Tag Archives: obesity

Ozempic And Wegovy: What To Know About Semaglutide Weight Loss Drugs

February 2, 2023 Admin Leave a comment

A new class of weight loss drugs on the market have been making waves since they were authorized as a treatment for obesity in 2021. Semaglutide injections, which you may know as Wegovy or Ozempic, have become wildly popular over the past several months, thanks to the buzz they’ve received from TikTok influencers (and rumors of use among some celebrities).

The prescription injections were introduced as a diabetes treatment in 2017, but people soon realized that the medications — which help people with diabetes to manage their blood sugar levels — also led to significant weight loss in people with obesity who’d struggled to lose weight with other treatments.

From there, interest in the drugs grew, and after clinical trials confirmed what people suspected — that semaglutide injections help people lose weight — demand soared, so much so that pharmacies across the country are experiencing shortages in both Wegovy and Ozempic. Obesity specialists understand the hype; this kind of prescription weight loss medication has been a long time coming.

“For those of us who treat obesity, this is a game-changer we’ve never seen before,” said Dr. Dan Azagury, a bariatric surgeon at Stanford Health Care. “This is the first time ever that we have really effective drugs to treat obesity.”

Obesity is one of the most common chronic health conditions in the United States, but until recently, we haven’t had very effective drugs to address the health complications it’s commonly linked to, such as high cholesterol and high blood pressure. Aside from lifestyle changes like diet and exercise, the go-to intervention for obesity has been surgery (think: gastric bypass or the duodenal switch).

According to Azagury, many obesity specialists noticed that, in the wake of receiving bariatric surgery, many patients were suddenly no longer diabetic. Upon investigating the reason for this, researchers identified new gut hormones, including one called glucagon-like peptide (GLP-1), that reacted to food going into the gut.

Further testing revealed that GLP-1, which increases after bariatric surgery, improves blood sugar levels, and consequently helps with diabetes. “That’s why major diabetes goes away within days of surgery,” Azagury said.

After this discovery, pharmaceutical companies set out to form a diabetes drug that could activate those GLP-1 receptors. That’s what led to the development of semaglutide ― a synthetic compound that mimics the effects of GLP-1 ― and later the semaglutide-based diabetes drug Ozempic, which got approval from the Food and Drug Administration in 2017.

The other key finding about GLP-1: It slows down digestion and reduces food intake, according to Dr. Janelle Duah, a Yale Medicine internist. This is why Ozempic, which is intended for diabetes, has been and continues to be prescribed off-label for weight loss, Azagury said.

The weight loss effects of GLP-1 (which are revved up through semaglutide), combined with the wild demand for Ozempic, drove the drug manufacturer, Novo Nordisk, to create a very similar drug specifically for weight loss: Wegovy. Essentially just a stronger dosage of Ozempic, Wegovy got FDA approval in June 2021.

Who’s a candidate for the medications?

Wegovy, a once-a-week shot, is for adults who have a body mass index over 30, or who have a BMI above 27 with at least one weight-related health issue (think: high blood pressure, diabetes or high cholesterol). It’s also meant to supplement physical activity and dietary changes, which is why obesity specialists like Azagury recommend that patients work with a comprehensive team of providers, including dietitians and therapists, if they can afford to. Patients can get the prescription through their primary care doctor, too.

Many people find that the injections help them feel fuller longer and reduce sugary cravings. It “makes them crave protein and fiber more — thus helping them stick to diet changes that can further enhance their weight loss,” Duah said. Some people say it also reduced their desire to drink alcohol, and helped them to get better sleep.

Ozempic is approved for Type 2 diabetes, not obesity or weight loss, although people are getting it off-label for weight loss purposes. It’s entirely legal for doctors to prescribe meds off-label, but this is likely adding to ongoing drug shortages — which is a major issue for people with diabetes who can’t get hold of the medications.

Obesity doctors are excited that there’s finally a medication to help people, but there are some barriers and side effects to note.

What’s the overall take on these weight loss medications?

Obesity doctors are thrilled. Often, people retain weight because of health problems out of their control, not for lack of willpower or discipline. Many patients with obesity have tried it all, only to see minimal results. “Now we have something to help them,” Azagury said.

According to Duah, the recent surge in prescriptions, for the most part, is for good reason. “It is by far the most efficacious weight loss medication on the market, with users losing up to 20% of their starting body weight,” Duah said.

And even though interest in these drugs is soaring, Azagury thinks they can help still more people. The original class of obesity drugs from the 1960s and ’70s had nasty consequences and likely soured many people on the whole idea. It might take some convincing for more people to accept that there’s finally an effective drug for weight loss available, Azagury said.

There’s also the issue of cost. These drugs aren’t always covered by insurance, Azagury said, so it can get expensive (to the tune of $1,500 to $1,800 a month). “That is the biggest challenge people will face,” Azagury said. “It’s FDA-approved; that doesn’t mean insurance is going to pay for it.”

According to Duah, this is one of the main reasons providers end up prescribing Ozempic instead. Unlike Wegovy, Ozempic is often covered for diabetes or insulin resistance, so patients looking for semaglutide injections can get access to them at a reasonable price.

There are some risks associated with semaglutide injections

As with any drug, there are risks — but the injections are surprisingly well tolerated, Azagury said. The most common side effects are gastrointestinal issues, like nausea, vomiting, constipation, gas and heartburn. These GI-related side effects should subside as your body gets used to the injections; until then, they can mostly be handled by eating smaller, more frequent meals or taking over-the-counter medications like bismuth subsalicylate or heartburn relief tablets, Duah said. (If the side effects persist, be sure to talk to your doctor about finding relief or other, more tolerable options.)

In rare cases, semaglutide injections can lead to thyroid tumors, which can be cancerous. Other potential serious side effects include pancreatitis, gallbladder problems, low blood sugar, kidney issues, allergic reactions and depression. The injections also shouldn’t be used with other drugs that contain semaglutide or that target GLP-1 receptors.

