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Professor Barry Borlaug presents the SUMMIT trial on the use of the GIP / GLP-1 receptor dual agonist in patients with obesity-associated Heart-Failure with Preserved Ejection Fraction, which has been published in New Engl J Med 2024 and elected the most important study in cardiology and lipidology 2024 by MARKUS at HOMe. Dr. Borlaug is Professor of Medicine and Director, Circulatory Failure Research, Division of Cardiovascular Diseases, and Chair for Research, Division of Circulatory Failure, Department of Cardiovascular Medicine at the Mayo Clinic, Rochester, Minnesota. He is a global leader in studies on mechanisms, diagnosis and treatment of heart failure, particularly heart failure with preserved ejection fraction (HFPEF). The interview was recorded on January 16th, 2025. Moderators: Prof. Dr. Dr. Stephan Schirmer (Kaiserslautern, Germany), Prof. Dr. Florian Custodis (Saarbrücken, Germany) and Prof. Dr. Gunnar Heine (Frankfurt, Germany). Articles discussed: GLP-1 receptor agonists are promising but unproven treatments for alcohol and substance use disorders. Leggio L, Hendershot CS, Farokhnia M, Fink-Jensen A, Klausen MK, Schacht JP, Simmons WK. Nat Med 2023 doi: 10.1038/s41591-023-02634-8 Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure: SUMMIT CMR Substudy. Kramer CM, Borlaug BA, Zile M MR, Ruff D, DiMaria JM, Menon V, Ou Y, Zarante AM, Hurt KC, Murakami M, Packer M; SUMMIT Trial Study Group. J Am Coll Cardiol 2024 doi: 10.1016/j.jacc.2024.11.001 Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. Packer M, Zile MR, Kramer CM, Baum SJ, Litwin SE, Menon V, Ge J, Weerakkody GJ, Ou Y, Bunck MC, Hurt KC, Murakami M, Borlaug BA; SUMMIT Trial Study Group. N Engl J Med 2024 doi: 10.1056/NEJMoa2410027 Effects of tirzepatide on circulatory overload and end-organ damage in heart failure with preserved ejection fraction and obesity: a secondary analysis of the SUMMIT trial. Borlaug BA, Zile MR, Kramer CM, Baum SJ, Hurt K, Litwin SE, Murakami M, Ou Y, Upadhyay N, Packer M. Nat Med 2024 doi: 10.1038/s41591-024-03374-z Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Obokata M, Reddy YNV, Pislaru SV, Melenovsky V, Borlaug BA. Circulation 2017 doi: 10.1161/CIRCULATIONAHA.116.026807 An evidence-based screening tool for heart failure with preserved ejection fraction: the HFpEF-ABA score. Reddy YNV, Carter RE, Sundaram V, Kaye DM, Handoko ML, Tedford RJ, Andersen MJ, Sharma K, Obokata M, Verbrugge FH, Borlaug BA. Nat Med 2024 doi: 10.1038/s41591-024-03140-1 A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction. Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. Circulation 2018 doi: 10.1161/CIRCULATIONAHA.118.034646 How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, Edelmann F, Fu M, Guazzi M, Lam CSP, Lancellotti P, Melenovsky V, Morris DA, Nagel E, Pieske-Kraigher E, Ponikowski P, Solomon SD, Vasan RS, Rutten FH, Voors AA, Ruschitzka F, Paulus WJ, Seferovic P, Filippatos G. Eur J Heart Fail 2020 doi: 10.1002/ejhf.1741 Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial. Tada A, Burkhoff D, Naser JA, Harada T, Pourmussa B, Reddy YNV, Jensen MD, Carter RE, Demmer RT, Testani JM, Chirinos JA, Borlaug BA. Circulation 2024 doi: 10.1161/CIRCULATIONAHA.124.068788 Cardiac and Metabolic Effects of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The CAMEO-DAPA Trial. Borlaug BA, Reddy YNV, Braun A, Sorimachi H, Omar M, Popovic D, Alogna A, Jensen MD, Carter R Circulation 2023 doi: 10.1161/CIRCULATIONAHA.123.065134
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Since the introduction of Semaglutide as a weight loss medication, many individuals have experienced significant success in their weight loss journey. Semaglutide works by mimicking a hormone that regulates appetite and food intake, leading to reduced caloric consumption and ultimately, weight loss. However, the real challenge lies in maintaining this weight loss in the long term. Without the right strategies in place, it can be easy to slip back into old habits and regain the weight that was lost. In this article, we will discuss various strategies for sustaining weight loss after using Semaglutide, ensuring that you can maintain your success and achieve lasting results.
Setting Realistic Goals and Expectations
One of the most important strategies for sustaining weight loss after using Semaglutide is setting realistic goals and expectations. It’s essential to understand that weight loss is a gradual process and that it’s normal to experience fluctuations along the way. By setting realistic goals, you can avoid feeling discouraged if you don’t see immediate results and stay motivated to continue on your weight loss journey.
