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Medscape
3 days ago
- Business
- Medscape
Nutritional Counseling May Be Free for Your Obesity Patients
As part of treating the overall well-being of your patients, it may be beneficial to recommend nutritional counseling. More insurance carriers are providing this service as a benefit. When patients have conditions such as type 2 diabetes, high blood pressure, heart disease or obesity, suggesting nutritional counseling could help your patients become more informed about making healthier choices. More health insurance plans cover nutritional counseling, although some may only provide coverage for specific conditions. 'Integrating nutritional counseling into routine clinical practice is essential and necessary to achieving optimal health outcomes,' said Scott Isaacs, MD, adjunct assistant professor of medicine, Emory University, and president of the American Association of Clinical Endocrinology, who is based in Atlanta. 'By ensuring that nutritional counseling is accessible, personalized, and supported by insurance, we empower our patients to prevent disease, effectively manage chronic conditions, and improve both quality of live and longevity.' What Exactly Is Nutritional Counseling? Nutritional counseling is a collaborative, patient-centered process led by registered dietitians or nutritionists, and it involves a comprehensive assessment of a patient's dietary habits (dietary history), medical history, cultural/ethnic preferences, and health goals, followed by personalized education and support, said Isaacs. Scott Isaacs, MD 'Think of nutritional counseling as a way to translate medical advice into a meal plan that is realistic and achievable for an individual's life situation. Nutritional knowledge with practical tips helps patients make gradual, sustainable dietary changes,' he said. 'This isn't about quick fixes, it's about building lifelong skills, making permanent lifestyle changes for better health.' Most Insurance Plans Will Cover It According to Isaacs, most health insurance plans, including those under the Affordable Care Act, cover nutritional counseling for preventive care and for patients with conditions like diabetes, obesity, high blood pressure, and heart disease. 'One of the most underused benefits is insurance-covered nutritional counseling,' he said. 'I encourage clinicians to proactively inform patients that these services are likely included in their health plan.' Although most insurance plans grant patients the self-refer option to a registered dietitian, some require a physician's referral, especially for specific diagnoses such as diabetes, obesity, or hypertension, said Isaacs. If a referral is needed, physicians should reassure patients that this is a routine process. How Does This Affect Treatment Plans? Nutrition counselling services are integral to holistic comprehensive care. Nutritional counseling can include: Comprehensive weight management programs Bariatric pre- and post-surgery Diabetes management Lowering cholesterol Irritable bowel syndrome Food allergies (including gluten) Personalized meal planning Medical nutrition therapy for chronic illnesses, including cancer Mindful eating techniques to address emotional and behavioral eating patterns Nutrition guidance during pregnancy and for sports performance Furthermore, medical specialists say that nutritional counseling can particularly be a win for those with specific health conditions. 'My perspective is that medical nutrition therapy is vital to overall patient care plans, especially in the setting such as celiac disease or short bowel syndrome,' said Lindsey Russell, MD, a gastroenterologist with the Center for Human Nutrition at Cleveland Clinic in Cleveland. 'At Cleveland Clinic, we practice a multidisciplinary approach to treating chronic diseases, such as inflammatory bowel disease, which includes registered dietitians as part of the treatment plan.' Why Patients Benefit From Nutritional Counseling? Isaacs at Emory University said nutritional counseling is a proven, evidence-based approach for managing and preventing chronic diseases such as obesity, diabetes, and cardiovascular conditions. 'Nutritional counseling is not just about diet, it's about giving patients practical, sustainable strategies to improve their health,' he said. Lindsey Russell, MD Among the benefits of personalized dietary guidance, Isaacs said, is helping patients with weight management, blood glucose control, lipid management, reduce cardiovascular risk, and support long-term health and vitality. Why Do Patients Trust Your Guidance? Patients appreciate nutrition advice they receive from their physicians, and studies show that when doctors introduce such conversations, patients are more likely to adopt meaningful lifestyle tweaks. 'By recommending nutritional counseling, we're not just treating disease, we're helping patients improve their health and quality of life,' Isaacs told Medscape Medical News . Encouraging Patients to Try Nutrition Counseling Once a doctor encourages a patient to use their insurance coverage to see a registered dietician, follow-through should be part of the plan. 'I encourage my patients to be open about their experiences — what they have tried, what has worked, what hasn't, and most importantly, their motivation for change,' said Christopher Scuderi, DO, a family physician who practices at Millennium Physician Group in Jacksonville, Florida, 'Having a clear 'why' behind their goals makes a significant difference in maintaining long-term commitment.' In his experience as a family physician, Scuderi noted that patients struggling with weight loss often consult with him after trying multiple approaches on their own. 'They frequently bring a wealth of questions, many stemming from misinformation found on social media. I have found that consulting a nutritionist can be especially helpful in addressing these concerns, providing sound guidance, and ensuring close follow-up,' he said. Christopher Scuderi, DO In addition, during the last 2 years, Scuderi said he's noticed an uptick in patient interest in glucagon-like peptide 1 (GLP-1) medications. Due to this, it has been easier to approach the topic of nutrition counseling. 'I have found it increasingly easier to discuss weight management with patients. Many are particularly interested in GLP-1 medications such as Wegovy and Zepbound,' he said. 'However, insurance coverage for these medications can be a significant barrier for many individuals.' In conclusion, Isaacs at Emory University said 'when nutrition is a routine part of medical care, it empowers patients to take charge of their health through the foods they eat every day.' To facilitate the incorporation of nutritional counseling for a patient's care plan he recommends the following steps:
Hindustan Times
26-05-2025
- Health
- Hindustan Times
Should Everyone Be Taking Ozempic? Doctors Say More People Could Benefit.