We’re still learning about long-term side effects, since the drug is relatively new. The injections aren’t a quick fix, and most people will have to stay on the medications for at least a year (and likely longer) to meet their weight loss goals and improve their health, according to Azagury. One study found that many people who stop taking the medications rapidly gain the weight back, supporting the growing belief that the injections are meant to be taken for the long haul.

Other than a slightly higher risk of gallstones (which is common with many types of rapid weight loss), we haven’t seen any long-term effects with liraglutide, a similar drug that’s been on the market since 2010. Azagury expects the same will be true with semaglutide-based medications, given their similarity ― but, of course, time will tell.

If you’re interested in semaglutide injections, talk to your doctor. Understand the risks and benefits, and keep in mind that due to inflation, supply issues and growing demand, these drugs tend to be back-ordered — often for the people who need them most. Hopefully, supply will ramp up soon and more insurers will cover the cost. That, Duah said, will help more people get the drugs at a fair price.

“If insurances covered weight loss medications like Wegovy and supply was increased, we wouldn’t be seeing these issues with keeping Ozempic stocked on our pharmacies’ shelves,” Duah said.

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‘Reverse Dieting’ Is Not a Weight Loss Cheat Code

January 31, 2023 Admin Leave a comment

Photo: Lolostock (Shutterstock)

To hear the TikTok girlies tell it, there’s a hack that will let you EAT MORE FOOD! While NOT GAINING WEIGHT! And it’s great if you are SICK OF DIETING! Never mind that one can achieve all those goals by a simple trick called “not dieting anymore.” No, it needs a name and a strict protocol: reverse dieting.

The basic idea of reverse dieting is that you slowly add a few more calories to your diet every week. So s you normally maintain your weight on 2,000 calories per day, but you’ve been eating 1,500 calories to lose weight. You might then “reverse diet” by eating 1,600 calories a day next week, 1,700 calories a day the week after that, and so on. Eventually you’ll be back up to 2,000 calories, or maybe even more.

This is not a trend that originated on TikTok. The term seems to have come from bodybuilders, whose sport requires that they engage in extreme cycles of bulking (gaining weight to gain muscle mass) and cutting (losing as much fat as possible before stepping on a stage). While the process can create dazzling physiques, it also fucks with your metabolism and overall health.

Reverse dieting is one approach for transitioning from an extreme cut, to maintenance or bulking: Instead of just pigging out the day after your bodybuilding show, you might rather slowly increase the amount of food you eat as you find your maintenance calories again.

This idea spawned the current trend of influencers pitching reverse dieting as the cure for all your diet-related complaints. But it doesn’t work that way.

The science behind reverse dieting

Some of the claims you’ll hear from thin women flexing their abs on TikTok, and from the bodybuilders saying to just trust them, bro, are true. Among them:

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Your metabolism adapts to dieting, so over time you have to eat less and less food to keep losing weight (this is a known thing).
After dieting a long time, you may be eating a miserably low number of calories.
Eating more food will allow your body to stop being so stingy with the calories, and can increase the number of calories your body burns.
After increasing your calories, someday you may be able to lose weight again while eating more food than when you were in the depths of your diet.

There are also a number of untruths and half-truths that come up. You may hear that increasing your calories too fast after a diet will make your body pack on fat, or that you can add 1,000 calories and still be losing weight, or something something hormones something cortisol. (Scroll long enough on fitness TikTok and somebody will explain that all your problems are due to cortisol. Take a drink.)

In any case, this is where “reverse dieting” comes in. Supposedly the cure to all of these ills is simply that you need to add 50 to 100 calories to your diet each week. The process is slow and requires patience, but stick to it and you too could look like this girl (imagine me moving my head to point at the before-and-after photos I’ve greenscreened behind me) on 2,400 calories instead of 1,200.

So what’s actually true about reverse dieting, and why is everybody so into it? Let’s take a closer look.

When it goes right, “reverse dieting” is just “not dieting” but with more rules

After reading all of those bullet points above, you might think, OK, so why not just stop dieting? You’ll get to eat more food, your body will burn more calories, and from there you can either diet again or—crazy idea here—just not diet anymore. Heck, you could give gaining weight a try.

And that is, in fact, the real answer. Just stop dieting. The world will not end. You can eat food again, and you will be fine. So why reverse diet?

As Eric Trexler, a nutrition and metabolism researcher, puts it here, the original reverse dieters’ goal was to smoothly transition from a calorie deficit, to maintenance, to their first bulk after a bodybuilding contest without gaining any more fat than they needed to. One problem with this approach is that after bodybuilders diet that hard, they need to regain fat. You can’t stay dangerously lean forever, and that’s true whether you’re a meathead or a TikTok girlie.

On social media, reverse dieting is often described as a way of continuing to diet while eating more calories. It’s true that if you’re in a 500 calorie deficit and you’re only adding 50 calories a week, you’ll continue to be in a deficit for a very long time—10 weeks, at that rate. Trexler notes that “this would serve only to delay even the most basic and immediate aspects of recovery, and make [the dieter’s] life unnecessarily difficult.”

Reverse dieting is not a cure for chronic dieting

There are two things going on here, I think. One is relatively harmless. Let’s say you’ve been on a diet and you’re ready to start gaining weight. Instead of eating an extra 1000 calories each day (to go from a 500 calorie deficit to a 500 calorie surplus), you can eat an extra few hundred this week, and add a few hundred more next week, and so on. You’ll be less surprised by changes in your weight (eating more food means there’s more food in your belly, so the scale might tick up a bit just from that) and it may be easier to figure out approximately how many calories you should eat going forward.

But that’s not how it’s being described on social media. Thin women are telling chronic dieters that they can eat more food while continuing to be very thin, if only they follow a strict reverse dieting protocol. But the strictness and the expectations can be damaging on their own.

