We are going to have a really good night, and we have experts in GLP-1 receptor agonist, so you can ask all your questions. We're all close family here. It's going to be fairly interactive. We have tons of questions for you to answer. And of course, you can ask any of your questions to us and also around the auditorium. So we hope you enjoy the program, and welcome to our session tonight. So we have a bunch of housekeeping things I have to do before we start. So there are... It's thinking. There we go, all right. So this is experts weigh in on weight management. My name is Leslie Cho. I'm from Cleveland Clinic, and with me is Dr. Michael Linkov, and Dr. Pam Tubb, and Dr. Amanda Vest, and Martine Altieri. We're going to be talking about the whole range of GLP-1 receptor agonist and weight management. So I should be going to my... There we go. So this is our acknowledgement, and this session is brought to us by Nova Nordisk. So just to have some housekeeping things here. To claim credit for this course, ensure that you have opted in through ACC credit system by visiting the accscientificsession.org backslash credit. You will receive a link to the course evaluation via email by April 1st. You must complete this evaluation to claim credit for this particular course. Completion information will be transmitted to ACCME on your behalf. To participate in the session with the audience response system, scan this QR code, open your ACC25 app on your mobile device, select the session, select the ARS icon, and respond to a poll or an ask question. We'll leave that up for right now. If somehow this slide goes away and you still want to participate, just open your device, select this session, select the ARS icon, and then you can do it. So here we go. Hopefully this will work, so God willing. So have your phones ready. The questions will display on your phone after all answer choices are read out loud. You'll have 20 seconds to pick your answers. So we're going to do some test questions here, okay? This is like being in elementary school. All right, here we go. 56-year-old man comes to the office for difficulty losing weight. He suffered an MI seven months ago, which was treated by primary stenting. His medical history is notable for hypertension, tobacco use, and chronic kidney disease stage 3. His GFR is around 48. After his MI, he's been compliant on beta blockers, ACE inhibitors, high-intensity statin, and dual antiplatelet therapy. His BMI is 36.1. His blood pressure is 128 over 72. His hemoglobin A1C is 6.2. He's reduced his smoking to two cigarettes a day. He's tried to follow a low-calorie diet and is walking for about 20 minutes three times a week, but has only lost six pounds since his MI. So here's your first assessment question. Based on the clinical studies, what would you anticipate or expect when initiating a GLP-1 receptor agonist such as semaglutide in this patient? A, he does not have diabetes and has not made intensive lifestyle attempts to lose weight, so semaglutide or any other GLP-1 receptor agonist is not indicated. B, he would be anticipated to lose around 8% to 10% of his body weight and reduce his risk of biochemical progression of diabetes, but he would not be expected to experience cardiovascular reductions since he does not have diabetes. C, he would lose about 8% to 10% of his body weight, reduce his risk of developing recurrent cardiac ischemic events, heart failure events, and biochemical progression to diabetes. And D, he would be anticipated to reduce his risk of developing recurrent cardiac ischemia only if he loses at least 5% of his body weight. So based on your clinical studies, what would you anticipate or expect when initiating GLP-1 receptor agonist such as semaglutide in this patient? Do you guys, does this work? Is this working on your phone? Can you see it on your phone? Yes? Yes. Okay. Did you answer? Yes? Okay. All right. Fantastic. The polls are locked. Okay, great. All right. We go to the next question. All right. Number two. Fifty-eight-year-old woman presents for a follow-up visit, describes dyspnea upon exertion, her past medical history is notable for heart failure with preserved EF, CAD with non-STEMI two years ago, and hypertension. She's on lisinopril, metoprolol, amfagliflozin, furosemide, risuvastatin, aspirin, and spironolactone. BMI is 34, blood pressure is 110 over 80. or 80, heart rate of 65, no significant findings on her physical exam. EGFR is 55, antiprobian P is around 200. Her EF shows LV, EF, or her echo shows EF of 60% without any valvular disease, and her nuclear stress test showed no ischemia. So, in addition to lifestyle modification, which of the following is the best next step in care to potentially improve her cardiovascular outcome? Number one, prescribed phentermine topamorate extended release, semaglutide, finarinone, increased epigloflozin to 25 milligrams, increased metoprolol to 100 milligrams. So, in addition to lifestyle modification, which of the following is the best next step in care to potentially improve her cardiovascular health? Fantastic. All right, third question. A patient with heart failure with preserved EF and body mass index of 32.5 presents to cardiology. According to the proposed diagnostic framework from the 2025 Lancet Diabetes and Endocrine Commission, how should clinical obesity be diagnosed? A, based upon BMI threshold of greater than 30 B, by combining BMI with at least one additional validated measure of adiposity, such as weight, circumference, body fat percentage, followed by identification of obesity-related organ dysfunction or activity limitation. By testing for diabetes, hypertension, or hyperlipidemia in adults with BMI greater than 40 to determine clinical consequences of excess adiposity. D, only through validated patient-reported tools of obesity-related symptoms. Or E, based on threshold of fat mass per dual x-ray absorptometry, scanning of greater than 15% in male and greater than 20% in female. So according to the proposed diagnostic framework from the 2025 Lancet, how should clinical obesity be diagnosed? Okay, fantastic. Last one. 82-year-old male with past medical history of atrial fibrillation, cardiomyopathy, CAD, hypertension, hyperlipidemia, sleep apnea, obesity, newly diagnosed diabetes presents to your clinic with a hemoglobin A1C of 6.6 and a BMI of 35. He expresses interest in joining weight loss program to manage his obesity and associated comorbidities. He has tried multiple diet programs in the past with limited success and a sedentary lifestyle due to limited mobility. He is motivated to make lifestyle changes but is concerned about long-term sustainability of weight loss. Which of the following is the most appropriate initial step in setting up a weight loss program for this patient? A. Establish a multidisciplinary team to provide comprehensive care. B. Initiate pharmacotherapy with anti-obesity medication like GLP-1 receptor agonist. C. Prescribe very low calorie diet to achieve rapid weight loss. D. Refer a patient to bariatric surgery given the BMI range. And E. Focus solely on increasing physical activity without dietary changes or pharmacotherapy. So which of the following is the most appropriate initial step in setting up weight loss program? Fantastic. Okay, so before we get started with our first presentation, just a show of hands here. How many of you have ever prescribed GLP-1 receptor agonist for weight loss? Hands. Okay. And how many of you have a weight loss clinic set up in your institution that deals with GLP-1 receptor agonist? Okay. And how many of you have a cardiometabolic clinic in your institution? Wow, it's very few. Okay, that's very interesting.

GLP-1 receptor agonists

weight management

Cleveland Clinic

obesity treatment

cardiovascular health