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

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

Body

How hip pain led Sydney karate master to life-changing weight loss journey

<div> Sydney-based karate instructor and personal trainer Glenn Stephenson knows the toll that joint pain and extra weight can take on physical activity. Despite decades of experience as a martial arts coach, Glenn found himself increasingly limited by severe hip pain and unwanted weight gain. </div> <div> In 2021, at 95 kilograms, the 64-year-old’s arthritis and reduced mobility affected not only his work but also his confidence. “I couldn’t move around like I wanted to, and as a master instructor, it felt wrong to be teaching students while carrying so much extra weight,” he admits. </div> <div> Glenn’s pain and discomfort prompted him to make a drastic change. Instead of resorting to extreme dieting, he adopted a more sustainable approach to weight loss to reduce joint and liver inflammation, and regain his mobility. He shed 20 kilograms and now walks four kilometres daily. “I can move better, my mental health has improved, and I feel more capable of guiding my students,” he says. </div> <div> Today, Glenn encourages others struggling with weight to take a balanced approach to fitness and health. “I look the part now, which gives me confidence as a master instructor to show my students that staying active is achievable at any age.” </div> <div> Dietitian Kirby Sorenson, from health platform <a title="https://www.getmosh.com.au/?utm_term=mosh&utm_campaign=Cross_Search_Brand_Mosh&utm_source=paid-search&utm_medium=adwords&utm_content=100740202037&hsa_acc=5792635568&hsa_cam=1701000406&hsa_grp=100740202037&hsa_ad=697110582898&hsa_src=g&hsa_tgt=kwd-295213997936&hsa_kw=mosh&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gclid=CjwKCAiAxKy5BhBbEiwAYiW--5qfGzQVQBG-CmA6baVMEeP5Zmk_oB_GOstA1n2vabFrLzbeDrEEnxoCM4YQAvD_BwE" href="https://www.getmosh.com.au/?utm_term=mosh&utm_campaign=Cross_Search_Brand_Mosh&utm_source=paid-search&utm_medium=adwords&utm_content=100740202037&hsa_acc=5792635568&hsa_cam=1701000406&hsa_grp=100740202037&hsa_ad=697110582898&hsa_src=g&hsa_tgt=kwd-295213997936&hsa_kw=mosh&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gclid=CjwKCAiAxKy5BhBbEiwAYiW--5qfGzQVQBG-CmA6baVMEeP5Zmk_oB_GOstA1n2vabFrLzbeDrEEnxoCM4YQAvD_BwE" data-outlook-id="bc4b923a-a4a3-4af0-80db-e837cd64b4c7">Mosh</a>, is encouraging Australians to ditch the Body Mass Index (BMI) in favour of more modern diagnostics to determine the risk of disease linked to higher body fat, declaring it’s unfairly categorising people as being overweight. </div> <div> Ms Sorenson says knowing your Body Roundness Index (BRI) as well as your Basal Metabolic Rate (BMR) can more accurately predict the risk of diseases like high blood pressure, type 2 diabetes and heart disease because it works out body fat levels based on height and waist circumference, rather than the BMI method which relies on height and weight. </div> <div> “BMI has long been criticised for inaccurately categorising people as overweight or obese because it doesn’t differentiate between those who carry a lot of muscle and individuals with fat in the wrong places,” Ms Sorenson says. </div> <div> “The problem is that it only looks at overall weight, while the BRI focuses on fat held around the abdomen which is the riskiest fat in terms of overall health. </div> <div> Once the BRI is determined, Ms Sorenson says it can help to know your Basal Metabolic Rate, which is largely determined by your total lean mass to help determine a healthy path to maintaining a healthy weight range. </div> <div> “The basal metabolic rate or BMR gives you an idea of how many calories your body burns doing the bare minimum; breathing, blood circulation, brain and nerve function. It can vary greatly from person to person, which explains why individual weight loss journeys can be so different,” Ms Sorenson said. </div> <div> For more information visit Moshy’s online <a title="https://www.getmoshy.com.au/weight-loss/basal-metabolic-rate-calculator?srsltid=AfmBOoobS-PiI_4sJn2ykpEG6vzq6qkvQXammfLv4Rm-mS5nwll6EN0m" href="https://www.getmoshy.com.au/weight-loss/basal-metabolic-rate-calculator?srsltid=AfmBOoobS-PiI_4sJn2ykpEG6vzq6qkvQXammfLv4Rm-mS5nwll6EN0m" data-outlook-id="800f9af2-0a34-4ac4-801b-d16714c7ec2e">BMR calculator</a>. Image credits: Supplied </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Globally, <a href="https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight">one in eight people</a> are living with obesity. This is an issue because <a href="https://www.aihw.gov.au/reports/risk-factors/risk-factors-to-health/contents/overweight-and-obesity">excess fat</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27423262/">increases the risk</a> of type 2 diabetes, heart disease and certain cancers. <a href="https://pubmed.ncbi.nlm.nih.gov/33393504/">Modifying your diet</a> is important for managing obesity and preventing weight gain. This might include reducing your calorie intake, changing your <a href="https://pubmed.ncbi.nlm.nih.gov/39143663/">eating patterns</a> and prioritising healthy food. But is one formula for weight loss more likely to result in success than another? Our <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">new research</a> compared three weight-loss methods, to see if one delivered more weight loss than the others: <ul> <li>altering calorie distribution – eating more calories earlier rather than later in the day</li> <li>eating fewer meals</li> <li>intermittent fasting.