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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”. As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”. We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out. Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise. <h2>How does it work?</h2> Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better. GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars. GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating. <iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe> GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action. Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more. GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection. <h2>What can users expect? What does the research say?</h2> Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly). A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs. Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up. Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>. Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up. <h2>Who is eligible for semaglutide?</h2> Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes. However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use. The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia. When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications. <h2>What else do you need to do during Ozempic treatment?</h2> Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials. Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week. STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling. A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>. <h2>But what are the side effects?</h2> Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain. In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos. More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions. To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term. Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.

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Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs. As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns. But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug. <h2>Potential benefits</h2> 1) It’s likely to help you lose weight The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity. The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight). In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg. Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication. 2) It may reduce your chronic disease risk factors When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases. In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels. In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels. 3) It might improve your quality of life, emotional wellbeing or sense of achievement The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health. Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image. <h2>What about the risks?</h2> 1) You may experience gastrointestinal symptoms In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%). In the UK study, nausea and diarrhoea were also commonly reported. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living. Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study. 2) You might feel fatigued Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants. 3) You might be among the minority who don’t tolerate the drug Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia. In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing. More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period. A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period. Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions. 4) It might be difficult to access Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024. To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication. 5) You might not always get clear information from vested interests Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>. Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications. <h2>Bottom line</h2> Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.

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Rebel Wilson's shocking weight loss confession

Rebel Wilson has confessed to using Ozempic to maintain her weight after dropping almost 40kgs in her "year of health" in 2020. While speaking to the Sunday Times about the release of her memoir, Rebel Rising, the Aussie actress confessed to using the drug, which is used to treat type 2 diabetes. The 44-year-old has previously referred to 2020 as her "year of health" after she lost a staggering amount of weight, and has now finally admitted to using Ozempic, but only to maintain her weight. She said, "Someone like me could have a bottomless appetite for sweets, so I think those drugs can be good." Rebel went on to clarify that she is no longer taking the drug, and is happy with her weight. The actress shared how wanting to have a baby kick-started her dramatic weight loss in 2020, but not everyone was happy about her plans for a drastic transformation. "Basically no one apart from my mum wanted me to lose weight," Wilson recalled. "People thought I'd lose my pigeonhole in my career, playing the fat funny character, and they wanted me to continue in that." Over the past four years, Wilson has admitted to gaining some of it back including 20lbs from "stress eating" leading up to the release of her book, with Covid lockdowns also playing a part in her fluctuating weight. "I know that my relationship with food is complicated," she said. "I feel strongly that young women shouldn't try to obsess over looking like Victoria's Secret models — they should just look like themselves." Image credits: Getty Images

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How much weight do you actually need to lose? It might be a lot less than you think

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> If you’re one of the <a href="https://www.finder.com.au/new-years-resolutions-statistics">one in three</a> Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards. But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers. Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range. Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight. Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits. <h2>Using BMI to define our target weight is flawed</h2> We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio. BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening. But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">because</a> it: <ul> <li> fails to consider two critical factors related to body weight and health – body fat percentage and distribution </li> <li> does not account for significant differences in body composition based on gender, ethnicity and age. </li> </ul> <h2>How does losing weight benefit our health?</h2> Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways. 1. Reducing cholesterol Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy. Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987606/">research</a> shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss. 2. Lowering blood pressure Our blood pressure is considered high if it reads more than 140/90 on at least two occasions. Excess weight is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">linked to</a> high blood pressure in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">several ways</a>, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure. Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke. Like the improvements in cholesterol, a 5% weight loss <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21358">improves</a> both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number). A <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000094221.86888.ae">meta-analysis of 25 trials</a> on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point. 3. Reducing risk for type 2 diabetes Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat). Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels. Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system. <a href="https://www.nejm.org/doi/full/10.1056/nejmoa012512">Research</a> shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%. 4. Reducing joint pain and the risk of osteoarthritis Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis. <a href="https://pubmed.ncbi.nlm.nih.gov/21425246/">Observational studies</a> show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold. Small amounts of weight loss alleviate this stress on our joints. <a href="https://pubmed.ncbi.nlm.nih.gov/15986358/">In one study</a> each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities. <h2>Focus on long-term habits</h2> If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">analysis</a> of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%. When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">physiological responses</a> to defend our body weight and “survive” starvation. Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217287/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-weight-do-you-actually-need-to-lose-it-might-be-a-lot-less-than-you-think-217287">original article</a>.

Body

How dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders

<a href="https://theconversation.com/profiles/samantha-withnell-1504436">Samantha Withnell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> Up to 72 per cent of women and 61 per cent of men are dissatisfied with their weight or <a href="https://doi.org/10.1016/j.eatbeh.2014.04.010">body image</a>, according to a U.S. study. Globally, millions of people <a href="https://doi.org/10.1111%2Fobr.12466">attempt to lose weight</a> every year with the hope that weight loss will have positive effects on their body image, health and quality of life. However, these motivated individuals often struggle to maintain new diets or exercise regimens. The rise of medications such as semaglutides, like <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101298">Ozempic</a> or <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101765">Wegovy</a>, <a href="https://www.cbc.ca/news/health/ozempic-weight-loss-1.6772021">might be viewed as an appealing “quick fix”</a> alternative to meet weight loss goals. Research led by our team and others suggests that such attempts to lose weight often do more harm than good, and even increase the risk of <a href="https://osf.io/9stq2">developing an eating disorder</a>. <h2>Weight loss and eating disorders</h2> Eating disorders are <a href="https://doi.org/10.1002/eat.20589">serious mental health conditions</a> primarily characterized by extreme patterns of under- or over-eating, concerns about one’s shape or body weight or other behaviours intended to influence body shape or weight such as exercising excessively or self-inducing vomiting. Although once thought to only affect young, white adolescent girls, eating disorders do not discriminate; eating disorders can develop in people of <a href="https://doi.org/10.1002/erv.2553">any age, sex, gender or racial/ethnic background</a>, with an estimated <a href="https://nedic.ca/general-information/">one million Canadians</a> suffering from an eating disorder at any given time. Feb. 1 to 7 is <a href="https://nedic.ca/edaw/">National Eating Disorders Awareness Week</a>. As a clinical psychologist and clinical psychology graduate student, our research has focused on how eating disorders develop and what keeps them going. Pertinent to society’s focus on weight-related goals, our research has examined associations between weight loss and eating disorder symptoms. <h2>Eating disorders and ‘weight suppression’</h2> In eating disorders research, the state of maintaining weight loss is referred to as “weight suppression.” Weight suppression is typically defined as the difference between a person’s current weight and their highest lifetime weight (excluding pregnancy). Despite the belief that weight loss will improve body satisfaction, we found that in a sample of over 600 men and women, weight loss had no impact on women’s negative body image and was associated with increased body dissatisfaction in <a href="https://doi.org/10.1016/j.bodyim.2023.01.011">men</a>. Importantly, being more weight suppressed has been associated with the <a href="https://doi.org/10.1093/ajcn/nqaa146">onset of eating disorders</a>, including anorexia nervosa and bulimia nervosa. <a href="https://doi.org/10.1007/s11920-018-0955-2">One proposed explanation</a> for the relationship between weight suppression and eating disorders is that maintaining weight loss becomes increasingly difficult as body systems that <a href="https://doi.org/10.3945/ajcn.110.010025">reduce metabolic rate and energy expenditure, and increase appetite</a>, are activated to promote weight gain. There is growing awareness that <a href="https://doi.org/10.1136/bmj.g2646">weight regain is highly likely following conventional diet programs</a>. This might lead people to engage in more and more extreme behaviours to control their weight, or they might shift between extreme restriction of food intake and episodes of overeating or binge eating, the characteristic symptoms of bulimia nervosa. <h2>Ozempic and other semaglutide drugs</h2> Semaglutide drugs like Ozempic and Wegovy are part of a class of drug called <a href="https://pdf.hres.ca/dpd_pm/00067924.PDF">glucagon-like peptide-1 agonists (GLP-1As)</a>. These drugs work by mimicking the hormone GLP-1 to interact with neural pathways that signal satiety (fullness) and slow stomach emptying, leading to reduced food intake. Although GLP-1As are indicated to treat Type 2 diabetes, <a href="https://www.cbc.ca/news/canada/london/ozempic-off-label-1.6884141">they are increasingly prescribed off-label</a> or being <a href="https://www.bbc.com/news/health-67414203">illegally purchased</a> without a prescription because of their observed effectiveness at inducing weight loss. Although medications like Ozempic do often lead to weight loss, the rate of weight loss may <a href="https://doi.org/10.1001/jama.2021.3224">slow down or stop over time</a>. Research by Lindsay Bodell, one of the authors of this story, and her colleagues on weight suppression may help explain why effects of semaglutides diminish over time, as <a href="https://doi.org/10.1016/j.physbeh.2019.112565">weight suppression is associated with reduced GLP-1 response</a>. This means those suppressing their weight could become less responsive to the satiety signals activated by GLP-1As. Additionally, weight loss effects are only seen for as long as the medication is taken, meaning those who take these drugs to achieve some weight loss goal are <a href="https://doi.org/10.1111/dom.14725">likely to regain most, if not all, weight lost</a> when they stop taking the medication. <h2>Risks of dieting and weight-loss drugs</h2> The growing market for off-label weight loss drugs is concerning, because of the exacerbation of <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">weight stigma</a> and the serious <a href="https://doi.org/10.1016/j.jand.2022.01.004">health risks</a> associated with unsupervised weight loss, including developing eating disorders. Researchers and health professionals are already raising the alarm about the use of GLP-1As in children and adolescents, due to concerns about their possible <a href="https://doi.org/10.1017/cts.2023.612">impact on growth and development</a>. Moreover, popular weight-loss methods, whether they involve pills or “crash diets,” often mimic symptoms of eating disorders. For example, intermittent fasting diets that involve long periods of fasting followed by short periods of food consumption may mimic and <a href="https://doi.org/10.1016/j.eatbeh.2022.101681">increase the risk of developing binge eating problems</a>. The use of diet pills or laxatives to lose weight has been found to increase the risk of <a href="https://doi.org/10.2105/AJPH.2019.305390">being diagnosed with an eating disorder in the next one to three years</a>. Drugs like Ozempic may also be <a href="https://doi.org/10.1002/eat.24109">misused by individuals already struggling with an eating disorder</a> to suppress their appetite, compensate for binge eating episodes or manage fear of weight gain. Individuals who are already showing signs of an eating disorder, such as limiting their food intake and intense concerns about their weight, may be most at risk of spiralling from a weight loss diet or medication into an eating disorder, <a href="https://doi.org/10.1002/eat.24116">even if they only lose a moderate amount of weight</a>. People who are dissatisfied with their weight or have made multiple attempts to lose weight often feel pressured to try increasingly drastic methods. However, any diet, exercise program or weight-loss medication promising a quick fix for weight loss should be treated with extreme caution. At best, you may gain the weight back; at worst, you put yourself at risk for much more serious eating disorders and other health problems.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221514/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/samantha-withnell-1504436">Samantha Withnell</a>, PhD Candidate, Clinical Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, Assistant Professor of Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dieting-weight-suppression-and-even-misuse-of-drugs-like-ozempic-can-contribute-to-eating-disorders-221514">original article</a>.

