Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder
▶Ep 15 · 0:32
clinicalObesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 15 · 0:32
quoteThe data clearly supports that obesity is a disease impacted by behavior.↗
▶Ep 15 · 0:37
quoteThe big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 15 · 0:44
clinicalObesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles.↗
▶Ep 15 · 1:08
epidemiologicalHistorically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 15 · 1:08
quoteHistorically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 15 · 1:15
guidelineThe new AAP clinical practice guidelines clearly state that obesity is a disease.↗
▶Ep 15 · 1:22
quoteThey clearly state that obesity is a disease.↗
▶Ep 15 · 1:25
guidelineTreatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 15 · 1:25
quoteThe key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 15 · 1:41
guidelineThe guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period.↗
▶Ep 15 · 1:55
guidelinePharmacotherapy is FDA labeled for adolescents above the age of 12.↗
▶Ep 15 · 2:02
clinicalCurrently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity.↗
▶Ep 15 · 2:08
guidelineBariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile.↗
▶Ep 15 · 2:29
clinicalWegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents.↗
▶Ep 15 · 2:44
clinicalData in adults on tirzepatide shows significant change in body weight compared to placebo.↗
▶Ep 15 · 2:51
clinicalBariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years.↗
▶Ep 15 · 2:51
clinicalOral GLP-1 medications are on the way in a few short years.↗
▶Ep 15 · 3:03
clinicalThere is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period.↗
▶Ep 15 · 3:18
clinicalThere is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem.↗
▶Ep 15 · 3:24
clinicalBariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids.↗
▶Ep 15 · 3:40
clinicalWeight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel.↗
▶Ep 15 · 3:56
clinicalWeight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status.↗
▶Ep 15 · 4:03
quoteIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 15 · 4:03
clinicalIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 15 · 4:22
epidemiologicalMetabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease.↗
▶Ep 15 · 4:31
clinicalObesity is a significant risk factor for MASLD.↗
▶Ep 15 · 4:34
epidemiologicalAbout 20% of youth in the United States have obesity, which is roughly 15 million children.↗
▶Ep 15 · 4:40
epidemiologicalApproximately 5 million children have both obesity and MASLD.↗
▶Ep 15 · 4:45
epidemiologicalBetween 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma.↗
▶Ep 15 · 4:56
epidemiologicalThere are racial and ethnic differences in MASLD prevalence.↗
▶Ep 15 · 5:09
epidemiologicalThe rates of severe forms of obesity are only increasing.↗
▶Ep 15 · 5:09
epidemiologicalObesity affects at least 35% of adults and 20% of children in Illinois alone.↗
▶Ep 15 · 5:19
clinicalObesity significantly increases the risk of long-term health problems and early death.↗
▶Ep 15 · 5:23
epidemiologicalThe economic impact of obesity is substantial, with reductions in GDP and increases in state spending.↗
▶Ep 15 · 5:30
quoteCrucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault.↗
▶Ep 15 · 5:30
opinionObesity is a disease driven by biology and it is no one's fault.↗
▶Ep 15 · 5:37
opinionAccess to effective obesity medications is a health equity issue.↗
▶Ep 15 · 5:41
epidemiologicalObesity disproportionately affects people of color and those living in poverty.↗
▶Ep 15 · 5:49
clinicalOrganizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country.↗
Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder
▶Ep 7 · 0:32
clinicalObesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 7 · 0:32
quoteThe data clearly supports that obesity is a disease impacted by behavior.↗
▶Ep 7 · 0:37
quoteThe big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 7 · 0:44
clinicalObesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles.↗
▶Ep 7 · 1:08
epidemiologicalHistorically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 7 · 1:08
quoteHistorically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 7 · 1:15
guidelineThe new AAP clinical practice guidelines clearly state that obesity is a disease.↗
▶Ep 7 · 1:22
quoteThey clearly state that obesity is a disease.↗
▶Ep 7 · 1:25
guidelineTreatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 7 · 1:25
quoteThe key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 7 · 1:41
guidelineThe guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period.↗
▶Ep 7 · 1:55
guidelinePharmacotherapy is FDA labeled for adolescents above the age of 12.↗
▶Ep 7 · 2:02
clinicalCurrently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity.↗
▶Ep 7 · 2:08
guidelineBariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile.↗
▶Ep 7 · 2:29
clinicalWegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents.↗
▶Ep 7 · 2:44
clinicalData in adults on tirzepatide shows significant change in body weight compared to placebo.↗
▶Ep 7 · 2:51
clinicalBariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years.↗
▶Ep 7 · 2:51
clinicalOral GLP-1 medications are on the way in a few short years.↗
▶Ep 7 · 3:03
clinicalThere is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period.↗
▶Ep 7 · 3:18
clinicalThere is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem.↗
▶Ep 7 · 3:24
clinicalBariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids.↗
