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Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

<p><em><a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a></em></p> <p>The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters.</p> <p>The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>.</p> <p>Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized.</p> <p>As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments.</p> <h2>The best of both worlds</h2> <p>GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight.</p> <p>The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction.</p> <p>This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>.</p> <h2>A new era</h2> <p>GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger.</p> <p>These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope.</p> <p>Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions.</p> <p>Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support.</p> <h2><strong>Treating the effects but not the causes</strong></h2> <p>To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again.</p> <p>In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta).</p> <p>Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise.</p> <h2><strong>Prescribe and treat</strong></h2> <p>A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it.</p> <p>This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance.</p> <p>This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic.</p> <h2>What lessons can we learn?</h2> <p>The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment.</p> <p>We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<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/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/aude-bandini-1488512"><em>Aude Bandini</em></a><em>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>.</em></p>

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No, you can’t reverse ageing by injecting ‘young blood’ and fasting. But that doesn’t stop people trying

<p><a href="https://theconversation.com/profiles/rachael-jefferson-buchanan-297850">Rachael Jefferson-Buchanan</a>, <em><a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a></em></p> <p>Like many celebrities and entrepreneurs, 45-year-old US tech billionaire Bryan Johnson is <a href="https://www.smh.com.au/lifestyle/health-and-wellness/taking-the-blood-of-your-17-year-old-son-anti-ageing-has-gone-too-far-20230530-p5dcd6.html">trying to reverse the ageing process</a>.</p> <p>Spending an average of US$2 million a year on an anti-ageing regimen, Johnson <a href="https://medium.com/future-literacy/at-45-i-now-age-slower-than-the-average-10-year-old-6932448fc608">claims</a> he now ages slower than some children. He explains: “the pace my body accumulates ageing damage is less than the average ten year old”.</p> <p>Many of Johnson’s age-reversal methods are questionable, involve dodgy science, and have known side effects.</p> <p>While you can’t stop the ageing process, and the gradual decline our bodies experience as we advance in years, there are some things we can all do – for free – to maintain our health as we age.</p> <h2>What does Johnson do? And is it scientific?</h2> <p><strong>Fasting</strong></p> <p>Johnson reports fasting for 23 hours a day. He then eats <a href="https://medium.com/future-literacy/one-meal-23-hr-fast-100-nutrition-18187a2f5b">one meal a day</a>: 2,250 calories of nutrient-dense food “customised” to his body’s needs.</p> <p>Eating for time-restricted periods in the day can have a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650338/">positive effect</a> on how we <a href="https://pubmed.ncbi.nlm.nih.gov/29955217/">metabolise nutrients</a>, inflammation levels, hormonal regulation, and <a href="https://www.health.harvard.edu/blog/how-good-is-your-cardiometabolic-health-and-what-is-that-anyway-202208182803">cardiometabolic health</a> (blood sugar, <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186">triglycerides</a>, cholesterol, blood pressure, BMI and waist circumference).</p> <p>However, a Spartan-like food intake can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2121099/">impair</a> how our body responds to sugar (known as glucose tolerance). And it’s not necessarily any more effective for weight maintenance than <a href="https://pubmed.ncbi.nlm.nih.gov/29419624/">reducing calorie intake at each meal</a>.</p> <p>Large-scale, long-term human trials are needed to confirm the <a href="https://pubmed.ncbi.nlm.nih.gov/34728336/">limited risk-benefit</a> findings of fasting.