</li> </ul> We analysed data from 29 clinical trials involving almost 2,500 people. We found that over 12 weeks or more, the three methods resulted in similar weight loss: 1.4–1.8kg. So if you do want to lose weight, choose a method that works best for you and your lifestyle. <h2>Eating earlier in the day</h2> When our metabolism <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/metabolic-syndrome">isn’t functioning properly</a>, our body can’t respond to the hormone insulin properly. This can lead to weight gain, fatigue and can increase the risk of a number of chronic diseases such as diabetes. Eating later in the day – with a <a href="https://pubmed.ncbi.nlm.nih.gov/23512957/">heavy dinner</a> and late-night snacking – seems to lead to <a href="https://pubmed.ncbi.nlm.nih.gov/33172509/">worse metabolic function</a>. This means the body becomes less efficient at converting food into energy, managing blood sugar and regulating fat storage. In contrast, consuming calories <a href="https://pubmed.ncbi.nlm.nih.gov/31151228/">earlier</a> in the day appears to <a href="https://pubmed.ncbi.nlm.nih.gov/29754952/">improve</a> metabolic function. However, this might not be the case for everyone. Some people naturally have an evening “chronotype”, meaning they wake up and stay up later. People with this chronotype appear to have <a href="https://pubmed.ncbi.nlm.nih.gov/36803075/">less success losing weight</a>, no matter the method. This is due to a combination of factors including genes, an increased likelihood to have a poorer diet overall and higher levels of hunger hormones. <h2>Eating fewer meals</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/30700403/">Skipping breakfast</a> is common, but does it hinder weight loss? Or is a <a href="https://pubmed.ncbi.nlm.nih.gov/28967343/">larger breakfast and smaller dinner</a> ideal? While <a href="https://pubmed.ncbi.nlm.nih.gov/28137935/">frequent meals</a> may reduce disease risk, recent studies suggest that compared to eating one to two meals a day, eating six times a day might increase <a href="https://pubmed.ncbi.nlm.nih.gov/32437566/">weight loss success</a>. However, this doesn’t reflect the broader research, which tends to show consuming <a href="https://pubmed.ncbi.nlm.nih.gov/33485709/">fewer meals</a> can lead to greater weight loss. <a href="https://pubmed.ncbi.nlm.nih.gov/39485353/">Our research</a> suggests three meals a day is better than six. The easiest way to do this is by cutting out snacks and keeping breakfast, lunch and dinner. Most studies compare three versus six meals, with limited evidence on whether <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7490164/">two meals is better than three</a>. However, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11530941/">front-loading your calories</a> (consuming most of your calories between breakfast and lunch) appears to be better for weight loss and may also help <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9605877/">reduce hunger</a> across the day. But more studies with a longer duration are needed. <h2>Fasting, or time-restricted eating</h2> Many of us eat over a period of more than <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">14 hours a day</a>. Eating late at night <a href="https://pubmed.ncbi.nlm.nih.gov/26411343/">can throw off</a> your body’s natural rhythm and alter how your organs function. Over time, this can increase your risk of type 2 diabetes and other chronic diseases, particularly among <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8617838/">shift workers</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/35194176/">Time-restricted eating</a>, a form of intermittent fasting, means eating all your calories within a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">six- to ten-hour window</a> during the day when you’re most active. It’s not about changing what or how much you eat, but <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">when you eat it</a>. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7262456/">Animal studies</a> suggest time-restricted eating can lead to weight loss and improved metabolism. But the evidence in humans is still limited, especially about the long-term benefits. It’s also unclear if the benefits of time-restricted eating are due to the timing itself or because people are eating less overall. When we looked at studies where participants ate freely (with no intentional calorie limits) but followed an eight-hour daily eating window, they naturally consumed about 200 fewer calories per day. <h2>What will work for you?</h2> In the past, clinicians have thought about weight loss and avoiding weight gain as a simile equation of calories in and out. But factors such as how we distribute our calories across the day, how often we eat and whether we eat late at night may also impact our metabolism, weight and health. There are no easy ways to lose weight. So choose a method, or combination of methods, that suits you best. You might consider <ul> <li>aiming to eat in an eight-hour window</li> <li>consuming your calories earlier, by focusing on breakfast and lunch</li> <li>opting for three meals a day, instead of six.</li> </ul> The <a href="https://link.springer.com/article/10.1007/s13679-024-00555-2">average adult gains 0.4 to 0.7 kg per year</a>. Improving the quality of your diet is important to prevent this weight gain and the strategies above might also help. Finally, there’s still a lot we don’t know about these eating patterns. Many existing studies are short-term, with small sample sizes and varied methods, making it hard to make direct comparisons. More research is underway, including well-controlled trials with larger samples, diverse populations and consistent methods. So hopefully future research will help us better understand how altering our eating patterns can result in better health.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/242028/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/loai-albarqouni-452476">Loai Albarqouni</a>, Assistant Professor | NHMRC Emerging Leadership Fellow, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/fasting-eating-earlier-in-the-day-or-eating-fewer-meals-what-works-best-for-weight-loss-242028">original article</a>. </div>

