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Last updated on 2025-11-18

2025-11-18

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The keto diet has taken the health and wellness world by storm in recent years, with its promise of fast weight loss and increased energy levels. However, adhering to a strict low-carb, high-fat diet can be challenging for many people. That’s where Keto Plus ACV Luxe Gummies come in. These delicious gummies are designed to help you achieve ketosis more easily and enjoy all the benefits of the keto diet without the hassle.

What are Keto Plus ACV Luxe Gummies?

Keto Plus ACV Luxe Gummies are a powerful combination of two popular weight loss supplements: exogenous ketones and apple cider vinegar. These gummies are formulated to help your body enter ketosis faster, burn fat for energy, and support overall weight loss. By taking Keto Plus ACV Luxe Gummies daily, you can experience all the benefits of the keto diet without the need to drastically change your eating habits.

When you’re in ketosis, your body burns fat for energy instead of carbohydrates, which can lead to rapid weight loss. However, achieving and maintaining ketosis can be tricky, especially for those new to the keto diet. Keto Plus ACV Luxe Gummies make it easier to stay in ketosis by providing your body with the exogenous ketones it needs to keep burning fat efficiently.

How do Keto Plus ACV Luxe Gummies work?

Keto Plus ACV Luxe Gummies work by increasing the levels of ketones in your blood, which helps your body enter a state of ketosis more quickly. This means that you’ll start burning fat for fuel instead of carbs, leading to faster weight loss and increased energy levels. The addition of apple cider vinegar in these gummies also helps support digestion and metabolism, making it easier for your body to process the fats you consume on the keto diet.

Many people struggle to stay in ketosis because it requires them to drastically reduce their carb intake. Keto Plus ACV Luxe Gummies provide a convenient solution by giving your body the ketones it needs to stay in ketosis, even if you occasionally indulge in higher-carb foods. These gummies can help you achieve your weight loss goals without feeling deprived or overwhelmed by strict diet rules.

Benefits of Keto Plus ACV Luxe Gummies

There are numerous benefits to incorporating Keto Plus ACV Luxe Gummies into your daily routine. Not only can they help you reach and maintain ketosis more easily, but they also support digestion, metabolism, and overall weight loss. These gummies are a convenient and delicious way to enjoy the benefits of the keto diet without the need to make drastic changes to your eating habits.

One of the main advantages of Keto Plus ACV Luxe Gummies is that they can help increase your energy levels and improve your focus. When your body is burning fat for fuel instead of carbs, you may experience a more stable and sustained energy throughout the day. This can help you stay more active and alert, making it easier to tackle your daily tasks and workouts.

Are Keto Plus ACV Luxe Gummies safe to use?

Keto Plus ACV Luxe Gummies are made with natural ingredients and are generally considered safe for most people to use. However, it’s always a good idea to consult with your healthcare provider before starting any new supplement regimen, especially if you have any underlying health conditions or are taking medications. Additionally, pregnant or nursing women should avoid taking these gummies without first consulting with their doctor.

Overall, Keto Plus ACV Luxe Gummies offer a convenient and effective way to support your weight loss goals and enjoy the benefits of the keto diet. By providing your body with the exogenous ketones it needs to stay in ketosis, these gummies can help you achieve your desired results more easily and without the need for strict dieting. Give Keto Plus ACV Luxe Gummies a try today and experience the ultimate ketosis combo for yourself!

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Have you ever watched an episode of Shark Tank that left you on the edge of your seat? One episode that continues to stand out is the 2021 episode featuring pitches for Keto Pills. As entrepreneurs entered the Tank with their innovative products, the Sharks were faced with a tough decision. Let’s revisit this episode and delve into the details of the pitches, the reactions of the Sharks, and the overall outcome of the Keto Pills segment.

The Pitches

The entrepreneurs behind the Keto Pills came prepared with their pitch, showcasing the benefits of their product and explaining why it stood out in the market. They highlighted the science behind the pills, how they helped with weight loss, and the potential for expansion into other health-related products. The Sharks listened intently, probing for more information and asking tough questions to gauge the viability of the business.

