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

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Jelena Dokic's powerful message on body image

<p>Jelena Dokic has shared a powerful message about body image, after years of online trolls commenting on her weight. </p> <p>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".</p> <p>"Whether 30 kilos more on the left 10 months ago or now. Proud of myself in exactly the same way," she said.</p> <p>"Because my size and number on the scale doesn't define me.</p> <p>"My kindness, hard work, humility, loyalty, good heart, resilience, strength in face adversity and fighting spirit does. And that's what really matters."</p> <p>"Nobody at your funeral will ever talk about your size," Dokic continued.</p> <p>"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.</p> <p>"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.</p> <p>"Because then you are just not a good person and it's not kind."</p> <p>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."</p> <p>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." </p> <p>"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.</p> <p>"That's just terrible. And what you think of me and others based on size says everything about you. Full stop."</p> <p>Dokic has been a vocal advocate for body positivity, after years of online trolls commenting on her changing body size. </p> <p>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. </p> <p><em>Images: Instagram</em></p>

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

<div class="theconversation-article-body"><em><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></em></p> <p>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.</p> <p>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:</p> <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> <p>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.</p> <p>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>.</p> <h2>How does it compare with weight-focused treatments?</h2> <p>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.</p> <p>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>:</p> <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> <p>We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Don’t get your health advice from influencers</h2> <p>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>.</p> <p>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.</p> <p>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.</p> <h2>What might treatment look like?</h2> <p>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.</p> <p>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:</p> <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> <p>If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist.</p> <h2>What if your goal is weight loss?</h2> <p>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.</p> <p>Broadly, there are three graded energy intake target levels:</p> <ol> <li> <p>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.</p> </li> <li> <p>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.</p> </li> <li> <p>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.</p> </li> </ol> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image </em><em>credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>.</em></p> </div>

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

<div class="theconversation-article-body"> <p><em><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></em></p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Though we found a range of ethical contradictions, most travellers were guided by self-interest.</p> <h2>A controversial but important topic</h2> <p>The issue of whether airlines should weigh passengers is an ethical minefield with no easy answers.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>What do passengers actually think?</h2> <p>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:</p> <ul> <li><strong>standard policy</strong> – currently the most widely used policy with passengers paying a standard price, irrespective of their weight</li> <li><strong>threshold policy</strong> – passengers are penalised if they are over a threshold weight</li> <li><strong>unit of body weight policy</strong> – passengers pay a personalised price based on their own body weight, per each pound.</li> </ul> <p>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.</p> <p>The threshold policy was the least acceptable. This policy was seen to violate established social norms and be generally less fair.</p> <p>The unit of body weight policy was preferred to the threshold policy, although participants raised concerns about whether it would be accepted by society.</p> <p>Perhaps unsurprisingly, we found that self-interest played a clear role in determining whether respondents considered a policy acceptable.</p> <p>Younger, male, financially well-off travellers with lower personal weight generally found the alternative policies more acceptable.</p> <h2>An ethical conflict</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/pay-by-weight-airfares-are-an-ethical-minefield-we-asked-travellers-what-they-actually-think-237856">original article</a>.</em></p> </div>

Travel Trouble

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Aussies top global list for biggest gambling losses

<p>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. </p> <p>That is more than most households pay for power and exceeds the average spend in similar countries like the US and New Zealand. </p> <p>Collectively, Australians lost $24 billion to gambling in 2020-21, with half of that amount lost through poker machines. </p> <p>The rest was lost on sports or race betting, in casinos, and on lotteries and Keno. </p> <p>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". </p> <p>"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.</p> <p>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. </p> <p>The report recommended the federal government ban all gambling advertisements and urged them to cut the number of pokies in each state over time.</p> <p>They also suggested a mandatory pre-commitment system for online gambling and pokies, which would put a limit on daily losses. </p> <p>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>. </p> <p><em>Images: </em><em>SNEHIT PHOTO / Shutterstock.com</em></p> <p> </p>

Money & Banking

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

<div class="theconversation-article-body"><em><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></em></p> <p>The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2022-PI-01930-1&amp;d=20240731172310101&amp;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.</p> <p>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=&amp;id=CP-2022-PI-01930-1&amp;d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity.</p> <p>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?</p> <p>Let’s look at what the science says.</p> <h2>What is Wegovy?</h2> <p>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.</p> <p>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.</p> <p>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.</p> <h2>How does Wegovy differ from Ozempic?</h2> <p>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.</p> <p>But there are two differences:</p> <p><strong>1) They are approved for two different (but related) reasons.</strong></p> <p>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.</p> <p>Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2022-PI-01930-1&amp;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.</p> <p>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.</p> <p><strong>2) They are both injected but come in different strengths.</strong></p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>Is Wegovy effective for weight loss?</h2> <p>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.</p> <p>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.</p> <p>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>.</p> <h2>What are the side effects of Wegovy?</h2> <p>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.</p> <p>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>.</p> <p>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).</p> <p>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.</p> <p>Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.</p> <p>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.</p> <p>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.</p> <p>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.</p> <h2>How can people access Wegovy?</h2> <p>Wegovy is available for purchase at pharmacists with a prescription from a doctor.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>.</em></p> </div>