For an extreme example, check out this video from a registered dietitian and eating disorder specialist. She describes a woman who was getting help for eating disorder recovery. The woman had such a low body weight, with associated health issues, that the dietitian says she “need[ed] to gain weight immediately.” But instead of following guidance from her care team that would have her gaining a pound a week, she secretly put herself on a reverse diet protocol. By adding just 50 calories each week to the too-low amount she was already eating, it took her three months to gain a whole pound of body mass—basically delaying her recovery by three months.

And here’s where I think we need to take a closer look at why reverse dieting posts are so popular in corners of social media that are focused on weight loss. While eating more sounds healthier—it’s a good start!—following a strict reverse diet is just another way of restricting.

Reverse dieting is sometimes just a way to restrict more

Let’s say, as in many of the examples on TikTok, that you are somebody currently eating 1,200 calories (officially a starvation diet) and no longer losing weight. Even if you are a small woman who never exercises—maybe because you don’t have the energy?—a healthy amount of daily calories will likely be 1,600 or more. So you’re supposed to eat 1,250 next week? And then 1,300 the week after that? At that rate, it would take eight weeks to get you up to the number that should be mere maintenance for you. Even if you don’t have an eating disorder, you’re creating the same problem for yourself as the ED patient in the dietitian’s case study.

What’s even more concerning to me is that 50 or even 100 calories is an extremely precise amount. If I’m aiming to eat 2,000 calories a day, maybe some days I’ll have 1,950 and some days I’ll have 2,100. Over time it balances out. But if you’re trying to hit exactly 1,850 and not 1,900 (because 1,900 is next week’s target) you’ll have to track your food meticulously. This is the kind of lifestyle where you’ll be weighing your toast before and after you spread the peanut butter, and you won’t want to eat at a restaurant, because how many calories are in each menu item? What if they’re heavy handed with the sauce?

In my scroll through #reversedieting TikTok, I found women saying that they had to miss out on family meals and deal with concern from their friends during their reverse diet. Clearly, they have not taken a step very far out of diet-land. For these folks, it actually seems like the “reverse” is essentially a way of extending their diet. You could be eating at maintenance for those eight weeks, but you’re restricting instead. And then what? Reverse dieting is often described as a way of increasing your calorie burn so you can diet again.

Even when the influencers show themselves gaining muscle and eating genuinely healthy numbers of calories (assuming that the numbers they cite are true), it’s still all couched in language around leanness and thinness, and features photos of their abs. Prioritizing leanness even while gaining muscle is some backwards-ass shit. It’s okay to not be able to see your abs while you are trying to make yourself bigger. As strongman JF Caron famously put it, “abs is not a thing of power. Is just a sign you don’t eat enough.”

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Obesity Causes Neurodegeneration Similar to Alzheimer’s Disease

January 31, 2023 Admin Leave a comment

A comparison of cortical thickness between the brains of obese patients to those with Alzheimer’s disease. Darker colors indicate similarities in cortical thickness between the two groups. Credit: Filip Morys

Controlling excess weight could lead to improved health outcomes and slow cognitive decline.

A correlation between neurodegeneration in obese people and

Previous research has shown that obesity is linked with Alzheimer’s disease (AD)-related changes, such as cerebrovascular damage and amyloid-ß accumulation. However, to date, no research has made a direct comparison between brain atrophy patterns in AD and obesity.

“Our study strengthens previous literature pointing to obesity as a significant factor in AD by showing that cortical thinning might be one of the potential risk mechanisms.” — Filip Morys

Using a sample of over 1,300 individuals, the researchers compared patterns of grey matter atrophy in obesity and AD. They compared the AD patients with healthy controls, and obese with non-obese individuals, creating maps of grey matter atrophy for each group.

The scientists found that obesity and AD affected grey matter cortical thinning in similar ways. For example, thinning in the right temporoparietal cortex and left prefrontal cortex were similar in both groups. Cortical thinning may be a sign of neurodegeneration. This suggests that obesity may cause the same type of neurodegeneration as found in people with AD.

Obesity is increasingly recognized as a multisystem disease affecting respiratory, gastrointestinal, and cardiovascular systems, among others. Published today (January 31, in the Journal of Alzheimer’s Disease on Jan. 31, 2022, this study helps reveal a neurological impact as well, showing obesity may play a role in the development of Alzheimer’s and dementia.

“Our study strengthens previous literature pointing to obesity as a significant factor in AD by showing that cortical thinning might be one of the potential risk mechanisms,” says Filip Morys, a PhD researcher at The Neuro and the study’s first author. “Our results highlight the importance of decreasing weight in obese and overweight individuals in mid-life, to decrease the subsequent risk of neurodegeneration and dementia.

Reference: “Obesity-Associated Neurodegeneration Pattern Mimics Alzheimer’s Disease in an Observational Cohort Study” by Filip Morys, Olivier Potvin, Yashar Zeighami, Jacob Vogel, Rémi Lamontagne-Caron, Simon Duchesne and Alain Dagher for the Alzheimer’s Disease Neuroimaging Initiative, 31 January 2023, Journal of Alzheimer’s Disease.
DOI: 10.3233/JAD-220535

This study was funded with a Foundation Scheme award to AD from the Canadian Institutes of Health Research, computing resources from Calcul Quebec and Compute Canada, and by a postdoctoral fellowship from Fonds de Recherche du Québec – Santé.

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Weight loss surgery extends lives, study finds

January 28, 2023 Admin Leave a comment

CNN
—

Weight loss surgery reduces the risk of premature death, especially from such obesity-related conditions as cancer, diabetes and heart disease, according to a new 40-year study of nearly 22,000 people who had bariatric surgery in Utah.

