R Rehman, MD, DABOM👩‍⚕️

Spent this beautiful afternoon meditating under the trees @BrownUniversity

The evolving landscape of obesity pharmacotherapy nature.com/articles/s4157… rdcu.be/fiw7g This new Review covers the evolution of obesity therapy from GLP1s to multi-receptor agonists, oral formulations, weight-loss quality approaches and tissue-specific drug targeting

🚨 SURMOUNT-MAINTAIN published in Lancet today 💉 Individuals after 60 weeks of high dose tirzepatide randomized to maintaining high dose vs. reduce dose to 5mg vs. placebo and followed for a 52 week maintenance period. 📊 After the 52 week maintenance period: ⬇️ High dose tirzepatide: 21.9% weight loss ⬇️ 5mg tirzepatide: 16.6% weight loss ⬇️ Placebo: 9.9% weight loss 🔑 Long-term treatment is necessary to maintain bodyweight reduction and its associated cardiometabolic benefits. Lowering the dose leads to variable degrees of weight regain. Discontinuation more definitely leads to weight regain. thelancet.com/journals/lance…

The deadline for abstract submissions is quickly approaching! Get your submissions in today : members.naspghan.org/Annualmeeting/…

#PreB2B IBDPoll1️⃣ 🔺14months old w bloody diarrhea, perianal fistula, failure to thrive. Treated for #VEOIBD w CsA & then IFX 10mg/kg q6wks, without improvement 🧬Genetic testing + homozygous IL-10RA mutation What’s the most appropriate therapy?

#PreB2B #IBDPoll2️⃣ 🔺Which clinical feature that distinguishes #VEOIBD from older kids #IBD is true ?

📣#PedsGI #AdultGI Join our series on Very Early Onset #IBD #VEOIBD 📌#B2B🧵 5/11 @DLeVine901 📌Convo 5/18 @GutMD_ 🗳️CME Polls👇🏻 🆓CME👉🏼 mnibd.short.gy/25-26 Support by edu grants @AbbVie @JNJInnovMed @TakedaPharma 📌Where are you in your career

Pivoting is NOT quitting. Pivoting is Authentic Growth! Love you @BMoshiree and THANK YOU for normalizing the many sticky realities of lifelong growth! Always be kind! You are NEVER stuck! What are YOU Creating? Grateful for the shared learning @ScrubsNHeels !

💊GLP-1 drugs like Ozempic and Wegovy have far-reaching health benefits beyond weight loss. In a new nationwide cohort study, researchers from Beth Israel Deaconess Medical Center are adding one more to that list: Prevention of ulcers in the gut! 🔗: ow.ly/8yez50YBJUs

Possible Trajectories For The Treatment of Obesity With Incretin Based Medicines pubmed.ncbi.nlm.nih.gov/41833473/ @DrNadolsky @DrKarlNadolsky @NutritionMadeS3 @drmatthewnagra @BevTchangMD @MichaelAlbertMD

Learn from @CNewberryMD and @AdamBuckholz on how obesity affects the GI tract and liver at our next Gastro Bites webinar on Tuesday, April 7, noon EDT. Learn insights from Dr. Nadege Gunn in a product theater supported by @Boehringer. Register for free➡️ow.ly/lVgi50YxPU9

It's time to abandon traditional "soluble" vs "insoluble" fiber classification Fiber functional characteristics are what matter when assessing its health impacts: 🔸Bulking (ability to increase volume of feces) 🔸Fermentability (where and how fast microbes consume fiber) 🔸Viscosity (ability to thicken and become gel-like) Make friends with fiber if you suffer from a GI disorder As there isn't a one-size-fits-all approach, we're here to help choosing the best dietary fibers based on your most burdensome symptom and likely cause of it Where to start? ❌Avoid/limit fiber ✅What can I do to incorporate and tolerate dietary fiber in the mid-long term? 👉Learn more: ginutritionfoundation.org/fiber-in-ibd-a…

Neuro-epithelial circuits promote sensory convergence and intestinal immunity‼️ 👉nature.com/articles/s4158… @wenzhang1120 @itchdoctor @immunologyliz @ZhennWang @BrainSinai @IcahnMountSinai 🎉 @GutBrainScience @unrmed @NYUPainResearch @MargolisLabNYU @RomeFoundation @RomeGastroPsych @AGA_Gastro @AmerGastroAssn

Updated clinical care pathway for #MASLD. A new AGA-led paper published in @AGA_Gastro incorporates updated disease nomenclature, emerging tools, and therapies. Read more: ow.ly/Qt2T50YsClA @NeilSkolnik @NoureddinMD @DrLoomba @AASLDtweets @ADA_DiabetesPro @ObesitySociety

#Obesity is associated with higher risk for 12 #cancer types and accounts for approximately 10% of annual new cancer cases in the US. 📄 This Review summarizes the primary biological pathways connecting obesity and cancer development. ja.ma/3OPhtgT

Trajectory of Weight Regain After Cessation of GLP-1 Receptor Agonists thelancet.com/journals/eclin… @DrNadolsky @DrKarlNadolsky @MichaelMindrum @MichaelAlbertMD @BevTchangMD

Reduced frequency GLP-1 therapy may maintain weight loss 👀 In a case series of 30 adults who reached weight plateau on weekly GLP-1, transitioning to dosing q14 days: -Maintained weight loss -Preserved body composition #ObesityMedicine #GLP1 #Semaglutide #Tirzepatide

This study in @UEGJournal is the first to show that microscopic colitis (MC) is associated with molecular and ultrastructural alterations in the brush border of colonocytes. By comparing patients with lymphocytic colitis (LC) and collagenous colitis (CC) to healthy individuals and those with irritable bowel syndrome (IBS-D), researchers identified a distinct signature of protein and gene dysregulation. Specifically, patients with CC were found to have significantly shorter and fewer microvilli, while those with LC show a decrease in microvilli density. These findings suggest that the breakdown of the intestinal epithelial barrier is a primary factor in the development of chronic watery diarrhoea. Notably, treatment with budesonide was shown to partially repair these physical abnormalities in the colon. This research offers promise of new diagnostic biomarkers and targeted therapies for this condition. onlinelibrary.wiley.com/doi/10.1002/ue…

🆕🔥Central & peripheral #Neuromodulators in #FD & #Gastroparesis: Symptom-Based #ClinicalReview‼️ 🎯A pragmatic, symptom-oriented & mechanism-based approach facilitate individualized treatment selection & optimize clinical outcomes 👉onlinelibrary.wiley.com/doi/10.1111/nm… @ANMSociety @esnm_eu

In a profession where burnout is real and the pace is relentless, moments like this steady you. They remind you that #compassion is not a weakness in medicine. It’s the core of it.

It’s noticing the parent who looks calm but is quietly unraveling. It’s advocating when something doesn’t sit right. It’s resisting the urge to cut corners even when the list is long and the shift is longer.

Being thorough isn’t just about ordering the right labs or knowing the latest guidelines. It’s staying a few extra minutes. Answering one more question. Explaining the plan again because fear makes it hard to absorb information the first time.