Episode Details

Introduction about Wegovy as a new treatment for obesity. Dr Amodio discusses fall prevention in older adults. 

News: Semaglutide for the treatment of obesity
By Hector Arreaza, MD, and Daniela Amodio, MD. 

About 70% of Americans suffer from overweight or obesity. It has been 7 years since a medication was approved by FDA for chronic weight management. 

As a reminder, Saxenda® (liraglutide, daily SQ injection) was approved in 2014 for the treatment of obesity in adults (7 years ago), and remarkably, in December 2020, Saxenda® was also approved for the treatment of obesity in children older than 12 years old (good to know). Saxenda® is a GLP-1 receptor agonist.

On June 4, 2021 (7 years later), Novo Nordisk® did it again and got approval for a new medication for the treatment of obesity (disclaimer, I do not receive any money from Novo Nordisk®)

After extensive trials (drum rolls), Wegovy® (pronounced wee-GOH'-vee) has been approved by the FDA for chronic weight management. The component is semaglutide, yes, you heard me right, this is the same component of Ozempic®, an injected medication FDA-approved for diabetes treatment, and it is the same component in Rybelsus® (pronounced reb-EL-sus), which is the same semaglutide but in oral form. 

-Wegovy® is a synthetic version of a hormone called glucagon-like peptide 1 (GLP-1). GLP is an incretin, and as such, it reduces glucose levels by optimizing the secretion of insulin and decreasing the secretion of glucagon during digestion. 

Wegovy® exerts its action in areas of the brain to curb appetite and increase satiety. 

The use of Wegovy is approved in adults with a BMI above 30 kg/m2, or above 27 kg/m2 who have at least one weight-related condition. As with other medications for obesity, Wegovy is an adjunct therapy which can be added to intensive lifestyle modifications.

This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. 

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Elderly Falls.   
By Daniela Amodio, MD, and Hector Arreaza, MD

Patients who are older than 65 are normally called “older patients”, but sometimes it’s confusing, older than who? What does it really mean? There are many euphemisms: seniors, older adults, elderly, “prolonged youth”, or old-timers.

“Aging experts… have tried calling people young old (65 to 74), old old (75-84) and oldest old (85+). Age-based categories at this stage of life often aren't helpful because there is so much variability in how people age.” (Tracey Gendron, gerontologist at Virginia Commonwealth University)[2]

Key points: 

1. A fall is one of the most common events that may make older adults lose their independence.

2. Complications from falls are the leading cause of death from injury in adults older than 65 years old.

3. A multifactorial risk assessments should be done in older adults with >2 falls in the past 12 months. 

Interventions that have shown to be effective in reducing falls: 

Medication review

Exercise programs for muscle strengthening and balance training

Vitamin D supplementation in vitamin D deficiency 

Use appropriate footwear 

Home hazardous assessment 

Comment: Deprescribing is an essential activity during your geriatric visits. Avoid unnecessary medications. Use the AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults to determine which medications you should either discontinue or change to minimize risk of falls. Some examples include: benzodiazepines, some antidepressants and dextromethorphan/quinidine. 

Prevalence and morbidity of fa