Compared with those of similar weight, people who underwent one of four types of weight loss surgery were 16% less likely to die from any cause, the study found. The drop in deaths from diseases triggered by obesity, such as heart disease, cancer and diabetes, was even more dramatic.

“Deaths from cardiovascular disease decreased by 29%, while deaths from various cancers decreased by 43%, which is pretty impressive,” said lead author Ted Adams, an adjunct associate professor in nutrition and integrative physiology at the University of Utah’s School of Medicine.

“There was also a huge percentage drop — a 72% decline — in deaths related to diabetes in people who had surgery compared to those who did not,” he said. One significant downside: The study also found younger people who had the surgery were at higher risk for suicide.

The study, published Wednesday in the journal Obesity, reinforces similar findings from earlier research, including a 10-year study in Sweden that found significant reductions in premature deaths, said Dr. Eduardo Grunvald, a professor of medicine and medical director of the weight management program at the University of California San Diego Health.

The Swedish study also found a significant number of people were in remission from diabetes at both two years and 10 years after surgery.

“This new research from Utah is more evidence that people who undergo these procedures have positive, beneficial long-term outcomes,” said Grunvald, who coauthored the American Gastroenterological Association’s new guidelines on obesity treatment.

The association strongly recommends patients with obesity use recently approved weight loss medications or surgery paired with lifestyle changes.

“And the key for patients is to know that changing your diet becomes more natural, more easy to do after you have bariatric surgery or take the new weight loss medications,” said Grunvald, who was not involved in the Utah study.

“While we don’t yet fully understand why, these interventions actually change the chemistry in your brain, making it much easier to change your diet afterwards.”

Despite the benefits though, only 2% of patients who are eligible for bariatric surgery ever get it, often due to the stigma about obesity, said Dr. Caroline Apovian, a professor of medicine at Harvard Medical School and codirector of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. Apovian was the lead author for the Endocrine Society’s clinical practice guidelines for the pharmacological management of obesity.

Insurance carriers typically cover the cost of surgery for people over 18 with a body mass index of 40 or higher, or a BMI of 35 if the patient also has a related condition such as diabetes or high blood pressure, she said.

“I see patients with a BMI of 50, and invariably I will say, ‘You’re a candidate for everything — medication, diet, exercise and surgery.’ And many tell me, ‘Don’t talk to me about surgery. I don’t want it.’ They don’t want a surgical solution to what society has told them is a failure of willpower,” she said.

“We don’t torture people who have heart disease: ‘Oh, it’s because you ate all that fast food.’ We don’t torture people with diabetes: ‘Oh, it’s because you ate all that cake.’ We tell them they have a disease, and we treat it. Obesity is a disease, too, yet we torture people with obesity by telling them it’s their fault.”

Most of the people who choose bariatric surgery — around 80% — are women, Adams said. One of the strengths of the new study, he said, was the inclusion of men who had undergone the procedure.

“For all-causes of death, the mortality was reduced by 14% for females and by 21% for males,” Adams said. In addition, deaths from related causes, such as heart attack, cancer and diabetes, was 24% lower for females and 22% lower for males who underwent surgery compared with those who did not, he said.

Four types of surgery performed between 1982 and 2018 were examined in the study: gastric bypass, gastric banding, gastric sleeve and duodenal switch.

Gastric bypass, developed in the late 1960s, creates a small pouch near the top of the stomach. A part of the small intestine is brought up and attached to that point, bypassing most of the stomach and the duodenum, the first part of the small intestine.

In gastric banding, an elastic band that can be tightened or loosened is placed around the top portion of the stomach, thus restricting the volume of food entering the stomach cavity. Because gastric banding is not as successful in creating long-term weight loss, the procedure “is not as popular today,” Adams said.

“The gastric sleeve is a procedure where essentially about two-thirds of the stomach is removed laparoscopically,” he said. “It takes less time to perform, and food still passes through the much-smaller stomach. It’s become a very popular option.”

The duodenal switch is typically reserved for patients who have a high BMI, Adams added. It’s a complicated procedure that combines a sleeve gastrectomy with an intestinal bypass, and is effective for type 2 diabetes, according to the Cleveland Clinic.

One alarming finding of the new study was a 2.4% increase in deaths by suicide, primarily among people who had bariatric surgery between the ages of 18 and 34.

“That’s because they are told that life is going to be great after surgery or medication,” said Joann Hendelman, clinical director of the National Alliance for Eating Disorders, a nonprofit advocacy group.

“All you have to do is lose weight, and people are going to want to hang out with you, people will want to be your friend, and your anxiety and depression are going to be gone,” she said. “But that’s not reality.”

In addition, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, a potential failure to lose weight or even weight gain, said Susan Vibbert, an advocate at Project HEAL, which provides help for people struggling with eating disorders.

“How are we defining health in these scenarios? And is there another intervention — a weight neutral intervention?” Vibbert asked.

Past research has also shown an association between suicide risk and bariatric surgery, Grunvald said, but studies on the topic are not always able to determine a patient’s mental history.

“Did the person opt for surgery because they had some unrealistic expectations or underlying psychological disorders that were not resolved after the surgery? Or is this a direct effect somehow of bariatric surgery? We can’t answer that for sure,” he said.

Intensive presurgery counseling is typically required for all who undergo the procedure, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.

“She was older, in her 40s. She had surgery and lost 150 pounds. And then she put herself in front of a bus and died because she had underlying bipolar disorder she had been self-medicating with food,” Apovian said. “We as a society use a lot of food to hide trauma. What we need in this country is more psychological counseling for everybody, not just for people who undergo bariatric surgery.”

Managing weight is a unique process for each person, a mixture of genetics, culture, environment, social stigma and personal health, experts say. There is no one solution for all.

“First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing,” Grunvald said. “That’s my first piece of advice.

“And if you believe your life is going to benefit from treatment, then consider evidence-based treatment, which studies show are surgery or medications, if you haven’t been able to successfully do it with lifestyle changes alone.”

