Tag Archives: Weight loss

Health

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

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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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Health

‘Reverse Dieting’ Is Not a Weight Loss Cheat Code

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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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Health

Influencer shares recipe for ‘low calorie fluff bowl’

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Dessert that won’t ruin your diet! Influencer shares recipe for viral 200-calorie fluff bowl – and you need just four ingredients

By Elmira Tanatarova For Mailonline

Published: | Updated:

An influencer has shared a recipe for a ‘low calorie fluff bowl’ to satisfy a sweet tooth in the evenings – and you only need four ingredients to make it.

British fitness TikToker Hayden Rolfe went viral with his delightful-looking, creamy dessert bowl, racking up more than 2.5 million views.

All you need to achieve the voluminous, velvety treat is to mix 50ml of unsweetended almond milk, with 150g of frozen strawberries, a handful of ice and a scoop of protein powder in a food processor for five minutes.

Hayden recommended topping it with a sprinkle of your favourite cereal for added crunch. 

Hayden says the whole bowl is under 200 calories, making for a perfect evening treat to satisfy a craving.

However, commenters appeared torn, with some excited to sample the snack, whereas others claimed almond milk ‘tastes like death’.

‘Oh I need to save this video,’ one poster gushed. 

‘Can’t wait to try this out,’ another added. ‘Thank you.’

British fitness TikToker Hayden Rolfe went viral with his delightful-looking, creamy dessert bowl, racking up more than 2.5 million views

All you need to achieve the voluminous, velvety treat is mix 50ml of unsweetended almond milk, 150g of frozen strawberries, a handful of ice and a protein scoop of your choice

Hayden says the whole bowl is under 200 calories, making for a perfect evening treat to satisfy a sweet craving

Elsewhere, snackers questioned Hayden’s methods, wondering whether the lush texture was down to his kitchen gadgets or products.

‘Do you think it’s the food processor that makes it fluffy?’ someone asked. ‘When I do this in my Vitamix it’s nice but doesn’t fluff.’

It’s worth noting, however, that putting ice in the food processor is not usually recommended because it can dull the blades – and recipes with ice are usually a task for the blender. 

A commenter also wondered: ‘Which protein are you using? I think some work better than others. Yours looks great.’

One sampler had a whole new twist on the recipe altogether, making a similar concoction in a CREAMi ice cream maker.

An influencer has shared a recipe for a ‘low calorie fluff bowl’ to satisfy a sweet tooth at night – and you only need four ingredients to make it

However, commenters appeared torn, with some excited to sample the snack, whereas others claimed almond milk ‘tastes like death’

However, not everyone was as enchanted by the fruity pink delight. 

‘Looks like that stuff everyone always accuses Macdonald’s of making their nuggets out of,’ one concerned foodie wrote.

‘And then..you regret the decision, throw it away and go buy ice cream,’ another added.

A third remarked: ‘Me eating a 100g Toblerone bar in one sitting atm.’ 

Hayden has more than 26,600 followers on TikTok and, alongside Ryan Smith, runs Online Nutritional Education (O.N.E), which aims to help guide people on weight loss and fitness goals in a healthy and sustainable way.

How to make Hayden Rolfe’s ‘protein fluff bowl’ 

TikToker Hayden Rolfe (@hayden_rolfe) shared how you can make the tasty snack to satisfy a sweet tooth, racking up 2.5 million views.

What you’ll need:

  • 50 ml unsweetened almond milk
  • 150 g frozen strawberries
  • Handful of ice
  • Scoop of protein powder
  • Cereal of your choice (optional)

To make the light snack, simply mix the ingredients together in a food processor for five minutes. 

TikToker Hayden Rolfe (@hayden_rolfe) shared how you can make the tasty snack to satisfy a sweet tooth, racking up 2.5 million views

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Health

Personal trainer: These are the signs you have a slow metabolism and quick ways you can boost it 

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A personal trainer has shared the 13 signs you have a slow metabolism, and how you can boost yours to achieve your goal weight fast.

Rachael Attard, from Sydney, said while you might not think about it, metabolism has a ‘huge impact on our health’, particularly when it comes to weight loss and gain.

