Transcript
Announcer:
This is GI Insights on ReachMD. Today, Dr. Fernando Bril will be talking about treatment options for patients with obesity and liver disease. He’s an Assistant Professor in the Division of Endocrinology, Diabetes, and Metabolism at the University of Alabama at Birmingham Heersink School of Medicine. Here’s Dr. Bril now.
Dr. Bril:
Once we screen patients with obesity for clinically significant fibrosis, we divide these patients into those with low risk and those with high risk. The important thing to remember is that even if they have a low risk of fibrosis, that doesn't mean that they are metabolically healthy. These are patients with increased adiposity and most likely increased insulin resistance. And they probably they have MASLD. So we are not testing whether they have fat in the liver. We just want to see if there's local damage in the liver where there is fibrosis. But all these patients may be metabolically sick, and they all need therapy.
So when we are addressing obesity, we want to focus on lifestyle intervention. We want to try to achieve weight loss. But many times, we know that in reality, the rate of success with lifestyle intervention is quite low.
So we're all different when we are in front of the patients. Some of us may be a little bit more aggressive. Some of us may be a little bit more conservative. So while lifestyle is the backbone of what we are trying to achieve—we want patients to eat better, we want patients to achieve weight loss—the reality is that most patients do not achieve targets if we just focus on lifestyle.
So that's when we start thinking about pharmacotherapy that could help these patients with obesity and MASLD, because, in the last few years, we have newer medications for weight loss that are safer. They are highly effective in achieving more than five and even more than 10 percent of weight loss. So we want to try to introduce these medications early on when we are thinking about addressing obesity in patients with liver disease.
Announcer:
You just heard Dr. Fernando Bril explaining how to address obesity in patients with liver disease. To access this and other episodes in our series, visit GI Insights on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!