Body

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Jelena Dokic's candid admission on weight loss

<p>Jelena Dokic has opened up on her 20kg weight loss and her previous struggles with depression and an eating disorder. </p> <p>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. </p> <p>She explained to her followers that her current weight loss was a result of her prioritising her mental health. </p> <p>"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. </p> <p>"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!!" </p> <p>She explained that in the first photo she was afraid to leave the house and was "broken" from her battle with depression and PTSD. </p> <p>"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. </p> <p>"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." </p> <p>"This was anxiety, depression, debilitating effect of trauma that made me feel I was worthless and not even worthy of living.</p> <p>"This was the result of being put down my whole life especially by people close to me." </p> <p>"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. </p> <p>She then explained that she wasn't asking for pity as she didn't want to victimise herself. </p> <p>"I wanted to survive and thrive and I got there." </p> <p>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." </p> <p>"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."</p> <p>"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."</p> <p>"Don't you ever give up on yourself and your goals. Don't ever be defined by someone else's judgement and comments." </p> <p>She encouraged her followers to stay true to themselves and remember their self-worth. </p> <p>"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." </p> <p><em>Images: Instagram</em></p>

Body

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New study links Ozempic and Wegovy to suicidal thoughts

<p>A new study has found a link between weight reduction drugs and reports of suicidal thoughts. </p> <p>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. </p> <p>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. </p> <p>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. </p> <p>The researches have called for "urgent clarification" and larger studies around how semaglutide medications impact the brain. </p> <p>"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. </p> <p>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. </p> <p>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. </p> <p>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. </p> <p>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. </p> <p><em>Images: Shutterstock</em></p> <p> </p>

Caring

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

<div class="theconversation-article-body"> <p><em><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></em></p> <p>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.</p> <p>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.</p> <p>Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles.</p> <h2>Health benefits</h2> <p><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.</p> <p>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.</p> <p>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>.</p> <h2>Improved confidence and body image</h2> <p>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>.</p> <p>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.</p> <p>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>.</p> <p>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.</p> <p>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:</p> <blockquote> <p>I wanted something that would allow me to train that just didn’t have anything to do with how I looked.</p> </blockquote> <p>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:</p> <blockquote> <p>We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we?</p> </blockquote> <p>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:</p> <blockquote> <p>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.</p> </blockquote> <p>This newfound confidence often spills over into other areas of life. As one woman said:</p> <blockquote> <p>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.</p> </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> <p><strong>1. Take things slow</strong></p> <p>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.</p> <p><strong>2. Prioritise proper form</strong></p> <p>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.</p> <p><strong>3. Consistency is key</strong></p> <p>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.</p> <p><strong>4. Find a community</strong></p> <p>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.</p> <h2>Are there any downsides?</h2> <p>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.</p> <p>Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging.</p> <p>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.</p> <p>The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/erin-kelly-1497598"><em>Erin Kelly</em></a><em>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>.</em></p> </div>

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3 signs your diet is causing too much muscle loss – and what to do about it

