welcome to as the do I'm Kathy buio now losing weight has been an eternal struggle for our species since the dawn of a man and over the last 100 years there have been countless bad diets way too many late night infomercials dangerous over-the-counter diet pills and dozens of APs guaranteeing weight loss through your smartphone now unfortunately none of them have been the Magic Bullet that overweight people were looking for and that was until now today we have Dr meline kjo Chief Pharmacy officer for Baptist Health and Dr Marissa Macio clinical pharmacy specialist at Baptist Health they're going to help walk us through the current wave of diabetic medications that are flying off the shelves and triggering shortages as well as answer any questions you may have send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe dooc page on our website allhealth ttv.com welcome to ask the do the show where we encourage our viewers to send in their health questions so let's kick things off with a question from one of our viewers and today's first question comes from Vanetta hello Vanetta thank you who just reached out to us through our website allhealth tv.com and she asked Dr Kaho I've been hearing a lot about OIC and the other weight loss meds but I'm so confused how do I know which one of them is best for me oh yeah I guess the most important question is do I have to be diabetic to get a prescription so Vanetta thanks for asking that question but let's talk about what these meds are you know these meds are called glucagon like peptides that's why they're known as gp1s receptor Agonist and they work by stimulating uh your um uh after eating simulating actually insulin while you're eating and slowly move through your body and your stomach so that you make it feel like you're Fuller and it sends a signal to your brain to let you know that you're full after eating so this is why it's utilized to help treat obesity so Vanette if you're just about to lose 10 pounds to get into a bikini this summer you know these meds are not for you now to answer your question you don't have to be a diabetic to be on weight loss medication W GOI Zep bound and seenda are the new gel lp1 medications that are indicated for weight loss OIC Victoza and manaro are the glp ones that are indicated for type 2 diabetes Now to know which Med is right for you first you're going to have to visit your doctor so that he can properly assess if you're a candidate for these medications and then you will need to determine how overweight You Are by measuring your BMI which is your body mass index so to start on this medication you must have a BMI greater than 27 and have at least a weight related issue like let's say pre-diabetes or high blood pressure or high cholesterol or if your BMI is is great than 30 then you are in the obese range and you will automatically qualify for this medication but it's your doctor who will determine which is best for you I have a feeling we're gonna be getting some great questions today's uh Dr kameho so estan just sent a question to us to our YouTube page and as Stan asked Dr kameho I'm a big guy like offensive lineman big I'm definitely overweight but how do I know if I'm considered obese and do I need to be obese to to get these mens okay offensive linemen okay that's pretty big so this is a great great question so do folks need to be obese Dr Kaho to get a prescription well Stan thanks for reaching out and Kathy I know some pretty big guys who are not obese and they're very fit but I'm GNA punt this one to Marissa Marissa actually sees a lot of athletes high-end athletes in her clinic so I'm just gonna say Marissa this one's yours to take yeah I'll take take it away so just like Dr just like Dr kameho had said it's important to speak with your doctor so they can determine your BMI so if your BMI is over 30 then you are in the obese range but BMI only takes into account a person's weight and height it does not take into account your total body composition athletes may have more muscle on their body than the average person and muscle weighs more than fat so while the BMI is a tool we currently use to G categorize overweight and obese people it's not the best indicator of how healthy a person is since it does not include the full picture of someone's body so like their muscle their body fat percentage their bone density their activity status or their dietary habits all of those play a role that's fantastic feedback thank you Dr maricio so we got an interesting question here it's something I've completely forgotten about Louisa's question is Dr kameho I have a question about these new Wonder drugs are there any side effects I'm asking because I remember my sister talking about some medication called olestra which gave her stomach cramps and horrible diarrhea oh my God I remember alestra they put that stuff in fattening foods like the potato chips like lays and Doritos so you could eat as much as you want and not gain weight but there was so many side effects to it so okay what is olestra and what kind of side effects then do drugs like OIC or gp1s have and Kathy you're right on alestra was a synthetic fat that they would put in all those snacks back in the early 90s so that you can eat as much as you want and they were all fat free but the biggest problem was that your body couldn't absorb the molecule and it caused many consumers to have horrible diarrhea stomach cramps it was pretty bad now back in the 90s as well because of that they came out with another medication called orat which was the name of the medication that wouldn't let your body absorb fat so it' make you go to the bathroom all the time if you ate a fatty meal but now the GP ones I think is really important for people to know what potential side effects they are going to face if they're going to take these medications so I think we should post them as well and really the number one uh I would say the number one nausea medication that you would see is H nausea nausea is one of the biggest ones that you you have