Childhood Obesity at the Crossroads of Science and Social Justice
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- Опубликовано: 7 май 2023
- Harvard's Dr. David Ludwig addresses whether GLP-1 weight loss drugs like semaglutide, Wegovy & Ozempic should replace keto and low-carb diets for obesity, even in children. Or can low-carb diets complement drug treatments to reduce costs and long-term health risks and provide a path to life-long metabolic health?
Dr. Ludwig's new paper on the social justice implications of this issue is co-authored by Dr. Jens J. Holst, who has been credited with discovering the hormone GLP-1.
The GLP-1 medications semaglutide, Wegovy & Ozempic have taken the weight loss community by storm. They are even recommended for children and adolescents with obesity. But what are the long-term consequences of such widespread use, and why has the medical community seemingly abandoned dietary changes and behavioral support for medications and surgery? And what about the impact on long-term metabolic health and on questions of social justice?
Dr. David Ludwig is a Harvard researcher and endocrinologist. We discuss how the mechanisms of these medications are similar to those of low-carb diets and how Dr. Ludwig feels there's room for short-term use of medications to complement low-carb nutrition for weight loss and improved metabolic health.
A key question we ask ourselves at Metabolic Mind is what impact GLP-1 drugs will have on brain function. They do not have the benefit that ketogenic diets do of leading to producing ketones, an efficient fuel for the brain, which appears to be a key mechanism of action of keto in treating serious mental illness. More research is needed to address this important topic.
Experts featured in this video:
David Ludwig, MD PhD
www.hsph.harvard.edu/profile/...
Twitter: / davidludwigmd
Jens Holst MD, DMSc
bmi.ku.dk/english/Staff/?pure...
Paper referenced in this video:
Childhood Obesity at the Crossroads of Science and Social Justice
jamanetwork.com/journals/jama...
Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at metabolicmind.org/
About us:
Metabolic Mind™ is a nonprofit initiative incubated by Baszucki Group. Our mission is to provide education and resources in the emerging field of metabolic psychiatry, including ketogenic interventions for mental disorders.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.
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#KetoForMentalHealth
#MetabolicPsychiatry
#GLP1
#Ozempic
#Wegovy
#Semaglutide
#BipolarTreatment
#MetabolicNeuroscience
#KetogenicMetabolicTherapy
#NutritionalKetosis
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#MentalHealthIsMetabolicHealth
#obesity
#socialjustice
Wow, 1400 dollars/month will allow for an *extremely* healthy organic whole foods diet. It seems highly unethical to me to keep eating SAD, while compensating for it with drugs. That would increase human misery just to keep funneling money to the pharmaceutical industry. It makes me so angry.
Compensating?🤔
Well said. Focusing that money on healthy nutrition will likely do much more long-term good than paying for medications.
@@1timbarrett thank you, yes (corrected)
I want to avoid all pharmaceutical drugs that I possibly can. I'd rather be heathy than treat symptoms of ill health.
Amen to that
Ketovore 14 months and 70 years young
Loving it 😂😂😂
I know I am way too far over to one side being very low carb, but unless we change the way people view food and diet we will still be chasing our tails. We make medications so we can eat what we want, we romanticize food and society is obsessed with food. Food is not really the cure most of the time it is the cause, we have to keep educating and give people the tools to make the right decisions.
It’s easy to say than done. Big food and big Pharma cobalts controls the narrative and media. It takes some critical thinking skills to get out of it. Most Americans can’t until they hit rock bottom, only 5% do realize there is alternative and the rest are just completely submerged in the system. They have no way to get out.
We should romanticize the right foods!
It's not rocket science. Just follow the money.
Sad but true.😢 Most humans WILL prioritize their children’s well-being over their own pocketbooks however.😅
Unfortunately the food and pharmaceutical industry controls all of the dietary info that you see on your Google news feed. Basic cooking should be a class in school, including shopping for the food and planning a meal.
I had a class like that in high school it was very fun!
It used to be a saying that the absolute last resort was the knife... We'll try everything before surgery. Now it seems surgery is a first option. Crazy change.
Thank you for this information and this interview!
Dr. Scher, Thank you, as always. You, Dr. Palmer, and your entire team at Metabolic Mind are helping to set people free from their mental "prisons" by advocating hope through metabolic health. So grateful! I am still confused, however, regarding the link between metabolic dysfunction and the escalating prevalence of mental illnesses amongst youth. It often takes years (indeed, decades) for a person to experience metabolic disorders. So, if metabolic dysfunction is the primary driver of mental health conditions, how is it that children are experiencing these conditions at such a young age? Could they be inheriting metabolic dysfunction from their parents (in the third trimester, for example)?
