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

<div class="theconversation-article-body"><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>. </div>

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"An incredible loss": Quincy Jones dies at age 91

Legendary music producer Quincy Jones, who worked with the likes of Michael Jackson and Frank Sinatra throughout his career, has died at the age of 91. According to a statement from his family, he died on Sunday night at his home in Bel Air surrounded by friends and family. “Tonight, with full but broken hearts, we must share the news of our father and brother Quincy Jones’ passing,” the statement read. “And although this is an incredible loss for our family, we celebrate the great life that he lived and know there will never be another like him.” “He is truly one of a kind and we will miss him dearly; we take comfort and immense pride in knowing that the love and joy, that were the essence of his being, was shared with the world through all that he created. Through his music and his boundless love, Quincy Jones’ heart will beat for eternity.” A pioneer in the music industry, Jones arranged records for Frank Sinatra and Ella Fitzgerald, composed the soundtracks for Roots and In the Heat of the Night, produced Michael Jackson's iconic album Thriller, and oversaw the all-star recording of We Are the World: the 1985 charity record for famine relief in Africa. Dozens of movie and music stars have paid tribute to Jones, such as American singer and pianist Harry Connick Jr., who said that Jones was his "hero". “My hero. truly one of the greatest minds the music world has ever known. he was so kind to me, so wonderful, such an influence. his legacy and his music will live forever. thank you for everything, Q. you were the dude,” he wrote on Instagram. Acting icon Morgan Freeman said the producer had "left an enduring legacy" behind. "Today, we say goodbye to the legendary Quincy Jones – a musical giant whose genius reshaped our world and left an enduring legacy. Rest well, Quincy." Actor Colman Domingo recalled meeting Jones in a personal message, writing, “He asked, where are you from? Philly I replied, his eyes twinkled and he talked about the Uptown Theatre. I was so thrilled to meet Mr. American Music himself. I literally kneeled because he was a King. Thank you Mr. Quincy Jones for giving us all the sound." Image credits: John Salangsang/Shutterstock Editorial

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Boy's tragic death in school crash sparks incredible community response

The 11-year-old boy who tragically died after a car <a href="https://oversixty.com.au/health/caring/child-dies-after-car-crashes-through-school-gate" target="_blank" rel="noopener">crashed</a> through his school's gate has been identified, with a family friend sharing more details about the horrific accident. Jack Davey was sitting with friends when a car slammed through a fence and into a group of Year 5 students at Auburn South Primary School on Tuesday afternoon. He was critically injured and died on the way to hospital, while four other children were also injured. School mum and friend of the family Lucy Pristel told <a href="https://au.news.yahoo.com/incredible-response-after-boys-tragic-death-in-melbourne-school-crash-052951244.html" target="_blank" rel="noopener">Yahoo News</a> the shocking incident has "affected" the entire "close-knit" community. “I have no words, to be honest with you. They are the most beautiful family. They would do anything for anyone,” she said. Lucy's own 11-year-old son, who is also a student at the school and played basketball with Jack, witnessed the tragedy unfold before his eyes. "Unfortunately a lot of the kids saw what happened," she said. "It's affected everybody. The school has offered councillors to us all, so there's been a lot of support. We're a close-knit community." To help support the grieving family, Lucy, along with some of the other school mums, decided to launch a <a href="https://www.gofundme.com/f/support-the-davey" target="_blank" rel="nofollow noopener" data-i13n="cpos:5;pos:1" data-ylk="slk:GoFundMe;cpos:5;pos:1;elm:context_link;itc:0;sec:content-canvas" data-rapid_p="15" data-v9y="1">GoFundMe</a> to help "ease the burden" of funeral costs, adding, "We just wanted to make life as easy as possible." In a matter of hours, the fundraiser has exceeded its goal, and at the time of writing over $140,000 has bee donated by the community. Lucy recalled the moment she found out about the horror that unfolded at the school on Tuesday afternoon, saying she didn't realise the extent of what had happened at first. "I actually drove past the school after it happened and didn't think much of it," she admitted. "Then I started hearing about it." "I ran down to the school... you could see parents for at least 300, 400 metres and I saw everyone hugging. That's when I knew something happened at our school [and not one of the others close by]." Ever since then, "everyone has just bound together," she said sharing the "pure horror" felt by everyone. Image credits: Facebook

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Tragic new details emerge about baby's death in Bali