‘Simply put, metabolism is the internal process by which your body expends energy and burns calories,’ Rachael wrote on Instagram.

‘It works 24/7 by converting the food and nutrients you consume into energy.’

Rachael said some of the factors that can impact your metabolism include your genes, hormones, lack of sleep, diet, dehydration, age, stress and the medications you’re taking.  

A personal trainer has shared the 13 signs you have a slow metabolism, and how you can boost yours to achieve your goal weight fast (Rachael Attard pictured)

Rachael (pictured) said some of the factors that can impact your metabolism include your genes, hormones, lack of sleep, diet, dehydration, age, stress and medications you’re taking

Some of the most common signs your metabolism is low include chronic fatigue and low energy, not feeling hungry in the morning and weight gain for no apparent reason.

Those with a slow metabolism might also experience constipation, depression, thinning hair, dry skin and brittle nails, as well as brain fog, hair loss and feeling cold all the time.

‘Other common signs frequent headaches, a low pulse rate and constant cravings for sugar and carbohydrates,’ Rachael said.

Signs of a slow metabolism

1. Chronic fatigue

2. Low energy

3. Not feeling hungry in the morning.

4. Weight gain for no apparent reason.

5. Constipation

6. Depression.

7. Thinning hair, dry skin and brittle nails 

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Signs of a slow metabolism 

8. Brain fog

9. Hair loss.

10. Feeling cold all the time

11. Frequent headaches

12. Low pulse rate

13. Constant cravings for sugar and carbs 

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But you can address your metabolism – and the PT uses a few simple ‘tried and tested tricks’ to give hers a boost, like eating a protein-rich breakfast (pictured)

But you can address your metabolism – and the PT uses a few simple ‘tried and tested tricks’ to give hers a boost, particularly after the holiday season, when you might be feeling sluggish from over-eating and drinking.

The first thing Rachael said she does is she will have a hot cup of water and lemon.

‘Lemons are a great way to boost your metabolism, because they are high in vitamin C and antioxidants, which help your immune system,’ Rachael wrote on her website. 

She said if you want to up the metabolism kick even more, you can add some cayenne pepper and ginger, which will help to promote a healthy digestive system, ‘making it easier for your metabolism to power through calories’.

Rachael (pictured) also recommends drinking a cup of warm water with lemon and making your regular water is icy cold

Next, the fitness pro always recommends that you drink icy cold water, as studies have shown this can help your metabolism.

‘By drinking cold water, your body has to work harder and burn more calories to process it. The study mentioned above found that you can burn 25 per cent more calories just by drinking cold water,’ Rachael said.

You can also still enjoy your cup of coffee, as studies have also shown that coffee and green tea also help with your metabolism – leading to more calories burned through the day.

Finally, Rachael (pictured) said increasing your muscle mass will work wonders at boosting your metabolism, and this comes from lifting weights

‘There are some foods that naturally increase your metabolism and protein is one of them,’ Rachael said. 

‘Your body burns lots more calories digesting protein than it does compared to fat and protein.’

For this reason, she recommends a protein-rich breakfast like healthy protein smoothies, yoghurt or eggs, taking care to limit sweeteners.

Finally, Rachael said increasing your muscle mass will work wonders at boosting your metabolism.

She said the amount of calories you burn per day is made up of three things:

‘First, it’s your resting (or basal) metabolic rate – so how many calories you burn at rest,’ she said. 

‘Then, it’s Thermogenesis – how many calories you burn through digestion (this sort of falls under the resting metabolic rate category).

‘Finally, it’s your physical activity – so how many calories you burn during exercise.’ 

But it’s the resting or basal metabolic rate (RMR or BMR) that makes up 60 to 85 per cent of your daily calories burned, and the only way to increase that is to boost your muscle mass.

The PT recommends you do this by lifting some weights at the gym or adding some resistance training into your workouts. 

For more information about Rachael Attard, you can visit her website here. 



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Houston patients struggle to find Ozempic as popularity for weight loss drugs skyrockets across social media

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HOUSTON – The drug Semaglutide was initially marketed under the name Ozempic to manage type two diabetes. Last year, Semaglutide was approved by the FDA to be used for weight loss under the name Wegovy.

