Stephanie Walsh

110 statements · 4 topics · summaries given as host listed separately

Featured statements

▶ Ep 15 · 2:15
once you've gained the weight, your body is going to fight you to keep it on. So it's not like you can just say, oh, I'm going to cut out, you know, that soda and it's all going to get better.
quote · Obesity
▶ Ep 24 · 16:05
if then they're on insulin, I mean, the longer they're on insulin, the less likely you are to help their diabetes.
quote · Obesity
▶ Ep 3 · 14:10
we offer medications at 3 months for less than 10% total body weight loss and at 6 months for less than 15%.
quote · Type 2 Diabetes
▶ Ep 3 · 13:00
You should use the lowest dose that your patient, you know, one, they can tolerate and that's effective
quote · Type 2 Diabetes
▶ Ep 9 · 14:23
New recommendations suggest performing endoscopy before patients transition to adult care after five years to check for Barrett's esophagus.
guideline · Pediatric Obesity
▶ Ep 9 · 14:05
Initial post-operative issues after sleeve gastrectomy include getting patients back to eating, ensuring adequate caloric intake, and some dehydration, though dehydration has improved.
clinical · Pediatric Obesity

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Stephanie's statements about Obesity 54 statements

Open the Obesity collection →

StayCurrent Forums - Obesity in Children

▶ Ep 15 · 1:47
epidemiological Pediatric obesity is a worldwide problem, particularly in countries that have become more developed. ↗
▶ Ep 15 · 2:15
quote once you've gained the weight, your body is going to fight you to keep it on. So it's not like you can just say, oh, I'm going to cut out, you know, that soda and it's all going to get better. ↗
▶ Ep 15 · 4:17
clinical Physical activity provides metabolic improvements in muscles, lungs, and other systems beyond just burning calories. ↗
▶ Ep 15 · 6:31
clinical Phentermine can cause jitteriness, increased heart rate, and usual stimulant side effects. ↗
▶ Ep 15 · 7:18
clinical Some patients stay on obesity medications forever, while others can stop and sustain weight loss, though it is difficult to predict which patients will need long-term medication. ↗
▶ Ep 15 · 7:18
clinical The combination of phentermine and Topamax is a medication that can be taken indefinitely. ↗
▶ Ep 15 · 8:52
clinical Pediatric bariatric surgery requires a multi-month preparation process including exercise logs, food logs, and lifestyle changes. ↗
▶ Ep 15 · 10:10
quote you're going to lose about 25%. What does that mean? And your body is your body. You're busty, you're busty, you're hippie, you're hippie, you are what you are. It's just going to be a smaller, healthier version of you. ↗
▶ Ep 15 · 10:10
clinical Patients are given clear numbers about expected weight loss (approximately 25%) and told their body type will remain the same, just becoming a smaller, healthier version. ↗
▶ Ep 15 · 12:24
clinical The sleeve gastrectomy is the first choice procedure for adolescents, with Roux-en-Y gastric bypass as the second choice. ↗
▶ Ep 15 · 14:05
clinical Initial post-operative issues after sleeve gastrectomy include getting patients back to eating, ensuring adequate caloric intake, and some dehydration, though dehydration has improved. ↗
▶ Ep 15 · 14:23
clinical Research shows that after sleeve gastrectomy, approximately one-third of patients develop reflux, one-third experience improvement in reflux, and one-third remain the same. ↗
▶ Ep 15 · 14:23
guideline New recommendations suggest performing endoscopy before patients transition to adult care after five years to check for Barrett's esophagus. ↗
▶ Ep 15 · 15:16
clinical Patients can be followed until age 21 at the speaker's institution. ↗