Tragic new details have merged about the sudden death of a toddler, who <a href="https://oversixty.com.au/travel/travel-trouble/profound-grief-baby-dies-during-family-holiday-in-bali" target="_blank" rel="noopener">died</a> while on a family holiday to Bali. According to Indonesian police, the 14-month-old boy drowned in a villa swimming pool at Villa Besar in Kerobokan, north of Kuta in Bali. Police spokesperson Avitus Panjaitan told <a href="https://www.dailymail.co.uk/news/article-14017027/Tragic-new-details-emerge-cause-Australian-babys-death-Bali.html" target="_blank" rel="noopener">Daily Mail Australia</a> that the family did not report the death to police, and officers only found out details after interviewing resort staff. Staff reported that the family had returned to the villa from a water park in the evening shortly before the alarm was raised that a baby was drowning in the pool just minutes later. The staff recalled seeing a woman pull the baby from the water and desperately performing CPR to revive the child, but by the time paramedics arrived on the scene, the child was already deceased. In the wake of the tragedy, the child's father Brendan Sharp shared a gut wrenching update on Facebook, describing his son as a "one of a kind" child who filled every room with laughter and light. "He was always happy and cheerful, lighting up the room with whomever was there," he said. "His cheekiness and affection were like no other, and he was always dancing and having fun with a side of cheeky." "You were so special my boy - keep shining like the star you are and keep an eye on all of us down here," he said. A <a href="https://www.gofundme.com/f/help-grace-and-brendan-cope-with-the-loss-of-their-baby-boy" target="_blank" rel="noopener">GoFundMe</a> page has been set up by the family to help cover the funeral, and to allow parents Grace and Brendan time to grieve without financial pressure. Image credits: Facebook / GoFundMe

Travel Trouble

Father breaks silence after wife and two children die in tragic drowning

Hoai Nguyen, 32, and her two children, Mitchell, 7, and Hazel, 5, were enjoying a day out at Shearer Park in south-west Sydney, and were walking down to a small pier on the waterfront before they were spotted <a href="https://www.oversixty.com.au/health/caring/unimaginable-sorrow-mother-and-two-children-drown-during-family-outing" target="_blank" rel="noopener">struggling in the Georges River</a> about 10.15am on Saturday. Hoai was pulled to shore shortly afterwards, but despite desperate attempts by rescuers and bystanders she could not be revived. The bodies of the two children were recovered a few hours later, metres from a jetty. The children's father, Dinh Nguyen, had been at work during the incident and only found out about the tragedy when police showed up at his house. He has since broken his silence, and told The Sydney Morning Herald that his wife was navigating a mental illness prior to her death. “She has bipolar disorder, and she has some ups and some downs,” he told the publication. “She takes medicine. Sometimes it works, sometimes it doesn’t.” He also recalled one of the last conversations the couple had, the night prior to the tragedy. “She told me the last night she didn’t sleep so she wanted to stay at home,” he said. According to The Daily Telegraph, detectives are now probing whether the incident was premeditated as they continue their investigations into the tragedy. The southwest Sydney community has since rallied around the family's loved ones, with bouquets of flowers and tributes seen at the riverbank as part of a growing memorial. A close friend of the family, Sarah Vu, has also organised a <a href="https://www.gofundme.com/f/hoai-mitchell-and-hazel-nguyen" target="_blank" rel="noopener">GoFundMe</a> page for the family which has since raised over $60,600 of their $40,000 goal. “I sincerely thank the entire community for their contributions,” she wrote in a social media tribute on Monday. “The family have decided to bring Hoai and the kids back to Vietnam. “The fund has currently exceeded my expectations, but I will keep the link open for anyone who still wants to donate.” "All we can do now is pray for you and the little ones to depart peacefully,” she added with a video of two young kids holding hands and skipping down a street together. Need to talk to someone? Don't go it alone. Lifeline: 13 11 14, <a href="https://www.lifeline.org.au/" target="_blank" rel="noopener">lifeline.org.au </a> SANE Support line and Forums: 1800 187 263, <a href="https://saneforums.org/" target="_blank" rel="noopener">saneforums.org</a> Headspace: 1800 650 890, <a href="https://headspace.org.au/" target="_blank" rel="noopener">headspace.org.au</a> Beyond Blue: 1300 224 635, <a href="beyondblue.org.au" target="_blank" rel="noopener">beyondblue.org.au </a> Images: Facebook/ GoFundMe

