{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Weight loss, GLP-1s and Sarcopenia: A Podcast with John Batsis, Shen Dewar, Aruna Josyula","description":"GLP-1 receptor agonists (the "Ozempics of the world") have been a truly revolutionary pharmacological advance in modern medicine. In randomized controlled trials (RCTs), these agents have been shown to do much more than just reduce weight, including significantly reducing cardiovascular events, lowering all-cause mortality in patients with type 2 diabetes, and even slowing the progression of chronic kidney disease. But as we see their use rapidly expand among older adults, we have to ask: at what cost? In geriatrics, weight loss is rarely simple. In older bodies, GLP1s carry increased risks, including accelerated muscle loss, functional decline, and possibly decreased bone density. So are we just trading weight loss for frailty? To help us untangle this complex web, we sit down with three expert geriatricians in obesity: Dr. John Batsis, Dr. Shen Dewar, and Dr. Aruna Josyula. What We Discuss in This Episode: How age-related changes alter the distribution of fat and muscle, even when body weight stays exactly the same. What are sarcopenia (muscle loss) and sarcopenic obesity, and why are they so dangerous for independence? A discussion on what happens to fat, muscle, and bone during standard weight loss versus weight loss accelerated by GLP-1s. Whether GLP-1-induced muscle loss a direct biological side effect from suppressed muscle protein synthesis, or is it simply the indirect result of a massive caloric deficit and dropping protein intake? A broad, geriatric-focused approach to weight, including a vital review of common medications that might actually be causing weight gain in the first place. Practical, actionable strategies to protect muscle mass and function when prescribing GLP1s A discussion of red flags in older adults, where we should have major hesitation before ever writing a prescription for a GLP-1 We cover this and more in the podcast. There is a forthcoming article in JAGS that addresses this topic, and we will add the link here once published.  If you want to take a deeper dive, take a look at some of the following references we discuss: Aruna\u2019s article in JAGS titled \u201cOne Size Fits None: Developing a Person-Centered Approach to Weight Management in Older Adults\u201d John\u2019s Annal\u2019s article on the \u201cEffect of Incretin-Based and Nonpharmacologic Weight Loss on Body Composition: A Systematic Review\u201d John\u2019s article on the \u201cUnintended risks of sarcopenic obesity during weight-loss interventions in older people\u201d in Nature Med.   An article titled \u201cThe Effects of Incretin Mimetic Therapies on Muscle and Bone Health in Older Adults\u201d A systematic review of the effect of weight loss on muscle-based indices An article on \u201cTreating Sarcopenic Obesity in the Era of Incretin Therapies: Perspectives and Challenges\u201d Shen\u2019s article describing \u201cThe Optimal Health Weight and Lifestyle (OHWL) Clinic\u201d Shen\u2019s article titled \u201cA Geriatrician\u2019s Approach to Managing the Complex Older Adult with Obesity\u201d Another JAGs article on \u201cOlder Adults with Obesity: The Need for a 4Ms Age-Friendly Approach to Care\u201d Lastly, CMS\u2019s information on the GLP1 bridge program   ","author_name":"GeriPal - A Geriatrics and Palliative Medicine Podcast","author_url":"http:\/\/www.geripal.org","html":"