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Dr David Johnson highlights new preoperative recommendations to protect against consequences of some diabetes and weight loss drugs that delay gastric emptying. https://www.medscape.com/viewarticle/994762?src=soc_yt -- TRANSCRIPT --- Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology in Eastern Virginia Medical School in Norfolk, Virginia. Recent national media attention has focused on the gastrointestinal (GI) side effects of glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs are used to treat type 2 diabetes and weight loss. The GI side effects include nausea, vomiting, and gastroparesis-like symptoms. I wanted to emphasize two key points especially important to clinicians providing this class of therapy. One: Clinicians need to be increasingly aware of the potential GI side effects and inform their patients when they start to prescribe these medications. And two: The American Society of Anesthesiologists (ASA) has recently released consensus-based recommendations for preoperative assessment and management of adults and children undergoing surgery who are taking these medications. The recommendations also apply to endoscopic procedures whereby anesthesia will be delivered. Gastric Impact of GLP-1 Agonists What are these GLP-1 agonists? The drugs for weight loss include liraglutide (Saxenda and Victoza) and semaglutide (Ozempic, Wegovy, Rybelsus, among others). The type 2 diabetes medications include semaglutide, dulaglutide (Trulicity), and exenatide (Byetta, Bydureon BCise), among others. They can be taken daily or by injection once a week. The GLP-1 agonist drug class works at the GI level to increase insulin secretion and decrease glucagon release, both of which mediate glycemic control, particularly postprandially. The drugs slow the gastric motility through decreased peristalsis and increased tonic contractility of the pylorus, essentially causing a delay in gastric emptying. Dr Michael Camilleri and his colleagues at the Mayo Clinic, in Rochester, Minnesota, conducted a small randomized, placebo-controlled double-blind study of the GLP-1 agonist liraglutide to investigate the mechanism of weight loss in patients who were overweight. They showed that there was a diminution in gastric emptying over 16 weeks in patients taking liraglutide. They found evidence of tachyphylaxis, but the rate of gastric emptying of solids remained slow compared with placebo, even at 16 weeks. Despite the observed waning of the gastric impact, we just don't know how long significant side effects persist when patients stop the drug for good. There are some reports of patients with protracted symptoms a year or more after they've stopped their GLP-1 agonist medications. Guidance for Preoperative Management These drugs would commonly be reviewed before patients go through procedures, and we need to be better aware as we start to see these patients for endoscopy. The ASA recommendations address the potential consequences of delayed gastric emptying and provide guidance for preoperative management of these drugs to prevent regurgitation and pulmonary aspiration of gastric contents. In patients on daily dosing, the ASA recommends holding these agents the day prior to the procedure. For patients on weekly dosing, the recommendations suggest withholding the dose a week before the procedure. Importantly, this should be in consultation with their diabetologist, just to assess any need for a bridging therapy to avoid hypoglycemia. On the day of the procedure, if GI symptoms, such as severe nausea, vomiting, retching, abdominal pain, and bloating, are present, clinicians should consider delaying the elective procedure and discuss the risks of the potential risks for aspiration. If the patient has no symptoms and the GLP-1 agonist has been withheld as advised, then you should proceed as usual. But if the patient has no symptoms and has not held their GLP-1 agonist, you should proceed with what the anesthesiologists call the "full stomach" precaution, which considers patients at potentially high risk for aspiration. There's a way of checking for that. Some centers can do a quick ultrasound on the stomach and see if there's food, debris, or liquid, and if that is not the case, they could proceed with no delay. But if there is no way to check gastric contents, then you should manage accordingly, which may require intubation or postponing an elective procedure for another day. These are new and changing issues. In our world as gastroenterologists, we should be considering — very strongly — mitigating strategies to protect the patients on this wonderful class of therapy. Sometimes these drugs can have significant side effects that we need to at least be aware of. Nothing is perfect, but let us be better informed. https://www.medscape.com/viewarticle/994762?src=soc_yt
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Ketorganix Gummies are a new player in the keto supplement field, offering a convenient and delicious way to support your ketogenic lifestyle. These gummies are formulated with high-quality ingredients that can help you stay in ketosis and reach your weight loss goals. With their tasty flavors and easy-to-use format, Ketorganix Gummies are quickly becoming a popular choice among those following a ketogenic diet.
