**Jim Hill:** Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

**Holly Wyatt:** And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

**Jim Hill:** Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

**Holly Wyatt:** Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

**Jim Hill:** Ready for the “And” factor?

**Holly Wyatt:** Let's dive in.

**Jim Hill:** Here we go. Today, we're talking about something that's truly transforming our lives, putting obesity first. For years, obesity was often treated as a secondary issue, something to discuss after managing heart disease, diabetes, or other conditions.

But now the tide's turning and obesity is finally being treated as the serious medical condition it is. So what does this mean for you? Well, it means access to better treatments, more comprehensive care, and for the first time real hope for lasting change. Today we'll be diving into how this shift is not only changing healthcare but more importantly how it's transforming individual lives. Holly, after years of minimal change, we're seeing something groundbreaking with the success of the new weight loss medications. Can you tell us why this moment is so pivotal in the field of obesity care?

**Holly Wyatt:** Yeah, Jim, you are absolutely right. This is something new. I think for a long time, most of my career, obesity was really kind of set aside. Doctors may talk about it, but it was at the end of their list. When they had time to address obesity, that's when they would address obesity, especially in primary care. But I think now because of these new treatments, especially the GLP-1 medications, we're starting to see people achieve weight loss that they didn't think was possible, and I think the healthcare providers didn't think it was possible. And it's starting to change how we manage chronic disease. I think that the clinicians are finally saying maybe I should put obesity at the top of the list of the things I'm going to talk about instead of the bottom of the list. And I think that can change everything in terms of how we treat diabetes and heart disease and so many other diseases. And this obesity-first approach is truly about, in my opinion, prioritizing the patient's overall health by tackling obesity. And that's a first. So I think this shift will make a big difference for our patients.

**Jim Hill:** Yeah, exactly. And today, Holly, we have a special guest who's at the forefront of this movement. Dr. Marc Cornier is a former colleague at Bars from the University of Colorado, and he's now a professor and director of the Division of Endocrinology at the Medical University of South Carolina. Marc has dedicated years to studying obesity, and he's about to take over as the president of the Obesity Society, which is a leading organization in obesity research. He is the perfect person to talk about this evolving topic and what it means for our listeners. Marc, welcome. It's great to have you here. Maybe you could start by telling us a bit about your journey in obesity research and how you've seen the field of obesity treatment evolve over the years. And more importantly, what does the obesity first movement mean for individuals who are dealing with obesity?

**Marc Cornier:** Right, Jim, and Holly. It's a pleasure to be here with you. Thanks for inviting me. Great to see old friends. And what a great topic. I mean, this is really what we're all about. I trained at the University of Colorado as an endocrinologist, and it was right after leptin was discovered. And there was this huge boom in research on the disease of obesity, appetite, and body weight regulation. And that really, I think, legitimized obesity as a disease to understand that there's true pathophysiology that can explain it. And so when I joined the research group, first of all, it was very fortunate to be in a center where there were world experts like yourself as mentors.

And it was a no-brainer to get involved in this area of research because there was so much happening. And my research changed over time and really started more on the metabolic side of things, but really started to focus on appetite regulation and dysregulation and started being involved in doing brain imaging studies where we could actually see what was happening in people's brains as it relates to food-related behaviors and food intake. And we were able to show that people who are prone to obesity, people with obesity, or people who have lost weight, have a different response to food signals than people who are lean in our obesogenic world. And so it's really convincing that this is pathophysiology and this is the disease of obesity. And so overall, I think some of us are calling this a neuro-metabolic disease.

It is a chronic, serious disease. And I think that's where it all kind of started and now to the point of really taking it to the patients. But I think we still have a lot of work, especially in primary care. The patients, the payers, and everyone, that obesity is a chronic disease. Because as you said, it should come first in our discussions with our patients. I think we have to change the mind frame of this is a disease that needs to be treated, just like we treat diabetes or hypertension.

It's always kind of a second-class citizen. We talk about using all these fancy drugs for diabetes, but we never question whether these are drugs that we use long-term. But when it comes to obesity, we have the same exact drugs, but we talk about, how long do we use these drugs.

**Holly Wyatt:** Primary care doctors used to tell me, I can't deal with the obesity. I've got to get their blood sugar under control. I've got to deal with this and then we can talk about the obesity. But I think, can we switch this? Can we flip it?

**Jim Hill:** But it sounds like it is flipping, Marc. And what do you think is driving this? Because talking to people in the field, I think people feel like we are maybe at a tipping point where we're starting to take this the way we should take it in clinical care.

