Michael Weintraub, MD

Rates of obesity of BMI 30-40 have had a mild increase over the last 20 years.

Rates of severe obesity BMI > 60 has dramatically risen- this graph is impressive.

Slide by Dr. Satya Dash at #ENDO2025

Pheochromocytoma survival curves are dismal, particularly in those with metastatic disease. We need better treatments for these patients.

Excellent lecture by Dr. Camilo Jimenez at #ENDO2025

Multiple benefits of GLP1s in reducing residual risk in those with type 1 diabetes.

Excellent talk by Dr. Kaitlin Love at #ENDO2025

GLP1 agonism prevents cardiovascular disease through both direct and indirect vascular effects
#ENDO2025

Studies showing benefits of GLP1 agonists in type 1 diabetes are accumulating.

Modest A1c reduction but impressive reductions in total daily insulin dose and weight reduction.

#ENDO2025

Retatrutide may be the most hotly anticipated GLP-1 based medication in development 🔥💊, but others are not far behind 🏃.

A triple agonist, UBT251, is under development in China 🇨🇳 and also mimics GLP-1, GIP, and glucagon 🧬⚗️.

“Food noise” is the “incessant mental chatter” or “constant rumination” about food.

It is increasingly recognized as a phenomenon particularly with its profound elimination with GLP1 treatment.

New Nature review: www.nature.com/articles/s41...

Great overview: conscienhealth.org/2025/07/lift...

“If you treat someone’s blood pressure or cholesterol you don’t get improvements in quality of life. You treat their weight you get all the benefits."

"That is the power of treating obesity.”

Inspiring talk by Dr. Lou Aronne on the clinical implications of CagriSema at #ADASciSessions #ADA2025

The long awaited triple agonist retatrutide phase 3 data is still pending ⏳🧪.

However, a body composition subanalysis of the phase 2 data is newly published 📄 showing lean mass loss of 38% of total weight loss 💪📉.

The etiology of obesity is most often multifactorial- a combination of environmental factors and genetic predisposition among thousands of genes.

However, a portion of cases are due to a single genetic cause, such as in the leptin-melanocortin pathway.

academic.oup.com/edrv/article...

What is the impact of tirzepatide on body composition? 🤔

There was an absolute loss in lean mass 💪⬇️, however there was a GREATER loss in fat mass 🧈🔥.

Thus, there was an increase in lean mass as percent body composition 📊💪. This correlates with what we see clinically

Eli Lilly drug preserves lean mass in patients losing weight on Wegovy Some doctors are concerned that patients taking weight loss drugs like Wegovy may be losing too much lean mass. A combination therapy might change that.

How should we think about the interesting bimagrumab & Semaglutide data #ADA2025 #weightloss #obesity How to assess meaningful functional benefit? www.statnews.com/2025/06/23/b...

Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity — A Phase 2 Trial | NEJM Maridebart cafraglutide (known as MariTide) is a long-acting peptide–antibody conjugate that combines glucagon-like peptide-1 receptor agonism and glucose-dependent insulinotropic polypeptide recep...

P2 data for the once monthly GIPR Antagonist GLP-1R agonist bispecific antibody, Maritide in people with #T2D as well as in #overweight and #obesity Even data for lower dose titration over several weeks in the same paper www.nejm.org/doi/full/10....

We’ve gone from 2 to over a dozen trials of GLP1s in alcohol use disorders in only a few years.

This comes on the heels of numerous observational and pharmacoepidiologic data supporting a reduction in alcohol use in GLP1 users.

#ADA2025 #ADASciSessions

Continuous glucose monitors are an excellent tool… when they work!

Studies report up to 26% early failure rate of these devices.

#ADA2025 #ADASciSessions

There is a national shortage of endocrinologists!

The majority of the country do not have local access to endocrinologists.

80% of those with diabetes are cared for by a PCP and no endocrinologist.

#ADA2025 #ADASciSessions

The prevalence of type 2 diabetes in the young is rising, and so are the complications.

80% of individuals develop a microvascular complication by 9 years over 9 years of follow-up!

#ADA2025 #ADASciSessions

❗ New CagriSema Phase 3 data released

Combination cagrilintide-semaglutide after 68 weeks in patients with Type 2 Diabetes and BMI > 27
⬇️ 13.7% weight loss vs 3.4% in placebo
⬇️ 1.8% a1c reduction vs 0.4% in placebo
73% had a1c <6.5%

🤢 72.5% had gastrointestinal side effects vs 34% in placebo

Tirzepatide in a target emulation trial demonstrates significantly lower MACE (HR 0.8) and all cause mortality (HR 0.6) compared to dulaglutide in T2DM. 🤯

#ADASciSessions #ADA2025

CAC > 300 is equivalent to prior ASCVD for risk of future cardiovascular events.

One could consider treating someone with CAC > 300 as SECONDARY prevention, not primary prevention.

Similar risk = similar therapies.

#ADA2025 #ADASciSessions

💉 GLP-1s were associated with 23% lower risk of mortality in those with type 2 diabetes on dialysis compared to non-users💡

🙏 Honored to be co-author on this observational analysis of 151,649 dialysis patients with type 2 diabetes, published today 📅

journals.lww.com/cjasn/abstra...

Adrenocortical carcinoma: a practical guide for clinicians Adrenocortical carcinoma is a rare endocrine malignancy. The management of patients with adrenocortical carcinoma is challenging for several reasons, including its heterogeneous but frequently aggress...

Martin Fassnacht et al present & discuss the challenges involved in the management of patients with adrenocortical carcinoma, together with their personal recommendations regarding 25 of what they believe are the most crucial clinical questions www.thelancet.com/journals/lan...
#EndoSky #OncSky

An argument for reduced dosing frequency of GLP-1s 💉 to maintain long-term weight loss ⚖️, based on mathematical modeling 📊:

➡️ Switching semaglutide from 1x/week to 1x/2 weeks = 50% fewer doses but 72% of weight loss retained ✅

onlinelibrary.wiley.com/doi/10.1002/...

IcoSema and the evolution of fixed-ratio insulin-GLP-1 receptor agonist therapies - PubMed IcoSema and the evolution of fixed-ratio insulin-GLP-1 receptor agonist therapies

💉 Once weekly fixed dose GLP1+insulin is one step closer to approval 💯

Two trials with once weekly basal insulin icodic and GLP-1 receptor agonist semaglutide (IcoSema) were recently published in Lancet.

pubmed.ncbi.nlm.nih.gov/40482672/

Most people with type 2 diabetes have adiposopathy-related diabetes—driven by excess visceral fat 🫃 and inflammation 🔥.

We need an adipocentric approach: targeting fat loss ⚖️, not just blood sugar 🩸, to improve outcomes ✅ and even reverse disease 🔄.

Review article: www.mdpi.com/2077-0383/14...

Adult Obesity The ICHOM Set of Patient-Centered Outcome Measures for Adults living with Obesity is the result of hard work by a group of leading physicians, measurement

In order to provide comprehensive obesity, care a clinic should strive to use multiple ways of evaluating success.

www.ichom.org/patient-cent...

Proud to contribute to the latest Core IM episode on Continuous Glucose Monitors!

www.coreimpodcast.com/2025/06/02/c...

The latest expert guidance on "Nutritional priorities to support GLP-1 therapy for obesity".

@jamflo2k.bsky.social

What can't metformin do?

Metformin decreased the risk of renal function deterioration, according to a retrospective observational multicenter cohort study included 316 693 patients with type 2 diabetes.