Body

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results. We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise. To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes. The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits. All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated. Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile. It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results. <h2>Exercise genes</h2> Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight. While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>. More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates. Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training. When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics. We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified. For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene. Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise. <h2>Piece of the puzzle</h2> Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight. While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan). It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern. On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/trying-to-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>. </div>

Body

Lotto winner loses $1 million prize

A mystery Lotto winner has forfeited their million-dollar winnings after failing to collect their prize money for an entire year. The ticket was purchased from a BP petrol station in Mawson Lakes, in North Adelaide, on September 27th 2023, but wasn't claimed before passing the one-year expiration date. According to The Lott spokeswoman Anna Hobdell, the lucky winner could've claimed their seven-figure prize simply by registering their ticket to a player card or online. "It's likely our mystery winner has (been) going about their year as normal with no idea they became an overnight millionaire more than a year ago," she said. "If the mystery winner had registered their ticket to a player card or online, they would have already been united with their million-dollar treasure." Ms Hobdell said any prize that goes unclaimed for a year will be forfeited to the Lotteries Commission of South Australia. She went on to say that the winner could still claim their $1 million, but would need to submit their ticket, a prize claim form and an ex-gratia statutory declaration form with the commission. "This also serves as an important reminder to register your tickets," Ms Hobdell said. Image credits: Shutterstock

