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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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Unveiling the Truth: Weight Regain after Wegovy or Zepbound. Join this channel to get access to perks: https://www.youtube.com/channel/UCnQiofnuXFcloJRoJTsc1FQ/join Download my FREE 7-Day Best Weight Journal: http://eepurl.com/gdB2qn Subscribe to the channel: https://www.youtube.com/@theofficialdrdan?sub_confirmation=1 Products I recommend to support your weight-loss journey: Managing Constipation: https://amzn.to/4bs0g3h Managing Diarrhea: https://amzn.to/3UUjNCm Managing Heartburn: https://amzn.to/3Vbfx31 Internalized Weight Bias: https://amzn.to/4avCpP3 Protein Bars: https://amzn.to/3RiItUr Scales and More: https://amzn.to/4bNJDPc Supplements: https://amzn.to/44TgobJ Activity Trackers I recommend: https://amzn.to/4dOYLOa My favorite Books: https://amzn.to/3Kb0VKt In this comprehensive video, delve deep into the intricate topic of weight regain after discontinuing medications such as Wegovy or Zepbound. Meticulously analyze the results of various studies, exploring the likelihood of regaining lost weight and the formidable challenges associated with long-term weight management post-medication cessation. Through meticulous examination of graphs, thorough discussion of trial outcomes, and insightful commentary, unravel invaluable insights into the nuanced realities of maintaining weight loss beyond medication intervention. Whether you're embarking on your weight loss journey, considering medication options, or seeking sustainable strategies for lasting results, this video provides indispensable guidance and clarity. Join the journey through the data, debunk common misconceptions, and shed light on the paramount importance of adopting sustainable lifestyle changes for enduring health benefits. Don't miss out on this informative exploration into the complexities of weight management. Remember to like, subscribe, and hit the notification bell for more enlightening content. Plus, consider joining the exclusive YT Membership for access to live sessions and personalized support. Embark on your journey toward optimal health and wellness today! Watch my previous videos about how to fight obesity and about the best medicine for weight loss: ▪️ Watch This Before Taking Mounjaro: https://youtu.be/BmkVtGgejhk ▪️ From Ozempic to Mounjaro: https://youtu.be/L9e46iFWwIs ▪️ Muscle Loss with Ozempic, Wegovy & Mounjaro: https://youtu.be/lnEH-v64aG0 ▪️ Managing Nausea from Ozempic, Wegovy and Trulicity!: https://youtu.be/3R1Fwhf02LE ▪️ Ozempic: Stomach Paralysis Update: https://youtu.be/MPyROywaM0g ▪️ How to Switch from Ozempic (or Wegovy) to Mounjaro: https://youtu.be/L9e46iFWwIs ▪️ Ozempic Paralyzed My Stomach: https://youtu.be/tj9thkkN5aM ▪️ How to Inject Mounjaro: step-by-step tutorial: https://youtu.be/piVHr7UqYDg – Live in Alberta? Come see me at my Pharmacist-led Obesity Clinic at Apothecare Pharmacy - http://apothecarerx.ca – Products to support your weight-loss journey: USA: https://amzn.to/3RC7MSd Canada: https://amzn.to/45gq4vg – Sign up for my newsletter: http://eepurl.com/gdB2qn – Contact Me: [email protected] – Have questions or need support on your weight-loss journey? Book a consultation with me: https://calendly.com/drdanconsult/he – For more about weight loss via habit mastery, visit https://www.healthevolved.co Join me on social media: ▪️ https://www.facebook.com/theofficialdrdan ▪️ https://www.instagram.com/theofficialdrdan ▪️ *NEW TIKTOK ACCOUNT: https://www.tiktok.com/@officialdrdan #weightloss #ozempicweightloss #ozempic

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Discover the top 5 Fat-Burning Foods that will transform your health 🌟 In this video, I reveal the most powerful natural foods for boosting your health and wellness. These science-backed superfoods are proven to deliver real results. What you'll learn: ✅ The best foods for Fat-Burning benefits ✅ How each food works in your body and mind ✅ Easy ways to add them to your diet ✅ Why these specific nutrients matter These aren't just random health tips - each food is carefully selected based on scientific research and nutritional value. Whether you're looking to improve your overall wellness or target specific health goals, these foods can make a real difference. 💡 Pro tip: Start with just one or two foods and gradually add more to your routine for sustainable results. 🔔 Follow for more evidence-based nutrition tips that actually work 👇 Let me know in the comments which food you've added to your diet #HealthyEating #Superfoods #NutritionTips #HealthyLifestyle #WellnessTips #NaturalHealth #HealthyFood #NutritionFacts #HealthBenefits #Wellness This content is for educational purposes only. Consult your healthcare provider before making dietary changes.

