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Drs Piña and Kosiborod discuss semaglutide in obesity-related HF with and without diabetes. Both STEP HFpEF trials show similar HF benefits despite less weight loss in patients with diabetes. https://www.medscape.com/viewarticle/semaglutide-benefits-hfpef-take-step-beyond-weight-loss-2024a10006z2?src=soc_yt -- TRANSCRIPT -- Ileana L. Piña, MD, MPH: Hello, and welcome to my blog. Today, I'm at the American College of Cardiology in Atlanta. I want to introduce and welcome Dr Kosiborod: from the Mid America Heart Institute, who has presented a very impactful paper, STEP HFpEF DM, that is in The New England Journal of Medicine right now. This is about semaglutide. A lot of patients ask me to give them that pill that makes them lose weight. I see primarily patients with heart failure (HF). So, Mikhail, congratulations on your presentation. Give us a little synopsis of what the trial is about. The STEP HFpEF Program Mikhail N. Kosiborod, MD: First of all, it is always a pleasure to be with you. Maybe a quick word about the STEP HFpEF program that included two trials: The first is STEP HFpEF, which was a trial of patients with obesity-related HF with preserved ejection fraction (HFpEF) who did not have diabetes, which we presented and published at European Society of Cardiology in August last year. The second installment of the program is the STEP HFpEF diabetes trial, which is essentially the same population of patients except they also have type 2 diabetes. I guess your question would be why we did two trials instead of just doing one trial that included patients, both with and without diabetes. I'll come back to that shortly. The crux of the hypothesis behind the program is that we all know the prevalence of HFpEF has increased dramatically in the past couple of decades. When I was a fellow in training, it was rare for me to see a patient with HF who had preserved EF. A majority of patients had HF with reduced EF. Now, the majority of people we see have HFpEF: Why did that happen? There are a lot of different reasons for the dramatic change in epidemiology. But certainly, one of them, at least in our opinion, is that the obesity epidemic has a lot to do with it. In fact, if you look at the population of patients with HFpEF in the United States, 80% of them are living with overweight or obesity. The hypothesis behind the program was that obesity is not just a comorbidity. It doesn't just happen to coexist by accident in this patient population, it may in fact be causing their HF. It may be a critical factor in the development and progression of HFpEF. In order to test our hypotheses, patients were randomly assigned to semaglutide, with the target dose of 2.4 mg once a week or matching placebo and treated for 52 weeks, or 1 year. The reason we did two separate trials is because part of that hypothesis was that if obesity is in fact the cause of HF, then certainly, weight loss would be probably not the only factor but "an important factor in the potential benefits of semaglutide in this patient population, provided that semaglutide is beneficial which of course we ultimately demonstrated. But what we knew from weight-loss trials — not HF trials but weight-loss trials of medications like semaglutide and also other anti-obesity medications like tirzepatide and others — is that people with diabetes tend to lose a lot less weight. With these medications, there's about a 40% less weight loss in people with type 2 diabetes. Lots of theoretical reasons why that could be the case. Nobody really knows for sure. We knew from the beginning that the weight loss likely was going to be different. Then, of course, there are other things that happen in people with diabetes: They have more severe HFpEF phenotype, and people with more severe disease sometimes don't respond to treatment the same way as those with less severe disease. Finally, we knew when we started the trial, which was back around 2019, 2020, that people with diabetes would be more likely to be treated with sodium-glucose cotransporter 2 (SGLT2) inhibitors. At the time, we didn't have the data for SLT2 inhibitors in HFpEF, but we knew that were going to be tested. There was, of course, an expectation that they may well be beneficial. For all of these reasons, we said, "You know what, the treatment effects may well be different between the patient population, but let's study them separately." Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/semaglutide-benefits-hfpef-take-step-beyond-weight-loss-2024a10006z2?src=soc_yt

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Understanding Chrissy Metz and Her Journey

Chrissy Metz, widely recognized for her compelling role as Kate Pearson on the hit NBC television series “This Is Us,” has become a beacon of hope and inspiration for millions around the world. Her journey has not only captivated audiences through her performances but also touched hearts with her real-life struggles and triumphs, particularly regarding weight loss. Metz’s openness about her personal battles with weight has made her an advocate for body positivity and self-acceptance. While many may see her as just an actress, her story extends far beyond the silver screen. It’s a narrative of resilience, passion, and commitment to change.

