Terry Streetmen (Host): Hello, I'm Terry Streetmen, Riverside Marketing Communications Representative. I'm joined on the Well Within Reach podcast today by Dr. Rachel Shell, Riverside Obesity Specialist and Way to Healthy Living Medical Director, and Nicole Potts, Registered Dietitian. They're here to discuss trending weight loss medications and how they compare to structured weight management programs like Riverside's Way to Healthy Living Program. Thank you both for being here today.

Nicole Potts, MS, RD, LDN, CDCES: Thanks for having us.

Host: Before we get started, we will take a quick break with a message from Riverside. Healthcare can be confusing, but thanks to your myRiverside myChart, you can easily manage not only your care, but your family's as well. With a single click, your myRiverside myChart lets you stay well connected to the same information your provider sees. You can view your health history, get test results, request prescription refills, pay your bill, or make an appointment. Manage your care from anywhere, your laptop, phone, or tablet. Learn more and enroll today at riversidemychart.org. Okay, we're back. I believe you're both first time guests. Can you tell us about your backgrounds and your roles here?

Rachel Shell, MD,: Well, hi, thank you for having me. My name is Rachel Shell and I have been a part of the Riverside Medical Group here in Kankakee since 2011 as an Endocrinologist. I recently became Board Certified in Obesity Medicine and am now the Medical Director of our new Way to Healthy Living weight management program that was launched in May of 2024.

Nicole Potts, MS, RD, LDN, CDCES: Hello, thanks for having us. My name is Nicole Potts. I'm a Registered Dietitian and Certified Diabetes Education Specialist here at Riverside for the past seven years. In 2003, I obtained a certification for weight management and obesity.

Host: Alright, well thank you so much for being here. So we'll jump right into the questions. Dr. Shell, can you tell us about some of these trending weight loss medications and maybe explain to us how they work?

Rachel Shell, MD,: So, most of the, uh, trending weight loss medications that are out there, fall into a category of medications called GLPs. GLP stands for glucagon like peptide. Glucagon like peptide is a hormone that attaches to multiple receptors throughout the body to regulate hunger, insulin production by the pancreas, and sugar production by the liver.

This hormone helps control sugars in persons with diabetes, which is what the medications were originally studied for and approved for use. They were released under Victoza, Ozempic, Trulicity, Mounjaro. But additional studies were completed to prove that these drugs also induced weight loss.

So hence, now there are multiple GLPs that are approved for the indication of obesity management and those are marketed under the names of Saxenda, Wegovy, and ZepBound.

Host: Thank you. Yeah, I know some of those names. You know, I hear Ozempic on social media a lot, and so it's good to know what they are and what they aren't for. With these medications, are there potential side effects and risks associated with them that people should know about?

Rachel Shell, MD,: Yes. I mean, all medications have potential risks. As a provider, we look at those risks and weigh them against the benefits to determine if a patient's an appropriate candidate for taking the medication.

Each medication that's FDA approved has what we call a prescriber's information pamphlet. This lists all the most common side effects, which in this class of medication tends to be nausea, diarrhea, constipation. There are some less common side effects like pancreatitis and medullary thyroid cancer that are more serious that patients need to be aware of, but they're not commonly a reason that a patient can't take the medication. I always would advise a patient that if they're interested in taking a medication that's new to them to have that discussion with their provider regarding the pros and the cons prior to initiation.

Host: Okay, well it's good

for people to be aware of those. And, you know, I know some of these medications are advertised and available through like third party providers. You see the commercials on TV. How important, keeping in mind those side effects, is it to have direct medical advice and supervision with these medications?

Rachel Shell, MD,: I think it's very important for anyone taking a medication, whether it's prescribed, compounded, or even over the counter, to always have a discussion with their provider about the pros and cons of what you're putting in your body. When a patient is taking one of these specific medications through a third party provider, it's most likely going to be a compounded form of the medication. So compounded medications are medications that are customized to meet an individual's needs. They're made in several different circumstances, including if a patient has a specific allergy to an ingredient that's in the FDA approved medication, or if there's a need to combine the medication with another medication, or give the medication via a different route of administration, or if a medication is in short supply, or it costs a lot of money, which is what we're seeing with these weight management medications. So prescribing or recommending a compounded form of a GLP treatment can be dangerous as providers really cannot ensure their safety, their effectiveness, and their quality since they don't carry the FDA approval.