Social media has nicknamed them “skinny pens” because they help people drop significant weight quickly, leading to the popularity and a shortage of both Ozempic and Wegovy.

The drug manufacturer Novo Nordisk confirms it’s struggling to meet demand and Houston patients, like Lauren Luman, say she doesn’t know what she’ll do.

“I reached out to my doctor again letting them know that I was still experiencing that shortage, at that time they were able to give me some more samples, but they said, ‘We’re not sure how long we’re going to continue to have the samples available,’” Luman said.

Ozempic helped Luman lose weight and control her blood sugar. Now, she says she’s getting the same answer at every pharmacy she visits.

“It’s been weeks or months since they’ve had any supply,” Luman said.

Endocrinologists have said they’re frustrated patients cannot find their medication. However, endocrinologist Dr. Disha Narang, suggests there’s a need for successful weight loss drugs on the market.

“Our nation is, you know, there’s an epidemic of obesity as well and we need to treat the obesity to prevent diabetes in the first place,” Dr. Narang said.

Doctors are not doing anything wrong by prescribing Ozempic for obesity. According to the FDA, healthcare professionals can choose to prescribe drugs off-label when medically appropriate.

“Its intended use is for it to be an anti-diabetic prescription,” Luman said. “So, if people are taking it just for the sake of weight loss, I feel like maybe they should step back and allow the people that have type two diabetes and really need it to lower their A1C the ability to get this prescription.”

According to one study, the weight loss may return once the patient discontinues use.

Copyright 2023 by KPRC Click2Houston – All rights reserved.

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Experts Recommend Drugs, Surgery for Teen Obesity in New Guidelines

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Image: Shutterstock (Shutterstock)

For the first time ever, experts with the American Academy of Pediatrics are recommending proactive medical intervention against childhood obesity. The organization’s new guidelines will no longer ask doctors to simply observe or delay treatment in children with obesity, defined as a body mass index over 30. They instead now emphasize a range of options, such as dietary and lifestyle counseling for younger children as well as medications and/or surgery for children 12 and over.

Past standards for treating childhood obesity have called for “watchful waiting,” the hope being that a child’s BMI (a measure of both weight and height) would naturally lower over time as they grew. In 2007, the AAP’s previous recommendations promoted a step-based approach, where doctors might slowly escalate from observation to treatment. But these new recommendations—released Monday—are the first clinical practice guidelines to put obesity treatments front and center.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” said Sandra Hassink, one of the authors behind the guidelines and vice chair of the AAP Clinical Practice Guideline Subcommittee on Obesity, in a statement released by the organization. “The goal is to help patients make changes in lifestyle, behaviors or environment in a way that is sustainable and involves families in decision-making at every step of the way.”

The lengthy guidelines outline a multitude of available treatments, depending on a child’s age and other circumstances (children under 2 are not considered eligible for obesity treatment).

For younger children, these options can include intensive health behavior and lifestyle treatment, which can involve regular counseling sessions with the child and family over a 3- to 12-month period. For children 12 and over, doctors are now advised to consider medications as a front-line option. And teens 13 and over can also be evaluated for bariatric surgery as a potential treatment.

In crafting its recommendations, the AAP cites many studies suggesting that the benefits of these treatments outweigh any potential risks they can carry. Patients who have undergone bariatric surgery seem to have a lower risk of developing obesity-related complications such as type 2 diabetes and have a longer life expectancy when compared to non-surgical patients matched in age and baseline BMI, for instance. Long-term health benefits have been seen in teen bariatric patients specifically, too.

A new class of medication, called incretins, has also greatly changed the landscape of obesity treatment in recent years. These drugs, combined with diet and exercise, have led to far larger weight loss on average than most other treatments and are approaching the typical results seen with bariatric surgery.

Last month, the Food and Drug Administration extended the approval of Novo Nordisk’s Wegovy, the first drug of this new generation, to children over 12, following clinical trial data showing that teens saw a similar improvement in BMI as adults. The shortages that have plagued Wegovy’s rollout since its approval in June 2021 may finally be over as well, with the company recently announcing that its supply should now be stable. Without insurance coverage, which is often limited, the drug can still cost over $1,000 a month, however.

