Northwestern Medicine Chief Medical Officer Dr. Kevin Most joins the Steve Cochran Show to discuss how tequila can alleviate muscle cramps, why BMI isn’t a good indicator of health, and he reveals the simplest food to eliminate from your diet to kickstart your weight loss journey.
Dr. Kevin Most’s Steve Cochran Show Notes:
Weight Loss- injection now, when will we have a pill?? – the medication can also help with Diabetes, BP and heart disease
- We talked in the past about Wegovy, Mounjaro and Ozempic, the once a week injectable medications that helped individuals with Type 2 Diabetes, that also showed benefit of weight loss
- The injectable drugs are being used as an off label medication for weight loss, even in non diabetics
- Researchers last month presented data which showed a 50 mg tablet of Ozempic each day was as effective as the weekly shots when using weight loss as a metric
- The study showed that 85% of those who took the pill lost at least 5% of their body weight, with the average being a 15% weight loss over the 68 week trial
- The thought is that many will not use the medication in the shot form which must be refrigerated, but would embrace the once a day pill formulation
- The pill would be taken once in the morning 30 minutes before any food
- Lilly also has an oral medication, in the same drug class, that has helped individuals lose an average of 15% of their body weight
- This was reported in NEJM last week.
- Orforglipron is the name of the Lilly medication, this is in a group of other meds all looking for that simple solution for weight loss.
- The 15% weight loss was seen with those taking the medication at the highest dose- for 36 weeks
- The study looked at 272 people with an average weight of 240lbs, after 36 weeks, the 15% weight loss was noted, as was positive effects on Cholesterol, triglycerides and blood pressure
- There are other companies looking at the same class of drugs and putting them thru clinical trials as well
- The oral drugs will all need larger clinical trials and are probably a year away from being on the market.
- The drug works by telling your that you are full, doing this by regulating insulin release, it is also shown to decrease the urge to eat.
- The market for this will be quite large if the studies continue to show not only a decrease in weight but also improvement with diabetes management and heart benefits
- Who wouldn’t want to take an oral pill, that can be taken with or without food, that lowers my cholesterol, lowers my blood pressure and decreases my weight by 15%
BMI- not the way to identify ideal body weight
- For over 10 years, Doctors have used the BMI (body mass index) as the gold standard for appropriate weight
- BMI is a calculation of your weight in kilograms divided by the square of height in meters
- BMI gained popularity in the 1980’s when the NIH used it as a measure for obesity
- It is noted in every medical record, it is used as a measure for joint replacement surgery (many use BMI of 40 as a cut off )
- BMI does not differentiate between lean and fat body mass
- 3 weeks ago the AMA came out and told doctors to de emphasize that measure as it has caused “historical harm”
- BMI research has shown that this number is not accurate in predicting risk of disease
- The reason for this change is that the data used for BMI standards in the past was based on non-Hispanic white populations
- The data does not consider gender or ethnicity.
- Not being told to STOP using BMI as a data point but take into considerations- body composition, waist circumference and genetic factors
- Waist measurement, body composition and adiposity ( how much fat is in the body) have greater indicators of poor health outcomes
- BMI does not differentiate between fat and lean muscle, nor does it differentiate where the fat is located.
- Studies have shown that fat around the abdomen is more dangerous for health events than fat that is noted in thighs and legs
- The racial differences must be taken into consideration as Hispanic and black individuals have a higher risk of developing Type 2 diabetes at lower BMI’s than white individuals.
- Drug companies now looking to develop new drugs that will hopefully cut fat mass while maintaining or increasing muscle mass.
- We need a new way to look at weight and the AMA is starting that trend
New nutritional labeling for food coming??? New labels by December of 2023??
- Is it by design that we place nutritional information on the back of our food packaging?
- Do we want to hide the nutritional facts to a point where it has to be looked for?
- Do we try to confuse individuals by stating calories by serving size?
- Do we look at daily value of each nutrient
- On some packaging limited nutritional information is placed on the front, not for information but more for marketing
- The FDA wants to change that, they want to make it easier for consumers to see and know what they are buying, they want to make it easier to make healthy choices
- Many countries have “front of package labels” These are symbols that are placed on the front of the packaging that alert the consumer when a product is high in some unhealthy nutrients, such as sodium or saturated fat
- They are doing this to impact consumer’s dietary choices
- Congress is looking to have mandatory front of packaging nutrition labeling which is common in many other countries already
- They are also looking at limiting fruit imagery and statements like “made with whole grain” unless the product have a substantial amount of fruit or whole grain.
- Looking to make it easier for consumers to identify nutrition and allergy information
- We know saturated fats are not good for ones health, should we not make it easy for the consumer to identify this ingredient in what they buy
- Congress is interested in limiting any deceptive marketing
- The FDA is embarking on a study to test front of package labels
- The food industry is hinting it will sue if the FDA requires labels that are thought to be restrictive
- Would we make better decisions if we knew sugar, fat and sodium levels in the prepared foods we were buying
- This is not even touching Bio Engineered foods or Genetic Modified Organisms or even what can be deemed to be “organic”