**Marc Cornier:** Yeah. I think the obvious is these new drugs. I think there's a lot of excitement. It's raising a lot of awareness. And the idea that a drug can have that big of an impact, and when you stop it, the disease is still there. We see our patients regain the weight.

**Jim Hill:** And people are surprised at that because I think they go into it saying, I'm going to take the drugs and get the weight off and then I'm going to stop.

**Marc Cornier:** Right. I also want to think that the years of work that the three of us and so many others have put into educating healthcare professionals and the public about obesity have had an impact, a slow gradual impact. And that really it's this new, these new therapies that are really taking the groundwork that we spend so much time working on and is really taking it off. But I still think there's still a lot of work.

I think a lot of barriers. But this idea that you mentioned at the beginning is that diabetes, hypertension, sleep apnea, are not comorbidities. These are complications of obesity. And so if we treat obesity, we are either preventing the complications or reversing those complications.

And that's a different mind frame. Like you said, obesity was always the last thing. Now we still often list obesity in our notes at last because if we'd listed it first, we may not get paid, which is again, part of the problem.

**Jim Hill:** You know, a couple of things, Marc. I always say two big takeaways for me from the obesity medications are first of all, it shows for real that it's not simply a problem of willpower. There is real biology at work here and people are susceptible.

It's not that they just have a lack of willpower. And the second one is to look at what could happen if we could reduce obesity. All these consequences of obesity go away. Heart disease, diabetes, kidney disease, the impact would be amazing.

**Marc Cornier:** Absolutely. I mean, there's no doubt about it. And I think the first step is convincing everyone, this is a disease and if we treat it, we can prevent these complications or treat the complications. But then we got to get through a number of other barriers that relate to insurance coverage and buy-in by everyone, to be honest. And I think people talk about, oh, but it's too expensive to keep these treatments long term.

Well, it's too expensive to not. And the other thing is, yeah, we say these are long-term therapies and they are, but the reality is we're going to have new therapies. I foresee that patients will be on one treatment for some period of time and they'll convert to another type of treatment to help maintain that weight loss long term. I think, Holly, you always said it, weight loss is one thing, weight loss maintenance is something else. And so I think same with whether it's diet, exercise, or both medical therapies, we have to have different treatment plans.

**Jim Hill:** I actually think that's another big thing the medications have done is they finally focused it on weight loss maintenance because, again, nobody's wanted to be in maintenance because they've never achieved an amount of weight loss that satisfies them. Now it's different. And I think the time for getting serious about weight loss maintenance is now.

**Holly Wyatt:** Well, I think for the first time, I actually had a doctor come up to me and say, you know, I think weight loss is different than weight loss maintenance. And I'm like, yes, yes, right. Because they're seeing the weight loss and now they're saying, okay, what do we do to maintain it and thinking about how do drugs play a role? How does diet play a role?

How does exercise play a role? And I totally agree with you. There may be a shift in medications. Maybe certain medications will work better for weight loss. Certain medications will work better for weight loss maintenance or in combination. So I agree, we're evolving. It's just starting what I think we can do.

**Marc Cornier:** Absolutely. You know, in reality, not everyone can be on some of these medicines or, you know, reasons that they can't be on them or they can't tolerate. And so we have to have other options for patients. You know, it's not just, you know, tirzepatide, semaglutide, you know, it's there. There's gonna be others. And it's brought some hope, but there are also frustrations with the lack of availability, and the lack of pay. I saw a patient yesterday who I prescribed one of these agents for him and he's losing weight.

He's doing great. And I thought it was covered because I didn't get a denial through the, you know, the medical record. I saw him yesterday, he's paying $750 a month and he said, it's getting to be a bit expensive. So I'm like, oh yeah. You know, so that's covered.

That's a covered benefit, you know, so we need changes here. And we have great centers like you do at your institution. We're developing this at ours prior in Colorado. These centers of excellence is great, but not all our patients can get to these centers. Nor can the centers absorb all the patients. So we've got to get the primary care providers on board and trained. I think there's also direct consumer approaches, which are you know, good and bad. There are some good ones, right? But it's another way to have patients get access. So these are all important issues that we're dealing with.

**Jim Hill:** So Marc, we don't have nearly as much data we need about the long-term consequences. But some of the data coming out, and again, it's very preliminary, suggests that maybe even half the people that go on these meds don't stay on them. And I think we know that if you stop the meds, you're likely going to be where you started from. How do we address that problem?