Money & Banking

"People are losing faith": Nat Barr takes aim at Albanese government

Prime Minister Anthony Albanese has defended his record on economic management as the Labor party's primary vote continues to slip in the polls against Peter Dutton ahead of next year's election. This week's Newspoll shows that Labor's primary vote has slumped to 31 per cent, the lowest it has been since the 2022 election, while the Coalition remains steady at 38 per cent. On Thursday, Sunrise host Nat Barr told the Prime Minister that while on her way to the studio she had spoken to a Labor-voting taxi driver who said he was "losing faith" in Albanese's leadership, as things were "too expensive". “This is your biggest problem, people like this cabby are losing faith. How do you respond to that?” Barr asked Albanese. Albanese defended his choices by pointing out that ABS figures released on Wednesday showed annual inflation rates at 2.7 per cent in August, down from 3.5 per cent in July, and the lowest it has been since August 2021. “Cost-of-living pressures are real, but that’s why we have engaged with responsible economic management in order to bring inflation down whilst we have been delivering cost-of-living relief,” he said. “Yesterday’s figures show the headline inflation is down from 3.5 to 2.7 (per cent), it is a good outcome. “There’s more work to be done, but we’ve done that whilst we have delivered a tax cut for that cabby who would have got nothing under the previous scheme.” Albanese added that energy bill relief, cheaper childcare, and fee-free TAFE places were also making a difference to cost-of-living pressures. However, Barr hit back and said that the cost-of-living measures such as the energy rebate were “artificial” as the rebate would end. “The RBA has said, this does not mean that inflation is under control. The power rebate is going to end and that’s keeping it at one level at the moment, that’s why they look at underlying inflation — they take out volatile stuff,” Barr said. “So, what do you say about inflation still being at this level?” she asked. “What I say is if you exclude volatile, the figures released yesterday, which are known as month-by-month, but they’re year-to-year … that figure is down from 3.7 down to 3 (per cent). That’s a remarkable drop,” Albanese responded. “The Reserve Bank Australia’s target band is 2 to 3 (per cent). Every single one of the figures yesterday that were released, whether it was headline, excluding volatile, mean, all of them saw significant drops in inflation. “Inflation is half what we inherited and one-third of where it peaked …That is in part because of the back-to-back budget surpluses that we have delivered that in part is, yes, energy bill relief, but also what we’ve done in cheaper childcare, fee-free TAFE, the deliberate policy design to help people whilst putting that downward pressure on inflation,” he said. Image: Sunrise

