Justin Ryder

236 statements · 6 topics

Liver Tumors (Hepatoblastoma/HCC) · guest expert

Featured statements

▶ Ep 15 · 1:41
The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period.
guideline · Liver Tumors (Hepatoblastoma/HCC)
▶ Ep 15 · 2:08
Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile.
guideline · Liver Tumors (Hepatoblastoma/HCC)
▶ Ep 27 · 1:25
Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting.
guideline · Obesity
▶ Ep 27 · 0:44
Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles.
clinical · Obesity
▶ Ep 13 · 3:40
Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel.
clinical · Obesity
▶ Ep 5 · 3:30
In Teen Labs, the only predictor of 10-year weight change was 6-month weight loss; no demographic, clinical, or social determinant factors predicted response.
clinical · Type 2 Diabetes

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Justin's statements about Liver Tumors (Hepatoblastoma/HCC) 40 statements

Open the Liver Tumors (Hepatoblastoma/HCC) collection →

Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder

▶ Ep 15 · 0:32
clinical Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 15 · 0:32
quote The data clearly supports that obesity is a disease impacted by behavior. ↗
▶ Ep 15 · 0:37
quote The big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 15 · 0:44
clinical Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles. ↗
▶ Ep 15 · 1:08
quote Historically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 15 · 1:08
epidemiological Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 15 · 1:15
guideline The new AAP clinical practice guidelines clearly state that obesity is a disease. ↗
▶ Ep 15 · 1:22
quote They clearly state that obesity is a disease. ↗
▶ Ep 15 · 1:25
quote The key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 15 · 1:25
guideline Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 15 · 1:41
guideline The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period. ↗
▶ Ep 15 · 1:55
guideline Pharmacotherapy is FDA labeled for adolescents above the age of 12. ↗
▶ Ep 15 · 2:02
clinical Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity. ↗
▶ Ep 15 · 2:08
guideline Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile. ↗
▶ Ep 15 · 2:29
clinical Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents. ↗
▶ Ep 15 · 2:44
clinical Data in adults on tirzepatide shows significant change in body weight compared to placebo. ↗
▶ Ep 15 · 2:51
clinical Oral GLP-1 medications are on the way in a few short years. ↗
▶ Ep 15 · 2:51
clinical Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years. ↗
▶ Ep 15 · 3:03
clinical There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period. ↗
▶ Ep 15 · 3:18
clinical There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem. ↗
▶ Ep 15 · 3:24
clinical Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids. ↗
▶ Ep 15 · 3:40
clinical Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel. ↗
▶ Ep 15 · 3:56
clinical Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status. ↗
▶ Ep 15 · 4:03
clinical It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 15 · 4:03
quote It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 15 · 4:22
epidemiological Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease. ↗
▶ Ep 15 · 4:31
clinical Obesity is a significant risk factor for MASLD. ↗
▶ Ep 15 · 4:34
epidemiological About 20% of youth in the United States have obesity, which is roughly 15 million children. ↗
▶ Ep 15 · 4:40
epidemiological Approximately 5 million children have both obesity and MASLD. ↗
▶ Ep 15 · 4:45
epidemiological Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma. ↗
▶ Ep 15 · 4:56
epidemiological There are racial and ethnic differences in MASLD prevalence. ↗
▶ Ep 15 · 5:09
epidemiological The rates of severe forms of obesity are only increasing. ↗
▶ Ep 15 · 5:09
epidemiological Obesity affects at least 35% of adults and 20% of children in Illinois alone. ↗
▶ Ep 15 · 5:19
clinical Obesity significantly increases the risk of long-term health problems and early death. ↗
▶ Ep 15 · 5:23
epidemiological The economic impact of obesity is substantial, with reductions in GDP and increases in state spending. ↗
▶ Ep 15 · 5:30
opinion Obesity is a disease driven by biology and it is no one's fault. ↗
▶ Ep 15 · 5:30
quote Crucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault. ↗
▶ Ep 15 · 5:37
opinion Access to effective obesity medications is a health equity issue. ↗
▶ Ep 15 · 5:41
epidemiological Obesity disproportionately affects people of color and those living in poverty. ↗
▶ Ep 15 · 5:49
clinical Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country. ↗
Justin's statements about Obesity 58 statements

