#458: Fat loss or weight loss? The number one GLP-1 question

Dr Nikita Kanani MBE is Global Medical Director at Neko Health and still a practising NHS GP. Before Neko she was medical director for primary care at NHS England, through the pandemic and the vaccine rollout, and she and Dr James Somauroo start there because it explains everything that comes after.She is precise about what those years were actually like. Two or three in the morning on Teams in her pyjamas, her daughter building a diorama of the Roman empire beside a call with the Prime Minister, and her mother running the family pharmacy without PPE while her father shielded. She was asked to join the vaccine programme the week before Diwali, argued for delivering it through primary care rather than around forty hospitals, and ended up with thousands of sites and a map on the wall.The second half is Neko's year three data, which James had read on the train in and came armed to argue about. More than eighty thousand scans in 2025. Life threatening findings holding steady at about one percent across three years, which is her answer to the charge that scanning more people only finds more noise. Five or six dermatology referrals to find a melanoma, against fifteen or twenty in general practice. People with a chronic condition improving two and a half times more than people without one.There is also an honest stretch on why she thinks worried well is the wrong argument, and where an NHS partnership might go next.Dr Nikita Kanani on LinkedIn: https://www.linkedin.com/in/drnikkikanani/Neko Health: https://www.nekohealth.comApply to be a guest: https://thehealthtechpodcast.comProduced by SomX: https://somx.health

Deborah Cohen is a medically qualified investigative journalist, formerly science editor at ITV News and health correspondent at BBC Newsnight, where she led the programme's COVID coverage. Her book, "Bad Influence: How the Internet Hijacked Our Health", shortlisted for the Royal Society science book prize, started from one question: are influencers making us sick? She spoke to more than 200 people to answer it, and the answer turned out to be more nuanced than the title suggests.She and James get into what happens when health information travels through people rather than institutions. Where companies get into trouble, which she puts at the point the hype outflanks the evidence. Why the Advertising Standards Authority is playing regulatory whack-a-mole, and how a prescription only migraine drug ended up advertised in her feed by a Kardashian, in a country where that advertising is banned. Why she would ban the words anti-vaxxer and anti-masker before she banned anything else. And what she thinks would actually help, from a register of influencers working with companies to better health literacy and real transparency about where our information comes from.James puts himself in the frame too, on the Instagram ad promising employers a better bottom line if their staff take GLP-1s, and on the work SomX turns down.Deborah's LinkedIn: https://www.linkedin.com/in/deborah-cohen-journalistDeborah's Book: https://oneworld-publications.com/work/bad-influence/Apply to be a guest: ⁠www.thehealthtechpodcast.com⁠Subscribe to Healthtech Pigeon 🐦: ⁠www.healthtechpigeon.com⁠Get in touch with James: ⁠www.jamessomauroo.com⁠This podcast was brought to you by ⁠SomX⁠.

This week, James is joined by Dr Sai Narimetla, an A&E doctor who simultaneously works in investment banking at SSG Capital, to ask why healthtech hasn't produced the exits that biotech and medical devices have. They get into fragmentation, why the deals that are happening don't make headlines, and what a clinical lens actually adds when you're diligencing a company.Connect with Sai: https://www.linkedin.com/in/sainarimetla/Learn more about SSG Capital: https://www.ssgcapital.uk/Apply to be a guest: https://www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon: https://www.healthtechpigeon.comGet in touch with James: https://www.jamessomauroo.comThis podcast was brought to you by SomX.

Martin Ratz co-founded Doccla after a heart attack at forty-four that he had no reason to have. Lying in a hospital bed in Stockholm, he noticed something obvious. Inside the building you are monitored constantly, and the minute you leave, nobody is watching at all.He and Dr James Somauroo trace what Doccla became from there. A research study at Northampton General that COVID shut down, then a virtual COVID ward stood up in a fortnight, then integrated care boards across England, plus Ireland, Germany and Austria. Martin is precise about who these patients are: multimorbid, mostly older, several long-term conditions each, and nothing like the customer of a consumer wearable. He is equally precise about what is actually blocking this, which is not the technology. It is commissioning. Doccla can take activity out of a hospital, but somebody still has to take the cost out, and the trust losing the income has no reason to help.There is also a good exchange on the something-is-better-than-nothing argument, where James revisits a position he now thinks was wrong about AI and mental health, and Martin's answer to the safety objection, which is that the alternative to a virtual ward is usually not a hospital bed.Doccla: https://www.doccla.comApply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.com