Body

Resistance (exercise) is far from futile: The unheralded benefits of weight training

<a href="https://theconversation.com/profiles/stuart-phillips-428766">Stuart Phillips</a>, <a href="https://theconversation.com/institutions/mcmaster-university-930">McMaster University</a> Everyone can agree that exercise is healthy. Among its many benefits, exercise improves heart and brain function, aids in controlling weight, slows the effects of aging and helps lower the risks of several chronic <a href="https://doi.org/10.1101%2Fcshperspect.a029694">diseases</a>. For too long, though, one way of keeping fit, aerobic exercise, has been perceived as superior to the other, resistance training, for promoting health when, in fact, they are equally valuable, and both can get us to the same goal of overall physical fitness. Aerobic exercise such as running, swimming and cycling is popular because it provides great benefits and with ample <a href="https://doi.org/10.1371/journal.pmed.1001335">scientific evidence</a> to back that up. What has been far less influential to date is that resistance training — whether that’s with dumbbells, weightlifting machines or good old push-ups, lunges and dips — works about as well as aerobic exercise in all the critical areas, including cardiovascular health. Resistance training provides another benefit: building strength and developing power, which become increasingly important as a <a href="https://doi.org/10.1007/s12603-021-1665-8">person ages</a>. <figure><iframe src="https://player.vimeo.com/video/843867756" width="500" height="281" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Video about different forms of resistance training explores how all are effective at building strength.</figcaption></figure> Building and maintaining muscle strength keeps us springing out of our chairs, maintaining our balance and posture and firing our metabolism, as my colleagues and I explain in a paper recently <a href="https://doi.org/10.1249/FIT.0000000000000916">published</a> by the American College of Sports Medicine. So, if aerobic exercise and resistance training offer roughly equal benefits, how did we end up with so many runners and cyclists compared to weightlifters? It was a combination of timing, marketing and stereotyping. <h2>The rise of aerobics</h2> The preference for aerobic exercise dates back to landmark research from the <a href="https://www.cooperinstitute.org/research/ccls">Cooper Centre Longitudinal Study</a>, which played a pivotal role in establishing the effectiveness of aerobics — Dr. Ken Cooper invented or at least popularized the word with his book <a href="https://www.cooperaerobics.com/About/Aerobics.aspx">Aerobics</a>, spurring desk-bound Baby Boomers to take up exercise for its own sake. Meanwhile, resistance training languished, <a href="https://www.cnet.com/health/fitness/does-lifting-weights-make-women-bulky/">especially among women</a>, due to the misguided notion that weightlifting was only for men who aspired to be hyper-muscular. <a href="https://www.britannica.com/biography/Charles-Atlas">Charles Atlas</a>, anyone? Cultural influences solidified the dominance of aerobic exercise in the fitness landscape. In 1977, Jim Fixx made running and jogging popular with <a href="https://en.wikipedia.org/wiki/The_Complete_Book_of_Running">The Complete Book of Running</a>. In the 1980s, Jane Fonda’s <a href="https://www.janefonda.com/shop/fitness-videos/jane-fondas-complete-workout/">Complete Workout</a> and exercise shows such as <a href="https://www.imdb.com/title/tt0268895/">Aerobicize</a> and the <a href="https://www.imdb.com/title/tt0299431/">20 Minute Workout</a> helped solidify the idea that exercise was about raising one’s heart rate. The very word “aerobic,” previously confined to the lexicon of science and medicine, entered popular culture about the same time as leg warmers, tracksuits and sweatbands. It made sense to many that breathing hard and sweating from prolonged, vigorous movement was the best way to benefit from exercising. All the while, resistance training was waiting for its turn in the spotlight. <h2>Recognizing the value of resistance</h2> If aerobics has been the hare, resistance training has been the tortoise. Weight training is now coming up alongside and preparing to overtake its speedy rival, as athletes and everyday people alike recognize the value that was always there. Even in high-level sports training, weightlifting did not become common until the last 20 years. Today, it strengthens the bodies and lengthens the careers of soccer stars, tennis players, golfers <a href="https://doi.org/10.1007/s40279-016-0486-0">and many more</a>. Rising popular interest in resistance training owes a debt to <a href="https://www.livestrong.com/article/545200-the-fall-of-fitness/">CrossFit</a>, which, despite its controversies, has helped break down stereotypes and introduced more people, particularly women, to the practice of lifting weights. It’s important to recognize that resistance training does not invariably lead to bulking up, nor does it demand lifting heavy weights. As our team’s research has shown, lifting lighter weights to the point of failure in multiple sets provides <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00154.2016">equal benefits</a>. <h2>Strength and ageing</h2> The merits of resistance training extend beyond improving muscle strength. It addresses a critical aspect often overlooked in traditional aerobic training: the ability to exert force quickly, or what’s called power. As people age, activities of daily living such as standing up, sitting down and climbing stairs demand <a href="https://doi.org/10.1186/s11556-022-00297-x">strength and power</a> more than cardiovascular endurance. In this way, resistance training can be vital to maintaining overall functionality and independence. <h2>Redefining the fitness narrative</h2> The main idea is not to pit resistance training against aerobic exercise but to recognize that they complement each other. Engaging in both forms of exercise is better than relying on one alone. The <a href="https://doi.org/10.1161/CIR.0000000000001189">American Heart Association</a> recently stated that “…resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease.” Adopting a nuanced perspective is essential, especially when we guide <a href="https://doi.org/10.1016/j.arr.2021.101368">older individuals</a> who may associate exercise primarily with walking and not realize the limitations imposed by neglecting strength and power training. Resistance training is not a one-size-fits-all endeavour. It encompasses a <a href="https://doi.org/10.1016/j.jshs.2023.06.005">spectrum of activities</a> tailored to individual capabilities. It’s time to redefine the narrative around fitness to make more room for resistance training. It’s not necessary to treat it as a replacement for aerobic exercise but to see it as a vital component of a holistic approach to <a href="https://doi.org/10.1249/ESM.0000000000000001">health and longevity</a>. By shedding stereotypes, demystifying the process and promoting inclusivity, resistance training can become more accessible and appealing to a broader audience, ultimately leading to a new way to perceive and prioritize the benefits of this form of training for <a href="https://doi.org/10.1136/bjsports-2021-105061">health and fitness</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/220269/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stuart-phillips-428766">Stuart Phillips</a>, Professor, Kinesiology, Tier 1 Canada Research Chair in Skeletal Muscle Health, <a href="https://theconversation.com/institutions/mcmaster-university-930">McMaster University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/resistance-exercise-is-far-from-futile-the-unheralded-benefits-of-weight-training-220269">original article</a>.

Body

5 ways to avoid weight gain and save money on food this Christmas

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> As Christmas approaches, so does the challenge of healthy eating and maintaining weight-related goals. The season’s many social gatherings can easily tempt us to indulge in calorie-rich food and celebratory drinks. It’s why we typically <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1602012">gain weight</a> over Christmas and then struggle to take it off for the <a href="https://www.sciencedirect.com/science/article/pii/S0031938414001528">remainder of the year</a>. Christmas 2023 is also exacerbating cost-of-living pressures, prompting some to rethink their food choices. Throughout the year, <a href="https://dvh1deh6tagwk.cloudfront.net/finder-au/wp-uploads/2023/03/Cost-of-Living-Report-2023.pdf">71% of Australians</a> – or 14.2 million people – <a href="https://retailworldmagazine.com.au/rising-cost-of-living-forces-aussies-to-change-diets/">adapted</a> their eating behaviour in response to rising costs. Fortunately, there are some simple, science-backed hacks for the festive season to help you celebrate with the food traditions you love without impacting your healthy eating habits, weight, or hip pocket. <h2>1. Fill up on healthy pre-party snacks before heading out</h2> If your festive season is filled with end-of-year parties likely to tempt you to fill up on finger foods and meals high in fat, salt, and sugar and low in nutritional value, have a healthy pre-event snack before you head out. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015032/#sec-a.g.atitle">Research</a> shows carefully selected snack foods can impact satiety (feelings of fullness after eating), potentially reducing the calories you eat later. High-protein, high-fibre snack foods have the strongest effect: because they take longer to digest, our hunger is satisfied for longer. So enjoy a handful of nuts, a tub of yoghurt, or a serving of hummus with veggie sticks before you head out to help keep your healthy eating plan on track. <h2>2. Skip the low-carb drinks and enjoy your favourites in moderation</h2> Despite the marketing promises, low-carb alcoholic drinks <a href="https://onlinelibrary.wiley.com/doi/10.1002/hpja.531">aren’t better for our health or waistlines</a>. Many low-carb options have a similar amount of carbohydrates as regular options but lull us into thinking they’re better, so we drink more. A <a href="https://www.vichealth.vic.gov.au/sites/default/files/K-013_Low-carb-beer_FactSheet_FINAL.pdf">survey</a> found 15% of low-carb beer drinkers drank more beer than they usually would because they believed it was healthier for them. A typical lager or ale will contain less than 1.5 grams of carbohydrate per 100 ml while the “lower-carb” variety can range anywhere from 0.5 grams to 2.0 grams. The calories in drinks come from the alcohol itself, not the carbohydrate content. Next time you go to order, think about the quantity of alcohol you’re drinking rather than the carbs. Make sure you sip lots of water in between drinks to stay hydrated, too. <h2>3. Don’t skimp on healthy food for Christmas Day – it’s actually cheaper</h2> There’s a perception that healthy eating is more expensive. But studies show this is a misconception. A <a href="https://southwesthealthcare.com.au/swh-study-finds-eating-a-healthier-diet-is-actually-cheaper-at-the-checkout/#:%7E:text=A%20recent%20study%20from%20the,does%20not%20meet%20the%20guidelines">recent analysis</a> in Victoria, for example, found following the Australian Dietary Guidelines cost the average family A$156 less a fortnight than the cost of the average diet, which incorporates packaged processed foods and alcohol. So when you’re planning your Christmas Day meal, give the pre-prepared, processed food a miss and swap in healthier ingredients: <ul> <li> swap the heavy, salted ham for leaner and lighter meats such as fresh seafood. Some seafood, such as prawns, is also tipped to be cheaper this year thanks to <a href="https://www.smh.com.au/goodfood/lobsters-up-prawns-stable-a-buying-guide-to-seafood-this-christmas-20231208-p5eq3m.html">favourable weather conditions</a> boosting local supplies </li> <li> for side dishes, opt for fresh salads incorporating seasonal ingredients such as mango, watermelon, peach, cucumber and tomatoes. This will save you money and ensure you’re eating foods when they’re freshest and most flavoursome </li> </ul> <ul> <li> if you’re roasting veggies, use healthier cooking oils like olive as opposed to vegetable oil, and use flavourful herbs instead of salt </li> <li> if there’s an out-of-season vegetable you want to include, look for frozen and canned substitutes. They’re cheaper, and <a href="https://www.sciencedirect.com/science/article/pii/S0889157517300418">just as nutritious</a> and tasty because the produce is usually frozen or canned at its best. Watch the sodium content of canned foods, though, and give them a quick rinse to remove any salty water </li> <li> give store-bought sauces and dressings a miss, making your own from scratch using fresh ingredients. </li> </ul> <h2>4. Plan your Christmas food shop with military precision</h2> Before heading to the supermarket to shop for your Christmas Day meal, create a detailed meal plan and shopping list, and don’t forget to check your pantry and fridge for things you already have. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586574/">Eating beforehand</a> and shopping with a plan in hand means you’ll only buy what you need and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206473/">avoid impulse purchasing</a>. When you’re shopping, price check everything. Comparing the cost per 100 grams is the most effective way to save money and get the best value. Check prices on products sold in different ways and places, too, such as nuts you scoop yourself versus prepacked options. <h2>5. Don’t skip breakfast on Christmas Day</h2> We’ve all been tempted to skip or have a small breakfast on Christmas morning to “save” the calories for later. But this plan will fail when you sit down at lunch hungry and find yourself eating far more calories than you’d “saved” for. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. What you eat for breakfast on Christmas morning is just as important too – choosing the right foods will <a href="https://theconversation.com/im-trying-to-lose-weight-and-eat-healthily-why-do-i-feel-so-hungry-all-the-time-what-can-i-do-about-it-215808">help you manage your appetite</a> and avoid the temptation to overindulge later in the day. <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">Studies</a> show a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. So before you head out to the Christmas lunch, have a large, nutritionally balanced breakfast, such as eggs on wholegrain toast with avocado. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/5-ways-to-avoid-weight-gain-and-save-money-on-food-this-christmas-219114">original article</a>.

