Latest / Morning Medical with Dr. Chow / The benefits of GLP-1 drugs, social media's impact on mental health, and tips for healthier eating

Transcript

The benefits of GLP-1 drugs, social media's impact on mental health, and tips for healthier eating · Morning Medical with Dr. Chow

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Good morning, and welcome to Morning Medical with Doctor Chow.
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I am your host, Doctor chiming Chow.
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In today's episode, we will be delving into the latest medical and health news from around the
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globe.
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We will discuss how GLP 1 drugs can benefit individuals with extreme obesity before
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bariatric surgery, examine the recent improvement in America's diet quality, explore
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the US, surgeon general's call for warning labels on social media platforms and answer a
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pressing question from a listener about why we often eat foods that we know are bad for us.
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Our first story today focuses on a new study that reveals the benefits of using GLP 1 drugs
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before undergoing bariatric surgery for individuals with extreme obesity.
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Surgery 2024 annual scientific meeting.
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Although the results have not yet been published in a peer reviewed scientific
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journal, the findings are promising.
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Extreme obesity is defined as having a body mass index or BMI of 70 or more.
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In 2022, there were nearly 280,000 metabolic and bariatric surgeries performed in the United
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States.
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The study suggests that people with extreme obesity can reduce their risk of complications
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from bariatric or metabolic surgery by taking GLP 1 drugs before the procedures.
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GLP 1 drugs, such as Ozempic, WAGOVY, Zepbound, and Montero, are highlighted as effective tools
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for weight loss prior to surgery.
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The research documented 113 patients with a BMI greater than 70 who attempted to lose weight
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ahead of metabolic and bariatric surgery.
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These patients were divided into 3 groups.
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Those who followed a medically supervised diet and exercise regimen.
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Those who took a single GLP 1 medication, mostly semaglutide, and those who engaged in
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multimodal therapy involving more than 1 GLP 1 drug.
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On average, patients were treated for 72.9 days.
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The study found that people taking multiple medications had the greatest percentage of
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total body weight loss at 13.1%.
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Followed by those on single GLP 1 therapy at 8.14%.
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And finally, those relying on diet and exercise at 5.95%.
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BMI reductions were most significant in patients treated for 6 to 12 months with
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combination drug therapy.
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John Morton, MD, a professor of surgery specializing in bariatric and minimally
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invasive procedures at the Yale School of Medicine, emphasized the importance of
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consulting a health care professional before considering such surgery.
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Doctor Morton, who was not involved in the study stated, I look for 2 things.
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1, their motivation.
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Why do they want to lose weight?
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I asked them that, and I also asked them how much weight they want to lose.
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And to the degree that they're fairly accurate with their weight loss goals, then that tells
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me how ready they are, and also if their motivations are appropriate.
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In other words, to improve their health or to interact more with their families, or be more
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productive at work.
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Doctor Nye Senn Morton added.
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I think the main takeaway from this study is we have a lot of options for people who have extra
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weight.
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And you should go to accredited centers to help figure out what's the best path forward.
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Extreme obesity can lead to numerous health complications including type 2 diabetes, heart
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disease, high blood pressure, certain cancers, stroke, gallbladder disease, fatty liver
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disease, high cholesterol, sleep apnea, arthritis, and infertility.
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According to the Centers for Disease Control, and prevention, around 42% of adults in the
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United States have obesity, putting them at increased risk for these conditions.
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Doctor Bobay Toss, Morton noted that while bariatric surgery carries some risks, it is
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generally quite safe.
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It has one of the safest safety records in surgery, he said.
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The mortality rate from bariatric surgery is less than that of hip or knee replacement or
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removal of a gallbladder.
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He further explained that losing 5 to 10% of total body weight can help with diabetes, blood
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pressure, or cholesterol issues, and losing 15% can help with problems like sleep, apnea, or
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fatty liver.
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However, people with severe obesity need to lose wins they face.
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If you want to reduce your risk from cancer associated with obesity, then you probably have
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to lose 25% of your total body weight.
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Doctor Remorton said, bariatric surgery affords you the most weight loss.
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And again, the risk is quite low.
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You do need to take into account the risk of doing nothing.
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And the risk of doing nothing carries significant risk People who carry extra weight
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who are obese reduce their lifespan on the order of 10 to 15 years.
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Mir Ali MD, a board certified bariatric surgeon and medical director of Memorial Care Surgical
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weight loss center at Orange Coast Medical Center in Fountain Valley, California provided
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additional insights.
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Doctor.
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Ali, who was not involved in the study, pointed out that patients with a BMI in the sixties or
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seventies.
