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In this video, obesity experts Holly Lofton, MD, and Marina Kurian, MD, discuss how clinicians can use the new weight loss medications to improve their patients' outcomes after bariatric surgery. https://www.medscape.com/viewarticle/996479?src=soc_yt -- TRANSCRIPT -- Holly Lofton, MD: Hello. I'm Dr Holly Lofton. I'm an obesity medicine specialist at NYU Langone Health in Manhattan. Today I have a special guest, Dr Marina Kurian, who is a clinical professor of surgery at NYU Langone Health and the president of the American Society for Metabolic and Bariatric Surgery. Welcome, Dr Kurian. Marina Kurian, MD: Thank you so much for having me. Holly. Thank you. Lofton: Today, I want to discuss a very hot topic, which is the combined use of bariatric surgery and antiobesity medications, because we know there are so many different modalities that are being used to treat overweight and obesity right now. Those include lifestyle interventions, antiobesity medications, and bariatric metabolic surgery. However, some patients need multiple modalities to achieve success. I want to ask you first: What are some of the more common metabolic bariatric surgeries that are performed today? Kurian: I'd say the two most common currently in the United States are the sleeve gastrectomy and the Roux-en-Y gastric bypass. In the sleeve gastrectomy, we remove a portion of the stomach, whereas in the gastric bypass, we make the stomach small and then reroute the intestines — so we don't remove any stomach in that procedure. With the sleeve gastrectomy, we expect patients to lose about 30%-35% of total body weight. And with the bypass, it can be slightly more — maybe 35%-40% of total body weight. Lofton: Have you seen patients who don't achieve this expected weight loss? Kurian: Absolutely. And when that occurs, something that we both do in our practices is to add antiobesity medication to that regimen. But first, of course, I look to see what type of diet they're on, what their caloric intake is, and what is their level of activity before I just say, "Hey, take this medication." Lofton: What would you say are other potential benefits of using antiobesity medications after bariatric surgery vs a revisional surgery or a second metabolic or bariatric surgery? Kurian: It's a complex answer. Some of the benefits obviously are if the medication can get the patient to their goal, then we're saving them an operation. I frequently do this with my patients first to see if they really would benefit from a revision. I'll start them on medication after their initial bariatric surgery to see how well they do with dietary modification and behavioral modification. And then I add the medication as well. If they lose enough weight, they don't need a bariatric revision. But if they don't lose or there's some other reason — like sometimes it's about access to the medications — then I will consider them for a revisional procedure, depending on what their initial operation was, of course. Lofton: Is there scientific evidence that antiobesity medications are better for patients after bariatric surgery than, say, just seeing a dietitian to get more results? Kurian: Absolutely. As you know, and I believe you've written some of that literature, there are plenty of articles out there that look at the use of antiobesity medications vs lifestyle change and dietary changes. Antiobesity medication along with that will really have the maximum results for patients. This is if they have weight recurrence after the initial procedure, or if they have inadequate weight loss and they're not following the trajectory that I usually feel that they should be on — based on my experience with so many patients. Lofton: That's a really good point, and I want to talk more about that for the audience. If you're a primary care physician and you're seeing someone with a previous bariatric surgery, even if it was 5 or 10 years ago, a very common practice was to refer them to a dietitian and have them log and track calories and things like that. But if the evidence is stating that they may be better managed by either seeing their bariatric surgeon for medication or revisional options, or seeing an obesity medicine specialist or even the primary care doctor prescribing medications, if the evidence is there, then that may change some of the current practices and help our patients get more success. Kurian: I think that's absolutely true. If you look at the landscape of obesity treatments that are out there, because we've had so many medications added to our arsenal, I know that many of our colleagues around the country are getting more familiar with using them in patients. I think the key to it is to try to identify who would benefit, and it is completely appropriate for the patient to be evaluated for the use of antiobesity medication, even if they've had surgery. https://www.medscape.com/viewarticle/996479?src=soc_yt