Benefits of Ketorganix Gummies
One of the main benefits of Ketorganix Gummies is their ability to support ketosis. These gummies contain exogenous ketones, which can help your body enter ketosis more quickly and stay there longer. This can help you burn fat more efficiently and reach your weight loss goals faster. Additionally, Ketorganix Gummies are formulated with other key ingredients like MCT oil and collagen, which can help support overall health and wellness while on a ketogenic diet.
Another benefit of Ketorganix Gummies is their convenience. Unlike traditional supplements that come in pill or powder form, these gummies are easy to take on the go. Simply pop a few gummies in your mouth whenever you need a keto boost, no water or mixing required. This makes it easier to stay on track with your keto goals, even when you’re busy or traveling.
Additionally, Ketorganix Gummies are delicious! With flavors like berry and citrus, these gummies taste more like a treat than a supplement. This can make it easier to stick to your ketogenic diet long-term, as you won’t feel like you’re missing out on sweets or desserts. Plus, the gummy format makes it easy to take your daily dose without any added hassle.
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When incorporating Ketorganix Gummies into your routine, it’s important to read the label and follow the recommended dosage guidelines. Typically, you’ll want to take 1-2 gummies per day, depending on your individual needs and goals. Some people may find that taking the gummies in the morning helps them stay focused and energized throughout the day, while others prefer to take them before a workout for an extra boost.
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If you’re new to ketogenic dieting or taking exogenous ketones, it’s a good idea to start slowly with Ketorganix Gummies and gradually increase your dosage as needed. Listen to your body and adjust your intake based on how you feel and how your body responds. Consulting with a healthcare professional or nutritionist can also help ensure you’re using Ketorganix Gummies safely and effectively.
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Ketorganix Gummies are available for purchase online through their official website and select retailers. When shopping for Ketorganix Gummies, it’s important to choose a reputable source to ensure you’re getting a genuine product. Be wary of counterfeit or expired products that may not provide the same benefits as authentic Ketorganix Gummies.
Many online retailers offer discounts and promotions on Ketorganix Gummies, so it’s worth shopping around to find the best deal. Some retailers may also offer bundle packages or subscription options, so you can save money and ensure you always have a supply of Ketorganix Gummies on hand. Check the official Ketorganix website for more information on where to purchase their gummies and how to get the best deal.
Overall, Ketorganix Gummies are a tasty and convenient way to support your ketogenic lifestyle. Whether you’re new to keto or a seasoned pro, these gummies can help you stay on track with your diet and reach your health and wellness goals. With their delicious flavors, high-quality ingredients, and easy-to-use format, Ketorganix Gummies are quickly becoming a must-have supplement for anyone following a ketogenic diet.
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Vita Keto Apple Gummies have become a popular choice for those looking to supplement their weight loss journey with a tasty treat. These gummies are designed to provide all the benefits of a traditional keto diet, but in a convenient and delicious apple-flavored form. Chemist Warehouse offers a variety of options when it comes to Vita Keto Apple Gummies, making it easy to find the perfect fit for your needs.
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When it comes to choosing the right Vita Keto Apple Gummies at Chemist Warehouse, there are several top picks that stand out from the rest. These options have been highly rated by customers and offer a range of benefits to help support your weight loss goals. Here are some of the top picks for apple gummies at Chemist Warehouse:
1. Vita Keto Apple Gummies with BHB
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These apple gummies are infused with BHB (Beta-Hydroxybutyrate), a ketone body that helps to kickstart the process of ketosis in the body. By incorporating BHB into these gummies, they are able to provide a quick and efficient source of energy for the body, making it easier to stay on track with your keto diet. Plus, the apple flavor makes them a delicious and enjoyable treat to look forward to.