Open the Obesity collection →

Justin Ryder, MD- 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 21 · 0:54
clinical Teen Labs 10-year latent class analysis identified four phenotypes of bariatric surgery responders. ↗
▶ Ep 21 · 1:30
clinical Superior responders (18% of cohort) lost about 45% of weight at nadir and maintained that loss out to 10 years. ↗
▶ Ep 21 · 2:00
clinical A second group lost about 35% at nadir and kept over 25% off at 10 years. ↗
▶ Ep 21 · 2:20
clinical A third group (one-third of cohort) had 12% BMI change at 10 years, comparable to semaglutide's mean response in adolescents at 1 year. ↗
▶ Ep 21 · 3:00
clinical Non-responders (red group) did not lose ideal weight, returned to baseline by 4 years, and overshot their starting weight. ↗
▶ Ep 21 · 3:30
clinical In Teen Labs, the only predictor of 10-year weight change was 6-month weight loss; no demographic, clinical, or social determinant factors predicted response. ↗
▶ Ep 21 · 4:30
clinical Teen Labs shows no difference in outcomes between Roux-en-Y gastric bypass and sleeve gastrectomy at 10 years. ↗
▶ Ep 21 · 5:00
clinical At 2 years, weight loss is about 30% in both sleeve gastrectomy and Roux-en-Y gastric bypass. ↗
▶ Ep 21 · 5:20
clinical Tirzepatide (Eli Lilly's dual GLP-1/GIP receptor agonist) shows 25% weight loss at 72 weeks, similar to surgery at 2 years. ↗
▶ Ep 21 · 5:40
quote We're always going to get a grade of C for bariatric surgery from these, these policymakers and these advocacy organizations until we have true randomized trials of surgery versus an alternative therapy that has the potential to have the same benefit. ↗
▶ Ep 21 · 5:40
opinion Bariatric surgery will continue to receive a grade of C from policymakers until randomized trials versus alternative therapies are conducted. ↗
▶ Ep 21 · 5:50
opinion Randomized trials of surgery versus medications are now ethically feasible because newer AOMs have potential for comparable benefit. ↗
▶ Ep 21 · 6:50
clinical Bariatric surgery is more effective in adolescents than adults, and this cannot be explained solely by duration of disease. ↗
▶ Ep 21 · 7:00
quote It can't simply be that it's duration of disease driven. And even if duration of disease was 50% of the reason why. A bariatric surgery is more effective in adolescents than it is in adults. There's still a lot to be learned from that other 50% ↗
▶ Ep 21 · 7:20
opinion Remission of type 2 diabetes in adolescents versus adults after bariatric surgery highlights the need for mechanistic studies. ↗
▶ Ep 21 · 7:40
opinion Mechanistic studies examining genetics, proteins, and metabolites may identify super-responders and guide combination therapies. ↗
▶ Ep 21 · 8:10
quote And so that's like 3 $15 million dollar ideas. So you're welcome. ↗
▶ Ep 21 · 11:50
opinion Clinical trial diversity is abysmal, and drug companies prioritize timeline over quality in enrollment. ↗

Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder

▶ Ep 27 · 0:32
clinical Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 27 · 0:32
quote The data clearly supports that obesity is a disease impacted by behavior. ↗
▶ Ep 27 · 0:37
quote The big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 27 · 0:44
clinical Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles. ↗
▶ Ep 27 · 1:08
epidemiological Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 27 · 1:08
quote Historically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 27 · 1:15
guideline The new AAP clinical practice guidelines clearly state that obesity is a disease. ↗
▶ Ep 27 · 1:22
quote They clearly state that obesity is a disease. ↗
▶ Ep 27 · 1:25
guideline Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 27 · 1:25
quote The key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 27 · 1:41
guideline The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period. ↗
▶ Ep 27 · 1:55
guideline Pharmacotherapy is FDA labeled for adolescents above the age of 12. ↗
▶ Ep 27 · 2:02
clinical Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity. ↗
▶ Ep 27 · 2:08
guideline Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile. ↗
▶ Ep 27 · 2:29
clinical Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents. ↗
▶ Ep 27 · 2:44
clinical Data in adults on tirzepatide shows significant change in body weight compared to placebo. ↗
▶ Ep 27 · 2:51
clinical Oral GLP-1 medications are on the way in a few short years. ↗
▶ Ep 27 · 2:51
clinical Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years. ↗
▶ Ep 27 · 3:03
clinical There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period. ↗
▶ Ep 27 · 3:18
clinical There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem. ↗
▶ Ep 27 · 3:24
clinical Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids. ↗
▶ Ep 27 · 3:40
clinical Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel. ↗
▶ Ep 27 · 3:56
clinical Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status. ↗
▶ Ep 27 · 4:03
clinical It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 27 · 4:03
quote It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 27 · 4:22
epidemiological Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease. ↗
▶ Ep 27 · 4:31
clinical Obesity is a significant risk factor for MASLD. ↗
▶ Ep 27 · 4:34
epidemiological About 20% of youth in the United States have obesity, which is roughly 15 million children. ↗
▶ Ep 27 · 4:40
epidemiological Approximately 5 million children have both obesity and MASLD. ↗
▶ Ep 27 · 4:45
epidemiological Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma. ↗
▶ Ep 27 · 4:56
epidemiological There are racial and ethnic differences in MASLD prevalence. ↗
▶ Ep 27 · 5:09
epidemiological Obesity affects at least 35% of adults and 20% of children in Illinois alone. ↗
▶ Ep 27 · 5:09
epidemiological The rates of severe forms of obesity are only increasing. ↗
▶ Ep 27 · 5:19
clinical Obesity significantly increases the risk of long-term health problems and early death. ↗
▶ Ep 27 · 5:23
epidemiological The economic impact of obesity is substantial, with reductions in GDP and increases in state spending. ↗
▶ Ep 27 · 5:30
quote Crucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault. ↗
▶ Ep 27 · 5:30
opinion Obesity is a disease driven by biology and it is no one's fault. ↗
▶ Ep 27 · 5:37
opinion Access to effective obesity medications is a health equity issue. ↗
▶ Ep 27 · 5:41
epidemiological Obesity disproportionately affects people of color and those living in poverty. ↗
▶ Ep 27 · 5:49
clinical Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country. ↗
Justin's statements about Obesity 40 statements

