Dr. Mary Claire Haver

And that's going off the data we had from gastric bypass patients and knowing what their muscle loss is with rapid weight loss after surgery.

And here we are looking at the, playing the long game with patients looking at muscle mass and bone strength.

So I was really skeptical until I

I started following Dr. Jenna Siwak and Dr. Rocio Salas-Whalen on social and looking at the medical research journal articles they were presenting and then pulling them myself and reading them myself and realizing, wait a minute,

I am allowing my own bias to stand in the way of what could be potentially best for a patient, especially when Dr. Rocio was really focusing and showing the body composition scans on her patients who were not losing any or significant muscle mass because of the way she was counseling them.

And I was like, oh, so I got educated.

And then we started on a very limited basis trying this medication on some of our patients who were struggling with obesity with the caveat that we were making sure that they knew how much protein that they would need and that they were committed to resistance training in order to, as they lost weight, through this, how the mechanism of the medication worked,

but they were getting adequate protein and adequate stimulation for their muscle and bones so that we would not put them in a position where they would have such significant muscle loss and bone loss, where they would be at risk for sarcopenia or frailty as they aged.

Keeping that in context,

we've done really well with this medication.

A, we do body scan everyone.

We know what their body composition is.

We know how much muscle mass they have.

And if they are losing muscle mass more than 10%, we are counseling them to come off the medications and adjust the dosing and really recommit to what the end goal is, is a healthier body, less visceral fat, less inflammation, and

and maintaining their bone and muscle strength.

We're very aggressive at recommending getting a baseline bone density before starting a GLP-1 so that you know what your bone density is before we start and how we need to focus on that as well.

Turns out pretty much the same thing that helps grow muscle grows bone.

And so those two things can usually go together.

But you know,

We take an hour with our patients on a new patient visit.