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

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

Body

Jelena Dokic's powerful message on body image

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

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Health at every size (or HAES) is a lifestyle counselling approach that promotes mindful eating and lifestyle behaviours to pursue health and wellness, without focusing on weight loss. Weight loss is seen as a <a href="https://www1.racgp.org.au/newsgp/clinical/understanding-the-%E2%80%98health-at-every-size%E2%80%99-paradigm">beneficial side effect</a>, rather than a goal. The <a href="https://www.sizeinclusivehealth.org.au/What-is-HAES">Association for Size Diversity and Health</a> first developed the approach in 2003 and revised it in 2013 and 2024. Its current <a href="https://asdah.org/haes/">core principles</a> promote: <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> It also aims to address <a href="https://theobesitycollective.org.au/our-work/#weight-stigma-awareness">stigma and discrimination</a> that people in larger bodies may experience when seeking medical care. Internationally, a <a href="https://asdah.org/listing/">range of health professionals</a> have incorporated the HAES approach into their treatment and services. Some organisations, such as <a href="https://obesitycanada.ca/guidelines/nutrition/">Obesity Canada</a>, have included HAES in their <a href="https://pubmed.ncbi.nlm.nih.gov/32753461/">guidelines for obesity treatment</a>. <h2>How does it compare with weight-focused treatments?</h2> We conducted a <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">systematic review and meta-analysis</a> of all the research studies published until November 2022 that had used HAES-based programs. Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">with</a>: <ul> <li>conventional weight loss programs (six studies)</li> <li>people on waiting lists receiving no treatment at all (six studies)</li> <li>groups where people received weekly social support in groups (four studies).</li> </ul> We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health. Our analysis found HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, meaning people had less subjective perceptions of hunger or eating in response to emotions. However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes. Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs and goals. <h2>Don’t get your health advice from influencers</h2> While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioner’s motives have been scrutinised because of their links <a href="https://www.washingtonpost.com/wellness/2024/04/03/diet-culture-nutrition-influencers-general-mills-processed-food/">with processed food companies</a>. The spotlight was put on the <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">very small number</a> of dietitian “influencers” (roughly 20 from a membership of more than 80,000 dietitians in the US and Canada) promoting “eat what you feel like” and discouraging people from making weight loss attempts, under the banner of HAES. They failed to mention they were being paid to promote products sold by food, beverage or supplement companies. US <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">author and dietitian Carrie Dennet</a> urges people to not look to influencers for health advice. Instead, seek non-judgemental health care from your GP. <h2>What might treatment look like?</h2> When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food. A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health and wellbeing goals. This might include strategies such as: <ul> <li>keeping a <a href="https://theconversation.com/what-does-having-a-good-relationship-with-food-mean-4-ways-to-know-if-youve-got-one-202622">food mood diary</a></li> <li>reflecting on factors that influence your eating</li> <li>practising <a href="https://theconversation.com/thinking-youre-on-a-diet-is-half-the-problem-heres-how-to-be-a-mindful-eater-99207">mindful eating</a></li> <li>learning about nutrient needs</li> <li>focusing on food enjoyment and the pleasure that comes from preparing, sharing and eating with others.</li> </ul> If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist. <h2>What if your goal is weight loss?</h2> When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations. Broadly, there are three graded energy intake target levels: <ol> <li> a reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water. </li> <li> a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">low-energy diet</a>, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure. </li> <li> the most restricted regime is a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a>, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products. </li> </ol> The aim of a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a> is to facilitate rapid weight loss when this is essential to improve health acutely such as poorly controlled type 2 diabetes. Such a diet should be used under supervision by your doctor and dietitian. When selecting an initial <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">strategy</a>, seek a balance between energy intake goals and your ability to stick to it. Your approach may change over time as your health needs change. If you need personalised nutrition advice, ask for a referral to an accredited practising dietitian. The <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">register of service providers though Dietitians Australia</a> allows you to view their expertise and location. Regardless of whether your practitioner uses a HAES approach or not, your health providers should always treat you with respect and address your personal health and wellbeing.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234376/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, Postdoctoral Researcher, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, Post Doctorate Fellow, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, Dietitian and early career researcher, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>. </div>