<div class="theconversation-article-body"><em><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></em></p> <p>When trying to lose weight, it’s natural to want to see quick results. So when the number on the scales drops rapidly, it seems like we’re on the right track.</p> <p>But as with many things related to weight loss, there’s a flip side: rapid weight loss can result in a significant loss of muscle mass, as well as fat.</p> <p>So how you can tell if you’re losing too much muscle and what can you do to prevent it?</p> <h2>Why does muscle mass matter?</h2> <p>Muscle is an important factor in determining our metabolic rate: how much energy we burn at rest. This is determined by how much muscle and fat we have. Muscle is more metabolically active than fat, meaning it burns more calories.</p> <p>When we diet to lose weight, we create a calorie deficit, where our bodies don’t get enough energy from the food we eat to meet our energy needs. Our bodies start breaking down our fat and muscle tissue for fuel.</p> <p>A decrease in calorie-burning muscle mass slows our metabolism. This quickly slows the rate at which we lose weight and impacts our ability to maintain our weight long term.</p> <h2>How to tell you’re losing too much muscle</h2> <p>Unfortunately, measuring changes in muscle mass is not easy.</p> <p>The most accurate tool is an enhanced form of X-ray called a dual-energy X-ray absorptiometry (DXA) scan. The scan is primarily used in medicine and research to capture data on weight, body fat, muscle mass and bone density.</p> <p>But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap.</p> <p>There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage.</p> <p>However, the accuracy of these scales is questionable. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122302/">Researchers found</a> the scales tested massively over- or under-estimated fat and muscle mass.</p> <p>Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting.</p> <h2>1. You’re losing much more weight than expected each week</h2> <p>Losing a lot of weight rapidly is one of the early signs that your diet is too extreme and you’re losing too much muscle.</p> <p>Rapid weight loss (of more than 1 kilogram per week) results in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702468/">greater muscle mass loss</a> than slow weight loss.</p> <p>Slow weight loss better preserves muscle mass and often has the added benefit of <a href="https://www.sciencedirect.com/science/article/pii/S0195666312000153">greater fat mass loss</a>.</p> <p>One study compared people in the obese weight category who followed either a very low-calorie diet (500 calories per day) for five weeks or a low-calorie diet (1,250 calories per day) for 12 weeks. While both groups lost similar amounts of weight, participants following the very low-calorie diet (500 calories per day) for five weeks lost <a href="https://pubmed.ncbi.nlm.nih.gov/26813524/">significantly more muscle mass</a>.</p> <h2>2. You’re feeling tired and things feel more difficult</h2> <p>It sounds obvious, but feeling tired, sluggish and finding it hard to complete physical activities, such as working out or doing jobs around the house, is another strong signal you’re losing muscle.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648712/">Research</a> shows a decrease in muscle mass may negatively impact your body’s physical performance.</p> <h2>3. You’re feeling moody</h2> <p>Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/26228522/">Research</a> on muscle loss due to ageing suggests low levels of muscle mass can negatively impact mental health and mood. This seems to stem from the relationship between low muscle mass and proteins called neurotrophins, which help regulate mood and feelings of wellbeing.</p> <h2>So how you can do to maintain muscle during weight loss?</h2> <p>Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight.</p> <h2>1. Incorporate strength training into your exercise plan</h2> <p>While a broad exercise program is important to support overall weight loss, strength-building exercises are a surefire way to help prevent the loss of muscle mass. A <a href="https://pubmed.ncbi.nlm.nih.gov/29596307/">meta-analysis of studies</a> of older people with obesity found resistance training was able to prevent almost 100% of muscle loss from calorie restriction.</p> <p>Relying on diet alone to lose weight will reduce muscle along with body fat, slowing your metabolism. So it’s essential to make sure you’ve incorporated sufficient and appropriate exercise into your weight-loss plan to hold onto your muscle mass stores.</p> <p>But you don’t need to hit the gym. Exercises using body weight – such as push-ups, pull-ups, planks and air squats – are just as effective as lifting weights and using strength-building equipment.</p> <p>Encouragingly, moderate-volume resistance training (three sets of ten repetitions for eight exercises) <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/sms.14237">can be as effective</a> as high-volume training (five sets of ten repetitions for eight exercises) for maintaining muscle when you’re following a calorie-restricted diet.</p> <h2>2. Eat more protein</h2> <p>Foods high in protein play an essential role in building and maintaining muscle mass, but <a href="https://europepmc.org/article/MED/19927027">research</a> also shows these foods help prevent muscle loss when you’re following a calorie-restricted diet.</p> <p>But this doesn’t mean <em>just</em> 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.</p> <h2>3. Slow your weight loss plan down</h2> <p>When we change our diet to lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">several physiological responses</a> to defend our body weight and “survive” starvation.</p> <p>Our body’s survival mechanisms want us to regain lost weight to ensure we survive the next period of famine (dieting). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">Research</a> shows that more than half of the weight lost by participants is regained within two years, and more than 80% of lost weight is regained within five years.</p> <p>However, a slow and steady, stepped approach to weight loss, prevents our bodies <a href="https://pubmed.ncbi.nlm.nih.gov/38193357/">from activating defence mechanisms</a> to defend our weight when we try to lose weight.</p> <p>Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime.</p> <hr /> <p><em>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.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/223865/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/nick-fuller-219993"><em>Nick Fuller</em></a><em>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/3-signs-your-diet-is-causing-too-much-muscle-loss-and-what-to-do-about-it-223865">original article</a>.</em></p> </div>

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‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

