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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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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>

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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>

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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>

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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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Andrew O'Keefe clashes with press after bail hearing

<p>Andrew O'Keefe has clashed with reporters outside a courtroom after he was granted bail following an interaction with police where he claims a crack pipe allegedly found in his pocket belonged to someone else.</p> <p>The disgraced former TV host sat quietly in the dock as his lawyer, Sharon Ramsden, applied for his release on bail at Waverley Local Court on Monday morning.</p> <p>Police allege the former Deal or No Deal host returned a positive drug test while driving after he was stopped shortly before midday on Sunday in Sydney’s affluent Bellevue Hill.</p> <p>Officers also allege that the 52-year-old also threatened a man in Point Piper shortly before he was stopped by police.</p> <p>The court was told Mr O’Keefe allegedly confronted the man at the property “potentially as a matter of jealousy” following a “rekindling” with his former partner.</p> <p>After O'Keefe was released on bail, chaos ensued outside Waverley police station as the TV host tried to make a quick exit. </p> <p>O'Keefe was followed by reporters as he stepped out into traffic and walked briskly away as he tried to avoid the camera crews. </p> <p>Footage captured by Channel 10 shows Mr O’Keefe handing a reporter her phone after it is dropped before telling her, “get out of my face”.</p> <p>Mr O’Keefe was ultimately granted bail despite magistrate Jacqueline Milledge telling the 52-year-old there were “a lot of aspects of the police facts that are of concern”.</p> <p>“There is a real concern you were somewhere you shouldn't have been and that drugs might still be a factor in your life, but I'm prepared to give you an opportunity to continue with your treatment,” she said.</p> <p>Mr O’Keefe will return before court next month as he faces a single charge each of intimidation and breach a court order, with police foreshadowing more charges pending forensic examination.</p> <p><em>Image credits: JOEL CARRETT/EPA-EFE/Shutterstock Editorial </em></p>

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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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"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>

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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>

Body

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4 things you’re likely doing that are damaging your hearing

<p>Your hearing is a precious gift, so it’s important to take good care of your ears. We’ve got some advice on the things to avoid, and what you can do to protect your hearing.</p> <p><strong>Using cotton tips</strong></p> <p>Though they’re commonly used for the job, cotton tips should never be used to clean out your ears. In fact, no solid object should be put inside your ears. Cotton tips account for around four per cent of all ruptured eardrums.</p> <p>These innocuous-looking objects can also cause bleeding, scratch your ear canal, or trigger an infection. So put them down and step away. Instead, use a commercial ear cleaner, or even just a few drops of mineral oil, baby oil, or glycerine to soften the earwax.</p> <p><strong>Don’t wait and see</strong></p> <p>If your hearing in one or both ears suddenly disappears without cause, you need to go and see your doctor as soon as you can. It could be inflammation, infection, or a decrease in blood supply to the area.</p> <p>If you need treatment, you’ll likely need it immediately to have any hope of restoring your hearing.</p> <p><strong>Using eardrops without advice</strong></p> <p>There are many over-the-counter eardrops available to help with things like swimmer’s ear. But in extreme cases, these products can cause deafness. Before you use anything, including a home remedy, get your doctor to check that you don’t have a ruptured eardrum.</p> <p>Some people may be born that way, or have had surgery as a child, or suffered an injury. If the ingredients in these drops make their way inside your eardrum, it can cause a lot of pain, and permanent deafness.</p> <p><strong>Always protect your ears</strong></p> <p>It’s incredibly important to protect your ears from permanent damage. Tiny hairs inside your ears act as hearing receptors, and these can be broken by extremely loud noises. Once they’re gone, they don’t come back.</p> <p>So things like loud music, fireworks, machinery, and artillery are all risky to be around. The best thing you can do is cover up with earmuffs whenever you’re around these things – especially if it’s on a regular basis. For extra safety, use earplugs as well.</p> <p><em>Image credits: Shutterstock </em></p>

Body

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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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The dos and don’ts of caring for your hearing aids

