Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode we have a special guest, Dr. Spencer Nadolsky.

Dr. Nadolsky is a board-certified obesity and lipid specialist known for his straightforward approach to fitness and health, and for pioneering obesity management via telemedicine. In this episode, we'll dive into various topics, including the intricacies of Lipoprotein(a) and its impact on cardiovascular health, the balance between lifestyle changes and pharmaceutical interventions, and the challenges of research funding in lifestyle modifications.

We’ll also explore Spencer’s insights on effective weight loss strategies, sustainable diets, and his personal journey with health and fitness. So, whether you're here to glean some practical tips or to understand the latest in medical research, stay tuned—this is going to be an enlightening conversation.

04:44 Sustainable weight loss requires satiating, nutritious food.
08:55 Intermittent fasting, increased exercise caused weight loss.
10:57 Dietary composition impacts health beyond weight loss.
14:05 Appetite largely dictates body weight and thinness.
17:09 Medication and bariatric surgery enhance weight loss results.
20:55 Future obesity prevention: targeting genetic and socioeconomic risks.
22:47 Medications reduce hypertension but overlook underlying causes.
25:51 Drug trial: ~10% weight loss, possible cardiovascular benefits.
29:32 Higher LDL and APOB increase long-term plaque risk.
33:40 Advise family about LDL cholesterol management realistically.
38:48 High school glucose test fueled sports nutrition interest.
39:59 Anti-aging field's evolving, medication secondary uses explored.
45:28 Biopsychosocial model emphasizes controllable and uncontrollable factors.
47:31 Lifestyle changes are equally important as medications.
49:49 Exciting times ahead; feedback appreciated. Stay tuned.

Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we are back with our second part to the two-part series focused on the intricate world of addiction treatment.

Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, Dr. Mong and Dr. Lamba will shed light on the promise and perils of new treatment approaches, underscore the necessity of comprehensive support systems, and point to the pivotal role of social supports and stable housing in fostering sustainable recovery.

We also tackle the cultural and historical context of the opioid crisis, including the profound impact of Purdue Pharma and the Sackler family. Dispelling misconceptions about fentanyl, you'll learn about the real risks, the invaluable role of naloxone, and practical steps for overdose prevention.

This episode is not just about groundbreaking therapies; we will discuss the critical need for rigorous, high-quality data to back new treatments and reflect on the significant influence of private companies in the field. Our guests will emphasize the paramount importance of addressing the root causes of substance use, building life skills, and creating supportive networks to prevent relapses.

Lastly, this episode will feature discussions on opioid tolerance, withdrawal management, and the nuanced balance between the risks of prescribing medications versus the risks of untreated withdrawal. You’ll gain insights into how healthcare teams can shift their perceptions and practices to better support patients with substance use disorders

Stay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!

04:17 Challenges and future of addiction treatment discussed.
09:36 Understanding withdrawal challenges in hospitals with unknown dosages.
12:02 Provide proper care despite addiction-related complications.
16:20 Colleague's guarded due to personal trauma, concerns.
20:05 Conversations led hospital to adopt PICC lines.
21:54 New grads integrate social responsibility with medical care.
27:20 Risk from checking on overdose is minimal.
29:15 There can't be too much widely accessible Narcan.
34:00 Need rigorous study for psychedelics in treatment.
35:39 Concerned new treatments overshadow foundational patient support measures.
41:40 "Cured" involves functional life, stability, coping mechanisms.
42:52 Substance use disorder: Patients can achieve long-term remission.
46:01 Meet needs without substances to avoid relapse.

Welcome to "Ditch the Lab Coat," the podcast where we dive into pressing health issues with scientific skepticism and heartfelt curiosity. I'm your host, Dr. Mark Bonta, and in this episode, we're embarking on the first of a two-part series focused on the intricate world of addiction treatment.

Joining us today are two distinguished guests: Dr. Jon Mong, a general internal medicine and addictions physician, and Dr. Wiplove Lamba, an addiction psychiatrist. Together, we'll explore the complexities of managing and treating addiction within hospital settings, the profound challenges faced by patients and healthcare providers alike, and the life-saving implications of treatments like opioid agonist therapy.
In this episode, we tackle the high relapse rates among opiate users, the effectiveness of medications for alcohol use disorders, and the importance of patient readiness in overcoming substance use. We'll also delve into the value of motivational interviewing in fostering patient cooperation and the evolving role of addiction medicine in modern healthcare.

Dr. Bonta reflects on his experiences and frustrations with addiction treatment, emphasizing the need for evidence-based approaches and reducing harm. We'll discuss the broader implications of addiction treatments, including societal perceptions and the importance of treating addiction as a complex, multifaceted issue.

Stay tuned as we unravel these topics and much more. So, grab your headphones and get ready for an enlightening conversation on addiction treatment with Dr. Jon Mong and Dr. Wiplove Lamba. Let's dive in!

06:28 Biopsychosocial overview and social determinants of health.
08:33 Addiction perception varies; harm reduction prioritizes context.
12:42 Substance use disorder defined by the four C's.
15:24 Challenges of informing patients about health impacts succinctly.
20:11 Enjoyed working with you; motivational interviewing technique.
21:40 Promote cooperation and autonomy in medical interactions.
24:38 Brief interventions reveal deeper patient issues for treatment.
30:23 Support for treating illness without moral judgment.
31:43 Understanding treatments can improve patient prognosis discussions.
34:59 Medication modulates neurotransmitters for alcohol use disorder.
39:44 Four reasons to start opioid agonist therapy.
42:14 Discharged patients risk fatal overdose; opioid therapy saves.
46:42 Patients generally agree with treatment but resist lifestyle changes.
49:00 Importance of discussing addiction and enabling behaviors.