CanadiaNole

@MichaelAlbertMD If an average person (excluding diabetics and morbidly obese) on a GLP1 exercises & eats a balanced diet, then they should be fine. The long-term data that I am interested in is how many of them actually incorporate these elements into their lives when they start taking the drug.

The critics of GLP-1 and next-generation obesity therapies have a data problem. Semaglutide and tirzepatide didn't earn their place in the NEJM and Lancet through anecdote—they did it through rigorous RCTs with hard endpoints. Tolerability concerns and discontinuation narratives are worth examining, but that scrutiny should be applied evenly—including to the financial relationships of those doing the examining. Meanwhile, patients are losing weight, reversing comorbidities, and coming back to the clinic asking for more. That's not marketing. That's medicine. The debate about whether these therapies matter is over. The only question left is whether you're going to be part of delivering them well—or watching from the outside while others do.

@MichaelMindrum When it comes to muscle, GLP1s are no different than any other diet that puts you in a caloric deficit. If you eat protein and resistance train, you should be fine. BUT MOST PEOPLE ON THESE DRUGS WILL NOT DO THAT. If they get off the drug, they will regain fat and be worse off.

"GLP-1s destroy muscle" — not quite. In the largest meta-analysis to date (15,782 patients), incretins lost the same lean mass proportion as lifestyle alone. The real muscle protector? Resistance training + protein. doi.org/10.1111/dom.70…

@jzux Anyone on a GLP1 should be eating a balanced, healthy diet (most importantly hitting protein targets) and resistence training. It's not a license to eat like shit.

can I ask a probably stupid but genuine question about ozempic? if the main way it works is by suppressing hunger and causing you to eat way less, are there strict guidelines to make sure you get enough nutrients in your diet? or are people getting malnourished?

@BenBikmanPhD People on GLP1s need to resistance train, eat sufficient protein and balance it out with carbs and some fat. There is zero reason to cut out healthy carbs.

GLP-1 medications are powerful and need to be used responsibly. I strongly believe they should be used at a lower dose and cycled with the purpose of learning to control carbohydrate cravings. Remember, like with every drug, there's a diminishing returns, when the drug becomes increasingly less effective if a high dose is maintained. Have an "off ramp", where a person can see test whether they've learned new habits and overcome the cravings for carbs.

@BowTiedHRT It's not bullshit and you're advice is bass ackwards. Going to the gym, getting weight down, improving sleep and eating better should improve your testosterone levels. No one should be jumping on TRT before trying to boost their levels naturally in this manner.

So sick of this pedantic, nonsensical bullshit. Do your research. Don’t just jump on TRT because you read it somewhere, but this idea that you need to be locked in and have your life perfect before you start TRT is an adventure in missing the fucking point. TRT is often the lever that gets you in the gym, gets your weight down, helps improve your sleep, and encourages you to eat better.

@drjasonfung Final Jeopardy: Despite calling themselves doctors, these are two social media grifters you should never take diet advice from. Who are Jason Fung and David Ludwig?

‘Prescribing’ fruits and veggies not useful for diabetes. Maybe try something more useful next time? Fasting or low carb maybe?

@fastrlife Fasting without a deficit does not result in fat loss.

In order to lose fat; Your body has to be in a catabolic state… There’s two ways to enter catabolism: 1. Calorie deficit (99.99% of people use this) 2. Fasting Aggressive calorie deficits are essentially starvation, which ruins metabolism and sex drive; Fasting doesn’t…

@CoachDanGo There are certainly alternative paths to explore, but to completely dismiss college as a viable path is moronic.

There is a 99% chance my kids will not go to college. If they want to go, then cool. But I don't see the point in going to college or any form of traditional schooling, given where the world is headed.

@Ford_Nick Two ribeyes?

Name one thing better than a ribeye..

@CoachDanGo Key is to make sure it heats to 450...don't buy it if it only goes to 400.

Having an air fryer is a cheat code. You get fried foods without drenching it in oil and you can reheat food without using a microwave. It also makes it so easy to cook tasty food. One of the best investments I’ve made in my kitchen.

@micheal_ws18 Pull ups

To all my gym goers… What’s the one exercise that changed your physique the most? 💪🏾

@paulsaladinomd I'll take the David's.

Which would you choose?

@drterrysimpson Despite the source, it would be prudent to review the ingredients before criticizing. If it truly is made of whole foods, I am intrigued regardless of who is selling it.

Always a check out lane

@Dr_Red_Gamer I do. I run a stopwatch to track.

Everyone is lying, no one actually rests 3 minutes in between sets

@ElieJarrougeMD Metabolic dysfunction doesn’t prevent access to stored fat. People with insulin resistance still lose fat in a sustained calorie deficit. Physiology affects how hard weight loss is, not whether energy balance applies. Willpower still matters.

Body fat storage is hormonally regulated. Body fat breakdown is hormonally regulated. Yes, the law of thermodynamics still applies. But the calorie model assumes your body can freely access stored energy. In metabolic dysfunction, that’s NOT the case. If your dysfunctional hormones trap fat in storage, your body increases hunger and lowers energy long before it burns that fat even while carrying 100+ pounds of stored energy. That’s not a willpower problem. That’s physiology. But we still tell people to “just eat less and exercise more.” 🤦🏻‍♂️

@CorbinSmithNFL It's not a dumb question. It makes a hell of a lot of sense, but it's unpopular because of the flawed perception it favours the rich. Reality is it would deter deferral of income and likely result in a flood of tax revenue at its outset.

I have a really dumb question: Why can't we just have a flat tax rate for every person? And get rid of the stupid deductions, etc? Just have everyone pay the same rate in the U.S.? It would save us from so many damn problems. And all these idiotic arguments.

@newstart_2024 Data does not support her conclusions. Outcome of replacing regular with diet coke clearly is fat loss as a result of caloric restriction.

Dr. Rhonda Patrick drops a wild irony bomb on Diet Coke: You're ditching sugar to avoid insulin spikes and obesity... but aspartame (Diet Coke's main sweetener) reshapes your gut microbiome to favor bacteria that harvest glucose more efficiently — making you more prone to weight gain. Animal studies show causal links; human associative data backs it up. The very drink people use to "stay lean" can backfire by shifting gut bugs toward obesity-promoting patterns. One can occasionally? Probably fine. One (or more) a day? You're constantly nudging your microbiome in the wrong direction. The ultimate plot twist: Diet Coke might be sabotaging the exact goal it's marketed for. Ditch the aspartame or keep sipping? What's your take on artificial sweeteners?

LMAOOO

@IdaIvey1 @kathysyock @EricTopol Reality: Everyone is aware that they can get an annual physical.

@SSAMAB9 @kathysyock @EricTopol Reality: No one is informing people of these tests, where to get them and how to get a referral. PCPs certainly are not. Also, insurance.

Predicting Alzheimer's disease up to 25 years in advance of any symptoms with the p-tau217 biomarker blood test, among 2,766 women mean age 70 jamanetwork.com/journals/jaman…

@jpolly22 100% keep the core (matthews, nylander, knies) and retool WITH A NEW COACHING STAFF. Rielly needs a fresh start elsewhere. I'd be fine moving Stolarz.

Leafs fans... Would you rather keep your core, retool, and try to be competitive next year... Or... Sell the house this summer and start from scratch?