<p>Proper care and maintenance of your hearing aids is important. It will ensure you to get the most out of your aids, prevent problems and maintain optimum hearing conditions. Here are some guidelines to help you care for them.</p> <p><strong>DO</strong>: clean your hearing aids regularly with a dry cloth or tissue.</p> <p><strong>DON’T</strong>: get your hearing aids wet. That means no wearing them in the shower or when swimming. If they happen to get wet, dry it off immediately.</p> <p><strong>DO</strong>: put your hearing aids in their case when you’re not using them</p> <p><strong>DON’T</strong>: wear your aids when using aftershave, hairspray, perfume, sunscreen, insect repellent and so on. They contain chemicals that could damage it. Allow time for drying before putting back on hearing aids.</p> <p><strong>DO</strong>: use a moisture protection kit/anti-humidity kit. They help with moisture problems (which can affect performance of hearing aids) and extend life of hearing aids.</p> <p><strong>DO</strong>: keep out of reach of pets and visiting grandkids. Dogs have been known to chew them up and if swallowed by either pet or grandkid, can be very dangerous.</p> <p><strong>DON’T</strong>: expose your device to extreme heats. Don’t leave them in a parked car, near a heater or wear while using a hairdryer. </p> <p><strong>DO</strong>: Store your hearing aid in a safe place that's dry and cool.</p> <p><strong>DON’T</strong>: leave your hearing aids switched on when you’re not using them.</p> <p><strong>DO</strong>: change batteries often so you won’t be stuck with aids that have suddenly run out of power.</p> <p><strong>DON’T</strong>: ever insert anything into the sound outlet as it could damage the receiver. If you can’t clean it properly, ask your hearing professional.</p> <p><strong>DO</strong>: remove any earwax that gets into your hearing aid. It could cause permanent damage.</p> <p><em>Image credits: Getty Images </em></p>

Hearing

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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>

Caring

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Foreign Minister Penny Wong’s heartbreaking loss

<p>Penny Wong has shared the devastating news of her mother's passing. </p> <p>The Australian Foreign Minister took to Instagram to pay tribute to her mother, Jane Chapman, who passed away on Sunday. </p> <p>"Yesterday my beloved mother, Jane Chapman, left us peacefully," she began her post. </p> <p>"Mum was a woman of exceptional intellect and penetrating insight, of mischievous wit and endless curiosity. </p> <p>“Most of all she was a woman of deep compassion and principle,” Wong said.</p> <p>“She gave expression to her compassion through her courage and determination for justice, qualities that have steeled me through all my life’s challenges.</p> <p>“Through her work, her choices, her courage and her deeds, she inspired and empowered me and so many others.</p> <p>"Mum loved me completely. And she loved her granddaughters Alexandra and Hannah beyond measure," she continued.</p> <p>"We will miss her terribly." </p> <p>She then thanked Tony Michele and the staff at Mary Potter Hospice for taking care of her mum and for their kindness. </p> <p>Parliamentary colleagues and the public shared their condolences in the comments. </p> <p>"My heart goes out to you. Nothing can prepare us for the loss of a parent. Jane was an incredible woman. Sending love to you and the family," Prime Minister Anthony Albanese wrote. </p> <p>"Sorry for your loss Penny. Losing your mum is so incredibly hard," added TV personality and former <em>Gogglebox</em> star Yvie Jones. </p> <p>"Your mum was great. Staunch, fierce, funny. I and aĺl her yoga class friends will miss her," one person wrote. </p> <p>"Words are completely inadequate at a time like this. I am so very sorry for your loss Penny. I hope the love and support of friends and family can offer you some comfort," added another.</p> <p>Chapman married Chinese-Malay architect Francis Wong while he was studying in Adelaide on a scholarship and shared two children together Penny and Toby. </p> <p>When they divorced, Chapman moved back to South Australia with her children.</p> <p>In 2001, 10 days after his 30th birthday and on the same day Wong was elected to the senate, Toby took his own life. </p> <p>Francis Wong passed away in May 2023. </p> <p><em>Image: Instagram</em></p>

Family & Pets

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Judge finds Bruce Lehrmann raped Brittany Higgins and dismisses Network 10 defamation case. How did it play out?