Metz has grappled with her weight since childhood, a struggle that many can relate to. Growing up in a society that often prioritizes thinness, she faced bullying and criticism, which affected her self-esteem and mental health. Despite these challenges, Chrissy developed a love for acting and storytelling, which became outlets for her emotions. Her path was neither straightforward nor easy; it was filled with challenges that tested her strength. However, her commitment to her craft eventually led her to success, allowing her to translate her struggles into relatable characters that resonate with audiences.

As Metz rose to fame, she decided to take charge of her health both for her own sake and as an example to her fans. This pivotal moment led to her incredible 100-pound weight loss journey. She started to adopt healthier lifestyle choices, focusing on nutrition and exercise while also addressing emotional aspects tied to her relationship with food. Her decision to lose weight was not just for aesthetic reasons but stemmed from her desire to improve her overall well-being and to combat the underlying health issues associated with obesity. This decision has inspired many fans to take a step towards healthier living.

The Decision to Change

One of the most significant turning points in Chrissy Metz’s life was the moment she decided to embark on her weight loss journey. This decision was not made lightly; it stemmed from a deep-seated desire to improve her health. Recognizing the impact that her weight had on her life, she sought the guidance of doctors and nutritionists to understand the long-term effects her lifestyle choices could have. Metz’s realization of the health risks associated with her weight was a catalyst for change. She recognized that her decision to lose weight was not merely about appearance but rather about achieving a holistic sense of well-being.

The beginning of Metz’s weight loss journey involved adopting a balanced diet. Instead of resorting to extreme dieting methods that could jeopardize her health, she focused on creating sustainable eating habits. By making gradual changes to her meals, she learned to embrace whole foods filled with nutrients while reducing processed food consumption. These dietary adjustments opened the door to not just weight loss but also enhanced energy levels and improved mental clarity. Chrissy took an honest approach to her food choices, realizing that indulging every so often did not equate to failure but rather to moderation.

In tandem with dietary changes, Metz incorporated physical activity into her daily routine. Initially, the prospect of exercising regularly was daunting. However, she saw it as an opportunity to explore various fun activities that kept her motivated. From walking to engaging in group fitness classes, each small step boosted her confidence. The more she moved, the more she discovered the joy of physical activity. This newfound enthusiasm not only aided in weight loss but also fostered a sense of community with others who shared similar fitness goals. The combination of mindful eating and consistent exercise laid the foundation for her transformative journey.

Overcoming Mental Barriers

Beneath the physical changes that Chrissy Metz underwent, a profound mental shift occurred. One of the most challenging aspects of her journey was confronting the emotional connections she had with food. Growing up, Metz sometimes turned to food for comfort during difficult times, and identifying these triggers was crucial in breaking unhealthy patterns. Therapy played a significant role in helping her understand her emotions better and develop healthier coping mechanisms. It was through professional support that she learned the importance of self-acceptance and self-love.

Additionally, Chrissy faced societal expectations and pressures regarding her body image. Being in the public eye magnified her challenges, but she used this visibility as a platform to advocate for authenticity and acceptance. Metz became vocal about the struggles that many individuals endure concerning body image, making it her mission to promote a narrative of strength in vulnerability. Her candidness about her insecurities resonated with many, proving that openness about one’s struggles could foster unity among those facing similar challenges.

The journey to mental well-being also involved celebrating small victories. Metz learned to appreciate each milestone, whether it was a pound lost or simply feeling more energetic. By recognizing the importance of self-compassion, she cultivated a positive relationship with her body. Emphasizing progress over perfection became her mantra, allowing her to enjoy the journey rather than obsess over the destination. This mental transformation was just as crucial as the physical changes, ultimately leading to a more fulfilling and balanced life.

Sharing Her Story

Chrissy Metz’s willingness to share her weight loss journey has inspired countless individuals, serving as a testament to the power of vulnerability and authenticity. By openly discussing her experiences, she has created a supportive community of followers who relate to her struggles. Her story reflects the notion that change is possible, no matter the starting point, and that one needs to confront not only the physical challenges but also the emotional ones. Through interviews, social media platforms, and public appearances, Metz has used her platform to shed light on the realities of weight loss and the importance of self-acceptance.