Body

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</a> Imagine checking in for a flight with your two teenage children. At the counter, you are told that your youngest teenager’s suitcase is two kilograms over the limit. You get slapped with a $75 penalty for their excess luggage. This penalty feels arbitrary and unfair. The youngest weighs about 45 kg, and their luggage weighs 25 kg, making their total payload on the flight 70 kg. Their older sibling, on the other hand, weighs 65 kg, and has brought 23 kg of luggage to check in. Their total weight is higher – 88 kg – yet they receive no penalty. Obviously, things aren’t that simple. Charging passengers based on their weight is highly controversial for many reasons. But that hasn’t stopped some airlines <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">experimenting</a> with such policies. Imagine checking in for your flight only to have the staff tell you to <a href="https://edition.cnn.com/travel/article/plus-size-travelers-slam-airline-seat-policies/index.html">purchase an extra seat</a> as you are a plus-size passenger. You feel discriminated against because you are using the same service as other passengers and your weight is beyond your control. But despite the lived experience of many and hot debate in the media, there has not been a formal study into what passengers themselves think about this matter. Our recently published <a href="https://doi.org/10.1002/jtr.2691">research</a> examined air passengers’ views on alternative airfare policies to understand whether the public finds them acceptable and what ethical considerations determine their views. Though we found a range of ethical contradictions, most travellers were guided by self-interest. <h2>A controversial but important topic</h2> The issue of whether airlines should weigh passengers is an ethical minefield with no easy answers. Despite its sensitivity, the aviation industry can’t ignore passenger weight. Airlines intermittently undertake <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">passenger weight surveys</a> as they need to accurately calculate payload to ensure flight safety and estimate fuel consumption. The evidence shows passengers are <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">getting heavier</a>. Airlines including the now-defunct <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">Samoa Air</a> and <a href="https://www.theguardian.com/us-news/2016/oct/23/hawaiian-airlines-american-samoa-weight-passengers">Hawaiian Airlines</a> have taken things one step further and experimented with weighing passengers regularly. Samoa Air, for example, became the first airline to introduce a “pay-as-you-weigh” policy, where the cost of your ticket was directly proportional to the combined weight of you and your luggage. In contrast, Canada has now long had a “<a href="https://otc-cta.gc.ca/eng/publication/additional-seating-and-one-person-one-fare-requirement-domestic-travel-a-guide">one person, one fare</a>” policy. It is prohibited and deemed discriminatory to force passengers living with a disability to purchase a second seat for themselves if they require one, including those with functional disability due to obesity. To complicate matters further, the issue of passenger and luggage weight is not only ethical and financial, but also environmental. More weight on an aircraft leads to more jet fuel being burned and more carbon emissions. About <a href="https://www.nature.com/articles/s41467-021-24091-y">5%</a> of human-driven climate change can be attributed to aviation, and the industry faces enormous pressure to reduce fuel consumption while it waits for low carbon substitutes to become available. <h2>What do passengers actually think?</h2> To get a better sense of how the public actually feels about this issue, we surveyed 1,012 US travellers of different weights, presenting them with three alternatives: <ul> <li>standard policy – currently the most widely used policy with passengers paying a standard price, irrespective of their weight</li> <li>threshold policy – passengers are penalised if they are over a threshold weight</li> <li>unit of body weight policy – passengers pay a personalised price based on their own body weight, per each pound.</li> </ul> The standard policy was the most acceptable for participants of differing weight, although the heavier the passenger, the more they preferred the standard policy. This can be partially explained by status quo bias. Generally, people are likely to choose a familiar answer. The threshold policy was the least acceptable. This policy was seen to violate established social norms and be generally less fair. The unit of body weight policy was preferred to the threshold policy, although participants raised concerns about whether it would be accepted by society. Perhaps unsurprisingly, we found that self-interest played a clear role in determining whether respondents considered a policy acceptable. Younger, male, financially well-off travellers with lower personal weight generally found the alternative policies more acceptable. <h2>An ethical conflict</h2> Alternative airfare policies that are based on passenger weight bring environmental and ethical concerns into conflict. Obviously, the effect isn’t from any one traveller, in particular, but averages over the entire industry. Interestingly, respondents that were more concerned about the environment – “ecocentric” – preferred air fare policies that would reduce the carbon emissions. This made them more open to the controversial alternatives. While the threshold policy was clearly rejected by many respondents as discriminatory, environmental concern played a role in the level of acceptance of the unit of body weight policy. It’s important to apply a critical lens here. These ecocentric travellers were also generally younger and had lower personal weights, so many would benefit from the alternative policies financially. For policymakers overall, our study suggests when it comes to controversial ticketing policies, the public is more likely to be swayed by self-interest than anything else.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237856/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, Professor, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/pay-by-weight-airfares-are-an-ethical-minefield-we-asked-travellers-what-they-actually-think-237856">original article</a>. </div>