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Midriff bulge linked to later physical decline, study says

January 24, 2023 Admin Leave a comment

Editor’s Note: Seek advice from a health care provider prior to starting a workout program.

CNN
—

If you are a man or woman approaching 50, look down at your middle. If you’re like many people, you might have to lean over a bit to see your feet. Yes, it’s the dreadful midriff bulge — that expanding waistline that can often creep up on you as you age, much like a receding hairline or extra wrinkles.

Tough to combat, it almost seems like a rite of passage, just part of the cycle of life, right? But a new study has found that allowing your middle to expand will do more than send you shopping for the next size up in britches -— it can also harm your physical abilities later in life.

The study, which followed 4,509 people who were 45 years old or older in Norway for over two decades, found participants who had a high or moderately high waist circumference at the start of the study were 57% more likely to be “frail” than those with a normal waistline.

But frailty is not that “tottering” elderly person bent over a cane that comes to mind. Instead, frailty includes a poor grip strength, a slower walking speed, overall exhaustion, unintentional weight loss and low physical activity.

People who were obese at the start of the study, defined as having a body mass index (BMI) of 30 and higher, were also 2.5 more likely to be frail than those with normal BMI (18.5 to 24.9), according to the study published January 23, 2023, in the journal BMJ Open.

There could be several reasons, according to study authors. Obesity leads to an increase in inflammation in fat cells, which can damage muscle fibers “resulting in reduced muscle strength and function,” study coauthor Shreeshti Uchai, a doctoral research fellow in nutritional epidemiology at the University of Oslo in Tromsø, Norway, and her colleagues wrote.

The results highlight the need to stay on top of both overall weight gain and any rise in waist circumference, and to broaden the definition of frailty, the authors concluded.

“In the context where the population is rapidly ageing and the obesity epidemic is rising, growing evidence recognises the subgroup of ‘fat and frail’ older individuals in contrast to viewing frailty only as a wasting disorder,” they wrote.

Exercise can help counter the growing frailty that aging may bring. Adults should perform muscle-strengthening exercises involving all major muscle groups on at least two or more days each week, in addition to exercising at least two hours and 30 minutes per week at a moderate intensity, according to the US Department of Health and Human Services’ physical activity guidelines for Americans.

Reducing body fat and building lean muscle can help improve balance and posture, Dr. Nieca Goldberg, the medical director of Atria New York City and clinical associate professor of medicine at New York University’s Grossman School of Medicine, told CNN previously.

To stay strong and healthy, try to do both aerobics and strength exercises.

They “appear to work together and help each other move toward better outcomes,” said Dr. William Roberts, a professor in the department of family medicine and community health at the University of Minnesota Medical School. “A balanced program of strength and aerobic activity is probably best and probably more closely mimics the activities of our ancestors, which helped determine our current gene sets.”

To get started on strength exercises, CNN fitness contributor Dana Santas, a mind-body coach in professional sports, suggests mastering body-weight movements first before moving on to free weights.

– Source:
CNN
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Try this 10-minute body-weight workout

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The Benefits of Taking Vitamin D Might Depend on Your Weight

January 18, 2023 Admin Leave a comment

Image: Shutterstock (Shutterstock)

The potential benefits of taking vitamin D supplements may be affected by your weight and height, new research suggests. The study found that overweight and obese people taking these supplements experienced a smaller increase of vitamin levels and other related markers relative to those with a lower body mass index.

The study is a reanalysis of the VITAL trial, a large-scale project that tested whether proactively taking vitamin D or marine omega-3 supplements could reduce older people’s risk of developing cancer and cardiovascular disease. The randomized, placebo-controlled trial was led by researchers from the Brigham and Women’s Hospital in Massachusetts, which is affiliated with Harvard University. It overall found no significant effect from either type of supplementation on these outcomes. But some data also indicated that vitamin D supplementation was associated with benefits in those with a BMI lower than 25 (BMI between 18.5 to 25 is considered “normal”), specifically a smaller risk of developing cancer and autoimmune disease, as well as a lower cancer mortality.

To better understand this link, some of the same researchers decided to study blood samples taken from over 16,000 volunteers over the age of 50 involved in the trial. These samples allowed them to look at people’s total vitamin D levels as well as other biomarkers of vitamin D, like metabolic byproducts and calcium, before the study began. About 2,700 of these volunteers also came back for follow-up blood tests two years later.

The team found that people’s levels of vitamin D and these biomarkers generally increased following supplementation, no matter their BMI. But this increase was significantly less pronounced in those with a BMI over 25, the threshold for overweight and obesity. This dampening effect was also seen in people who had low levels of vitamin D at baseline, meaning those who would experience the greatest benefit from supplementation. The team’s findings were published Tuesday in JAMA Network Open.

“We observed striking differences after two years, indicating a blunted response to vitamin D supplementation with higher BMI,” said study author Deirdre Tobias, an associate epidemiologist in Brigham’s Division of Preventive Medicine, in a statement from Harvard. “This may have implications clinically and potentially explain some of the observed differences in the effectiveness of vitamin D supplementation by obesity status.”

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As for why this may be happening, the researchers point to two possible theories. It’s possible, for instance, that higher levels of body fat may allow more vitamin D—a fat-soluble vitamin—to be pulled away from a person’s blood circulation and stored away. Obesity-related liver problems might also make it harder for people to metabolize vitamin D as effectively.

This is only one study, however, and more research will be needed to confirm the patterns seen here. But the authors say that their findings might eventually lead to a reevaluation of the positives and negatives of vitamin D supplementation and how to improve its use for people across the board. People with higher BMI, for example, may need higher doses of vitamin D to achieve the same benefits seen in those with lower body weight.

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Health

Obesity Expert Reveals What You Should Do When Weight Loss Plateaus : ScienceAlert

January 18, 2023 Admin Leave a comment

Anyone who has tried to lose weight will be familiar with these nine frustrating words: the last five kilos are the hardest to lose.