Novo Nordisk's Ozempic be added to the water supply? That is the kind of half-joking question that doctors kick around when a new class of drugs begins to help a big chunk of the population. Cardiologists used to quip about spiking water systems with cholesterol-reducing statins because of their ability to prevent heart attacks. Now, Ozempic and others in the 'GLP-1' category of drugs are approaching that critical mass. They are showing promise for an ever-expanding list of diseases, beyond today's most common uses of weight loss and treating diabetes. Heart, kidney and liver diseases. Sleep apnea. Arthritis. Alzheimer's disease. Alcohol addiction. Even aging. Some of these are potential benefits that need further study. 'It is getting to the point of wondering what GLP-1 agonists aren't good for,' pharmaceutical researcher and blogger Derek Lowe wrote in the academic journal Science last year. If this trajectory continues, doctors say millions more people would benefit from them—maybe even one-third to a majority of adults. But they also caution about use of the drugs in people who don't medically fit the bill because it could cause malnourishment. Doctors would have to figure out ways to guard against excessive weight loss in people who aren't overweight, perhaps putting them on special diets, said Dr. Scott Isaacs, an endocrinologist in Atlanta. The drugs—which also include Wegovy, Mounjaro and Zepbound—mimic naturally occurring gut hormones such as GLP-1. The medicines promote production of insulin, which helps control blood-sugar levels in people with Type 2 diabetes. They suppress appetite and make people feel full faster when eating, helping overweight people lose many pounds. In diabetes and obesity alone, the eligible patient population is huge. More than 100 million American adults—or 40%—have obesity. About 38 million have diabetes. Many of the proven and potential benefits of the drugs cascade from their effect on obesity. Losing weight relieves sleep apnea. It takes pressure off the joints, helping with arthritis. 'If you treat obesity, all of the complications of obesity that we spend a lot of our time treating in medicine should get better,' said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine. But it also seems likely that some benefits are independent of weight loss, possibly because of anti-inflammatory effects of the drugs. 'The science is evolving very quickly in understanding how these medications affect so many organs and inflammation,' said Dr. Robert Kushner, an obesity-treatment specialist at Northwestern University's Feinberg School of Medicine. Doctors say GLP-1-type drugs may help with psoriatic arthritis, an autoimmune condition that causes joint pain and skin rashes, because of weight loss but also for their potential to reduce inflammation. Susan Abernethy of North Cove, Wash., started taking Eli Lilly's diabetes drug Mounjaro in 2023 to help treat her psoriatic arthritis after older treatments weren't working as well. The 58-year-old chief operating officer of a nonprofit credits Mounjaro with helping her lose weight and relieving her joint pain. She takes it along with Taltz, which is approved to treat psoriatic arthritis. Her insurance pays for the combination in part because she also has Type 2 diabetes. 'After about four years of not being able to run and do things, I've been able to do a couple of 5Ks again,' she said. 'I can walk longer on the beach than before.' Lilly is studying the combination of Taltz and Mounjaro's main ingredient to treat psoriatic arthritis in a Phase 3 study, with hopes of seeking regulatory approval of the use if the study is successful. Doctors are also seeing success in treating people with certain liver diseases. Isaacs prescribes GLP-1s for people with a fatty-liver condition called metabolic dysfunction-associated steatohepatitis, or MASH, which is estimated to afflict about 15 million Americans. A study published in the New England Journal of Medicine in April found that semaglutide, the main ingredient of Ozempic and Wegovy, improved the condition in patients. Another area being considered: Alzheimer's disease. Researchers believe GLP-1s may have neuroprotective effects, slowing loss of brain volume. A small study in the U.K. last year found that Novo Nordisk's GLP-1 liraglutide slowed cognitive decline versus a placebo. Novo is conducting a Phase 3 trial of semaglutide in patients with early Alzheimer's. About 137 million American adults—more than half of the adult population—are eligible for treatment with the GLP-1 drug semaglutide, based on having Type 2 diabetes, meeting the threshold for excess body weight, or having established cardiovascular disease and excess weight, researchers estimated in a paper published in JAMA Cardiology last year. In comparison, about 82 million U.S. adults are eligible for statins. But only a fraction of those eligible are currently taking a GLP-1 drug—about 8.3 million in the U.S. this year, TD Cowen estimated. The percentage of the eligible population taking a GLP-1 outside the U.S. is even smaller. 