Each entrepreneur brought a unique perspective to the table, with some focusing on the health benefits of the Keto Pills while others emphasized the business strategy and potential for growth. As the pitches progressed, it became clear that the Sharks were intrigued by the product but needed more convincing to make a deal.

The Shark’s Reactions

As the entrepreneurs presented their pitches, the Sharks had varying reactions to the Keto Pills. Some were skeptical, questioning the science behind the product and the potential for long-term success. Others saw the opportunity for investment, recognizing the growing trend of health and wellness products in the market.

Each Shark brought their own expertise to the table, offering insights and advice to the entrepreneurs based on their knowledge and experience. Some Sharks saw potential in the Keto Pills and were eager to make a deal, while others hesitated, citing concerns about the competitive landscape and the overall strategy of the business.

The Outcome

Ultimately, the entrepreneurs behind the Keto Pills had to make a decision – would they accept an offer from one of the Sharks, or would they leave the Tank empty-handed? The tension mounted as the entrepreneurs weighed their options, considering the implications of each deal on the future success of their business.

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In the end, a deal was struck between one of the entrepreneurs and a Shark, marking a turning point in the journey of the Keto Pills. The entrepreneurs walked away with valuable advice, a strategic partnership, and the funds needed to take their business to the next level. The episode ended on a high note, showcasing the power of entrepreneurship and innovation in the face of tough competition.

As we reflect on the 2021 Shark Tank episode featuring Keto Pills, we are reminded of the challenges and opportunities that come with entering the Tank. The entrepreneurs behind the Keto Pills demonstrated resilience, passion, and a willingness to take risks – qualities that are essential for success in the business world. Their journey serves as a reminder that with hard work, dedication, and a great product, anything is possible in the world of entrepreneurship.

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Are you struggling to reach your weight loss goals? Have you tried numerous diets and exercise programs without seeing the results you desire? If so, you are not alone. Many people struggle with their weight and find it challenging to shed those extra pounds. However, there is a solution that can help you finally reach your weight loss apex – Apex Keto.

What is Apex Keto?

Apex Keto is a revolutionary dietary supplement that is designed to support your ketogenic lifestyle. The ketogenic diet is a low-carb, high-fat diet that has been shown to help people lose weight and improve their overall health. However, it can be challenging to maintain ketosis, the state in which your body burns fat for energy instead of carbs. That’s where Apex Keto comes in. It is specially formulated to help you stay in ketosis and reach your weight loss goals faster and more effectively.

One of the key ingredients in Apex Keto is beta-hydroxybutyrate, or BHB. BHB is a ketone body that is produced by the liver during ketosis. When you take Apex Keto, it provides your body with an immediate source of BHB, which can help boost your energy levels and support fat burning. This can be especially beneficial if you are following a ketogenic diet and need an extra push to help you stay on track.

In addition to BHB, Apex Keto also contains other natural ingredients that are known for their weight loss and health benefits. These ingredients work together to help suppress your appetite, increase your metabolism, and improve your overall well-being. By incorporating Apex Keto into your daily routine, you may be able to see faster and more sustainable results from your ketogenic lifestyle.

How to Use Apex Keto

Using Apex Keto is easy and convenient. Simply take two capsules with water daily, preferably before a meal. It is recommended to follow a ketogenic diet while taking Apex Keto to maximize its benefits. Make sure to drink plenty of water throughout the day to stay hydrated and support healthy digestion. Additionally, incorporating regular exercise into your routine can help enhance the effects of Apex Keto and boost your weight loss efforts.

It is important to note that individual results may vary when using Apex Keto. While some people may see significant weight loss and improvements in their health within a few weeks, others may take longer to experience the full benefits. It is essential to be patient and consistent with your use of Apex Keto to achieve your desired results. Remember, weight loss is a journey, and the key is to stay dedicated and focused on your goals.

Before starting any new dietary supplement, it is always a good idea to consult with your healthcare provider, especially if you have any underlying health conditions or are taking any medications. Your healthcare provider can help determine if Apex Keto is right for you and provide guidance on how to incorporate it into your weight loss plan safely and effectively.

The Benefits of Apex Keto

There are many benefits to using Apex Keto to support your weight loss journey. One of the main advantages is that it can help you reach ketosis faster and more efficiently, which can lead to increased fat burning and weight loss. By providing your body with an immediate source of BHB, Apex Keto can help jumpstart your metabolism and provide you with sustained energy throughout the day.