The AAP’s guidelines arrive at a time when the rise in U.S. obesity rates, including among children, has only accelerated, likely in part due to the covid-19 pandemic. The new recommendations notably do not cover how best to prevent obesity in children, though the organization has promised to release separate recommendations for that in the near future.

“The medical costs of obesity on children, families and our society as a whole are well-documented and require urgent action,” said lead author Sarah Hampl in a statement. “This is a complex issue, but there are multiple ways we can take steps to intervene now and help children and teens build the foundation for a long, healthy life.”

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Health

Skip breakfast and you can enjoy one of these delicious feasts while seeing the pounds fall off…

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Anyone who has struggled to lose a few pounds might be sceptical that you can enjoy smashed avocado, fried halloumi, ­kedgeree, or a chorizo omelette for brunch each day and still lose up to 2kg a week.

But on my new Fast 800 keto plan, you absolutely can.

That’s because, by keeping a close track on the latest research, and liaising with top nutritional ­scientists, I have fine-tuned my approach to weight loss. I have ­created a clever three-stage process which promises rapid results and sustained slenderness, while eating good ­quantities of real food.

If you want to lose quite a few pounds rapidly (which studies have found to be highly motivating and the best way to tackle type 2 ­diabetes), why not skip breakfast and start your day with one of these ­substantial brunches at midday?

Dr Michael Mosley has combined the best elements of both his Fast 800 and 5:2 diets to turbo-charge your weight loss. In an exclusive extract from his wife Dr Clare Bailey’s new book he reveals all (pictured together) 

There’s compelling science behind the health and weight-loss benefits of ‘time restricted eating’ (which means crunching your meals into a 12, ten or even eight-hour window).

Combine this with restricting calories to 800-900 a day to mimic fasting and you end up with an extremely healthy, but powerfully effective weight-loss plan. It encourages the body to go into ketosis, a natural state where you burn fat for fuel.

Breaking your nightly fast with one of these healthy, protein-rich dishes will also keep hunger at bay for longer. And you can follow that with an evening meal of piri-piri chicken, turkey burgers or sausage casserole and you can — if you follow the rules carefully — still find room for a chocolate peanut butter cookie, as long as you keep to a daily intake of 800-900 calories.

The science of weight loss has moved on a lot since the days of ­cabbage soup, lemon juice, social isolation and boring abstinence.

What’s so impressive about the recipes created by my wife, Dr Clare Bailey, working closely with Kathryn Bruton, is that they have been carefully calibrated to meet the requirements of my weight-loss plan.

All are based on the proven super-healthy principles of the Mediterranean diet. 

By keeping a close track on the latest research, and liaising with top nutritional ­scientists, I have fine-tuned my approach to weight loss

There’s compelling science behind the health and weight-loss benefits of ‘time restricted eating’

The science of weight loss has moved on a lot since the days of ­cabbage soup, lemon juice, social isolation and boring abstinence

They are high in protein (known to keep your muscles strong and to keep hunger at bay), low in ­carbohydrates (so your body can easily hit a turbo-charged fat-­burning keto button) and carefully ­calorie counted, too.

For a slow-but-steady route to weight loss, intersperse your 800-900 calorie ‘fast days’ with more relaxed ‘non-fast’ days (following a 5:2 or 3:4 ­pattern of intermittent fasting). You can still use these ­recipes, but increase the ­portion sizes and add healthy carbs such as ­wholegrain bread or noodles, brown rice or starchy veg.

Find recipe videos and tips on Instagram #drclarebailey

MEDICAL NOTE: Rapid weight loss does not suit everyone. If you are frail, have a significant underlying medical condition, are on insulin, have type 2 diabetes and are on medication, are on blood pressure medication, have moderate or severe retinopathy, or have epilepsy or gallstones, or are pregnant or breastfeeding, please talk to your doctor before going on this diet. It is not suitable for teenagers, people with a history of an eating disorder, a psychiatric illness, or if unwell, underweight or doing endurance exercise.