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Hello, Happy to see you here! In this video, we'll show you a 3-minute breakfast drink for natural weight loss. Try this healthy option for a delicious and nutritious start to your day! WEIGHT LOSS PLAYLIST : https://www.youtube.com/playlist?list=PLeRAsmj4ljudIpTbZnfOZoMVMgmdjD6L3 PAPAYA FOR WEIGHT LOSS : Papayas are low in calories while being packed with essential nutrients. Papayas have a high water content—about 88% of the fruit is water. This makes it hydrating and can help you feel full, reducing the chances of overeating. Papayas are a good source of dietary fiber, which aids in digestion and helps keep you feeling fuller for longer. This can help curb your appetite and reduce overall calorie intake. Papaya contains an enzyme called papain, which helps break down proteins and promotes better digestion. This enzyme can aid in the digestive process, reducing bloating and discomfort, and may help in the absorption of nutrients from the food you eat. Papaya has a relatively low glycemic index (GI), meaning it doesn’t cause a rapid spike in blood sugar. Papayas have natural detoxifying properties. They help flush out toxins from the body, which can aid in weight loss by improving liver function and reducing bloating. CARROT FOR WEIGHT LOSS : Carrots are very low in calories, making them an excellent option for those trying to lose weight. Carrots are a good source of fiber, with one medium carrot providing around 2 grams of fiber. Fiber is known to help you feel fuller for longer, reducing overall food intake and curbing hunger. Carrots are an excellent source of beta-carotene, which the body converts into vitamin A. This nutrient is essential for maintaining healthy vision, skin, and immune function. Carrots have a low glycemic index, meaning they don’t cause rapid spikes in blood sugar levels. Carrots have a high water content (about 87% water), which adds to their volume without adding many calories. DETAILED RECIPE : loading soon..... Visit us at : Website : www.wonderways.in Fb Page: https://www.facebook.com/wonderwaysecom Instagram : https://www.instagram.com/wonder.ways 🧡Thanks for watching! 🧡Please leave a LIKE,COMMENT and SHARE this video! 🧡SUBSCRIBE my YouTube Channel for more videos and click the BELL so you will not miss any of my videos! drinking water to lose weight,drinking hot water to lose weight,drinking hot water,benefits of drinking hot water,how to drink water for weight loss,water for weight loss,weight loss with warm water,does drinking hot water help in weight loss?,drinking water,how to drink water to lose weight,hot water for weight loss,warm water for weight loss,drink water,how drinking hot water helps in weight loss,water to lose weight weight loss,fat loss,best fat burner,ayurvedic fat burner,belly fat,weight loss tips,how to lose belly fat,how to lose weight, weight loss,diy weight loss,natural remedies,no diet,lose weight,how to get rid of belly fat,lose belly fat in 1 week,ayurvedic home remedies for weight loss,home remedies for weight loss,fat melter,best belly fat melter,weight loss powder,natural powder to lose weight,ayurvedic powder to lose weight How To Lose Weight Fast 10 kgs in 10 Days - Full Day Indian Diet/Meal Plan For Weight Loss, 900 calorie meal plan,how to lose weight fast 10 kg in 10 days,meal plan to lose weight fast,lose 10 kgs in 10 days,lose 10 kgs,how to lose belly fat,diet plan for weight loss in 10 days,22 lbs in 10 days,indian meal plan,indian diet plan, tea for weight loss

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📌Connect For Collaborations & Podcast Enquiries - [email protected] Connect with us on: Youtube: http://www.youtube.com/@Podwithnik Instagram: https://www.instagram.com/podwithnik/ Facebook: https://www.facebook.com/share/iKCuHQ1VsUo143Vq/?mibextid=qi2Omg About Nikhil Kohli: He is a well-traveled IT pro with 15+ years of corporate experience. Life’s too short to go it alone, so he thrives on learning from others. He holds great expertise in content creation and public speaking. His communication skills, especially his gift for listening, have opened doors to fascinating people and stories.

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