Neşe Targen RD

🔸Specialist Bariatric Dietitian at HealthMatters Group, London, UK | Cyprus 🔸Advocate for people living with #obesity

[Michael Weintraub, MD @MWeintraubMD]

🚨 Retatrutide TRIUMPH-1 Phase 3 top-line results, much awaited and just announced

⬇️ 28.3% Weight loss at 80 weeks
⬇️ 30.3% weight loss at 104 weeks among adults with baseline BMI >35

🏥 These are levels of weight loss only seen previously with bariatric surgery

💉 Low dose retatrutide 4mg achieved 19% weight loss at 80 weeks. Discontinuation rate due to adverse events lower than placebo

🔬 Retatrutide is a triple agonist of GLP-1, GIP, and glucagon.

🔥 I have never been more excited to go to the upcoming American Diabetes Association conference where more detailed data will be presented

[ThePeptideList @PeptideList]

Everyone's talking about retatrutide for weight loss (28.7%). Almost nobody's talking about what it does to your liver.

More than 80% reduction in liver fat. Over 90% normalization rates. In a body composition substudy from the Phase 3 program.

100 million Americans have fatty liver disease. Most don't know it. There's no FDA-approved treatment for it besides "lose weight and hope."

Retatrutide's glucagon receptor activation appears to directly target hepatic fat metabolism not just as a side effect of weight loss, but as a primary mechanism.

This isn't a weight loss drug that happens to help your liver. It might be a liver drug that happens to cause weight loss.

Phase 3 weight loss data drops first half of 2026.
Watch this space.

[Prof Kamlesh Khunti @kamleshkhunti]

Important review on weight Weight Regain and Cardiometabolic Consequences After Discontinuation of GLP-1 Receptor Agonists

GLP-1RA discontinuation should be considered a high-risk clinical transition rather than a treatment endpoint.

Structured follow-up and multidisciplinary management are essential to preserve long-term cardiometabolic benefits.

https://t.co/zw9fjyntap

[Michael Mindrum, MD @MichaelMindrum]

What happens when a patient on semaglutide progresses to dialysis — do you stop it?

📢New pooled RCT analysis (SUSTAIN-6, SELECT, FLOW, SOUL; n=34,064) finally addresses this clinical gap.

📈307 patients initiated dialysis
🟢165 stayed on treatment
🔴SAEs: 45% (sema) vs 57% (placebo)
🫀MACE rate: 9.7 vs 16.1 per 100 PY
☠️All-cause mortality: 13.8 vs 18.1 per 100 PY
✅ Numerically favourable across the board.

Continuation appears safe — not powered for efficacy, but reassuring for a question we face regularly.

🏁A dedicated trial is still needed.

https://t.co/IYvbiuxXx9

[Okan Aytaş @OkanAytaas]

Filistin’i dünyadan silmek istediler, tüm dünya Filistin oldu.

🇵🇸

#FreePalestine

[Scott Isaacs @scottisaacsmd]

Phase 1 trial of #amycretin, an oral GLP-1 & amylin receptor agonist. Participants lost up to 24.3% of their body weight after 36 weeks. Most side effects were mild/moderate GI symptoms.
https://t.co/L1bZqfK0el

[Michael Albert, MD @MichaelAlbertMD]

🧠 Tirzepatide doesn’t just reduce appetite—it rewires the brain.
- - -
A new Nature Medicine Phase 1 RCT (n=114) explored how tirzepatide changes eating behavior—and the brain’s response to food—in people with overweight or obesity.

📉 Key Findings at 3–6 Weeks
🔹-524 kcal/day intake vs. placebo by week 3
🔹↓ Brain activation to high-fat, high-sugar foods in the orbitofrontal cortex, cingulate gyrus, hippocampus, and medial frontal gyrus
🔹Fewer cravings for sweets, fast food, carbs, and fats
🔹Reduced impulsivity and tendency to overeat
🔹–7.0 kg weight loss at 6 weeks with tirzepatide vs. –3.7 kg (liraglutide) and –0.6 kg (placebo)

🧪 Clinical translation:
Obesity is not a failure of willpower—it’s a neurobehavioral disease.

