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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels. However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>. Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes. Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked? <h2>Osteoarthritis and obesity</h2> Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis. Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation. For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>. Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help. But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten. Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness. <h2>Semaglutide for osteoarthritis?</h2> The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight. They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight. As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group. The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group. This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale. The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>. Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test. <h2>How could semaglutide reduce knee pain?</h2> It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain. But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>. While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not. The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity. It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue. There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this. Further, it can be difficult to access. <h2>I have knee osteoarthritis, what should I do?</h2> Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<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/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstocl 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/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.

Body

Fasting, eating earlier in the day or eating fewer meals – what works best for weight loss?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Globally, <a href="https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight">one in eight people</a> are living with obesity. This is an issue because <a href="https://www.aihw.gov.au/reports/risk-factors/risk-factors-to-health/contents/overweight-and-obesity">excess fat</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27423262/">increases the risk</a> of type 2 diabetes, heart disease and certain cancers. <a href="https://pubmed.ncbi.nlm.nih.gov/33393504/">Modifying your diet</a> is important for managing obesity and preventing weight gain. This might include reducing your calorie intake, changing your <a href="https://pubmed.ncbi.nlm.nih.gov/39143663/">eating patterns</a> and prioritising healthy food. But is one formula for weight loss more likely to result in success than another? Our <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">new research</a> compared three weight-loss methods, to see if one delivered more weight loss than the others: <ul> <li>altering calorie distribution – eating more calories earlier rather than later in the day</li> <li>eating fewer meals</li> <li>intermittent fasting.</li> </ul> We analysed data from 29 clinical trials involving almost 2,500 people. We found that over 12 weeks or more, the three methods resulted in similar weight loss: 1.4–1.8kg. So if you do want to lose weight, choose a method that works best for you and your lifestyle. <h2>Eating earlier in the day</h2> When our metabolism <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolic-syndrome">isn’t functioning properly</a>, our body can’t respond to the hormone insulin properly. This can lead to weight gain, fatigue and can increase the risk of a number of chronic diseases such as diabetes. Eating later in the day – with a <a href="https://pubmed.ncbi.nlm.nih.gov/23512957/">heavy dinner</a> and late-night snacking – seems to lead to <a href="https://pubmed.ncbi.nlm.nih.gov/33172509/">worse metabolic function</a>. This means the body becomes less efficient at converting food into energy, managing blood sugar and regulating fat storage. In contrast, consuming calories <a href="https://pubmed.ncbi.nlm.nih.gov/31151228/">earlier</a> in the day appears to <a href="https://pubmed.ncbi.nlm.nih.gov/29754952/">improve</a> metabolic function. However, this might not be the case for everyone. Some people naturally have an evening “chronotype”, meaning they wake up and stay up later. People with this chronotype appear to have <a href="https://pubmed.ncbi.nlm.nih.gov/36803075/">less success losing weight</a>, no matter the method. This is due to a combination of factors including genes, an increased likelihood to have a poorer diet overall and higher levels of hunger hormones. <h2>Eating fewer meals</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/30700403/">Skipping breakfast</a> is common, but does it hinder weight loss? Or is a <a href="https://pubmed.ncbi.nlm.nih.gov/28967343/">larger breakfast and smaller dinner</a> ideal? While <a href="https://pubmed.ncbi.nlm.nih.gov/28137935/">frequent meals</a> may reduce disease risk, recent studies suggest that compared to eating one to two meals a day, eating six times a day might increase <a href="https://pubmed.ncbi.nlm.nih.gov/32437566/">weight loss success</a>. However, this doesn’t reflect the broader research, which tends to show consuming <a href="https://pubmed.ncbi.nlm.nih.gov/33485709/">fewer meals</a> can lead to greater weight loss. <a href="https://pubmed.ncbi.nlm.nih.gov/39485353/">Our research</a> suggests three meals a day is better than six. The easiest way to do this is by cutting out snacks and keeping breakfast, lunch and dinner. Most studies compare three versus six meals, with limited evidence on whether <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7490164/">two meals is better than three</a>. However, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">front-loading your calories</a> (consuming most of your calories between breakfast and lunch) appears to be better for weight loss and may also help <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9605877/">reduce hunger</a> across the day. But more studies with a longer duration are needed. <h2>Fasting, or time-restricted eating</h2> Many of us eat over a period of more than <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">14 hours a day</a>. Eating late at night <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">can throw off</a> your body’s natural rhythm and alter how your organs function. Over time, this can increase your risk of type 2 diabetes and other chronic diseases, particularly among <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8617838/">shift workers</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/35194176/">Time-restricted eating</a>, a form of intermittent fasting, means eating all your calories within a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">six- to ten-hour window</a> during the day when you’re most active. It’s not about changing what or how much you eat, but <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">when you eat it</a>. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">Animal studies</a> suggest time-restricted eating can lead to weight loss and improved metabolism. But the evidence in humans is still limited, especially about the long-term benefits. It’s also unclear if the benefits of time-restricted eating are due to the timing itself or because people are eating less overall. When we looked at studies where participants ate freely (with no intentional calorie limits) but followed an eight-hour daily eating window, they naturally consumed about 200 fewer calories per day. <h2>What will work for you?</h2> In the past, clinicians have thought about weight loss and avoiding weight gain as a simile equation of calories in and out. But factors such as how we distribute our calories across the day, how often we eat and whether we eat late at night may also impact our metabolism, weight and health. There are no easy ways to lose weight. So choose a method, or combination of methods, that suits you best. You might consider <ul> <li>aiming to eat in an eight-hour window</li> <li>consuming your calories earlier, by focusing on breakfast and lunch</li> <li>opting for three meals a day, instead of six.</li> </ul> The <a href="https://link.springer.com/article/10.1007/s13679-024-00555-2">average adult gains 0.4 to 0.7 kg per year</a>. Improving the quality of your diet is important to prevent this weight gain and the strategies above might also help. Finally, there’s still a lot we don’t know about these eating patterns. Many existing studies are short-term, with small sample sizes and varied methods, making it hard to make direct comparisons. More research is underway, including well-controlled trials with larger samples, diverse populations and consistent methods. So hopefully future research will help us better understand how altering our eating patterns can result in better health.<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/242028/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, Assistant Professor | NHMRC Emerging Leadership Fellow, <a href="https://theconversation.com/institutions/bond-university-863">Bond 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/fasting-eating-earlier-in-the-day-or-eating-fewer-meals-what-works-best-for-weight-loss-242028">original article</a>.

