The epidemiology of nonalcoholic fatty liver disease: a global perspective
Fasting insulin levels fell by 35.1% versus 5.0% in placebo, a gap that reflects reduced insulin resistance at the tissue level [4]
The Takeaway Managing weight after stopping a GLP-1 doesnt need to be an uphill battle
If scope of practice is about competency rather than tradition, and if we obtain appropriate training, then prescribing medications that affect both metabolic and mental health falls within an expanded but reasonable scope for psychiatrists specializing in metabolic-psychiatric care
Recommendations include: 150-300 minutes weekly moderate-intensity aerobic activity Resistance training 2-3 times weekly to maintain muscle mass Non-exercise activity thermogenesis (NEAT) optimization through increased daily movement Pharmacological Alternatives: Beyond GLP-1 receptor agonists, FDA-approved weight loss medications include: Phentermine-topiramate (Qsymia): Appetite suppressant combination Naltrexone-bupropion (Contrave): Affects reward pathways and appetite Orlistat (Xenical, Alli): Lipase inhibitor reducing fat absorption These alternatives have different mechanisms, adverse effect profiles, and efficacy (typically 5-10% weight loss), allowing individualized selection