Stephanie Walsh, MD - 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 24 · 1:00
quote what is adequate weight loss? ↗
▶ Ep 24 · 1:40
quote the kids that can lose weight usually lose weight, and the kids who can't don't ↗
▶ Ep 24 · 3:20
quote I have a saying that I put in mind, like if some of these kids, you know, they get their license over the course of this. And they have what I call the Starbucks phenomenon. ↗
▶ Ep 24 · 4:20
quote I always am a huge proponent for physical activity ↗
▶ Ep 24 · 4:30
quote the benefits of physical activity. Long term are something that is not represented as well ↗
▶ Ep 24 · 4:40
epidemiological Physical activity for girls is always lower than boys, and physical activity for kids is predominantly influenced by their moms. ↗
▶ Ep 24 · 5:10
clinical Physical activity impacts mental health. ↗
▶ Ep 24 · 5:10
quote physical activity does impact mental health ↗
▶ Ep 24 · 5:50
quote I've actually really been using some of the bupropion post-op ↗
▶ Ep 24 · 5:50
clinical Bupropion post-op helps with mood and gives patients extra support toward weight loss, though patients are supposed to be 18. ↗
▶ Ep 24 · 6:20
quote I haven't used Contrave at all ↗
▶ Ep 24 · 7:20
quote It is a psychological benefit. It's the fact that even if they can stabilize their weight or even lose a little bit, it helps them stay super engaged in the program. ↗
▶ Ep 24 · 7:45
quote almost all my kids can only take phentermine and Topamax. I don't really have access to GLP ones for, for most of my bariatric patients at all. ↗
▶ Ep 24 · 10:00
clinical In Atlanta, phentermine is only available in 15 mg capsule form, which cannot be broken in half. ↗
▶ Ep 24 · 10:00
quote In Atlanta, I can only find 15 mg in capsule form. So it's not even like you can break it in half for phentermine. ↗
▶ Ep 24 · 10:25
quote Not everybody wants to lose as much weight, and it really just depends on what works for them. ↗
▶ Ep 24 · 10:40
opinion There is significant medication hesitancy among families in Atlanta. ↗
▶ Ep 24 · 10:45
quote we have a lot of medication hesitancy here in Atlanta ↗
▶ Ep 24 · 10:55
quote there's camps of people who very much like, I'll never do surgery. I want medications. And then there's another camp that's like, I want nothing with long-term medications. I want surgery. ↗
▶ Ep 24 · 11:20
quote they're sending out the 1.7 and 2.4, but there, there's very, very little of the, the lower doses. Um, they're just prioritizing the people who are trying to maintain. ↗
▶ Ep 24 · 11:20
clinical Novo Nordisk is sending out the 1.7 and 2.4 mg doses but very little of the lower doses, prioritizing people already on maintenance. ↗
▶ Ep 24 · 12:40
guideline As of last year, 1.7 mg is considered a maintenance dose, so there should be less issue with insurers covering it. ↗
▶ Ep 24 · 12:40
quote the 1.7 is considered now a maintenance dose, so there should be less issue about insurers paying for 1.7. ↗
▶ Ep 24 · 13:00
quote You should use the lowest dose that your patient, you know, one, they can tolerate and that's effective ↗
▶ Ep 24 · 13:00
opinion The lowest effective and tolerable dose should be used for each patient, and ramp-up should be individualized. ↗
▶ Ep 24 · 13:20
quote all of these very restrictive rules and regulations, um, from insurers and pharmacies about how you can and can't prescribe it are really, they're all just an impediment. ↗
▶ Ep 24 · 14:10
clinical Medications are offered at 3 months for less than 10% total body weight loss and at 6 months for less than 15%. ↗
▶ Ep 24 · 14:10
quote we offer medications at 3 months for less than 10% total body weight loss and at 6 months for less than 15%. ↗
▶ Ep 24 · 14:25
opinion These thresholds (10% at 3 months, 15% at 6 months) are very conservative given the Teen-LABS data. ↗
▶ Ep 24 · 14:25
quote those are very conservative given the teen labs data ↗
▶ Ep 24 · 14:40
clinical In a cohort of 750 patients, modeling shows that if a patient is off the weight loss curve at 3 months, they never get back on that curve. ↗
▶ Ep 24 · 14:45
quote if you don't have, uh, if you're off the curve at 3 months, you're never, you're never back on that curve. ↗
▶ Ep 24 · 15:00
clinical A cohort of patients did not get satiety from their sleeve despite the same amount of resection each time. ↗
▶ Ep 24 · 15:00
quote I had a cohort of patients who did not get satiety from their sleeve, uh, no matter, you know, and I obviously do the same. Amount of resection each time. ↗
▶ Ep 24 · 15:15
clinical Patients without satiety are started on Vyvanse at 2 weeks post-op. ↗
▶ Ep 24 · 15:20
quote those patients, we start on 2 weeks, 2 weeks post-op. If they don't have satiety, they get on Vyvanse right away. ↗
▶ Ep 24 · 15:25
opinion Studies looking at 6 months or later time points for medication initiation are way too late; the data strongly suggest starting earlier and being more aggressive. ↗
▶ Ep 24 · 15:32
quote all the, all the studies, including my own, looking at 6 months or later time points, they're gonna be great, but they're actually way too late. ↗
▶ Ep 24 · 16:05
quote if then they're on insulin, I mean, the longer they're on insulin, the less likely you are to help their diabetes. ↗
▶ Ep 24 · 16:05
clinical The longer patients are on insulin, the less likely you are to help their diabetes. ↗
Stephanie's statements about Pediatric Obesity 15 statements

