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Welcome to another enlightening episode of Think Like a Pancreas! Join host Gary Scheiner as he engages in a comprehensive discussion with Dr. Paula Diab, a physician and diabetologist from South Africa. Together, they explore the complexities of weight management for individuals who take insulin, offering practical insights and expert advice. Learn more about Integrated Diabetes Services at @ 00:00:53 Introduction and Guest Background The episode begins with an introduction to the podcast 'Think Like a Pancreas' and its host, Gary Scheiner. The guest, Dr. Paula Diab, is introduced as a physician and diabetologist from South Africa. She shares her background, including her medical education, specialization in diabetes, and passion for translating complex diabetes information into user-friendly formats. 00:03:08 Challenges of Weight Management with Insulin Gary and Paula discuss the challenges of managing weight while taking insulin, which is a growth hormone that promotes fat storage and weight gain. They acknowledge the difficulty of balancing glucose management with weight management, as insulin is necessary for controlling blood sugar levels but also contributes to weight gain. 00:04:13 Hormonal Interplay and Appetite Regulation The discussion delves into the interplay of hormones like leptin, ghrelin, and amylin in regulating appetite and weight. They explain how the absence of amylin in people with diabetes can lead to increased hunger and faster digestion, making weight management even more challenging. 00:12:16 Weight Management Strategies The guests explore various weight management strategies, including medications like GLP-1 agonists (e.g., Ozempic, Trulicity, Victoza) and SGLT2 inhibitors, which can help regulate appetite and promote weight loss. They also discuss the importance of lifestyle changes, such as diet, exercise, and behavioral therapy, as well as surgical options like gastric bypass for severe cases. 00:26:20 Holistic Approach and Paula's Weight Loss Pyramid Paula introduces her 'Weight Loss Pyramid' concept, which emphasizes a holistic approach to weight management. The pyramid includes foundational elements like behaviors, sleep, stress management, and attitude, followed by caloric balance, meal planning, and physical activity. Medical interventions and surgical options are at the top of the pyramid, to be considered in conjunction with the lower levels.

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