Dr. Sarah Stombaugh:
Before we get into the episode, I am thrilled to announce we are launching an online course, The GLP Guide. The GLP guide is a must have resource for patients who have been prescribed any of the GLP medications such as Wegovy, Ozempic, semaglutide, Zepbound, Mounjaro, tirzepatide, Saxenda, liraglutide. There are a lot of them and this course is available for anyone to purchase. We often hear from people who haven't been given much information about their GLP medications. No one has told them how to handle side effects, what nutrition recommendations they should follow, or what to expect in the longterm. And it can be really intimidating and simply frustrating to feel like you're alone in your weight loss journey. With the GLP guide, you'll get access to all of the answers to the most common questions for patients using GLP medications, not sure how to use your pen, struggling with nausea, wondering how to travel with your medications. We've got you covered for only $97 for one year access. This is an opportunity you do not want to miss. The course is launching on October 1st. For more information and sign up, please visit www.sarahstombaughmd.com/glp. You don't have to be on this journey alone. We are here to guide you.
And now for today's episode, this is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast.
Announcer:
Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh.
Dr. Sarah Stombaugh:
Hello everyone and welcome to today's episode. I have a guest with me and I'm super excited. She and I have been trying to coordinate this for a while and so it is such a treat to have her on. This is Dr. Cate Varney. She is a family medicine and obesity medicine physician local to me in Charlottesville, Virginia. She's at the University of Virginia and she is just awesome in the obesity medicine space. Does a lot with the obesity committee or with the Obesity Society with OMA, the Obesity Medical Association and their committees does a lot of work in advocacy and it is such a treat to have her on. Today we are talking about updates from the Obesity Society conference that happened this last fall because that is all of the latest breaking research in the field of obesity medicine. Cate, Dr. Varney, thank you so much for having coming here today. I'm so excited to have you on.
Dr. Catherine Varney:
Thanks for having me. I'm excited to share these updates.
Dr. Sarah Stombaugh:
Awesome. Well, tell us, I gave you a little bit of a brief introduction, but tell me a little bit more about yourself, how you came to be in this space and then really serving such a major role in this community because a lot of people love learning from you. You do a lot of work in the advocacy space and I would love to hear about that.
Dr. Catherine Varney:
Thanks. Yeah, so I came to obesity medicine kind of through my own personal experience. As you said, I'm a family medicine physician by initial board certification, and I just found really early on that family medicine is what we call preventative medicine. And preventative medicine is treating obesity because if you treat obesity, you treat all these other things that I'm seeing on a daily basis, high blood pressure, cholesterol, diabetes. So I kind of wanted to get back to the root of treatment and treating this underlying thing that we could prevent these chronic diseases. And so like I said, personally, I've struggled with this and I remember sitting across from my primary care physician at one point and just begging for help with my weight and I was just out of medical school and I remember them saying to me, Kate, you just graduated medical school. You know what to do, just eat less, exercise more. And I was like, oh, I've never tried that before.
Dr. Sarah Stombaugh:
What amazing advice.
Dr. Catherine Varney:
Yeah, take all my money. So I said, I am going to figure this out. And my goal is for my primary care physicians to never have that interaction with their primary care physician. And that's why I do a lot of the advocacy and teaching and education. Right now. I'm the director of obesity medicine curriculum for the University of Virginia Family Medicine Residency. And my goal is for those family medicine residents to come out and be able to have that conversation with their patients in a meaningful way and also a compassionate way because I hear so many times by the time the patients, and you probably hear this too, that by the time the patients get to you, they talk about these situations that they've had with other physicians and providers that were really not positive, leaves a really bad taste in their mouth. And so my goal is for just to educate as many possible, I've learned this and now I want to go out and spread the gospel.