Open the Obesity collection →

Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder

▶ Ep 13 · 0:32
clinical Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 13 · 0:32
quote The data clearly supports that obesity is a disease impacted by behavior. ↗
▶ Ep 13 · 0:37
quote The big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 13 · 0:44
clinical Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles. ↗
▶ Ep 13 · 1:08
epidemiological Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 13 · 1:08
quote Historically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 13 · 1:15
guideline The new AAP clinical practice guidelines clearly state that obesity is a disease. ↗
▶ Ep 13 · 1:22
quote They clearly state that obesity is a disease. ↗
▶ Ep 13 · 1:25
quote The key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 13 · 1:25
guideline Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 13 · 1:41
guideline The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period. ↗
▶ Ep 13 · 1:55
guideline Pharmacotherapy is FDA labeled for adolescents above the age of 12. ↗
▶ Ep 13 · 2:02
clinical Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity. ↗
▶ Ep 13 · 2:08
guideline Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile. ↗
▶ Ep 13 · 2:29
clinical Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents. ↗
▶ Ep 13 · 2:44
clinical Data in adults on tirzepatide shows significant change in body weight compared to placebo. ↗
▶ Ep 13 · 2:51
clinical Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years. ↗
▶ Ep 13 · 2:51
clinical Oral GLP-1 medications are on the way in a few short years. ↗
▶ Ep 13 · 3:03
clinical There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period. ↗
▶ Ep 13 · 3:18
clinical There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem. ↗
▶ Ep 13 · 3:24
clinical Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids. ↗
▶ Ep 13 · 3:40
clinical Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel. ↗
▶ Ep 13 · 3:56
clinical Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status. ↗
▶ Ep 13 · 4:03
quote It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 13 · 4:03
clinical It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 13 · 4:22
epidemiological Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease. ↗
▶ Ep 13 · 4:31
clinical Obesity is a significant risk factor for MASLD. ↗
▶ Ep 13 · 4:34
epidemiological About 20% of youth in the United States have obesity, which is roughly 15 million children. ↗
▶ Ep 13 · 4:40
epidemiological Approximately 5 million children have both obesity and MASLD. ↗
▶ Ep 13 · 4:45
epidemiological Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma. ↗
▶ Ep 13 · 4:56
epidemiological There are racial and ethnic differences in MASLD prevalence. ↗
▶ Ep 13 · 5:09
epidemiological Obesity affects at least 35% of adults and 20% of children in Illinois alone. ↗
▶ Ep 13 · 5:09
epidemiological The rates of severe forms of obesity are only increasing. ↗
▶ Ep 13 · 5:19
clinical Obesity significantly increases the risk of long-term health problems and early death. ↗
▶ Ep 13 · 5:23
epidemiological The economic impact of obesity is substantial, with reductions in GDP and increases in state spending. ↗
▶ Ep 13 · 5:30
quote Crucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault. ↗
▶ Ep 13 · 5:30
opinion Obesity is a disease driven by biology and it is no one's fault. ↗
▶ Ep 13 · 5:37
opinion Access to effective obesity medications is a health equity issue. ↗
▶ Ep 13 · 5:41
epidemiological Obesity disproportionately affects people of color and those living in poverty. ↗
▶ Ep 13 · 5:49
clinical Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country. ↗
Justin's statements about Pediatric Obesity 40 statements

Open the Pediatric Obesity collection →

Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder

▶ Ep 10 · 0:32
clinical Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 10 · 0:32
quote The data clearly supports that obesity is a disease impacted by behavior. ↗
▶ Ep 10 · 0:37
quote The big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 10 · 0:44
clinical Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles. ↗
▶ Ep 10 · 1:08
quote Historically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 10 · 1:08
epidemiological Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 10 · 1:15
guideline The new AAP clinical practice guidelines clearly state that obesity is a disease. ↗
▶ Ep 10 · 1:22
quote They clearly state that obesity is a disease. ↗
▶ Ep 10 · 1:25
quote The key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 10 · 1:25
guideline Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 10 · 1:41
guideline The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period. ↗
▶ Ep 10 · 1:55
guideline Pharmacotherapy is FDA labeled for adolescents above the age of 12. ↗
▶ Ep 10 · 2:02
clinical Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity. ↗
▶ Ep 10 · 2:08
guideline Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile. ↗
▶ Ep 10 · 2:29
clinical Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents. ↗
▶ Ep 10 · 2:44
clinical Data in adults on tirzepatide shows significant change in body weight compared to placebo. ↗
▶ Ep 10 · 2:51
clinical Oral GLP-1 medications are on the way in a few short years. ↗
▶ Ep 10 · 2:51
clinical Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years. ↗
▶ Ep 10 · 3:03
clinical There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period. ↗
▶ Ep 10 · 3:18
clinical There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem. ↗
▶ Ep 10 · 3:24
clinical Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids. ↗
▶ Ep 10 · 3:40
clinical Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel. ↗
▶ Ep 10 · 3:56
clinical Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status. ↗
▶ Ep 10 · 4:03
clinical It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 10 · 4:03
quote It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 10 · 4:22
epidemiological Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease. ↗
▶ Ep 10 · 4:31
clinical Obesity is a significant risk factor for MASLD. ↗
▶ Ep 10 · 4:34
epidemiological About 20% of youth in the United States have obesity, which is roughly 15 million children. ↗
▶ Ep 10 · 4:40
epidemiological Approximately 5 million children have both obesity and MASLD. ↗
▶ Ep 10 · 4:45
epidemiological Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma. ↗
▶ Ep 10 · 4:56
epidemiological There are racial and ethnic differences in MASLD prevalence. ↗
▶ Ep 10 · 5:09
epidemiological Obesity affects at least 35% of adults and 20% of children in Illinois alone. ↗
▶ Ep 10 · 5:09
epidemiological The rates of severe forms of obesity are only increasing. ↗
▶ Ep 10 · 5:19
clinical Obesity significantly increases the risk of long-term health problems and early death. ↗
▶ Ep 10 · 5:23
epidemiological The economic impact of obesity is substantial, with reductions in GDP and increases in state spending. ↗
▶ Ep 10 · 5:30
opinion Obesity is a disease driven by biology and it is no one's fault. ↗
▶ Ep 10 · 5:30
quote Crucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault. ↗
▶ Ep 10 · 5:37
opinion Access to effective obesity medications is a health equity issue. ↗
▶ Ep 10 · 5:41
epidemiological Obesity disproportionately affects people of color and those living in poverty. ↗
▶ Ep 10 · 5:49
clinical Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country. ↗
Justin's statements about Pediatric Obesity 40 statements

