In this episode of Docs Who Lift, the Nadolsky brothers dive deep into the newly released American Association of Clinical Endocrinology (ACE) Algorithm for Obesity Care led by Dr. Karl himself. They explore:

Why ACE moved away from a BMI-only approach to a person-centered, complication-centric model

The new staging framework (ABCD) that helps individualize treatment intensity

How to interpret “clinical” vs “preclinical” obesity under the new model

Updated targets for clinically meaningful weight loss (5%, 10%, 15% tiers)

The emphasis on resistance training, sleep, and behavioral health alongside nutrition

Practical guidance for selecting anti-obesity medications and identifying the right therapy for each patient

Whether you’re a clinician, health professional, or patient trying to understand modern obesity care, this episode breaks it all down in a practical, real-world way without the jargon.

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Takeaways

• The book aims to dispel myths surrounding the Biggest Loser study.
• Miscommunication in media has led to public confusion about metabolism.
• Metabolic adaptation is a response to weight loss, not a determinant of it.
• Cultural factors significantly influence eating habits and food choices.
• The food environment plays a crucial role in dietary behaviors.
• Bipartisan support is necessary for effective food policy changes.
• Understanding metabolism requires a nuanced approach beyond just calories.
• The relationship between exercise and metabolism is complex and not fully understood.
• Appetite signals are a major factor in weight regain after dieting.
• Education about nutrition science is essential for public understanding.
  
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Takeaways

Menopausal women often prioritize weight gain concerns over other symptoms.

The study observed an association between hormone therapy and weight loss with GLP-1 medications.

Retrospective studies have limitations but can provide valuable insights.

Future research should focus on randomized controlled trials to confirm findings.

The relationship between estrogen and GLP-1 signaling needs further exploration.

Funding for research can be challenging, especially for early career investigators.

Collaboration between different specialties is crucial for comprehensive patient care.

The media often misrepresents research findings, leading to misconceptions.

Individualized treatment plans are essential for menopausal women.

There is a need for more awareness about the effects of menopause on health.

Research Links:
Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use
Combination of obesity medication tirzepatide and menopause hormone therapy fuels weight loss

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