Food & Wine

I’m trying to lose weight and eat healthily. Why do I feel so hungry all the time? What can I do about it?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Benjamin Franklin, one of the founding fathers of the United States, famously said nothing is certain except death and taxes. But I think we can include “you’ll feel hungry when you’re trying to lose weight” as another certainty. The reason is basic biology. So how does this work – and what can you do about it? <h2>Hormones control our feelings of hunger</h2> Several hormones play an essential role in regulating our feelings of hunger and fullness. The most important are ghrelin – often called the hunger hormone – and leptin. When we’re hungry, <a href="https://pubmed.ncbi.nlm.nih.gov/11739476/">ghrelin</a> is released by our stomach, lighting up a part of our brain called the hypothalamus to tell us to eat. When it’s time to stop eating, hormones, including <a href="https://pubmed.ncbi.nlm.nih.gov/8717038/">leptin</a>, are released from different organs, such as our gut and fat tissue, to signal to the brain that we’re full. <h2>Dieting disrupts the process</h2> But when we change our diet and start losing weight, we disrupt how these <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">appetite hormones function</a>. This triggers a process that stems from our hunter-gatherer ancestors. Their bodies developed this mechanism as a survival response to adapt to periods of deprivation and protect against starvation. The levels of hormones <a href="https://pubmed.ncbi.nlm.nih.gov/23126426/">managing our hunger increase</a>, making us feel hungrier to tell us to eat more, while the ones responsible for signalling we’re full decrease their levels, intensifying our feelings of hunger. We end up increasing our calorie consumption so we eat more to regain the weight we lost. But worse, even after the kilos creep back on, <a href="https://pubmed.ncbi.nlm.nih.gov/22029981/">our appetite hormones don’t restore</a> to their normal levels – they keep telling us to eat more so we put on a little extra fat. This is our body’s way of preparing for the next bout of starvation we will impose through dieting. Fortunately, there are things we can do to manage our appetite, including: <h2>1. Eating a large, healthy breakfast every day</h2> One of the easiest ways to manage our feelings of hunger throughout the day is to eat most of our food earlier in the day and taper our meal sizes so dinner is the smallest meal. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> shows a low-calorie or small breakfast leads to increased feelings of hunger, specifically appetite for sweets, across the course of the day. <a href="https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00344-8">Another study</a> found the same effect. Participants went on a calorie-controlled diet for two months, where they ate 45% of their calories for breakfast, 35% at lunch and 20% at dinner for the first month, before switching to eat their largest meal in the evening and their smallest in the morning. Eating the largest meal at breakfast resulted in decreased hunger throughout the day. <a href="https://pubmed.ncbi.nlm.nih.gov/32073608/">Research</a> also shows we burn the calories from a meal 2.5-times more efficiently in the morning than the evening. So emphasising breakfast over dinner is good not just for hunger control, but also weight management. <h2>2. Prioritising protein</h2> Protein helps contain feelings of hunger. This is because protein-rich foods such as lean meats, tofu and beans suppress the appetite-stimulating ghrelin and stimulate another hormone called <a href="https://www.sciencedirect.com/science/article/pii/S1550413106002713">peptide YY</a> that makes you feel full. And just as eating a breakfast is vital to managing our hunger, what we eat is important too, with <a href="https://pubmed.ncbi.nlm.nih.gov/24703415/">research</a> confirming a breakfast containing protein-rich foods, such as eggs, will leave us feeling fuller for longer. But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado. <h2>3. Filling up with nuts and foods high in good fats and fibre</h2> Nuts often get a bad rap – thanks to the misconception they cause weight gain – but nuts can help us manage our hunger and weight. The filling fibre and good fats found in nuts take longer to digest, meaning our hunger is satisfied for longer. <a href="https://pubmed.ncbi.nlm.nih.gov/12791613/">Studies</a> suggest you can include up to 68 grams per day of nuts without affecting your weight. Avocados are also high in fibre and heart-healthy monounsaturated fats, making them another excellent food for managing feelings of fullness. This is backed by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567160/">study</a> confirming participants who ate a breakfast incorporating avocado felt more satisfied and less hungry than participants who ate a meal containing the same calories but with lower fat and fibre content. Similarly, eating foods that are high in soluble fibre – such as <a href="https://pubmed.ncbi.nlm.nih.gov/24820437/">beans</a> and vegetables – make us feel fuller. This type of fibre attracts water from our gut, forming a gel that slows digestion. <h2>4. Eating mindfully</h2> When we take time to really be aware of and enjoy the food we’re eating, we slow down and eat far less. A <a href="https://pubmed.ncbi.nlm.nih.gov/28718396/">review</a> of 68 studies found eating mindfully helps us better recognise feelings of fullness. Mindful eating provides our brain enough time to recognise and adapt to the signals from our stomach telling us we’re full. Slow down your food consumption by sitting at the dinner table and use smaller utensils to reduce the volume of food you eat with each mouthful. <h2>5. Getting enough sleep</h2> Sleep deprivation disturbs our <a href="https://www.sciencedirect.com/science/article/abs/pii/S1389945708700133">appetite hormones</a>, increasing our feelings of hunger and <a href="https://www.nature.com/articles/ncomms3259">triggering cravings</a>. So aim to get at least seven hours of uninterrupted sleep a night. Try switching off your devices <a href="https://journals.sagepub.com/doi/full/10.1177/1477153515584979">two hours before bed</a> to boost your body’s secretion of sleep-inducing hormones like melatonin. <h2>6. Managing stress</h2> Stress increases our <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">body’s production of cortisol</a> and triggers food cravings. So take time out when you need it and set aside time for stress-relieving activities. This can be as simple as getting outdoors. A <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">2019 study</a> found sitting or walking outdoors at least three times a week could reduce cortisol levels by 21%. <h2>7. Avoiding depriving ourselves</h2> When we change our diet to lose weight or eat healthier, we typically restrict certain foods or food groups. However, this <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">heightens activity</a> in our mesocorticolimbic circuit – the reward system part of the brain – often resulting in us craving the foods we’re trying to avoid. Foods that give us pleasure release feel-good chemicals called endorphins and learning chemicals called dopamine, which enable us to remember – and give in to – that feel-good response. When we change our diet, activity in our hypothalamus – the clever part of the brain that regulates emotions and food intake – <a href="https://pubmed.ncbi.nlm.nih.gov/18568078/">also reduces</a>, decreasing our control and judgement. It often triggers a psychological response dubbed the “what-the-hell effect”, when we indulge in something we think we shouldn’t feel guilty about and then go back for even more. Don’t completely cut out your favourite foods when you go on a diet or deprive yourself if you’re hungry. It will take the pleasure out of eating and eventually you’ll give into your cravings. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-trying-to-lose-weight-and-eat-healthily-why-do-i-feel-so-hungry-all-the-time-what-can-i-do-about-it-215808">original article</a>.

Body

Oprah's weight-loss backflip: "I'm done with the shame"

Oprah Winfrey has become one of the first A-list celebrities to openly admit that she has resorted to using weight loss medication after months of speculation, according to Page Six. “I now use it as I feel I need it, as a tool to manage not yo-yoing,” she told People Magazine. “The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for.” The 69-year-old added, “I’m absolutely done with the shaming from other people and particularly myself.” This reversal comes after the actress rocked a <a href="https://www.oversixty.co.nz/health/body/slimmed-down-oprah-addresses-ozempic-rumours" target="_blank" rel="noopener">slimmed down look</a> at the premiere for the reboot of The Color Purple last week. She had previously denied using weight loss drugs in an episode of Oprah Daily’s The Life You Want: The State of Weight, where she said turning to weight loss medication is "the easy way out.” Although she did not disclose exactly which drug she took, or whether it was the celebrity favourite Type II diabetes medication Ozempic, the media mogul revealed the reason why she had a change of heart. She told People Magazine that she became more open to using a pharmaceutical after conducting a panel discussion with medical experts in July. “I had the biggest ‘aha’ along with many people in that audience,” she said. “I realised I’d been blaming myself all these years for being overweight, and I have a predisposition that no amount of willpower is going to control.” She also shared the success she has had with the unnamed medication, claiming that she gained only half a pound “instead of gaining eight pounds like [she] did last year,” after Thanksgiving. Winfrey added that ultimately it wasn't about the number on the scale but “it was a second shot for me to live a more vital and vibrant life.” The O Magazine founder also said that the medication were just a larger part of her health and fitness regimen, which includes hiking. “I know everybody thought I was on it, but I worked so damn hard. I know that if I’m not also working out and vigilant about all the other things, it doesn’t work for me.” Images: Arturo Holmes/The Hollywood Reporter via Getty Images