You’re just about to hit your target weight, but suddenly the scales won’t budge – even though you’re still following the same healthy diet, lifestyle habits, and exercise plan.

There’s a scientific basis for why losing the last few kilos is hard, called the weight-loss plateau.

But before you hit Google for one of those programs promising to help you lose the last five kilos, here’s some important information about why it occurs, and five simple things you can do to break through it.

Understanding the weight-loss plateau

The weight-loss plateau is basic biology.

When your body registers something threatening its survival, it automatically triggers a series of physiological responses to protect against the threat.

So when we adjust our diet and reduce our calorie intake, our body registers we’re losing weight and believes it’s under threat. It makes adjustments for protection, reducing our metabolic rate and burning less energy, slowing the rate at which we lose weight.

It also secretes higher levels of an appetite hormone called ghrelin, which is known to increase hunger and promote the conservation of fat stores.

Research has shown this plateau starts to creep in anywhere between three and six months of weight loss, and then typically weight regain occurs. So for those needing to lose a large amount of weight, the plateau will be evident well before the last five kilos.

A weight-loss plateau can be hard to break. Whatever the time frame, it’s a sign your previously successful approach to losing weight needs modification.

Here’s what you can do.

1. Revisit your weight-loss goal

The first and most important thing you may need to modify when you hit a weight-loss plateau is your definition of healthy body weight.

Ask yourself: what’s so special about the weight I’m trying to achieve?

Many people use the body mass index (BMI) to set their weight-loss goal but the number on the scales – and the score generated when you enter your weight and height into the BMI calculator – is nonsense. It doesn’t tell the whole story of what it means to be a healthy weight.

This is because the BMI calculator misses two more meaningful measures: body fat percentage and body fat distribution.

If you’ve been exercising regularly as part of your weight-loss plan, you’ll have gained muscle, or improved your muscle-to-fat ratio, and muscle is heavier than body fat, impacting the number on the scales.

You’re also likely to have changed where fat is distributed in your body, reducing the amount of unhealthy fat stored around the stomach, close to the organs, thus reducing your risk of disease.

So grab the tape measure, check how your clothes fit, and think about how you feel to confirm whether you really need to lose those final few kilos. Work towards a waist circumference of about 80 cm for women and about 90-94 cm for men.

2. Focus on meal size throughout the day

The current fad is intermittent fasting. This often means breakfast is the first to be scrapped from the menu in an attempt to cut calories from the diet and shorten the time you’re allowed to eat throughout the day.

But when you eat and how much you eat at each meal does matter, and it’s breakfast that’s the most important.

Controlled research studies have shown this is the time when your body best uses the calories you put in – in fact, it burns the calories from a meal two-and-a-half times more efficiently in the morning compared with the evening.

Instead of reducing your eating window, load up your breakfast, and reduce the size of your evening meal.

3. Consider more strength-building exercises

Relying on diet alone to lose weight can reduce muscle along with body fat. This slows your metabolism, and makes it harder to keep the weight off in the long term.

Any physical activity will go a long way to preserving your muscle mass, but it’s important to incorporate a couple of days of strength-building exercises in your weekly exercise routine.

Exercises using body weight – like push-ups, pull-ups, planks, and air squats – are just as effective as lifting weights in the gym.

4. Review your food intake

As you lose weight, your body requires less fuel, so reviewing and adjusting your calorie intake is essential when you hit a weight-loss plateau.

Generally speaking, you need to consume 10 percent fewer calories when you reduce your weight by 10 percent, just to maintain the new weight. But this shouldn’t mean deprivation or starvation.

Instead, you should be focusing on an abundance of nutrient-dense foods and keeping the treats and takeaway to just once per week.

5. Check your stress

Stress will derail your weight-loss success. Stress increases your body’s production of cortisol, promoting fat storage and triggering unhealthy food cravings.

The best type of stress management is exercise. To encourage more exercise, take up something you enjoy, no matter what it is. But make sure to include variety, as doing the same routine every day is a sure-fire way to get bored and avoid activity, and can also make it hard to hit your goals.

The bottom line

A weight-loss plateau is frustrating and can derail your diet attempt.

Understanding why the weight-loss plateau occurs, making sure the weight-loss target you’ve set is realistic, and following the steps above will get you back on track.

Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Health

Can Intermittent Fasting Help Combat Youth Obesity?

January 17, 2023 Admin Leave a comment

Parents and doctors are looking for new strategies to help adolescents with obesity. One controversial approach drawing the interest of some families is intermittent fasting, which limits people to eating for just a part of the day or week.

Intermittent fasting has gained traction among adults who use it to try to manage weight and improve health. Doctors have largely avoided trying it with adolescents out of concern that introducing a fasting period to their schedules might result in nutritional gaps or trigger eating disorders when teens are rapidly growing and developing.

Now, a small number of doctors and researchers are evaluating types of intermittent fasting in adolescents, searching for solutions as rates of obesity and Type 2 diabetes rise. One pediatric endocrinologist in Los Angeles is launching a clinical trial looking at eating within a set time window in adolescents with obesity. Researchers in Australia are completing a separate trial, the results of which they expect to publish later this year.

Roughly one-fifth of children in the U.S. are considered obese, according to data from the Centers for Disease Control and Prevention. Pediatricians are so concerned that the American Academy of Pediatrics for the first time this month recommended physicians offer weight-loss drugs for children with obesity.

Any approach that limits when and how an adolescent eats must be handled cautiously, doctors say.

Families and doctors need to be very careful with any form of intermittent fasting in youth as it can be a slippery slope with a potential risk of eating disorders, says

Jason Nagata,

a pediatrician and eating-disorder specialist at the University of California, San Francisco. Doctors have also raised questions about the potential long-term effects of intermittent fasting on developing bodies.