Another benefit of Apex Keto is that it can help suppress your appetite and cravings, making it easier to stick to your ketogenic diet. Many people struggle with overeating or snacking on unhealthy foods when trying to lose weight. With Apex Keto, you may find that you feel fuller for longer and have fewer urges to indulge in high-calorie snacks.

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Additionally, Apex Keto may help improve your mental clarity and focus. Some people experience brain fog or difficulty concentrating when they are on a low-carb diet. However, the ingredients in Apex Keto are believed to support cognitive function and promote mental alertness, which can be beneficial for work, school, or daily activities.

Why Choose Apex Keto?

There are many reasons why you should consider incorporating Apex Keto into your weight loss plan. One of the main reasons is that it is a natural and safe way to support your ketogenic lifestyle. Unlike other weight loss supplements that may contain harmful chemicals or stimulants, Apex Keto is made with high-quality, all-natural ingredients that are free of fillers or additives.

Another reason to choose Apex Keto is that it is easy to use and convenient for your busy lifestyle. Simply take two capsules a day with water, and you can enjoy the benefits of increased energy, reduced appetite, and improved focus. No need to mix powders, count calories, or track macros – Apex Keto takes the guesswork out of reaching your weight loss goals.

Furthermore, Apex Keto is backed by a satisfaction guarantee, so you can feel confident in trying it risk-free. If you are not completely satisfied with your results, you can return the product within a specified time frame for a full refund. This demonstrates the manufacturer’s confidence in the effectiveness of Apex Keto and their commitment to customer satisfaction.

Conclusion

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Are you looking for a delicious way to support your weight loss journey while following a keto diet? Look no further than keto gummies! These tasty treats are packed with ingredients that can help boost metabolism, reduce cravings, and support overall fat loss. In this article, we’ll explore the top-rated keto gummies on the market to help you choose the best option for your weight loss goals.

1. What are Keto Gummies?

Keto gummies are a convenient and tasty way to incorporate key ingredients into your diet that can support weight loss while following a ketogenic eating plan. These gummies are typically low in carbs and sugar, making them a perfect addition to your keto lifestyle. They often contain ingredients like exogenous ketones, MCT oil, collagen, and other nutrients that can help boost fat burning and reduce hunger cravings.

By enjoying keto gummies regularly, you can help support your body’s ability to stay in ketosis, a metabolic state where your body burns fat for fuel instead of carbs. This can lead to more efficient weight loss and improved energy levels, making it easier to stick to your keto diet long term.

Many people find keto gummies to be a delicious and convenient alternative to traditional weight loss supplements, as they can be easily incorporated into your daily routine. Plus, with a wide variety of flavors to choose from, you’re sure to find a keto gummy that satisfies your sweet tooth while helping you reach your weight loss goals.

2. How Do Keto Gummies Support Weight Loss?

Keto gummies contain ingredients that are specifically chosen to help support weight loss while following a ketogenic diet. For example, exogenous ketones in keto gummies can help raise your blood ketone levels, making it easier for your body to stay in ketosis and burn fat for fuel. MCT oil is another common ingredient in keto gummies, known for its ability to increase energy levels and promote fat burning.

In addition to these key ingredients, many keto gummies also contain collagen, a protein that can help support skin health, joint function, and muscle recovery during weight loss. By providing your body with these essential nutrients, keto gummies can help support your overall health and wellness while you work towards your weight loss goals.

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Furthermore, the low carb and sugar content of keto gummies makes them an excellent option for those following a keto diet. By choosing keto gummies over traditional sugary snacks, you can help reduce your carb intake and support your body’s ability to burn fat for fuel, leading to more efficient weight loss results.

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When it comes to choosing the best keto gummies for weight loss, there are several top-rated options to consider. One popular choice is Kiss My Keto’s Keto Gummies, which are made with high-quality ingredients like exogenous ketones, MCT oil, and collagen to support fat burning and reduce cravings. These gummies come in delicious flavors like raspberry lemon, making them a tasty way to support your weight loss goals.

