Update on semaglutide (and other weight loss drugs) | #20
Plus: New lung cancer screening guidelines, MDMA, and the Portfolio Diet
Greetings everyone—
We have had lots of news since the last one of these!
First, I want to welcome Amanda Applebaum to the team at Dignity Integrative. Amanda is a certified functional health coach and has additional training in nutrition. She is an expert at guiding clients to take control of their health and their life, and her approach to helping patients to identify and implement SUSTAINABLE changes aligns perfectly with my own.
Amanda has published a new blog post on the “Deep Dive,” which is part of our initial consultation. In it, we go in-depth into our patients’ lifestyles to see what is hindering or supporting their path to optimal health.
Also, we’ve recently published:
5 Integrative Medicine Book Recommendations. See what I’ve read and would recommend that influenced my views on integrative medicine.
3X4 Genetics: Personalized Care Plans from a Full Genetic Roadmap. Learn about 3X4 Genetics, a new company that we are partnering with to provide detailed genetic testing to help us create ultra-personalized care plans for each of our patients.
How integrative medicine can help manage chronic pain. Finally, we’ve published an overview of how an integrative medicine doctor can help you come up with a plan to manage and begin to reduce (or eliminate) chronic pain.
Now, on to this month’s recommendations:
#1: Semaglutide and other weight loss drugs may increase other risks of serious disease
GLP1 agonists like semaglutide and liraglutide are now being widely used to treat obesity, with or without diabetes.
According to this study of over 4,000 patients taking the medication, there is a 4x risk for pancreatitis and a 3.6x risk of gastroparesis. While these are non-life-threatening diseases, the higher risk of using these medications needs to be considered.
It is one reason we focus on the Four Pillar approach prior to considering pharmaceutical treatment.
#2: MDMA shows huge promise for treating severe depression and PTSD
PTSD is a debilitating condition that is resistant to most treatments. These results from a Phase III trial using MDMA (a psychedelic medication) compared to standard treatment showed impressive results in 100 subjects. 46% in the MDMA-assisted therapy group vs 21% in the standard treatment group met remission criteria (or were no longer considered to have PTSD). This was after 3 sessions of MDMA-assisted psychotherapy. The use of psilocybin and MDMA is showing incredible promise for those patients suffering from typical treatment-resistant severe depression and PTSD.
#3: Who Should Get Screened for Lung Cancer?
Lung cancer is the #1 cancer killer. This year, the American Cancer Society estimates about 238,340 new cases of lung cancer (117,550 in men and 120,790 in women). and about 127,070 deaths.
So, who should get screened for this killer? New guidelines lower the threshold for former smokers to anyone with a 20-pack-year history. If you are between 50-80 years of age and have smoked for the equivalent of 20 pack years (1 pack per day for 1 year equals one pack year, 2 packs per day for 1 year equals 2 pack years) get yourself screened as most lung cancers are diagnosed at advanced stage with much lower survivability long term.
#4: Evidence on the “Portfolio Diet”
The portfolio diet, developed by a Canadian researcher, has been shown to reduce cardiovascular risk by 30% in this observational study over a 30-year period following 200,000 individuals.
Higher rates of foods like beans, nuts, and those high in fiber conferred lower risk while those diets higher in saturated fat conferred higher risk.
This is very similar to findings for the Mediterranean Diet which has been the most studied dietary regimen in history. While I am not a fan of ‘diets’ I do think that maintaining a healthy nutritional regimen you can follow for the rest of your life is the best way to optimize health, and lower the risk of the big 3 (cardiovascular disease, cancer, and dementia) as well as extend healthspan.
#5: The link between sleep and dementia
Loss of slow-wave (deep) sleep as we age confers a higher risk for dementia.
This study used the Framingham data set of 346 individuals followed for five years having two sleep studies. Every 1% reduction in deep sleep translated to a 27% increased risk of developing dementia. Slow-wave sleep (SWS) supports the aging brain in many ways, including facilitating the glymphatic clearance of proteins that aggregate in Alzheimer's disease.
It is one reason we take sleep disorders very seriously and work to optimize sleep as one of the Four Pillars of health.