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.. ready for a KILLER routine? on a positive note: it's only 10 minutes & the music is amazing! ♥︎ / Werbung I know, we have a love-hate relationship to my 15min HIIT workout. Me too, I admit that. A 10min routine was definitely missing on my channel! Still a killer, still burning lots of calories, still breaking a sweat.. but: it's only 10 minutes :D This workout is: 1. FILLED WITH BASICS. Nothing too fancy, nothing too dancy. Ask your male partner to join! They won't need to shake their hips for this one. 2. a mix out of "QUICK MOVEMENTS" and "ACTIVE BREAKS". You will find Dolphin Holds & Planks in between all the quick movements. Almost feels like a break, but don't forget to keep the core strength :D 3. HIGH ENERGY. For some reason it doesn't drag me down - but rather gives me MORE energy! Might also be the music though. by the way: NO LUNGES. __ If you struggle or need a break: don't worry about it. Take a small rest, get something to drink & continue once you're ready :) most important is that you don't quit and push yourself. ▸ Depending on your fitness level, height and weight you will burn between 70-130 kcal. I burned about 80kcal in those 10min (which is a lot for me, I'm a small human and I normally burn about 250kcal in a 1h session). __ ▸ you can find FREE WORKOUT PLANS on my Instagram Channel. 30min, 45min and Beginner Friendly combinations. Check out the Highlight Bubble "Workout Plans" for that. ➞ Instagram http://www.instagram.com/pamela_rf/ ▸ use #PamelaReif if you want me to see your workout pics and videos! __ I update my workout playlist weekly & it's available on Spotify, Apple Music, etc. ♥︎ http://wmg.click/GetActive 1. Jason Derulo - Take You Dancing 0:00 - 3:07 2. Hyperclap - Cry for you 3:08 - 5:31 3. Wave Wave (feat. Joel Crouse) - Broke (Alle Farben Remix) 5:32 - 8:25 4. Robin Schulz - Alane (Yves V Remix) 8:26 - 10:45 __ ➞ Instagram http://www.instagram.com/pamela_rf/ ➞ Food Account http://www.instagram.com/pamgoesnuts/ __ Business Contact: [email protected] __ unterstützt durch Warner Music Germany Disclaimer: When joining me for this workout video, you need to take some precautions as your health and safety is the most important. To avoid any injury or harm, you need to check your health with your doctor before exercising. By performing any fitness exercises without supervision like with this video, you are performing them at your own risk. See a fitness professional to give you advice on your exercise form. Pamela Reif will not be responsible or liable for any injury or harm you sustain as a result of this video.

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🦠 Consider THIS ⬇️ Parasites change the endocrine system because the immune system becomes activated when they are present; causing a cytokine storm and disrupting your hormone balance ➡️ Hormones like CORTISOL, INSULIN & GLUCAGON which regulate blood sugar and stress are commonly affected These immune responses can disrupt the delicate balance of hormones, affecting the hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-thyroid (HPT) axis, and other hormonal pathways Some common symptoms of parasitic infections that I’ve seen in my Perimenopause patients are: Fatigue Weak immunity Disturbed sleep Weight changes Irregular cycles Truly the only way to rule this Root Cause out is to test-not-guess! If you’ve made it to your fourth decade and have never been dewormed - BRAVA 👏🏼 but if you suspect you may have a parasitic infection — ask your provider for a stool test :) ➡️➡️➡️ What are your thoughts on parasites? (besides the fact that they’re gross) ___________________________________________________________________________________ Looking for more? Sign up to be a part of our community (and get ONLY things I talk about over email!) sent out a few times a month: https://labwellhealthcare.com​​​​ Find me: Instagram: https://www.instagram.com/drfrancescaleblanc Pinterest: https://www.pinterest.com/drfleblanc/​​​​ ----------------------------------------------------------------- *This content is strictly the opinion of Dr. Francesca LeBlanc, and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. LeBlanc nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.

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What’s the best way to lose weight? It’s not exercise or cutting calories; it’s by changing what’s on your fork. It’s not calories in, calories out; where they come from counts so much more because food is information. You want the food you eat to tell your body to burn fat, create sustained energy, slow the aging process and reduce inflammation. Eat the wrong foods and the message is just the opposite, leading to headaches, gas and bloating, joint pain, skin problems, fatigue and cravings, all signs of food intolerances. The seven most common food intolerances are gluten, dairy, eggs, soy, corn, peanuts, sugar and artificial sweeteners. In the Virgin Diet I say drop seven foods, lose seven pounds in just seven days. Combined with my other secret weapon, you can practically guarantee your success. What is it? You write it down! Not just the good stuff, write it all down so you can look back and understand, “Why do I feel so crappy today?” Losing weight and getting healthy shouldn’t be hard. Find those foods that really work for your body, it becomes practically effortless! --- Any one of our videos have the power to transform your body and your life so make sure you never miss one by clicking here to subscribe https://www.youtube.com/user/jjvirginvideos?sub_confirmation=1 MY MOST POPULAR VIDEOS: https://youtube.com/playlist?list=PLrjR6f-fNMKpEdQl1RmBUPsYJLqaxcG3c THE VIRGIN DIET - LIFESTYLE SHOW: https://youtube.com/playlist?list=PLrjR6f-fNMKq5wxJNvbVeJIgMg8IKsmKC HEALTHY RECIPES: https://youtube.com/playlist?list=PLrjR6f-fNMKrLNl2LbtW-Zegitvge4iSL --- Hi I’m JJ, welcome to my channel. If you’re looking to lose weight, boost your energy and look and feel fabulous and fit over 40, you’re in the right place. Here you’ll find the healthy recipes, fitness routines and the nutrition information you need to achieve healthy weight loss that stays off. Welcome to the family! --- #JJVirgin #FatLoss #WeightLoss ---

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