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Face higher risks during surgery due to complications with anesthesia and the physical
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challenges of moving a patient with such a high BMI.
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The higher their BMI, the higher their risk, Doctor Riley said, but also recovery is harder
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when the patient is extremely large.
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So there's a lot of different factors that go into play.
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These medications can be used to help someone lower their weight and reduce their surgical
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risks to some extent.
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Doctor Ali emphasized that the amount of weight a patient needs to lose before surgery is
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highly individualized.
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There's no set number.
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It's very much dependent on the patient, their body habits, their age, general health, and
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other risk factors.
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He said, we can have a pre operative evaluation by different specialists.
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They could see the anesthesiologist ahead of time to assess their risks for anesthesia.
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It just depends on the patient.
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If they have more heart or lung factors, we might have them lose more weight or.
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In summary, the study presented over the weekend suggested that for people with extreme
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obesity, taking GLP 1 agonists like Ozempic or Wegave, before bariatric or metabolic surgery
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is the most effective method to reduce surgical or recovery complications.
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Extreme obesity, defined as having a body mass index of more than 70, can lead to multiple
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health conditions and make anesthesia difficult to manage during bariatric surgery.
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Experts recommend consulting with a health care professional to tailor the most appropriate pre
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and post surgical plan for each patient Our next story delves into the topic of America's
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diet quality, which has seen a slight improvement over the past 2 decades.
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According to a new study, the nutritional quality of the average American diet has moved
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from an f to a d.
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While this is a small step forward, It highlights the need for further improvements.
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The study conducted by researchers at Tufts University and published in the annals of
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internal medicine analyzed 2 decades of nutritional data.
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Senior study author and cardiologist, doctor Darias Mosafarian, who is also the director of
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the Food Is Medicine Institute at Tufts University, shared his insights on the
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findings.
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There is good news.
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Americans are starting to hear the message about nutrition, and some companies and
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restaurants are starting to make healthier products.
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It's a little bit of an improvement, he said.
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However, Doctor So Mosafarian added that the majority of the improvement occurred between
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19992010.
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With no significant advances in nutrition after that period.
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We have stalled as a nation, and that does not bode well for our health, he stated.
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If I was grading America on its diet, I'd give it a d just up from an f.
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The study found that the number of adults in the United States who consumed a poor diet
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decreased from about 49% to just over 37% between 19992020.
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This represents a drop of 11.4%.
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Additionally, the number of individuals who ate somewhat better nutritionally rose by 10.5%.
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A poor diet as defined by the study includes too many refined grains processed meats, sugary
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beverages, and ultra processed foods high in added sugar, salt, and fat.
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Healthy choices such as fruits and vegetables were notably low in this eating style.
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Intake of fruits and vegetables didn't increase at all over this 20 year period, which is
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pretty striking, noted Doctor lines from the American Heart Association includes at least
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the daily recommended servings of fruits and vegetables, as well as more beans, whole
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grains, nuts, and seeds.
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The nutritionally ideal diet also contains few sugary beverages, processed meats, refined
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grains, and ultra processed foods.
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Unfortunately, the study found that the number of people who ate an ideal diet which includes
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the recommended 9 cups of fruits and vegetables daily rose by less than 1%.
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Doctor B.
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Mosafarian pointed out.
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People often ask me, well, if the diet's slowly improving, why is obesity and diabetes still
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going up?
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It's still going up because only 1.58% of Americans have an ideal diet.
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We still have a long way to go.
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More than a 1,000,000 Americans die each year from diet related diseases such as obesity,
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cancer, heart disease, and type 2 diabetes according to the United States Food And Drug
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Administration.
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Unhealthy diets and food insecurity cost the United States an estimated $1,100,000,000,000
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in health care expenditures and lost productivity annually.
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Doctor 1, Walter Willett, a professor of epidemiology and nutrition at the Harvard T.
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H.
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Chan School of Public Health emphasized the severity of the situation.
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I think it is correct to emphasize that diet quality remains dismal in the United States.
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There is no secret why Americans are experiencing epidemics of obesity and diabetes
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and declining life expectancy.
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He said, Doctor Willett was not involved in the study.
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The study analyzed dietary information on nearly 52,000 United States adults who
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participated in the National Health And Nutrition examination survey, or N Haines.
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Nutritional advances were highest among women, younger adults, Hispanic adults and people with
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more education and higher incomes who had access to private health care insurance.
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Fewer gains were seen in men black or older adults, and people with less income, lower
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educational levels, non private health insurance, and food insecurity issues.
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Disparities in the population by education and income and race and ethnicity are the same or
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sometimes getting worse.