Tirzepatide didn’t increase “restraint” or “discipline”—it reduced the drive to eat by dampening brain responses to food cues.

This is mounting evidence that drug therapy doesn’t just affect appetite—it reshapes brain circuits tied to craving, reward, and satiety.

➡️ We need to stop treating obesity like a lifestyle “choice” and start treating it like the chronic, biologically mediated condition it is.

📎https://t.co/uGcOEAsToJ

[Dr Alo, DO, FACC @MohammedAlo]

Tirzepatide & Brain Activation

New 6-week phase 1 tirzepatide study showed that:

1️⃣ Tirzepatide reduced daily caloric intake by 525 calories compared to placebo after only 3 weeks.

2️⃣ It also lowered appetite, food cravings, urges to overeat, hunger, and sensitivity to food cues.

3️⃣ Brain activity in response to high-fat, high-sugar foods decreased in areas linked to reward and craving (medial frontal cortex, cingulate gyrus, orbitofrontal cortex, and hippocampus).

@NutritionMadeS3 @DrNadolsky @DrKarlNadolsky @drmatthewnagra @MichaelAlbertMd @MichaelMindrum

Study Link: https://t.co/jrJxXeEKE4

[Neşe Targen RD @NTargen]

@srkntnyldz Bunu yapan göçmenden ziyade Londra’da doğup büyüyen bir birey sanırım.. ne yazıkki bunlar çete halinde hareket ediyor.. Londra’nın belli başlı bölgelerinde yaşıyorlar.. dikkatli olmanızı öneririm

[Michael Albert, MD @MichaelAlbertMD]

🚨 GLP-1s vs Surgery: Who Wins Long Term?
- - -
A new 2-year comparative study from NYU Langone just dropped—and the results are clear:

📊 Bariatric Surgery vs GLP-1s (semaglutide/tirzepatide):
🔹 25.7% total body weight loss with surgery vs 5.3% with GLP-1s (intention-to-treat)
🔹 Even in per-protocol analysis (continuous GLP-1 use), surgery still outperformed: 24.6% vs 7.6%
🔹 Surgery had better HbA1c improvement, too

🔍 Translational Insight:
Yes, the relatively low weight loss in the medication group was partly due to therapy interruptions and discontinuation. But that’s exactly the point:
➡️ If a treatment is regularly interrupted by prior auths, high out-of-pocket costs, or drug shortages, that limits its real-world effectiveness.
➡️ Clinical effectiveness ≠ theoretical efficacy in a vacuum. Access matters.

📌 Bottom line:
For patients with severe obesity (BMI ≥35), bariatric surgery still provides superior long-term outcomes—and it does so reliably, without being derailed by market forces.
Abstract: https://t.co/NlOas6X8j6

[Mary O'Kane @Mpmok]

Exciting news! The Handbook of Bariatric Nutrition has been published. This is an essential resource for dietitians, nutritionists and other healthcare professionals working in metabolic and bariatric surgery https://t.co/MU0Pv5Plh6

[Michael Albert, MD @MichaelAlbertMD]

🏆 Tirzepatide vs. Semaglutide
The heavyweight bout we’ve all been waiting for—and it’s a TKO.
- - -
A new NEJM study just dropped the first head-to-head trial in people with obesity (no diabetes).
Here’s how it played out over 72 weeks:

🥇 Tirzepatide (Zepbound) vs 🥈 Semaglutide (Wegovy)
🔹 –20.2% vs –13.7% weight loss → 47% greater relative reduction
🔹 20% on tirzepatide lost ≥30% of their body weight (triple the semaglutide rate!)
🔹 Waistline: –18.4 cm vs –13.0 cm
🔹 Sex matters: women in both arms lost ~6% more than men

📉 Responder rates (tirzepatide vs semaglutide):
✅ ≥10% loss: 81.6% vs 60.5%
✅ ≥15% loss: 64.6% vs 40.1%
✅ ≥20% loss: 48.4% vs 27.3%
✅ ≥25% loss: 31.6% vs 16.1%

⚠️ Side effects?
Mostly GI. Mostly manageable. No new red flags.

Bottom line:
This isn’t incremental—it’s transformational.
GLP-1 was the revolution. Tirzepatide is the next frontier.

