Obesity

Woman, 64 years of age. History of Class II Obesity and hyperlipidemia. While she had obesity, her glucose levels were elevated. A1C 8.2%. She followed a lower carb meal plan, was active, took metformin and a GLP-1, a statin and an ACE-I. She lost 22% total body weight. A1C then remained in the 6-6.5% range for 3 years on this treatment plan. Over the past 8 months, due to insurance and her statement of denial that she ever really had diabetes, she stopped taking her glucose-lowering medication, statin, and ACE-I, wasn’t as strict with meal plan or activity, and stopped checking her glucose, but did not gain back her weight.

In part 2 of this exclusive ADA interview, Anthony Cincotta discusses the Cycloset Safety Trial study design and findings regarding the cardiovascular safety of Cycloset.

The prevalence of obesity and insulin resistance syndrome, rare only a century ago in most geographic locals of the world are now disorders whose prevalence represents the majority of humans in westernized countries on planet Earth. This simple observation strongly suggests that factors other than or in addition to genetic mutations/alterations are facilitating this rapid onset in disease occurrence world wide. Although the insulin resistance syndrome is viewed by the medical community as a defect of normal physiology, a plethora of available evidence indicates that the insulin resistant condition evolved among vertebrates as a survival strategy to enable increased survivability of ensuing, predictable seasons of low/no food (including glucose) availability.

I am a neuroendocrinologist by training, having received my Bachelor’s degree in biochemistry and molecular biology from the University of California, Santa Barbara and Master’s and Doctorate degrees from Louisiana State University (LSU) in physiology under the mentorship of Dr. Albert H. Meier. It was at LSU that my interest in the biological clock system and its role in the regulation of metabolic physiology was sparked by the revolutionary discoveries and elucidations made by Dr. Meier’s lab concerning biological clock mechanisms regulating physiology. He and his group in the early 1960s were the very first to demonstrate the existence in any organism of circadian rhythms of physiological responses to neuroendocrine factors. At LSU, I began investigating the possibility that modern human pathology of the metabolic syndrome (and several other progressive pathologies) was not a result of any “genetic defect” but of an environmentally induced (e.g., diet, stress, sleep-wake architecture) alteration of circadian neuroendocrine information presented to the clock system that then responded to direct the body to the obese/insulin resistant state as a survival response to such information.

In part 2 of this exclusive interview from AACE 2016, Dr. Garvey discusses the available tools -- medication, surgery, lifestyle interventions - to combat obesity, and which strategies are most effective.

In part 1 of this exclusive interview from AACE 2016, Dr. Timothy Garvey discusses the new comprehensive clinical practice guidelines for patients with obesity.

Dr. Tim Garvey talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting in Boston about obesity as a disease and establishment of rational care patterns for patients with obesity.

In Part 7, the final installment of this Exclusive Interview, Dr. Tim Garvey talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting in Boston about what he wants other physicians to understand about treating obesity. Dr. Tim Garvey, MD, FACE is the professor and chair of …

In Part 6 of this Exclusive Interview, Dr. Tim Garvey talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting in Boston about understanding how carbs affect the issue of treating obesity. Dr. Tim Garvey, MD, FACE is the professor and chair of the Department of Nutrition …

In Part 5 of this Exclusive Interview, Dr. Tim Garvey talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting in Boston about the most effective method of treating obesity – nutrition, physical activity, or education. Dr. Tim Garvey, MD, FACE is the professor and chair of …