{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Mikkipedia","title":"GLP-1 Medications in Practice: A New Zealand View with Dr Lara Courtenay","html":"","width":"100%","height":180,"duration":2993,"description":"Episode Summary\nDr Lara Courtenay is a New Zealand-trained GP and bariatric physician with the Weightless Specialist Team at the MacMurray Centre in Auckland, and she has worked in obesity medicine since 2020. Mikki has talked about GLP-1 medications with plenty of international researchers and doctors, so after hearing Lara speak for the Goodfellow Unit she wanted a New Zealand view from someone working with patients every day. Lara explains why GP knowledge of these medications here is variable, and why, in her clinic, the dietitians and psychologists around the medication matter as much as the prescription itself.\nThey talk about perimenopausal women who are doing everything right and still cannot shift fat, and Lara's analogy of the medication letting go of the handbrake. They also cover prescribing criteria and the limits of BMI, dose escalation and cost, appetite and food noise, and why some plateaus come from eating too little, where Lara's clinic often lowers the dose and has people eat more. Lara is candid about what she does not know. She says the evidence suggests most people need to stay on something long term, that she cannot predict who will manage without it, and that her view on high-intensity exercise is clinic advice she \"could be wrong\" about. The conversation finishes with regular eating and breakfast, exercise intensity and HRT.\nKey Topics\nWhy knowledge of GLP-1 medications among New Zealand GPs is \"variable\": some GPs will not discuss them and refer on, while others are highly skilled prescribers\nHow Lara came into obesity medicine through gastric balloons in 2020, and a clinic model where patients could not get the medication without seeing a dietitian\nOlder options such as Saxenda and Contrave, which could work well, and how much of the shift to the weekly drugs is effectiveness versus marketing and online hype\nPerimenopausal women who exercise, eat well and still cannot lose fat, and Lara's explanation that the medication lets go of the...","thumbnail_url":"https://img.transistorcdn.com/5uUjJw6NUZC5FWMQgLCI47ibFa6tBB2C0z8A_feCZiY/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS8wNjI2/NTEwMjAyMWQ2M2Iy/ZjliYjA4ZGFhMTBh/N2E2Ni5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}