Open the Pediatric Obesity collection →

Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder

▶ Ep 9 · 0:32
clinical Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 9 · 0:32
quote The data clearly supports that obesity is a disease impacted by behavior. ↗
▶ Ep 9 · 0:37
quote The big picture view is that it's a multifactorial disease impacted by a robust gene-environment interaction. ↗
▶ Ep 9 · 0:44
clinical Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles. ↗
▶ Ep 9 · 1:08
epidemiological Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 9 · 1:08
quote Historically, about 90% of our efforts over the past 50 years have been on prevention of childhood obesity. ↗
▶ Ep 9 · 1:15
guideline The new AAP clinical practice guidelines clearly state that obesity is a disease. ↗
▶ Ep 9 · 1:22
quote They clearly state that obesity is a disease. ↗
▶ Ep 9 · 1:25
guideline Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 9 · 1:25
quote The key takeaway is that the treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting. ↗
▶ Ep 9 · 1:41
guideline The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period. ↗
▶ Ep 9 · 1:55
guideline Pharmacotherapy is FDA labeled for adolescents above the age of 12. ↗
▶ Ep 9 · 2:02
clinical Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity. ↗
▶ Ep 9 · 2:08
guideline Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile. ↗
▶ Ep 9 · 2:29
clinical Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents. ↗
▶ Ep 9 · 2:44
clinical Data in adults on tirzepatide shows significant change in body weight compared to placebo. ↗
▶ Ep 9 · 2:51
clinical Oral GLP-1 medications are on the way in a few short years. ↗
▶ Ep 9 · 2:51
clinical Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years. ↗
▶ Ep 9 · 3:03
clinical There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period. ↗
▶ Ep 9 · 3:18
clinical There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem. ↗
▶ Ep 9 · 3:24
clinical Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids. ↗
▶ Ep 9 · 3:40
clinical Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel. ↗
▶ Ep 9 · 3:56
clinical Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status. ↗
▶ Ep 9 · 4:03
quote It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 9 · 4:03
clinical It is much easier to lose weight than to keep it off, which is demonstrated across many studies. ↗
▶ Ep 9 · 4:22
epidemiological Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease. ↗
▶ Ep 9 · 4:31
clinical Obesity is a significant risk factor for MASLD. ↗
▶ Ep 9 · 4:34
epidemiological About 20% of youth in the United States have obesity, which is roughly 15 million children. ↗
▶ Ep 9 · 4:40
epidemiological Approximately 5 million children have both obesity and MASLD. ↗
▶ Ep 9 · 4:45
epidemiological Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma. ↗
▶ Ep 9 · 4:56
epidemiological There are racial and ethnic differences in MASLD prevalence. ↗
▶ Ep 9 · 5:09
epidemiological Obesity affects at least 35% of adults and 20% of children in Illinois alone. ↗
▶ Ep 9 · 5:09
epidemiological The rates of severe forms of obesity are only increasing. ↗
▶ Ep 9 · 5:19
clinical Obesity significantly increases the risk of long-term health problems and early death. ↗
▶ Ep 9 · 5:23
epidemiological The economic impact of obesity is substantial, with reductions in GDP and increases in state spending. ↗
▶ Ep 9 · 5:30
quote Crucially, we need to reiterate that obesity is a disease driven by biology and that it is no one's fault. ↗
▶ Ep 9 · 5:30
opinion Obesity is a disease driven by biology and it is no one's fault. ↗
▶ Ep 9 · 5:37
opinion Access to effective obesity medications is a health equity issue. ↗
▶ Ep 9 · 5:41
epidemiological Obesity disproportionately affects people of color and those living in poverty. ↗
▶ Ep 9 · 5:49
clinical Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country. ↗
Justin's statements about Type 2 Diabetes 18 statements

