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Summary In this episode of the Future of Dermatology Podcast, Dr. Faranak Kamangar discusses the evolving landscape of dermatology with a focus on incretin medications, particularly GLP-1 agonists. This podcast explores the historical context of these medications, their role in weight management, and the implications for dermatological health. Dr. Kamangar addresses the side effects associated with these treatments, including the phenomenon known as 'Ozempic face,' and offers recommendations for maintaining healthy weight and skin health. Takeaways - Incretin medications include GLP-1 agonists and GIPs. - GLP-1 agonists have been used since 2005 for diabetes. - Weight loss medications can have significant side effects. - Rapid weight loss can lead to 'Ozempic face' due to fat loss. - Maintaining muscle mass is crucial during weight loss. - Long-term use of weight loss medications may be necessary. - Lifestyle changes are essential for sustainable weight management. - Dermatologists should be aware of the metabolic effects of these medications. - Natural fat in the face is important for youthful appearance. - Body contouring devices can help target specific fat areas. Chapters 00:00 - Introduction to Dermatometabolic Series 02:47 - Understanding Incretin Medications 06:02 - The Role of GLP-1 Agonists in Weight Management 09:10 - Exploring Side Effects and Safety Profiles 12:08 - Comparative Effectiveness of Semaglutide and Terzepatide 14:48 - Ozempic Face: Causes and Solutions 21:07 - Recommendations for Healthy Weight Management

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Latisa S. Carson, M.D. is a board-certified physician in Obstetrics and Gynecology and a medical weight loss specialist and is board-certified in Obesity Medicine and is a member of the Obesity Medicine Association. She is the only female African American obstetrician-gynecologist in solo private practice in San Diego County. Her residency training was completed at Southern Illinois University, Springfield, Illinois and her internship year was spent at King/Drew Medical Center in Los Angeles, California. Dr. Carson is a University of Kansas School of Medicine graduate, from Kansas City, Kansas. She has a special interest in helping her community achieve a healthier weight and active lifestyle and offers physicians supervised, medically supported weight loss programs that include nutrition, behavior management, weight loss medication, and exercise guidance. Together Dr. Carson and I dive into all things weight loss from GLP-1 receptors to the incredibly popular Ozempic and semaglutide compounded medicines. Dr. Carson shares her experience with using GLP-1 receptor antagonists with her patients and offers her wisdom regarding the pillars of health that must be supported by practitioners to optimize lasting patient success. She highlights both the negative and positive side effects associated with weight loss medicines, offers guidelines for effectively tapering off medication, and shares insights into the slow but steady functional medicine changes that are coming into traditional medicine. Her advice is both encouraging and pragmatic, and our conversation is filled with insights for any practitioner who is interested in successfully incorporating today’s hottest weight loss medications into their practice. I’m your host, Evelyne Lambrecht, thank you for designing a well world with us. *Episode Resources:* Dr. Latisa Carson https://www.uniquelyfitmedicalweightloss.com/ *Design for Health Resources:* Designs for Health - https://www.designsforhealth.com/ Nutrition Blog: Muscle Tone Matters: The Key to Optimal Body Composition and Metabolic Health - https://www.casi.org/muscle-tone-matters-key-optimal-body-composition-metabolic-health Nutrition Blog: The Hidden Effects: Medications and Their Impact on Your GI Tract - https://www.casi.org/medications-and-their-impact-on-gi-tract Research Blog: Influence of Probiotics on Weight Management in Obesity - https://www.casi.org/node/1557 Research Blog: The Stomach-Brain Axis: Hunger’s Not All in the Mind - https://www.casi.org/node/971 Visit the Designs for Health Research and Education Library which houses medical journals, protocols, webinars, and our blog. https://www.designsforhealth.com/research-and-education/education *Chapters:* 00:00 Intro 03:18 Dr. Carson recalls her mother’s experience as a nurse, her own introduction to weight loss medicine, and her initial connection with Designs for Health. 07:20 Defining GLP-1 and GLP-1 receptor agonists and the role of drugs including Ozempic and dual agonist drugs such as Terzepitide in obesity management. 10:30 Key differences between brand names and semaglutide compounded medicines, as well as injected versus oral medicines. 14:10 Semaglutide success rates, adherence rates, and average weight loss goal timelines. 15:15 Dr. Carson’s individualized approach to dosing and titration at every stage of a weight loss journey. 21:30 Dr. Carson’s comprehensive support program includes weekly visits, medicines, diet plans, and frequent patient engagement. 25:35 Muscle mass loss and management of other extreme side effects and complications from these medications. 33:42 Dr. Carson’s experience with favorable side effects in managing other addictions with these medicines. 36:14 Guidelines for tapering off medication and successfully keeping the weight off. 39:00 Addressing the mindset of a patient and past trauma in ways that will be most helpful. 43:25 Dr. Carson shares her desire to integrate functional medicine into her traditional medicine OB practice earlier in her career. 45:35 Detox pathways are a critical first step to weight loss. 51:23 Dr. Carson shares what she has changed her mind about over the course of her career, her personal favorite supplements, and her favorite health practices.

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I talk about my week 48 progress on the GLP-1 medication Monjaro. I've seen great health improvements, including increased muscle mass, reduced visceral fat, and my A1C dropping from 10.2 to 5.While the scale is up slightly this week, I'm focusing on the positive changes in my body and overall health. I encourage others to not get caught up in comparing their journey to others, as we all have different bodies and results. My goal is to get to a healthy weight range for me, which may not be as low as some expect. I'm grateful for the progress I've made and invite others to join me on this journey. #GLP1 #Mounjaro #WeightLoss #HealthJourney #DEXA #A1C #BodyPositivity #mounjarojourney