So that's, I've been doing this for about 15 years now at the University of Virginia. We started our combined bariatric obesity medicine clinic and we are comprehensive center. We have a first try accredited comprehensive obesity medicine clinic in Virginia for adult and adolescent bariatric surgery with obesity medicine certification. And that's through our major national accreditation body. So we're really proud of that. But we started that in October, 2021 and it's just taken off and I love doing this. And as you probably know and some of your listeners, we've made major gains with advocacy recently with Biden's, one of Biden's last things going out the door as he's trying to get Medicare to cover obesity medications. We've been working on that with the Obesity Medicine Association for probably what going on 12th year. So this is huge. So it's an exciting time in obesity medicine and I'm excited to share what I learned at Obesity Week, which like you said is our major once a year international conference.
We have anywhere from two to 5,000 people that attend every year. Scientists, clinicians, researchers, dieticians, social workers. It's just such a great opportunity for networking. But this is where all that breaking information, all the latest and greatest data comes, you can just walk through hundreds and hundreds of research poster presentations. And so this is what I'm going to try. We are kind of limited on time today, but I'm going to try to drop the information that I was really excited about.
Dr. Sarah Stombaugh:
Yes, and I am really excited because when we think about right now you're hearing all about the GLP Ozempic is that Mounjaro and there's been this huge really paradigm shift over the last few years and what the treatment of obesity looks like. But the really cool thing is that when you look at some of the research, that was all the stuff that was being presented five plus years ago. And so we're seeing all the earliest signs of that information is coming out here. So what I would love to do, and we talked about is really focus on maybe the top three things that you learned at that conference. What are the biggest breakthroughs that we can look forward to seeing in the diagnosis and treatment of obesity over the next few years? So tell me of everything you saw at the conference, I'm sure it was hard to narrow it down, is
Dr. Catherine Varney:
When I was researching this, I was like, oh my gosh, there's so many things and having to whittle it down was hard. So maybe we'll have to do a follow up to Yeah,
Dr. Sarah Stombaugh:
We could. Absolutely. Yeah. What are the top 25 things you learned? So tell me what was the thing that stood out to you most at the conference?
Dr. Catherine Varney:
I think probably Viking Therapeutics. Okay. So in the last couple years, Novo Nordisk and Eli Lilly have been kind of the champions in this area of these new incretin based therapies, wegovy Zep bound for weight loss. And so they've been kind of the leaders. But here comes Viking Therapeutics with the VK2735, which is also a GLP-1 and GIP receptor agonist similar to Zepbound. So it's those two incretin hormones. And so they've been working on, one of the first thing they've been working on was their subcutaneous injection. And the thing that's unique about this one is the subcutaneous injection was actually, it's at once a month, but they presented phase one study data from their first oral formulation. And I think this is my speculation is that in the phase two trials with the VK2735, the subcutaneous monthly, they were having issues with adverse side effects.
And that's a lot of what people have with the GI side effects. So I think this was their answer to trying to accommodate for that. So their phase one study, it's an oral formulation going up to a hundred milligrams daily. And what it showed, and I think this is the most remarkable thing, and I'm going to try to show comparisons of why I'm excited about this, but the placebo adjusted weight loss after 28 days, one month is 6.8%, but without the placebo adjustment, 8.2% from baseline. So 8% of your body weight and three 30 days. That's amazing. So as a reminder, the FDA, in order to classify a medication as a weight loss medication, obesity medication, they want to see that the medication induces at least a 5% weight loss after three months. So they're getting 8% after one month, and a hundred percent of participants achieved at least 5% weight loss compared to 0% with placebo.
So that's super exciting and more interesting. Everybody's always concerned about the GI side effects with these medications, and 90% of people reported mild side effects, but specifically we have to look at this a little bit deeper. Of those having GI side effects, 84% of that group said they're mild, right? 4% reported vomiting and 7% diarrhea. So I think that is really, this is what I'm excited about with these medications is because these two other companies have kind of held the market, and if people didn't respond well or they had really bad GI side effects, they were out of luck. But with this, we're getting more people coming into the market offering formulations that are going to be, we can be able to spread out if there's anybody that doesn't like injection. We've got this oral formulation now.