you're also going to diarrhea constipation sometimes vomiting headache heartburn and fatigue now those are the common side effects there could be a few more here and there but those are the ones people usually will will experience during this now there are ways we we minimize the side effects is by starting these medication at a very low dose and titrating up every four weeks to see how you tolerate the meds and also make sure to eat small more frequent meal throughout the day and avoid F actually avoid fried or any greasy food because nausea is usually the worst so when you go too long without eating because you feel full it's not good so it's always important to eat little things constantly throughout the day and it'll help manage those uh side effects thank you Dr kameho now in case you missed it the first time here's another opportunity to find out where to send in your questions send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com well Instagram is representing today and this one comes to us from Howie who has a non OIC question for Dr kameho hi doc I know everyone's asking about asking you about OIC or Zep bound today but you know what it's too damn expensive for this guy I want to know if there are meds that have the opposite effect and cause you to gain weight if so which types are they and what can I do to stop it okay are you able to switch ke Dr Kaho and get out of the glp1 zone and answer this one for Howie actually honestly I wouldn't mind a little break but great question Howie and you know what this is right up Melissa's alley Marissa why did you take this one absolutely so there's a list of commonly medic uh common medications that can cause weight gain I'm going to go over five of them there's quite a few out there but the top five that I typically see number one would be diabetes medications um like insulin they can cause your body cells to absorb more sugar from your blood and then your body in will in return will then convert that sugar into fat and this can lead to about 5 to 10 pound weight gain the second one would be anti-depressants so this is like ssris or tcas like amitri iene fluoxitine or perotin these ones can cause weight gain some anti-depressants can cause it more than others I would recommend discussing your medication options with your provider If you experience weight gain after starting anti-depressant the third category is mood stabilizers these are medications such as clapene lithium or olanzapine and these mood stabilizers or anticho medications can directly affect the brain and stimulate a person's appetite causing the weight gain and then affecting their metabolism the fourth category would be beta blockers so this is something like Atenolol propanolol or metol for example and these are often used to help people with chronic high blood pressure or other heart conditions these medications can cause a person to gain on average about two to three pounds of weight within the first few months of treatment it's best to consult your doctor for an alternative option to make sure and also make sure that you're implementing healthy lifestyle choices and the fifth category I would talk about is corticosteroids so prazone dexamethazone hydrocortisone for example long-term use of these types of steroids can lead to weight gain due to the increased cortisol levels which is the stress hormone in the body and this can enhance your appetite so I would recommend limiting the use of the codor steroids and then only using them for a short period of time one thing to note that if you're thinking your prescription medication is causing your weight gain do not suddenly stop taking the medication without speaking to your doctor first that was a great question thank you so much okay so the next question comes to us from d'vorah who reached out through YouTube Dr Kaho I was at book club last week and I heard from one of the girls that she'd heard from one of her former members who'd been on the pill was also taking OIC ended up getting pregnant can it really happen or is this just some urban legend okay I've been hearing about OIC babies a lot Dr gaho so I want to know this as well is there Trum truth to this um deorah good question another very typical one but yes it is not an urban legend you know folks who are obese who want to get pregnant sometimes get put on these medications because it is helps improve you know obesity and increases the risk of infertility so optimal weight control can improve pregnancy outcomes but Zep bound and manaro may decrease the intended effect of an oral contraceptive due to delayed gastric emptying so the problem is your oral contraceptives aren't always effective and so it is recommended to use an additional barrier method like condoms while you're on these medications now however waste loss medications I want to make sure people understand they're not recommended during pregnancy due to safety issues and it's not also recommended to try to conceive while you're on these medications due to lack of studies in this population so if you want to do that please stop your medications at least one to two months before trying to conceive but it isn't an urban legend people have gotten pregnant on these medications there you go debunked okay let's see what we got here okay here's a Facebook question from Sylvio for Dr Kaho hey doctor like the guy before said these new drugs are way too expensive so will there be a generic version soon and what about the over-the-counter stop do they work or is it just a scam okay so he has a a couple of really good question here especially about the over-the-counter stuff and those price points Dr Kaho can you share a little bit more about that sure and Sylvia I I appreciate the Outreach and trust me I feel your pain on this we get asked all this all the time but you know Marissa actually works a lot uh with patients in clinic and they she always gets asked question so I'm going to let Marissa take this one yeah this is a this is a great question so currently the gop1 medications