Another top pick is Perfect Keto’s Keto Gummies, which are made with clean ingredients and zero added sugars. These gummies contain exogenous ketones and MCT oil to help boost energy levels and support fat loss while following a ketogenic diet. With flavors like strawberry and lemon, Perfect Keto’s Keto Gummies are a delicious way to stay on track with your weight loss journey.

For those looking for a gummy that also supports gut health, Smart Sweets’ Keto Gummies are a great option. These gummies are made with prebiotic fiber to support digestive health and contain only 3g of sugar per bag, making them a low-carb treat that won’t derail your weight loss efforts. Smart Sweets’ Keto Gummies come in flavors like peach and raspberry, making them a satisfying snack that can help curb cravings and support weight loss.

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Are you looking for a convenient way to support your weight loss journey with the keto diet? Look no further than Keto ACV gummies! These delicious gummies are packed with the powerful combination of apple cider vinegar (ACV) and key ingredients to help boost your metabolism and burn fat more efficiently. And the best part is, you can now shop for Keto ACV gummies on Amazon for easy access and fast delivery right to your doorstep!Trusttheprocess Dontgiveup Yougotthis Staythecourse Glp1 Glp1forweightloss

Benefits of Keto ACV Gummies

Keto ACV gummies offer a variety of benefits for individuals looking to achieve their weight loss goals. One of the key benefits is the inclusion of ACV, which has been shown to help control appetite, reduce belly fat, and regulate blood sugar levels. Additionally, these gummies contain other ingredients such as BHB salts and MCT oil, which can help enhance ketosis and increase energy levels. By incorporating these gummies into your daily routine, you can experience faster and more effective weight loss results.

Furthermore, Keto ACV gummies are a convenient and portable option for those who are always on the go. Instead of having to measure out liquid ACV or take multiple pills throughout the day, you can simply grab a few gummies and enjoy them anytime, anywhere. This makes it easier to stay consistent with your weight loss efforts and ensures that you are getting the necessary nutrients to support your goals.

How to Use Keto ACV Gummies

Using Keto ACV gummies is simple and straightforward. All you need to do is take the recommended serving size each day, typically 2-6 gummies depending on the brand and formulation. It’s best to take the gummies with a meal to help with digestion and absorption of the ingredients. Additionally, make sure to drink plenty of water throughout the day to stay hydrated and support your weight loss efforts.

For optimal results, it’s recommended to combine Keto ACV gummies with a healthy diet and regular exercise routine. The gummies can help boost your metabolism and support ketosis, but they are most effective when used in conjunction with other healthy habits. By following a balanced approach to weight loss, you can maximize the benefits of these gummies and achieve your desired results more quickly.

Why Choose Keto ACV Gummies on Amazon

There are several reasons why shopping for Keto ACV gummies on Amazon is a smart choice. First and foremost, Amazon offers a wide selection of brands and formulations to choose from, allowing you to find the perfect option to suit your needs and preferences. Additionally, Amazon provides fast and convenient shipping options, so you can receive your gummies in a timely manner without having to wait weeks for delivery.

Furthermore, shopping on Amazon allows you to read reviews and ratings from other customers who have tried the product. This can help you make an informed decision and ensure that you are purchasing a high-quality product that delivers on its promises. With the convenience and reliability of Amazon, you can shop for Keto ACV gummies with confidence and start seeing results in no time.

Summary/Frequently Asked Questions

Q: How do Keto ACV gummies help with weight loss?

A: Keto ACV gummies contain apple cider vinegar and other key ingredients that can help boost metabolism, control appetite, and enhance ketosis, leading to more effective weight loss results.

Q: Can I take Keto ACV gummies on the go?

A: Yes, Keto ACV gummies are a convenient and portable option for those with a busy lifestyle. Simply take the recommended serving size each day, no matter where you are.

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Q: Are there any side effects of taking Keto ACV gummies?

A: As with any supplement, it’s essential to consult with a healthcare professional before adding Keto ACV gummies to your routine. While side effects are rare, some individuals may experience digestive issues or allergic reactions.

Q: How long will it take to see results from using Keto ACV gummies?

A: Results may vary depending on individual factors such as diet and exercise habits. However, many users report seeing noticeable results within a few weeks of consistent use.