Let’s talk:
Access. Equity. Long-term outcomes.
Are formularies ready for this future?

🔗 Full NEJM study: https://t.co/463akhNp1K

#Zepbound #Wegovy #Tirzepatide #Semaglutide #ObesityMedicine #GLP1 #GIP #NEJM #WeightLoss #HealthTech #DigitalHealth #MedTwitter h/t @scottisaacsmd for images.

[Michael Albert, MD @MichaelAlbertMD]

Tirzepatide outperforms Semaglutide in head-to-head obesity trial (SURMOUNT-5):
- - -
🔸Tirzepatide: −20.2% weight loss
🔸Wegovy: −13.7% weight loss
(47% greater relative reduction)

Avg weight lost:
➔ Tirzepatide: −50.3 lbs
➔ Wegovy: −33.1 lbs

31.6% on tirzepatide hit ≥ 25% body weight loss (vs 16.1% on Semaglutide).

⚠️ Topline results — full publication still pending.

Announcement: https://t.co/HAptppy6gh #ObesityCare #GLP1 #Tirzepatide #Wegovy #SURMOUNT5 #ObesityMedicine

[Michael Albert, MD @MichaelAlbertMD]

What really happens when patients stop GLP-1s like semaglutide or tirzepatide?
A new systematic review & meta-analysis in Obesity Reviews has answers—and they’re critical for anyone treating obesity as a chronic disease.

TLDR: "Discontinuation of GLP-1RA treatment leads to weight regain, regardless of lifestyle interventions, and should therefore be considered a chronic therapy to prevent weight regain and associated undesirable outcomes related to obesity."

Key findings:
After stopping liraglutide, patients regained ~2.2 kg ⚖️

After stopping semaglutide/tirzepatide, patients regained ~9.7 kg ⚠️

Weight regain was proportional to initial weight loss

Lifestyle changes alone did not prevent regain

Implication:
GLP-1 receptor agonists are not a short-term solution.
If the goal is durable weight loss and risk reduction, stopping therapy may reverse progress.

We don’t stop:
Antihypertensives when blood pressure normalizes

Statins when LDL improves
Why treat obesity differently?

This study reinforces what many of us already know:
Obesity is chronic. GLP-1 therapy should be chronic too.
Let’s treat it that way.

Full article: https://t.co/sqKxsLe2lI

[Neşe Targen RD @NTargen]

@bernalacin35 “Sağlık Bakanlığı Açıklama

Bu gece aniden rahatsızlanması nedeniyle 00.17’de Mağusa Devlet Hastanesi’ne müracaat ettirilen sanatçı Volkan Konak, 00.42’de tüm müdahalelere rağmen maalesef hayatını kaybetmiştir.”

[Nacho Sánchez Amor @NachoSAmor]

Following with huge concern the news on Istanbul Mayor @ekrem_imamoglu's detention among 100 people along with a 4-day ban on demonstrations. Again, as in all moves of last months, the Istanbul Chief Public Prosecutor's Office. Full speed towards a complete authoritarian state.

[Nacho Sánchez Amor @NachoSAmor]

Turkish politics have an endless creativity. It seemed far fetched but now it's real. Istanbul University has revoked the diploma of @ekrem_imamoglu that it conceded 35 years ago in what can only be seen as a politically driven manoeuvre to impede his presidential candidacy. Sad.

[Scott Isaacs @scottisaacsmd]

There is a strong correlation between adiposity, vitamin D deficiency, and insulin resistance.
https://t.co/6Er9SiotfR

[Adrian Brown PhD RD @BrownAdey]

Happy #WorldObesityDay 2025.

#Obesity is not a choice, #obesity is a complex, relapsing, progressive condition & NOT personal responsibility!

Lets work together to change the food environment, health inequity & focus on the wider system & NOT the individual

#ChangingSystems

[Cem Say @say_cem]

Bugün evlilikte resmi nikâh zorunluluğunu ve tek eşle evlilik esasını getiren, kadınlara istedikleri mesleğe girebilme hakkını veren ve mahkemelerde tanıklık yapma, miras ve boşanma konularında kadınla erkeği eşitleyen Türk Medeni Kanunu'nun çıkarılmasının 99. yıldönümü. 🇹🇷