Body

When it comes to weight, your ‘diet’ is much more than what you eat

Atkins, keto, palaeo, gluten-free, low-carb, low-fat, high-fat, raw, vegan, vego, pescatarian – phew, that’s a lot of different diets! <div class="copy"> And it’s by no means an exhaustive list. The old adage ‘you are what you eat’ has come to be a mantra for good diet and health. It was originally coined by 19th-century German philosopher Ludwig Feuerbach, himself drawing on commentary by an earlier French gourmand Anthelme Brillat-Savarin. Increasingly, science is finding new connections between diet and our overall picture of health. You may have heard how our gut microbiome acts as a second brain, or that avoiding unprocessed foods can lead to all-cause mortality. But when it comes to many fad diets that promise quick weight loss or improved health, the science can sometimes be skimp. This can change over time as researchers test the influence of diet on general health, weight management and as a medical treatment. The <a href="https://cosmosmagazine.com/health/mediterranean-diet-heart-dementia/">Mediterranean diet</a> is probably closest to the mark as a lifestyle of choice, in terms of overall health, nutrition, and diet science. It emphasises <a href="https://cosmosmagazine.com/health/nutrition/plant-based-diets-could-prevent-type-2-diabetes/">fruit and vegetable</a> consumption, with some wholegrain breads and cereals, legumes, nuts, seeds and fish, with olive oil as a primary fat source. This diet is either explicitly endorsed by many health authorities around the world such as the <a href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet" target="_blank" rel="noreferrer noopener">American Heart Association</a>, the <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/nutrition/mediterranean-diet-for-reducing-cardiovascular-dis" target="_blank" rel="noreferrer noopener">Royal Australian College of General Practitioners</a> as a diet for lowering cardiovascular disease risk, or used as a basis for other recommendations. The World Health Organization also <a href="https://www.who.int/europe/news/item/07-05-2018-fostering-healthier-and-more-sustainable-diets-learning-from-the-mediterranean-and-new-nordic-experience" target="_blank" rel="noreferrer noopener">advises</a> on ways for the Mediterranean and similar New Nordic diets to be implemented as <a href="https://iris.who.int/bitstream/handle/10665/326264/9789289053013-eng.pdf?sequence=3" target="_blank" rel="noreferrer noopener">health policy</a>. But diet might be better considered about more than what goes in one’s mouth. Dr Evangeline Mantzioris, Program Director of the Nutrition and Food Sciences Degree at the University of South Australia, says a truer interpretation of the world extends beyond merely food and drink. “The word diet actually derives from the Greek word diaita, which means the way you choose to live your life,” Mantzioris told the <a href="https://cosmosmagazine.com/tag/debunks/" target="_blank" rel="noreferrer noopener">Debunks podcast.</a> “So it’s not just about the food, it’s about the exercise, it’s about the social interaction, it’s about the rest. It’s about the sleep. It’s all of that.” The WHO’s 2019 Health Evidence Network Synthesis Report also acknowledges both social and sleep components of the lifestyle, noting shared eating practices, post-meal siestas and lengthy meal times all contribute to positive health effects. In terms of the nutritional component, Mantzioris notes that adherence to the diet requires not just an uptake of olive oil, but cutting down on less beneficial foods and an active lifestyle. “It’s not just the olive oil, it’s dropping down the meat, it’s mainly a plant food diet, it’s purposeful exercise,” she says. “I’m always a little bit nervous when people just talk about the diet and the food without considering the rest of it. “In the 60s, when the health benefits of the Mediterranean diet were seen […] they were out there harvesting, growing their food, preparing their food, doing all that sort of purposeful exercise in the outdoor environment, often in quite steep terrain. So that is just as important. “The Mediterranean diet continues to be shown to be quite healthy and beneficial in terms of improving chronic disease risk, even without weight loss.” Mantzioris says that the diet has also been shown to improve cognitive and mental health outcomes. Diet is the focus of the latest episode of Debunks from Cosmos and 9Podcasts, where we dive not simply into what makes a good diet, but the principles that dieticians and nutritionists look for when recommending one for a patient to consider. <iframe title="Weight: Do diets actually work?" src="https://omny.fm/shows/debunks/weight-do-diets-actually-work/embed?style=Artwork" width="100%" height="180" frameborder="0"></iframe>  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=287991&title=When+it+comes+to+weight%2C+your+%E2%80%98diet%E2%80%99+is+much+more+than+what+you+eat" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div class="copy"> </div> <div>Image credits: Shutterstock</div> <div> </div> <div><a href="https://cosmosmagazine.com/health/body-and-mind/diet-is-much-more-than-what-you-eat/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/matthew-agius/">Matthew Ward Agius</a>. </div>

Body

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> What do British Prime Minister <a href="https://www.sciencefocus.com/the-human-body/one-meal-a-day-diet-omad">Rishi Sunak</a> and singer <a href="https://theconversation.com/one-meal-a-day-diet-popular-with-celebrities-could-do-more-harm-than-good-heres-why-203086">Bruce Springsteen</a> have in common? They’re among an ever-growing group of public figures touting the benefits of eating just one meal a day. As a result, the one meal a day (OMAD) diet is the latest attention-grabbing weight loss trend. Advocates claim it leads to fast, long-term weight loss success and better health, including delaying the ageing process. Like most weight-loss programs, the OMAD diet makes big and bold promises. Here’s what you need to know about eating one meal a day and what it means for weight loss. <h2>The OMAD diet explained</h2> Essentially, the OMAD diet is a type of intermittent fasting, where you fast for 23 hours and consume all your daily calories in one meal eaten within one hour. The OMAD diet rules are presented as simple and easy to follow: <ol> <li> You can eat whatever you want, provided it fits on a standard dinner plate, with no calorie restrictions or nutritional guidelines to follow. </li> <li> You can drink calorie-free drinks throughout the day (water, black tea and coffee). </li> <li> You must follow a consistent meal schedule, eating your one meal around the same time each day. </li> </ol> Along with creating a calorie deficit, resulting in weight loss, advocates believe the OMAD diet’s extended fasting period <a href="https://www.frontiersin.org/articles/10.3389/fphys.2021.771944/full">leads to physiological changes</a> in the body that promote better health, including boosting your metabolism by triggering a process called ketosis, where your body burns stored fat for energy instead of glucose. <h2>What does the evidence say?</h2> Unfortunately, research into the OMAD diet is limited. Most studies have examined its impact on <a href="https://www.cell.com/cell-metabolism/pdf/S1550-4131(18)30512-6.pdf">animals</a>, and the <a href="https://pubmed.ncbi.nlm.nih.gov/35087416/">primary study</a> with humans involved 11 lean, young people following the OMAD diet for a mere 11 days. Claims about the OMAD diet typically rely on research into intermittent fasting, rather than on the OMAD diet itself. There is <a href="https://www.cfp.ca/content/66/2/117.short">evidence</a> backing the efficacy of intermittent fasting to achieve weight loss. However, <a href="https://www.nature.com/articles/s41574-022-00638-x">most studies</a> have focused on short-term results only, typically considering the results achieved across 12 weeks or less. One <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">longer-term study from 2022</a> randomly assigned 139 patients with obesity to either a calorie-restricted diet with time-restricted eating between 8am and 4pm daily, or to a diet with daily calorie restriction alone for 12 months. After 12 months, both groups had lost around the same weight and experienced similar changes in body fat, blood sugar, cholesterol and blood pressure. This indicates long-term weight loss achieved with intermittent fasting is not superior and on a par with that achieved by traditional dieting approaches (daily calorie restriction). <h2>So what are the problems with the OMAD diet?</h2> 1. It can cause nutritional deficiencies and health issues. The OMAD diet’s lack of nutritional guidance on what to eat for that one meal a day raises many red flags. The meals we eat every day should include a source of protein balanced with wholegrain carbs, vegetables, fruits, protein and good fats to support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">optimum health, disease prevention and weight management</a>. Not eating a balanced diet will result in nutritional deficiencies that can result in poor immune function, fatigue and a decrease in bone density, leading to osteoporosis. Fasting for 23 hours a day is also likely to lead to extreme feelings of hunger and uncontrollable cravings, which may mean you consistently eat foods that are not good for you when it’s time to eat. 2. It’s unlikely to be sustainable. You might be able to stick with the OMAD diet initially, but it will wear thin over time. Extreme diets – especially ones prescribing extended periods of fasting – aren’t enjoyable, leading to feelings of deprivation and social isolation during meal times. It’s hard enough to refuse a piece of office birthday cake at the best of times, imagine how this would feel when you haven’t eaten for 23 hours! Restrictive eating can also lead to an unhealthy relationship with food, making it even harder to achieve and maintain a healthy weight. 3. Quick fixes don’t work. Like other popular intermittent fasting methods, the OMAD diet appeals because it’s easy to digest, and the results appear fast. But the OMAD diet is just another fancy way of cutting calories to achieve a quick drop on the scales. As your weight falls, things will quickly go downhill when your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">body activates its defence mechanisms</a> to defend your weight loss. In fact, it will regain weight – a response that stems from our hunter-gatherer ancestors’ need to survive periods of deprivation when food was scarce. <h2>The bottom line</h2> Despite the hype, the OMAD diet is unsustainable, and it doesn’t result in better weight-loss outcomes than its predecessors. Our old habits creep back in and we find ourselves fighting a cascade of physiological changes to ensure we regain the weight we lost. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-the-omad-diet-is-one-meal-a-day-actually-good-for-weight-loss-and-is-it-safe-207723">original article</a>.