<p><em><a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Our <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">ageing population</a> brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).</p> <p>Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are <a href="https://www.senseswa.com.au/wp-content/uploads/2016/01/a-clear-view---senses-australia.pdf">living with dual sensory impairment</a>.</p> <p>Combined vision and hearing loss <a href="https://doi.org/10.1177/0264619613490519">describes</a> any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is <a href="https://doi.org/10.1016/j.annepidem.2012.02.004">increasingly common</a> as people get older.</p> <p>The experience can make older people feel isolated and unable to participate in important conversations, including about their health.</p> <h2>Causes and conditions</h2> <p>Conditions related to hearing and vision impairment often <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">increase as we age</a> – but many of these changes are subtle.</p> <p>Hearing loss can start <a href="https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/highlighting-priorities-for-ear-and-hearing-care">as early as our 50s</a> and often accompany other age-related visual changes, such as <a href="https://www.mdfoundation.com.au/">age-related macular degeneration</a>.</p> <p>Other age-related conditions are frequently prioritised by patients, doctors or carers, such as <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview">diabetes or heart disease</a>. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our <a href="https://hdl.handle.net/2123/29262">research</a> told us</p> <blockquote> <p>I don’t see too good or hear too well. It’s just part of old age.</p> </blockquote> <h2>An invisible disability</h2> <p>Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts <a href="https://doi.org/10.1080/09638280210129162">social activities and communication</a>, making it difficult for older adults to manage.</p> <p>It is underdiagnosed, underrecognised and sometimes misattributed (for example, to <a href="https://doi.org/10.1093/geronb/gbz043">cognitive impairment or decline</a>). However, there is also growing evidence of links between <a href="https://doi.org/10.1002/dad2.12054">dementia and dual sensory loss</a>. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, <a href="https://doi.org/10.1002/dad2.12054">feel happy and be safe</a>.</p> <p>A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:</p> <blockquote> <p>There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.</p> </blockquote> <h2>Isolated yet more dependent on others</h2> <p>Global trends show a worrying conundrum. Older people with dual sensory impairment become <a href="https://doi.org/10.1002/dad2.12054">more socially isolated</a>, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.</p> <p>One aspect of this is how effectively they can <a href="https://doi.org/10.1001/jamanetworkopen.2020.25522">comprehend and communicate in a health-care setting</a>. Recent research shows <a href="http://dx.doi.org/10.3390/healthcare12080852">doctors and nurses in hospitals</a> aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, <a href="https://www.mdpi.com/2227-9032/12/8/852">researchers note</a>. It facilitates:</p> <ul> <li>shorter hospital stays</li> <li>fewer re-admissions</li> <li>reduced emergency room visits</li> <li>better treatment adherence and medical follow up</li> <li>less unnecessary diagnostic testing</li> <li>improved health-care outcomes.</li> </ul> <h2>‘Too hard’</h2> <p>Globally, there is a better understanding of how important it is to <a href="https://www.who.int/publications/i/item/9789240030749">maintain active social lives</a> as people age. But this is difficult for older adults with dual sensory loss. One person told us</p> <blockquote> <p>I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.</p> </blockquote> <p>Again, these experiences increase reliance on family. But caring in this context is tough and largely <a href="https://doi.org/10.3389/feduc.2020.572201">hidden</a>. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring <a href="https://doi.org/10.1159/000507856">frustration, social isolation and depression</a> for carers too. One spouse told us:</p> <blockquote> <p>He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.</p> </blockquote> <p>So, what can we do?</p> <p>Dual sensory impairment is a growing problem with potentially devastating impacts.</p> <p>It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.</p> <p>We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to <a href="https://www.tandfonline.com/doi/full/10.1080/09649069.2019.1627088">navigate health care</a>.</p> <p>Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/232142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, Lived Experience Research Fellow, Centre for Disability Research and Policy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, Postdoctoral research fellow, Department of Linguistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-keep-away-from-people-combined-vision-and-hearing-loss-is-isolating-more-and-more-older-australians-232142">original article</a>.</em></p>

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How often should you really weigh yourself?

