We should be screening everyone with hypertension for primary aldosteronism, according to the recently released Endocrine Society guidelines. Follow this diagnostic algorithm Full guidelines: academic.oup.com/jcem/article...

How to individualize obesity medication treatment depending on obesity-related conditions. Great summary by the newly released update to the AACE Evaluation and Treatment of Adults with Obesity 2025 Consensus Statement www.endocrinepractice.org/article/S153...

Developing clinical practice guidelines is quite a process. The GRADE format methodology translates evidence to medication decision-making recommendations after performing systemic review of the available evidence. www.bmj.com/content/389/...

A higher BMI is correlated with increased risk of overall mortality. It follows the same overall curve as higher cholesterol and blood pressure, as illustrated in these graphs 📈 Controlling any and all of these risk factors lowers our overall risk of death. pubmed.ncbi.nlm.nih.gov/28489290/

Obesity rates have skyrocketed starting in the 1970s now reaching 40% in the United States. "It seems highly unlikely that the obesity epidemic can be explained by a widespread drop in willpower happening in the late 1970s." www.cell.com/cell/fulltex...

A collection of all my favorite podcasts to stay up to date in Diabetes Care Check out this Marvel-style crossover episode hosted at ADA. overcast.fm/+AABFhuN39pM

Rates of obesity of BMI 30-40 have had a mild increase over the last 20 years. Rates of severe obesity BMI > 60 has dramatically risen- this graph is impressive. Slide by Dr. Satya Dash at #ENDO2025

Pheochromocytoma survival curves are dismal, particularly in those with metastatic disease. We need better treatments for these patients. Excellent lecture by Dr. Camilo Jimenez at #ENDO2025

Multiple benefits of GLP1s in reducing residual risk in those with type 1 diabetes. Excellent talk by Dr. Kaitlin Love at #ENDO2025

GLP1 agonism prevents cardiovascular disease through both direct and indirect vascular effects #ENDO2025

Studies showing benefits of GLP1 agonists in type 1 diabetes are accumulating. Modest A1c reduction but impressive reductions in total daily insulin dose and weight reduction. #ENDO2025

Retatrutide may be the most hotly anticipated GLP-1 based medication in development 🔥💊, but others are not far behind 🏃. A triple agonist, UBT251, is under development in China 🇨🇳 and also mimics GLP-1, GIP, and glucagon 🧬⚗️.

“Food noise” is the “incessant mental chatter” or “constant rumination” about food. It is increasingly recognized as a phenomenon particularly with its profound elimination with GLP1 treatment. New Nature review: www.nature.com/articles/s41... Great overview: conscienhealth.org/2025/07/lift...

“If you treat someone’s blood pressure or cholesterol you don’t get improvements in quality of life. You treat their weight you get all the benefits." "That is the power of treating obesity.” Inspiring talk by Dr. Lou Aronne on the clinical implications of CagriSema at #ADASciSessions #ADA2025

The long awaited triple agonist retatrutide phase 3 data is still pending ⏳🧪. However, a body composition subanalysis of the phase 2 data is newly published 📄 showing lean mass loss of 38% of total weight loss 💪📉.

The etiology of obesity is most often multifactorial- a combination of environmental factors and genetic predisposition among thousands of genes. However, a portion of cases are due to a single genetic cause, such as in the leptin-melanocortin pathway. academic.oup.com/edrv/article...

What is the impact of tirzepatide on body composition? 🤔 There was an absolute loss in lean mass 💪⬇️, however there was a GREATER loss in fat mass 🧈🔥. Thus, there was an increase in lean mass as percent body composition 📊💪. This correlates with what we see clinically

How should we think about the interesting bimagrumab & Semaglutide data #ADA2025 #weightloss #obesity How to assess meaningful functional benefit? www.statnews.com/2025/06/23/b...

P2 data for the once monthly GIPR Antagonist GLP-1R agonist bispecific antibody, Maritide in people with #T2D as well as in #overweight and #obesity Even data for lower dose titration over several weeks in the same paper www.nejm.org/doi/full/10....

We’ve gone from 2 to over a dozen trials of GLP1s in alcohol use disorders in only a few years. This comes on the heels of numerous observational and pharmacoepidiologic data supporting a reduction in alcohol use in GLP1 users. #ADA2025 #ADASciSessions

Continuous glucose monitors are an excellent tool… when they work! Studies report up to 26% early failure rate of these devices. #ADA2025 #ADASciSessions

There is a national shortage of endocrinologists! The majority of the country do not have local access to endocrinologists. 80% of those with diabetes are cared for by a PCP and no endocrinologist. #ADA2025 #ADASciSessions

The prevalence of type 2 diabetes in the young is rising, and so are the complications. 80% of individuals develop a microvascular complication by 9 years over 9 years of follow-up! #ADA2025 #ADASciSessions

❗ New CagriSema Phase 3 data released Combination cagrilintide-semaglutide after 68 weeks in patients with Type 2 Diabetes and BMI > 27 ⬇️ 13.7% weight loss vs 3.4% in placebo ⬇️ 1.8% a1c reduction vs 0.4% in placebo 73% had a1c <6.5% 🤢 72.5% had gastrointestinal side effects vs 34% in placebo

Tirzepatide in a target emulation trial demonstrates significantly lower MACE (HR 0.8) and all cause mortality (HR 0.6) compared to dulaglutide in T2DM. 🤯 #ADASciSessions #ADA2025

CAC > 300 is equivalent to prior ASCVD for risk of future cardiovascular events. One could consider treating someone with CAC > 300 as SECONDARY prevention, not primary prevention. Similar risk = similar therapies. #ADA2025 #ADASciSessions

💉 GLP-1s were associated with 23% lower risk of mortality in those with type 2 diabetes on dialysis compared to non-users💡 🙏 Honored to be co-author on this observational analysis of 151,649 dialysis patients with type 2 diabetes, published today 📅 journals.lww.com/cjasn/abstra...