'Global uptake of weight-loss drugs is minuscule relative to the addressable market,' TD Cowen analysts wrote in a research note. Still, some people clearly shouldn't take the drugs. 'I do believe that a large percent of the population, but not everybody, is going to be able to get some benefit,' Aronne said. People with a history of a type of thyroid cancer, or with certain head and neck tumors, shouldn't take them because earlier studies showed the drugs caused those types of tumors in rats. Some doctors are reluctant to prescribe them to people with a history of pancreatitis because some patients taking the drugs have developed severe cases of that condition. And some doctors shy away from prescribing them for cosmetic weight loss when no other medical conditions are present. Use of the drugs will surely grow. Morgan Stanley analysts estimate that by 2035, the number of Americans using a GLP-1 for obesity alone will rise to about 29 million. But even that would only represent 20% of the eligible obesity population. That is because anti-obesity drugs are expensive. List prices are over $1,000 a month, many insurance plans don't cover them and even manufacturer-discounted prices are still several hundred dollars a month. Tolerability and manufacturing capacity of the drugs might also be issues. Some patients stop taking the drugs because they suffer unpleasant gastrointestinal side effects. And two main manufacturers, Lilly and Novo, only recently resolved drug shortages by increasing production. But they are still far from reaching enough capacity to supply significantly bigger percentages of both current and future eligible populations. More studies and better drugs could help boost the treatment rate. Companies are developing newer GLP-1s that could deliver greater weight loss, and pill versions that might be appealing to patients who don't like getting shots. Write to Peter Loftus at Get 360° coverage—from daily headlines to 100 year archives.
Mint
26-05-2025
- Health
- Mint
Should everyone be taking Ozempic? Doctors say more people could benefit.
Novo Nordisk's Ozempic. Should Ozempic be added to the water supply? That is the kind of half-joking question that doctors kick around when a new class of drugs begins to help a big chunk of the population. Cardiologists used to quip about spiking water systems with cholesterol-reducing statins because of their ability to prevent heart attacks. Now, Ozempic and others in the 'GLP-1" category of drugs are approaching that critical mass. They are showing promise for an ever-expanding list of diseases, beyond today's most common uses of weight loss and treating diabetes. Heart, kidney and liver diseases. Sleep apnea. Arthritis. Alzheimer's disease. Alcohol addiction. Even aging. Some of these are potential benefits that need further study. 'It is getting to the point of wondering what GLP-1 agonists aren't good for," pharmaceutical researcher and blogger Derek Lowe wrote in the academic journal Science last year. If this trajectory continues, doctors say millions more people would benefit from them—maybe even one-third to a majority of adults. But they also caution about use of the drugs in people who don't medically fit the bill because it could cause malnourishment. Doctors would have to figure out ways to guard against excessive weight loss in people who aren't overweight, perhaps putting them on special diets, said Dr. Scott Isaacs, an endocrinologist in Atlanta. The drugs—which also include Wegovy, Mounjaro and Zepbound—mimic naturally occurring gut hormones such as GLP-1. The medicines promote production of insulin, which helps control blood-sugar levels in people with Type 2 diabetes. They suppress appetite and make people feel full faster when eating, helping overweight people lose many pounds. In diabetes and obesity alone, the eligible patient population is huge. More than 100 million American adults—or 40%—have obesity. About 38 million have diabetes. Many of the proven and potential benefits of the drugs cascade from their effect on obesity. Losing weight relieves sleep apnea. It takes pressure off the joints, helping with arthritis. 'If you treat obesity, all of the complications of obesity that we spend a lot of our time treating in medicine should get better," said Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine. Eli Lilly's Zepbound and other GLP-1 drugs help control appetite and blood sugar by mimicking naturally occurring gut hormones. But it also seems likely that some benefits are independent of weight loss, possibly because of anti-inflammatory effects of the drugs. 