Journeys Metabolic

NAFLD (non-alcoholic fatty liver disease) has been rebranded MASLD (metabolic dysfunction-associated steatotic liver disease). Good for paying attention to it, bad for not mentioning this this is a purely dietary disease. It should have been rebranded DAFLD (diet-associated fatty liver disease). Get rid of sugar and alcohol, and your liver returns to normal. Somehow they missed that...

The demand side for tools to address excess weight is astronomical, but the supply side isn't filling the gap. Asking already overburdened clinicians to deploy a comprehensive lifestyle intervention alongside medications is asking too much. Most have no training in the intervention - and no time to dedicate to it. It's no wonder the intervention fizzles out. The durability and effectiveness are better when deployed by an endocrinology or obesity medicine clinic, but hoping to extend that to all people is unrealistic. Most endocrinologists are working at capacity with long waiting lists. The sheer number of people developing diabetes is outpacing the specialists' capacity to care for them. We are getting more & more physicians boarded in Obesity Medicine but it's unlikely to result in a bunch of new Obesity Medicine clinics with robust comprehensive programs. Large health systems (that employ most doctors) may allow these specialists to specialize, assuming they continue to funnel the health system labs, radiology, and referrals - where the money lies Clinics that aren't tied to expensive procedures are becoming extinct. Most patients who want these medications are already getting them from their local med spa or an online telehealth platform (none of which are likely to offer the comprehensive care needed to replicate the results seen in studies). How do we bridge this gap? #digitalhealth, Journeys Metabolic, Jim Howard https://lnkd.in/gBKfhwcp

At Journeys Metabolic, we look for passionate leaders that are fueled by first-mover impact in #metabolic disease reversal through #AI powered precision interventions. Are you up to the challenge to scale change throughout our #healthcare ecosystem?

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.  Sepsis is difficult to treat and carries a high risk of death - both during the acute phase as well as in the months after the incident.  Most patients who develop sepsis have underlying metabolic disease - their bodies are already struggling. Adding an infectious process sends them over the edge.  Multiple studies have shown the long-term metabolic benefits of following a ketogenic diet.  When followed correctly (focusing on whole foods rather than ultra-processed keto’ish products), a ketogenic diet typically leads to significant improvements in overall metabolic health. This recently published study shows the potential of the ketogenic diet to help heal patients in the acute phase of their illness. Although the overall mortality rate was unchanged, those who were placed on a ketogenic diet during the acute phase of their illness did better and required fewer interventions, such as: Improved Recovery: Patients on the ketogenic diet needed less mechanical ventilation, vasopressors, or dialysis Less Acute Care: Patients on the ketogenic diet spent fewer days in the ICU Reduced Insulin Dependency: By day 4, none of the patients on a ketogenic diet required insulin, unlike up to 60% on a standard diet, showing better blood sugar management Enhanced Immune Function: Patients on the ketogenic diet had lower levels of pro-inflammatory markers, indicating a more balanced immune response. While more research is necessary, imagine what we could achieve by continuing the intervention beyond the acute phase of the illness! Journeys Metabolic, Jim Howard https://lnkd.in/g4bQBPQF

The narrative that GLP-1 agonists (& all the variations that are making their way to market) are magic solutions is dangerously misleading. While they can be helpful tools, sustainable weight management requires a multifaceted approach. Suppressing hunger hormones is only a small part of the solution and, by itself, isn't very durable. https://lnkd.in/g9wH8gAr