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Doctor.
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Mosafarian remarked.
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The study found that people with lower income saw a 5% improvement in nutritional quality.
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While those with higher incomes improved their nutritional score by 16%.
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Doctor Swillart commented on the broader context of these findings, We do need to avoid
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just blaming the victims of the dysfunctional United States food system for the terrible
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diets documented in the survey.
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He said.
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We failed to educate students about nutrition in our schools and feed them unhealthy diets.
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Our health care system is missing in action almost completely.
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We allow advertising to seduce children into junk foods and beverages that kill them
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prematurely.
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And we indirectly subsidize unhealthy foods in many ways that make healthier options
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relatively more expensive and less available to low income Americans.
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Despite these challenges, There are easy ways to improve the nutritional quality of your
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diet.
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Experts suggest cooking at home as often as possible.
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My top suggestion is to shop at the grocery store as much as you can, rather than getting
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your food at a coffee shop sandwich shop or quick serve restaurant.
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Doctor Mike Mosafarian advised, he added that even eating at a full service restaurant should
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be limited as prior research found that about 80% of all food consumed by Americans from
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restaurants was of poor diet quality.
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Shockingly, even when we compared fast food versus sit down restaurants, there wasn't a
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dramatic difference in quality, he said.
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Instead, try to choose minimally processed foods to cook at home and avoid ready to heat
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and eat convenience foods prevalent at grocery stores.
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Bringing your lunch and snacks to work can also help improve your diet.
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Another key recommendation is to avoid sugary beverages.
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While many Americans understand that sugary sodas are unhealthy, they may not realize that
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energy drinks, sports drink, and caffeinated beverages can be equally sugar laden.
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Energy drinks, pre sweetened iced teas, and specialty coffee drinks can have more sugar
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than soda, Doctor Mosafarian warned.
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I see people walking out of the coffee shop with drinks with whipped cream on top.
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Don't drink your sugar.
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Once sugary beverages are removed from the diet, only 6% of calories in the country come
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from added sugar in foods.
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In contrast, about 35 percent of calories in the country come from refined grains and
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starches.
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Refined grains such as refined bread, refined rice, crackers, and chips are the biggest
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contributors to the poor quality diet of Americans with an average of 5.2 servings per
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day.
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Whole grains, on the other hand, still contain the bran and germ, which are nutritional
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powerhouses full of healthy fats, antioxidants, minerals, and vitamins e and b.
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Whole grains take longer to digest do not raise blood sugar as quickly as refined grains and
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contain more fiber, which can reduce the risk of chronic disease promote weight loss and
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improve digestion.
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Examples of whole grains include barley, vulgar, pharaoh, millet, quinoa, black rice,
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brown rice, red rice, wild rice, oatmeal, and popcorn.
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Refined grains such as white flour, corn grits, white bread, and white rice have been milled to
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remove the bran and germ, giving them a finer texture and longer shelf life.
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However, this process also removes essential nutrients like dietary fiber, iron, and
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vitamins.
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Refined grains are found in nearly all ultra processed foods, including breakfast cereals,
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desserts, pastries, bread, and crackers.
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To improve your diet, experts suggest replacing refined grains with whole grains and nourishing
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your gut microbiome with fruits vegetables, beans, nuts, and seeds.
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Formented foods such as yogurt, sour kraut, and kimchi can also support a healthy microbiome.
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The United States surgeon general has called on congress to require warning labels on social
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media platforms similar to those now mandatory on cigarette boxes.
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In an opinion piece published in the New York Times on Monday, doctor Vivek Murthy said that
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social media is a contributing factor in the mental health crisis among young people.
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It is time to require a surgeon general's warning label on social media platforms.
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Stating that social media is associated with significant mental health harms for
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adolescents.
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A surgeon general's warning label which requires congressional action, would regularly
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remind parents and adolescents that social media has not been proved safe.
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Murphy said Evidence from tobacco studies show that warning labels can increase awareness and
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change behavior.
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Murphy emphasized that the use of a warning label alone would not make social media safe
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for young people, but would be part of the steps needed to address the issue.
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Social media use is highly prevalent among young people, with up to 95% of youth ages 13
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to 17, reporting that they use a social media platform, and more than a third saying that
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they use social media almost constantly according to 2022 data from the Pew Research
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Center.
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Last year, Murphy warned that there was not enough evidence to show that social media is
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safe for children and teens.
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He said at the time that policy makers needed to address the harms of social media in the
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same way they regulate things like car seats baby formula, medication, and other products
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children use.