Travel Trouble

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

Jelena Dokic's candid admission on weight loss

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

Body

New study links Ozempic and Wegovy to suicidal thoughts

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

Caring

Channel Seven loses veteran reporter to rival network

A Channel Seven reporter has announced he is leaving the network to join a rival station. Journalist Steve Hart from the 7News room in Brisbane shared that he is leaving the network after two years to join the WIN News, owned by Nine, in Wollongong. Hart, who first joined the Seven Network in 2022 after leaving Network 10, will have his last day on September 11th. The news was revealed in an internal email to staff on Tuesday, which cited “family reasons” as the driving force behind Hart’s decision. According to <a id="U841326290785qZ" href="https://www.couriermail.com.au/entertainment/veteran-journalist-steve-hart-leaves-channel-7-for-rival-network/news-story/8311df15d77a4e4aa251bc64a709f16c" data-tgev="event119" data-tgev-container="bodylink" data-tgev-order="8311df15d77a4e4aa251bc64a709f16c" data-tgev-label="entertainment" data-tgev-metric="ev">Courier Mail</a>, Hart’s wife has been living in Sydney, and his regular weekend commutes to be with her have played a significant role in his choice to relocate closer to his family. The news of Hart's departure comes after the 7News room in Brisbane has faces a series of controversies, with many high profile presenters fleeing the network. Hart's departure comes just one week after sports presenter Shane Webcke announced his decision to step back from the news desk, following discussions with management to reduce his work hours and focus on his family’s agricultural business. The departure of both Hart and Webcke is understood to be unrelated to the recent wave of redundancies at Seven, and comes after the ABC Four Corners investigation into <a href="https://oversixty.com.au/finance/legal/bombshell-allegations-of-toxic-channel-seven-workplace-aired" target="_blank" rel="noopener">toxic</a> workplace culture in the Brisbane newsroom. Image credits: 7News

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment. This is more than just anecdotal. According to data from the <a href="https://app.powerbi.com/view?r=eyJrIjoiZGU1YWFhZDgtMmRhZi00YTgyLThhMzItYjc2ODk5NTg0MTg1IiwidCI6IjhkMmUwZjRjLTU1ZjItNGNiMS04ZWU3LWRhNWRkM2ZmMzYwMCJ9">Australian Sports Commission</a>, the number of women <a href="https://www.clearinghouseforsport.gov.au/research/ausplay/results#portal">participating in weightlifting</a> (either competitively or not) grew nearly five-fold between 2016 and 2022. Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles. <h2>Health benefits</h2> <a href="https://www.womenshealth.gov/a-z-topics/osteoporosis">Osteoporosis</a>, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases <a href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670">bone density</a>, a crucial factor for <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-47">preventing osteoporosis</a>, especially for women negotiating menopause. Strength training also improves <a href="http://link.springer.com/10.1007/s40279-015-0379-7">insulin sensitivity</a>, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better <a href="https://doi.org/10.1139/apnm-2020-0245">heart health</a> too. There’s a mental health boost as well. Strength training has been linked to reduced symptoms of <a href="https://doi.org/10.1001/jamapsychiatry.2018.0572">depression</a> and <a href="http://link.springer.com/10.1007/s40279-017-0769-0">anxiety</a>. <h2>Improved confidence and body image</h2> Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and <a href="https://www.tandfonline.com/doi/full/10.1080/2159676X.2019.1634127">conquer challenges</a>. This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S1755296623000194">recent study</a> found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym. Strength training also has the potential to positively impact <a href="https://journals.lww.com/nsca-jscr/abstract/2002/11000/Relations_of_Strength_Training_to_Body_Image_Among.25.aspx">body image</a>. In a world where women are often judged on appearance, lifting weights can shift the focus <a href="http://journals.sagepub.com/doi/10.1177/0193732502238256">to function</a>. Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success. Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative <a href="https://journals.humankinetics.com/view/journals/wspaj/aop/article-10.1123-wspaj.2022-0088/article-10.1123-wspaj.2022-0088.xml">research</a> I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us: <blockquote> I wanted something that would allow me to train that just didn’t have anything to do with how I looked. </blockquote> Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said: <blockquote> We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we? </blockquote> This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained: <blockquote> Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life. </blockquote> This newfound confidence often spills over into other areas of life. As one woman said: <blockquote> I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter. </blockquote> <h2>Feeling inspired? Here’s how to get started</h2> 1. Take things slow Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering <a href="https://theconversation.com/what-are-compound-exercises-and-why-are-they-good-for-you-228385">compound movements</a>, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient. 2. Prioritise proper form Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially. 3. Consistency is key Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else. 4. Find a community Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum. <h2>Are there any downsides?</h2> Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag. Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging. If you’re concerned about getting too “bulky”, it’s very difficult for <a href="https://journals.sagepub.com/doi/epub/10.1177/0031512520967610">women</a> to bulk up like male bodybuilders without pharmaceutical assistance. The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erin-kelly-1497598">Erin Kelly</a>, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/strength-training-has-a-range-of-benefits-for-women-here-are-4-ways-to-get-into-weights-221307">original article</a>. </div>

