As the widespread adoption of GLP-1 receptor agonists reshapes the treatment landscape for obesity and metabolic disease, a new and arguably more intricate challenge is emerging: guiding patients through the phase that follows with GLP-1 nutritional support. The discontinuation of GLP-1 therapy is not merely the end of pharmacologic appetite suppression; it represents a critical metabolic inflection point, where compensatory physiology can rapidly unravel previous progress if left unchecked.1,2 What follows is far from benign. Appetite mechanisms recalibrate, often overshooting…

By: Yekta Dowlati, PhD GLP-1 receptor agonists (GLP-1 RAs), including semaglutide and liraglutide, have redefined therapeutic strategies for type 2 diabetes and obesity by harnessing incretin biology to achieve profound metabolic benefits.1 These agents enhance glucose-dependent insulin secretion, suppress glucagon, delay gastric emptying, and reduce appetite through central and peripheral pathways. However, the same physiological mechanisms that underpin their efficacy are intrinsically linked to gastrointestinal (GI) side effects—an area of growing clinical significance.2 Nausea, early satiety, bloating, diarrhea, and constipation…

By: Yekta Dowlati, PhD   The therapeutic landscape for obesity and type 2 diabetes mellitus (T2DM) has been revolutionized by glucagon-like peptide-1 receptor agonists (GLP-1 RAs), with weight reductions approaching magnitudes once exclusive to bariatric surgery. Yet, alongside dramatic fat mass loss, emerging data underscore a concerning reality: a substantial fraction of weight shed on GLP-1 RAs is lean mass — up to 40% in some trials.1,2 As muscle quantity and quality are integral to metabolic resilience, physical function, and…

Akkermansia muciniphila is a unique mucin-loving keystone species residing in the human gastrointestinal tract, purportedly offering health benefits, especially in the realms of metabolic health and obesity.1 Clinical investigations exploring A. muciniphila supplementation in overweight and obese cohorts seek to elucidate its potential impact on metabolic parameters, adiposity, and other health metrics. Studies consistently show reduced abundance in obesity, type 2 diabetes, high blood pressure, and other metabolic conditions.2 Intervention studies in animals demonstrated A. muciniphila administration reversed high-fat diet-induced metabolic disorders,…

by Melissa Blake, ND Introduction The COVID-19 pandemic has raised many clinical questions that we do not yet have clear answers for. What does appear to be clear is the connection between metabolic health and disease risk. In particular, obesity poses a significant increased risk of infection and mortality, with statistics suggesting its presence in nearly half of hospitalized or deceased COVID-19 patients.1 As our waistlines expand, so too does the incidence of diabetes.2,3 Preexisting type 2 diabetes (T2D) has…

Host: Deanna Minich, PhD Guest: Erik Lundquist, MD In this discussion, Erik Lundquist, MD and Deanna Minich, PhD explore thyroid physiology, assessment, and clinical pearls for treating patients with thyroid dysfunction or disorders. The crux of the discussion is treating the individual patient, not the labs. You will learn valuable insights and effective clinical strategies that Dr. Lundquist utilizes every day in his clinic to provide personalized support to patients with thyroid disorders. Dr. Lundquist shares that in his medical school…

by Sara Gottfried, MD, and Kari Hamrick, PhD, RD Polycystic ovary syndrome (PCOS) is a problem of hormone dysregulation that can lead to irregular menstrual cycles, high androgens, and its downstream sequelae such as acne and hirsutism, infertility, weight gain, and cardiovascular disease. As practitioners and their affected female patients anguish over the root cause and solutions, one part is very clear: up to 85% of women with PCOS are insufficient in vitamin D.1 For our patients with PCOS, correcting…

Host: Deanna Minich, PhD Guest: Kara Fitzgerald, ND In this discussion, Kara Fitzgerald, ND and Deanna Minich, PhD explore the active process of inflammation resolution and how to provide clinical support to quench inflammation chronicity in your patients. Dr. Fitzgerald thinks of inflammation broadly, as a complex immune response to a variety of inputs. The offensive input could be a pathogenic insult like a bacterial or viral infection, and the inflammatory response is acute and protective to the patient. But when…