2017 * Summer: Andrew Dudum, a Silicon Valley entrepreneur, conceives the idea for a company to address men's health issues with discretion. * November 1: Hims officially launches as a direct-to-consumer wellness brand focused on men's health, offering telehealth consultations and discreet shipping of treatments for hair loss (finasteride, minoxidil) and erectile dysfunction (sildenafil). * First Week: Hims reportedly surpasses $1 million in sales, experiencing significant early demand. 2018 * October: Hims unveils Hers, a dedicated line for women's health and wellness, applying the same model of telehealth and stylish branding to areas like birth control, skincare, and women's hair care. Hers also begins offering emergency contraception. * Hims & Hers expands its product offerings beyond initial categories to include vitamins and supplements for general wellness and sleep. 2019 * January: Hims & Hers achieves "unicorn" status with a valuation over $1 billion after a Series C funding round. * Hims products become available in Target stores, marking the brand's first brick-and-mortar presence. * Andrew Dudum reports that the Hims & Hers platform is seeing two to three thousand patient consultations daily across various categories. 2020 * Early 2020: The COVID-19 pandemic begins, significantly increasing the need for and acceptance of telehealth services. * Within Days of Lockdowns: Hims & Hers rapidly launches a virtual primary care service at cost to alleviate pressure on the traditional healthcare system. * Mid-2020: Hims & Hers rolls out online psychiatry services in most states, allowing patients to receive evaluations and prescriptions for mental health conditions. * Hims & Hers also introduces individual therapy in select states and free anonymous online support groups led by counselors. * By the end of the year, Hims & Hers is providing psychiatry services in 44 states and therapy in 32 states. 2021 * January: Hims & Hers goes public on the New York Stock Exchange (NYSE) via a SPAC merger, becoming Hims & Hers Health, Inc. (ticker symbol HIMS), raising approximately $280 million and achieving a valuation of around $1.6 billion. The NYSE is adorned with a Hims & Hers banner proclaiming "The future of healthcare." * Hims & Hers acquires Apostrophe, a personalized teledermatology and online pharmacy service specialising in custom-compounded prescription skincare, for an estimated $150–190 million. * Hims & Hers continues to expand its product lines across sexual health (e.g., "Hard Mints"), hair care (improved topicals), and skincare. 2022 * Hims & Hers further expands its over-the-counter skincare line through a partnership. * By late 2022, Hims & Hers reports having facilitated over a million telehealth consultations. 2023 * Early 2023: Hims & Hers appoints a Senior Vice President of Mental Health. * Actress Kristen Bell partners with Hers as a mental health ambassador. * Spring: Hims & Hers launches its Weight Management program, initially focusing on conventional strategies. * Mid-2023: Hims & Hers introduces "Heart Health by Hims," its first foray into cardiovascular health, offering personalised sexual health treatments with integrated cardiovascular support in collaboration with the American College of Cardiology and partnering with Labcorp for convenient lab testing. * Late 2023: Hims & Hers announces "MedMatch," an AI-powered tool to provide clinical decision support, initially focused on mental health treatment recommendations. * Hims & Hers begins offering access to compounded semaglutide injections for weight loss at a lower cost than branded options, capitalising on drug shortages. 2024 * Hims & Hers rapidly scales its Weight Loss by Hims & Hers program, including compounded semaglutide, nutritional coaching, and exercise guidance. * September: Hims & Hers announces a special initiative offering compounded GLP-1 treatments for as low as $99 per month for "community heroes." * Hims & Hers acquires a peptide compounding facility in California to strengthen its supply chain for injectable medications. * Dr. Jessica Shepherd is appointed Chief Medical Officer for the Hers brand. * Hims & Hers launches the Hims & Hers Health Collective, an ambassador program for customers. * Hims & Hers achieves profitability for the first time. * Hims & Hers experiences a surge in inquiries about its weight loss program following a controversial Super Bowl TV commercial criticising the traditional healthcare system for its approach to obesity. * Two U.S. Senators express concern to the FDA about the content of the Super Bowl ad. * Hims & Hers adds pharmacy and regulatory experts to its leadership team. * Hims & Hers pilots a program with a major hospital system for patient referrals. 2025 * February: The FDA officially declares the shortage of semaglutide over, impacting the ability of compound...