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

<div class="theconversation-article-body"> <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>. </div>

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"Absolutely heartbroken": Son of AFL legend tragically dies at age 24

Warning: This article contains discussions about suicide that some readers may find distressing. The son of a premiership-winning AFL has tragically taken his own life, with his grieving family paying tribute to the "affectionate and cheeky" young man. Kye Hart, son of former West Coast Eagles player David Hart, died on Saturday at the age of 24. “On 21st September our family lost Kye who is a son, brother, uncle, nephew and grandchild. We are absolutely heartbroken and devastated,” a family member has written on a <a href="https://www.gofundme.com/f/kye-david-hart" target="_blank" rel="noopener">GoFundMe</a> fundraiser that has been established to help Mr Hart’s family with funeral expenses. “There aren’t enough words to describe how much we love Kye and how much we will miss him,” the fundraiser reads. “Kye’s love and affection was contagious, his cheeky beautiful smile would light up any room. Kye had the biggest heart and only wanted to give and help others." “In this incredibly difficult time we are reaching out for your support to navigate through the challenging times ahead. The funds raised will go towards covering immediate expenses and funeral costs." “We are grateful for your kindness, prayers and support through this tragedy.” Other friends and family paid tribute to Kye on social media, with one family friend writing, “His name was Kye Hart. Just 24 freaking years old for god’s sake. Enough! When are we going to sort mental health out in this world!” Another added, “Sorry for your loss and his family too. A life cut too short.” <p style="box-sizing: inherit; border: 0px; font-stretch: inherit; line-height: inherit; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 24px; padding: 0px; vertical-align: baseline;">Kye leaves behind his parents Linda and David Hart, who represented the West Coast Eagles in the 1980s and 1990s, helping them claim their victory in the premierships. Need to talk to someone? Don't go it alone. Call Lifeline on 13 11 14 or visit lifeline.org.au Beyond Blue: 1300 224 636 SANE: 1800 187 263; saneforums.org Mensline Australia: 1300 78 99 78 Image credits: GoFundMe <div class="media image" style="box-sizing: inherit; margin-bottom: 24px; align-items: center; display: flex; flex-direction: column; width: 705.202209px; max-width: 100%;"> </div>

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

Body

"Just so tragic": Grandfather of slain boys speaks out

Warning: This article contains distressing content that readers may find upsetting. The grandfather of the two young boys who were <a href="https://oversixty.com.au/finance/legal/mother-arrested-after-two-boys-found-dead-in-blue-mountains-home" target="_blank" rel="noopener">found dead</a> in their home in the Blue Mountains has spoken out about his profound loss, while also sharing an update on his daughter's mental state while she remains in prison. Geoff Densmore is preparing to bury his grandsons Ben, 9 and Russell, 11, who were found dead in their mother’s Faulconbridge home on September 10th. Mr Densmore is also trying to support his daughter, Trish Smith, who has been charged over the alleged murder of her two children, as she remains under police guard. Ms Smith was rushed to hospital with self-inflicted injuries after the bodies of the two young brothers were discovered in their beds by their father, with both boys suffering fatal stab wounds. Mr Densmore told <a href="https://www.dailytelegraph.com.au/news/nsw/trish-smith-living-a-bad-nightmare-after-allegedly-killing-her-sons-at-their-blue-mountains-home/news-story/b8a91443d155a988155dd5e27410becb" target="_blank" rel="noopener">The </a><a href="https://www.dailytelegraph.com.au/news/nsw/trish-smith-living-a-bad-nightmare-after-allegedly-killing-her-sons-at-their-blue-mountains-home/news-story/b8a91443d155a988155dd5e27410becb" target="_blank" rel="noopener">Daily Telegraph</a> that he is preparing to bury his grandsons, while trying to cope with the devastating loss. “The kids, they were special kids, so special,” Mr Densmore said. “I have to put them under the ground. I’ve got so much to do. So many people are affected by this, the government has got to do something about this.” He went on to clarify that both he and his wife had no idea about their daughter's mental health struggles until it was too late. “We really don’t know what happened. We had no idea she was unwell. Many prayers and private masses have been said for her,” he said. “You can’t imagine what it’s like. Imagine if it happened to your family." “Linda, she’s not good, she’s very religious. She’s praying. I think I might crack one day but I’m trying not to. I’m trying to be strong for everyone. I still can’t understand that Ben … Russell. They’re gone.” Mr Densmore said he was not angry with Ms Smith, instead saying: “There is only one word for it: tragic. It’s just so tragic.” The grandfather has not spoken to his daughter following her charges, however, he did say Ms Smith was in “a bad way”. “We are all dealing with this, the whole community. We have to bury two children, we’ve never been in this situation before. We’re not sure what to do.” Need to talk to someone? Don't go it alone. Call Lifeline on 13 11 14 or visit lifeline.org.au Beyond Blue: 1300 224 636 SANE: 1800 187 263; saneforums.org Image credits: Supplied / NSW Police