Dr. Sarah Stombaugh:
Oh, that's amazing. And over the last couple of years, I feel like we've seen a lot of people, I'll try the injections. I know it's such a great medication available to me. But having that oral option and that 8% is, I mean, that's astounding because when you look at the resolution of comorbidities associated with obesity, hypertension, impaired fasting, glucose, diabetes, prediabetes, hyperlipidemia, all of it, we start to, as you start to cross into even 5%, but especially at 10%, you start to see really significant improvement sometimes even then resolution. So if you're talking about one month, I mean the two month, three month, six month data, that's really cool. I thank you for sharing that with us.
Dr. Catherine Varney:
And one of the things that the companies are now looking at in these phase two studies is because likely one of the things that we worry about, and I'm sure you address this with your patients too, is we worry about with rapid weight loss, I tell my patients, you don't just lose fat. When you lose weight, you lose a combination of fat muscle and water. Ideally, we want that percentage to be like 80, so to be what we call healthy weight loss, we want that to be at 80% adipose, 20% less of muscle mass, and then less than 1% water weight.
So these companies, when they're studying this now, they're actually looking at body composition. So they're making sure that they're not significantly losing a lot of muscle mass. What a lot of the naysayers are saying, they're like, oh, well, they're losing a lot of weight, but it's all muscle. And clinically I'm doing body composition with my patients and I'm not seeing that. But that's because with your patients, we give a comprehensive approach of it's not just take this medication and good luck. You got to be eating a lot of protein. You got to be doing exercise because that helps maintain and helps the patient lose 20% or less of muscle.
Dr. Sarah Stombaugh:
Absolutely. And I think we're sort of seeing with some of the, I'll say older GLP, but with the Wegovy, Zepbound, that fear has come up and those studies are happening, but there's so much anecdotal data from people who've been doing this of, Hey, it's pretty preventable to create issues with sarcopenia where we're having disproportionate muscle mass loss. It's pretty doable to be able to reduce that risk. As long as we are doing the protein, as long as we are doing the resistance training, we can really reduce that risk. And so I love, it's pretty neat that they're doing that as part of the early trials because then you just have that information. We can help to provide that reassurance because it's not just about the number and the scale. It's really about body fat percentage and what is that adipose tissue creating? And so excellent, I'd love to hear that.
Dr. Catherine Varney:
And then a follow up. Yeah, as a follow up, the phase two study, the venture trial with Viking, that was the VK235, that's the monthly subcutaneous. They were showing at 13 weeks, this monthly subcutaneous, 14.7% weight loss from baseline. So as a reminder, semaglutide at 12 weeks on average resulted in four to 6% weight loss, and tirzepatide was around six to 8% at 12 weeks. So this is really, it's a showstopper. So 88% of people compared to 4% with placebo achieved at least 10% weight loss. So pretty remarkable on those phase two trials. But again, like I said, 92% of people were reporting mild to moderate GI side effects, and 68% was mild, 32% were moderate. And I think that's probably what they were concerned about a little bit, but 0% severe. The thing we worry about with the GI side effects is that we don't want our patients to be miserable. And also too, that leads to greater rates of discontinuation. So it's nice look that they're addressing this head on and then trying to create accommodations for it and adjusting the medications.
Dr. Sarah Stombaugh:
Yeah, absolutely. Well, that's neat. All right. Tell me what was the next most exciting thing you heard at the conference?
Dr. Catherine Varney:
So I would say it's exciting, but at the same time, I have a lot of hesitation about this. So Epitome Medical, they presented data on their drug-free biodegradable capsule, and this is going to sound familiar to you, this capsule, this capsule, it's made of an absorbent polymer that expands in the stomach to create a gel-like structure, which takes up space and then it makes you feel full. My concern with this is that it's kind of reinforcing that bias that it's just a fullness issue versus it's not a hormonal issue, this medication, or it's actually considered a medical device, not a drug, because it just basically passes through you that it doesn't address the underlying issues that we know from observational studies that patients with obesity, we have issues with GLP-1, GIP, leptin, ghrelin, all these hormonal things. So it's not addressing that underlying issue. But the FDA actually cleared this for BMIs of 25 to 40, so 25, we're meeting a lot more people in trying to prevent obesity, which I like. Obviously it's contraindicated in pregnancy and eating disorders, and I imagine it will probably also be with people that have a history of bariatric surgery, but a little bit less impressive. 55% of people achieved at least 55% weight loss, and there were no serious adverse side effects. But we have to remember that when they do these trials, there was only 279 participants. And as you and I know,
Dr. Sarah Stombaugh:
Small group,
Dr. Catherine Varney:
Right? So my concerns with this, so you're already probably thinking in your mind Plen, right?