Key takeaway from this article: "Health plans, clinical teams, patients, and – more broadly – society must deploy a full range of comprehensive population health tools to get the nation back to a healthy weight." "Clinicians and policymakers must resist the seeming quick fix of GLP-1s. Greater attention and resources must be devoted to treating the whole person." "Ultimately, the price paid to people’s long-term health may be more concerning than the price paid out-of-pocket." Yes! There is a huge difference between treating cardiometabolic diseases, (including obesity) and managing and medicating the symptoms. Comprehensive care is necessary. But how do we provide this? Healthcare is fragmented. Even if health plans cover all of the pieces necessary for comprehensive care (which they rarely do), coordinating them into something truly comprehensive is a monumental task. Who is expected to coordinate and oversee this for patients? Clinicians are already collapsing under the burden of treating chronic disease. Asking them to steer this is unrealistic. Furthermore, we don't have the resources or the funds to deploy this type of program at scale. Yet, patients want (and need) it. They are searching for help. Journeys Metabolic is a physician-developed, prescriptive digital therapeutic that delivers an intensive lifestyle intervention targeting the root cause of cardiometabolic diseases. If you are a health plan or a hospital system looking for a way to help patients with their cardiometabolic health, why not provide them with something robust, based on science? Something that extends healthcare into the home, helping the patients and easing the burden on your primary care clinicians? Without direction, people will find solutions on their own. And relying on TikTok influencers' advice is unlikely to create lasting improvements in health. https://lnkd.in/gijeiw3u

The field of metabolic psychiatry is absolutely fascinating. In the past few years, we've done a fairly good job of helping people connect the dots between metabolic/mitochondrial dysfunction and end-organ disease. Metabolic disease in the pancreas manifests as prediabetes/diabetes. Metabolic disease in the liver manifests as MASLD/MASH. Metabolic disease in the vascular system manifests as ASCVD. But as a whole, most of us have largely ignored the brain. It makes sense that metabolic dysfunction in the brain leads to diseases of the brain - not only Alzheimer's disease (which is now getting dubbed type I diabetes) but bipolar mood disorder, depression, anxiety, ADHD - and so many more. When you dive deep into biochemistry, it makes complete sense. Props to all the visionary leaders in the field of #metabolicpsychiatry: Christopher Palmer, Georgia Ede MD, Shebani Sethi MD, ABOM, Matthew Bernstein and so many more!

May is #MentalHealth Awareness Month, and this Psychology Today article from Kirk Nylen, PhD outlines progress in this space. Among the many therapeutic areas #JourneysMetabolic supports with our EHR-interoperable digital therapeutic, patients with mental health disorders have incredibly profound clinical impact that truly give their lives back. 50-60% of #bipolar patients, for example are non-responsive to medications, a staggering number. There is hope in what many traditionally suggest is hopeless. Not any more. #ketogenic #digitaltherapeutics #insulinresistance #valuebasedcare #baszuckigroup #metabolicpsychiatry

This!

The US healthcare system is beautifully designed to manage diseases - i.e., utilize pharmacotherapy and procedures to address the symptoms of chronic disease. This shouldn't come as a great surprise to anyone - managing disease (without curing it) is a very profitable industry. Treating disease - addressing the drivers of chronic disease - is a different story. Working upstream on root causes is typically placed in the realm of "wellness" - a realm adjacent to, but not intimately connected to, the field of medicine. We have collectively accepted this system of disease management for many years. After all, managing disease (taking a pill) is typically much easier for both patients and clinicians than identifying and addressing the underlying drivers of disease. Although most of us want to apply this same philosophy to the disease of obesity, it's not going to work. The sheer prevalence of the disease combined with the prohibitively high cost of the (lifelong) intervention is too much for us to bear. Rather than seeing this as a sign that it's time to change our approach (from disease management to disease treatment), we are collectively ignoring it - looking toward the horizon for the next medical breakthrough. There is certainly a place for these new anti-obesity medications, but they need to be deployed as part of a strategy that addresses the drivers of obesity. Along with other manifestations of cardiometabolic dysfunction, obesity is primarily driven by insulin resistance. Treating insulin resistance isn't something that can be done by simply taking a medication. Medications don't make their way into the mitochondria! Treating insulin resistance involves changing the day-to-day input the body receives. It's a process that takes time and energy. It requires sustained changes in the way we live our day-to-day lives. Helping people see what that process looks like, providing them with tools that make it easier, and supporting them as they do the hard work of implementing lifestyle change is what we do at Journeys Metabolic. We are doing our part to shift the focus from disease management to disease treatment! #insulinresistance, #healthcare, #sickcare, #cardiometabolichealth https://lnkd.in/gTV_e9EX