Courtney Peterson,

an associate professor of nutrition sciences at the University of Alabama at Birmingham who studies intermittent fasting in adults, says she would be worried about adolescents’ getting enough nutrients. “I think it’s worth testing but testing with caution,” she says.

Her research has found that adults with obesity who ate between 7 a.m. and 3 p.m. lost on average an extra 5 pounds more than a control group eating over 12 hours or more, and adults with prediabetes who ate over a six-hour period starting early in the day showed improvements in blood-sugar levels.

Intermittent fasting is an umbrella term for eating strategies that involve fasting. One such strategy, time-restricted eating, or TRE, limits eating to a set number of hours a day—often eight—with no limitations on what or how much you eat. In the remaining hours, you refrain from eating or drinking except for water.

Alaina Vidmar,

a pediatric endocrinologist and obesity-medicine specialist at Children’s Hospital Los Angeles, is starting a clinical trial to evaluate whether an eight-hour window of eating, from 11 a.m. to 7 p.m., results in changes in insulin and glucose response for teens with obesity.

The researchers are also looking at weight loss and body-fat mass, as well as blood pressure and cholesterol.

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The research stems from conversations Dr. Vidmar had with families of patients with obesity in recent years. Some had asked her about time-restricted eating, or had tried it and said they liked it. She tested the concept in teenagers with obesity to see if setting an eight-hour window of eating was feasible in a pilot study published in the journal Nutrients in 2021.

“They enjoyed doing it, they felt like their whole family could do it, and over time they were losing weight,” Dr. Vidmar says of the teens.

Now, her lab is enrolling 100 youth between 12 and 21 years old with Type 2 diabetes and obesity in a 12-week trial. Participants are screened and monitored for any negative eating behaviors, she says. So far, she hasn’t found that time-limited eating “impacts eating behaviors or worsens disordered eating in any way,” she says.

In Australia, researchers are studying how teens with obesity respond to a different form of fasting called intermittent energy restriction.

In this approach, for three days a week you eat roughly one-quarter of the calories you normally do, says

Natalie Lister,

a researcher and dietitian at the University of Sydney. On the other four days, you have no calorie limits.

Dr. Lister says she and colleagues started looking into intermittent fasting in adolescents with obesity a few years ago when patients started asking about it. They conducted a pilot trial with 30 adolescents, published in 2019. Now, the researchers are completing a trial whose results they expect to publish later this year.

The health team monitors for eating disorders and depression, and the study doesn’t enroll anyone with a high risk of disordered eating, says Dr. Lister. Dietitians provide guidelines to help ensure participants are meeting nutritional requirements.

In adults with obesity, the data on TRE is mixed when it comes to weight loss, but two systematic reviews of the existing research both found a modest weight-loss benefit overall, says Dr. Peterson. Studies have also found that adults experience improvements in measures such as insulin resistance, reducing blood-glucose levels, particularly when their eating window starts early in the day.

Matthew Muros, a 15-year-old in Carson, Calif., struggles with his weight and prediabetes. Matthew participated in Dr. Vidmar’s pilot studies last year. The first two weeks were challenging, he notes.

“I did feel really hungry. I just kept on drinking water,” he says.

He says it got easier, and when the study was over he decided to stick with the schedule. He has lost about 30 pounds, and his blood-glucose levels have improved.

He has also changed his diet, having less soda, fast food and carbohydrates. “I’m trying to eat a little bit more healthy,” he says.

Write to Sumathi Reddy at Sumathi.Reddy@wsj.com

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The witches selling ‘healing spells’ for cancer and obesity

January 15, 2023 Admin Leave a comment

Self-proclaimed witches, voodoo practitioners and healers are conning ‘desperate’ people out of hundreds of pounds by promising to cure problems like impotency, obesity and even cancer with bogus spells, MailOnline can reveal.

This website found dozens of sellers on websites like the freelance finder Fiverr and online store Etsy advertising a number of quack cures or magic for as much as £150 a pop.

Experts labelled some of the more light-hearted claims as ‘pure fantasy’, while others promising to heal or cure serious diseases like cancer were branded ‘irresponsible’ and ‘dangerous’.

One of the most common health spells found for sale online were those promising to reverse a loss of sex drive or erectile dysfunction (ED).

A seller on Fiverr claimed they can use Ayurvedic medicine, a traditional form of healing in India, to cure cancer, but British experts of the disease said there was ‘no evidence’ for this

Experts have also slammed a seller on Fiverr offering to cure long-Covid with a dubious breathing technique developed in the former Soviet Union

Now deleted posts on online market place Etsy offered to cast spells to increase libido and grow penises, or help people lose weight for over £100

Fiverr user astralhealing offered to use Wiccan magic to help people shed excess pounds for nearly £22

The Japanese therapy that harnesses ‘energy’: What is Reiki and does it really work?

Pronounced ‘ray-key’, Reiki, which means ‘universal energy’ in Japanese, is a type of complementary therapy in which a practitioner puts their hands lightly on or near your body.

It is a Japanese healing art that was developed by Mikao Usui in Japan in the early 20th century.

One of the main aims is to help you relax and ease stress and tension by changing and balancing the ‘energy fields’ in and around your body to help on a physical, psychological, emotional and spiritual level.

Some people with cancer may use Reiki alongside their treatment and some people say they feel better after using therapies such as Reiki.

There are no reports of harmful side effects of Reiki, though there is no scientific evidence to show that Reiki can prevent, treat or cure cancer, or any other disease.

However some healthcare professionals accept Reiki as a complementary therapy which may help lower stress, promote relaxation and reduce pain.

Source: Cancer Research UK

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A particular spell listing, which promised to not only provide a libido burst but also grow a man’s penis, was for sale for £147.65 on Etsy by Alicia Basir, a Brazilian woman who claims to be able to cast magical spells.