Body

Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

<a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results. We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise. To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes. The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits. All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated. Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile. It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results. <h2>Exercise genes</h2> Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight. While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>. More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates. Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training. When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics. We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified. For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene. Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise. <h2>Piece of the puzzle</h2> Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight. While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan). It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern. On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<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/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</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/trying-to-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>.

Body

What is ‘health at every size’ lifestyle counselling? How does it compare with weight-focused treatments?

<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>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Health at every size (or HAES) is a lifestyle counselling approach that promotes mindful eating and lifestyle behaviours to pursue health and wellness, without focusing on weight loss. Weight loss is seen as a <a href="https://www1.racgp.org.au/newsgp/clinical/understanding-the-%E2%80%98health-at-every-size%E2%80%99-paradigm">beneficial side effect</a>, rather than a goal. The <a href="https://www.sizeinclusivehealth.org.au/What-is-HAES">Association for Size Diversity and Health</a> first developed the approach in 2003 and revised it in 2013 and 2024. Its current <a href="https://asdah.org/haes/">core principles</a> promote: <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> It also aims to address <a href="https://theobesitycollective.org.au/our-work/#weight-stigma-awareness">stigma and discrimination</a> that people in larger bodies may experience when seeking medical care. Internationally, a <a href="https://asdah.org/listing/">range of health professionals</a> have incorporated the HAES approach into their treatment and services. Some organisations, such as <a href="https://obesitycanada.ca/guidelines/nutrition/">Obesity Canada</a>, have included HAES in their <a href="https://pubmed.ncbi.nlm.nih.gov/32753461/">guidelines for obesity treatment</a>. <h2>How does it compare with weight-focused treatments?</h2> We conducted a <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">systematic review and meta-analysis</a> of all the research studies published until November 2022 that had used HAES-based programs. Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">with</a>: <ul> <li>conventional weight loss programs (six studies)</li> <li>people on waiting lists receiving no treatment at all (six studies)</li> <li>groups where people received weekly social support in groups (four studies).</li> </ul> We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health. Our analysis found HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, meaning people had less subjective perceptions of hunger or eating in response to emotions. However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes. Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs and goals. <h2>Don’t get your health advice from influencers</h2> While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioner’s motives have been scrutinised because of their links <a href="https://www.washingtonpost.com/wellness/2024/04/03/diet-culture-nutrition-influencers-general-mills-processed-food/">with processed food companies</a>. The spotlight was put on the <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">very small number</a> of dietitian “influencers” (roughly 20 from a membership of more than 80,000 dietitians in the US and Canada) promoting “eat what you feel like” and discouraging people from making weight loss attempts, under the banner of HAES. They failed to mention they were being paid to promote products sold by food, beverage or supplement companies. US <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">author and dietitian Carrie Dennet</a> urges people to not look to influencers for health advice. Instead, seek non-judgemental health care from your GP. <h2>What might treatment look like?</h2> When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food. A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health and wellbeing goals. This might include strategies such as: <ul> <li>keeping a <a href="https://theconversation.com/what-does-having-a-good-relationship-with-food-mean-4-ways-to-know-if-youve-got-one-202622">food mood diary</a></li> <li>reflecting on factors that influence your eating</li> <li>practising <a href="https://theconversation.com/thinking-youre-on-a-diet-is-half-the-problem-heres-how-to-be-a-mindful-eater-99207">mindful eating</a></li> <li>learning about nutrient needs</li> <li>focusing on food enjoyment and the pleasure that comes from preparing, sharing and eating with others.</li> </ul> If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist. <h2>What if your goal is weight loss?</h2> When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations. Broadly, there are three graded energy intake target levels: <ol> <li> a reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water. </li> <li> a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">low-energy diet</a>, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure. </li> <li> the most restricted regime is a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a>, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products. </li> </ol> The aim of a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a> is to facilitate rapid weight loss when this is essential to improve health acutely such as poorly controlled type 2 diabetes. Such a diet should be used under supervision by your doctor and dietitian. When selecting an initial <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">strategy</a>, seek a balance between energy intake goals and your ability to stick to it. Your approach may change over time as your health needs change. If you need personalised nutrition advice, ask for a referral to an accredited practising dietitian. The <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">register of service providers though Dietitians Australia</a> allows you to view their expertise and location. Regardless of whether your practitioner uses a HAES approach or not, your health providers should always treat you with respect and address your personal health and wellbeing.<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/234376/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>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, Postdoctoral Researcher, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, Post Doctorate Fellow, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, Dietitian and early career researcher, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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/what-is-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>.

