FDA warnings regarding GLP-1 medications

All right. Welcome back to Live and Local. So there is new FDA warnings right now on GLP-1 medications like Wegovy, Ozempic, Mounjaro, Zepbound, saying that they must carry a new warning label regarding a rare side effect that can cause permanent. Vision loss. So I want to bring in the main physician at the Institute of Anti-Aging. There he is. We are talking to Dr. Richard Lacone. Thank you so much for joining us. I know this is a big topic of conversation for many people because so many people are on GLP-1s. What are you seeing as far as vision loss? Well, you know, this condition, which is a sudden and. Generally permanent loss of either all or part of your visual field in one eye. It's not new. Neon has been around for years and years, and it's associated with type 2 diabetes, hypertension, obstructive sleep apnea, vascular disease in general. So it's really kind of a condition of usually of older people who have one or more of the major health conditions that we know cause vascular trouble. And so the fact that they're finding some association, now the GLP-1s are associated with these folks, they're all on GLP-1s now. So you're going to see an association, but it doesn't really mean causation. And everybody in the field of medicine knows this. I mean, it's a hot topic, and it's going to stay a hot topic until they do more studies. But none of the studies that have been done show causation. It's just an association. That's an interesting point because I think everybody is really looking at this FDA review of over 125 clinical trials, and they found that roughly six out of every 100,000 patients taking GLP-1 drugs for at least a year, they were the ones that were ending up with the at least partial vision loss. So that's fewer than... Four people per 100,000 for those taking placebos or other diabetes medications. I mean, is this... It's always been rare. Yeah. So is this enough to alarm somebody that has been on GLP-1s for a couple years? Well, you know... They certainly should be aware of it. And if they develop any symptoms that relate to their eyesight, they should certainly go straight to their doctor. Thank But it really is a condition associated with the conditions that they're being treated for. And GLP-1s have an astonishingly successful rate in lowering blood sugar and lowering body weight, which causes high blood sugar. So they're very effective drugs. you. But because they're being used so frequently now. It was going to turn up. It had to turn up because, you know, if you're given that many diabetics, you know, the ones and the diabetics are the ones who get neon and other typical obstructive sleep apnea is a very common one. There's also a genetic association that causes NEON, and they have a half a dozen genes they know cause it. And so... It's not a causative factor, not yet. Thank It may turn up to be a minor causative factor. It might increase your risk. One of the things that some of the investigators really kind of felt, you it was that some of these people, the GLP-1 was so effective at lowering blood pressure, very it might have lowered, excuse me, it's lowering their blood sugar. It might have lowered the blood sugar too fast. In other words, these people are going to need closer monitoring. much. And if the doctor detects that the blood sugar is really plummeting, well, they've got to cut the dose because it can really whack your blood sugar. And that could cause neon. Wow. What are some warning signs that patients need to be on the lookout for, whether it's their vision or anything? Yeah, well, I mean, for neon, the number one thing is going to be either graying or dulling or, you know, kind of areas of your vision that seem to be changing, either changing color, changing, you know, intensity of the image or blurring of the image, graying out of the image. And again, it usually occurs in areas. Areas. Not the entire, although it can affect the entire visual field at once, it can do that. But usually it's areas or spots around in the visual field. But it's serious because it is permanent. And that's one of the reasons that it's getting so much attention. And of course, the FDA. It's going to be very, very quick to pick this up because, you know, they really, I think the FDA wants to slightly chill the fever of GLP-1s that are going around this country. Everybody, everybody wants them just about, if you're just a couple of pounds overweight, they're going to their doctors and ask for GLP-1. And so that's really kind of what it's about, I think. It's going to get some attention and they really want to. Let people know that no medication is 100% safe. And, you know, if you don't need GLP-1 to lose five pounds, then don't seek it. Yeah, Doc, that's an interesting point. A lot of people on my social media or even in person, they're just assuming that I use the GLP-1. For when I got married in April and I'm like, I used nothing but hard work and dedication and protein. It's just funny how that conversation has shifted from like. It used to be taboo and now people are like, so what GLP-1 did you use? Like I didn't use the GLP-1, but I want to bring up the point of just the holistic approach to weight loss. And I know you probably preach this at your practice. It's not just about getting on one of these GLP-1s. Is there other recommended things that people should really try to implement when they want to lose a few pounds, even if it's with a GLP-1? Absolutely. I mean, I think we've been trying to send that message for years, even when we had other drugs that weren't as effective. But we try to tell people, look, this is not something that's going to go away. If you use a drug to lose weight, you may end up just getting it right back when you go off of the drug, and you don't want to be on it forever. So yeah, you've got to eat properly, eat up, get well. Fairly restricted carbohydrate diet, avoid junk foods, watch your calories. Calories is important. As a matter of fact, the GLP-1s, a lot of people don't realize this, but what they induce is a starvation-style diet. It's a definitely a low calorie diet, ultra low because you just don't feel like eating. And so you'll end up dropping down to 1100 calories, you know, a day, which was going to be, you know, you're going to lose weight. Wow. I mean, that's such a good point. And yeah, it's it's just I cut alcohol for six months and did the good old fashioned cut the calories, lifted the weights, did my walks. Yeah. Almost everybody who quits alcohol almost always tells you they lost weight. I know. It's even just a puffiness too. So yeah, I felt, I felt great. And I still try to stick to those habits that I built over the six months of wedding prep. Is there anything else that you would like to tell our audience as far as the weight loss go? I know you do much more than that too. You're the anti aging center. So I would imagine the Botox and all the things. Well, we believe in the holistic approach to wellness, so we try to look at everything, your lifestyle, your exercise, that's critical for losing weight, you know, and so lifestyle, exercise, eating, the whole picture, and, you know, alcohol, that's another one too, because so many people, their weight problem is due to alcohol, you know. I hope. So I like to remind people, alcohol is a carbohydrate. It's all carbohydrates. So So, you know, it's just another way to trim the carbs, eat a broad, healthy diet, lots of vegetables, kind of a paleo Mediterranean style diet. And you'll lose weight if you stick with it and throw in some resistive exercise. So yeah, and you have to do that anyway, You put on GLP-1s, if you don't exercise, you're going to lose your muscle. Yes. Muscles are so in right now, too. They're just it. Yeah. And if you lose the muscle, even though you lost weight, you'll end up shapeless. You know, you'll just be kind of. I love a good crunchy shoulder and defined arms. That's what we're going for, right? That's what everybody wants. There we go. And it takes lifting those weights to get there. Well, thank you so much for coming on the show. We so appreciate it, Dr. Richard. We can't thank you enough. Thanks for asking. Thank you. All right.