Open the Pediatric Obesity collection →

Welcome & Introduction: Pediatric Obesity 2017

▶ Ep 1 · 3:07
quote Yes, I, I'm super excited. This is our 5th 1, and I think this lineup is spectacular. ↗

StayCurrent Forums - Obesity in Children

▶ Ep 9 · 1:47
epidemiological Pediatric obesity is a worldwide problem, particularly in countries that have become more developed. ↗
▶ Ep 9 · 2:15
quote once you've gained the weight, your body is going to fight you to keep it on. So it's not like you can just say, oh, I'm going to cut out, you know, that soda and it's all going to get better. ↗
▶ Ep 9 · 4:17
clinical Physical activity provides metabolic improvements in muscles, lungs, and other systems beyond just burning calories. ↗
▶ Ep 9 · 6:31
clinical Phentermine can cause jitteriness, increased heart rate, and usual stimulant side effects. ↗
▶ Ep 9 · 7:18
clinical Some patients stay on obesity medications forever, while others can stop and sustain weight loss, though it is difficult to predict which patients will need long-term medication. ↗
▶ Ep 9 · 7:18
clinical The combination of phentermine and Topamax is a medication that can be taken indefinitely. ↗
▶ Ep 9 · 8:52
clinical Pediatric bariatric surgery requires a multi-month preparation process including exercise logs, food logs, and lifestyle changes. ↗
▶ Ep 9 · 10:10
clinical Patients are given clear numbers about expected weight loss (approximately 25%) and told their body type will remain the same, just becoming a smaller, healthier version. ↗
▶ Ep 9 · 10:10
quote you're going to lose about 25%. What does that mean? And your body is your body. You're busty, you're busty, you're hippie, you're hippie, you are what you are. It's just going to be a smaller, healthier version of you. ↗
▶ Ep 9 · 12:24
clinical The sleeve gastrectomy is the first choice procedure for adolescents, with Roux-en-Y gastric bypass as the second choice. ↗
▶ Ep 9 · 14:05
clinical Initial post-operative issues after sleeve gastrectomy include getting patients back to eating, ensuring adequate caloric intake, and some dehydration, though dehydration has improved. ↗
▶ Ep 9 · 14:23
clinical Research shows that after sleeve gastrectomy, approximately one-third of patients develop reflux, one-third experience improvement in reflux, and one-third remain the same. ↗
▶ Ep 9 · 14:23
guideline New recommendations suggest performing endoscopy before patients transition to adult care after five years to check for Barrett's esophagus. ↗
▶ Ep 9 · 15:16
clinical Patients can be followed until age 21 at the speaker's institution. ↗
Stephanie's statements about Pediatric Obesity 1 statement