Body

Can coffee help you avoid weight gain? Here’s what the science says

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Coffee is well recognised as having a positive impact on long-term health. Drinking the equivalent of three to four cups of instant coffee a day <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">reduces the risk</a> of many health conditions including heart disease, type 2 diabetes and some cancers. Most people gain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984841/">small amounts of weight</a> each year as they age. But can coffee help prevent this gradual weight gain? A group of researchers examined whether drinking an extra cup of coffee a day – or adding sugar, cream or a non-dairy alternative – resulted in more or less weight gain than those who didn’t adjust their intake. Their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002916523661702">research</a> (currently a pre-proof, which means it has been peer reviewed but is yet to undergo the final formatting and copyediting) found a modest link between coffee and gaining less weight than expected. People who drank an extra cup of coffee a day gained 0.12 kg less weight than expected over four years. Adding sugar resulted in a fraction more (0.09 kg) weight gain than expected over four years. <h2>How was the study conducted? What did it find?</h2> Researchers combined data from three large studies from the United States: two <a href="https://nurseshealthstudy.org">Nurses’ Health Studies</a> from 1986 to 2010, and from 1991 to 2015, and a <a href="https://www.hsph.harvard.edu/hpfs/about-the-study/">Health Professional Follow-up study</a> from 1991 to 2014. The Nurses’ Health Studies are two of the largest cohort studies, with more 230,000 participants, and investigates chronic disease risks for women. The Health Professional Follow-up study involves more than 50,000 male health professionals and investigates the relationship between diet and health outcomes. Participants in all three studies completed a baseline questionnaire, and another questionnaire every four years to assess their food and drink intake. Using the combined datasets, researchers analysed changes in coffee intake and changes in the participants’ self-reported weight at four-year intervals. The average four year weight-gains for the nurses’ studies were 1.2kg and 1.7kg, while participants in the health professionals study gained an average of 0.8kg. The researchers found that increasing unsweetened caffeinated or decaffeinated coffee intake by one cup a day was associated with a weight gain that was 0.12 kg less than expected over four years. Adding creamer (milk) or a non-dairy alternative did not significantly affect this weight change. However, adding sugar (one teaspoon) to coffee was associated with a weight gain that was 0.09 kg more than expected over four years. These associations were stronger in participants who were younger and had a higher body mass index at the beginning of the studies. <h2>What are the pros and cons of the study?</h2> This study is unique in two ways. It had a very large sample size and followed participants for many years. This adds confidence that the associations were real and can likely be applied to other populations. However, there are three reasons to be cautious. First, the findings represent an association, not causation. This means the study does not prove that coffee intake is the true reason for the weight change. Rather, it shows the two changes were observed together over time. Second, the findings around weight were very modest. The average four-year weight gain averted, based on one cup of coffee, was 0.12 kilograms, which is about 30 grams per year. This amount may not be a meaningful change for most people looking to manage weight. Finally, this analysis did not consider the variability in the amount of caffeine in coffee (which we <a href="https://pubmed.ncbi.nlm.nih.gov/17412475/">know can be high</a>), it just assumed a standard amount of caffeine per cup. <h2>How could coffee help with weight management?</h2> Caffeine is a natural stimulant which has been <a href="https://www.sciencedirect.com/science/article/pii/S0149763416300690">shown to</a> temporarily reduce appetite and increase alertness. This may help to feel less hungry for a short period, potentially leading to reduced energy intake. Some people consume coffee before exercise as a stimulant to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777221/">improve their workout performance</a> – if a workout is more effective, more energy may be expended. However, the benefit is largely thought to be short-lived, rather than long-term. Caffeine has also been <a href="https://www.sciencedirect.com/science/article/pii/S0271531720304449">shown to</a> speed up our metabolism, causing more energy to be burned while resting. However, this effect is relatively small and is not a suitable substitute for regular physical activity and a healthy diet. Finally, coffee has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725310/">mild diuretic effect</a>, which can lead to temporary water weight loss. This is water loss, not fat loss, and the weight is quickly regained when you re-hydrate. <h2>Is it worth trying coffee for weight loss?</h2> Losing weight can be influenced by various factors, so don’t get too enthusiastic about the coffee-weight link highlighted in this new study, or increase your coffee intake to unreasonable levels. Most adults can safely consume around <a href="https://www.healthdirect.gov.au/caffeine">400mg</a> of caffeine a day. That’s the equivalent of two espressos or four cups of instant coffee or eight cups of tea. If you are pregnant or breastfeeding, it is important to talk to your doctor before increasing your caffeine intake, because caffeine can be passed through to your growing baby. If you need individualised weight guidance, talk to your GP or visit an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher & Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-coffee-help-you-avoid-weight-gain-heres-what-the-science-says-214954">original article</a>.

Body

Dawn French hits back at "shameful" weight loss comments

Dawn French has hit back at hurtful comments about her drastic weight loss almost a decade ago, admitting she "never rejected" the size she was. In 2014, the British comedian and actress dropped over 45kg after undergoing a hysterectomy following a terrifying cancer scare. The dramatic weight loss came after French's surgeon said she would heal better from the procedure if she lost weight. At the time, dozens of articles were written about French's transformation, praising her weight loss. Now, the 65-year-old has taken umbrage with the comments, telling <a href="https://www.thetimes.co.uk/article/id-never-felt-so-ugly-how-dawn-french-learnt-to-love-her-flaws-3z95kc823" target="_blank" rel="noopener">The Times</a> how unfair it is that women are in the public eye are often “reduced” to descriptions of their appearance. “I have never rejected the bigger woman I have been. Lots of people do it and say, ‘Oh, you look so much better – now you look well.’ And I think, ‘F*** off! Don’t judge that other person who I loved,’” she said. “[British singer] Alison Moyet is a very good friend and so often she has been reduced to descriptions of her physicality.” “She’s this giant talent, why reduce her to that? I’m not taking any s*** from anyone about any of it,” she said. French went on to reflect on the early days of her career, which began in the late 1980s alongside Jennifer Saunders. Despite the success of their BBC show French and Saunders, they were often described by how they looked, something she says “never” happened to their male colleagues. “For many years Jennifer [Saunders] and I were always described by how we looked, especially me, because I was the bigger one.” “It was always about ‘running to fat’ or ‘plump’, and they never said that about any of the male comedians.” “I absolutely own whatever my size is and I will call myself whatever I want. But if I feel like the intent is to shame me, I will not have it,” French said. Image credits: Getty Images

Body

What is ‘budget Ozempic’ that’s all over social media? Can it help me lose weight?

<a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Social media is lighting up over what influencers are calling “<a href="https://www.forbes.com/sites/brucelee/2023/09/09/budget-ozempic-tiktok-trend-how-its-contributing-to-the-laxative-shortage/?sh=1f54511b1569">budget Ozempic</a>”. These are drugs normally used as laxatives and stool softeners, but people are taking them to lose weight. The demand is so high in the United States, there are reports this is contributing to <a href="https://www.wsj.com/health/wellness/laxative-shortage-diet-weight-loss-5a15bf02">shortages</a> in pharmacies. These laxatives are just the latest alternatives influencers are touting for the <a href="https://www.abc.net.au/news/2023-09-09/ozempic-maker-novo-nordisk-becomes-biggest-company-in-europe/102812584">blockbuster drug</a> Ozempic. So, does “budget Ozempic” help you lose weight? Any weight loss is likely to be temporary and using these laxatives long term may be dangerous. <h2>Ozempic is in short supply</h2> Ozempic contains the active ingredient semaglutide. It is a prescription-only drug used to treat type 2 diabetes. One side effect of taking it is significant weight loss. This has led to so many people trying to obtain the drug there have been <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">shortages</a>. Instead, some people have turned to more easily accessible over-the-counter alternatives to try to lose weight. That includes <a href="https://theconversation.com/natures-own-ozempic-or-berberine-is-all-over-social-media-but-does-it-really-help-you-lose-weight-206855">berberine</a>, which has been dubbed “nature’s own Ozempic”. <h2>What is ‘budget Ozempic’?</h2> “Budget Ozempic” is different to “nature’s own Ozempic”. It is the polymer polyethylene glycol 3350, or PEG 3350 for short. Chemically, it’s similar to other polymers used as ingredients in cosmetics, drug delivery, <a href="https://www.chemistryworld.com/features/raiders-of-the-lost-pigments/3007237.article">archaeological preservative paints</a>, soaps and even <a href="https://navyrecognition.com/index.php/naval-news/naval-news-archive/2023/june/13261-northrop-grumman-hits-production-milestone-with-trident-ii-d5-s-2000th-rocket-motor.html">missile fuel</a>. It’s not to be confused with ethylene glycol, which is used in antifreeze. Medically, PEG 3350 is mainly sold in Australia through pharmacies in <a href="https://australianprescriber.tg.org.au/articles/managing-constipation-in-adults.html">laxative and stool softening</a> products. It is also used to clean out your bowels before a colonoscopy. The products are referred to as <a href="https://www.healthdirect.gov.au/medicines/medicinal-product/aht,22630/macrogol-3350">macrogols</a>. Brands include DulcoSoft, Movicol, OsmoLax, ClearLax and ColonLYTELY. <h2>How can it cause weight loss?</h2> PEG 3350 is known as an <a href="https://www.nhs.uk/conditions/laxatives/#:%7E:text=Osmotic%20laxatives%20draw%20water%20from,brand%20names%20Duphalac%20and%20Lactugal">osmotic laxative</a>. It uses osmosis – how your body manages the balance of electrolytes in your blood serum – to soften your stools and treat constipation. When you swallow a drink with PEG 3350 the polymer isn’t absorbed by the body. Instead, as it passes through your intestines it draws water to it, making your faeces much more watery. Because it draws more water out of your body than you put into it from the drink, your weight goes down. That is, it just makes you dehydrated. This means any weight loss is likely to be short-lived; when you next drink, your body will retain more of the water to replace what was lost. To have any significant and sustained weight loss you’d need to take a lot of PEG 3350 every day. And at most, you would only lose a few kilograms. This is different to how <a href="https://www.nps.org.au/assets/medicines/42ccacc2-2326-42ad-ad14-abd6010499a4.pdf">Ozempic</a> works. Ozempic is similar to a family of hormones in your body called <a href="https://pubmed.ncbi.nlm.nih.gov/29364588/">incretins</a>. These have a number of actions that control both blood sugar levels and weight. For example, they slow how quickly food is absorbed from the stomach and decrease appetite, both of which help with sustained weight loss. <h2>Dangers and side effects</h2> PEG 3350 can make you <a href="https://www.healthdirect.gov.au/dehydration">dehydrated</a>. You may feel dizzy or light-headed, have a headache and have a dry mouth, lips or eyes. The concentration of electrolytes in your blood, such as salt, may also be too high (known as hypertonic blood serum). Hypertonic blood serum can affect the shape of your red blood cells, making it harder for them to carry oxygen around your body. This results in symptoms that include fatigue and tiredness, and those other symptoms of being dehydrated. In extreme cases it can result in <a href="https://psmf.org/story/emily-jerry/">death</a>. Incorrect levels of electrolytes can lead to other serious problems, affecting your heart and muscles. It can also lead to seizures, confusion, and coma. It can be dangerous to take PEG 3350 if you have heart disease, if your doctor has put you on a sodium-restricted diet, or if you already have an electrolyte disorder, such as <a href="https://www.healthdirect.gov.au/potassium">hyperkalaemia</a> (high potassium levels). These products are also dangerous for elderly people, those with kidney problems, and in very young children. Common side effects include anal irritation, vomiting, diarrhoea, nausea, cramps, pain, and swelling of your abdomen. Some people can have allergic reactions. If you use laxatives, including PEG 3350-based products, for a long period of time (over a period of weeks or months) then you may experience <a href="https://www.eatingdisorders.org.au/wp-content/uploads/2019/10/Eating-disorders-and-laxatives.pdf">withdrawal symptoms</a> if you stop taking them suddenly. These include constipation, bloating, weight gain and fluid retention. <h2>In a nutshell</h2> Overall, if you’ve been struggling with weight loss, then PEG 3350-based products are not a safe and effective solution. Any weight loss you experience will be temporary and may put your health at risk. Safer and more effective solutions are available. Eating healthily and exercising regularly are important first steps for anyone who wishes to lose weight. Otherwise, your GP or local pharmacist can help you with both lifestyle changes and medication options to help with weight loss.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213457/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-budget-ozempic-thats-all-over-social-media-can-it-help-me-lose-weight-213457">original article</a>.

