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Patients with obesity are at the forefront of latest developments in medicine once again, with new options but many new questions still to be solved, including a public health emergency and shortage despite the latest advances. In this latest interview Angela Fitch MD, FACP, FOMA, Dipl. ABOM critically reviews the advances, public health emergency, and problems with patient access to obesity treatments with an important call to action to the entire healthcare community. She offers a scientific overview of latest obesity treatments, incredibly practical solutions as well as valuable tips for treatments of obesity you do not want to miss!


Angela Fitch, MD, FACP, FOMA is a leader in the field of obesity medicine, immediate past president of the Obesity Medicine Association, Assistant Professor of Medicine at Harvard University, and former co-director of the Massachusetts General Hospital Weight Center. She is a dedicated clinician, as well as an activist for obesity medicine, board member of the Obesity Action Coalition, and a founding member of the Massachusetts Coalition for Action on Obesity.

0:00 Episode Highlights - Public Health Emergency: only 5-10% of 140 million patients w/ access to obesity care

1:36 Episode + Guest Introduction

3:31 Inspiration behind Dr. Angela Fitch's activism + specialization in Obesity

3:56 Background in engineering, primary care with GLP1 agonists

5:16 Obesity is a heterogeneous chronic disease

7:26 How far we have advanced in obesity treatments from phentermine and topiramate to semaglutide (Wegovy)or tirzepatide (Zepbound) and their relative probability in losing 20% bodyweight

8:49 Surgery vs newer GLP1 and other obesity treatments and new investigational drug retatrutide

10:03 Triple mechanism of experimental new obesity drug retatrutide

10:16 Comparison of Tirzpatide - double agonist (GLP1 / GIP): Semaglutide - single mechanism (GLP1) agonist, and retatrutide - triple agonist (GLP1, GIP, and glucagon)

11:18 Success Factors in Obesity Treatments

13:01 Why lifestyle and diet are not effective in many patients

13:41 Personal case study of diet and weight loss with associated GERD

14:24 Dr. Fitch's lifestyle tips: 5P's: planned portions, plants + protein, power, pillow, pause

15:48 Our society does not promote healthy nutrition

18:38 Lifestyle effective in only 5% of patients with obesity

19:02 Weight loss and maintenance - two different biologic phenomena

21:00 How to gain a Metabolic Advantage

23:28 Weight loss maintenance post surgery vs medications

25:32 How patients can access drugs despite obesity medicine shortage

26:06 Public Health Emergency - Obesity Medicine is not a Standard health insurance benefit in the U.S.

28:33 140 million Americans qualify for treatment, but only 5-10% receive it

29:26 Why we are awaiting new drug approvals - why patients are turning to non-FDA approved options

31:00 Reality - alternative ways patients are accessing obesity treatments

31:36 Dr. Fitch's solutions - declare public health emergency, consider vial formulations, coordinate comprehensive care

34:42 Call to Action and Challenge to Healthcare Community

39:23 Dr. Fitch's Current and Future Focus

39:57 Expansion of Dr. Fitch's knownwell patient centered medical home & collaborative practice across new locations in the U.S., 75% telemedicine

If you have an interest in digital health or digital therapeutics and want to know the latest analyses, trends, and tangible lessons, my latest guest on Alloutcoach, Giorgia Pezzotta is the person I strongly recommend that you follow. Giorgia is a health and innovation engineer, emerging leader, and entrepreneur recognized among 100 under 35 young talents by Financial Times to innovate the "future of Italian entrepreneurship worldwide". She is personally committed to driving change, creating strategic innovation, and promoting social impact.

Her purpose is to ensure that innovation and technology improve people's health and healthcare management, and deliver a better future for our society.She works as Key Account Project Manager at a French unicorn digital health company Doctolib, and an instrumental part of the Italian launch team of hospitals. Doctolib is the first digital health service in Europe and one of the fastest-growing healthcare tech companies. Giorgia previously served as a healthcare consultant at KPMG Advisory S.p.A.

0:00 Highlight from Episode - Advantages of continuous monitoring of root causes of chronic disease with remote patient monitoring, digital wearables and telemedicine to reach more patients in rural areas

1:45 Episode + Guest Introduction

3:44 Giorgia's Journey to her Passion for Health Innovation

7:58 Unique Learning Motive behind Digital Health Content Strategy

8:48 What are the latest health innovations with biggest impact on patients?

13:57 Where are the biggest investments focused on health innovation?

16:14 What are some quality metrics and standards among different Digital Health products?

