Dr. Rocio Salas-Whalen
speaker
288 appearances
3 recordings
2 series
first heard Apr 2025
last heard May 2025
Dr. Rocio Salas-Whalen’s voice in public audio — every appearance, attributed to the second.
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food, processed food, ultra processed food that will lead to wanting to consume more. Right. Then when we talk about also there's some mutations that may also cause obesity. Right. And then when we talk about hormonal, so through a person's life, there could be hormonal changes, shifts, imbalances that is going to promote waking.
We can talk about hypothyroidism, right, which thyroid hormone controls your metabolism. Then we can talk about PCOS, polycystic ovarian syndrome, when there's hyperinsulinemia, insulin resistance, and this promotes visceral fat. Visceral fat promotes insulin resistance, insulinemia, and it goes into a vicious cycle.
We also talk about perimenopause and menopause with the changes of fluctuations or the drop of estrogen. This promotes visceral fat. The subcutaneous fat that you had in your fertile years in your hips and your breasts goes intra-abdominally. This visceral fat promotes insulin resistance, and then you go into that vicious cycle again.
Also, because of the drop of estrogen, we see a decrease in lean muscle mass. Muscle mass is your burning calorie machine. If you lose it, then your metabolism slows down. Then we go into aging. Aging also, as we age, we tend to lose muscle mass. It's harder to build muscle. And also it promotes waking. And then we go into environmental factors.
As we talk, the food industry, industrialization, plastic, pesticides, all of those things disrupt your endocrine system. We call them endocrine disrupting chemicals because they disrupt the function, the normal function of your hormones. They mimic your hormones. So they occupy the receptors where your hormones should go and do a function. And this can promote obesity and fertility.
So they're real things that are impacting people's life on the day-to-day basis.
Knowing this and understanding this, you move away of anxiety. putting the pressure on the patient, right? You move away of being a one participant in this equation. It goes more into a team, what you can do for the patient and educating the patient. It becomes a team. Let's talk about, as an example, diabetes, type 2 diabetes.
We know it's a chronic multifactorial disease, but we have no trouble prescribing and treating medications for it, right? It's widely accepted from the patient side, from the physician side. Let's talk about hypertension. Same thing, right? We know that lifestyle can help it or make it worse. but that is not causing the disease.
Therefore, we feel comfortable treating it and the patients accepting treatment. And when we provide treatment for type two diabetes, hypertension, high cholesterol, we always talk about eating healthier and exercising, but it doesn't replace the treatment. So if we see obesity as a disease, we can act the same way.
Understand and support the patient and their lifestyle, but also provide a medical treatment.
But also there's other things like medications that patients may take for certain particular disease that can promote waking, right? There's a lot of antidepressants that can promote waking, blood pressure medications that can promote waking, right? And many times there's no other option for the patient. And this can also lead to obesity.
The first FDA-approved GLP-1 was in 2005.
Yes. The FDA name, it was by Eli Lilly. It was called Bayera. And this was twice a day subcutaneous injection. So it was a daily, twice a day injection that patients had to do. Okay. And the first indication was for type 2 diabetes because GLP-1 is a hormone.
Glucagon-like peptide. And it's a peptide or a hormone.
No, peptide is... what we call a short chain of amino acids. A long chain of amino acid is a protein. So before protein, it's a peptide. Peptides can help to produce or inhibit the secretion of hormones. The most important finding of this drug, and I actually met the person, the doctor, the researcher who isolated this, the GLP-1 outside the human body. It was in a lizard.
called the Gila monster. And the lizard, the venom of this lizard, caused pancreatitis on its victims. So Dr. Eng, John Eng, being an endocrinologist and researcher at the VA hospital in the Bronx, wondered what in the venom affected the pancreas. And he isolated GLP-1.
It causes pancreatitis, so the prey dies from pancreatitis.
So it stimulates to produce insulin. The problem in type 2 diabetes is insulin-resistant and hyperinsulinemia. So with time, with frequent stimulation of the pancreas, every time you eat, every time you eat anything that has glucose, your pancreas produces insulin. But with time, it overworks. Your body stops responding the same way to the insulin that you make.
So you become resistant to your own insulin. The pancreas in response tries to overcompensate and make more insulin overworked. but your body is resistant to it. So you have hyperinsulinemia and insulin resistance. So these are the two main pathologic factors that lead to somebody to develop type 2 diabetes.
And this is the beauty of medicine, right? One thing is made or developed for a particular disease or reason. We find out later that it has other benefits like GLP-1.
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