**Marc Cornier:** Well, I think, again, it starts with education. This is a disease that needs long-term treatment. I think, you know, patients, they lose the weight and they stabilize. They don't think the medicine's working anymore because they stopped losing weight.

But we have to educate them that this is what's happening. People do this in all disease states. If you look at all the patients that you write a prescription for a statin, well, how many patients actually stay on that statin long-term?

There's, you know, a good percentage that doesn't. You know, so I think, again, it takes education of our patients. And so our providers have to educate their patients that way. It still comes down to this is a disease and it doesn't just go away with a temporary treatment. So for me, that's where it is. You know, when patients do the experiment, right, they stop the drug because they ran out of their prescription. They didn't get back to their provider in time. And then they start gaining weight and then they freak out, right? So we'd love to have a plan in place.

**Holly Wyatt:** I'm going to switch just a little bit because I know you deal with all different kinds of treatments, not just the new medication. So, I've been thinking about this. So how do you think the role of bariatric surgery, which we've been using for years and it is effective in producing significant weight loss? How do you think it may evolve now with this kind of new context of pharmacological interventions that are getting up there close, not quite, but close to bariatric?

**Marc Cornier:** I think there will always be a role for bariatric surgery procedures. There'll be the patients who already have class three of severe obesity, who will never get their BMI down, even with medical therapy to the degree that they need, or patients who can't tolerate medicines or have contraindications. So there's always going to be a need, I think.

**Holly Wyatt:** But does it change it? Does it shift it? Does bariatric become for that class of obesity? And now we kind of have a middle ground where we don't think of bariatric surgery, we think of these medications.

**Marc Cornier:** Absolutely. But I also see combined therapies with medical therapy and surgery, especially for severely elevated BMI patients, where you treat them medically, have their surgery, then come back and restart medical therapy to get the maximum weight loss. But I think it will. Not will it put the surgeons out of business?

I don't think so. I think there's still going to be a need. I think we'll have better surgeries too, and better procedures. And there's always going to be that choice of, do I want to take treatment on a regular basis or do I want to get the procedure done? I think that will still be there. But it's going to impact it, no doubt.

**Jim Hill:** We need more tools, not fewer tools. And the more tools you have, the more clinicians can look at their toolbox and try different things.

**Marc Cornier:** Absolutely. And we know that there are different types of obesity in terms of the phenotypes. And people will respond to different treatments differently. If you look at the tirzepatide data, the average weight loss is close to 20%. But there are patients who have actually gained weight on that drug.

**Jim Hill:** We're going to talk about that in a minute. Holly and I are kind of doing some work in that area. But let me ask you this question. A lot of our listeners are either trying to lose weight, thinking about losing weight or trying to keep weight off. How does this approach change the conversation in the doctor's office when these people go in? And particularly, like people, you know, obesity experts is one thing. But just going into your family care doc or your primary care doc, how is this approach going to change that interaction, do you think?

**Marc Cornier:** Well, I think one is it's an interaction that's more like a true medical interaction. Now we treat diabetes or hypertension and it's going to be again, ultimately, I love that the term obesity first. That was a new one for me and I love it. Did you trademark that, by the way?

**Jim Hill:** No, no, it's not us. It's out there. There are people that are talking about it. So we stole it from the conversation out there.

**Marc Cornier:** Great. So the conversation is going to be different, but it's going to be more medical. And I think in a way these new treatments take care of the caloric restriction for us. So we don't have to spend an hour talking about diet, but I think it changes our behavior modification recommendations, our lifestyle recommendations, and it becomes more of a making sure patients get adequate protein, hydration, minerals, vitamins, etc., more like when we treat patients with bariatric surgery. So I think it does require a good close observation. When people have bad outcomes, it's because they were just given a prescription and not told to do anything. The importance of exercise needs to be even more so emphasized. I mean, I've always been a proponent, but I think it really is key. We don't have good data yet in terms of whether we should be doing more resistance training. Are people really losing more muscle mass on these drugs than they should be because of the weight loss? I think it's unclear still.

**Jim Hill:** I agree. We need lots more data, but Holly, let's dive in a little bit and tell Marc some of the things that we're doing. What we're particularly interested in, Marc, is Holly and I have been very interested in lifestyle and lifestyle management. We actually embrace these medications because our challenge, what we've really been interested in is weight loss maintenance, but the problem is nobody ever wanted to be in maintenance because they didn't lose enough weight. So we're looking at now people that lose weight on the medications. A, is this going to change their goals? So now they're at a lower weight, but they may not be more fit. They may not be working on some of the mental health stuff.