When setting goals, it’s crucial to be specific, measurable, achievable, relevant, and time-bound. This means setting concrete objectives that you can track, ensuring that they are within your reach, aligning with your values and priorities, and establishing a timeline for achieving them. By taking a strategic approach to goal-setting, you can maintain your focus and stay on track towards your long-term weight loss goals.
Additionally, it’s essential to manage your expectations and understand that sustainable weight loss takes time. While Semaglutide can assist in jumpstarting your weight loss journey, it’s still up to you to maintain healthy habits and make lasting lifestyle changes. By being patient with yourself and staying committed to your goals, you can set yourself up for long-term success.
Embracing a Balanced and Nutritious Diet
Another crucial strategy for sustaining weight loss after using Semaglutide is embracing a balanced and nutritious diet. While Semaglutide can help reduce your appetite and cravings, it’s essential to fuel your body with nutrient-dense foods that support your overall health and well-being. Make sure to include a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats in your diet to ensure that you’re getting all the essential nutrients your body needs.
One effective way to ensure that you’re eating a balanced diet is to meal prep and plan your meals in advance. By preparing healthy meals ahead of time, you can avoid the temptation of reaching for convenient, unhealthy options when you’re hungry or pressed for time. Additionally, practicing mindful eating can help you tune into your body’s hunger and fullness cues, ensuring that you’re eating to fuel your body rather than out of boredom or emotional triggers.
It’s also essential to practice moderation and portion control, even when enjoying your favorite treats. Remember that no foods are off-limits, but it’s crucial to enjoy them in moderation and be mindful of how they fit into your overall diet. By striking a balance between nutritious foods and indulgences, you can sustain your weight loss while still enjoying the foods you love.
Staying Active and Incorporating Exercise
Alongside a balanced diet, staying active and incorporating exercise into your routine is key to sustaining weight loss after using Semaglutide. Regular physical activity not only helps burn calories and maintain muscle mass but also has numerous health benefits, including improving cardiovascular health, boosting mood, and reducing stress levels. Aim to incorporate a combination of aerobic exercise, strength training, and flexibility exercises into your weekly routine to achieve a well-rounded fitness regimen.
Find activities that you enjoy and look forward to, whether it’s going for a walk in nature, taking a dance class, or hitting the gym with a friend. By finding activities that you love, you’re more likely to stick with them long term and make exercise a sustainable part of your lifestyle. Additionally, setting specific, measurable fitness goals can help keep you motivated and track your progress over time, whether it’s increasing your endurance, building strength, or improving flexibility.
If you find it challenging to stay motivated to exercise, consider seeking support from a workout buddy, joining a group fitness class, or working with a personal trainer. Having someone to hold you accountable and provide encouragement can make a significant difference in staying consistent with your exercise routine and achieving your weight loss goals.
Prioritizing Sleep and Stress Management
Another critical aspect of sustaining weight loss after using Semaglutide is prioritizing sleep and stress management. Lack of sleep and chronic stress can have a significant impact on your appetite, cravings, metabolism, and overall well-being, making it harder to maintain your weight loss goals. Aim to get at least 7-9 hours of quality sleep each night to support your body’s natural restoration and recovery processes and regulate hunger hormones.
In addition to adequate sleep, finding healthy ways to manage stress is essential for sustained weight loss. Chronic stress can lead to emotional eating, cravings for high-calorie foods, and disrupted sleep patterns, all of which can sabotage your weight loss efforts. Practice stress-reducing techniques such as meditation, deep breathing exercises, yoga, or spending time in nature to help calm your mind and body and reduce overall stress levels.
It’s also crucial to prioritize self-care and make time for activities that bring you joy and relaxation. Whether it’s reading a book, taking a hot bath, or spending time with loved ones, finding moments of rest and rejuvenation can help refresh your mind and body and support your overall well-being. By managing your sleep and stress levels, you can create a supportive environment for sustained weight loss and long-term success.
Seeking Support and Accountability
Finally, seeking support and accountability from others can be a valuable strategy for sustaining weight loss after using Semaglutide. Whether it’s through joining a weight loss support group, working with a health coach, or enlisting the help of friends and family, having a support system in place can help keep you motivated, accountable, and encouraged throughout your weight loss journey.
Consider sharing your goals and progress with a trusted friend or family member who can cheer you on and provide motivation when you’re feeling discouraged. Joining a weight loss group or online community can also offer valuable insights, tips, and encouragement from others who are on a similar journey. Additionally, working with a health coach or nutritionist can provide personalized guidance and support to help you navigate any challenges or setbacks along the way.
Remember that it’s okay to ask for help and lean on others for support when needed. By surrounding yourself with a supportive network of individuals who have your best interests at heart, you can stay focused, motivated, and committed to sustaining your weight loss and achieving lasting success.
By implementing these strategies and making sustainable lifestyle changes, you can maintain your weight loss success long term and enjoy the many benefits of a healthier, happier life. Remember that weight loss is a journey, not a destination, and it’s essential to be patient, kind to yourself, and consistent in your efforts. With the right mindset, habits, and support, you can sustain your weight loss after using Semaglutide and continue to thrive in your health and wellness goals.
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