That's a great question. At this point, any answer would be speculative as we need more mechanistic research to fully answer it. But I think we can agree that testing for insulin resistance and metabolic dysfunction is underused and improperly done. If we rely on fasting blood sugar to detect insulin resistance, we will miss the majority. So a first step is to test with fasting insulin/HOMA-IR or even a Kraft test to better understand the prevalence of insulin resistance in adolescents and young adults as they are less likely to show the characteristic increased waist-to-height ratio. And we can work to better define the impact of genetic predisposition and lifestyle epigenetic triggers. So, there is still a lot of work to be done, and in the meantime, hopefully, we can reach and help people who need it. Thanks for your comment!
@metabolicmind Thank you for your great insights, education, and leadership. I get a strong sense that the "fog" is starting to lift and that well-intentioned professionals are beginning to embrace something "new." That is inevitably do, in large part, to your and your team's amazing work. Grateful.
@jesusislord27 you might want to look at the work of Dr. Ben Bikman. His particular field of research is predominantly insulin, including the potential impact on a fetus. A metabolicly unhealthy mother can cause a dramatic difference in the health of the child, before and after birth. It seems as though humans are becoming ill, in many ways, at progressively younger ages.
@@pursuehealth940 Thanks for the tip! I will look into Dr. Bikman's work, especially as it pertains to "inherited" metabolic dysfunction.
I think these drugs are incredibly exciting and produce a lot of the same effects as a low carb diet. I don't think there will be a silver bullet for treating obesity, we really need all hands on deck.
I also think if we inform patients taking these drugs they can get a similar effect by going low carb we can essentially let people try how the diet feels before they come off the drug
I’m trying to tell people this in large Mounjaro/Wegovy/Ozempic groups and I get yelled at saying I’m an advocate for the diet industry and am the reason people have binge eating disorders (even though the binge eating comes from the overconsumption sugar knocking at the door of their reward center lol). They keep yelling no food is bad and I’m like okay but an overconsumption of types of foods, especially once’s pumped with toxic chemicals, refined sugars, processed carbs is absolutely bad, how is it not? And then I get blocked lol
@@saltybaelv- I agree. Many have no interest in changing their WOE at all or in fasting; they just want to pop a pill.
There are no long term studies of this drug. The only way to assess its effects is to do a 5 hr. glucose tolerance test and insulin curve to see where the starting point is of beta cell efficiency and insulin resistance. Then after 1 or 2 or 3 years of drug treatment and after the drug has left the system, retest with another 5 hr gtt and insulin curve.
It appears to me that the drug wears out the beta cells and increases insulin resistance and that is why the dose has to be increased.
Additionally too much TRPV1 can cause pancreatitis and colitis.
Lastly, this drug stimulates TRPV1 and that gets glucose into skeletal muscle cells independent of the insulin receptor and excess glucose oxidation will cause the cell to become insulin resistant as the cell makes too much ROS.
Very interested in your understanding of this drug. What about Mounjaro (trizepatide)? It’s a GLP-1 + GIP. It has half the GLP-1 in semaglutide (Wegovy/Ozempic). But studies show they are experiencing more weight loss. Would love your understanding of how GIP just like how you explained GLP-1.
@@saltybaelv they all stimulates TRPV1. TRPV1 is essential for insulin production. When insulin goes up the insulin and TRPV1 receptors are both up-regulated on cells in the periphery that consume the glucose.
Another concern is that TRPV1 puts glucose into the cell and when the cell runs out of antioxidants needed to control the oxidants from glucose breakdown (glycolysis) the cell’s mitochondria become damaged and the cell becomes resistant to insulin. Mevalonate is the oxidant produced by the glucose breakdown. The mevalonate pathway leads to metabolic products that cause increased cholesterol and increased geranyl peptides that lead to osteoclasts that break down bone and lead to osteoporosis.
Yes, blood glucose goes down but it is important to look at the details after that.
As far as I see all glp-1 receptor agonists are the same, the concentration and dose likely affect weight loss as well as diet and exercise.
@@susanbeever5708 I very much appreciate this response and breakdown. I’m currently taking tirzepatide and have read nothing but positive studies while simultaneously looking for negative ones but have yet to find. If you happen to know of any studies of GLP-1 and these pathways I’d would be grateful if you shared them with me.
@@saltybaelv my knowledge is a compilation from individual research studies.
My primary concern is hyperinsulinemia from too much TRPV1 and glp-1.
Hyperinsulinemia is directly related to inflammation of endothelial cells that line our arteries and leads to atherosclerosis.
Ketosis leads to high cholesterol but it is native, none atherogenic LDL because no glucose is used for energy, ketones, particularly hydroxybutarate is used. When glucose is restricted as in the ketogenic diet the cell compartmentalizes the key enzyme HMG-CoA that starts the mevalonate pathway that makes cholesterol. As we know we need good, non atherogenic cholesterol for our hormones and immune system.