There's an opportunity. And then the other thing we're working on is exactly what you said. For the people who can't or don't want to stay on the medications, can we help them transition to lifestyle to keep the weight off, keeping in mind that the medications can be a rescue strategy if things get tough? So I think it's a whole new world in how the behavioral strategies might interplay with the effectiveness of the medications.

**Marc Cornier:** Yeah, I agree. I mean, in a way, you know, when we used to use, and people still do use meal replacements and aggressive caloric restriction and people lost a good bit of weight, right? In our program in Colorado, the average weight loss was what, 17% similar to what you see with some of these medical therapies. But there wasn't that excitement to do weight maintenance afterwards.

And so I think we still need to convince patients, even on medical therapy, that weight maintenance is an exciting thing, and then find the right tools. Do you alter the medicines? Do you use lordosis? Do you do intermittent therapy? I think, you know, there's that one study that was, I think it was with liraglutide and exercise or exercise alone or what have you, and the liraglutide exercise group did better.

**Jim Hill:** Had a little bit of an effect, positive effect.

**Marc Cornier:** I mean, but it was positive. And obviously, it wasn't the same amount of weight loss that we see with semaglutide or tirzepatide. But I think the premise is there. I think that's important. I think it's great that you're doing work in that area still because that's critical, right? Because we always say it's easy to help people lose weight. It's that long-term maintenance that's the hard part.

**Holly Wyatt:** So I'm going to switch just a little bit. I'm going to have you put your future obesity society president hat on, right? How long till you become president?

**Marc Cornier:** January 1.

**Holly Wyatt:** Oh, January 1. Okay. So it's coming. I'm going to ask a question about stigma because I think that's important. Do you think that the stigma around obesity is going to change or is changing with this obesity first? I mean, how are these drugs impacting that kind of bias and stigma we see in the population?

**Marc Cornier: I** think a lot of the issues we see that are surrounding this area of stigma and bias, to me, still focuses back on people not believing in obesity as a disease. And so if we can convince people that this is a true disease, then there'll be less stigma.

**Marc Cornier:** What's the first thing that patient gets done when they walk in the office? To get weighed. Almost always, right?

**Jim Hill:** Yep.

**Marc Cornier:** So there you have the opportunity.

**Jim Hill:** So, Marc, I have a question for you. These drugs are amazing for weight loss. I mean, people are really reaching their weight loss goal. How are they going to relate to primary prevention? I mean, it's one thing to treat obesity, but in the long term, we would like to keep it from developing in the first place. Thoughts on that?

**Marc Cornier:** Yeah, that's a great question. You know, obviously, prevention is always better than treatment. And would we consider using these types of treatments?

**Holly Wyatt:** Maybe have a strong family history.

**Jim Hill:** It's like treating prediabetes. You're treating people that are at risk. So it's something to think about.

**Marc Cornier:** It is. Obviously, these drugs are not approved for that and are not only approved if you are overweight and have complications associated with that weight. But certainly, it needs to be studied. What are the implications from a cost and public health perspective? You know, I think those are important. But it's true. If someone's starting to gain weight, let's intervene now.

**Holly Wyatt:** So you're preventing them from gaining weight, but you can also think that you're preventing them from type 2 diabetes. You're preventing them from heart disease. You're all the list of things you're preventing. So it's even a bigger prevention than just preventing a single disease.

**Marc Cornier:** Absolutely. Now, the question is, can you predict if someone's actually going to develop obesity? And are there good ways to predict it so that you could then prevent it? I think that would be important because you don't want to treat a bunch of people who wouldn't have developed obesity, although the majority will, as we know. I think first we need to get people with obesity treated and those with overweight and complications. And then, you know, you're going to take this stepwise, but you guys are always thinking way ahead of me.

**Jim Hill:** Well, but it's really nice to have these conversations. You know, Holly and I chat that I think it's been decades since not much has happened in the obesity field. And suddenly, it's like, I think it's been a huge disruption. And I use that term in a positive way. So at least we're having these conversations.

Would we, for example, want to use it to prevent obesity and pregnancy, which could stop the epigenetic treatment? There are so many possibilities. And right now, these are conversations, but I hope these conversations lead to the kind of research that would help us understand how to use these tools.

**Marc Cornier:** Absolutely. I'll give you a little quick example. We got a grant for a women's health initiative our goal was to find young women pre-pre-diabetes at risk for diabetes before they ever conceive, right, so that we could intervene early. It was very difficult to convince these young women to come in and be treated. And the sponsor kept saying, why don't you just treat the diabetes patients? You know, I'm like, that wasn't the point. We want to intervene early so that you stop that cycle of fetal programming.