Family & Pets

Jelena Dokic's powerful message on body image

Jelena Dokic has shared a powerful message about body image, after years of online trolls commenting on her weight. The tennis great took to Instagram to share before and after photos of her from nine months ago with the caption: "NOW THE SAME PERSON REGARDLESS OF MY SIZE". "Whether 30 kilos more on the left 10 months ago or now. Proud of myself in exactly the same way," she said. "Because my size and number on the scale doesn't define me. "My kindness, hard work, humility, loyalty, good heart, resilience, strength in face adversity and fighting spirit does. And that's what really matters." "Nobody at your funeral will ever talk about your size," Dokic continued. "They will talk about who you were as a person. So make sure they can say what an amazing and kind person you were. And that's what it's about. Legacy of kindness and being a good person. "And if you do it at a size 20 or a size 2, it really doesn't matter. But don't ever judge anyone and don't ever base your opinion on others based on their size. "Because then you are just not a good person and it's not kind." She then urged her followers to be kind before saying that she is not ashamed of who she was "because it doesn't matter what size I am as long as I am a good person." She continued saying that no matter what size she is "nobody will shame me into feeling bad about myself and who I am especially nobody that sits behind a keyboard or phone and takes time out of their life to write something negative to someone else especially someone that you don't even know." "And the same goes if you see me or anyone else in person and you judge us and base your opinion of us based on our size," she said. "That's just terrible. And what you think of me and others based on size says everything about you. Full stop." Dokic has been a vocal advocate for body positivity, after years of online trolls commenting on her changing body size. Just last month she opened up about her <a href="https://www.oversixty.com.au/health/body/jelena-dokic-s-candid-admission-on-weight-loss" target="_blank" rel="noopener">body transformation </a>and struggles with depression and an eating disorder. Images: Instagram

Body

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

<div class="theconversation-article-body"><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>. </div>

Body

Tragic flaw sees man use voluntary assisted dying drugs prescribed for his wife

Warning: This article contains discussions of suicide and depression that some readers may find upsetting A Queensland coroner has criticised the state's voluntary assisted dying laws, after an elderly man took his own life using drugs prescribed for his wife. The Coroner's Court in Brisbane held an inquest into the May 2023 death of a man in his 80s, referred to by the pseudonym ABC. The man's partner, who had a terminal illness, was found eligible for the voluntary assisted dying [VAD] program in March 2023. Under that law a person can self-administer a VAD substance in a private location but they must nominate a "contact person" who will be legally required to return any unused or leftover portion within 14 days. The self-administered drug was delivered to the couple's home a month later, and the man was the "contact person" responsible for the substance. On the same day the drug arrived, his wife was admitted to hospital with Covid, where they decided to take an intravenous VAD drug. She died in hospital on May 8, 2023. The man was told to return the drug within two days of his partner's death, but he failed to do so, using it to take his own life eight days later. He did not return the drug as he was unable to leave his home, and there was no arrangement made for a health professional to collect it. ABC’s adult daughter recalled the moment she found her lifeless father after returning from running errands. “I thought he was asleep in the chair. I put my arms around him. He was cold,” she told the inquest. The woman became emotional and said that she found an empty box in the kitchen and “knew immediately it was the VAD”. In his findings, coroner David O’Connell said he was not judging the merits of VAD, but it had led to a "tragedy" only 107 days after it was legalised. “Persons should not be placed in a position where they can be led into unwise decisions,” the coroner said in his findings handed down on Wednesday. O'Connell said that the laws had failed to find a balance between a patient's autonomy and lethal medication safety. “The VAD law has (the substance) provided to persons with no medical training, no regulatory oversight, and in a period of great personal and emotional turmoil,” he said. The inquest heard ABC had previously been diagnosed with, and received medication for depression, which should've been considered before approving someone as a contact person. "The fact that ABC had been medically diagnosed with depression and took medication was not something the VAD authorities considered, or even enquired on, when approving them to be a Contact Person. Indeed, there are simply no checks or enquiries of the Contact Person's suitability," he said. He added that while there was no breach of protocol or legislative processes by QVAD personnel, it was "not a well-considered law". O'Connell recommended the Queensland government implement an earlier draft of VAD laws that required oversight by a medical professional at all times. Queensland Health Minister Shannon Fentiman said the government would consider the coroner’s recommendations. “Following that case, we are working on a review of that legislation coming up to three years that will start next year, and that will obviously be one of the things that we look at,” she said. Image: Shutterstock