Extracted by Louise Atkinson from The Fast 800 Keto Recipe Book by Dr Clare Bailey, Kathryn Bruton and Dr Michael Mosley, published by Short Books @ £18.99

Join the Fast 800 online programme with your free trial today at thefast800.com

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Health

Exercise won’t help you lose weight, says top diet expert

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 Exercising won’t help you lose weight on its own, one of the country’s leading experts has sensationally claimed.

Professor Tim Spector, a prolific dietary researcher and author, accepted that working out is ‘great’ for your overall health, especially your heart.

He even insisted that ‘we should all do it’.

But in terms of losing weight, Professor Spector argued that exercise was ‘no use on its own’. It goes against advice from health agencies across the planet who state that it is ‘key’ in beating the bulge.

Professor Spector acknowledged that while exercise as it is ‘great for your health’ and ‘fantastic for your mood’, you should not exercise alone if ‘your goal is weight loss’

Professor Tim Spector (pictured above) said that exercise has been ‘grossly exaggerated as an easy fix for our obesity problem’

 Exercise – of any kind – actually plays ‘very little role in weight loss’, he stated on Steven Bartlett’s podcast The Diary of a CEO.

Professor Spector, who trained as an epidemiologist and gained fame for tracking Covid during the pandemic, said: ‘All the long-term studies show it doesn’t help weight loss…

‘It’s been grossly exaggerated as an easy fix for our obesity problem.

‘All the studies show that.

‘The only caveat to that is if you have changed your diet, improved your diet and lost some weight, maintaining some exercise does prevent it going back up again.

‘But on its own, if you don’t change your diet, it’s no use and that’s well known now by all obesity experts and the studies.’

He added: ‘It’s great for your health, I exercise. It’s fantastic for your mood, it’s great for your heart.

‘We should all do it, but absolutely not if your goal is weight loss.

‘That’s a huge myth, particularly perpetuated by gyms and fitness apps. It is complete nonsense,’ he said.

Professor Spector’s comments go against some of the most-trusted health advice. ‘Being active is key to losing weight and keeping it off,’ the NHS says.

It adds that eating fewer calories will help you lose weight but keeping the flab off permanently ‘requires physical activity to burn energy’.

A calorie is a way of measuring energy — either the amount contained in food or the amount burnt through activity.

People put on weight when they consume more calories than they burn off through daily activities. To lose weight, more calories need to be used than those taken in.

As a result, limiting calories – or exercising more – are the first steps for many seeking a svelte physique.

Speaking on the same podcast, Professor Spector advised that people wanting to lose weight simply look at changing their diets.

He said calorie counting, although effective in the short-term, was ‘complete nonsense’ because most people who adhere to the tedious regime ‘bounce back’.

Instead, he advised eating more plant-based foods, doing so within a 10-hour window and avoiding ultra-processed items.

Official guidelines suggest adults should get 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week spread over four to five days.

Examples of vigorous exercise include running, swimming, skipping and walking up stairs.

Similar advice – which also includes muscle-strengthening exercises on two days a week – exists in the US.

A lack of exercise, combined with unhealthy diets, have been blamed for growing obesity epidemics across the world.

Two-thirds of British adults are overweight, with more of us predicted to grow fatter in the future. Rates are even higher in the US.

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How should people lose weight? 

Professor Tim Spector, an expert in nutrition, said some people can lose weight in the short term by limiting their calorie intake. But almost all ‘bounce back’ to their original weight and ‘many go above it’, he claimed.

He argued the approach — advocated by the NHS as one way to lose weight — is a ‘giant camouflage’ that keeps people focused on calories rather than the quality of what they’re eating.

Professor Spector shared his three tips for those looking to reach their healthiest weight:

Avoid ultra-processed foods

Ultra-processed foods are foods that have undergone industrial processing and look nothing like the original foods they come from.

They typically contain a lot of added salt, sugar, fat, and other chemical additives.

Researchers have found that people who ate an ultra-processed diet consumed an extra 300 calories a day more than people who ate a minimally processed diet.

Tip: If you ever want to see how processed something is, look at how many ingredients there are. Generally speaking, the more ingredients, the more processed.