Body

Ozempic is in the spotlight but it’s just the latest in a long and strange history of weight-loss drugs

<a href="https://theconversation.com/profiles/laura-dawes-1445353">Laura Dawes</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> Losing weight conveniently, cheaply, safely. That’s been the holy grail of weight-loss ever since 19th century English undertaker and weight-loss celebrity William Banting’s 1863 <a href="https://www.gutenberg.org/files/57545/57545-h/57545-h.htm">Letter on Corpulence</a> spruiked his “miraculous” method of slimming down. Since then, humans have tried many things – diet, exercise, psychotherapy, surgery – to lose weight. But time and again we return to the promise of a weight-loss drug, whether it’s a pill, injection, or tonic. A “diet drug”. The <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%2520Obesity%2520in%2520America%2520traces,problem%2520facing%2520American%2520children%2520today.">history of diet drugs</a> is not a glowing one, however. There have been so many popular drug treatments for excess weight over the years. All, however, have eventually lost their shine and some have even been banned. <h2>Ozempic is a recent arrival</h2> <a href="https://www.novonordisk.com/our-products/our-medicines.html">Ozempic and its sister drug Wegovy</a>, both manufactured by Novo Nordisk, are the latest offerings in a long history of drug treatments for people who are overweight. They contain the same active ingredient – semaglutide, which mimics a hormone, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1544319118303273">GLP-1</a> (glucagon-like peptide-1) that acts on the hypothalamus (the brain’s “hunger centre”) to regulate appetite. As an obesity treatment, semaglutide appears to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573908/">work</a> in part by reducing appetite. These are injections. And there can be <a href="https://www.novonordisk.com.au/content/dam/nncorp/au/en/pdfs/Ozempic-1mg-cmi-v3.0.pdf%22%22">side effects</a>, most commonly nausea and diarrhoea. Although marketed as treatments for chronic obesity and diabetes, they have <a href="https://www.forbes.com/health/body/ozempic-for-weight-loss/#footnote_1">exploded in popularity</a> as diet drugs, largely thanks to social media. This has helped drive a <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#:%7E:text=Why%2520the%2520Ozempic%2520shortage%2520happened,label%2520prescribing%2520for%2520weight%2520loss.">shortage of Ozempic</a> for diabetes treatment. <h2>From ‘gland treatment’ to amphetamines</h2> But Ozempic is not the first weight-loss drug. For example, organotherapy (gland treatment) was <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%20Obesity%20in%20America%20traces,problem%20facing%20American%20children%20today.">hugely popular</a> in the 1920s to 1940s. It rode on a wave of enthusiasm for endocrinology and specifically the discovery that “ductless glands” – such as the thyroid, pituitary and renal glands – secreted chemical messengers (or “hormones”, as they came to be known). These hormones coordinate the activities and growth of different parts of the body. Doctors prescribed overweight people extracts of animal glands – either eaten raw or dried in pill form or injected – to treat their <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%20Obesity%20in%20America%20traces,problem%20facing%20American%20children%20today.">supposedly “sluggish glands”</a>. For slaughterhouse companies, this was a lucrative new market for offal. But organotherapy soon fell from favour. There was no evidence excess weight was usually caused by underperforming glands or that gland extracts (thyroid in particular) were doing anything other than <a href="https://my.clevelandclinic.org/health/diseases/21741-thyrotoxicosis">poisoning you</a>. <a href="https://nyupress.org/9780814776391/on-speed/">Amphetamines</a> were first used as a nasal decongestant in the 1930s, but quickly found a market for weight-loss. Why they worked was complex. The drug operated on the hypothalamus but also had an effect on mental state. Amphetamine is, of course, an “upper”. The theory was it helped people feel up to dieting and gave pleasure not found on a plate. Amphetamines too, <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2007.110593">fell from treatment use</a> in the 1970s with Nixon’s “war on drugs” and recognition they were addictive. <h2>Another decade, another drug</h2> Each decade seems to produce its own briefly popular weight-loss drug. For example, the popular <a href="https://www.nytimes.com/1997/09/23/science/how-fen-phen-a-diet-miracle-rose-and-fell.html">diet drug</a> of the 1980s and 90s was fen-phen, which contained appetite suppressants fenfluramine and phentermine. During the height of its craze, vast numbers of users testified to dramatic weight loss. But after users experienced heart valve and lung disease, fen-phen was <a href="https://pubmed.ncbi.nlm.nih.gov/9688104/">withdrawn</a> from the market in 1997. Its producer allocated a <a href="https://www.bloomberg.com/news/articles/2012-08-23/pfizer-asks-end-to-fen-phen-suits-linked-to-lung-ailment">reported US$21 billion</a> to settle the associated lawsuits. The hormone <a href="https://www.webmd.com/obesity/features/the-facts-on-leptin-faq">leptin</a> aroused excitement in the mid-1990s. Leptin seemed, for a brief moment, to hold the key to how the hypothalamus regulated fat storage. Pharmaceutical company Amgen <a href="https://www.science.org/doi/10.1126/science.7732366">wagered millions</a> buying the <a href="https://pubmed.ncbi.nlm.nih.gov/30532682/">rights</a> to the research in the hope this discovery could be turned into a treatment, only to discover it didn’t translate from mice into people. Far from not having enough leptin, people with obesity tend to be <a href="https://www.healthline.com/nutrition/leptin-101">leptin-resistant</a>. So taking more leptin doesn’t help with weight-loss. Amgen <a href="https://news.harvard.edu/gazette/story/2009/01/obesity-reviving-the-promise-of-leptin/">sold</a> the rights it had paid so much for. <a href="https://www.healthline.com/nutrition/ephedra-sinica">Ephedra</a> was popular as a weight-loss treatment and as a stimulant in the 1990s and 2000s, finding buyers among athletes, body builders and in the military. But the US Food and Drug Administration <a href="https://ods.od.nih.gov/HealthInformation/Ephedra.aspx">banned</a> the sale of dietary supplements containing ephedra in 2004 after it was linked to <a href="https://www.nejm.org/doi/full/10.1056/nejmc1502505">health problems</a> ranging from heart attacks and seizures to strokes and even death, and in Australia ephedra is <a href="https://www.legislation.gov.au/Details/F2023L00864">prescription-only</a>. Now we have Ozempic. Just because the history of diet drugs has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362858/">been so dire</a>, we shouldn’t jump to conclusions about new ones – Ozempic is not a drug of the 1920s or 1960s or 1990s. And as <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%2520Obesity%2520in%2520America%2520traces,problem%2520facing%2520American%2520children%2520today.">history recognises</a>, multiple complexities can combine to push a drug into popularity or damn it to history’s rubbish bin. These include patients’, physicians’ and industry interests; social attitudes about drug treatment; evidence about safety and efficacy; beliefs and knowledge about the cause of excess weight. One noticeable contrast with past diet drug experiences is that now, many people are <a href="https://www.nytimes.com/2022/11/22/well/ozempic-diabetes-weight-loss.html">happy to talk</a> about using Ozempic. It seems to be increasingly socially acceptable to use a drug to achieve weight-loss for primarily aesthetic reasons. (Due to Ozempic shortages in Australia, though, doctors have been <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/ozempic-semaglutide-supply-update">asked</a> to direct current supplies to people with type 2 diabetes who satisfy certain criteria. In other words, it’s not really meant to be used just to treat obesity). <h2>Our enduring search for weight-loss drugs</h2> Ozempic is predicted to earn Novo Nordisk <a href="https://www.pharmaceutical-technology.com/comment/novo-nordisk-ozempic/">US$12.5 billion this year alone</a>, but it’s not just industry interests stoking this enduring desire for weight-loss drugs. Patients on an endless cycle of dieting and exercise want something more convenient, with a more certain outcome. And doctors, too, want to offer patients effective treatment, and a drug prescription is a workable option given the constraints of appointment times. The body positivity movement has not yet ousted anti-fat bias or stigma. And despite <a href="https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference">decades of recognition</a> of the major role our physical and social environment plays in human health, there’s little political, public or industry appetite for change. Individuals are left to personally defend against an obesogenic environment, where economic, cultural, social, health and urban design policies can conspire to make it easy to gain weight but hard to lose it. It is no wonder demand for weight-loss drugs continues to soar.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209324/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-dawes-1445353">Laura Dawes</a>, Research Fellow in Medico-Legal History, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ozempic-is-in-the-spotlight-but-its-just-the-latest-in-a-long-and-strange-history-of-weight-loss-drugs-209324">original article</a>.

Body

Renaming obesity won’t fix weight stigma overnight. Here’s what we really need to do