</p> <p><strong>Acid peels</strong></p> <p>Johnson has weekly <a href="https://www.asds.net/skin-experts/skin-treatments/chemical-peels/chemical-peels-for-aging-skin">acid peels</a> (which use a mild acid to exfoliate the skin) to maintain a “youthful glow”.</p> <p>But you cannot smooth sagging facial skin or remove deep scars or wrinkles. Acid peels also <a href="https://www.mayoclinic.org/tests-procedures/chemical-peel/about/pac-20393473">come with risks</a>, including organ damage, infection, scarring and swelling.</p> <p><strong>Plasma infusions</strong></p> <p>Perhaps the most bizarre youth-inducing procedure Johnson has attempted is receiving blood transfusions from his 17-year-old son.</p> <p>US biotech companies have explored <a href="https://www.theguardian.com/society/2020/feb/02/could-young-blood-stop-us-getting-old-transfusions-experiments-mice-plasma">plasma infusions</a> to tackle age-related diseases in humans for decades. But there are no proven clinical benefits.</p> <p><a href="https://www.redcrossblood.org/donate-blood/blood-donation-process/what-happens-to-donated-blood/blood-transfusions/risks-complications.html">Side effects from blood transfusions</a> include blood-borne infections, fever and allergic reactions.</p> <h2>Historical attempts to stay youthful</h2> <p>Humans have been experimenting with <a href="https://academic.oup.com/biomedgerontology/article/59/6/B515/662071">anti-ageing methods for centuries</a>. These have included all sorts of behavioural and lifestyle practices that are quirky, questionable, and even sadistic.</p> <p>Ancient practices included <a href="https://www.marieclaire.com/beauty/news/a14382/anti-aging-beauty-through-history/">crocodile dung face masks</a>, which the Greeks and Romans used to brighten their complexions.</p> <p>Romans also used <a href="https://beautytap.com/2019/03/donkey-milk">donkey milk</a> and <a href="https://www.ancient-origins.net/history/swans-fat-crocodile-dung-and-ashes-snails-achieving-beauty-ancient-rome-003240">swan fat</a> to minimise wrinkles, due to their acclaimed rejuvenating properties.</p> <p><a href="https://www.livescience.com/44071-cleopatra-biography.html">Cleopatra</a> apparently took daily baths in sour donkey milk. To sustain this lavish habit, she had a <a href="https://www.naturanecosmetics.com/en/content/26-faits-historiques">herd of 700 donkeys</a>. Sour milk contains <a href="https://science.jrank.org/pages/3780/Lactic-Acid-Lactic-acid-in-foods.html">lactic acid</a>, a naturally occurring <a href="https://www.mecca.com.au/edits/ingredients/alpha-hydroxy-acids/">alpha-hydroxy acid (AHA)</a> that exists in many modern-day exfoliants. So this idea was grounded in basic science, at least.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/530478/original/file-20230607-27-bv0w1t.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Milk bath with dried fruits and flowers" /><figcaption><span class="caption">Don’t waste milk on a bath.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bath-milk-flowers-1051210370">Shutterstock</a></span></figcaption></figure> <p>During the 16th and 17th century, “Countess Dracula” aka <a href="https://en.wikipedia.org/wiki/Elizabeth_B%C3%A1thory">Elizabeth Bathory</a> allegedly resorted to serial killing to quench her thirst for youthfulness, <a href="https://www.nationalgeographic.com/travel/article/the-bloody-legend-of-hungarys-serial-killer-countess">bathing in the blood of her young victims</a>.</p> <h2>The quest continues with cryotherapy</h2> <p>Fountain of youth fixations have inspired many contemporary anti-ageing trends. Exposure to cold is a firm favourite.</p> <p><a href="https://www.nature.com/articles/s43587-023-00383-4">Some research</a> suggests this could have <a href="https://neurosciencenews.com/cold-aging-22928/">benefits</a> relating to longevity, by slowing cellular degeneration, <a href="https://www.cryo.com.au/anti-ageing-benefits-of-whole-body-cryotherapy/">stimulating collagen and elastin production</a>, increasing the metabolism, and reducing inflammation.</p> <p>Dutch motivational speaker Wim Hof includes <a href="https://www.wimhofmethod.com/cold-water-immersion">cold water immersion</a> as one of the three pillars of his <a href="https://www.wimhofmethod.com/">Wim Hof Method</a> to “increase mind-body connection”.</p> <p>Athletes such as <a href="https://www.dailymail.co.uk/sport/football/article-2469985/Cristiano-Ronaldo-buys-Cryotherapy-chamber.html">Cristiano Ronaldo</a> use <a href="https://my.clevelandclinic.org/health/treatments/21099-cryotherapy">cryotherapy</a>, exposing their bodies to extremely cold temperatures for two to four minutes to decrease the signs of ageing and enhance their general health.