19:08 Are there any plans to accelerate regulation and approval of digital therapeutics globally?

22:11 How should patients choose which digital health app to use?

25:36 Lessons for Entrepreneurs in Digital Health

28:47 Final Message: Importance of finding someone who believes in you

In this new "InWeekend" series premiere of the podcast, the host, Tim Mikhelashvili, CEO of Amedea Pharma shares real world lessons from his career in the Medical Affairs function in the pharmaceutical industry to propose a modern approach to raising new standards in healthcare quality and ways of working in an environment constrained by resources and increasingly exposed to data.

He reviews 1 validated organizational change framework, 1 global case study, 5 latest research studies and benchmarking reports in the field or across different industries, cites clips from an organizational change expert Ron Carucci and a double Olympian swimmer Chris Cook to debate why work should be like a sport for a diverse, multi-functional profession not directly tied to revenue, to consistently improve its Medical Impact on patient outcomes and business profit.



0:09 Intro

0:47 "InWeekend" Series Premiere Description

1:14 Episode Intro

2:18 Change Perspective from Performance Review to Personal Record

3:15 Article Overview - Approach to New Ways of Working

3:40 Lessons from Career

4:25 What "Going to Work as if Competing in a Sport" means for Medical Affairs / Healthcare

4:56 Merging principles of Sportsmanship with Science at Amedea Pharma

5:04 Selecting the Right Data from Limitless Options to Show Medical Impact

6:31 Breaking Down Performance into Activities and Outcomes to make Metrics Meaningful

7:30 Metrics and Human Ambition addressing the Competitors in All of Us

8:27 Three outcomes of avoiding human ambition as leaders

11:19 Implicit vs Explicit Competition in a real-world case study

13:36 Origin of We vs They Internal Rivalries

15:22 Case Studies of Medical Affairs directly generating revenue

17:05 Cost of Decreased Cross-Functional Collaboration - Clip from Podcast with Ron Carucci

20:06 Healthcare as Cost vs Investment

22:21 Why Sports adds Certainty and Objectivity to Healthcare

23:17 Lack of personal recognition in Medical Affairs

24:11 Sports - Celebration of Personal Accountability

24:30 Why work is more like war today than sports

25:34 Addressing skeptics - why introduce more pressure through sports at work?

26:58 How true sports view of work sparks life in least competitive employees

27:41 Medical Affairs Innovation Olympics case study

29:19 ToMo - Total Motivational Factor Score Model overview

32:32 - Common Organizational Processes that improve employee motivation / engagement

34:27 Performance Evaluations Irrelevant to Job Role - recent research

35:15 Latest Medical Affairs Metrics Benchmarking Results and Gaps in meaning and analysis

39:50 Our Approach to Performance reflects how we view our responsibility

40:01 Recent study on lost productivity and money on subjective performance management

40:17 Recent HBR research on comparing employees against themselves versus against each other

41:57 Three questions to consider to improve performance metrics

43:04 Argument - what if we change/raise standards of performance management?

44:02 Chris Cook - Double Olympian swimmer's advice in a short podcast clip: Compete more often against yourself and against more people

48:54 The Competition Paradox: Lesson

49:33 Three Myths vs Facts on Performance Metrics

50:56 Final Advice to Stretch Yourself in Life

51:57 Personal Invitation to Sign Up for the 2024 Medical Affairs Innovation Olympic Trials

On this special Live broadcast of the @Alloutcoach Podcast I welcomed back Dr. Pierantonio Russo, Chief Medical Officer at EVERSANA, cardiac and heart transplant surgeon trained at Mayo Clinic, academic medical school lecturer, expert in health economics and population medicine, bioinformatics, Machine Learning, and digital medicine to the show to share the highlights from his recent state of the art presentation of the "Hospital of the Future" in Rome, Italy. He is a renowned physician executive and speaker who has a healthcare experience from all its angles as a chief clinician in cardiac surgery, health insurance decision-maker, health system leader and administrator, and therefore shares his specific cases of med tech innovations already underway as well as the critical success factors including personalizing healthcare delivery using remote patient monitoring or applying social determinants of health data.
0:00 Episode Introduction
1:48 Dr. Pierantonio Russo - Journey of a Healthcare Career from all of its Angles
6:14 Health Innovations Already Underway w/ Strongest Impact
13:44 Why Certain Health Systems are More Successful in Adopting Innovation
15:28 When will Health Tech Innovations Go Mainstream to the Community
17:36 Specific Outcomes of AI / ML on Patient Outcomes
22:45 Role of Convenience in Health Innovation - Quadruple Aim
26:57 Impact of Med Tech on the Art of Medicine or Decision-Making
29:39 What are the economic real-world benefits of Med Tech?
32:18 AI/ML can improve Social Determinants of Care and Value-Based Care
35:17 Final Message: Critical Steps to Consider Which Technology to Implement in Medicine