<div class="theconversation-article-body"> <p><em><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></em></p> <p>Few topics are more debated in health than the value of the humble bathroom scale. Some experts advocate daily self-weigh-ins to promote accountability for weight management, particularly when we’re following a diet and exercise program to lose weight.</p> <p>Others suggest ditching self-weigh-ins altogether, arguing they can trigger negative <a href="https://link.springer.com/article/10.1007/s13679-015-0142-2">psychological responses and unhealthy behaviours</a> when we don’t like, or understand, the number we see on the scale.</p> <p>Many, like me, recommend using scales to weigh yourself weekly, even when we’re not trying to lose weight. Here’s why.</p> <h2>1. Weighing weekly helps you manage your weight</h2> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&amp;report=abstract">Research</a> confirms regular self-weighing is an effective weight loss and management strategy, primarily because it helps increase awareness of our current weight and any changes.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&amp;report=abstract">systematic review of 12 studies</a> found participants who weighed themselves weekly or daily over several months lost 1–3 BMI (body mass index) units more and regained less weight than participants who didn’t weight themselves frequently. The weight-loss benefit was evident with weekly weighing; there was no added benefit with daily weighing.</p> <p>Self-weigh-ins are an essential tool for weight management as we age. Adults <a href="https://pubmed.ncbi.nlm.nih.gov/23638485/">tend to gain weight</a> progressively <a href="https://pubmed.ncbi.nlm.nih.gov/8363190/">through middle age</a>. While the average weight gain is typically between <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031938414001528">0.5–1kg per year</a>, this modest accumulation of weight can lead to obesity over time. Weekly weighing and keeping track of the results helps avoid unnecessary weight gain.</p> <p>Tracking our weight can also help identify medical issues early. Dramatic changes in weight can be an early sign of some conditions, including problems with our thyroid, digestion and diabetes.</p> <h2>2. Weekly weighing accounts for normal fluctuations</h2> <p>Our body weight can fluctuate within a single day and across the days of the week. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192384/">Studies</a> show body weight fluctuates by 0.35% within the week and it’s typically higher after the weekend.</p> <p>Daily and day-to-day body weight fluctuations have several causes, many linked to our body’s water content. The more common causes include:</p> <p><strong>The type of food we’ve consumed</strong></p> <p>When we’ve eaten a dinner higher in carbohydrates, we’ll weigh more the next day. This change is a result of our bodies temporarily carrying more water. We <a href="https://pubmed.ncbi.nlm.nih.gov/25911631/">retain 3–4 grams of water</a> per gram of carbohydrate consumed to store the energy we take from carbs.</p> <p>Our water content also increases when we consume <a href="https://www.ncbi.nlm.nih.gov/books/NBK50952/">foods higher in salt</a>. Our bodies try to maintain a balance of sodium and water. When the concentration of salt in our bloodstream increases, a mechanism is triggered to restore balance by retaining water to dilute the excess salt.</p> <p><strong>Our food intake</strong></p> <p>Whether it’s 30 grams of nuts or 65 grams of lean meat, everything we eat and drink has weight, which increases our body weight temporarily while we digest and metabolise what we’ve consumed.</p> <p>Our weight also tends to be lower first thing in the morning after our food intake has been restricted overnight and higher in the evening after our daily intake of food and drinks.</p> <p><strong>Exercise</strong></p> <p>If we weigh ourselves at the gym after a workout, there’s a good chance we’ll weigh less due to sweat-induced fluid loss. The amount of water lost varies depending on things like our workout intensity and duration, the temperature and humidity, along with our sweat rate and hydration level. On average, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993146/">we lose 1 litre of sweat</a> during an hour of <a href="https://link.springer.com/article/10.1007/BF00421168">moderate-intensity exercise</a>.</p> <p><strong>Hormonal changes</strong></p> <p><a href="https://theconversation.com/from-energy-levels-to-metabolism-understanding-your-menstrual-cycle-can-be-key-to-achieving-exercise-goals-131561">Fluctuations in hormones</a> within your menstrual cycle can also affect fluid balance. Women may experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">fluid retention</a> and temporarily gain 0.5–2kg of weight at this time. Specifically, the luteal phase, which represents the second half of a woman’s cycle, results in a shift of fluid from your blood plasma to your cells, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">bloating</a>.</p> <p><strong>Bowel movements</strong></p> <p>Going to the bathroom can lead to small but immediate weight loss as waste is eliminated from the body. While the amount lost will vary, we generally eliminate <a href="https://pubmed.ncbi.nlm.nih.gov/1333426/">around 100 grams of weight</a> through our daily bowel movements.</p> <p>All of these fluctuations are normal, and they’re not indicative of significant changes in our body fat or muscle mass. However, seeing these fluctuations can lead to unnecessary stress and a fixation with our weight.</p> <h2>3. Weekly weighing avoids scale obsession and weight-loss sabotage</h2> <p>Weighing too frequently can create an obsession with the number on the scales and do more harm than good.</p> <p>Often, our reaction when we see this number not moving in the direction we want or expect is to further restrict our food intake or embark on fad dieting. Along with not being enjoyable or sustainable, fad diets also ultimately increase our weight gain rather than reversing it.</p> <p>This was confirmed in a <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">long-term study</a> comparing intentional weight loss among more than 4,000 twins. The researchers found the likelihood of becoming overweight by the age of 25 was significantly greater for a twin who dieted to lose 5kg or more. This suggests frequent dieting makes us more susceptible to weight gain and prone to future weight gain.</p> <h2>So what should you do?</h2> <p>Weighing ourselves weekly gives a more accurate measure of our weight trends over time.</p> <p>Aim to weigh yourself on the same day, at the same time and in the same environment each week – for example, first thing every Friday morning when you’re getting ready to take a shower, after you’ve gone to the bathroom, but before you’ve drunk or eaten anything.</p> <p>Use the best quality scales you can afford. Change the batteries regularly and check their accuracy by using a “known” weight – for example, a 10kg weight plate. Place the “known” weight on the scale and check the measurement aligns with the “known” weight.</p> <p>Remember, the number on the scale is just one part of health and weight management. Focusing solely on it can overshadow other indicators, such as <a href="https://theconversation.com/can-you-be-overweight-and-healthy-182219">how your clothes fit</a>. It’s also essential to pay equal attention to how we’re feeling, physically and emotionally.</p> <p>Stop weighing yourself – at any time interval – if it’s triggering anxiety or stress, and get in touch with a health-care professional to discuss this.</p> <hr /> <p><em>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.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/223864/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-often-should-you-really-weigh-yourself-223864">original article</a>.</em></p> </div>