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Dr David Johnson highlights new preoperative recommendations to protect against consequences of some diabetes and weight loss drugs that delay gastric emptying. https://www.medscape.com/viewarticle/994762?src=soc_yt -- TRANSCRIPT --- Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology in Eastern Virginia Medical School in Norfolk, Virginia. Recent national media attention has focused on the gastrointestinal (GI) side effects of glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs are used to treat type 2 diabetes and weight loss. The GI side effects include nausea, vomiting, and gastroparesis-like symptoms. I wanted to emphasize two key points especially important to clinicians providing this class of therapy. One: Clinicians need to be increasingly aware of the potential GI side effects and inform their patients when they start to prescribe these medications. And two: The American Society of Anesthesiologists (ASA) has recently released consensus-based recommendations for preoperative assessment and management of adults and children undergoing surgery who are taking these medications. The recommendations also apply to endoscopic procedures whereby anesthesia will be delivered. Gastric Impact of GLP-1 Agonists What are these GLP-1 agonists? The drugs for weight loss include liraglutide (Saxenda and Victoza) and semaglutide (Ozempic, Wegovy, Rybelsus, among others). The type 2 diabetes medications include semaglutide, dulaglutide (Trulicity), and exenatide (Byetta, Bydureon BCise), among others. They can be taken daily or by injection once a week. The GLP-1 agonist drug class works at the GI level to increase insulin secretion and decrease glucagon release, both of which mediate glycemic control, particularly postprandially. The drugs slow the gastric motility through decreased peristalsis and increased tonic contractility of the pylorus, essentially causing a delay in gastric emptying. Dr Michael Camilleri and his colleagues at the Mayo Clinic, in Rochester, Minnesota, conducted a small randomized, placebo-controlled double-blind study of the GLP-1 agonist liraglutide to investigate the mechanism of weight loss in patients who were overweight. They showed that there was a diminution in gastric emptying over 16 weeks in patients taking liraglutide. They found evidence of tachyphylaxis, but the rate of gastric emptying of solids remained slow compared with placebo, even at 16 weeks. Despite the observed waning of the gastric impact, we just don't know how long significant side effects persist when patients stop the drug for good. There are some reports of patients with protracted symptoms a year or more after they've stopped their GLP-1 agonist medications. Guidance for Preoperative Management These drugs would commonly be reviewed before patients go through procedures, and we need to be better aware as we start to see these patients for endoscopy. The ASA recommendations address the potential consequences of delayed gastric emptying and provide guidance for preoperative management of these drugs to prevent regurgitation and pulmonary aspiration of gastric contents. In patients on daily dosing, the ASA recommends holding these agents the day prior to the procedure. For patients on weekly dosing, the recommendations suggest withholding the dose a week before the procedure. Importantly, this should be in consultation with their diabetologist, just to assess any need for a bridging therapy to avoid hypoglycemia. On the day of the procedure, if GI symptoms, such as severe nausea, vomiting, retching, abdominal pain, and bloating, are present, clinicians should consider delaying the elective procedure and discuss the risks of the potential risks for aspiration. If the patient has no symptoms and the GLP-1 agonist has been withheld as advised, then you should proceed as usual. But if the patient has no symptoms and has not held their GLP-1 agonist, you should proceed with what the anesthesiologists call the "full stomach" precaution, which considers patients at potentially high risk for aspiration. There's a way of checking for that. Some centers can do a quick ultrasound on the stomach and see if there's food, debris, or liquid, and if that is not the case, they could proceed with no delay. But if there is no way to check gastric contents, then you should manage accordingly, which may require intubation or postponing an elective procedure for another day. These are new and changing issues. In our world as gastroenterologists, we should be considering — very strongly — mitigating strategies to protect the patients on this wonderful class of therapy. Sometimes these drugs can have significant side effects that we need to at least be aware of. Nothing is perfect, but let us be better informed. https://www.medscape.com/viewarticle/994762?src=soc_yt

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