Try time-restricted eating

Eat all your meals in a window of ten hours, and then fast for 14 hours, most of which happens overnight whilst you sleep. Like us, our gut microbes also need to rest and recuperate so we can give time for the gut lining to repair. Our results from the ZOE Health Study showed this almost immediately reduces any snacking from your diet and more importantly, stopped people from snacking late at night – the worst kind of snack for our health.

Tip: Skipping breakfast or delaying it by a few hours is the easy way to lengthen your fast.

Eat 30 plants each week

Rather than focusing on the number of calories, focus on the number of plants a week.

For people trying to lose weight, I’d recommend eating a diversity of different foods. 30 plants a week is something we should all be aiming for to improve our gut health.

Tip: Remember a plant isn’t just fruit and veg, it’s also nuts, seeds, herbs and spices so it’s easier than it looks.

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Entertainment

1000-lb Sisters star Tammy Slaton, 36, shows off her new look

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Tammy Slaton, from TLC reality show 1000-lb Sisters, has revealed her drastic weight loss after being admitted into a food rehab center. 

The TV star, 36, left fans shocked after she showed off her new look now that she’s shed pounds, prompting fans to praise her for how ‘amazing’ she looks. 

In a viral video posted to TikTok, Tammy appeared to be noticeably slimmer as she seems to have shed off a huge amount of weight. 

In the video, Tammy only shows her face and lip-syncs to holiday song Where Are You Christmas?, captioning the clip: ‘I know Christmas is over but I thought this was funny/cute.’ 

Tammy Slaton, from reality show 1000-lb Sisters, has revealed her weight loss

The reality star, 36, left fans shocked after she showed off her new look

The reality star’s comments section was quickly flooded with messages from fans who congratulated her on her weight loss journey.

Last month, Tammy – who previously revealed she was pansexual -married her partner, Caleb Willingham, during an intimate ceremony, surrounded by only family and loved ones.  

The lovebirds tied the knot at the Windsor Lane Rehabilitation Center in Ohio, which is where they initially met while both seeking treatment. 

The reality star raised concerns among fans in March after her TikTok account seemed to have been deactivated once she was rushed to the emergency room. 

Tammy had been taking her fans along with her on her weight loss journey through her social media as she received treatment at the rehabilitation center.

But when fans noticed her social media account was displaying an error message at the same time she was sent to the hospital and placed on a ventilator after she stopped breathing, they panicked.  

Last month, Tammy married her partner, Caleb Willingham, during an intimate ceremony, surrounded by only family and loved ones

The reality star (pictured after weight loss) raised concerns among fans in March after her TikTok account seemed to have been deactivated once she was rushed to the emergency room

The terrifying ordeal was featured on the TV series, with her sister Amanda saying: ‘They’re just telling us that her lungs have given up, and like her body is shutting down’

While at the hospital, Tammy underwent a tracheotomy – a surgical produce where doctors make an incision on the neck and place a breathing tube into the trachea. 

The following days were filled with many ups and downs for Tammy and her family as medical experts told the reality star’s family she may not be survive. 

The terrifying ordeal was featured on the season three finale of the reality TV series, with Tammy’s sister Amanda telling the cameras: ‘They’re just telling us that her lungs have given up and like her body is shutting down. 

‘So at this point, we’re facing making funeral arrangements for my little sister […] She’s been in such a bad place for so long.

‘She waited too long. And now that she has the courage to step out and get the help that she needs, now this.’

The reality star’s fans gushed over her new appearance as they said she looked ‘so happy’ following her weight loss

When filming the show the sisters weighed a combined total of 1,000 pounds and were told they needed to lose weight to undergo additional weight loss surgery. 

During the series, Tammy weighed a total of 605 pounds, and she had to move in with her sister and brother-in-law after her last hospital stay because she needed help with everyday tasks. 

Now, Tammy has lost a significant amount of weight and seems to have less health problems as well.  

Tammy’s breathing tube is still visible in many of her social media posts as the star continues to seek treatment and continue with her weight loss journey. 

The reality star’s fans gushed over her new appearance as they said she looked ‘so happy.’ 

One user said: ‘Tammy, you’re looking great!’