<a href="https://theconversation.com/profiles/ravisha-jayawickrama-1457644">Ravisha Jayawickrama</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/blake-lawrence-1452739">Blake Lawrence</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>, and <a href="https://theconversation.com/profiles/briony-hill-1041619">Briony Hill</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> The stigma that surrounds people living in larger bodies is pervasive and deeply affects the people it’s directed at. It’s been described as one of the last acceptable <a href="https://theconversation.com/how-australias-discrimination-laws-and-public-health-campaigns-perpetuate-fat-stigma-80471">forms of</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592337">discrimination</a>. Some researchers think the term “obesity” itself is part of the problem, and are calling for a <a href="https://pubmed.ncbi.nlm.nih.gov/27967229/">name change</a> to reduce stigma. They’re <a href="https://onlinelibrary.wiley.com/doi/10.1111/obr.13590">proposing</a> “adipose-based chronic disease” instead. We study the stigma that surrounds obesity – around the time of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.13147">pregnancy</a>, among <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.23266">health professionals</a> and health <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00071-8/fulltext">students</a>, and in <a href="https://www.phrp.com.au/issues/october-2022-volume-32-issue-3/weight-stigma-in-australia/">public health</a> more widely. Here’s what’s really needed to reduce weight stigma. <h2>Weight stigma is common</h2> Up to <a href="https://pubmed.ncbi.nlm.nih.gov/26596238/">42% of adults</a> living in larger bodies experience weight stigma. This is when others have negative beliefs, attitudes, assumptions and judgements towards them, unfairly viewing them as lazy, and lacking in willpower or self-discipline. People in larger bodies experience <a href="https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2008.636">discrimination</a> in many areas, including in the workplace, intimate and family relationships, education, health care and the media. Weight stigma is associated with <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1116-5">harms</a> including increased cortisol levels (the main stress hormone in the body), negative body image, increased weight gain, and poor mental health. It leads to decreased uptake of, and quality of, health care. Weight stigma may even pose a <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1116-5">greater threat</a> to someone’s health than increasing body size. <h2>Should we rename obesity?</h2> Calls to remove or rename health conditions or identifications to reduce stigma are not new. For example, in the 1950s homosexuality was classed as a “<a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2022.180103">sociopathic personality disturbance</a>”. Following many years of protests and activism, the term and condition <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695779/">were removed</a> from the globally recognised classification of mental health disorders. In recent weeks, European researchers have renamed non-alcoholic fatty liver disease “metabolic dysfunction-associated steatotic liver disease”. This occurred after <a href="https://www.bmj.com/content/382/bmj.p1587">up to 66%</a> of health-care professionals surveyed felt the terms “non-alcoholic” and “fatty” to be stigmatising. Perhaps it is finally time to follow suit and rename obesity. But is “adiposity-based chronic disease” the answer? <h2>A new name needs to go beyond BMI</h2> There are two common ways people view obesity. First, most people use the term for people with a body-mass index (BMI) of 30kg/m² or above. Most, if not all, public health organisations also use BMI to categorise obesity and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00138-9/fulltext">make assumptions</a> about health. However, BMI alone is not enough to accurately summarise someone’s health. It does not account for muscle mass and <a href="https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf">does not provide</a> information about the distribution of body weight or adipose tissue (body fat). A high BMI can occur <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">without</a> biological indicators of poor health. Second, obesity is sometimes used to describe the condition of excess weight when mainly <a href="https://onlinelibrary.wiley.com/doi/10.1111/obr.13590">accompanied by</a> metabolic abnormalities. To simplify, this reflects how the body has adapted to the environment in a way that makes it more susceptible to health risks, with excess weight a by-product of this. Renaming obesity “adiposity-based chronic disease” acknowledges the chronic metabolic dysfunction associated with what we currently term obesity. It also avoids labelling people purely on body size. <h2>Is obesity a disease anyway?</h2> “Adiposity-based chronic disease” is an acknowledgement of a disease state. Yet there is still no universal consensus on whether obesity is a disease. Nor is there clear agreement on the definition of “disease”. People who take a biological-dysfunction approach to disease <a href="https://pubmed.ncbi.nlm.nih.gov/25336733/">argue</a> dysfunction occurs when physiological or psychological systems don’t do what they’re supposed to. By this definition, obesity may <a href="https://pubmed.ncbi.nlm.nih.gov/37279872/">not be classified as a disease</a> until after harm from the additional weight occurs. That’s because the excess weight itself may not initially be harmful. Even if we do categorise obesity as a disease, there may still be value in renaming it. Renaming obesity may improve public understanding that while obesity is often associated with an increase in BMI, the increased BMI itself is not the disease. This change could move the focus from obesity and body size, to a more nuanced understanding and discussion of the biological, environmental, and lifestyle factors <a href="https://onlinelibrary.wiley.com/doi/10.1111/obr.13590">associated</a> with it. <h2>Workshopping alternatives</h2> Before deciding to rename obesity, we need discussions between obesity and stigma experts, health-care professionals, members of the public, and crucially, <a href="https://www.phrp.com.au/issues/october-2022-volume-32-issue-3/weight-stigma-in-australia/">people living with obesity</a>. Such discussions can ensure robust evidence informs any future decisions, and proposed new terms are not also stigmatising. <h2>What else can we do?</h2> Even then, renaming obesity may not be enough to reduce the stigma. Our constant exposure to the socially-defined and acceptable idealisation of smaller bodies (the “thin ideal”) and the pervasiveness of weight stigma means this stigma is deeply ingrained at a societal level. Perhaps true reductions in obesity stigma may only come from a societal shift – away from the focus of the “thin ideal” to one that acknowledges health and wellbeing can occur at a range of body sizes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209224/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ravisha-jayawickrama-1457644">Ravisha Jayawickrama</a>, PhD candidate, School of Population Health, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/blake-lawrence-1452739">Blake Lawrence</a>, Lecturer, Curtin School of Population Health, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>, and <a href="https://theconversation.com/profiles/briony-hill-1041619">Briony Hill</a>, Deputy Head, Health and Social Care Unit and Senior Research Fellow, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/renaming-obesity-wont-fix-weight-stigma-overnight-heres-what-we-really-need-to-do-209224">original article</a>.

Body

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

<a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, <a href="http://www.theconversation.com/">The Conversation</a> Australian of the Year and body positivity advocate Taryn Brumfitt has <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">called for</a> doctors to avoid discussing a patient’s weight when they seek care for unrelated matters. A 15-minute consultation isn’t long enough to provide support to change behaviours, Brumfitt says, and GPs don’t have enough training and expertise to have these complex discussions. “Many people in larger bodies tell us they have gone to the doctor with something like a sore knee, and come out with a ‘prescription’ for a very restrictive diet, and no ongoing support,” Brumfitt <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">told the Nine newspapers</a>. By raising the issue of weight, Brumfitt says, GPs also risk turning patients off seeking care for other health concerns. So should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts. Brett Montgomery - GP academic Yes, sometimes – but with great care. I agree that weight stigma is damaging, and insensitively raising weight in consultations can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251566" target="_blank" rel="noopener">hurt people's feelings and create barriers</a>to other aspects of health care. I also agree people can sometimes be “overweight” yet <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0287218" target="_blank" rel="noopener">quite healthy</a>, and that common measures and categories of weight are <a href="https://theconversation.com/bmi-alone-will-no-longer-be-treated-as-the-go-to-measure-for-weight-management-an-obesity-medicine-physician-explains-the-seismic-shift-taking-place-208174">questionable</a>. On the other hand, I know obesity <a href="https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf" target="_blank" rel="noopener">is associated with</a> heart disease, joint problems, diabetes and cancers. GPs should be ready to help people with their weight when they want help. <a href="https://www.bmj.com/content/377/bmj-2021-069719.full?ijkey=FnARkmvxLOMFvlb&keytype=ref">Our assistance somewhat effective</a>, though sadly dietary efforts often have minimal effect on weight in the long term. Meanwhile, treatments causing larger weight changes (<a href="https://insightplus.mja.com.au/2021/10/bariatric-surgery-public-system-access-still-terrible/">surgery</a> and <a href="https://www.nature.com/articles/s41366-022-01176-2">some medicines</a> are often financially inaccessible. I feel safe discussing weight when my patient raises the issue. Fearing hurting people, I often avoid raising it myself. I focus instead on health rather than weight, discussing physical activity and healthy diet – these are good things for people of any size. Emma Beckett - Nutrition scientist No. It’s not likely to succeed. Large systematic reviews bringing together multiple studies of multiple weight-loss diets show weight loss is not generally maintained long term (<a href="https://pubmed.ncbi.nlm.nih.gov/32238384/">12 months</a> to <a href="https://www.nature.com/articles/0802982">four years</a>). The idea that weight is about willpower is outdated. The current body of evidence <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">suggests</a> we each have a weight set point that our body defends. This is determined by genetics and environment more so than education. There may be associations between weight and health outcomes, but losing weight <a href="https://theconversation.com/just-because-youre-thin-doesnt-mean-youre-healthy-101185">does not necessarily equate</a> with improving health. Fat stigma and fatphobia are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866597/">harmful too</a> and can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/">compromise access to health care</a>. Instead, consider asking a better question. Healthy eating reduces disease risk <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/">regardless of weight</a>. So maybe ask how many vegetables are your patients eating. Would they like to see a dietitian to discuss strategies for a better-quality diet? Liz Sturgiss - GP/researcher No. A <a href="https://pubmed.ncbi.nlm.nih.gov/33211585/">US study</a> estimates it would take a family doctor 131% of their work hours to implement all preventive health-care recommendations. It's impossible to address every recommendation for preventative care at every consultation. One of the key skills of a GP is balancing the patient and doctor agenda. <a href="https://www.obesityevidencehub.org.au/collections/treatment/weight-bias-and-stigma-in-health-care">Weight stigma</a> can deter people from seeking health care, so raising weight when a patient doesn't have it on their agenda can be harmful. A strong <a href="https://academic.oup.com/fampra/article/38/5/644/6244494?login=false">therapeutic relationship</a> is critical for safe and effective health care to address weight. Weight is always on my agenda when there is unexpected weight loss. If a patient has rapid weight loss, I am concerned about an undetected <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283307/">cancer</a> or infection. Additionally, I am increasingly seeing patients who are unable to afford food, who often have <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/introduction">poor oral health</a>, who lose weight due to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1747-0080.12580">poverty</a>. Weight loss for the wrong reasons is also a very concerning part of general practice. Nick Fuller - Obesity researcher Yes. GPs should play a role in the early detection of weight issues and direct patients to evidence-based care to slow this progression. <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Research</a> shows many people with obesity are motivated to lose weight (48%). <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Most</a> want their clinician to initiate a conversation about weight management and treatment options. However, this conversation <a href="https://pubmed.ncbi.nlm.nih.gov/32385580/">rarely occurs</a>, resulting in <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">significant delays to treatment</a>. Starting the conversation presents challenges. Although obesity is a complex disease related to multiple factors, it's still <a href="https://pubmed.ncbi.nlm.nih.gov/25752756/">highly stigmatised</a>in our society and even in the <a href="https://pubmed.ncbi.nlm.nih.gov/23144885/">clinical setting</a>. Sensitivity is required and the wording the clinician uses is important to make the patient feel safe and avoid placing blame on them. Patients often <a href="https://pubmed.ncbi.nlm.nih.gov/20823355/">prefer terms</a> such as “weight” and “BMI” (body mass index) over “fatness,” “size” or “obesity”, <a href="https://pubmed.ncbi.nlm.nih.gov/27354290/">particularly women</a>. Measuring weight, height and waist circumference should be <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">considered routine in primary care</a>. But this needs to be done without judgement, and in collaboration with the patient. Helen Truby - Nutrition scientist Yes. A high body weight contributes to many chronic conditions that negatively impact the <a href="https://www.aihw.gov.au/australias-health/summaries">quality of life and mental health</a> of millions of Australians. Not all GPs feel confident having weight conversations, given the sensitive nature of weight and its stigma. GPs' words matter – they are a <a href="https://doi.org/10.1111/nbu.12320">trusted source</a> of health information. It’s critical GPs gain the skills to know when and how to have <a href="https://doi.org/10.1186/s12875-019-1026-4">positive weight conversations</a>. GPs need to offer supportive and affordable solutions. But effective specialist weight management programs are few and far between. More equitable access to programs is essential so GPs have referral pathways after conversations about weight. GPs' time is valuable. Activating this critical workforce is essential to meet the <a href="https://www.health.gov.au/resources/publications/national-obesity-strategy-2022-2032?language=en">National Obesity Strategy.</a> <a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, Deputy Editor and Senior Health Editor, <a href="http://www.theconversation.com/">The Conversation</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-gps-bring-up-a-patients-weight-in-consultations-about-other-matters-we-asked-5-experts-209681">original article</a>.