'The science is evolving very quickly in understanding how these medications affect so many organs and inflammation," said Dr. Robert Kushner, an obesity-treatment specialist at Northwestern University's Feinberg School of Medicine. Doctors say GLP-1-type drugs may help with psoriatic arthritis, an autoimmune condition that causes joint pain and skin rashes, because of weight loss but also for their potential to reduce inflammation. Susan Abernethy of North Cove, Wash., started taking Eli Lilly's diabetes drug Mounjaro in 2023 to help treat her psoriatic arthritis after older treatments weren't working as well. The 58-year-old chief operating officer of a nonprofit credits Mounjaro with helping her lose weight and relieving her joint pain. She takes it along with Taltz, which is approved to treat psoriatic arthritis. Her insurance pays for the combination in part because she also has Type 2 diabetes. 'After about four years of not being able to run and do things, I've been able to do a couple of 5Ks again," she said. 'I can walk longer on the beach than before." Lilly is studying the combination of Taltz and Mounjaro's main ingredient to treat psoriatic arthritis in a Phase 3 study, with hopes of seeking regulatory approval of the use if the study is successful. Doctors are also seeing success in treating people with certain liver diseases. Isaacs prescribes GLP-1s for people with a fatty-liver condition called metabolic dysfunction-associated steatohepatitis, or MASH, which is estimated to afflict about 15 million Americans. A study published in the New England Journal of Medicine in April found that semaglutide, the main ingredient of Ozempic and Wegovy, improved the condition in patients. Another area being considered: Alzheimer's disease. Researchers believe GLP-1s may have neuroprotective effects, slowing loss of brain volume. A small study in the U.K. last year found that Novo Nordisk's GLP-1 liraglutide slowed cognitive decline versus a placebo. Novo is conducting a Phase 3 trial of semaglutide in patients with early Alzheimer's. Production of Novo Nordisk's Wegovy. If many more people are going to take GLP-1 drugs, more capacity is needed. About 137 million American adults—more than half of the adult population—are eligible for treatment with the GLP-1 drug semaglutide, based on having Type 2 diabetes, meeting the threshold for excess body weight, or having established cardiovascular disease and excess weight, researchers estimated in a paper published in JAMA Cardiology last year. In comparison, about 82 million U.S. adults are eligible for statins. But only a fraction of those eligible are currently taking a GLP-1 drug—about 8.3 million in the U.S. this year, TD Cowen estimated. The percentage of the eligible population taking a GLP-1 outside the U.S. is even smaller. 'Global uptake of weight-loss drugs is minuscule relative to the addressable market," TD Cowen analysts wrote in a research note. Still, some people clearly shouldn't take the drugs. 'I do believe that a large percent of the population, but not everybody, is going to be able to get some benefit," Aronne said. People with a history of a type of thyroid cancer, or with certain head and neck tumors, shouldn't take them because earlier studies showed the drugs caused those types of tumors in rats. Some doctors are reluctant to prescribe them to people with a history of pancreatitis because some patients taking the drugs have developed severe cases of that condition. And some doctors shy away from prescribing them for cosmetic weight loss when no other medical conditions are present. Use of the drugs will surely grow. Morgan Stanley analysts estimate that by 2035, the number of Americans using a GLP-1 for obesity alone will rise to about 29 million. But even that would only represent 20% of the eligible obesity population. That is because anti-obesity drugs are expensive. List prices are over $1,000 a month, many insurance plans don't cover them and even manufacturer-discounted prices are still several hundred dollars a month. Tolerability and manufacturing capacity of the drugs might also be issues. Some patients stop taking the drugs because they suffer unpleasant gastrointestinal side effects. And two main manufacturers, Lilly and Novo, only recently resolved drug shortages by increasing production. But they are still far from reaching enough capacity to supply significantly bigger percentages of both current and future eligible populations. More studies and better drugs could help boost the treatment rate. Companies are developing newer GLP-1s that could deliver greater weight loss, and pill versions that might be appealing to patients who don't like getting shots. Write to Peter Loftus at