Dr. Sarah Stombaugh:
Yeah. I'm like, what about Plenti? Isn't that sort of the same thing? Right.
Dr. Catherine Varney:
So similar, I remember sitting at obesity week in a plenti presentation where they were just presenting this data back in, I think it was like 2018 or something, but Plenti was a very similar medication. They marketed it as a non-drug medical device for this, and it was the same thing. It was polymers that expanded in the stomach. It was FDA approved in April of 2019. But then due to really disappointing sales and concerns for effectiveness, the manufacturer actually discontinued it in 2022. And I don't know if you used this with your patients or not, but I
Dr. Sarah Stombaugh:
Never did.
Dr. Catherine Varney:
Yeah, I used it in a small group of people because it was a little bit for access, it was a little less expensive. I really had high hopes for it. But really clinically, once it got out to market for the reasons why they pulled it off because of low sales, I really expected it to be good. But it just really was a little bit disappointing. I think that there is a market for this for some people because with the observational studies studies people that have a lower BMI, that BMI from 25 to 27, they're concerned about their weight, their weight creeping up over the years. They may not have really severe metabolic dysfunction that's adversely affecting those hormones like GLP-1, GIP. It could be more of a neurotransmitter thing and a feeling of fullness at that point. But I think that given our rates of obesity in the United States, I think that it's a very small subset of a population that this is going to be applicable for. But it is an option for people that want to avoid a medicine per se. They want to use something that passes through them. And so I think that, I hope that they have better effectiveness, but fingers crossed on that and we'll see.
Dr. Sarah Stombaugh:
Yeah. Well I think as you say, for patients who we know that obesity is a disease of adipose tissue, we know that adipose tissue is not just this blob that sits in our body, but is rather very hormonally active and chronic obesity is hard to treat because of that hormonal activity, not because of a willpower thing, not because of that eat less and move more. But when we look at patients who are more on the cusp struggling with the earliest signs of overweight, for example, are we able to provide that as a preventative care before it progresses? You said approved up to BMI of 40, it's hard to imagine a patient with a BMI of 39.9 that that's going to be the right call for them, but for that patient who just crosses over into that threshold and may looking for a more low risk intervention, as you say. Yeah. All right. I will have to keep my eye out.
Dr. Catherine Varney:
Yep. I'm thinking for my women that are going through perimenopause that are starting to have some metabolic dysfunction starting, we hear a lot about a women, they're like, oh, my weight has been constant for my whole life. And then they start going through these perimenopausal changes and they start to not have as much control with their weight. That's kind of the population I'm thinking of when I think of in my population.
Dr. Sarah Stombaugh:
Yeah. Alright, well, we'll have to see what happens. Thanks for sharing that. And tell me number three, I know like we said, you could probably come up with 25, but what is the third most exciting thing you learned at obesity week?
Dr. Catherine Varney:
So the third is the select trial, so sponsored by Novo Nordisk. This is for semaglutide, which is Wegovy. And so it showed less adverse events compared to placebo in the areas of patients getting a stent, having a heart attack, getting AFib, having cardiac failure, acute kidney injury, and coronary artery disease. And so some of our listeners know that Wegovy was FDA approved for risk reduction of cardiovascular events. And I think that we, based on finding this, that they're going to be less likely to get a scent AFib cardiac failure, acute kidney injury. I think what we can expect from this data is that we're going to see these medications getting more indications. So it's going to come out for the indication of reduction of cardiovascular risk, but it's also going to come out for risk reducing risk of renal failure just like that we're seeing with tirzepatide. It seems like tirzepatide is getting approved for something new every week or they're trying to find some new thing. So as you know, tirzepatide was just FDA approved in December for treatment of sleep apnea. I expect Wegovy to have expanding indications of use, therefore being able to treat a larger population.
