Dr. Osman Ali, Gastroenterologist

oaklongevity-obesitycertifieddoctordietician
Can you tell us about your role as a gastroenterologist at Oak?
My experience and training in gastroenterology, hepatology and minimally invasive bariatric endoscopy, allows me to design and implement effective and comprehensive strategies to help our members achieve long-term weight loss results, and improvement in obesity related comorbidities. The Oak Longevity program provides innovative and patient centric strategies in helping address weight loss, longevity and aligning the gut brain axis with patient safety at the forefront. Our team at Oak is in the process of developing a comprehensive evidence-based lifestyle guide to help augment a more tailored and personalized treatment plan to help achieve enhanced member outcom  

Metabolic Syndrome and Weight Loss:

Can you explain how weight loss and metabolic syndrome works from a medical perspective and some of the most common misconceptions?
Metabolic syndrome is a cluster of risk factors that, when they appear together, dramatically raise your risk of heart disease, heart failure, stroke and diabetes, as well as other non-cardiovascular conditions. Nearly one in three Americans have metabolic syndrome. If you have obesity and complications from metabolic syndrome, you may need weight-loss to help you lose weight. Weight-loss medicines can help you lose weight by making you feel less hungry. They can also reduce how much fat your body absorbs from your food. We’re so inundated by advertisements for weight loss programs, tips and products that it’s easy to lose track of what’s real and what’s fake on the quest to lose weight Common Misconception : Once you start, you’ll keep losing weight Weight loss takes time, You can expect more substantial loss at the beginning of your lifestyle change and then increasing difficulty with weight loss as you get closer to your goal weight. Having the right guidance and plan towards healthy weight loss is ideal.  

Genetics and Weight Loss:

How do genetics influence an individual’s ability to lose weight?
Some people do have genetic syndromes that lead to obesity, and have genes that can be turned on or off depending on their environment, which can lead to obesity. While obesity does have a strong correlation with genetics, genetics are not absolute determinants. You have the ability to positively influence your health in many ways, and a healthy diet, lifestyle along with the compliment of the right medication can help to prevent chronic diseases and improve overall quality of life.    

Behavioral and Lifestyle Changes:

What lifestyle modifications can support long-term weight management?
You can’t outrun (pun intended) an unhealthy diet. Avoiding unhealthy calorie dense, nutrition poor foods should always be avoided. Of note, limiting alcohol to near zero, is a newly supported measure by the American Heart Association. Additionally, you might not burn as many calories during exercise as you think. Your device or fitness tracker may tell you that you burned 800 calories with a 45-minute workout, but the reality is that you have most likely burned less than that. So, use those numbers as a comparative tool rather than as an exact measurement. As always, a healthy diet, an active lifestyle with 30 minutes of heart raising exercise and resistance training up to 3-5 days a week can help in long-term weight management.  

Overview of GLP-1s:

What types of weight loss medications are currently available and shown to be effective and safe for weight loss? How do they work?
The FDA has approved six of these drugs—orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound)—for long-term use. Four of these drugs are approved for adults and children ages 12 and older. It is important to note that GLP-1 medications have been shown to have the most effective weight loss while minimizing side effects therefore are now preferred to other medications.
What are compounded medications vs. brand name medications?
Compounded drug products serve an important role for patients whose clinical needs cannot be met by an FDA-approved drug product (Brand Name).  
Why is it important to get your medications from FDA overseen 503b pharmacies?
Drug products for identified individual patients can be compounded by licensed pharmacists in State-licensed pharmacies and Federal facilities and by licensed physicians operating under section 503 of the FD&C Act Therefore, FDA overseen pharmacies will comply with the highest of standards.  
What are some other benefits of GLP-1s on conditions outside of obesity such as PCOS, liver disease, etc?
Treatment with GLP-1 receptor agonists may reduce the risk of developing cirrhosis, liver cancer, and other adverse liver outcomes in adults with type 2 diabetes and chronic liver disease Recently, GLP-1 receptor agonists have demonstrated weight reduction efficacy with remarkable metabolic and reproductive benefits among individuals with polycystic ovary syndrome (PCOS), according to published study finding published. GLP-1s have also shown promising results in decreasing the risk of cardiac, liver, neurocognitive and pulmonary diseases.  
How effective are weight loss medications compared to lifestyle changes alone?
Lifestyle changes serve as the foundation of weight loss. However, research has shown that patients who suffer from obesity lose less than 3-5% percent of their excess body weight from lifestyle modifications alone. Many patients require escalation of weight loss measures to include medication, which, on average, can result in up to 15% of excess weight loss.  
What are the common side effects associated with weight loss medications and are there any long-term risks or concerns with using these medications??
Most common weight loss medications may cause side effects including diarrhea, nausea, or vomiting. Other more serious side effects include Increased blood pressure and heart rate, insomnia, nervousness, restlessness, dependence, abuse or withdrawal. Newer GLP-1 medications have the least risk serious side effects compared to older medications previously approved by the FDA.  
How do you determine the best weight loss medication for an individual patient…are there specific conditions or factors that might make one medication more suitable than another?
Weight management medications are meant to help people who have health problems related to overweight or obesity. Health care professionals use BMI to help decide whether you might benefit from weight management medications. Your health care professional may prescribe a medication to treat your overweight or obesity if you are an adult with:
  • a BMI of 30 or greater a BMI of 27 or greater, and you have weight-related health problems such as high blood pressure NIH external link or type 2 diabetes
  • Choosing a medication to treat overweight or obesity is a decision between you and your health care professional; important factors to consider include the likely benefits of weight loss
  • Co-morbid conditions (such as heart disease, fatty liver disease)
  • the medication’s possible side effects
  • your current health issues and other medications
  • your family’s medical history
  • cost
Certain GLP-1 agonists have been shown to have a better effect on, diabetes, cardiac and liver outcomes which may be considered when choosing the right medication for you.  

Gastroenterology:

How does gut health impact weight loss and overall metabolism? Are there specific gastrointestinal conditions that can affect weight management?
In the past decade, remarkable breakthroughs have allowed scientists to count and characterize the genes in our gut bacteria. Our gut bacteria have 250 to 800 times more genes than we have human genes. When we eat food, our gut breaks it down into small pieces. Only the smallest pieces get absorbed into our blood. The rest is eliminated as waste material. In other words, not all of the calories in the food we eat get into our body and increase our weight. The gut bacteria help break down food. Some bacteria are better able to chop food into those smallest pieces that get digested, add calories to our body and thereby tend to increase our weight. Theoretically, if our guts have more of those kinds of bacteria, it should be harder to lose weight.

What are the potential impacts of significant weight loss on digestive health and how can patients maintain a healthy gut while pursuing weight loss?
Certain foods are rich in a number of different foods are good for gut bacteria, including:
  • Whole grains: They’re high in fiber, which is digested by healthy gut bacteria like Bifidobacteria and may aid weight loss
  • Fruits and vegetables: contain many different fibers that are good for gut bacteria. Eating an assortment of plant-based foods can improve gut bacteria diversity, which is linked to a healthy weight
  • Nuts and seeds: Nuts and seeds also contain lots of fiber and healthy fats, which help support the growth of healthy bacteria in the gut
  • Polyphenol-rich foods: These include dark chocolate, green tea. In these foods can’t be digested alone but are broken down by beneficial gut bacteria, promoting the growth of good bacteria
  • Fermented foods: yogurt, kombucha, kefir and sauerkraut. They contain beneficial bacteria like lactobacilli and can minimize other disease-causing bacteria in the intestines
  • Probiotics: Probiotics are not necessary all of the time, but they can help restore healthy gut bacteria after an illness or course of antibiotics and may even aid weight loss
On the other hand, eating some foods in excess may harm gut your bacteria, including:
  • Sugary foods: A diet high in sugar can stimulate the growth of certain unhealthy bacteria in the gut, which may contribute to weight gain and other chronic health disorders
  • Artificial sweeteners: Artificial sweeteners such as aspartame and saccharin reduce beneficial bacteria in the intestines, which may contribute to high blood sugar
  • Foods containing unhealthy fats: Healthy fats such as omega-3s support beneficial bacteria in the intestines, whereas too many saturated fats may contribute to the growth of disease-causing bacteria
  Complete a quick form for a free physician consult to learn how an Oak Longevity GLP-1 prescription (Ozempic®, Zepbound®, Wegovy®, Ozempic®, compounded semaglutide, compounded semaglutide + more) can help you lose up to 23% of your weight (clinically-proven*) on the Oak Longevity Program™. Oak’s Care Team is available to you during your journey for free support and guidance.