zet bound saxenda and wovi are currently under patent meaning that they're only available by the brand name however drug makers are currently experiencing a nationwide shortage of these medications and by law these medications are able to be compounded at compounding pharmacies under the generic names so these medications would still require a prescription and I highly recommend discussing this option with your provider it might be a better Financial option for you but you want to make sure that it's both safe and effective now there is a currently a one FDA approved OTC or over-the-counter medication and it's called Ally uh Dr Kaho mentioned it earlier under the generic name orist stat and this one you can buy without a prescription at your local pharmacy this medication however is only shown to have minimal weight loss so about 3 to 5% of your weight loss from your Baseline and lots of side effects including abdominal pain greasy stools gas and diarrhea so I would recommend discussing this option with your primary care provider prior to starting that and to make sure it's a right choice for you so Dr Mario just to jump in here quickly are you saying that there may be generic brands in the future in the future once the patent is is uh completed then I do think they will come out with generic versions of the medication great thank you okay looks like we got another question from the Graham so this time it's from Wayne and Wayne asks hi doctor let's see I came into some money and could actually afford oamic Z Bounder monjaro how often do I need to see my doctor while I'm on the medication is it safe to use them longterm or are there risks again two great questions I'm loving this I know some people that are on this new drugs and I'm sure they don't know the answer to Wayne's questions so what can you say well Kathy I'm sure you're right A lot of people just kind of jump into the pool without doing much research here so excellent question Wayne but before I answer your question let's check out an informative video from our friends at the Mayo Clinic it's a medication called seatide better known by the brand names OIC and wovi OIC is approved by the Food and Drug Administration to treat type 2 diabetes wovi is now approved to help with weight loss these drugs have been shown to help people lose on average about 15% of their body weight it works by tricking your brain and stomach into feeling full so you don't overeat it's really changed how we think about these weight loss medications it's a prescription medication the FDA advises it only for people with a body mass index or BMI greater than 30 or a BMI of 27 or more with a weight related health condition a common side effect is nausea these are injections and you give them once a week to yourself uh typically the belly so much like an insulin injection would be they're also expensive and often times not covered by insurance so check with your provider I think it's a great tool I think for a lot of people it certainly makes a significant difference to how they feel about food um and how they feel about their own hunger signals and their ability to control that and that's very powerful so Wayne you'll need to at least visit your doctor monthly as the medications need to be dose adjusted every four weeks until you get into a m dose but Marissa is there anything you'd like to add to this question yeah so when you start a weight loss medication it's important to understand your Baseline weight and your labs to assess your current state of health and then you may need to repeat these after 3 to six months of being on the medication to monitor your changes it's also beneficial to create smart goals including exercise and nutrition and making sure that you update your progress with your provider so that you are experiencing the behavior change and getting the most out of your medication while you're on the weight loss Journey thank you Dr Mauricio now if you got questions you know the drill we've got answers and in case you missed it the first couple of times here's yet another chance to find out where to send in your questions send in your questions to questions at allhealth tv.com or allhealth go on Facebook or YouTube or visit the ask the the doc page on our website allhealth tv.com all right finally a brave soul has sted up and is asking the hard questions and it comes from Heidi on YouTube Dr Kaho not to come off as judgmental but I can't believe nobody's asked these two most important questions so I guess it's up to me how much do these medications cost and are they covered by Medicare and insurance I couldn't be prouder Heidi you go girl let's find out how much these medications cost well you know Heidi unfortunately the injectable weight loss medications are very costly W GOI runs about $1,300 a month and Zep bound is about ,000 a month but both wobi and Zep bound have saving cards that are given by the manufacturer that could use that could be used at the pharmacy to cut the cost down to about 500 if your insurance doesn't cover it now just like the commercial like the video before said most Commercial Insurance don't cover mate loss medications because unfortunately obesity is not considered a chronic disease in our country according to insurance plans but check with your plan some plans do cover it now Medicare will Now cover wag GOI for its new indication if the patient has had a history of a heart attack a stroke or peripheral artery disease and they're overweight or obese and Medicaid currently does not cover any of these M loss medications okay so it looks like we have time for at least one more question and it's from Clarice on Instagram and her question is hi Dr Kaho do I need to follow a particular diet if I'm on these diabetic medications and how soon should I expect to see results so Marissa you're counseling patients and clinic and I know you seeing a lot of patients with results every day what would be your recommendations yeah for the expectations for weight loss we typically shoot for 1 to 