Q: Can I purchase Keto ACV gummies in bulk on Amazon?

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Understanding Lainey Wilson’s Motivations for Weight Loss Surgery

Lainey Wilson, a rising star in the music industry, has been a beacon of hope and inspiration for many. Known for her empowering songs and down-to-earth personality, she has also been open about her personal struggles, particularly concerning weight management. Lainey’s decision to explore weight loss surgery was influenced by her desire for health, personal well-being, and a more vibrant lifestyle. She understands that for many people, maintaining a healthy weight can be a significant challenge, often requiring a multi-faceted approach. This article delves deeply into her 3-step weight loss surgery journey, providing a thorough overview of her motivations, the surgical process, recovery, and the emotional and physical transformations that accompany such a life-altering decision.

In her professional life, Wilson has faced the pressures of conforming to industry standards, which often celebrate certain body types while overlooking others. This reality can create immense stress and shame for individuals who do not fit these molds. Lainey has repeatedly highlighted how societal expectations surrounding body image served as both a motivating factor and a source of frustration in her life. Thus, the decision to undergo weight loss surgery emerged not solely from a desire for a particular aesthetic but rather as a means to reclaim control over her health and confidence.

Moreover, weight loss surgeries are often regarded as a last resort for those who have struggled with diet and exercise alone. Lainey’s story is no different. After trying numerous weight loss methods with moderate success, she realized that she needed additional assistance to achieve her goals. Thus, embarking on this journey was an act of self-love, a step towards prioritizing her health and well-being, rather than succumbing to the pressures and expectations of the music industry. Each phase of her journey reflects a deep commitment to her holistic well-being.

The Pre-Surgery Preparation Phase

The journey towards weight loss surgery begins well before the actual procedure. Pre-surgery preparation is a crucial step that can determine the success of the operation and the patient’s long-term health outcomes. For Lainey Wilson, this phase encompassed a series of assessments, medical clearances, and emotional preparations. First and foremost, she underwent a meticulous evaluation by a team of healthcare professionals who reassessed her health status, medical history, and any potential risks associated with surgery. This comprehensive assessment ensured that she was a suitable candidate for the procedure.

In addition to physical evaluations, Lainey also engaged in consultations with nutritionists who provided valuable guidance on dietary modifications. They worked together to establish a meal plan that would not only help her shed those extra pounds but also set the foundation for a sustainable, healthy lifestyle post-surgery. This weight loss journey requires a commitment to long-term changes in eating habits rather than short-term fixes, a philosophy Lainey has embraced wholeheartedly.

Preparing mentally for surgery is as vital as addressing physical health. Emotional readiness can significantly impact the success of weight loss surgery. Lainey sought support from various sources: family, friends, and even professional counselors. This support network allowed her to openly discuss her fears, aspirations, and motivations, reinforcing her commitment to this life-altering decision. By the time she approached the surgery date, Lainey had a solid understanding of what would happen next, both physically and emotionally. She recognized that this journey was not solely about losing weight; it was about fostering a healthier lifestyle that would enhance her overall quality of life.

Experiencing the Surgery: What it Entailed

The moment of the surgery itself is often filled with a mix of excitement and anxiety. For Lainey Wilson, the actual procedure was a remarkable turning point in her weight loss journey. Choosing a minimally invasive approach, Lainey opted for a laparoscopic method, a procedure that typically features shorter recovery periods and fewer complications. Under the care of a qualified surgical team, the operation focused on altering her digestive system to promote weight loss—either through gastric bypass or sleeve gastrectomy, depending on specific health indicators and recommendations.

Throughout the surgery, Lainey received close supervision from the medical staff, ensuring a safe and comfortable experience. Post-surgery, she was monitored carefully as she transitioned into recovery. Understanding the importance of medical oversight, she adhered closely to the postoperative protocols established by her healthcare providers. This included a period of rest followed by a gradual reintroduction of solid foods, beginning with liquids to ease her body into the new dietary requirements.

Despite the many challenges that accompany any surgical procedure, Lainey remained upbeat and determined. Emphasizing the importance of community, she attracted support from her fans through social media, sharing updates about her recovery journey. This openness not only helped her process the physical changes taking place but also fostered a connection with her audience, transforming her personal story into an empowering narrative that resonates with many facing similar challenges. By maintaining transparency about her experience, Lainey showcased the human side of weight loss surgery, revealing the inner strength required to navigate this path.