Martin Fassnacht et al present & discuss the challenges involved in the management of patients with adrenocortical carcinoma, together with their personal recommendations regarding 25 of what they believe are the most crucial clinical questions www.thelancet.com/journals/lan... #EndoSky #OncSky

An argument for reduced dosing frequency of GLP-1s 💉 to maintain long-term weight loss ⚖️, based on mathematical modeling 📊: ➡️ Switching semaglutide from 1x/week to 1x/2 weeks = 50% fewer doses but 72% of weight loss retained ✅ onlinelibrary.wiley.com/doi/10.1002/...

💉 Once weekly fixed dose GLP1+insulin is one step closer to approval 💯 Two trials with once weekly basal insulin icodic and GLP-1 receptor agonist semaglutide (IcoSema) were recently published in Lancet. pubmed.ncbi.nlm.nih.gov/40482672/

Most people with type 2 diabetes have adiposopathy-related diabetes—driven by excess visceral fat 🫃 and inflammation 🔥. We need an adipocentric approach: targeting fat loss ⚖️, not just blood sugar 🩸, to improve outcomes ✅ and even reverse disease 🔄. Review article: www.mdpi.com/2077-0383/14...

In order to provide comprehensive obesity, care a clinic should strive to use multiple ways of evaluating success. www.ichom.org/patient-cent...

Proud to contribute to the latest Core IM episode on Continuous Glucose Monitors! www.coreimpodcast.com/2025/06/02/c...

The latest expert guidance on "Nutritional priorities to support GLP-1 therapy for obesity".

What can't metformin do? Metformin decreased the risk of renal function deterioration, according to a retrospective observational multicenter cohort study included 316 693 patients with type 2 diabetes.

🚨 The first oral therapy for pheochromocytoma is approved by the FDA. Belzutifan is now approved to treat locally advanced, unresectable, or metastatic pheochromocytoma or paraganglioma. Belzutifan inhibits HIF-2a and is already approved for Advanced Renal Cell Carcinoma and von Hippel-Lindau

🌟 A new Perioperative management of GLP1s consensus statement has just dropped In those taking GLP1s without gastrointestinal symptoms (nausea, vomiting): GLP1s should be continued perioperatively 24 hour fast for solids 4 hour fast of clear liquids before general anesthesia

Potential market competition is fierce in the obesity space. We are not tapped out on the added benefits future medications can have on top of current options. Source: ICER White Paper icer.org/wp-content/u...

Over half of adults in the United States, 136 million, are eligible to receive GLP1-RA 🫨 Who benefits most? How costly is this for the healthcare system? How much downstream costs are offset by preventing obesity-related diseases? Answers to these questions will best help resource allocation

$480 billion in direct healthcare costs can be attributed to the associated diseases caused by obesity. $1.2 trillion in indirect costs (2016)

🆙 GLP1 discontinuation after one year is high Treatment discontinuation rate varies by study but can be 50% after 1 year. 👨‍🦳 🤢 Age >65 and gastrointestinal events are predictors of higher discontinuation rates. Those with type 2 diabetes have lower discontinuation rates.

Why does tirzepatide have a more tolerable gastrointestinal side effect profile than semaglutide? 🤢 🤲 GIP agonism coupled with GLP1 receptor agonism decreases gastrointestinal side effects. In a study of a long-acting GIP added to liraglutide attenuated GI side effect rates seen with liraglutide.

There are numerous GLP-1 actions throughout the body. There is an ever-growing list of established indications for GLP-1 based medications. And an even more rapid expanding list of investigations indications. What an exciting time to be a researcher in this space! Source: Drucker, 2025

Is the weight loss with GLP1s due to the gastrointestinal side effects? 🤔 No, not according to the trials. Studies of semaglutide and tirzepatide show that gastrointestinal side effects had minimal contribution (<6%) to the weight loss achieved. doi.org/10.1111/dom.... doi.org/10.1111/dom....

A decade ago insulin sensitizers as a treatment for Type 2 Diabetes were looking to go the way of the dodo 🥲 . Rosiglitazone, an insulin sensitizer, showed increase CV events, when a goal of T2DM treatment is to prevent these events 💯 However, promising future approaches are under investigation

The first oral small molecule GLP-1, orforglipron, ACHIEVEd 1.3-1.6% a1c reduction in patients with type 2 diabetes. 🤯 💯 This a1c reduction makes orforglipron one of the most effective oral medications for type 2 diabetes. investor.lilly.com/news-release...

Hand grip strength is predictive of overall mortality with a J shaped curve relationship in older adults with severe obesity. Strength above 31kg was the minimum and 36kg was the optimal strength level. www.nature.com/articles/s41...

📝 More and more recommendations and evidence exists to minimize ultra-processed foods. But what are they? 🤔 www.frontiersin.org/journals/nut...

Roux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding. Sleeve gastrectomy has inferior weight loss and lower mean quality of life score compared with Roux-en-Y gastric bypass. www.thelancet.com/journals/lan...