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To comply with United States federal regulation, social media companies already
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banned children under thirteen from signing up for their platforms, but children have been
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shown to easily get around the bands, both with and without their parents' consent.
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Other measures that social platforms have taken to address concerns about children's mental
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health can also be easily circumvented.
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For instance, TikTok introduced a default 60 minute time limit for users under 18.
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But once the limit is reached, minors can simply enter a passcode to keep watching.
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Murphy believes that the impact of social media on young people should be a more pressing
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concern.
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Why is it that we have failed to respond to the harms of social media when they are no less
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urgent or widespread than those posed by unsafe cars planes, or food.
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These harms are not a failure of willpower and parenting.
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They are the consequence of unleashing powerful technology without adequate safety measures,
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transparency, or accountability, he wrote.
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In January, the chief executive officers of Meta TikTok, X, and other social media
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companies went before the Senate Judiciary Committee to testify as parents worry that they
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are not doing enough to protect young people.
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The executives touted existing safety tools on their platforms and the work they have done
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with nonprofits and law enforcement to protect minors.
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Murphy said Monday that Congress needs to implement legislation that will protect young
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people from online harassment, abuse, and exploitation, and from exposure to extreme
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violence and sexual content.
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The measures should prevent platforms from collecting sensitive data from children and
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should restrict the use of features like push notifications, autoplay, an infinite scroll,
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which prey on developing brains and contribute to excessive use.
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Murphy wrote.
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The surgeon general is also recommending that companies be required to share all their data
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on health effects with independent scientists and the public.
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Which they currently do not do and allow independent safety audits.
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Murphy said that schools and parents also need to participate in providing phone free times
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and that doctors, nurses, and other clinicians should help guide families towards safer
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practices.
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Now we move on to our Ask a doctor segment.
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Today, we address a question many of us have pondered.
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Why do I keep eating foods that I know are bad for me?
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According to experts, the reasons for this pattern are deeply rooted in human nature.
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Doctor Jesus L, Lazar Zabaru, a family physician with TPMG Grafton Family Medicine in
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Yorktown, Virginia, explains Unfortunately, it's just human behavior.
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We tend to gravitate toward things that are enjoyable, and a lot of things that are bad for
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us are very enjoyable.
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Convenience and comfort also plays significant roles in this repeated cycle of making poor
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food choices.
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There's a reason they call a lot of these foods comfort foods, ads, doctor Lazarusaburu.
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They bring us a lot of joy at a primal level.
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When discussing dietary choices with his patients, Doctor Liza Baru attempts to learn
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about their preferences and behavior.
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Delving into not only their food choices, but also portion sizes.
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One common denominator that could help everyone is decreasing the serving size, he says.
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Logging what you eat can also be part of setting health goals.
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Doctor Bin Liza Baru suggests It is important to enjoy and savor foods as well, which can
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actually help to regulate consumption.
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We have forgotten to enjoy our food, he says.
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We just eat because it's time to eat, and we're so busy that we forget to enjoy a meal.
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When we do enjoy a meal, we tend to eat less of it.
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Doctor, Natasha Buoyan, a family doctor with 1 medical in Phoenix, Arizona, adds that the poor
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quality of many Americans diets is not just an individual issue, but a systemic problem.
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Processed foods are often more affordable than healthier options.
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She says.
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They are also convenient, especially for people who are working long hours, families, and other
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groups who may not have the luxury of time.
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Processed foods are often filled with sugars, starch, sodium, and unhealthy fats, Doctor.
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Bulyan warns.
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They also increased the risk of things like obesity, diabetes, and heart disease, she says.
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To help patients get on a path to better health, doctor Lizarzabrew often brings
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people's feelings into the equation.
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It's worthwhile to appeal to emotion and help patients make a change for someone other than
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themselves, like for a child, parent, or friend, he says.
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That is a lot more powerful of a motivator than me telling them it's good for them.
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Doctor Lazarzaboru also advises patients to prioritize their nutrition just as they would
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other important areas, like family, work, and finances.
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As a family physician, rather than telling patients what to do, I like to engage in a
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conversation, he says.
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After we establish the individual person's motivation for change, We talk about what
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realistic changes they can make.
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In many cases, simple changes can have a lasting impact.
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This might mean drinking more water each day, adding more vegetables to dinner, or cooking
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one meal at home rather than eating out.
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Small and practical changes are often the foundation for successful healthy changes.
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Doctor Chi Puyyan Adds.
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That wraps up today's episode of Morning Medical with Doctor Chow.
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Thank you for joining us as we explore the latest in medical and health news.
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Be sure to tune in tomorrow for more insights and updates from the world of medicine.
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Until then, stay healthy and take care.