Caring

Aussies top global list for biggest gambling losses

A new report has revealed that Australians are the biggest gambling losers in the world, with the average Australian adult gambling away $1635 per year according to the Grattan Institute think tank. That is more than most households pay for power and exceeds the average spend in similar countries like the US and New Zealand. Collectively, Australians lost $24 billion to gambling in 2020-21, with half of that amount lost through poker machines. The rest was lost on sports or race betting, in casinos, and on lotteries and Keno. The report also claims that there are more pokies than post boxes and public toilets across Australia, bringing light to the "lax approach" that has let the industry "run wild". "Gambling products are designed to be addictive, and the consequences can be catastrophic: job loss, bankruptcy, relationship breakdown, family violence, even suicide," the report's authors wrote. People in the Northern Territory and NSW lost the most amount of money, with the two states having the highest concentration of polies in their jurisdiction. The report recommended the federal government ban all gambling advertisements and urged them to cut the number of pokies in each state over time. They also suggested a mandatory pre-commitment system for online gambling and pokies, which would put a limit on daily losses. There are many different ways to get help and information about gambling. Call the National Gambling Helpline on 1800 858 858; use <a href="https://www.gamblinghelponline.org.au/tools-resources/chat-counselling" target="_blank" rel="noopener">online counselling</a>. Images: SNEHIT PHOTO / Shutterstock.com

Money & Banking

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

<div class="theconversation-article-body"><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>. </div>

Body

Jelena Dokic's candid admission on weight loss

Jelena Dokic has opened up on her 20kg weight loss and her previous struggles with depression and an eating disorder. The former tennis player took to Instagram on Sunday to share before and after shots from her weight loss, taken seven years apart, and her past battles with self-worth. She explained to her followers that her current weight loss was a result of her prioritising her mental health. "This is not about body size but feeling that I am not worthy enough to even live!!! On the left 7 years ago," she said. "Even though I have a bit less weight now on the right, this is not about weight. Because even if I was half the size on the left, I would still feel the same. And how is that? Not worthy enough to even live!!" She explained that in the first photo she was afraid to leave the house and was "broken" from her battle with depression and PTSD. "My face, body language and even clothing on the left says it all. This is how low my self worth was. I was afraid to get out of the house," she shared. "I was not able to look people in the eye, I just wanted to wear black or dark grey and cover myself up. I even remember wishing to somehow fully cover my face and head and could I possibly not even need to go out of the house for the rest of my life." "This was anxiety, depression, debilitating effect of trauma that made me feel I was worthless and not even worthy of living. "This was the result of being put down my whole life especially by people close to me." "The person on the left was broken, shattered, battling anxiety, depression, PTSD, BPD and an eating disorder. At times I hoped I wouldn't wake up so that I don't have to feel like this anymore," she continued. She then explained that she wasn't asking for pity as she didn't want to victimise herself. "I wanted to survive and thrive and I got there." She then shared a few motivating words on courage and resilience, saying: "Fight hard. Every single day, don't give up and no matter how scary it is get outside of your comfort zone. It will get easier and more comfortable to do so." "Keep going after it even when it's scary. Be brave and never give up. The way to start feeling good in your own skin and life is to be who you really are and embrace and love yourself." "Don't be afraid of mistakes and failures, they make you learn and as long as you get back up, that's all that matters." "Don't you ever give up on yourself and your goals. Don't ever be defined by someone else's judgement and comments." She encouraged her followers to stay true to themselves and remember their self-worth. "Be yourself. Being authentic, real and vulnerable is the way to being happy and thriving. You are worthy and never allow anyone to tell you otherwise." Images: Instagram