And so what you're saying makes a lot of sense. You know, on the other hand, you know, these drugs, it's unclear if they're safe during pregnancy. We don't recommend weight loss during pregnancy, so intervene before. Yes. You know, before and you're absolutely right.

**Jim Hill:** So Holly, we have a ton more questions from Marc, but we're sort of running out of time. Do you have any big burning last questions that you want to ask him?

**Holly Wyatt:** Well, I think we should go to one from our listeners.

**Jim Hill:** Okay, let's do that. So Betty asks, I've tried every diet out there and nothing seems to work long term. What makes these new weight loss medications different? Are they really going to work for someone like me who has struggled for years?

**Marc Cornier:** Absolutely. These drugs are going to alter neurocircuits in your brain that are going to allow you to caloric restrict. In a way, it'll potentially force you to caloric restrict. Part of the problem is you went on these diets that were hard to adhere to because your biology was trying to get you to regain that weight. Once, when you reduce your calories, you get hungrier. The hormones that control all this change.

The activity in your brain changes. And so it's very, very difficult to adhere to that long term. And so you aren't able to, and then you regain the weight.

These medicines will alter that biology so that you will be able to contain long-term caloric restriction and then keep that weight off long-term. So I think it works especially well for people like you.

**Holly Wyatt:** Yeah. I think the ones that have really struggled sometimes, this is really where they notice a big difference. So I think getting the message out that even if you've struggled for years, be open to the possibility that this would be a different outcome for you.

**Marc Cornier:** Absolutely.

**Holly Wyatt:** All right. Let me see. We have a couple more. Let's hear from Sarah. Sarah says, I've never had a doctor really take my weight seriously before, but I want to make a change. How do I bring up this obesity first approach with my doctor? What should I ask to ensure my weight is treated as a priority?

**Marc Cornier:** That's a great question, Sarah. I think be proactive. You’re a person who wants help. You bring that up to your provider. I mean, often our providers don't want to bring it up because they know it's going to be a long conversation and they don't have 20 minutes and they're not trained in it. And so we've been trying to tell, educate our primary care providers especially, ask, is it okay to talk about your weight if you feel like their weight is a problem? And so as a patient, I think, yeah, be proactive in bringing it up. And if your provider doesn't feel comfortable with it, this is not their priority. I mean, I think you need to find another healthcare professional who will help you.

And there are centers all over the country, you know, whether they're centers of excellence, you know, affiliated with universities or there are good programs out there. You need to find somebody who will listen to you and approach you obesity first. But my guess is if you bring it up, your primary care provider will listen to you.

**Jim Hill:** Marc, in years past when we looked at barriers to why primary care physicians didn't really address obesity, one of the big ones was they didn't feel like they had any tools to succeed. And that has changed big time. And I think that in itself might change the behavior of a lot of primary care physicians.

**Holly Wyatt:** Especially if the primary care physicians start having patients coming in and saying, I want to talk about my weight, I want to talk about my weight first. The more they see the patients coming in saying that, that's going to be, okay, I need to learn about this. This is something, you know, becomes a higher priority for the clinician.

**Marc Cornier:** Right. And it's also the data, you know, are pretty strongly convincing too, right? The people do really well and now we're seeing clinical benefits. You know, that was part of the problem too, is, you know, the medicines we had before, you know, they gave you five, maybe 10% weight loss. We didn't really see big benefits in clinical outcomes. But now we're seeing, you know, effects on mortality and cardiovascular disease, sleep apnea, heart failure, kidney disease, you name it. So I think that that all changes.

Right now, today, it's as a provider, you're frustrated though, because the majority of these patients aren't going to have these benefits covered. You know, it's, I don't know if you watched the South Park episode, the end of obesity. If you haven't watched it, you should watch it. Cartwright, I think, is the character who's told, you know, we have a treatment for you, you know, to help you lose weight. And he had so much hope and excitement, but then they couldn't get the medicines up. And he was so sad, you know, and it was so real. And so that's been frustrating. But there are changes happening.

**Holly Wyatt:** I think that's going to change. That's going to change supply and demand. Things are going to change. There are just too many new medications coming. This is just a matter of time, I think.

**Marc Cornier:** It is. It is. And we're seeing it happening already. And so I think there's a lot of optimism about this. And, you know, this happens every time there's a new treatment. You know, it takes a little while for things to get covered. And a few years later, you're like, you don't even remember that time.