In addition to her personal narrative, Metz has inspired others to embrace their journeys, emphasizing the significance of community and support systems. She advocates for individuals to share their experiences, no matter how daunting. By highlighting the importance of connection and understanding, she encourages others to step out of isolation and into a network of shared experiences. This approach cultivates an environment where individuals can empower each other, creating a ripple effect that encourages more people to be vulnerable and honest about their challenges.

Moreover, Chrissy’s story extends beyond her personal life; it integrates into her professional career as well. Her portrayal of Kate Pearson has received accolades, in part because of the authenticity she imbues into the character, which mirrors her real-life struggles. Through art, Metz communicates her message that authenticity stems from one’s ability to share their story, embrace imperfections, and find strength in vulnerability. This alignment between her personal journey and her professional endeavors reinforces her role as a powerful advocate for body positivity and self-love.

A New Chapter: Maintaining a Healthy Lifestyle

As Chrissy Metz continues her journey, maintaining a healthy lifestyle has become her primary focus. The 100-pound weight loss was not merely a destination but a significant transformation that she intends to uphold. Metz emphasizes that embracing a healthy lifestyle is an ongoing process, requiring continuous dedication and effort. Rather than viewing it as a one-time achievement, she understands the importance of making mindful choices daily to preserve her well-being and stay motivated on her path. This realization is pivotal in showcasing how sustainable practices yield long-term benefits, confirming that health is a lifelong commitment.

In her pursuit of healthier living, Chrissy has learned the importance of balance. This means allowing herself the occasional treat without feeling guilty, which fosters a commendable relationship with food. By following a balanced approach, she continues to enjoy meals, explore new recipes, and maintain a fulfilled life while prioritizing her health. This moderation not only aids her physical health but also supports her emotional well-being, enhancing her overall quality of life.

Community support also remains integral to Metz’s success. Engaging with fellow supporters who share similar aspirations contributes to her motivation and accountability. This network aids in sustaining healthy habits, exchanging recipes, fitness routines, and tips for maintaining mental health. Metz has highlighted how these connections foster resilience and create a supportive environment for people to grow together. Ultimately, her emphasis is not solely on weight loss, but rather on the holistic journey of embracing life, fostering relationships, and cultivating joy.

Celebrating the Journey

Chrissy Metz’s weight loss journey goes far beyond the numbers on a scale; it celebrates resilience, courage, and self-discovery. By sharing her story, she encourages others to embrace their transformations, acknowledging that everyone’s journey is unique and personal. This celebration is not about achieving a ‘perfect’ body but rather about feeling good within oneself. Metz’s transparent narrative challenges societal views on beauty, reinforcing the idea that self-love and acceptance triumph over temporary aesthetic standards.

The importance of community and connection stands at the forefront of Metz’s philosophy regarding personal growth. Celebrating each other’s stories can foster an environment of encouragement that inspires individuals to take charge of their health. Chrissy’s journey serves as a reminder that every step, no matter how small, is worthy of recognition and appreciation. This culture of celebration cultivates positivity surrounding body image, allowing individuals to take pride in their efforts and progress.

In concluding her journey, Metz has reminded her followers that transformation is not about perfection; it’s about continuous growth and learning. Her candidness about setbacks, triumphs, and everything in between creates realistic expectations for those embarking on similar journeys. Ultimately, Chrissy Metz’s narrative is an invitation for individuals to appreciate their unique paths and to embrace their worth, passion, and potential while living authentically and confidently.

Summary and Frequently Asked Questions

Chrissy Metz’s inspiring journey of losing 100 pounds resonates with many who face their own battles with weight and self-image. Her story reflects the powerful interplay between physical health and mental well-being, making her narrative rich with lessons for those aiming for similar transformations. Transitioning from a place of vulnerability to one of strength, Metz has become a symbol of hope, encouraging people to confront their challenges with grace and tenacity.

Many often wonder about the specifics of her journey, including the methods she employed to achieve such significant weight loss. Chrissy Metz has openly shared that it involved a combination of mindful eating, regular physical activity, and addressing the emotional aspects associated with food. The essential lesson here is that weight loss is not about quick fixes but rather about developing sustainable habits, seeking support, and engaging in positive self-talk.