Navigating the Recovery Phase

Recovery after weight loss surgery is a multifaceted process, encompassing physical, emotional, and social aspects. For Lainey Wilson, this phase required patience and a mindful approach to her lifestyle changes. Initially, she faced physical limitations, struggling with basic tasks and adapting to her new diet. This adjustment period was essential, teaching her how to listen to her body and understand its responses to the significant changes initiated by the surgery. Through monitoring portion sizes and being conscious of food choices, Lainey slowly learned how to navigate her new relationship with food.

Emotional recovery was equally important, as Lainey confronted moments of frustration and self-doubt. Alongside the physical transformations, emotional shifts were bound to occur. Her self-image was in flux, and she had to navigate the complexities of changing perceptions, both from herself and society. During this challenging time, she leaned heavily on her support network—friends, family, and mental health professionals—who provided the encouragement needed to stay resolute during her journey.

As Lainey progressed in her recovery, she began to experience the benefits of her surgery, both physically and mentally. The initial losses on the scale instilled a sense of accomplishment and motivation to continue pursuing a healthier lifestyle. Engaging in physical activities that she previously found challenging became enjoyable, allowing Lainey to embrace a more active and fulfilling routine. This newfound vitality slowly shifted the narrative around who she is, creating a positive feedback loop that encouraged further growth. Lainey’s journey exemplifies how recovery can lead to rediscovery and renewal, offering insights into the importance of nurturing both the body and the mind after such a monumental change.

Celebrating the Transformation and Continuous Improvement

The transformation that Lainey Wilson underwent following weight loss surgery was not merely a physical change; it was an awakening. As the months progressed, she noticed a significant shift in her energy levels, outlook on life, and overall well-being. No longer burdened by the same constraints, Lainey discovered a plethora of opportunities to pursue her passion for music in new and dynamic ways. This renewed enthusiasm was palpable, both personally and professionally, as she began to engage more with her fans and the public, inspiring many with her story.

Practicing self-love and acceptance became central themes for Lainey as she continued her journey. Throughout this phase, she made it a point to celebrate every small victory, from fitting into a pair of jeans that hadn’t fit in years to completing a previously daunting hike. Acknowledging these milestones was crucial in sustaining her motivation and reinforcing her commitment to a healthier lifestyle. Lainey’s emphasis on celebration serves as a reminder that weight loss journeys should be marked not only by numbers on a scale but by the profound changes in perspective and self-worth.

Looking beyond her initial transformation, Lainey remains committed to continuous improvement. She understands that weight loss surgery is not a quick fix but rather a stepping stone towards a healthier life. Maintaining open communication with healthcare providers, she commits to regular check-ups and nutritional guidance. Additionally, she shares her ongoing efforts with her audience, reinforcing the importance of community support in achieving lasting change. Lainey Wilson’s journey resonates deeply, showcasing the resilience of the human spirit and the dedication it takes to overcome challenges and emerge victorious.

Reflecting on a Journey: Summary and Q&A

Lainey Wilson’s journey through weight loss surgery illustrates not only the physical changes that can occur through medical intervention but also the emotional and mental transformations that accompany such a colossal life change. From her initial motivations to the rigorous preparation, surgery, and recovery, each step of her journey serves as a testament to resilience, perseverance, and the pursuit of holistic well-being. In sharing her story, Lainey continues to inspire countless others who face similar struggles, proving that change is indeed possible when one dedicates themselves to their health.

For those contemplating similar paths, several questions frequently arise. One of the most important questions is whether weight loss surgery is the right choice: it is essential to consult with qualified healthcare professionals and assess individual health conditions before making a decision. Another common question involves the type of procedure to be pursued—considerations include the specific health situation, desired outcomes, and personal preference. Education around these choices can significantly influence long-term success.