<p><em><a href="https://theconversation.com/profiles/brendan-clift-715691">Brendan Clift</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Bruce Lehrmann has lost his defamation suit against Channel Ten and journalist Lisa Wilkinson after the media defendants proved, on the balance of probabilities, that Lehrmann raped his colleague Brittany Higgins in Parliament House in 2019.</p> <p>After a trial lasting around a month, Federal Court Justice Michael Lee – an experienced defamation judge – concluded that both Lehrmann and Higgins had credibility issues, but ultimately <a href="https://www.judgments.fedcourt.gov.au/judgments/Judgments/fca/single/2024/2024fca0369">he was persuaded</a> that Lehrmann raped Higgins, as she’d alleged and he’d denied.</p> <h2>Criminal trials by proxy</h2> <p>Ordinarily, charges like rape would be resolved through the criminal courts, but Lehrmann’s criminal trial was <a href="https://www.abc.net.au/news/2022-10-27/jury-discharged-in-trial-of-bruce-lehrmann-brittany-higgins/101583486">aborted</a> in October 2022 after juror misconduct. The charges against him were soon <a href="https://www.news.com.au/national/nsw-act/courts-law/bruce-lehrmann-sexual-assault-charge-dropped-dpp-confirms/news-story/3f82dd388d2cfa38680f7d4f4ceb1c5e">dropped</a>, nominally over concerns for Higgins’ mental health.</p> <p>Higgins, however, foresaw civil proceedings and <a href="https://www.theguardian.com/australia-news/2023/dec/05/brittany-higgins-volunteered-to-be-defamation-trial-witness-as-she-would-not-let-rapist-become-a-millionaire-ntwnfb">offered to testify</a> should they arise. That they did, as Lehrmann, free from the burden of any proven crime, sued several media outlets for defamation over their reporting into the allegations (<a href="https://www.fedcourt.gov.au/services/access-to-files-and-transcripts/online-files/lehrmann">the ABC</a> and <a href="https://www.theguardian.com/australia-news/2023/dec/06/abc-agrees-to-pay-bruce-lehrmann-150000-to-settle-defamation-claim-court-documents-reveal">News Corp</a> both settled out of court).</p> <p><iframe class="flourish-embed-iframe" style="width: 100%; height: 550px;" title="Interactive or visual content" src="https://flo.uri.sh/visualisation/17195035/embed" width="100%" height="400" frameborder="0" scrolling="no" sandbox="allow-same-origin allow-forms allow-scripts allow-downloads allow-popups allow-popups-to-escape-sandbox allow-top-navigation-by-user-activation"></iframe></p> <div style="width: 100%!; margin-top: 4px!important; text-align: right!important;"><a class="flourish-credit" href="https://public.flourish.studio/visualisation/17195035/?utm_source=embed&amp;utm_campaign=visualisation/17195035" target="_top"><img src="https://public.flourish.studio/resources/made_with_flourish.svg" alt="Made with Flourish" /></a></div> <p>Like Ben Roberts-Smith’s <a href="https://theconversation.com/dismissed-legal-experts-explain-the-judgment-in-the-ben-roberts-smith-defamation-case-191503">recent defamation suit</a> against the former Fairfax papers, this became another case of civil proceedings testing grave allegations in the absence of a criminal law outcome.</p> <p>The form of proceedings made for some key differences with the aborted criminal trial. In criminal cases, prosecutors are ethically bound to act with moderation in pursuing a conviction, which requires proof beyond a reasonable doubt, while defendants have the right to silence. By contrast, this trial featured detailed accounts from both sides as each sought to convince, in essence, that their contentions were likely to be correct.</p> <p>Also like the Roberts-Smith case, live streaming of the trial generated very high levels of public engagement. Today’s stream reached audiences of more than 45,000 people. It gave us the chance to assess who and what we believe, and to scrutinise the parties’ claims and the media’s reporting. The Federal Court doesn’t have juries, but we, the public, acted as a de facto panel of peers.</p> <p>We saw accusations and denials, revealing <a href="https://www.abc.net.au/news/2023-12-23/bruce-lehrmann-defamation-trial-network-ten-lisa-wilkinson-ends/103260752">cross-examination</a> of the protagonists, witness testimony from colleagues, CCTV footage from nightclubs to Parliament House complete with lip-reading, expert testimony on alcohol consumption and consent, and lawyers constructing timelines which supported or poked holes in competing versions of events.</p> <p>The complexity of high-stakes legal proceedings was on display, with Justice Lee issuing many interim decisions on questions of procedure and evidence. Whenever transparency was at stake, it won.