**Jim Hill:** You want to do one more question, Holly?

**Holly Wyatt:** I want to, let's go to the vulnerability question. I want to get Marc’s. He's been pretty vulnerable, but let's do some more.

**Jim Hill:** All right. Go for it.

**Holly Wyatt:** All right. Vulnerability question number one. You've been a leader in the field for many years, but I imagine it hasn't always been easy. Have there been moments when you've doubted whether real change and obesity treatment was possible? And how did you overcome that doubt?

**Marc Cornier:** Yeah. I mean, I think clearly there were many times where, you know, you had a new treatment, ah, boom, it gets taken away. Or it's that frustration that you just can't convince people. And I think that has been very frustrating. At the same time, it's that we need to do a better job of convincing people that this is the disease, of convincing the payers that they need to pay for that. You know, and I think in some respects, that difficulties or some of those past failures have pushed us all to then because we are convinced that this is the right thing to do, that we're going to push on and we're going to maybe attack this in a different way. And so I think that hopefully has made us stronger. You know, and I think we all, you know, we have a core group of people who have supported each other to do this.

Organizations like obesity society and others have really allowed us to continue these conversations. So yeah, I think there were definitely times where I thought, yeah, I don't know. Is this really going anywhere? Should I be really focusing on other things?

**Holly Wyatt:** Yeah. Well, remember we had medications come out and then they had bad side effects. I can remember being, that was very, you know, discouraging time when we had fen-phen, you know, that came out as a medication combination.

We thought, oh, combinations the way to go. Then side effects that were, you know, not good related to that medicine. I know that was a time and then we didn't have medications for a while after that. And so I don't know, I was very frustrated for a period of time. Never gave up hope, but definitely frustrated that we couldn't do better.

**Marc Cornier:** Right. And I think the, obviously, there's so much of the pipeline right now too, that's exciting. And we all have our personal stories that motivate us to really push forward. And I think that makes us all stronger. And I think now there's a lot of optimism.

**Jim Hill:** Marc, let's do one more quick question and answer on this area. In an area where so many people feel judged or stigmatized, how do you personally, as a healthcare provider, ensure that your patients feel seen, heard, and supported?

**Marc Cornier:** Yeah, that's so important. Again, I think having open discussions, not blaming patients, right? Talking about a comeback to the same thing, that they have a disease, it's not their fault and that we're here to help them and to work with them as a team. I think little things, as we talked about earlier, of making sure that the office setting is conducive, that the chairs are the right size, that the scale is not out in the open and people are yelling out, oh, your weight is 350. Things like that. I think those are all important things as well. But I think the most important is what happens in that room, one-on-one, is really putting the person in front of you first. They're not an obese patient. They're a patient who has obesity. And I think that's incredibly important.

**Jim Hill:** Cool. All right, Holly, do you want to do the wrap-up from the sessions?

**Holly Wyatt:** Oh, no, Jim, that's your job. I let you do that every time.

**Jim Hill:** All right. So what we've heard today is there's been a sea change in how we're seeing weight management. And this idea of obesity first, and Mark, I really like the term too, is really changing things. So we're getting to the point where when you walk into your physician's office, they don't immediately start managing your blood pressure or your diabetes, etc. They have a conversation about how managing your obesity could in turn improve all those things. And what makes this so powerful is now we have tools to produce in most people an amount of weight loss that can greatly improve their health. And these tools show that the problem is not your lack of willpower. And these people who have struggled for years aren't weak people.

They aren't lacking in anything. They are fighting their biology. And finally, we have medications that Holly and I talk about that can level the playing field in terms of pushing it back against your biology.

So we see this obesity first thing as something that should be supported and encouraged and hopefully primary care physicians and even specialists are going to get on board in understanding that we can greatly improve health of our population by treating obesity first. How's that, Holly? You did a good job, Marc. It's been great seeing you. It's been great having this conversation. You are really emerging as such a great leader in this field. You're going to have a wonderful year as TOS President. And we can always say we knew you when. So thank you.

**Marc Cornier:** Well, thanks for having me. It was a lot of fun. And it's always great to see you and hopefully, we'll see you soon.

**Holly Wyatt:** Yes.

**Jim Hill:** Well, stay tuned for more episodes as we continue to explore the factors influencing our weight and our health. See you later.

**Holly Wyatt:** Bye, everybody.

**Jim Hill:** And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

**Holly Wyatt:** If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

**Jim Hill:** We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

**Holly Wyatt:** And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.