The emotional aspect is also critical, as individuals often grapple with feelings of anxiety and fear regarding surgery and recovery. Finding a strong support system can alleviate some of these struggles; connecting with others who have undergone similar experiences can provide valuable insights and encouragement. Lastly, many wonder about the long-term impacts of weight loss surgery on mental health, nutrition, and lifestyle. While there may be challenges along the way, long-lasting transformation is possible through dedication, guidance, and a focus on holistic health. Lainey Wilson’s journey encapsulates not just the possibility of change but also the power of community and self-acceptance.

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Drs Akshay Jain and Girish Joshi discuss clinical considerations to keep in mind when someone on GLP-1 therapy is undergoing elective procedures. https://www.medscape.com/viewarticle/glp-1-guidance-reduce-regurgitation-and-aspiration-risk-2024a1000d35?src=soc_yt -- TRANSCRIPT -- Akshay B. Jain, MD: Welcome back to ADA 2024 updates. I'm endocrinologist Dr Akshay Jain from Vancouver in Canada, and today we've got a very special guest. We've got Professor Dr Girish Joshi. Dr Joshi is a professor of anesthesiology and pain medicine at UT Southwestern in Dallas, Texas. He was one of the speakers at a very impactful session that was talking about the postoperative and intraoperative considerations for people who are on GLP-1 therapy. He's here to talk with us about clinical considerations that one needs to keep in mind when someone on glucagon-like peptide 1 (GLP-1) receptor agonist therapy is undergoing elective procedures. Welcome, Dr Joshi. Girish P. Joshi, MD: Thank you, Akshay. It's an honor. Jain: I was attending your session, and I found it very clinically impactful. This is something that we are seeing more and more in clinical practice. For our viewers today, can you share with us, as an anesthesiologist, the potential risks for aspiration and the rates of aspiration that you're seeing in people who are on GLP-1 therapy? Joshi: We don't know the exact rate of aspiration with GLP-1 therapy because there are no good studies, but there are several anecdotal reports, including several personal communications where people have contacted me and the American Society of Anesthesiologists (ASA). I'm the chair of the task force for these GLP-1 recommendations developed by the ASA. To give an example, one of the cases reported to me was from a colleague in Dallas where a patient, otherwise completely healthy, came in for a shoulder arthroscopy — a simple outpatient procedure in a freestanding ambulatory surgery center. Surgery went fine. At the end of the procedure, she regurgitated gastric content and aspirated, and then had to be taken to the intensive care unit (ICU) and she spent 7 days in the ICU. Retrospectively, it was recognized that she was on GLP-1 therapy for weight loss, which was not disclosed. This was just before the ASA came up with the guidance, basically, so people didn't know that GLP-1 receptor agonists do increase the risk for aspiration. Jain: That's a really good point straight from your clinical practice. For our viewers who may not be familiar with the guidelines, could you tell us, in a nutshell, for people on GLP-1 therapy who are going in for an elective procedure that requires general anesthesia, what would be the recommendations for holding GLP-1s? Joshi: I have to first emphasize that currently, the evidence to provide any guidance is sparse, and whatever studies are available are basically questionable or of poor quality. With that said, the reason why the ASA came up with the guidance was to inform our colleagues, anesthesiologists, as well as our colleagues from surgery and other proceduralists of this concern about increased regurgitation and aspiration in patients on GLP-1 receptor agonists. That was the primary aim. Because the evidence is sparse, we basically came up with different approaches to decrease or mitigate the risk for regurgitation and aspiration. It starts with having a collaborative discussion, including the patients, or shared decision-making with the physicians and the patient regarding the potential risks, so mention to the patient that there is a potential risk. Then, avoid the elective procedures in patients at high risk. Examples of patients at high risk would be those who are basically in the escalation phase of the GLP-1 therapy, patients with prior history of gastroparesis, or patients on drugs that can cause gastroparesis. I don't know whether you remember I had an algorithm I developed and presented at the American Diabetes Association (ADA) meeting, where I presented the potential risk factors. If the patients are at risk for regurgitation and aspiration, that's the patient population we've got to be extra careful with. Maybe start off withholding the drug if the patients are on, say, a weekly therapy, then 1 week before, though the evidence is minimal. Nevertheless, more importantly, avoid elective procedures during that escalation phase in this patient population. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/glp-1-guidance-reduce-regurgitation-and-aspiration-risk-2024a1000d35?src=soc_yt