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As you consider incorporating Vita Keto Apple Gummies into your weight loss routine, you may have some questions about these products and how they can benefit you. Here are some frequently asked questions about Vita Keto Apple Gummies at Chemist Warehouse:
Q: How do Vita Keto Apple Gummies work?
A: Vita Keto Apple Gummies are designed to support the process of ketosis in the body, which is a metabolic state where the body uses fat for fuel instead of carbohydrates. By providing a source of BHB and other key ingredients, these gummies help to promote fat burning and energy production, making it easier to stay in ketosis and reach your weight loss goals.
Q: Are Vita Keto Apple Gummies safe to use?
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Q: Can Vita Keto Apple Gummies help me lose weight?
A: Vita Keto Apple Gummies can be a helpful tool in supporting weight loss goals, especially when used in conjunction with a healthy diet and exercise routine. These gummies are formulated to provide key ingredients that support ketosis and fat burning in the body, making it easier to stay on track with your weight loss journey. However, individual results may vary, so it is important to be consistent with your use of these gummies and make healthy choices in all areas of your life.
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An Overview of Lauren Manzo’s Remarkable Transformation
Lauren Manzo, known for her appearance on the reality television series “The Real Housewives of New Jersey,” has made headlines not just for her family drama but for her incredible journey of personal transformation. In recent years, she has achieved an impressive 80-pound weight loss that has left fans and followers both inspired and curious about her approach to diet and fitness. This article delves into the game-changing diet hacks that contributed significantly to her success. Her journey is not simply about shedding pounds; it represents a profound shift in her lifestyle, emotional health, and overall well-being.
Weight loss journeys can often feel overwhelming, with countless diets and fitness regimens available promising quick results. However, Lauren’s approach stands out due to its focus on sustainability and enjoyment rather than deprivation and strict rules. She emphasizes that effective weight loss should not feel like punishment; instead, it should be a celebration of the self and a path toward greater health. By changing her relationship with food and adopting mindful eating habits, Lauren has managed to achieve her weight loss goals while still enjoying the foods she loves.
In this article, we will explore the pivotal diet hacks that facilitated Lauren’s transformation. These strategies are approachable and practical, making them applicable to anyone looking to make a change in their life. From understanding portion control to utilizing the benefits of nutrient-rich foods, Lauren’s approach offers key insights into how lifestyle changes can lead to sustainable health benefits. Join us as we unravel the techniques that helped Lauren Manzo redefine her life and achieve her body goals, providing inspiration for others who wish to embark on a similar journey.
Understanding Portion Control: A Key to Success
One of the cornerstones of Lauren Manzo’s diet transformation has been her focus on portion control, a concept often overlooked in today’s fast-paced eating culture. People frequently consume more than they realize, especially when dining out or snacking mindlessly. Lauren’s journey began by shifting her awareness towards the amount of food she was consuming. By learning to gauge appropriate serving sizes, she not only reduced her caloric intake but also embraced a more mindful way of enjoying her meals.
Learning how to measure portions does not require the use of complicated tools or scales. Instead, simple visual cues can assist individuals in identifying appropriate portions. For instance, Lauren discovered that a fist-sized portion of carbohydrates, a palm-sized piece of protein, and a plate full of vegetables was a balanced approach to constructing her meals. This visual representation made it easier for her to stay on track without feeling restricted or deprived. Over time, as Lauren incorporated these practices, she began to understand her body’s hunger signals better, allowing her to eat when truly hungry and stop when satisfied.
Moreover, practicing portion control has significant psychological benefits. By allowing herself to enjoy a wide variety of foods while keeping portions in check, Lauren formed a healthier relationship with food. This control alleviated the feelings of guilt and shame often associated with eating certain foods, empowering her to indulge in moderation. With less deprivation, she found it easier to stick with her eating habits over the long term, ultimately leading to her remarkable 80-pound weight loss.