Open the Type 2 Diabetes collection →

Justin Ryder, MD- 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 5 · 0:54
clinical Teen Labs 10-year latent class analysis identified four phenotypes of bariatric surgery responders. ↗
▶ Ep 5 · 1:30
clinical Superior responders (18% of cohort) lost about 45% of weight at nadir and maintained that loss out to 10 years. ↗
▶ Ep 5 · 2:00
clinical A second group lost about 35% at nadir and kept over 25% off at 10 years. ↗
▶ Ep 5 · 2:20
clinical A third group (one-third of cohort) had 12% BMI change at 10 years, comparable to semaglutide's mean response in adolescents at 1 year. ↗
▶ Ep 5 · 3:00
clinical Non-responders (red group) did not lose ideal weight, returned to baseline by 4 years, and overshot their starting weight. ↗
▶ Ep 5 · 3:30
clinical In Teen Labs, the only predictor of 10-year weight change was 6-month weight loss; no demographic, clinical, or social determinant factors predicted response. ↗
▶ Ep 5 · 4:30
clinical Teen Labs shows no difference in outcomes between Roux-en-Y gastric bypass and sleeve gastrectomy at 10 years. ↗
▶ Ep 5 · 5:00
clinical At 2 years, weight loss is about 30% in both sleeve gastrectomy and Roux-en-Y gastric bypass. ↗
▶ Ep 5 · 5:20
clinical Tirzepatide (Eli Lilly's dual GLP-1/GIP receptor agonist) shows 25% weight loss at 72 weeks, similar to surgery at 2 years. ↗
▶ Ep 5 · 5:40
opinion Bariatric surgery will continue to receive a grade of C from policymakers until randomized trials versus alternative therapies are conducted. ↗
▶ Ep 5 · 5:40
quote We're always going to get a grade of C for bariatric surgery from these, these policymakers and these advocacy organizations until we have true randomized trials of surgery versus an alternative therapy that has the potential to have the same benefit. ↗
▶ Ep 5 · 5:50
opinion Randomized trials of surgery versus medications are now ethically feasible because newer AOMs have potential for comparable benefit. ↗
▶ Ep 5 · 6:50
clinical Bariatric surgery is more effective in adolescents than adults, and this cannot be explained solely by duration of disease. ↗
▶ Ep 5 · 7:00
quote It can't simply be that it's duration of disease driven. And even if duration of disease was 50% of the reason why. A bariatric surgery is more effective in adolescents than it is in adults. There's still a lot to be learned from that other 50% ↗
▶ Ep 5 · 7:20
opinion Remission of type 2 diabetes in adolescents versus adults after bariatric surgery highlights the need for mechanistic studies. ↗
▶ Ep 5 · 7:40
opinion Mechanistic studies examining genetics, proteins, and metabolites may identify super-responders and guide combination therapies. ↗
▶ Ep 5 · 8:10
quote And so that's like 3 $15 million dollar ideas. So you're welcome. ↗
▶ Ep 5 · 11:50
opinion Clinical trial diversity is abysmal, and drug companies prioritize timeline over quality in enrollment. ↗