Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: Resolutions vs. Reality #03. GLP-1 Analogues in the Treatment of Obesity

Leading: Dariusz Litera

Guest: Włada Radzewicz, diabetology specialist

Duration: approx. 11 minutes

Modern medicine is increasingly turning to pharmacological tools to support the treatment of obesity and metabolic disorders. In recent years, GLP-1 analogues have attracted particular attention from patients and physicians alike. These drugs have changed the way we think about weight loss, but have also raised many questions and controversies.

In this podcast episode, the conversation focuses on the line between being overweight due to lifestyle choices and a medical condition requiring treatment. The hosts, along with a guest expert, discuss when behavioral treatments are no longer sufficient, the role of diagnostics, and why the decision to initiate pharmacotherapy should always rest with a physician.

The discussion also addresses safety, adverse effects, and long-term consequences of using GLP-1 analogues. The discussion is grounded in clinical practice and the challenges faced daily by patients with obesity and metabolic syndrome.

Full podcast transcript

[00:00:00] Introduction

Dariusz Litera:

Modern medicine offers increasingly effective tools to support people with obesity and metabolic disorders. Among them are medications that have transformed the approach to weight loss. When do they actually help, when can they be harmful, and why there's still no substitute for a healthy lifestyle? Want to know? Find out what your doctor has to say.

Today, your doctor is diabetologist Dr. Włada Radzewicz. Hello again, Dr.

Dr. Vlada Radzewicz:

Good morning, Mr. Darek.

[00:00:28] When being overweight becomes a clinical problem

Dariusz Litera:

How can you recognize when excess weight is developing into a clinical problem that requires not only physical activity and conscious dietary choices, but something more—pharmaceutical support? When is that moment, doctor?

Dr. Vlada Radzewicz:

When behavioral treatments fail, I'm referring to diet, exercise, adequate sleep, stress management, and daily routines. If these elements don't work, we begin to consider further steps.

[00:00:59] Are GLP-1 analogues for everyone?

Dariusz Litera:

The patient still hits a wall – they step on the scale, and nothing changes. Stress, discouragement, and demotivation set in. GLP-1 analogues have been around for about 10 years and are widely used worldwide. Are these medications for everyone? Is pharmacological support even necessary at the beginning of the journey?

Dr. Vlada Radzewicz:

Let's definitely not start with such strong medications right away. GLP-1 analogues are drugs designed for specific disease entities. This is a substance that can help, but it can also harm. We shouldn't start the drug when we're not treating a disease, but rather a disorder.

[00:01:50] Why the decision rests with the doctor

Dariusz Litera:

And this is the decision of the doctor who makes the diagnosis.

Dr. Vlada Radzewicz:

Fortunately, these medications are available only by prescription. If we begin pharmacological treatment, we must be aware that previous steps have been ineffective for the specific condition.

We always look at the problem holistically. Why can't a patient lose weight? Is it a thyroid issue? Or some other disorder? We don't start medications because someone read they're the best for fighting obesity, but rather because the patient meets specific criteria.

[00:03:14] Metabolic syndrome and comorbidities

Dariusz Litera:

How do these types of drugs affect the body and metabolism?

Dr. Vlada Radzewicz:

We're talking about three pillars leading to diabetes: insulin resistance, prediabetes, and diabetes. These are diseases that often coexist within metabolic syndrome.

Metabolic syndrome encompasses obesity, hypertension, and carbohydrate metabolism disorders. These are the most common problems encountered in obese patients.

Dariusz Litera:

That's a bit of a deadly combination.

Dr. Vlada Radzewicz:

Unfortunately, yes. In Poland, people with metabolic syndrome most often die from cardiovascular disease. Each additional factor—hypertension, high blood sugar, obesity—increases this risk. Therefore, proper assessment of the patient's condition and appropriate treatment are crucial.

[

00:06:16] When are GLP-1 analogues contraindicated?

Dariusz Litera:

Are there situations when GLP-1 analogues are contraindicated?

Dr. Vlada Radzewicz:

Of course. Like any medication, they have their contraindications. The basic principle is: we don't choose a medication for the patient, but the patient for the medication. Obesity itself isn't the only criterion for initiating such a powerful therapy.

[00:07:20] Most common side effects

Dariusz Litera:

Do you observe any typical side effects?

Dr. Vlada Radzewicz:

Most often, they affect the digestive tract and result directly from the drug's mechanism of action. Diarrhea, abdominal pain, flatulence, belching—all of which may occur. is associated with the digestive process.

[00:08:47] Other drug effects

Dariusz Litera:

There are also reports of a reduced desire for alcohol.

Dr. Vlada Radzewicz:

This isn't observed in all patients, but it is indeed observed. This is due to its action on receptors. It sometimes also helps reduce cigarette smoking. These could be called "desirable side effects.".

However, it's important to remember that the drug was originally introduced to treat diabetes, and weight loss was considered a side effect. It's still a treatment that requires caution and proper diagnosis before initiation.

[00:10:07] Does treatment have to be lifelong?

Dariusz Litera:

Do patients who achieve good results have to take these medications for the rest of their lives?

Dr. Vlada Radzewicz:

Obesity is a chronic disease and can recur. As with hypertension, some patients require long-term treatment, sometimes lifelong. It's important to be aware of the consequences of chronic medication use.

[00:11:12] Ending

Dariusz Litera:

Diabetologist Dr. Włada Radzewicz, a specialist in diabetes, said in the podcast CO DOJ TYJ DOKARZ. Doctor, thank you very much for meeting with us.

Dr. Vlada Radzewicz:

I will keep my fingers crossed for everyone very much.

Key takeaways for patients:

• Being overweight becomes a clinical problem when behavioral treatments are ineffective.
• GLP-1 analogues are drugs intended for specific disease entities and not for every overweight patient.
• The decision to initiate pharmacotherapy should always be based on a full diagnosis and clinical evaluation.
• Obesity often coexists with other diseases as part of the metabolic syndrome.
• Medicines can cause side effects, most often affecting the digestive system.
• Obesity treatment in some cases is chronic.

Information about the authors:

Dr. Włada Radzewicz – diabetology specialist, specializing in the diagnosis and treatment of diabetes, insulin resistance and metabolic disorders.

Dariusz Litera – medical communication specialist, host of an educational podcast dedicated to evidence-based medicine and clinical practice.

Attention!

This material is for informational and educational purposes only. It does not replace an individual medical consultation. If you experience any disturbing symptoms or have concerns about your health, please contact us. consult a doctor.

Link:

Diabetologist