This week, James is joined by Dr Kapil Savania, Medical Lead at Voy (formerly Manual) and a practising NHS GP, for a candid look at the fast-blurring line between healthcare and wellness. They dig into who should own preventative medicine, what TRT actually is — and where it gets abused — and why "fat loss," not weight loss, has to be the goal in the GLP-1 era. It's an honest conversation about holding both hats: the NHS clinician and the industry medical lead.Connect with Kapil: https://www.linkedin.com/in/ksavania/Learn more about Voy: https://www.joinvoy.com/Apply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.

This week, James is joined by Yasir Sacranie, pharmacist, content creator and founder of MicroPharm, the education platform helping thousands of trainee pharmacists pass their registration exam. Yasir talks candidly about bootstrapping a healthcare education business alongside a demanding NHS role, the family moment that finally pushed him to leave the NHS for good, and why he's deliberately keeping AI at arm's length in his business. They also get into why he still works one day a week as a barista — and what that teaches him about craft.Connect with Yasir: https://www.linkedin.com/in/yasir-sacranie/Learn more about MicroPharm: https://www.micropharm.uk/Apply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.

In this episode of The Healthtech Podcast, James is joined by Professor Reza Razavi, Professor of Paediatric Cardiovascular Science at King's College London and CEO of Fraiya, an AI ultrasound software company. Reza shares the deeply personal story behind Fraiya — including his own daughter's near-fatal undiagnosed heart condition as a newborn — and explains how AI applied to the routine 20-week anomaly scan could close the gap between the 50% of congenital heart defects currently missed and a detection rate approaching 97-98%. They get into what it actually takes to build AI that clinicians trust, why the NHS financial environment makes or breaks adoption, and how a team of 14 people is on the verge of launching across six European countries.Connect with Reza: https://www.linkedin.com/in/reza-razavi-a50967265/Learn more about Fraiya: https://www.fraiya.com/ Apply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.

In this episode of The Healthtech Podcast, James is joined by Steve Bulera, Chief Scientific Officer for Safety Assessment and Toxicology at Charles River Laboratories — one of the world's largest CROs, and a company that almost every new drug passes through on its way from lab to human trials. They dig into one of the most significant shifts in preclinical drug development: the move away from traditional animal testing towards virtual control groups, AI-assisted decision-making, and what Steve calls "new approach methodologies." It's a candid conversation about where the science is, why the regulators are cautious, and what it actually takes to change a decades-old industry from within.Connect with Steve: https://www.linkedin.com/in/steven-bulera-245234a9/ Learn more about Charles River Laboratories: https://www.criver.comApply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.

In this episode of The Healthtech Podcast, James is joined by Jamie Cox, Co-Founder and CTO of Scarlet — Europe's only notified body specialised in software and AI medical devices. Jamie shares how a frustrating experience building AI triage software at Babylon Health led him and co-founder James Dewar to a radical idea: build a notified body from the ground up, designed specifically for iterative software development. They explore why the current regulatory system creates artificial bottlenecks for health tech founders, what it actually means to regulate an LLM as a medical device, and why making certification faster and cheaper could fundamentally reshape who gets to bring products to market.Connect with Jamie: https://www.linkedin.com/in/jamie-cox-01458b3a/Learn more about Scarlet: https://www.scarlet.cc/Apply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.

This week, James is joined by Shravan Nageswaran, co-founder and CEO of Atman Labs, the London applied-AI research company building diagnostic AI that reasons like a doctor — without relying on large language models. They dig into why LLMs fall short on real clinical reasoning, what "safety" actually means when a system takes a patient history, and how reinforcement learning over a medical knowledge graph could reshape primary care. A genuinely different take on the "can AI be a doctor?" question.Connect with Shravan: https://www.linkedin.com/in/shravan-nageswaran-8961801a1Learn more about Atman Labs: https://atmanlabs.aiApply to be a guest: www.thehealthtechpodcast.comSubscribe to Healthtech Pigeon 🐦: www.healthtechpigeon.comGet in touch with James: www.jamessomauroo.comThis podcast was brought to you by SomX.