Body

Weight loss: why you don’t just lose fat when you’re on a diet

<a href="https://theconversation.com/profiles/adam-collins-1179004">Adam Collins</a>, <a href="https://theconversation.com/institutions/university-of-surrey-1201">University of Surrey</a> When you go on a diet, you don’t just lose fat – you lose muscle too. This can have many repercussions – not only on your fitness and strength, but on your metabolism. To lose weight (body fat), you need to be in a calorie deficit. This means consuming fewer calories than your body uses, or exercising to burn more calories than you consume. During the first few days in a calorie deficit, the body uses up its small reservoir of <a href="https://pubmed.ncbi.nlm.nih.gov/1615908/">glycogen stores</a> for energy. Glycogen is a string of glucose (sugar) that comes from the carbohydrates you eat. Since carbs are the body’s main energy source, this is why any glucose the body doesn’t immediately use is stored to use for energy later. But as carbohydrate molecules bind with water, this means that when the body stores glycogen, it also stores water in the muscles. As these glycogen stores are used up, the body also releases a significant amount of water. This is often called “water weight”, and explains why some may feel they lose considerable weight early in their diet. Given you only have days’ worth of glycogen stores, this is why the body uses fat to store extra calories for when you need it. Once the glycogen stores are used up, the body shifts to metabolising fat to get the energy it needs to function. But not all tissues can use fat for energy – such as the brain. This is why the body needs to metabolise your muscles when you’re in a calorie deficit. Protein (from the food you eat) is stored in your muscles. The body can convert this stored protein into glucose for energy. But this means you subsequently lose the muscle tissue itself when that happens. This has significant consequences – including <a href="https://pubmed.ncbi.nlm.nih.gov/35103583/">slowing the metabolism</a>, which may ultimately drive weight regain after losing weight. <h2>Muscle loss</h2> Many factors can affect how much muscle you lose while in a calorie deficit. While it was once thought that the more fat you had, the <a href="https://pubmed.ncbi.nlm.nih.gov/10673906/">less muscle you lost</a> in a calorie deficit, this has since been disproved – with both <a href="https://pubmed.ncbi.nlm.nih.gov/3066619/">lean</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/17367567/">obese people</a> losing significant rates of muscle when dieting. <a href="https://pubmed.ncbi.nlm.nih.gov/29957829/">Ethnicity</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32734691/">genetics</a> may, however, play a role – with studies showing black people tend to lose more muscle mass in a calorie deficit than white people do. Some research also suggests that genetic variants may make some people more susceptible to <a href="https://pubmed.ncbi.nlm.nih.gov/32734691/">certain dietary changes</a>, which may determine how much muscle mass they end up losing. Muscle loss will also happen regardless of whether you lose weight <a href="https://pubmed.ncbi.nlm.nih.gov/30925026/">gradually or quickly</a>. A better determinant of how much muscle you’ll lose depends on <a href="https://pubmed.ncbi.nlm.nih.gov/30925026/">how much weight you end up losing</a>. If a person loses 10% of their body weight, typically around 20% of this is fat-free mass (the proportion of body mass that isn’t fat – such as muscle). This can equate to several kilograms of muscle. Many people also think that what you eat while losing weight may determine how much muscle you lose, with it commonly believed that if you eat plenty of protein you’re less likely to lose muscle mass. This is <a href="https://pubmed.ncbi.nlm.nih.gov/19246357/">debatable</a>, with research showing people lose as much muscle on high-protein weight loss diets as people who followed other types of diets. Low-carb diets have also been claimed to promote more fat loss. But studies comparing <a href="https://pubmed.ncbi.nlm.nih.gov/22258266/">different types of diets</a> have found that low-fat high-carb diets seem to offer <a href="https://pubmed.ncbi.nlm.nih.gov/28193517/">the same, if not better, fat loss</a> than low-carb, high-fat diets – with no differences in muscle loss. <h2>Protein and exercise</h2> Given all that has been said, the only way to prevent muscle loss somewhat while losing weight is to combine exercise (particularly <a href="https://pubmed.ncbi.nlm.nih.gov/18356845/">resistance exercise</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/28507015/">endurance exercise</a>) with a diet higher in protein. This is because exercise stimulates muscle growth – but this process can only happen if you have an adequate supply of protein. It’s suggested adults normally aim to consume <a href="https://pubmed.ncbi.nlm.nih.gov/34371981/">0.8g of protein per kilogram of body weight</a> per day to maintain muscle mass. But given the extra demand exercise places on the muscles, a person will probably need to consume 1.2-1.5g of protein per kilogram of body weight to preserve muscle during weight loss. People who exercise a lot may need to increase that to more than <a href="https://pubmed.ncbi.nlm.nih.gov/28642676/">2g per kilogram of body weight</a> when losing weight. <a href="https://pubmed.ncbi.nlm.nih.gov/22221216/">Older people</a> may also need to consume more protein than average. Just be wary of consuming too much protein (more than 2.5g per kilogram of body weight) as eating more than your body uses could have an <a href="https://pubmed.ncbi.nlm.nih.gov/28507015/">adverse effect</a> on your metabolism by potentially making the body less able to draw upon glucose for energy. It may also put greater pressure on the kidneys and liver – which could lead to serious <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460905/#:%7E:text=High%20dietary%20protein%20intake%20can,a%20role%20in%20kidney%20health.">health issues</a>, such as liver and kidney damage. Even if you prevent muscle loss when losing weight, other metabolic changes still happen that promote weight regain – such as changes in your metabolic rate (the minimum amount of calories your body needs to survive) and <a href="https://pubmed.ncbi.nlm.nih.gov/21677272/">increases in appetite and hunger</a>. This is why, when trying to lose weight, the most important thing to consider is how sustainable your diet and lifestyle changes are. The easier these are to maintain, the better chances you have of keeping the weight off.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/209258/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-collins-1179004">Adam Collins</a>, Principal Teaching Fellow, Nutrition, <a href="https://theconversation.com/institutions/university-of-surrey-1201">University of Surrey</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/weight-loss-why-you-dont-just-lose-fat-when-youre-on-a-diet-209258">original article</a>.

Body

This eating habit is key to losing weight

New research has found the time of day you eat is key to losing weight. The findings reveal that your best efforts to cut back may prove ineffective if you’re not timing your meals correctly. A study found that mice lost weight when they were given a reduced calorie diet and only ate during the day. Rodents who consumed the same diet but ate at night did not reap the same results. Lead author of the study, Dr Joseph Takahashi, said, “Translated into human behaviour, these studies suggest that dieting will only be effective if calories are consumed during the daytime when we are awake and active.” Dr Takahashi added, “They further suggest that eating at the wrong time at night will not lead to weight loss even when dieting.” Scientists from the University of Texas Southwestern Medical Center also believe the timing of meals is important as it also affects circadian rhythms, the body’s 24-hour clock. They have highlighted how the research may explain how dietary habits impact lifespan. The study observed this by testing the day/night cycles of mice under different feeding schedules. Two groups of mice were fed at the wrong time during their normal cycle. One group was given 30 per cent less calories and the other group had unlimited food, but both groups were more active at night. Various research has associated sleep problems with an increased risk of obesity. “'It has been known for decades that calorie restriction prolongs lifespan in animals, but these types of studies are very difficult to conduct because they required manual feeding of subjects over many years," Dr Takahashi said “This automated system, which can be scaled up for large and very long longevity studies, provides the means to address open questions about what mechanisms extend lifespan in mammals.” Image credit: Shutterstock The research was published in the journal Cell Metabolism.

Body

John Goodman flaunts impressive 90kg weight loss

John Goodman has stepped out on the red carpet for his TV show, showing off his incredible 90kg weight loss. The 70-year-old Hollywood legend attended the premiere of the third season of The Righteous Gemstones at the 62nd Monte-Carlo TV festival, showing off the impressive results of his health and fitness overhaul. The actor looked pleased with his results as he walked the red carpet in a fitted suit jacket and beige trousers ahead of the festival, where he was also serving as jury president. <img src="https://oversixtydev.blob.core.windows.net/media/2023/06/goodman-weight-embed.jpg" alt="" width="1280" height="720" /> Goodman previously explained that he realised he needed to make changes after tipping the scales at his heaviest weight of 178kg. The Roseanne star kickstarted his wellness journey in 2007, after he quit drinking and hired a personal trainer to help him reach his health goals. He went on to commit to a “Mediterranean-style eating plan”, which focuses on nutrient-rich whole foods and grains and has an emphasis on fresh produce and olive oil, and began exercising six days a week. His fitness plan includes an elliptical bicycle and treadmill and a daily step count of 10,000-12,000 steps. While on his dedicated health mission, he has been candid about the ups and downs of making a major lifestyle overhaul. In 2010, he told People magazine, “It takes a lot of creative energy to sit on your a**e and figure out what you’re going to eat next.” “I wanted to live life better.” “I just got tired, sick and tired of looking at myself. You’re shaving in the mirror and you don’t want to look at yourself. It gets dangerous.” Image credits: Getty Images

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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

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What is ‘budget Ozempic’ that’s all over social media? Can it help me lose weight?

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Renaming obesity won’t fix weight stigma overnight. Here’s what we really need to do

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

Weight loss: why you don’t just lose fat when you’re on a diet

This eating habit is key to losing weight

John Goodman flaunts impressive 90kg weight loss

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Health

Lifestyle

Finance

Entertainment

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Keep up to date

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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

Rebel Wilson's shocking weight loss confession

How much weight do you actually need to lose? It might be a lot less than you think

How dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders

Resistance (exercise) is far from futile: The unheralded benefits of weight training

5 ways to avoid weight gain and save money on food this Christmas

I’m trying to lose weight and eat healthily. Why do I feel so hungry all the time? What can I do about it?

Oprah's weight-loss backflip: "I'm done with the shame"

When it comes to weight, your ‘diet’ is much more than what you eat

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

Can coffee help you avoid weight gain? Here’s what the science says

Dawn French hits back at "shameful" weight loss comments

What is ‘budget Ozempic’ that’s all over social media? Can it help me lose weight?

Ozempic is in the spotlight but it’s just the latest in a long and strange history of weight-loss drugs

Renaming obesity won’t fix weight stigma overnight. Here’s what we really need to do

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

Weight loss: why you don’t just lose fat when you’re on a diet

This eating habit is key to losing weight

John Goodman flaunts impressive 90kg weight loss

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