Dr. Sarah Stombaugh:
I love that when I think this shift that we've seen really now over the last year with Medicare accepting wegovy and then just finding out in the last day or two that they'll be accepting the Upbound for the treatment of sleep apnea. It really starts to be this huge shift of people like you and I and others in the medical community have recognized and been treating obesity as a disease. But what we know from an insurance standpoint is that there is still this exclusion where there are commercial insurers and Medicare and Medicaid that just simply do not treat obesity. And so if the diagnosis is obesity, there's no coverage for those medications. So you and I run into a lot is you've got a patient who has type two diabetes and it's like, okay, we can use Ozempic, we can use Mounjaro medications that have that indication, but when someone has the diagnosis of obesity, there's not coverage for Zepbound and there's not coverage for Wegovy. And so we've sort of seen this back door open as you will because we know obesity is associated with cardiovascular disease and with sleep apnea, with chronic kidney disease and all of these other things. So it's fun to see the comorbidities being shown, Hey, these do reduce this risk. And seeing the approval for that, especially coming from Medicare, is a huge deal because we typically will see commercial insurers will follow in line with that. And so it's really exciting to see some of these other indications.
Dr. Catherine Varney:
Yeah, it's frustrating and this is where I want not only physician and provider, but also patients to be an advocate about pushing for these medications. We've seen that people are pushing for this. Bernie Sanders is helping us in Congress to push for inclusion and of these medications for diabetes at a cheaper cost. And I think that there's this balance between thinking that the insurers are kind of the bad people, but I think what we have to remember too, and I remind a lot of my patients, it's the insurers definitely, they put up a lot of barriers like these medications are FDA approved for certain bmi, but you'll see that insurers go, well, we're not covering it until their BMI gets to 40. So they're putting up these barriers and they are purely financial in order to have a less amount of people because these medications are so expensive.
So that's one of the exciting things about these other things coming to market is that there's going to be more competition and with more competition in theory, we've seen liraglutide go generic and other people starting to manufacture this. So prices are coming down. And so there's this balance between advocacy toward the insurance. I mean, I don't think we can really advocate to them because they're going to try to protect their bottom line until these medications are more affordable. But advocacy to your state senators, your federal senator or representatives sending letters, they matter. And you can even ask to meet with these people and tell them you'll probably end up meeting with a staffer from their office, but meeting with them. And they love hearing personal accounts of how patients that had coverage and then lost coverage. They want to hear these things. You wouldn't believe how many times I've met with senators or representatives that are just mind blown with some of the information that I tell them about with obesity.
Because unless you're working with it or have personally been affected by it, the misinformation about obesity is still out there. Research shows that up to 20% of healthcare providers still don't think that obesity is a disease, even though it's been recognized for decades by the World Health Organization and the European Union for as a disease of obesity. And since 2012, the American Medical Association. So you have all these healthcare people saying obesity is a disease, yet you have all these other insurers. And then also by proxy, the regulations that are coming from the state and the federal regulations that limit their ability to intervene and say, listen, you guys need to cover this, right? You need to cover birth control. You need to cover this. So we need to, I really urge your patients and your listeners to get active in doing that. And one of the ways they can do that is by going to the Obesity Action Coalition website and learning more, they have preformed letters that you can kind of write and then fill in your information to make it more personal.
Dr. Sarah Stombaugh:
Absolutely. And I love mean what a powerful call to action because I think the more people that can share their stories and give this information help to understand the way these medications have helped them, or I have patients who pay many, many hundreds of dollars per month for access to medications with coupons, for example. What if they were able to access these medications in a more affordable way and continue to see those health benefits? It's so important. And I love, there's both this piece of advocating and then the research piece of let's accumulate the data to show that yes, this does provide a cost savings down the road, and this is supporting and reducing other medical conditions. And so it's an exciting time to be in our space.