</p> <p>The preference for full disclosure led to the <a href="https://www.theguardian.com/law/2024/apr/02/bruce-lehrmann-defamation-trial-network-10-fresh-evidence-bid-lisa-wilkinson-brittany-higgins-delay-ntwnfb">case being re-opened</a> at the eleventh hour to call former Channel 7 producer Taylor Auerbach as a witness, providing a denouement that the judge called “sordid”, but which had little relevance to the final result.</p> <h2>An argument over the truth</h2> <p>Lehrmann had the burden of proving that the defendants published matter harmful to his reputation. That matter was Wilkinson’s interview with Higgins on Channel Ten’s The Project in which the allegations were made.</p> <p>A statement is only defamatory if it’s untrue, but in Australian law, the publisher bears the burden of proving truth, should they opt for that defence. And more serious allegations usually require more compelling proof, as the law views them as inherently more unlikely.</p> <p>This can be onerous for a defamation defendant, but it also involves risk for the plaintiff, should the defendant embark on an odyssey of truth-telling yet more damaging to the plaintiff’s image. That happened to <a href="https://www.bbc.com/news/world-australia-65717684">Ben Roberts-Smith</a> and it happened to Lehrmann here.</p> <p>On the other hand, if the media hasn’t done their homework, as in <a href="https://www.judgments.fedcourt.gov.au/judgments/Judgments/fca/single/2023/2023fca1223">Heston Russell’s case</a> against the ABC (also presided over by Justice Lee), the complainant can be vindicated.</p> <p>This case was a manifestation of Lehrmann’s professed desire to “<a href="https://www.theguardian.com/australia-news/2023/oct/26/how-bruce-lehrmanns-media-interviews-cost-him-his-anonymity-in-toowoomba-case">light some fires</a>”. Few players in this extended saga have emerged without scars, and here he burned his own fingers, badly.</p> <p>As Justice Lee put it, Lehrmann, “having escaped the lion’s den [of criminal prosecution], made the mistake of coming back to get his hat”.</p> <h2>How was the case decided?</h2> <p>Lehrmann denied having sex with Higgins, whereas Higgins alleged there had been non-consensual sex. The defamatory nature of the publication centred on the claim of rape, so that was what the media defendants sought to prove.</p> <p>This left open the curious possibility that consensual sex might have taken place: if so, Lehrmann would have brought his case on a false premise (there had been no sex), but the media would have failed to defend it (by not proving a lack of consent), resulting in a Lehrmann win.</p> <p>That awkward scenario did not arise. The court found sex did in fact take place, Higgins in her heavily-inebriated and barely-conscious state did not give consent, and Lehrmann was so intent on his gratification that he ignored the requirement of consent.</p> <p>Justice Lee found Lehrmann to be a persistent, self-interested liar, whereas Higgin’s credibility issues were of lesser degree, some symptomatic of a person piecing together a part-remembered trauma. The judge drew strongly on the evidence of certain neutral parties who could testify to incidents or words spoken in close proximity to the events.</p> <h2>Defamation laws favour the aggrieved</h2> <p>Australian defamation law has historically favoured plaintiffs and, despite recent <a href="https://www.ruleoflaw.org.au/civil/defamation/2021-law-reform/">rebalancing attempts</a>, it remains a favoured legal weapon for those with the resources to use it.</p> <p>This includes our political class, who sue their critics for defamation with unhealthy frequency for a democracy. In the United States, public figures don’t have it so easy: to win they must prove their critics were lying.</p> <p>In Australia, the media sometimes succeeds in proving truth, but contesting defamation proceedings comes at great financial cost and takes an emotional toll on the journalists involved.</p> <p>Nor can a true claim always be proven to a court’s satisfaction, given the rules of evidence and the fact that sources may be reluctant to testify or protected by a reporter’s guarantee of confidentiality.</p> <p>But this case demonstrates that publishers with an appetite for the legal fight can come out on top.<!-- 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/225891/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/brendan-clift-715691"><em>Brendan Clift</em></a><em>, Lecturer of law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/judge-finds-bruce-lehrmann-raped-brittany-higgins-and-dismisses-network-10-defamation-case-how-did-it-play-out-225891">original article</a>.</em></p>

