Endocrine dialogues

Newly published treatment algorithm for the pharmacologic treatment of obesity and its complications, from the European Association for the Study of Obesity (EASO) ⚕️ Semaglutide and tirzepatide are recommended as first line to treat obesity AND to treat underlying obesity-related complications. This framework incorporates weight management ⚖️ and complications management into equal goals. Treat the adipose tissue accumulation to prevent organ dysfunction AND reverse organ dysfunction🫀🫁 Recommendations based on their own meta-analysis 📊, both published today 🗓️. EASO Framework: nature.com/articles/s4159… Meta-analysis: nature.com/articles/s4159…

As always → more research is needed Want to know more? nature.com/articles/s4143…

Higher calorie intake Faster eating → less satiety Additives & packaging chemicals (like bisphenol-A, phthalates) linked to obesity ✅ Conclusion: Observational studies strongly associate UPF with obesity, and one RCT supports a causal link. +

🍔🥤 Ultra-Processed Foods & Obesity: What’s the Evidence? Over recent decades, consumption of ultra-processed foods (UPF) has risen in parallel with obesity. Coincidence… or causality? 🤔 +

Skeletal muscle 💪 should be viewed as a vital metabolic organ 🧬. Preserving lean mass during weight loss ⚖️ is essential for physical performance 🏃‍♂️ and long-term metabolic health ❤️‍🩹. The risks of muscle loss, from impaired gly-caemic control 🩸 to loss of independence 🧑‍🦽, must be addressed proactively ⚠️. Muscle loss ❌💪 must not be the cost if adipose tissue loss 🧊➡️🔥 is the goal 🎯 pubmed.ncbi.nlm.nih.gov/40721501/

Takeaway: GLP-1 RAs don’t seem to disproportionately reduce lean mass (lean mass loss << fat mass loss). Want to learn more? pubmed.ncbi.nlm.nih.gov/40181228/ pubmed.ncbi.nlm.nih.gov/39719170/

💪 Muscle mass loss & GLP-1 receptor agonists: what do we know? Muscle loss with GLP-1 RAs (like semaglutide and tirzepatide) has been debated. Two new meta-analyses shed more light: +

How do we learn? Life—and medicine—is built on automatic moves, as we're usually good at predicting what comes next. But consciousness arises from prediction errors. And only through consciousness can learning happen!

🚨 New in @AGA_CGH 🚨 Waist-to-height ratio (WHtR) >>> BMI/waist in predicting: 🔑 Severe hepatic steatosis (AUROC 0.79) 🔑Advanced fibrosis (AUROC 0.78) 🔑 Especially effective in Hispanics @ebtapper @EndoDialogues @PittIMChiefs @PittGIM @BIDMC_GI cghjournal.org/article/S1542-…

@vitorborin_ E sintomas? Muito inespecíficos. Cansaço pode ser muita coisa! O ponto é que chamar de “anta” médicos com determinadas condutas em situações questionáveis é só uma forma agressiva de lidar com a falta de conhecimento que todos nós estudando sistemas biológicos temos!

@vitorborin_ Um TSH relativamente elevado acontece na recuperação de doenças clínicas. O que é relativamente elevado? Clássico corte é 20, mas claro que é mais complexo que isso. Um TSH de 19 ou 28 como citado deve ser tratado? Quanto mais alto, mais provavelmente hipotireoidismo

Já solicitou um TSH pro seu paciente internado? Sabe interpretar? Vamos supor que você atende uma mulher de 48 anos internada por pneumonia. Ela queixa-se de astenia há anos. Por alguma razão você decide solicitar um TSH e ele vem de 10. Qual sua hipótese diagnóstica?