Another user added: ‘You look so beautiful!’ 

‘You look amazing. It’s great to see you so happy,’ someone else wrote. 

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Health

Worrying signs that your fatty liver is getting worse | Health

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Fatty liver often appears harmless and has rarely any symptoms in the initial stages. It all starts with a build-up of fat in liver that is not broken down properly due to consuming too many calories or diseases like diabetes, high cholesterol among others. In the initial stages, there is hardly any inflammation of damage to the liver and many people may not reach advanced stages of fatty liver disease where the risks of liver cirrhosis and liver cancer goes up. Fatty liver in many people goes undiagnosed in the early stages because it’s most asymptomatic. However, as the disease progresses one may start to notice yellowing of skin, dull ache in the lower right side of the ribs, swelling in abdomen, legs, weight loss among many other symptoms. (Also read: 8 fruits you must eat to reverse fatty liver disease)

“Fatty liver is on the rise due to lifestyle and diet changes. A sedentary lifestyle and excess intake of processed and high-calorie diet are some of the major causes of this condition. Though alcohol tops the chart as an etiology for fatty liver, non-alcoholic fatty liver is equally on the rise due to this,” says Dr Amol Dahale, Consultant, Gastroenterology, Manipal Hospitals, Baner-Pune.

“Mostly detected in asymptomatic patients, few people can develop symptoms like upper abdominal pain, nausea, fatigue, decreased appetite even jaundice in a few cases. Though look benign initially, few people develop cirrhosis and even liver cancer which can be fatal,” says Dr Dahale.

Dr. Pratik Tibdewal, Consultant Gastroenterologist, Wockhardt Hospitals, Mira Road explains in detail the four stages of fatty liver disease and when should one start worrying.

FIRST STAGE: NO RED FLAGS

There are four stages of Non-Alcoholic Fatty Liver Disease (NAFLD) which determine the progression of the disease. The first stage is simple fatty liver or steatosis. This happens when the liver cells start to build-up fat, but without inflammation or scarring at this stage. There are no red flags in this stage and a large number of people don’t even know they have fatty liver. Not everyone with fatty liver will get non-alcoholic steatohepatitis (NASH) which is the second stage.

SECOND STAGE: INFLAMMATION

The second stage of NAFLD is non-alcoholic steatohepatitis (NASH). Here, there is a build-up of fat in the liver cells along with inflammation as the liver is repairing damaged tissue. If the damaged tissue is more then there can be scarring of the liver leading to fibrosis

THIRD STAGE: FIBROSIS

The third stage of NAFLD is fibrosis. It is seen when the scar tissue is there in the liver and in the blood vessels around the liver. Thus, treating inflammation may prevent further progression or even reverse some of the damage. However, if not tackled at the right time, it can lead to cirrhosis.

FOURTH STAGE: CIRRHOSIS

The fourth stage of NAFLD is cirrhosis. At this stage, the liver will completely stop working and there can be signs and symptoms such as yellowing of the skin and a dull ache in the lower right side of the ribs and one will suffer from liver damage which can lead to Ascites (abnormal swelling), leg swelling, bleeding from vomiting or altered consciousness which will require hospitalisation and may require a liver transplantation.

Dr Shankar Zanwar Consultant Gastroenterologist, Wockhardt Hospital, Mumbai Central shares fatty liver danger signs that nobody should ignore.

– If the patient starts getting fatigue in activities which are not usually tiresome

– Loss of desire to eat food

– Yellowish discolouration of eyes and urine

– Fullness of abdomen typically due to fluid accumulation

– Blood vomiting

– Black coloured stools

– Leg swelling

– Weight loss

– Abnormal mental activity in form of disturbed sleep and wake cycle, irrelevant talking, disorientation

– Easy bruisability meaning bleeding under skin with trivial injuries

“As the dictum goes that prevention is better than cure, early diagnosis and treatment can lead to a complete reversal of the disease. Today with the availability of multiple detection tools like ultrasound, fibro scan, blood tests, early diagnosis is possible. Regular exercise, dietary and lifestyle changes along with medicines can help us to cure fatty liver,” says Dr Dahale.

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