Dr. Catherine Varney:
Some of the limitations that we have when we were meeting with Virginia representatives recently, the problem that we have is that it does it absolutely. You can't deny that five, 10 years down the road, you're seeing incredible health benefits. You're seeing reduction in healthcare costs exponentially. There's been many research papers to show that the problem with say, here in Virginia, we're what we call a balanced budget state. And so they can't go into deficit each year in order saying, okay, we're going to go into deficit, but in three years we're going to make it up because they're balanced budget, they have to meet their budget every year and they can't go into deficit. So that's one of our limitations here.
But I think also too, we kind of blame the insurers, but also it's really the employer. The employer has to opt in for coverage of obesity, medication, obesity treatment is not included, unfortunately, kind of like how fertility treatment is not a guaranteed treatment. Employers have to opt in for that, and less than 33% of employers opt in for that treatment. So you and I, we always have to think, we're always sharing, okay, does this employer, does this employer, it took us three to five years with the University of Virginia to really advocate and push for their employees to have coverage. So it's been kind of a slow rolling thing, but you just kind of keep pushing. So another thing that patients can do is they can go to their employer and they say, I really wish that you would cover these medications to their HR department.
Dr. Sarah Stombaugh:
And there's on the Wegovy website, they have a really great form letter that can be filled out, and I'll fill that out often for my patients and have them submit it to the HR and sometimes not sure if it's doing much, but we do the best that we can to make sure that we're providing that advocacy.
Dr. Catherine Varney:
So some more from the select trial. So it gave us some more information about complications. Again, you have a lot of naysayers always saying like, oh, it's going to cause this, it's going to cause that. And what we did see is that there was a higher incidence of gallstones in those treated with semaglutide versus placebo, but it wasn't significant compared to placebo. And I think that that can be explained because of the weight loss, because when you're on semaglutide, you're going to have greater weight loss, and with greater weight loss, you get more cell turnover, and so you have a higher risk of gallstone formation versus the placebo. They're losing less, so they're not going to get those gallstones right. So I think that that can be explained, but also too, it wasn't statistically significant. We also saw that there was less incidences of acute cholecystitis or inflammation of the gallbladder compared to placebo. And again, this just confirms what there's been at least two meta analysis. A meta analysis, as you know for your listeners, is a really big look at all the different research studies that has shown that you basically have the same risk of getting acute pancreatitis, inflammation of your gallbladder or your gallbladder or your pancreas, whether you're on this medication or not. And it's more likely probably because of the weight loss and not the medication.
Dr. Sarah Stombaugh:
I love that one, being able to show not having gallstones, but not necessarily having acute cholecystitis. That inflammation of the gallbladder I think is a really important point. Excellent.
Dr. Catherine Varney:
We also saw that there was no difference in suicidal ideation. The European Health Organization, they raised the alarm on this about, I think it was about a year and a half ago, two years ago, that they felt that there was an increased risk of suicidal ideation. But the CDC and NIH have both conducted analysis earlier this last year that actually showed a decrease in suicidal ideation. So thoughts of suicide and self-harm among all races, all genders, and all age groups in the adult population. So I think, again, this confirms what we see clinically because as prescribers, when this first came out, I was like, that's weird because my patients seem to be getting their depression and anxiety seems to be getting better. And so it just confirms what we've seen clinically.
Dr. Sarah Stombaugh:
Excellent. Yeah, when those reports first came out, it's like, well, it's centrally acting. I think it's important that we're paying attention and making sure that there's not issues here. And clinically the number of patients who will say, I'm not even asking about it, but they're like, my anxieties, it's been unrecognizable. I've not been like this for years, or My depression has really improved alongside this medication. So that's excellent to see that being played out in a more formal way.
