Episode 400: 408. CME Obesity and MASH

27/09/2025 1h 2min Episodio 400
Episode 400: 408. CME Obesity and MASH

Listen "Episode 400: 408. CME Obesity and MASH"

Episode Synopsis


GLP1 drugs work but they likely need lifestyle modificationsNo convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history existStopping therapy usually results in weight gainInsurance coverage for weight loss is limited and variable 
Semaglutide for type 2 diabetes max dose is 2.0 mg weekly Semaglutide for weight loss has a goal dose of 2.4 mg weekly
Diagnose steatotic liver disease with imaging and 1 metabolic risk factor (or biopsy)
After diagnosis check FIB-4:
Low risk, continue to monitor with FIB-4 every 2-3yrs 
Intermediate risk, order VCTE and consider referral if >F1 
High risk order a VCTE and referral (20% end with SLD)

2 FDA approved medications for liver fibrosis are not cheap, expect insurance push back

More episodes of the podcast Questioning Medicine