With rising socio-economic pressures on health systems and healthcare professionals to continue to deliver the best clinical outcomes, staff shortages and countless sources of Medical Information to support their approaches to patient care, the topic of practical methods of applying Medical Education in innovative ways has never been more critical. In this episode I speak to a renowned leader and expert in the industry of Medical Education, Rob Braun, President, Global Learning Collaborative - Omnia Education, Prova Education, Medtelligence, and AGILE with decades of experience in senior executive roles managing or advertising accredited Continuing Medical Education (CME) in oncology, women's health / gynecology, cardiology, neurology, dermatology, gastroenterology across pharma, biotech, and life sciences with recognized brands such as WebMD, and Mesdcape, among others. He shares his modern view of Medical Education focused podcasts and their ultimate practical value on improving patient outcomes by illustrating latest trends as well as insights from recent data.

0:00 Introduction

0:08 Speaker Introduction: Rob Braun

1:26 Rob's Intro: Global Learning Initiative

2:19 How does a podcast differentiate itself across different channels in impact on healthcare outcomes?

4:28 How does your approach help people apply the information rather than just listen?

8:13 How can we improve the impact of KPIs on patient outcomes in Medical Education and what roles can podcasts address these gaps?

10:32 What are some trends among the types of HCPs most likely to attend Med Ed podcasts?

12:56 Dr Ian Lang quote from 1991

13:23 How do you measure impact on clinical outcomes?

15:08 Is there a particular time range after the activity during which it is best to test knowledge?

16:30 What are some incentives you use for more HCPs to respond to Med Ed program outcomes surveys?

17:09 How has the quality of Med Ed programs changed in the recent years and what impact do the HCPs preferences have on these trends?

20:27 What makes continuing medical education that is accredited critically different from all other growing sources?

22:28 Where can HCPs, others tune in to participate in innovative Med Ed programs?

24:49 Final Message from Rob Braun: Creativity in Medical Education

What a better way to start the new 2024 year than to learn about the current, realistic prospect of living longer and better lives due to the latest advances in medicine and pharmaceutical research from a preventive and longevity medicine advocate, researcher, and expert, James Peyer, PhD. This episode features a personal, candid story of his journey from academia into the industry, inspiration behind pursuing preventive healthcare and longevity treatments, and latest new treatments in human trials that increase healthspan and lifespan from a keynote speech at the 2nd annual global Medical Affairs Innovation Olympics Opening Ceremony in 2023. Subscribe to Alloutcoach and share this episode with your friends!

0:00 Episode Introduction
5:10 James Peyer's Keynote Speech Outline
7:14 James Peyer's late grandfather and inspiration to pursue prevention medicine
7:55 Frustration with Health System's Interaction with Elderly
9:53 Early animal experiments in genes doubling lifespan
11:14 80+ treatments that extend healthy lifespan in animal models today
13:09 Real-world reason why human trials in slowing aging did not advance
14:10 Breakthrough Idea to Advance Prevention Medicine in Humans
16:35 Cambrian Bio's unique Longevity Platform Ecosystem
19:42 Two Longevity Medicine Biotech Case Studies
20:50 Amplifier Therapeutics - a Cambrian Bio Pipeline Company
23:48 New Promise in 10-year race to develop an AMPK (central energy regulator) activator
25:40 ATX-304: new AMPK candidate in human trials
27:50 Second Vignette: Velakor - agrin-induced pleiotropic cardiac repair
31:11 Velakor's Agrin in human clincal trials in 2024 to regenerate heart muscle
33:25 Q1: Regulatory approval considerations for other longevity medicine companies
34:08 Conduct Primary and Secondary Prevention Trials - FDA supportive of preventive treatments
35:21 FDA interested in preventive medicine, transition from sick care to preventive care in US
37:11 Q2: Difference between healthspan and lifespan, and impact on drug development
38:22 Patient Survey Data on Critical Value of Quality not only Length of Life
41:25 Q3: Technological innovations most promising in increasing longevity and healthspan
43:49 James' Final Message on Innovation and Entrepreneurship