Body

New study links Ozempic and Wegovy to suicidal thoughts

A new study has found a link between weight reduction drugs and reports of suicidal thoughts. Semaglutide, the drug sold under the brand names Ozempic and Wegovy, has been widely used for weight loss despite only being approved for the treatment of diabetes. An analysis of data on the adverse drug reactions database of the World Health Organisation found a disproportionate number of people reporting suicidal thoughts while using semaglutide. The research published in JAMA Network also found that the effect was "significant" compared to other diabetes medication, and that people with anxiety and depression were more likely to report suicidal thoughts when taking the drug. The researches have called for "urgent clarification" and larger studies around how semaglutide medications impact the brain. "The study raises key questions about whether additional precautions are needed when prescribing semaglutide," Trevor Steward, a neurobiology researcher from the University of Melbourne said. However, there are a few limitations with the study as there were a lack of information about the dosages, and did not adjust for things like alcohol and substance misuse and off-label use. While the study did not find a direct cause between suicidal thoughts and the use of semaglutide, it is important to raise concerns, especially for those who may want to use these drugs based on information they found on social media, and therefore do not fully understand the risks. The use of semaglutide for weight loss in Australia is considered 'off label', meaning that it has been prescribed for purposes outside of its approved use. The Therapeutic Goods Administration (TGA) believes that these prescriptions have been driving shortages, which they are trying to address and believe will last until 2025. Images: Shutterstock

Caring

Tragic new details emerge after three-time mayor found dead at just 45

Three-time Maribyrnong mayor Sarah Carter was found dead at her home on Tuesday, Now, her devastated mother Gaynor Morris has broken her silence and revealed that Carter was due to fly to Europe with her partner, Nikki Roy, but never made it to the airport. “She hadn’t made it to the airport to meet him for their holiday together,” Morris told the Herald Sun. “He (Roy) went and checked on her and he literally found her dead. “No-one knows anything different unfortunately.” She was treated by emergency services at her home in Maribyrnong, Victoria at 3:45pm on Tuesday but unfortunately could not be saved. Her cause of death is not yet known but Victoria police has confirmed that her death is not being treated as suspicious. Carter's mother said that Roy was “absolutely heartbroken”. “I think she sets a great example for everybody and there’s a lot of people that will miss her. I am very proud,” she added. Carter was a councillor on Maribyrnong Council, in Melbourne’s west, which covers suburbs including Footscray, Yarraville and Tottenham as well as Maribyrnong. She was first elected to office in 2008 and was the first woman who served as mayor of Maribyrnong three times. Many believed that her political career could go beyond council boundaries. “Children’s champion, community leader, Labor through and through. The best of us,” Former Labor leader and current minister Bill Shorten said in a tribute to Carter. “My thoughts are with her family and loved ones in this difficult time.” Labor MP Tim Watts added that her “energy was limitless”. “She had an impact on so many people’s lives. “She gave so much of herself and wanted to give so much more. She’s been taken from us far too soon. “It’s a terrible loss to our community and our country”. Images: Instagram

Caring

“Tragic news”: Cricket legend dies at just 55

England cricket great Graham Thorpe has passed away aged just 55. The England and Wales Cricket Board confirmed the news on Monday, with no immediate cause of death announced. He was regarded as one of the best batters of his generation, with a career that spanned 100 Test matches. “It is with great sadness that we share the news that Graham Thorpe, MBE, has passed away,” a statement from the ECB said. "There seem to be no appropriate words to describe the deep shock we feel at Graham's deaths. "More than one of England's finest-ever batters, he was a beloved member of the cricket family and revered by fans all over the world. "His skill was unquestioned, and his abilities and achievements across a 13-year international career brought so much happiness to his teammates and England and Surrey CCC supporters alike. "Later, as a coach, he guided the best England men's talent to some incredible victories across all formats of the game. The cricket world is in mourning today. "Our hearts go out to his wife Amanda, his children, father Geoff, and all of his family and friends during this unimaginably difficult time. "We will always remember Graham for his extraordinary contributions to the sport." Thorpe made his international debut in 1993 and scored a century on his first Ashes appearance, becoming the first England player to do so in 20 years. He played 82 one-day international games for England and amassed over 6700 runs in the Test arena, including 16 centuries. After retiring from playing duties in 2005, Thorpe transitioned into coaching and spent time as a batting coach for the national side between 2010 and 2022. He was set to take over the head coaching role with Afghanistan before falling ill. Tributes have poured in from Thorpe's fellow teammates and former coaches. “RIP Thorpey. Thanks for all the advice throughout my career, you were a great player and a brilliant teammate. You have gone far too young but you leave as an England cricket legend ... Thoughts with all who knew Thorpey and to all the family xxx,” Michael Vaughan, who captained Thorpe towards the end of his Test career, wrote on social media. Former Australian coach Darren Lehmann paid tribute by tweeting three tear emojis. “Heartbreaking to see Thorpey has passed away. He was one of my heroes growing up and I was fortunate to work with him. My thoughts go out to all of his friends and family during this tough time,” wrote current England opener Ben Duckett. “This is desperately tragic news. Aged just 55," Channel 7 commentator Alison Mitchell said. Image: Colorsport/ Shutterstock editorial