2 pounds of weight weight loss per week each person really responds to the medication differently so it really depends on what they're doing and making sure that they're following the lifestyle modifications as well while they're on the medication so implementing a 500 calorie reduced diet that focuses on nutrient-dense Foods may help you reach your weight loss goals and that includes a diet rich in fruits vegetables whole grains lean proteins and healthy fats the mediteran Ian diet is a great guide to follow additionally if you want to focus on uh your portion control and then aim for well balanced meals staying hydrated and drinking plenty of water throughout the day will also help you maintain that feeling of fullness and support your bodily function and then you don't necessarily have to cut anything out of your diet but you do want to be more mindful of the foods that you eat and limit your added sugars your processed foods sweetened Beverages and alcohol it's important to follow the guidance of your provider and you may want to work closely with a registered dietitian nutritionist or a wellness coach thank you Dr maricio now I actually have questions I jotted them down so I you know as a host I still have questions for the pharmacist so thank you so much for answering these ahead of time so let's talk about this this is my my so the weight loss medications do they interact with other prescriptions or if you have like another health condition as you were talking about earlier does that happen I can take this one so yeah that definitely does happen um that's why it's so important to talk with your your provider to see if weight loss medications are right for you and that way you can determine which one would be right for you so some medications can not they can interact if you have other conditions like a like a heart condition for example um because they might have side effects that increase your heart rate or your blood pressure and so you wouldn't want to use one of those medication options in someone who has that past medical history and then you also want to make sure that you're checking the other medications that you're on to make sure there's no duplicate side effects that you may experience from those medications thank you Dr Maris you I'll have one more and when we go to our pharmacist obviously we love asking questions to our pharmacists so are they able to help us if we have any questions about our weight loss Journey about how to properly use the medication pharmacists are a great wealth of knowledge they really know how to do a lot of stuff especially in Wellness areas as well um if you not sure go talk to your pharmacists who you normally go see to pick up for your medications from um they have a they have a great knowledge they're really well-rounded and Marissa I know you you counsel a lot of these patients in in wellness and what are some of the well uh Wellness things that you're doing in your clinic to help these patients uh improve and help lose weights with these medications so like we talked about earlier you know a lot of there's a lot of side effects that may potentially be experienced with the medication so as a pharmacist I'm able to help my patients they can you know call me or come to the pharmacy directly if they want to speak with a pharmacist there and we can help with mitigating those side effects so if they're experiencing nausea we can ask them what kind of foods are you eating how often are you eating and make those recommendations to help prevent those side effects from returning so a lot of times about the food that can definitely play a big role in um the side effects that they may be experiencing can also help with keeping you accountable making sure that your prescription is Affordable um whether it's going through the insurance or we can help you find a coupon to help pay for the medication uh pharmacists have a like you said a wealth of knowledge that we can provide so definitely don't feel afraid to reach out to your local pharmacist we actually have time for one more question and I and we got one from IG again from Instagram and this one comes from Eric do I need to be on these medications long term that's actually a great question we didn't hear about that so I would say um you know as long as you're on the medications this is a big thing um the the most important thing is why did you get on the medication you want to lose weight but even though these medications help you lose weight the most important thing is that you really need to focus on changing your lifestyle because what happens is as a after a long term is you might want to get off the meds and sometimes Insurance don't cover it for too long either but this way once you've lost your gold weight you should be thinking of changing your behavior and how you eat and I would say if you do that then you shouldn't have to be on these medications for a very long term now it also depends on how much weight you have to lose but um I think the most important thing is while you're on these medications that are helping you lose the weight change your lifestyle exercise do a lot of much more uh things that you can be mindful of so that you can help keep your the weight that you've lost Marissa is there anything you'd like to add on that yeah yeah great great response I think the only thing I would add is that some of the medications are meant to be used for a short-term period so for example fent me that one's typically like a short-term option about 3 months versus your gp1 medications which are typically more of a long-term treatment and working closely with your provider or your pharmacist will really help you in understanding realistic expectations of how long you may need to be on that medication thank you so much Dr Mauricio this is so helpful again that's all the time we have for today I wish we had more but guess what we'll be back next week I'm Kathy Boo and I'll see you next time on the dock send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com