Body

Pay-by-weight airfares are an ethical minefield. We asked travellers what they actually think

<a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</a> Imagine checking in for a flight with your two teenage children. At the counter, you are told that your youngest teenager’s suitcase is two kilograms over the limit. You get slapped with a $75 penalty for their excess luggage. This penalty feels arbitrary and unfair. The youngest weighs about 45 kg, and their luggage weighs 25 kg, making their total payload on the flight 70 kg. Their older sibling, on the other hand, weighs 65 kg, and has brought 23 kg of luggage to check in. Their total weight is higher – 88 kg – yet they receive no penalty. Obviously, things aren’t that simple. Charging passengers based on their weight is highly controversial for many reasons. But that hasn’t stopped some airlines <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">experimenting</a> with such policies. Imagine checking in for your flight only to have the staff tell you to <a href="https://edition.cnn.com/travel/article/plus-size-travelers-slam-airline-seat-policies/index.html">purchase an extra seat</a> as you are a plus-size passenger. You feel discriminated against because you are using the same service as other passengers and your weight is beyond your control. But despite the lived experience of many and hot debate in the media, there has not been a formal study into what passengers themselves think about this matter. Our recently published <a href="https://doi.org/10.1002/jtr.2691">research</a> examined air passengers’ views on alternative airfare policies to understand whether the public finds them acceptable and what ethical considerations determine their views. Though we found a range of ethical contradictions, most travellers were guided by self-interest. <h2>A controversial but important topic</h2> The issue of whether airlines should weigh passengers is an ethical minefield with no easy answers. Despite its sensitivity, the aviation industry can’t ignore passenger weight. Airlines intermittently undertake <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">passenger weight surveys</a> as they need to accurately calculate payload to ensure flight safety and estimate fuel consumption. The evidence shows passengers are <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">getting heavier</a>. Airlines including the now-defunct <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">Samoa Air</a> and <a href="https://www.theguardian.com/us-news/2016/oct/23/hawaiian-airlines-american-samoa-weight-passengers">Hawaiian Airlines</a> have taken things one step further and experimented with weighing passengers regularly. Samoa Air, for example, became the first airline to introduce a “pay-as-you-weigh” policy, where the cost of your ticket was directly proportional to the combined weight of you and your luggage. In contrast, Canada has now long had a “<a href="https://otc-cta.gc.ca/eng/publication/additional-seating-and-one-person-one-fare-requirement-domestic-travel-a-guide">one person, one fare</a>” policy. It is prohibited and deemed discriminatory to force passengers living with a disability to purchase a second seat for themselves if they require one, including those with functional disability due to obesity. To complicate matters further, the issue of passenger and luggage weight is not only ethical and financial, but also environmental. More weight on an aircraft leads to more jet fuel being burned and more carbon emissions. About <a href="https://www.nature.com/articles/s41467-021-24091-y">5%</a> of human-driven climate change can be attributed to aviation, and the industry faces enormous pressure to reduce fuel consumption while it waits for low carbon substitutes to become available. <h2>What do passengers actually think?</h2> To get a better sense of how the public actually feels about this issue, we surveyed 1,012 US travellers of different weights, presenting them with three alternatives: <ul> <li>standard policy – currently the most widely used policy with passengers paying a standard price, irrespective of their weight</li> <li>threshold policy – passengers are penalised if they are over a threshold weight</li> <li>unit of body weight policy – passengers pay a personalised price based on their own body weight, per each pound.</li> </ul> The standard policy was the most acceptable for participants of differing weight, although the heavier the passenger, the more they preferred the standard policy. This can be partially explained by status quo bias. Generally, people are likely to choose a familiar answer. The threshold policy was the least acceptable. This policy was seen to violate established social norms and be generally less fair. The unit of body weight policy was preferred to the threshold policy, although participants raised concerns about whether it would be accepted by society. Perhaps unsurprisingly, we found that self-interest played a clear role in determining whether respondents considered a policy acceptable. Younger, male, financially well-off travellers with lower personal weight generally found the alternative policies more acceptable. <h2>An ethical conflict</h2> Alternative airfare policies that are based on passenger weight bring environmental and ethical concerns into conflict. Obviously, the effect isn’t from any one traveller, in particular, but averages over the entire industry. Interestingly, respondents that were more concerned about the environment – “ecocentric” – preferred air fare policies that would reduce the carbon emissions. This made them more open to the controversial alternatives. While the threshold policy was clearly rejected by many respondents as discriminatory, environmental concern played a role in the level of acceptance of the unit of body weight policy. It’s important to apply a critical lens here. These ecocentric travellers were also generally younger and had lower personal weights, so many would benefit from the alternative policies financially. For policymakers overall, our study suggests when it comes to controversial ticketing policies, the public is more likely to be swayed by self-interest than anything else.<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/237856/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, Professor, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</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/pay-by-weight-airfares-are-an-ethical-minefield-we-asked-travellers-what-they-actually-think-237856">original article</a>.