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"A true fighter": Tragic loss to Australian media

<p>Trailblazing journalist and editor Judith Whelan has passed away at the age of 63. </p> <p>The ABC confirmed Whelan's death, saying she died on Wednesday after a long battle with cancer.</p> <p>ABC managing director David Anderson was among the first to pay tribute to the “loved and respected” Whelan, confirming her death. </p> <p>“We have lost a great friend and journalism has lost a true fighter,” <a href="https://www.abc.net.au/about/media-centre/statements-and-responses/judith-whelan-announcement/104027286?utm_content=link&utm_medium=content_shared" target="_blank" rel="noopener">he said in a statement</a> released by the public broadcaster.</p> <p>“Judith always had the instincts that made her such a formidable journalist. She carried with her a commitment to truth and accountability and instilled these values in those who worked with her."</p> <p>“A valued mentor to younger journalists, Judith nurtured while leading by example. Judith was tough but caring and wanted those around her to succeed. Young reporters knew Judith would champion their work if the story needed to be told.”</p> <p><em>Sydney Morning Herald</em> editor Bevan Shields said Whelan will always remain a beloved part of their team.</p> <p>“Judith was a wonderful editor, colleague and friend. She was at the Herald for more than three decades and remains part of our DNA. We are heartbroken by her death,” he told the <em>Herald</em>.</p> <p>“She had a finely tuned news radar but also revelled in journalism that could entertain and inform readers. She was a natural leader and a beautiful person. Our thoughts are with Chris, Sophia and Patrick.”</p> <p>Whelan first joined the ABC in 2016, where she was first appointed Director of Regional and Local News before taking the role of ABC editorial director in 2022.</p> <p>Prior to her work at the public broadcaster, Whelan worked for several other publications, including<em> Sydney Morning Herald</em>, where she also served as news director and editor of its weekend edition.</p> <p>The talented media executive was one of just three female editors in the SMH’s history.</p> <p>Well respected in her field, Whelan’s career also saw her stationed in both the Pacific and Europe as a foreign correspondent, and she was also nominated for a Walkley Award for her news and feature writing.</p> <p><em>Image credits: ABC</em></p>

Caring

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Jelena Dokic hits back at body shaming trolls

<p>Jelena Dokic has hit back at body shaming trolls after revealing her dramatic weight loss. </p> <p>The former tennis player revealed that she has lost 20kgs after becoming concerned about her family's health history, and she had a message for online bullies. </p> <p>“It’s not good if you gain weight and it’s not good if you lose weight. It’s not good if you are a size zero, 10 or 18 it seems,” she wrote in the raw Instagram post on Monday. </p> <p>“So you all know I am very open and honest.</p> <p>“Whether I gain weight, lose weight, depressed, feel great, go through the good or the bad, I am always honest about both sides.</p> <p>“So I thought I would just quickly address my recent weight loss because a few people have written to me and also commented.</p> <p>“So, I have lost 20 kilos from my heaviest weight last year.</p> <p>“I had some health issues but also I just wanted to get healthier and fitter and when I turned 40 last year, I really started to think about my family history of diabetes, high blood pressure and heart problems.</p> <p>“Also, my work has increased dramatically and I needed to be fitter both physically and mentally and have more energy.</p> <p>“I didn’t have enough energy especially mentally to keep up. I needed to eat healthier to achieve that.</p> <p>“So, I didn’t focus on weight so much but just making better choices to feel my best.</p> <p>“With that the weight started coming off.”</p> <p>While she has previously faced people bullying her over her weight gain, she revealed that she's also been copping flak for losing weight, with some shaming her saying that: "I have succumbed to the ‘diet culture’ and don’t represent the plus size people anymore."</p> <p>"Please don’t even go there,” she said. </p> <p>She added that she will always stand up for people no matter their size, especially women. </p> <p>“It was always about not judging, shaming and bullying people no matter what their weight and size is and instead highlighting that kindness is what matters, not our size.</p> <p>“So, while I have lost 20 kilos it changes nothing.</p> <p>“I still want people to value me and others based on whether we are kind and good people.</p> <p>“I will always be proud of myself and not hide or be embarrassed no matter what size I am. And I will always be against body shaming and against valuing people based on their size and weight no matter if I gain or lose some kilos and dress sizes.</p> <p>“Always against body shaming no matter what.”</p> <p>Her post has already received over 45,000 likes and 3,000 comments, with many praising her for speaking up. </p> <p>“Keep well Jelena, don’t listen to the noise, you will never please everyone. Just keep doing the amazing work you do, love your commentary,” wrote one follower. </p> <p><em>Images: Instagram</em></p>