Open the Pediatric Obesity collection →

Welcome & Introduction: Pediatric Obesity 2017

▶ Ep 1 · 3:07
quote Yes, I, I'm super excited. This is our 5th 1, and I think this lineup is spectacular. ↗
Stephanie's statements about Type 2 Diabetes 40 statements

Open the Type 2 Diabetes collection →

Stephanie Walsh, MD - 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 3 · 1:00
quote what is adequate weight loss? ↗
▶ Ep 3 · 1:40
quote the kids that can lose weight usually lose weight, and the kids who can't don't ↗
▶ Ep 3 · 3:20
quote I have a saying that I put in mind, like if some of these kids, you know, they get their license over the course of this. And they have what I call the Starbucks phenomenon. ↗
▶ Ep 3 · 4:20
quote I always am a huge proponent for physical activity ↗
▶ Ep 3 · 4:30
quote the benefits of physical activity. Long term are something that is not represented as well ↗
▶ Ep 3 · 4:40
epidemiological Physical activity for girls is always lower than boys, and physical activity for kids is predominantly influenced by their moms. ↗
▶ Ep 3 · 5:10
clinical Physical activity impacts mental health. ↗
▶ Ep 3 · 5:10
quote physical activity does impact mental health ↗
▶ Ep 3 · 5:50
quote I've actually really been using some of the bupropion post-op ↗
▶ Ep 3 · 5:50
clinical Bupropion post-op helps with mood and gives patients extra support toward weight loss, though patients are supposed to be 18. ↗
▶ Ep 3 · 6:20
quote I haven't used Contrave at all ↗
▶ Ep 3 · 7:20
quote It is a psychological benefit. It's the fact that even if they can stabilize their weight or even lose a little bit, it helps them stay super engaged in the program. ↗
▶ Ep 3 · 7:45
quote almost all my kids can only take phentermine and Topamax. I don't really have access to GLP ones for, for most of my bariatric patients at all. ↗
▶ Ep 3 · 10:00
quote In Atlanta, I can only find 15 mg in capsule form. So it's not even like you can break it in half for phentermine. ↗
▶ Ep 3 · 10:00
clinical In Atlanta, phentermine is only available in 15 mg capsule form, which cannot be broken in half. ↗
▶ Ep 3 · 10:25
quote Not everybody wants to lose as much weight, and it really just depends on what works for them. ↗
▶ Ep 3 · 10:40
opinion There is significant medication hesitancy among families in Atlanta. ↗
▶ Ep 3 · 10:45
quote we have a lot of medication hesitancy here in Atlanta ↗
▶ Ep 3 · 10:55
quote there's camps of people who very much like, I'll never do surgery. I want medications. And then there's another camp that's like, I want nothing with long-term medications. I want surgery. ↗
▶ Ep 3 · 11:20
clinical Novo Nordisk is sending out the 1.7 and 2.4 mg doses but very little of the lower doses, prioritizing people already on maintenance. ↗
▶ Ep 3 · 11:20
quote they're sending out the 1.7 and 2.4, but there, there's very, very little of the, the lower doses. Um, they're just prioritizing the people who are trying to maintain. ↗
▶ Ep 3 · 12:40
quote the 1.7 is considered now a maintenance dose, so there should be less issue about insurers paying for 1.7. ↗
▶ Ep 3 · 12:40
guideline As of last year, 1.7 mg is considered a maintenance dose, so there should be less issue with insurers covering it. ↗
▶ Ep 3 · 13:00
opinion The lowest effective and tolerable dose should be used for each patient, and ramp-up should be individualized. ↗
▶ Ep 3 · 13:00
quote You should use the lowest dose that your patient, you know, one, they can tolerate and that's effective ↗
▶ Ep 3 · 13:20
quote all of these very restrictive rules and regulations, um, from insurers and pharmacies about how you can and can't prescribe it are really, they're all just an impediment. ↗
▶ Ep 3 · 14:10
quote we offer medications at 3 months for less than 10% total body weight loss and at 6 months for less than 15%. ↗
▶ Ep 3 · 14:10
clinical Medications are offered at 3 months for less than 10% total body weight loss and at 6 months for less than 15%. ↗
▶ Ep 3 · 14:25
quote those are very conservative given the teen labs data ↗
▶ Ep 3 · 14:25
opinion These thresholds (10% at 3 months, 15% at 6 months) are very conservative given the Teen-LABS data. ↗
▶ Ep 3 · 14:40
clinical In a cohort of 750 patients, modeling shows that if a patient is off the weight loss curve at 3 months, they never get back on that curve. ↗
▶ Ep 3 · 14:45
quote if you don't have, uh, if you're off the curve at 3 months, you're never, you're never back on that curve. ↗
▶ Ep 3 · 15:00
clinical A cohort of patients did not get satiety from their sleeve despite the same amount of resection each time. ↗
▶ Ep 3 · 15:00
quote I had a cohort of patients who did not get satiety from their sleeve, uh, no matter, you know, and I obviously do the same. Amount of resection each time. ↗
▶ Ep 3 · 15:15
clinical Patients without satiety are started on Vyvanse at 2 weeks post-op. ↗
▶ Ep 3 · 15:20
quote those patients, we start on 2 weeks, 2 weeks post-op. If they don't have satiety, they get on Vyvanse right away. ↗
▶ Ep 3 · 15:25
opinion Studies looking at 6 months or later time points for medication initiation are way too late; the data strongly suggest starting earlier and being more aggressive. ↗
▶ Ep 3 · 15:32
quote all the, all the studies, including my own, looking at 6 months or later time points, they're gonna be great, but they're actually way too late. ↗
▶ Ep 3 · 16:05
quote if then they're on insulin, I mean, the longer they're on insulin, the less likely you are to help their diabetes. ↗
▶ Ep 3 · 16:05
clinical The longer patients are on insulin, the less likely you are to help their diabetes. ↗