Travel Trouble

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<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> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<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/237308/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>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross 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/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>.

Body

Strength training has a range of benefits for women. Here are 4 ways to get into weights

<a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment. This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022. Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles. <h2>Health benefits</h2> <a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause. Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too. There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>. <h2>Improved confidence and body image</h2> Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>. This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym. Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>. Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success. Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us: <blockquote> I wanted something that would allow me to train that just didn’t have anything to do with how I looked. </blockquote> Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said: <blockquote> We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we? </blockquote> This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained: <blockquote> Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life. </blockquote> This newfound confidence often spills over into other areas of life. As one woman said: <blockquote> I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter. </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> 1. Take things slow Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient. 2. Prioritise proper form Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially. 3. Consistency is key Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else. 4. Find a community Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum. <h2>Are there any downsides?</h2> Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag. Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging. If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance. The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<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/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>.

Body

Weight loss: drinking a gallon of water a day probably won’t help you lose weight

<a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a> It’s often claimed that if you’re trying to lose weight, one of the things you should do each day is drink plenty of water – with some internet advice even suggesting this should be as much as a gallon (about 4.5 litres). The claim is that water helps burn calories and reduce appetite, which in turn leads to weight loss. But while we all might wish it was this easy to lose weight, unfortunately there’s little evidence to back up these claims. <h2>Myth 1: water helps burn calories</h2> One <a href="https://pubmed.ncbi.nlm.nih.gov/14671205/">small study</a>, of 14 young adults, found drinking 500ml of water increased resting energy expenditure (the amount of calories our body burns before exercise) by about 24%. While this may sound great, this effect only lasted an hour. And this wouldn’t translate to a big difference at all. For an average 70kg adult, they would only use an additional 20 calories – a quarter of a biscuit – for every 500ml of water they drank. <a href="https://pubmed.ncbi.nlm.nih.gov/16822824/">Another study</a> of eight young adults only saw an increase in energy expenditure when the water was fridge cold – reporting a very modest 4% increase in calories burned. This may be because the body needs to use more energy in order to bring the water up to body temperature, or because it requires more energy for the body to filter the increased volume of fluid through the kidneys. And again, this effect was only seen for about an hour. So although scientifically it might be possible, the actual net increase in calories burned is tiny. For example, even if you drank an extra 1.5l of water per day, it would save fewer calories than you’d get in a slice of bread. It’s also worth noting that all this research was in young healthy adults. More research is needed to see whether this effect is also seen in other groups (such as middle-aged and older adults). <h2>Myth 2: water with meals reduces appetite</h2> This claim again seems sensible, in that if your stomach is at least partly full of water there’s less room for food – so you end up eating less. A number of studies actually support this, particularly those conducted in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859815/#:%7E:text=Thus%2C%20when%20combined%20with%20a,meal%20EI%20following%20water%20ingestion.">middle-aged and older adults</a>. It’s also a reason people who are unwell or have a poor appetite are advised <a href="https://www.ageuk.org.uk/bp-assets/globalassets/salford/forms/improve-your-food-and-drink-intake.pdf">not