Dr. Catherine Varney:
And it may be also too, it was looking that way initially because we know that obesity is contributing. Patients with obesity have higher rates of depression and anxiety among the general population. And that's probably multifactorial. It probably does have to do with what we call that sick fat disease, like the hormones and neurochemicals that are coming off that, but also to the social and healthcare stigma that they encounter with having obesity. So it's really exciting to see that. That was confirmed too. And then the last thing that we saw was that there was no difference in the risk of malignant neoplasms or cancers. So that was exciting. There was concern about these medications with thyroid cancer, and what we see is that there was an increased risk of a very rare type of thyroid cancer, this type of thyroid cancer. It's usually genetic, so you're going to see it in multiple family members, and it makes up less than two to 3% of all thyroid cancers.
Most thyroid cancers that you see are a completely different one. And when we saw that in the study, it was only in the rodent models. It wasn't demonstrated in the human subjects. And that makes sense to me as a researcher scientist, is that because rodents have a lot more of these receptors in their thyroid tissue that we don't have the calcitonin receptors. And so also too, it was dose dependent. The dose that it took to activate these thyroid tumors in the rodents was 26 to 44 times higher than we would even give a human. So I think that obviously there's a black box warning that if you have a history of that super rare type of thyroid cancer, we're not going to be using these medications. But I think that when we look at risk and benefit, the risk of you getting thyroid cancer versus the risk of all these things that obesity can cause heart attacks, strokes, high blood pressure, diabetes, other
Dr. Sarah Stombaugh:
Cancers,
Dr. Catherine Varney:
Other cancers, that I think that the risk outweighs the benefit of use of these medications.
Dr. Sarah Stombaugh:
Absolutely. And I think with that, it's so common in my practice, I'm sure you have this too, thyroid cancer as a whole, right? There's multiple different types of thyroid cancer. It's a very prevalent type of cancer. And so something that comes up a lot in my practice is, oh, my second cousin had thyroid cancer, and I don't know what kind it was. I'm like, let's see if we can find out, because I think it's valuable. But if we're speaking statistically, it's very unlikely that we're talking about this medullary thyroid cancer. So excellent to see more clinical trials in that area. Awesome. Anything else about that conference that I know we've said we could probably talk about a million different things, but with some of those trials you've picked?
Dr. Catherine Varney:
Yeah, they looked a little bit deeper into the prediabetes population, and they found that cardiovascular benefits were independent of their baseline starting blood sugar, the magnitude that their blood sugar came down or their kidney function. So again, I think that I have my predictions for this year. I think that within this next year, these semaglutide is probably going to be approved for and maybe tirzepatide two for heart failure, but also I am really hoping that sometime this year or early next year for pre-diabetes as well.
Dr. Sarah Stombaugh:
Yes, that would be amazing because there's so many people who fall in that population.
Dr. Catherine Varney:
Yep.
Dr. Sarah Stombaugh:
All right. Excellent. I think anything else with that select trial or others there?
Dr. Catherine Varney:
That's it. Again, I think that we could probably come back here and talk more about the tirzepatide data, but that'll be number two or something.
Dr. Sarah Stombaugh:
Yeah, I love that. Well, let me ask you, Dr. Varney, this has been so fun. As you're thinking about our time together, is there anything you didn't have a chance to share that you think is really important for my listeners to know?
Dr. Catherine Varney:
I think I covered it. I kind of wanted to touch on the patient being an advocate for themselves. We're here to help that as well, but really pushing and advocating for yourself for these treatment with your employer and your legislators.
Dr. Sarah Stombaugh:
Absolutely. And we'll put the links for the Obesity Action Coalition in the show notes. I think that's a great thing for people to be able to easily access. So anyone can grab it there. Dr. Varney, if patients are interested in, or listeners are interested in learning more about you, where can they learn more about you or potentially even work with you?
Dr. Catherine Varney:
So I'm on Twitter at Cate Varney and also at my UVA website. Currently, we're taking patients. We're growing. There's a great demand. Currently we're only taking patients from a select referral population, mainly helping people after bariatric surgery. But we're expanding and we're going to be hiring new providers so we can open up and get more into the community and help more people, especially with all these new indications coming. But check me out at the UVA website and Twitter.
Dr. Sarah Stombaugh:
Excellent. And thank you again so much for coming on. It's really been a pleasure. And to all my listeners, thank you for joining us for today's episode. We will see you all next week.