Episode 43: The one where I discuss all things Fractyl with Dr. Harith Rajagopalan

About this episode

This episode features Dr. Harith Rajagopalan discussing the innovative Duodenal Mucosal Resurfacing procedure and its implications for obesity care.

Resetting the Metabolic Setpoint: Duodenal Mucosal Resurfacing (DMR) and the Future of Obesity Care with Dr. Harith Rajagopalan Is the duodenum the "early warning beacon" for metabolic disease? In this episode, we sit down with Dr. Harith Rajagopalan, MD, PhD, Co-Founder and CEO of Fractyl Health, to discuss the revolutionary shift from treating downstream symptoms of diabetes and obesity to addressing the upstream root cause in the gut. We dive deep into the science and technique of Duodenal Mucosal Resurfacing (DMR)—an automated, 45-minute endoscopic outpatient procedure designed to reset the metabolic setpoint. Dr. Rajagopalan explains how high-fat, high-sugar diets pathologically alter the duodenal mucosa and how "resurfacing" this tissue can provide a durable off-ramp for patients on GLP-1 therapies. Key highlights include: The "Reset" Mechanism: How the duodenum acts as the body's nutrient-sensing center and why it becomes dysfunctional. Technical Deep Dive: A look at the automated circumferential saline injection and thermal ablation process (and the future of through-the-scope devices). The "Remain" Trial Data: Breakthrough insights into post-GLP-1 weight maintenance and…

People in this episode

Host: Mankanwal Sachdev

Guest: Dr. Harith Rajagopalan

Topics covered

• metabolic disease
• obesity care
• Duodenal Mucosal Resurfacing
• endoscopic procedures
• diabetes treatment
• gut health

Keywords

• metabolic setpoint
• duodenum
• endoscopy
• weight maintenance
• gene therapy
• nutrient-sensing center

Mentioned in this episode

Organizations: Fractyl Health

Products: Duodenal Mucosal Resurfacing (DMR), GLP-1 therapies, Rejuva Platform

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