to drink before eating</a> as it may lead to under-eating. But for people looking to lose weight, the science is a little less straightforward. <a href="https://pubmed.ncbi.nlm.nih.gov/17228036/">One study</a> showed middle-aged and older adults lost 2kg over a 12-week period when they drank water before meals compared with people who didn’t drink any water with their meal. Younger participants (aged 21-35) on the other hand did not lose any weight, regardless of whether they drank water before their meal or not. But since the study didn’t use blinding (where information which may influence participants is withheld until after the experiment is finished), it means that participants may have become aware of why they were drinking water before their meal. This may have led some participants to purposefully change how much they ate in the hopes it might increase their changes of losing weight. However, this doesn’t explain why the effect wasn’t seen in young adults, so it will be important for future studies to investigate why this is. The other challenge with a lot of this kind of research is that it only focuses on whether participants eat less during just one of their day’s meals after drinking water. Although this might suggest the potential to lose weight, there’s <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">very little good-quality evidence</a> showing that reducing appetite in general leads to weight loss over time. Perhaps this is due to our body’s biological drive to <a href="https://pubmed.ncbi.nlm.nih.gov/28193517/">maintain its size</a>. It’s for this reason that no claims can be legally made in Europe about foods which help make you <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/satietyenhancing-products-for-appetite-control-science-and-regulation-of-functional-foods-for-weight-management/E4CCAE4C90A220994FD29C27FAE7F666">feel fuller for longer</a> with <a href="https://www.gov.uk/government/publications/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-1924-2006-on-nutrition-and-health-claims-made-on-foods/nutrition-and-health-claims-guidance-to-compliance-with-regulation-ec-19242006#section-6">reference to weight loss</a>. So, although there might be some appetite-dulling effects of water, it seems that it might not result in long-term weight change – and may possibly be due to making conscious changes to your diet. <h2>Just water isn’t enough</h2> There’s a pretty good reason why water on its own is not terribly effective at <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/eating-habits-and-appetite-control-a-psychobiological-perspective/0D0605739F5150D1A7C49420D75F3CDF">regulating appetite</a>. If it did, prehistoric humans might have starved. But while appetite and satiation – feeling full and not wanting to eat again – aren’t perfectly aligned with being able to <a href="https://pubmed.ncbi.nlm.nih.gov/20736036/">lose weight</a>, it might be a helpful starting point. Part of what helps us to feel full is our stomach. When food enters the stomach, it triggers stretch receptors that in turn lead to the release of hormones which tell us we’re full. But since water is a liquid, it’s rapidly emptied from our stomach – meaning it doesn’t actually fill us up. Even more interestingly, due to the <a href="https://pubmed.ncbi.nlm.nih.gov/16934271/">stomach’s shape</a>, fluids can bypass any semi-solid food content that’s being digested in the lower part of the stomach. This means that water can still be quickly emptied from the stomach. So even if it’s consumed at the end of a meal it might not necessarily extend your feelings of fullness. If you’re trying to eat less and lose weight, drinking excessive amounts of water may not be a great solution. But there is evidence showing when water is mixed with other substances (such as <a href="https://pubmed.ncbi.nlm.nih.gov/30166637/">fibre</a>, <a href="https://www.sciencedirect.com/science/article/pii/0031938494903034">soups</a> or vegetable sauces) this can delay how fast the stomach empties its contents – meaning you feel fuller longer. But while water may not help you lose weight directly, it may still aid in weight loss given it’s the healthiest drink we can choose. Swapping high-calorie drinks such as soda and alcohol for water may be an easy way of reducing the calories you consume daily, which may 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/211311/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston 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/weight-loss-drinking-a-gallon-of-water-a-day-probably-wont-help-you-lose-weight-211311">original article</a>.

Body

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>.

Body

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>.

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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>.

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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>

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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>.

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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>.

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