I've been struggling to lose weight even while on a ketogenic diet. I'm thinking of doing 3-6 months of semaglutide just to help kick things off while I continue my ketogenic diet.
If keto isn't working then maybe you should try carnivore. Or just do what big pharma want you to do and take the pill.
all they do is make you fast more so fast more
Ludwig remains a plausaible source DESPITE his association with Harvard but i dont know how long he can maintain that
Great interview. Thank you! 🙏
Plausible?🤔
I understand these new drugs target muscles
Can you link me to that?
@@saltybaelv I think Dr. Ken Berry talks about this
I guess I don’t understand why people get so excited about taking pills. Yes, there are times that medication can certainly help or may be needed in some situations, but when it comes to chronic disease related to metabolic health, things may be able to be completely reversed without popping one pill (and the root cause, insulin resistance, is addressed). Why not celebrate that, instead of giving money to an industry that obviously doesn’t care one iota about our health or well-being? The pharmaceutical industry wants you on as many drugs as possible for as long as possible, spending as much of your money as possible, AND THEY’RE SUCCEEDING!
On top of that, the drugs they shill often have horrible side effects that only lead to more drugs and NEVER address the root cause of anything. I’d rather try everything else before ever taking medication for something that is a lifestyle issue.
I think this class of drugs is dangerous. Since they increase the body's production of insulin, they force the pancreas to work harder which could damage it in the long run. Having high insulin is very dangerous as well. At best, I can see these being used in the short term as someone corrects their diet.
Interestingly, as Dr. Ludwig explains, the net effect is less insulin production. I really like how he explained that!
@@metabolicmind I'm not sure I am sold on that. My wife is on it and she continues to eat the same amount of garbage as she always had. I understand that if you only eat when you're actually hungry it may have a net improvement on insulin but I doubt it helps with emotional eaters.
@@finagillit is helping with emotional eaters because it’s hitting the GLP-1 receptors in that part of the brain. My husband is on Ozempic and he doesn’t crave his nicotine, which he’d usually go after when stressed out. My bestfriend is a binge emotional eater, wants sugar big time and she doesn’t crave sugar or binge eat anymore.
I suggest watching Dr. Seeds video on peptides and semaglutide (since Ozempic / Wegovy is essentially a peptide). Very safe and very neat.
The Harvard professors conscious is eating him alive. He came here to tell the world keto is the way to go but doesn’t not want to lose his funding from the big Pharma 😉. Well at least he risked something by coming to this podcast and talking against the idea of putting kids on the drug. Credits to him.
You are nuts. Ludwig is a leading proponent of the carb insulin model as a cause of obesity. It's the Harvard school of health that pushes all kinds of carbs. Ludwig is definitely keto.
If you look at the keto doctors, they all eventually go 90% or more carnivore ie super low carb.
Conscience?🤔
The Harvard professor has no funding from Big Pharm (never did). No funding from Big Food, either.
That's a very important point! In a world full of financial conflicts, Dr. Ludwig is an important exception.
@@DavidLudwigMDPhD Hi professor, I can’t believe my eyes when I saw your reply to my comments. Thank you for fighting this war alone the people, not the corporations. The corporations shape millions of peoples’ mind every day. But for the grass roots, it’s just a few individuals a day. This is not easy task but indeed worth of fighting. The system is so corrupted somebody has to do something or we are going down together.
Hi,
So I started Mounjaro (tirzepatide) to help lose stubborn insulin resistant weight. It’s working. BUT an amazing and unexpected side effect that has caused me to deep dive into metabolic health and the gut/brain axis (that I used to think was rubbish). Well, I have PMDD, often misdiagnosed as Major Depressive Disorder. We found that the Major depression episodes ONLY happened right before my monthly cycle. Well, the first month and every month since being on Mounjaro I DO NOT have depression or even the anger and irritability that came with it. I didn’t change my diet. My activity level. My stress level. This was all due to simply taking the lowest dose of Mounjaro. This caused me to look into blood glucose, now my levels are completely “normal”. Everything about my blood work is “normal” to a standard American doctor. I haven’t gone to functional (yet) because cost. Anyways, I’m sure somthing is off.
But this is fascinating and I’ve learned now that diet has such a huge effect. I tried keto in the past and really didn’t have any amazing benefits or results at all. Probably committed 3 soild months of getting into ketosis.
Anyways, I’d love to know the link between Mounjaro, the type 2 diabetes med and why the hell it got rid of my debilitating depression and irritability.
Could be working to help you change when and what you eat and dont forget the placebo effect.
Down the road is when side effects often come to light.