Another common query regards how she maintains her new healthy lifestyle. Metz emphasizes the importance of balance, ensuring that she treats herself occasionally without derailing her overall health goals. She advocates for embracing food as a source of nourishment and enjoyment while fostering a positive relationship with it. This healthy perspective aids in sustaining her transformed lifestyle, proving that it is possible to prioritize health without sacrificing joy. Through her story, Chrissy Metz continues to inspire others to celebrate their journeys, no matter the ups and downs.

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Weight loss can be a challenging journey for many individuals. From trying various diets to exercising regularly, finding the right method to shed unwanted pounds can often feel like a never-ending battle. However, a new medication called Semaglutide has been making waves in the weight loss industry. This drug, originally used to treat type 2 diabetes, has shown promising results in helping individuals achieve significant weight loss. In this article, we will explore what to expect when using Semaglutide for weight loss.

How does Semaglutide work?

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that works by mimicking the effects of a hormone called incretin. This hormone is released in the intestine in response to food intake and helps regulate blood sugar levels. By activating the GLP-1 receptors in the brain, Semaglutide can increase feelings of fullness, reduce appetite, and slow down stomach emptying. These effects can lead to a decreased caloric intake, ultimately resulting in weight loss.

In addition to its effects on appetite and food intake, Semaglutide also has metabolic benefits. It can improve insulin sensitivity, reduce liver fat content, and increase energy expenditure. These metabolic changes can further contribute to weight loss and improvements in overall health.

Overall, Semaglutide offers a comprehensive approach to weight loss by targeting multiple aspects of metabolism and appetite regulation. This makes it a promising option for individuals struggling to lose weight through traditional methods.

What are the expected results?

Clinical trials have shown that Semaglutide can help individuals achieve significant weight loss. In a study published in The New England Journal of Medicine, participants who took Semaglutide lost an average of 15-20% of their body weight over 68 weeks. This level of weight loss is considered to be clinically significant and can lead to improvements in various health parameters, such as blood pressure, cholesterol levels, and blood sugar control.

It is important to note that individual results may vary, and the amount of weight lost will depend on factors such as starting weight, diet, exercise habits, and adherence to the medication. However, Semaglutide has consistently demonstrated superior weight loss outcomes compared to other weight loss interventions.





Moreover, the benefits of Semaglutide extend beyond weight loss. Studies have shown that this medication can also help reduce the risk of developing obesity-related complications, such as cardiovascular disease, stroke, and type 2 diabetes. By promoting weight loss and improving metabolic health, Semaglutide can have a positive impact on overall well-being.

What are the potential side effects?

Like any medication, Semaglutide can cause side effects in some individuals. The most common side effects reported in clinical trials include nausea, diarrhea, constipation, vomiting, and abdominal pain. These side effects are usually mild to moderate in severity and tend to improve over time as the body adjusts to the medication.

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In rare cases, Semaglutide can also cause more serious side effects, such as pancreatitis, gallbladder disease, and kidney problems. It is important to discuss the potential risks and benefits of Semaglutide with a healthcare provider before starting treatment. Patients should be monitored closely for any signs of adverse reactions while taking this medication.

Overall, the safety profile of Semaglutide is favorable, and the benefits of weight loss and improved metabolic health typically outweigh the potential risks. However, it is important to consult a healthcare provider for personalized advice and guidance on using Semaglutide for weight loss.

How to use Semaglutide for weight loss?

Semaglutide is typically administered as a once-weekly injection under the skin. The dosage may vary depending on the individual’s weight loss goals and tolerance to the medication. It is important to follow the prescribed dosing schedule and instructions provided by a healthcare provider.

In addition to taking Semaglutide, individuals are encouraged to follow a healthy diet and exercise regimen to maximize the benefits of the medication. A balanced diet rich in fruits, vegetables, lean proteins, and whole grains, combined with regular physical activity, can support weight loss and overall well-being.

It is also essential to monitor progress regularly and communicate any concerns or challenges with a healthcare provider. Adjustments to the dosage or treatment plan may be necessary to ensure optimal results and minimize side effects. By working closely with a healthcare team, individuals can achieve successful weight loss with Semaglutide.