</p> <p>However, the <a href="https://www.medicinenet.com/what_are_the_side_effects_of_cryotherapy/article.htm">risks of cryotherapy</a> include bone fractures, frostbite, nerve damage, bleeding, cramping, swelling and skin infections.</p> <h2>So what can we do to age well?</h2> <p>Two of the more mainstream anti-ageing methods that Johnson recommends are the daily self-care habits of sleep and exercise.</p> <p>He has a <a href="https://medium.com/future-literacy/sleep-and-impulse-control-87e844218ff2">strict sleep schedule</a> that involves retiring to bed at 8pm, with a one-hour wind-down in a darkened room.</p> <p>Adults report poorer sleep quality and difficulty being able to sleep for long enough <a href="https://www.news-medical.net/health/How-Does-the-Suprachiasmatic-Nucleus-(SCN)-Control-Circadian-Rhythm.aspx">as they age</a>. Sleeping too much or too little is <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1043347/full">associated with</a> a greater risk of obesity, heart disease and <a href="https://theconversation.com/research-check-can-sleeping-too-much-lead-to-an-early-death-101323">premature death</a>.</p> <p>Developing a regular sleep routine, reducing bedroom distractions such as mobile phones, and exercising regularly can all help to <a href="https://www.sleepfoundation.org/aging-and-sleep">alleviate sleep problems</a>.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=383&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=383&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=383&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=482&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=482&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/530491/original/file-20230607-29-cw0f29.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=482&amp;fit=crop&amp;dpr=3 2262w" alt="Child and grandfather walk on a beach" /><figcaption><span class="caption">Exercise is also important for healthy ageing.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/s-vhziQHngM">Vidar Nordi Mathisen/Unsplash</a></span></figcaption></figure> <p>Exercise, often cited as a <a href="https://www.marketwatch.com/story/exercise-is-the-wonder-drug-for-healthy-aging-11633642719">wonder drug for healthy ageing</a>, is something Johnson takes very seriously. He does a “<a href="https://www.youtube.com/watch?v=HNywRJgCRaQ">Blueprint</a>” workout that includes specially designed daily techniques, as well as <a href="https://www.hsph.harvard.edu/nutritionsource/high-intensity-interval-training/">high-intensity interval training sessions</a>, hiking and playing sport.</p> <p>From middle age onwards, we all need to exercise regularly, to increase our muscle mass, bone density, strength, endurance, coordination and balance. One of the greatest health risks for older people is <a href="https://www.ncbi.nlm.nih.gov/books/NBK560761/">falling</a>, which balance, flexibility, endurance and strength training <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381224/">can help</a> reduce. Physical activity can bring <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408452/">social benefits</a> in older adults if undertaken in groups, and there are well-known <a href="https://www.whiddon.com.au/yourlife/the-mental-health-benefits-of-exercise-for-older-adults/">mental health gains</a>.</p> <p>Small changes in sleep, diet (eating <a href="https://health.gov/news/202107/nutrition-we-age-healthy-eating-dietary-guidelines">plenty of vegetables, fruit, wholegrains, healthy fats, and enough protein</a>), and exercise can support <a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01900-5">healthy ageing</a>, reducing the chance of early death, and helping us all to lead an active and independent life in our senior years. Now that <em>is</em> something worth investing in.<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/207038/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/rachael-jefferson-buchanan-297850">Rachael Jefferson-Buchanan</a>, Lecturer in Human Movement Studies (Health and PE) and Creative Arts, <em><a href="https://theconversation.com/institutions/charles-sturt-university-849">Charles Sturt University</a></em></p> <p><em>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-you-cant-reverse-ageing-by-injecting-young-blood-and-fasting-but-that-doesnt-stop-people-trying-207038">original article</a>.</em></p> <p><em>Images: Getty</em></p>