‘You will have fast and long-lasting erections. Your member will be admired by all who see it, they will appreciate it big and hard,’ she wrote in post now deleted by Etsy.

At time of writing, the product had been bought at least 40 times according to the reviews.

Ms Basir claims to be a psychic capable of casting magical spells and having trained in practices linked to voodoo, satanism, alchemy and tarot.

On Fiverr, a marketplace for freelancers looking for work, self-proclaimed healer fantastic_magic offers to cure impotency by sending remote healing energy to the buyer.

Those employing his services pay up to £47.48 for seven distant energy projection healing sessions per day for 21 days.

Professor Giulio Garaffa, a consultant at the International Andrology clinic in London, urged men to be cautious about such ‘miracle cures’.

‘Men should be cautious about miracle cures or spells being sold online promising to cure lack of libido or ED,’ he said.

‘Anything that purports to treat a medical conditions and it is not based by scientific research should not be trusted.’

While the spells wouldn’t do any actual harm to the body, because people aren’t actually taking anything, he urged men to seek actual medical help for these issues.

This was because not only are many legitimate medical treatments available, but also because ED can be a symptom of something more serious.

‘Erectile dysfunction may be the only sign of a more serious underlying medical problem, such as cardiovascular disease or hormonal imbalances,’ he said.

Weight loss spells were another regular feature on both websites, with costs ranging from between £4 to £120 per cast.

One seller, astralhealing, who claims to be able to use witchcraft, wrote: ‘Passed down through generations this powerful time tested Wiccan spell can be use to help anyone lose weight, look slim or turn fat to muscle.’

Dr Frankie Phillips, a spokesperson for the British Dietetic Association, the UK’s professional body for dieticians, slammed spell sellers for taking advantage of the vulnerable.

‘It is a complete con to expect miracle cures,’ he said.

‘As a dietitian I know that advice I give is based on solid evidence… not fantasy and myth.

‘Sadly there are no quick solutions…and those making money out of pedalling such claims are preying on vulnerable and sometimes desperate people.’

Nutritionist Kim Pearson also urged people to also avoid wasting money on people promising a quick and easy solution to losing weight.

‘It is important to be wary about “miracle cures” being promoted online,’ she said.

‘It’s worth remembering the old adage “if it sounds too good to be true, it probably is”.’

Both experts urged people interested in losing weight to explore information from reputable organisations or medical experts that recommend a combination of a healthier diet and exercise to tackle obesity.

While most of the spells and alternative therapies will only hurt your wallet, some were criticised for potentially offering people false hope of cancer cures.

Fiverr user amanbhardwajvlo, who claims to be a medical student from India, offers to cure people with cancer using Ayurveda, an alternative medicine of Indian origin that uses a combination of herbal tonics, sometimes containing dangerous metals, yoga, massage and enemas as treatment.

‘I cure people by ayurveda,’ they wrote, adding: ‘I specially full cure of blood cancer.’

Professor Karol Sikora, a world-renowned oncologist with over 40 years experience, told MailOnline while alternative therapies have some merit in making people with cancer feel better, patients can be taken advantage of and misled.

‘Complementary therapy is a valid adjunct to conventional treatment, but this looks like money making nonsense,’ he said.

‘Getting cancer patients heads around their illness and its treatment is really important but giving the impression that they can cure cancer is very dangerous.’

Self-proclaimed healer fantastic_magic offerd to cure impotency by sending remote healing energy to the for 21 days at the price of just over £48

Some healers on Fiverr offer to send waves of healing energy over great distances using Reiki a Japanese alternative medicine for £10 a week

Professor Edzard Ernst, chair of complementary medicine at the University of Exeter, also slammed the advertisement.

‘The claim that Ayurvedic medicine cures cancer is not merely unsupported by evidence, it also is irresponsible and dangerous,’ he said.

He also said the plethora of remote Reiki healers on Fiverr promising to send healing energy over distances was ridiculous.

‘There is no reliable evidence that Reiki is effective for any condition; the notion that it should work online is absurd,’ he said.

Reiki is an ancient Japanese technique for stress reduction, relaxation and healing.

Healers claim they do this by channelling energy through their palms into patients, though some claim to be able to send this force without physically touching the recipient and even if separated by great distances.

The practice is said to be popular among several Hollywood stars, including Gwyneth Paltrow, Cameron Diaz and Angelina Jolie.

Some Fiverr Reiki healers, like Colorado-based reikichristy, sell their services for up to £50 for five weeks of ‘continuous’ healing energy.

Professor Ernst also criticised one seller, who went by the name Vanessa, who promised to ease symptoms of long Covid with ‘Buteyko Breathwork’.

Buteyko is a name given to a breathing technique developed in the 1950s Soviet Union to help alleviate asthma by reducing the amount of carbon dioxide in the body.

The NHS says there is no evidence it works for asthma and Professor Ernst said the same was true for long Covid.

‘The notion that Buteyko breathing helps patients suffering from long Covid is pure fantasy and not backed by evidence,’ she said.

Long Covid is a poorly understood condition where for some people infected with virus continue to suffer with ongoing symptoms after 12 weeks.

Etsy removed the posts after being alerted to them by MailOnline, saying they were in violation of its policies.

A spokesperson for the company said: ‘We take the safety of our marketplace very seriously.’

However, they added that Etsy ‘is not a curated or juried marketplace’ and that ‘prohibited item may appear for sale on the site before our enforcement teams have a chance to remove it’.

A spokesperson for Fiverr said the posts brought to their attention were now being removed as per their community guidelines forbidding sellers seeking to ‘provide medical treatment, advice, or supply’.

They added: ‘We take swift action to ensure any illegitimate gigs are blocked and we continue to actively monitor the site to catch and remove any services that may get through our filters.’

The spokesperson added they have launched an investigation into how the posts had made it through Fiverr’s filtering system.