Summaries Stephanie gave as host · 8 summaries

Recaps of other experts' statements, not Stephanie's own clinical position.

Summaries Stephanie gave as host · Obesity 4 summaries

Open the Obesity collection →

Stephanie Walsh, MD - 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 24 · 1:30
host summary Stephanie Walsh summarizing the discussion: The top group of patients at 10 years post-op is doing much worse, while another group is only down 12% weight loss. ↗
▶ Ep 24 · 8:00
host summary Stephanie Walsh summarizing the discussion: Tom's unpublished study on phentermine and topiramate post-op included approximately 12 kids and showed improvement. ↗
▶ Ep 24 · 9:00
host summary Stephanie Walsh summarizing the discussion: Evan's unpublished study shows kids who lose weight lose weight with meds as well, with improvements across groups. ↗
▶ Ep 24 · 9:05
host summary Stephanie Walsh summarizing the discussion: the kids who lose weight, lose weight with meds as well ↗
Summaries Stephanie gave as host · Type 2 Diabetes 4 summaries

Open the Type 2 Diabetes collection →

Stephanie Walsh, MD - 2024 Pediatric Bariatric Surgery Update Course

▶ Ep 3 · 1:30
host summary Stephanie Walsh summarizing the discussion: The top group of patients at 10 years post-op is doing much worse, while another group is only down 12% weight loss. ↗
▶ Ep 3 · 8:00
host summary Stephanie Walsh summarizing the discussion: Tom's unpublished study on phentermine and topiramate post-op included approximately 12 kids and showed improvement. ↗
▶ Ep 3 · 9:00
host summary Stephanie Walsh summarizing the discussion: Evan's unpublished study shows kids who lose weight lose weight with meds as well, with improvements across groups. ↗
▶ Ep 3 · 9:05
host summary Stephanie Walsh summarizing the discussion: the kids who lose weight, lose weight with meds as well ↗