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

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>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.</p> <p>But while we all might wish it was this easy to lose weight, unfortunately there’s little evidence to back up these claims.</p> <h2>Myth 1: water helps burn calories</h2> <p>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%.</p> <p>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.</p> <p><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.</p> <p>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.</p> <p>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).</p> <h2>Myth 2: water with meals reduces appetite</h2> <p>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.</p> <p>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.</p> <p>But for people looking to lose weight, the science is a little less straightforward.</p> <p><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.</p> <p>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.</p> <p>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.</p> <p>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>.</p> <p>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.</p> <h2>Just water isn’t enough</h2> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><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></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/weight-loss-drinking-a-gallon-of-water-a-day-probably-wont-help-you-lose-weight-211311">original article</a>.</em></p> </div>

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Dr Chris Brown recalls "dramatic" personal renovation disaster

<p><em>Dream Home</em> host Dr Chris Brown has revealed his own renovation fail on the latest episode of the show. </p> <p>The vet turned TV star has taken on a new role where he guides six teams of aspiring renovators through the joys — and pitfalls — of house remodelling in the new Channel 7 reality show. </p> <p>Speaking to 7NEWS, the star recalled the terrifying moment his home nearly fell in on itself when he was trying to build a garage. </p> <p>“On my first renovation, I decided I needed a garage underneath my house,” he said, adding that he had council approval for the renovation. </p> <p>“With a couple of tradies, we went about digging out the garage underneath the house, in the sand.</p> <p>“We just kept on digging, digging, digging, until a rather large sound indicated the house was about to fall into the hole!</p> <p>“So that’s about as dramatic as it as it gets.</p> <p>“To have your house sort of falling in on itself, that was a pretty big learning curve.”</p> <p>He said that the problem was solved "very quickly" with a lot of underpinning and structural support. </p> <p>“A lot of those steel support posts that you can sort of wind up and down, they went in, and thankfully the house didn’t fold in half,” he said, laughing at the situation. </p> <p>He added that unexpected situations like this are what make renovation shows so appealing as "there’s so much natural drama, you don’t have to fake anything." </p> <p>“Choices have to be made, and it’s either the right way or the wrong way, and you only really discover that as you go along," he added. </p> <p>“Sometimes it’s too late to turn back once you realise you’ve made a terrible mistake.”</p> <p>Chris added that his role on the show is almost as a"coach" to the pairs, supporting them through the renovation challenges, and helping them get to the finish line. </p> <p>“What these couples are going through, and just how much they put on the line to get these renovations done, is quite inspiring and quite uplifting and but also thoroughly entertaining,” he said. </p> <p><em>Image: Seven</em></p>

Real Estate

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Telstra announces thousands of job losses

<p>Telstra is set to axe 2,800 jobs, or 9 percent of their total workforce, by the end of 2024 in a bid to save a whopping $350 million. </p> <p>The telco giant announced that the job cuts would "begin immediately" as a result of the impending business "reset" strategy. </p> <p>Chief executive officer Vicki Brady announced the cuts on Tuesday, and said the job cuts were "difficult" but "necessary" as parts of Telstra were not performing to the required levels.</p> <div> <div>"We need to be a more efficient and sustainable business to ensure we can keep investing at the levels required to meet the ever-increasing demand for our connectivity and services for our customers right across the country," she said.</div> </div> <p>Ms Brady also assured Telstra customers that the job losses would not affect customer service teams. </p> <p>“We have invested significantly in our customer service over recent years. That includes on-shoring our call centres for consumer and small business customers, it includes buying back our stores to deliver consistently good experience,” she said.</p> <p>“None of these changes impact those commitments." </p> <p>“As we work through the further changes still to come that I expect to be able to share with our employees in mid-July, customer service and experience will continue to be a key priority in that.”</p> <p>Despite Ms Brady's claims, Communication Workers Union (CWU) National Assistant Secretary, James Perkins, who represents Telstra workers said there was no way the substantial job cuts would not affect services.</p> <p>“While the detail of where exactly these jobs are being cut from is still unclear, one thing is certain – it will have a devastating impact on services,” Mr Perkins said. </p> <p>“You can’t slash thousands of jobs without seriously impacting the delivery of services across the country. Telstra has to answer to this.”</p> <p>The job cuts come as Telstra continues to scale up AI adoption, after the company announced in February it was expanding two in-house developed generative AI solutions following “promising pilots with frontline team members, enabling faster and more successful interactions with customers”.</p> <p><em>Image credits: Shutterstock</em></p>