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Keeping up with the science of cosmetic injectables

<p>There’s a good chance that you or someone you know has considered cosmetic injectables; medical procedures that involve injecting a substance under your skin to change some part of your appearance.</p> <p>Whether you want to reduce the appearance of wrinkles in your forehead, increase the fullness of your lips, or reduce the amount of fat under your chin – there’s a chemical substance that can be injected to do it.</p> <p>But what exactly are these substances? How do they work? And are there risks associated with going under the needle?</p> <h2>Start with the classic: Botox</h2> <p>Botox is a drug made from botulinum toxin, a neurotoxin protein produced by the bacterium Clostridium botulinum. In large amounts, this neurotoxin can cause botulism, a rare but serious illness that affects the nerves and can even result in death.</p> <p>Botulinum toxin actually consists of 7 different subtypes of toxins, but only botulinum toxin types A and B are used clinically. Type A is the one approved as a cosmetic injectable and it can be used soften the appearance of facial wrinkles and adjust brow positioning.</p> <p>But how does it work? Well, it blocks nerve signals from reaching injected muscles, which stops them from being able to contract. The resulting localised muscle weakness or paralysis prevents the muscles from forming lines in the skin.</p> <p>Botulinum toxin is a type of enzyme called a protease and it cleaves or cuts specific proteins that are essential for the release of neuro-transmitters. These are chemical messengers used by the nervous system to transmit messages between neurons or from neurons to muscles.</p> <p>Specifically, it blocks the release of the neurotransmitter acetylcholine from presynaptic motor neurons. But the effects of Botox ultimately aren’t permanent, because function is recovered by sprouting new, unaffected nerve terminals, which usually takes three to four months.</p> <h2>Hyaluronic acid fillers are becoming increasingly popular</h2> <p>Dermal fillers are substances injected into the skin to plump out wrinkles or alter the shape of the face in some way – for instance, adding volume to the lips or cheeks, or altering the shape of the nose or jawline.</p> <p>One popular substance used in fillers is hyaluronic acid: a long, linear sugar molecule found naturally throughout the body. It’s one of the most hydrophilic, or water-loving, molecules in nature and just one gram of it can bind up to 6 litres of water – kind of like how gelatine binds up water to form jelly.  </p> <p>Hyaluronic acid gel can be modified to have different physical properties, which then alters the ways in which it can be used. By introducing chemical bonds to crosslink between the hyaluronic acid strands the firmness and stress-resistance of the substance can be increased, which is important when defining or altering the appearance of features like the nose, jawline, or cheekbones.</p> <p>Hyaluronic acid injections aren’t permanent and are slowly broken down and re-absorbed into the body over time. This is done by an enzyme called hyaluronidase, which is found throughout the body. It cuts up the long hyaluronic acid polymers into smaller fragments that are then further degraded by other enzymes.</p> <h2>Other substances can also be used as dermal fillers</h2> <p>Though less popular than hyaluronic acid, collagen can also be used as a cosmetic injectable filler.</p> <p>Collagen is the major structural component of the dermis in the skin and provides strength and support to it. As we age, the production of collagen decreases and that results in the reduction in skin volume we see in aged skin.</p> <p>It was the first material to be approved by the U.S. Food and Drug Administration for injection into facial scars, furrows, and lines. Collagen injections replenish the collagen lost from the face and can be derived from cows (bovine), pigs (porcine), or even human cells.</p> <p>But, what if instead of adding volume, you want to get rid of it? Lipolytic injections are a non-surgical way to reduce localised subcutaneous fat deposits, like the one found under your chin.</p> <p>The substances phosphatidylcholine (PC) and deoxycholic acid (DC) are used to chemically reduce the number of fat cells around the injection site by causing fat cells to die. DC is a bile salt that induces fat cell death by acting as a detergent to break apart the cell membrane. The exact mechanism of action for PC isn’t well understood, but its thought that it stimulates enzymes called lipases to break down fats.</p> <h2>Before you go out and book an appointment, a quick safety PSA.</h2> <p>With cosmetic injections, like any medical procedure, there are always risks involved and sometimes these risks can be serious and even life threatening.</p> <p>Anyone that performs a cosmetic injection must have extensive knowledge of facial anatomy, as well as the required training and experience, so that the risk of something adverse happening can be minimised. The Australian Therapeutic Goods Association recommend finding a registered practitioner and making sure that the product used in your procedure is registered by checking the Australian Register of Therapeutic Goods, which lists all of the products that can be legally supplied in Australia.</p> <p><strong>This article first appeared on <a href="https://cosmosmagazine.com/health/the-science-of-cosmetic-injectables/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Imma Perfetto.</strong></p> <p><em>Image: Shutterstock</em></p>

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Man’s skin ruined after tanning injection disaster

<p><span style="font-weight: 400;">Before a much anticipated holiday to Spain, 28-year-old Dylan Wright wanted to boost his golden tan. </span></p> <p><span style="font-weight: 400;">To get the glow he was searching for, he purchased $18 tanning injections, and administered two of them before leaving for the airport. </span></p> <p><span style="font-weight: 400;">However, at the end of his six-day trip, his complexion was a lot darker than he expected. </span></p> <p><span style="font-weight: 400;">Dylan says that looking back, he probably should’ve used only one syringe, but didn’t want to run the risk of bringing the injections through airport security. </span></p> <p><span style="font-weight: 400;">“I bought them before to make the most of the sun. I went on the sunbeds a bit before the holiday but didn’t take the injections until just before I left,” he told </span><a href="https://swns.com/"><span style="font-weight: 400;">SWNS</span></a><span style="font-weight: 400;">. </span></p> <p><span style="font-weight: 400;">Sharing his story to TikTok, Dylan said he has been left with permanent physical reminders of the injections, and even experienced a cancer scare as a result. </span></p> <p><span style="font-weight: 400;">“The doctors called me an idiot and told me it’s a side effect from the drug, but now I’m stuck with [freckles],” he said. </span></p> <p><span style="font-weight: 400;">“I’ve got freckles like I’m in my 50s or 60s. It feels like my skin’s aged.”</span></p> <p><span style="font-weight: 400;">The injections contain a lab-made hormone called melanotan II to increase melanin production, but at the cost of lasting skin damage. </span></p> <p><span style="font-weight: 400;">Now that Dylan’s  excessive tan has faded, he is trying to spread awareness of the dangers of tanning injections, and urging people to do their own research. </span></p> <p><span style="font-weight: 400;">“It’s really not worth it. There’s safer ways to tan, like fake tanning,” he said. </span></p> <p><span style="font-weight: 400;">“It gave me a wake-up call … It’s a classic case of being 20 and thinking you’re invincible.”</span></p> <p><em><span style="font-weight: 400;">Image credits: TikTok</span></em></p>

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