Dr. Sarah Molasky

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127 appearances 1 recordings 1 series first heard Mar 2024 last heard Mar 2024

Dr. Sarah Molasky’s voice in public audio — every appearance, attributed to the second.

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Health Chatter · Weight Loss Meds · 28 Mar 2024 podcast

legitimately paying 500 a month for their co-payment for these medications and i just don't know that that's going to change unless the generics are significantly cheaper and in my experience they haven't been that much cheaper when the generics initially come out it seems to take at least five to ten years before enough other manufacturers are making that generic for it to bring the cost down and this is in america specifically other countries it's much cheaper

You know, like what is it, what I want to know is my patient's motivation, right? Like what is it that you're wanting to get out of this medication, weight loss, okay, how much weight are you looking to lose? Why that number? Are there certain activities you're not able to do right now that you miss being able to do or that you want to be able to do?

And based on their answers, you know, I'm just going to give honest opinions, you know, from me about whether I even think that medication is

worth asking their clinician about, or if it makes more sense, like, hey, you haven't really, okay, you've, you've cut down on, like, this thing, but you're still, I'm looking at your cart, and you have these things in it that, you know, you have, like, three boxes of pop in your cart, like, just cut out the pop. cut out the pop for a month and see how you do.

I would rather give like non-medical options to people first before they jump to a medical option. And people may be surprised for a pharmacist to say that, but just because I'm an expert on drugs doesn't mean I want everyone to be on them. I want people to be solely on the things they need to be on in order to maintain a happy, healthy life, whatever that looks like for them.

And, you know, I really try to push the lifestyle changes first. But if someone says, look, This is how I've been eating all this time. I'm working with a registered dietitian. I'm exercising, you know, in this many times day doing this type of exercise, and I'm still just not losing the weight. Depending on their body type, I might also ask if they've ever been put on metformin.

And metformin was one of the drugs I wanted to talk about that's a diabetes med, but it's also used for various issues like polycystic ovarian syndrome. pre-diabetes and insulin resistance.

And for some people who hold a lot of fat, like on their torso, rather than like all throughout their body or towards their lower body, insulin resistance might be part of what's going on because insulin resistance doesn't cause you to be obese.

But if you are already holding a lot of fat in that midsection area, that can lead to insulin resistance, which can then lead to weight being harder to lose, or like, it's a vicious cycle. So metformin is extremely cheap. It's a very old medication, very well studied. And while it has side effects, we're talking like diarrhea,

There are many other side effects to it, but the common one is diarrhea, and it's pretty manageable for most patients. So I would ask, have you talked to your doctor about trying that since you've done all these other things? Ask your doctor if this is appropriate for you, right? Because it's very cheap.

Even if they don't have really good insurance, I think through like the discount program that my work uses, it's like 30 something bucks for a three month supply. Like it's really not bad. So it's worth trying.

And for many people, by taking metformin to address insulin resistance, that can actually, that combined with not eating a ton of extra sugar and exercising can be really helpful because metformin also tells the muscles in the body, hey, there's extra sugar. sugar floating around the blood, could you like snatch it up and use it for fuel, which helps your muscles grow too.

So then if somebody is actually working out because they want to have more muscle in their body than fat, metformin has been shown to cause a small amount of weight reduction. It's known for that. That's one of its known side effects. But also if you have insulin resistance, it can really be impactful.

Yeah, so I would explain that the vaccines and the injectable diabetes or weight loss meds have very different purposes and go through the body in very different ways. Generally, the diabetic injections are done in the fat, whereas vaccines, most of them are done in the muscle.

So like all the ones I give, that's not true, I do MMR, but most of the vaccines I give are in the muscle and they go into your body, your immune system responds to it done like that's that's it the vaccine doesn't hang around in your body forever, right?

And with these injectables, they're being injected every week or every day or whatever, because they need to tell your body, give your body the messages, right? These are just messenger molecules that are saying, hey, do this. And your body's like, fine, I will. And then you have to keep telling your body to do this over and over. So they just work very differently.

The vaccines are a one-time message that basically tells your body how to drop a wanted poster for a specific pathogen for a specific bad guy that's trying to invade your body so that your body can recognize it faster. These injectables are just telling your body the message.

It's reminding your body, Hey, I need you to, you know, do these things so that we can keep the blood sugar under control and as a side effect, potentially lose the weight.

Right. They're metabolized at different rates. Yeah.

Thank you. I've loved being here. This is the kind of thing I like talking about. And I don't There's one thing I wanted to say, just because I feel like there's a lot of takeaways from these drugs that are usually not helpful on social media. And I feel like this is a good place to do it. But I just like to remind everybody that every single body is different.

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