The Power of Nutrient-Dense Foods
Another impactful hack from Lauren Manzo’s diet journey is her commitment to incorporating nutrient-dense foods into her meals. Instead of focusing solely on calorie restriction, Lauren shifted her attention to the quality of the foods she was consuming. Nutrient-dense foods, which are rich in vitamins, minerals, and other essential nutrients, not only support overall health but also promote feelings of fullness and satisfaction. Filling her plate with vegetables, lean proteins, healthy fats, and whole grains was a game changer for her weight loss journey.
Lauren’s commitment to meal prepping played a vital role in achieving this. By preparing meals in advance, she ensured that she always had healthy options available on busy days when temptation might lead her astray. This practice empowered her to make better food choices. For instance, she began each week by preparing a variety of salads packed with greens, colorful vegetables, and lean proteins. These nutrient-rich meals became staples in her diet, demonstrating that healthy eating doesn’t have to be boring or monotonous.
The incorporation of nutrient-dense foods also allowed Lauren to explore new ingredients and recipes. She became adventurous, stepping outside her comfort zone by trying different grains, legumes, and vegetables that she had previously overlooked. This not only introduced her to a broader array of flavors and textures but also kept her meals exciting. By integrating diverse nutrients into her diet, Lauren nurtured her body while simultaneously engaging in the joy of cooking and eating.
Mindful Eating: Cultivating a Positive Relationship with Food
A significant aspect of Lauren Manzo’s transformation can be attributed to her practice of mindful eating. In an era where many individuals are distracted by screens, busy schedules, and fast-paced lifestyles, it can be easy to lose touch with one’s body and its dietary needs. Lauren recognized the importance of reconnecting with the act of eating. By intentionally slowing down and paying attention to her meals without distraction, she learned to savor each bite and appreciate her food fully.
Mindful eating involves engaging all the senses while eating. Lauren found joy in the colors, textures, and flavors of her meals. She took the time to notice how certain foods made her feel both physically and emotionally. This awareness helped her discern what nourished her body and what did not. By practicing gratitude for her meals, Lauren cultivated a deeper appreciation of food, elevating her experience and reinforcing her commitment to healthy eating habits.
Furthermore, mindful eating has numerous benefits, like reducing emotional eating and improving digestion. Lauren noticed that when she was fully present during meals, she was less likely to eat out of boredom or stress. By focusing on the experience rather than mindlessly consuming food, she could listen to her body’s signals of hunger and fullness more accurately. This profound connection not only enhanced her relationship with food but also contributed to her sustainable weight loss success.
Staying Active: The Role of Fitness in Weight Loss
While Lauren Manzo’s weight loss is primarily rooted in her dietary changes, staying active plays an integral role in her transformation. Engaging in physical activity not only enhances the effectiveness of healthy eating but also promotes numerous overall wellness benefits. After deciding to prioritize her health, Lauren explored different types of exercises to find what felt most enjoyable and sustainable for her lifestyle. This exploration was crucial for her motivation, and it helped her integrate fitness into her daily routine seamlessly.
Lauren embraced a combination of strength training, cardio, and flexibility exercises. She realized that varying her workouts kept things fresh and exciting, preventing feelings of monotony. Strength training helped her build muscle, which is essential for increasing metabolism, while cardio workouts provided an effective means of burning calories. By incorporating activities she enjoyed, such as dancing or hiking, Lauren was able to cultivate a positive relationship with exercise, making it something she looked forward to rather than a chore.
Additionally, Lauren benefited from the sense of community and support that came with engaging in group workouts or fitness classes. Surrounding herself with like-minded individuals kept her motivated to stay accountable to her goals. She discovered that fitness was not just about weight loss but also about cultivating friendships, sharing experiences, and celebrating achievements. The combination of enjoyment, social interaction, and physical activity contributed to Lauren’s emotional well-being, proving that the journey to a healthier self can indeed be fun.