Money & Banking

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"Forever grateful": Jana Pittman's heartbreaking loss

<p>Former Olympian Jana Pittman is in mourning after the sudden death of her long-time coach and friend Jackie Byrnes. </p> <p>Pittman paid tribute to Byrnes on Instagram after her death on Thursday, following a long battle with an illness.</p> <p>Byrnes had previously spoken about her ongoing journey with various skin cancers and melanomas in late 2021, saying it was “amazing” that she had survived to that point.</p> <p>The legendary sporting coach led both Pittman and Melinda Gainsford-Taylor, who also became a world champion, to the elite level while having a major impact on athletics for decades.</p> <p>Athletes both described Byrnes as a second mum in emotional tribute posts after Athletics Australia broke the news of her passing. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7EbnHuPFlF/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7EbnHuPFlF/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jana Pittman (@janapittmanofficial)</a></p> </div> </blockquote> <p>“It is with great sadness to share that one of my coaches Jackie Byrnes passed away last night,” Pittman wrote.</p> <p>“She coached me to my first Olympic Games and three world youth/junior gold medals... but it was more than her amazing athletic skills."</p> <p>“It was Jackie’s ability to embrace my quirks, emotions, chaos and passion. She set the framework for all my future success."</p> <p>“For dozens of athletes she was a coach, mother, mentor and friend, including the incredible Melinda!! I still vividly remember the day Jackie asked me to join them and train with Mel!"</p> <p>“Many times since I have wondered what could have been if I had stayed longer under her stewardship!"</p> <p>“All that had the privilege of being guided by her will agree she had a unique gift of leaving everyone she met better than before, and for that, we are forever grateful."</p> <p>“Her legacy of kindness, resilience, and inspiration will always be remembered. Thank you Jackie for the gift you gave us all.. genuine care and love! Rest in peace, Jackie.”</p> <p><em>Image credits: Instagram </em></p>

Family & Pets

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What happens when I stop taking a drug like Ozempic or Mounjaro?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.</p> <p>But does weight come back when you stop using it?</p> <p>The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people.</p> <p>So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.</p> <h2>It’s a long-term treatment, not a short course</h2> <p>If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.</p> <p>For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.</p> <p>Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)</p> <p>Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.</p> <h2>Why do people stop?</h2> <p>Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>.</p> <p>But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons.</p> <p>Understanding what stopping does to the body is therefore important.</p> <h2>So what happens when you stop?</h2> <p>When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen:</p> <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> <p>blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars</p> </li> <li> <p>over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back</p> </li> <li> <p>weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.</p> </li> </ul> <p>While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.</p> <h2>Is stopping and starting the medications a problem?</h2> <p>People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>.</p> <p>When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.</p> <p>Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.</p> <h2>How can you avoid gaining weight when you stop?</h2> <p>Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:</p> <ul> <li> <p>getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a></p> </li> <li> <p>exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it</p> </li> </ul> <ul> <li> <p>addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies</p> </li> <li> <p>eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.</p> </li> </ul> <p>Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<!-- Below is The Conversation's page counter tag. 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More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>.</em></p> </div>

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"I miss her hugs": British acting legend shares heartbreaking loss

<p>Actor Warwick Davis has shared the heartbreaking news of his wife's death. </p> <p>The actor, known for his roles in <em>Harry Potter</em> and <em>Star Wars</em>, took to social media to share the news of his wife Samantha's death, who passed away at the age of 53. </p> <p>“Her passing has left a huge hole in our lives as a family. I miss her hugs”, Warwick, 54, said.</p> <p>He added, “She was a unique character, always seeing the sunny side of life she had a wicked sense of humour and always laughed at my bad jokes.</p> <p>“Without Sammy, there would have been no Tenable quiz show, no Willow series. No Idiot Abroad Series 3.”</p> <p>Warwick said Samantha was his “most trusted confidant and an ardent supporter of everything I did in my career”.</p> <p>The couple’s children, Harrison and Annabelle, added, “Mum is our best friend and we’re honoured to have received a love like hers</p> <p>“Her love and happiness carried us through our whole lives”.</p> <p>Warwick and Samantha met on the set of the movie Willow in 1988 and got married three years later. </p> <p>Samantha had achondroplasia, a bone growth disorder that causes disproportionate dwarfism.</p> <p>Warwick has previously opened up about his wife’s health after she was rushed to hospital with sepsis in 2018, and had to undergo several different surgeries to stabilise her condition. </p> <p>Warwick, co-founder of charity Little People UK, has often spoken out about the health battles related to his condition, as well his wife’s.</p> <p>He was born with Spondyloepiphyseal dysplasia congenita (SED), an extremely rare genetic form of dwarfism, which has been inherited by both their daughter Annabelle and son Harrison.</p> <p><em>Image credits: Getty Images </em></p>

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