Caring

Grandmother's plea after tragic fatal school excursion

A 13-year-old girl from New Zealand has tragically died after sustaining an “unsurvivable head injury” during a school excursion to an ice skating rink. Kymani was rushed from Alpine Ice Sports Centre to Christchurch Hospital in a critical condition on Tuesday morning, after falling while skating with her classmates. Following her sudden death, the young girl's grandmother created an online <a href="https://givealittle.co.nz/cause/ice-skating-school-trip-unexpected-tragedy" target="_blank" rel="noopener">fundraiser</a>, where she explained, “Sadly while on a school excursion Kymani fell, sustaining an unsurvivable head injury.” “This is a parent’s worst nightmare — sending your child to school and to never return home,” Kymani’s family said. “Her parents, brothers, sisters and whanau are devastated. Kymani was a beautiful girl, only 13 years old." “As this is an unexpected tragedy, any funds would be gratefully appreciated and will go towards preparing for what comes next.” "Aroha nui Hiley-Hetaraka whanau (Much love to the Hiley-Hethara family)." The skating rink was closed on Tuesday, as spokesperson said the staff’s “thoughts are with the family at this time”. The Ministry of Education also released a statement, which read, “We are deeply saddened by the tragic news and our thoughts are with the family and school community. Our traumatic incident team is available to support the school for as long as needed.” WorkSafe NZ is looking into the incident. Image credits: givealittle.co.nz

Caring

The tragic reason Miriam Margolyes is still working at 83

Miriam Margolyes has shared the tragic reason that she is still working in showbiz at the age of 83. The acting legend has long suffered with spinal stenosis – a condition that occurs when the spinal canal or neural foramen narrows, putting pressure on the spinal cord and nerve roots. Despite suffering from the debilitating illness, the 83-year-old British star has appeared on numerous TV shows over the years. Now, speaking candidly to the Radio Times, Margolyes admitted that she is still working to fund her medical bills. She said, “I’m worried that I won’t have enough money for carers when I finally get paralysed or whatever it is that’s going to happen to me.” Despite dealing with the physical constraints that come from both her spinal stenosis and her age, which she finds “limiting and depressing”, she said she refuses to slow her pace. “When you know that you haven’t got long to live and I’m probably going to die within the next five or six years, if not before, I’m loath to leave behind performing. It’s such a joy.” “I yearn to play roles that don’t confine me to wheelchairs, but I’m just not strong enough.” Margolyes recently underwent major heart surgery, speaking candidly about the operation with the Table Manners podcast. “I’ve got a cow’s heart now,” she said. “Well, not the whole heart. I’ve had an aortic valve replaced by a cow’s aortic valve. “I don’t know how common it is. I’d never heard of that operation. But it saves you from having open-heart surgery, which would be infinitely more invasive.” In the same interview, Margolyes revealed she expected to be a wheelchair soon. “When you get old you become obviously aware of your vulnerability. I have a bad back, I’m probably going to be in a wheelchair soon and you have to come to terms with what life throws at you.” Image credits: Ken McKay/ITV/Shutterstock Editorial

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

Jelena Dokic's candid admission on weight loss

New study links Ozempic and Wegovy to suicidal thoughts

Tragic new details emerge after three-time mayor found dead at just 45

“Tragic news”: Cricket legend dies at just 55

Grandmother's plea after tragic fatal school excursion

The tragic reason Miriam Margolyes is still working at 83

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