Final Thoughts on Lauren Manzo’s Weight Loss Journey
Lauren Manzo’s transformational journey is a testament to the power of dedication, mindful practices, and the right lifestyle changes. Her emphasis on portion control, nutrient-dense food choices, mindful eating, and incorporating enjoyable physical activity has led to her impressive 80-pound weight loss and a healthier overall lifestyle. Each of these strategies reflects her commitment to not only losing weight but also enhancing her quality of life. This journey shows that achieving one’s health goals is possible, and each small change can lead to significant, lasting results.
People often wonder how sustainable weight loss can be achieved. The answer lies in finding a balance that fits one’s lifestyle. Lauren’s story serves as an excellent reminder that it’s essential to listen to one’s body, prioritize what makes you feel good, and enjoy the process. It’s not merely about the numbers on a scale but rather about creating a fulfilling life that embraces health, passion, and happiness.
As Lauren continues to inspire her followers with her journey, she reinforces the notion that anyone can take charge of their health. Her tips can serve as valuable tools for anyone looking to embark on a weight loss journey or simply wishing to live a healthier life. The key is to start small, remain consistent, and remember that it is the cumulative effect of these small changes that leads to monumental transformations.

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When it comes to weight loss supplements, Via Keto Gummies have been making waves in the market. Many people are turning to these gummies as a natural and effective way to lose weight and improve their overall health. Reddit, a popular online platform known for its diverse communities and honest reviews, is a great place to find insights and reviews from real users of Via Keto Gummies. In this article, we will delve into the world of Via Keto Gummies on Reddit, exploring the experiences and opinions shared by users on this platform.
Reddit Users’ Experiences with Via Keto Gummies
Reddit users have been sharing their experiences with Via Keto Gummies, detailing how these gummies have helped them on their weight loss journey. Many users have reported positive results, such as improved energy levels, reduced cravings, and faster metabolism. Some users have even shared before and after photos showcasing their impressive weight loss transformations after incorporating Via Keto Gummies into their daily routine.
One Reddit user, u/KetoQueen23, shared her experience with Via Keto Gummies, stating that they helped her break through a weight loss plateau she had been struggling with for months. She mentioned that the gummies tasted great and were easy to incorporate into her busy schedule. Another user, u/FitFam4Life, praised the gummies for helping him curb his late-night cravings and stay on track with his keto diet.
However, not all Reddit users have had a positive experience with Via Keto Gummies. Some users have reported minimal results or mild side effects such as digestive issues or headaches. It is important to note that individual experiences may vary, and what works for one person may not work for another. It is always recommended to consult with a healthcare professional before starting any new supplement regimen.
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To get the most out of Via Keto Gummies, it is important to follow the recommended dosage and usage instructions. Most manufacturers recommend taking 1-2 gummies per day, either with or without food. It is also advisable to drink plenty of water throughout the day to stay hydrated and aid in the digestion and absorption of the gummies’ ingredients.
In addition to taking Via Keto Gummies regularly, incorporating a healthy diet and regular exercise routine can help enhance the gummies’ effects and promote weight loss. Many Reddit users have found success by following a ketogenic diet while taking Via Keto Gummies, as the gummies are designed to support ketosis and fat burning in the body.
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It is also important to be patient and consistent when using Via Keto Gummies. Weight loss results may not happen overnight, and it may take a few weeks to notice significant changes in your body. By staying committed to your weight loss goals and incorporating Via Keto Gummies into your daily routine, you can maximize your results and achieve the health and wellness outcomes you desire.
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For those interested in trying Via Keto Gummies, they are widely available for purchase online through various retailers and e-commerce platforms. It is important to buy from reputable sellers to ensure you are getting a genuine product that is safe and effective. Prices for Via Keto Gummies may vary depending on the quantity and packaging options available.
Some retailers offer discounts and promotions for bulk purchases or subscription options, allowing you to save money and stock up on your favorite gummies. It is always a good idea to compare prices and read reviews from other customers before making a purchase to ensure you are getting the best deal on Via Keto Gummies.
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