Recently, one of my esteemed psychiatric colleagues, Dr. Roger McIntyre, MD - from the University of Toronto - penned an interesting piece in Expert Perspectives in Major Depressive Disorder. In it he noted a "pathophysiologic convergence" (translation: where the bad things come from and get together on) between mood disorders (depression, metabolic disorders (overweight, diabetic, pre-diabetic), and the development of chronic inflammation. It's known that higher markers of inflammation have been seen in patients who have both diabetes and a major depressive disorder. In a remarkable pilot study by Mansur and colleagues, liraglutide, a GLP-1 agonist, promoted both weight loss and improved metabolic parameters, such as decreased blood sugars and insulin levels, in non-diabetic individuals with mood disorders. Liraglutide may be better known to people as Victoza , a shot for the express purpose of dealing with diabetes and metabolic syndrome, and Saxenda , which is the same medication rebranded for weight loss. Even more significantly, and probably as a direct result of the drop in high blood sugars with patients on these drugs, there were increases in the volume of the subcortical structures in the brain, as well as increases in frontal gray matter volumes. Both developments were associated with weight loss as well as increased regional brain volume and improvement in depressive symptoms. In a quick review of the published peer-reviewed medical literature today (4/17/2024) I found 91 results: here. There is abundant evidence that the GLP-1 agonists improve and/or stabilize depression. At Cady Wellness Institute, we focus on an integrated approach to health. So even if the testosterone, estrogen, and progesterone levels are optimum for the ladies, and the testosterone is optimum for the guys, it doesn't necessaraily mean that your blood sugars, the risk for diabetes, and cortical regions affected by a high glycemic load will be OK. And if they're not, you could be in for a whole world of hurt. That's the main reason that I became so fascinated with the GLP-1 drugs. There are three problems with these drugs, however. One is the cost. Thousands of dollars a month, which we found a way to cut down to 1/10th of the big pharma pricing. Second, is how they are being administered. Is there any effort to avoid blasting patients with the maximum dose for the duration of their careers as patients? And after that, what? These agents work by slowing down transit time in the gut, and, understandably, your appetite drops off. You lose weight. You feel great. But unless you're planning on being permanently wed to your Ozempic, Mounjaro, or Saxenda, you will gain all the weight back with more to spare at the end. Your appetite will come galloping back and try to help you recover from the starvation that your body feels it has been dealing with. Finally, the third problem is that these drugs cause muscle loss. You lose muscle at the same time you lose fat, and both are due to decreased calories you are consuming. The BTL equipment we have procured at CWI melts fat and builds muscle even if you are on a GLP-1 agent. We haven't become a weight loss shot clinic or a med spa. We are still an integrative medicine and mental health clinic. What we are doing is using all the technology we can bring to bear to help our patients - whether it's for weight loss, getting their blood sugars under control, or even dealing with depression through better blood sugar regulation. Give us a call and come check us out!

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