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

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

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Ozempic isn’t approved for weight loss in Australia. So how are people accessing it?

<p><em><a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-bartlett-849104">Andrew Bartlett</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>To say that Ozempic is a <a href="https://www.theguardian.com/business/2024/jan/31/obesity-drug-ozempic-novo-nordisk-record-wegovy">blockbuster drug</a> is an understatement. Manufacturer Novo Nordisk is scrambling to expand production sites to keep up with global demand.</p> <p>While Ozempic is only approved for the treatment of diabetes in Australia, it is also marketed overseas for weight loss under the brand name Wegovy.</p> <p>Social media is full of posts and endorsements by celebrities who are using it for weight loss. Faced with limited access in Australia, some people who need the medication for diabetes can’t access it.</p> <p>Others are turning to the internet to source it from compounding pharmacies – a practice Australia’s regulator, the Therapeutic Goods Administration (TGA), plans to clamp down on.</p> <h2>How doctors are prescribing Ozempic</h2> <p>Use of Ozempic for weight loss in Australia is considered “<a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#why-the-tga-cant-stop-offlabel-prescribing">off label</a>”. This is when a doctor prescribes a medicine for a purpose outside of what is approved.</p> <p>Ozempic is only approved to be used for the treatment of diabetes in Australia, but its off-label prescribing for weight loss is driving <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#when-will-the-ozempic-shortage-end">shortages</a> which the TGA thinks will last until 2025.</p> <p>To manage these shortages, Australian doctors and pharmacies are being asked <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#information-for-prescribers">not to start new patients</a> on Ozempic and to prioritise it for patients with type 2 diabetes who are already stabilised on this medicine.</p> <p>However, the TGA <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#why-the-tga-cant-stop-offlabel-prescribing">says</a> it: "does not have the power to regulate the clinical decisions of health professionals and is unable to prevent doctors from using their clinical judgement to prescribe Ozempic for other health conditions."</p> <h2>Why can’t we just make more?</h2> <p>The active ingredient in Ozempic, semaglutide, is a delicate <a href="https://www.britannica.com/story/what-is-the-difference-between-a-peptide-and-a-protein">peptide</a> molecule made up of two small chains of amino acids. It’s just one in a family of drugs that are classified as GLP-1 inhibitors.</p> <p>Because it’s a peptide, its manufacture is complex and requires specialised facilities beyond those used to make normal chemical-based drugs.</p> <p>It is also delivered via an injection, meaning that it has to be manufactured under strict conditions to ensure it is both sterile and temperature controlled.</p> <p>This means increasing production is not as simple as just deciding to manufacture more. Its manufacturer <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#why-the-tga-cant-stop-offlabel-prescribing">needs time</a> to build new facilities to increase production.</p> <h2>Compounding pharmacies are making their own</h2> <p><a href="https://www.fda.gov/drugs/guidance-compliance-regulatory-information/human-drug-compounding#:%7E:text=Compounding%20is%20generally%20a%20practice,needs%20of%20an%20individual%20patient">Compounding</a> is the practice of combining, mixing, or altering ingredients of a drug to create a formulation tailored to the needs of an individual patient.</p> <p>Australian law allows <a href="https://www.pharmacyboard.gov.au/codes-guidelines.aspx">pharmacists to compound</a> only when it is for the treatment of a particular patient to meet their individual clinical need and there is no suitable commercially manufactured product available. An example is making a liquid form of a drug from a tablet for people unable to swallow.</p> <p>Compounded products are not held to the same safety, quality and efficacy standards required for mass produced medicines. This recognises the one-off nature of such compounded medicines and the professional training of the pharmacists who prepare them.</p> <p>Recently, pharmacies have been relying on these compounding rules to produce their own Ozempic-like products at scale and ship them to consumers around Australia.</p> <p>However, there are risks when using these products. The US Food and Drug Administration (FDA) has recently <a href="https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss#:%7E:text=Are%20there%20concerns%20with%20compounded,available%20to%20treat%20a%20patient.">warned consumers</a> of the dangers of using compounded formulations that contain particular salt formulations of semaglutide. It has received more reports of side effects in patients using these products.</p> <h2>How the regulator plans to tighten the loophole</h2> <p>The TGA is taking a number of steps to tighten the compounding loophole and there are ongoing investigations in this area.</p> <p>In December 2023, the agency issued a <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">public safety warning</a> on the dangers of these compounded medicines.</p> <p>More recently, it has proposed <a href="https://www.abc.net.au/news/2024-02-29/compounding-pharmacies-mounjaro-ozempic/103283926">removing GLP-1 drugs</a>, which includes Ozempic, from Australia’s compounding exemptions. This would effectively ban pharmacies from making off-brand Ozempic. This proposal is <a href="https://www.tga.gov.au/news/media-releases/consultation-remove-glucagon-peptide-1-glp-1-receptor-agonist-analogues-pharmacist-extemporaneous-compounding-exemption">currently under consultation</a> and a final decision is expected by June this year.</p> <p>If you want to access the drug for weight loss before the shortage is over, be aware that compounded products are not identical to approved Ozempic and have not been evaluated for safety, quality and efficacy.</p> <p>Supply of copycat versions is also likely to be limited, given the ongoing TGA crackdown.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.<!-- 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/224859/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 --></em></p> <p><em><a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-bartlett-849104">Andrew Bartlett</a>, Associate Lecturer Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</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/ozempic-isnt-approved-for-weight-loss-in-australia-so-how-are-people-accessing-it-224859">original article</a>.</em></p>

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