▶Ep 7 · 3:40
clinicalWeight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel.↗
▶Ep 7 · 3:56
clinicalWeight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status.↗
▶Ep 7 · 4:03
clinicalIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 7 · 4:03
quoteIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 7 · 4:22
epidemiologicalMetabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease.↗
▶Ep 7 · 4:31
clinicalObesity is a significant risk factor for MASLD.↗
▶Ep 7 · 4:34
epidemiologicalAbout 20% of youth in the United States have obesity, which is roughly 15 million children.↗
▶Ep 7 · 4:40
epidemiologicalApproximately 5 million children have both obesity and MASLD.↗
▶Ep 7 · 4:45
epidemiologicalBetween 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma.↗
▶Ep 7 · 4:56
epidemiologicalThere are racial and ethnic differences in MASLD prevalence.↗
▶Ep 7 · 5:09
epidemiologicalThe rates of severe forms of obesity are only increasing.↗
▶Ep 7 · 5:09
epidemiologicalObesity affects at least 35% of adults and 20% of children in Illinois alone.↗
▶Ep 7 · 5:19
clinicalObesity significantly increases the risk of long-term health problems and early death.↗
▶Ep 7 · 5:23
epidemiologicalThe economic impact of obesity is substantial, with reductions in GDP and increases in state spending.↗
▶Ep 7 · 5:30
opinionObesity is a disease driven by biology and it is no one's fault.↗
▶Ep 7 · 5:30
quoteCrucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault.↗
▶Ep 7 · 5:37
opinionAccess to effective obesity medications is a health equity issue.↗
▶Ep 7 · 5:41
epidemiologicalObesity disproportionately affects people of color and those living in poverty.↗
▶Ep 7 · 5:49
clinicalOrganizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country.↗
Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder
▶Ep 9 · 0:32
quoteThe data clearly supports that obesity is a disease impacted by behavior.↗
▶Ep 9 · 0:32
clinicalObesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 9 · 0:37
quoteThe big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction.↗
▶Ep 9 · 0:44
clinicalObesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles.↗
▶Ep 9 · 1:08
epidemiologicalHistorically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 9 · 1:08
quoteHistorically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity.↗
▶Ep 9 · 1:15
guidelineThe new AAP clinical practice guidelines clearly state that obesity is a disease.↗
▶Ep 9 · 1:22
quoteThey clearly state that obesity is a disease.↗
▶Ep 9 · 1:25
quoteThe key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 9 · 1:25
guidelineTreatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.↗
▶Ep 9 · 1:41
guidelineThe guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period.↗
▶Ep 9 · 1:55
guidelinePharmacotherapy is FDA labeled for adolescents above the age of 12.↗
▶Ep 9 · 2:02
clinicalCurrently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity.↗
▶Ep 9 · 2:08
guidelineBariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile.↗
▶Ep 9 · 2:29
clinicalWegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents.↗
▶Ep 9 · 2:44
clinicalData in adults on tirzepatide shows significant change in body weight compared to placebo.↗
▶Ep 9 · 2:51
clinicalBariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years.↗
▶Ep 9 · 2:51
clinicalOral GLP-1 medications are on the way in a few short years.↗
▶Ep 9 · 3:03
clinicalThere is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period.↗
▶Ep 9 · 3:18
clinicalThere is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem.↗
▶Ep 9 · 3:24
clinicalBariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids.↗
▶Ep 9 · 3:40
clinicalWeight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel.↗
▶Ep 9 · 3:56
clinicalWeight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status.↗
▶Ep 9 · 4:03
clinicalIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 9 · 4:03
quoteIt is much easier to lose weight than to keep it off, which is demonstrated across many studies.↗
▶Ep 9 · 4:22
epidemiologicalMetabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease.↗
▶Ep 9 · 4:31
clinicalObesity is a significant risk factor for MASLD.↗
▶Ep 9 · 4:34
epidemiologicalAbout 20% of youth in the United States have obesity, which is roughly 15 million children.↗
▶Ep 9 · 4:40
epidemiologicalApproximately 5 million children have both obesity and MASLD.↗
▶Ep 9 · 4:45
epidemiologicalBetween 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma.↗
▶Ep 9 · 4:56
epidemiologicalThere are racial and ethnic differences in MASLD prevalence.↗
▶Ep 9 · 5:09
epidemiologicalObesity affects at least 35% of adults and 20% of children in Illinois alone.↗
▶Ep 9 · 5:09
epidemiologicalThe rates of severe forms of obesity are only increasing.↗
▶Ep 9 · 5:19
clinicalObesity significantly increases the risk of long-term health problems and early death.↗
▶Ep 9 · 5:23
epidemiologicalThe economic impact of obesity is substantial, with reductions in GDP and increases in state spending.↗
▶Ep 9 · 5:30
quoteCrucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault.↗
▶Ep 9 · 5:30
opinionObesity is a disease driven by biology and it is no one's fault.↗
▶Ep 9 · 5:37
opinionAccess to effective obesity medications is a health equity issue.↗
▶Ep 9 · 5:41
epidemiologicalObesity disproportionately affects people of color and those living in poverty.↗
▶Ep 9 · 5:49
clinicalOrganizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country.↗