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Dr. Mehmet Oz, popularly known as Dr. Oz, is a renowned cardiothoracic surgeon and television personality who has gained fame for his health advice and guidance on weight loss. Over the years, he has recommended various weight loss pills that claim to help individuals shed excess pounds effectively. In this article, we will take a closer look at some of the top weight loss pills recommended by Dr. Oz and examine their potential benefits and side effects.

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One of the weight loss pills that Dr. Oz has endorsed is green coffee bean extract. This supplement is derived from unroasted coffee beans and contains high levels of chlorogenic acid, a compound believed to aid in weight loss by reducing the absorption of carbohydrates from the digestive tract. According to Dr. Oz, green coffee bean extract can boost metabolism and promote fat burning, making it a popular choice among individuals looking to lose weight.

However, it’s essential to note that the effectiveness of green coffee bean extract for weight loss is still debated among experts. While some studies have shown promising results, others have found limited evidence to support its weight loss claims. Additionally, like any supplement, green coffee bean extract may cause side effects such as jitteriness, anxiety, and digestive issues in some individuals.

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Another weight loss pill recommended by Dr. Oz is Garcinia Cambogia, a tropical fruit also known as Malabar tamarind. Garcinia Cambogia is believed to suppress appetite and block the production of fat in the body, making it a popular choice for individuals seeking to control their weight. Dr. Oz has highlighted the potential benefits of Garcinia Cambogia in his show, claiming that it can help individuals lose weight without the need for rigorous dieting or exercise.

While some studies have shown that Garcinia Cambogia may aid in weight loss, the evidence is still inconclusive. Some research suggests that the active ingredient in Garcinia Cambogia, hydroxycitric acid (HCA), may help prevent fat storage and reduce appetite. However, more rigorous studies are needed to confirm these claims and determine the long-term effects of Garcinia Cambogia on weight loss.

Raspberry Ketones

Raspberry ketones are natural substances that give raspberries their distinct aroma and flavor. These compounds are also believed to aid in weight loss by increasing the breakdown of fat in the body and regulating metabolism. Dr. Oz has recommended raspberry ketones as a weight loss supplement, claiming that they can help individuals burn fat effectively and achieve their weight loss goals.

While some studies have shown that raspberry ketones may promote weight loss in animal studies, there is limited evidence to support their effectiveness in humans. Additionally, the safety and long-term effects of raspberry ketones as a weight loss supplement are not well understood. Individuals considering raspberry ketones for weight loss should consult with a healthcare provider to discuss potential risks and benefits.

CLA (Conjugated Linoleic Acid)

CLA, or Conjugated Linoleic Acid, is a type of fatty acid found in dairy and meat products. This supplement is believed to promote weight loss by reducing body fat, increasing metabolism, and enhancing muscle growth. Dr. Oz has recommended CLA as a weight loss aid, citing its potential benefits in burning fat and improving body composition.

Some studies have suggested that CLA may aid in weight loss by reducing appetite, boosting metabolism, and increasing the breakdown of fat in the body. However, the evidence on CLA’s effectiveness for weight loss is mixed, with some studies showing limited results. Individuals considering CLA as a weight loss supplement should consult with a healthcare provider to determine if it is a safe and appropriate option for their weight loss goals.

Pyruvate

Pyruvate is a natural compound that plays a crucial role in energy production and metabolism in the body. This supplement is believed to aid in weight loss by enhancing fat metabolism, reducing appetite, and boosting energy levels. Dr. Oz has discussed the potential benefits of pyruvate for weight loss, highlighting its ability to support fat burning and promote weight loss without the need for drastic dieting or exercise.

While some studies have shown that pyruvate may help individuals lose weight by increasing metabolism and burning fat, the evidence is still limited. More research is needed to confirm the efficacy of pyruvate as a weight loss supplement and determine its long-term effects on weight management. Individuals interested in pyruvate for weight loss should consult with a healthcare provider to discuss its potential benefits and risks.

Weight loss pills recommended by Dr. Oz have gained popularity for their potential to aid in weight loss and improve overall health. However, it’s essential to approach these supplements with caution and consult with a healthcare provider before incorporating them into your weight loss routine. While some weight loss pills may offer benefits, others may have limited evidence to support their effectiveness or cause adverse side effects. By staying informed and making informed decisions about weight loss pills, you can take steps towards achieving your weight loss goals in a safe and healthy manner.

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