So for a medication to gain FDA approval, the medication actually has to go through a lot of studies and be reviewed and brought to the Center for Drug Evaluation and Research, which will eventually lead to the FDA approval of that medication. They have to know that that medication has more benefits than potential risks for the population that it's going to be given to, and it has to be approved for a specific indication. Medical societies, including the Obesity Medicine Association, typically advise against compounded medications for weight loss because we don't know all of that data. Here at Riverside Endocrinology, we currently do not prescribe or administer any type of compounded compunded GLPs.

Host: Okay, that's a lot of really good information and stuff I don't know that I would have thought of, and that compounding is, is complicated. Nicole, what role do lifestyle and diet changes then play in achieving like sustainable weight management, either with or without these medications?

Nicole Potts, MS, RD, LDN, CDCES: Sure. Lifestyle and diet changes are the foundation to any sustainable weight loss process. The Way to Healthy Living program goals are really to develop new healthy habits, geared not only to achieve weight loss, but also to reduce risk factors of chronic diseases, such as heart disease and diabetes.

Host: Okay, well before we get into our next question, we'll take a quick break to talk about primary care at Riverside.

Riverside knows that health is your greatest asset and having a primary care provider you know and trust plays a vital role in your health journey. Don't have a primary care provider? Good news! Riverside has a team of primary care providers ready to partner with you on your health journey. Find a Riverside primary care provider at riversidehealthcare.org/primarycare.

Okay, so you touched on this right before that little break, but could you tell our listeners more about the Way To Healthy Living program and sort of what's included?

Nicole Potts, MS, RD, LDN, CDCES: So the Way To Healthy Living program is a multidisciplinary medical supervised approach to weight loss. Patients will meet with an endocrinologist, a registered dietitian, an exercise specialist at the Riverside Health Fitness Center, and a behavior therapist who will all work will work together to develop a plan that works best for the patient. The Way to Healthy Living program is six months where you will meet with an endocrinologist followed by a registered dietitian once a month for those six months. The patient will also be enrolled in a FitRx program where they will meet with an exercise scientist who will create a customized workout plan for the patient.

There will also be virtual sessions to be completed monthly that will provide educational information on different nutritional topics.

Host: All right. Well, it sounds like there's a big commitment, but it sounds worth it to get that sustainable change. Is there anything more to the commitment that the program entails or does that kind of cover it?

Nicole Potts, MS, RD, LDN, CDCES: So it is six months. We just want to make sure that patients are committed for those six months, and really making sure that we're committed to these lifestyle changes long term. It is, a requirement of the program too that they attend 80 percent of the visits in total.

Host: Okay. Well that's good. I imagine making kind of lifestyle changes is not a thing that happens overnight. So, I'm glad that we cover that and have them, you know, in that long term. What does make the Way To Healthy Living program different from maybe taking these medications alone?

Rachel Shell, MD,: The Way To Healthy Living Program, again, as Nicole stated, it's medically supervised, so you're getting the expertise of a team of providers, including our obesity specialists, our registered dietitians, our fitness specialists, and even a behavioral therapist. All of this combined, gives patients a partnership, and a tool, to help make those changes and, sustain that lifestyle intervention that we know is key to success in weight loss.

Host: Okay. The next question here, I know we kind of touched on it before about the cost of these medications. How do the costs and insurance coverages differ between say, you know, just doing the weight loss medication or like a weight management program like Way To Healthy Living?

Nicole Potts, MS, RD, LDN, CDCES: Sure. So each insurance is so individualized. Most commercially insured patients will have some kind of coverage for weight management program and possibly weight loss medications. However, being in a weight management program, such as Way To Healthy Living, once again, provides that medically supervised weight loss, along with creating some healthy habits as well.

Host: Okay, So with all that information, you know, if someone's considering one of these things, weight management or, these medications, where should somebody start with that?

Nicole Potts, MS, RD, LDN, CDCES: So if a patient is interested in the Way To Healthy Living Program, they should have that discussion with their primary care provider to see if they would meet the criteria for the program. Their primary care provider, they can send a referral and we can get the patient scheduled.

Host: Okay. So with all that information in mind, thank you again for all of that. Is there anything else that you want to add for our listeners before we finish up?

Nicole Potts, MS, RD, LDN, CDCES: We are excited to team up with the community to create a supportive environment so that patients can optimize their health.

Host: Well, thank you so much for joining me today with all this great information. To remind our listeners, if you're interested in learning more about the Diabetes Wellness Center or the Way To Healthy Living Program, please call Riverside Diabetes Wellness Center at 815-936-6515 or visit myRHC.net./diabetes.

Thank you for tuning in to Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for Well Within Reach on Apple, Spotify, or wherever you get your podcasts. And to learn more about Riverside, visit riversidehealthcare.org.