Body

Flight cancelled after crew member loses it at passenger

An Air Canada flight heading from Morocco to Montreal was cancelled on Friday after a flight attendant lost it at a passenger who reportedly requested a blanket. Viral footage of the incident showed a female flight attendant yelling: “You will behave or we will get off!” at a female passenger. “I’ll tell the captain right away. Yes or no?” When a passenger asked the flight attendant to call the captain, she refused and said: “I don’t want no bullying against my crew”. She then stormed up the aisle before she turned around and yelled: “Everyone behave! Be quiet … or you’re getting off.” <blockquote class="twitter-tweet"> Stress levels are quite high in the sky these days : An Air Canada flight from Casablanca (CMN) to Montreal (YUL) was canceled due to the inappropriate behavior of a flight attendant on July 26, 2024. The Airbus A330-343 aircraft (C-GHLM) did the taxi aiming a departure while… <a href="https://t.co/h3s4fbGF5A">pic.twitter.com/h3s4fbGF5A</a> — FL360aero (@fl360aero) <a href="https://twitter.com/fl360aero/status/1817249195960455420?ref_src=twsrc%5Etfw">July 27, 2024</a></blockquote> According to CTV News, the meltdown occurred after the passenger asked for a blanket. In a statement to the publication, Air Canada said the flight had been rescheduled for Saturday with a different crew. “We are taking this incident very seriously. It is under review, and we will take appropriate action,” the statement read. “It is under review, and we will take appropriate action. We apologise to our customers and deeply regret that their experience today fell far short of what they have come to expect when flying with Air Canada.” The airline has also offered compensation to all passengers affected by the delay. Images: X

Travel Trouble

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

<div class="theconversation-article-body"><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> 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. 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. So how you can tell if you’re losing too much muscle and what can you do to prevent it? <h2>Why does muscle mass matter?</h2> 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. 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. 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. <h2>How to tell you’re losing too much muscle</h2> Unfortunately, measuring changes in muscle mass is not easy. 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. But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap. There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage. 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. Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting. <h2>1. You’re losing much more weight than expected each week</h2> 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. 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. 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>. 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>. <h2>2. You’re feeling tired and things feel more difficult</h2> 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. <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. <h2>3. You’re feeling moody</h2> Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass. <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. <h2>So how you can do to maintain muscle during weight loss?</h2> Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight. <h2>1. Incorporate strength training into your exercise plan</h2> 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. 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. 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. 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. <h2>2. Eat more protein</h2> 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. But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado. <h2>3. Slow your weight loss plan down</h2> 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. 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. 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. Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime. <hr /> At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223865/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/3-signs-your-diet-is-causing-too-much-muscle-loss-and-what-to-do-about-it-223865">original article</a>. </div>

Body

Kyle Sandilands loses licence live on air

Kyle Sandilands has been left reeling after being told, while live on-air, that he has lost his NSW drivers licence. The radio host was told by his KIISFM manager about the unfortunate licence loss, while Sandilands and his co-host Jackie O were discussing speeding fines. After telling Jackie that speeding fines don’t bother him, Kyle was left red-faced when Bruno Bouchet chimed in to say the 53-year-old recently received a new penalty notice. “I don’t have enough points! I’m on the razor’s edge!” Kyle admitted, adding that he has “No points” left on his licence. “Both Kyle and I are. We can’t afford to lose anything!” Jackie added. When newsreader Brooklyn Ross asked if it meant Kyle had lost his licence, Bruno confirmed that he had. “He finds out live on air that he’s lost his license. But you know what? It’s only the sixth time,” Jackie O laughs, before Kyle corrects her, “The ninth time.” Kyle was still in disbelief over the penalty notice, even after being handed photographic evidence of him speeding in a Sydney tunnel. “So, on my speed sign recognition, it said 90km. But on the sign in the tunnel, it said 80km,” he began pleading his case. “And I remember Chris Minns, the Premier of New South Wales, sitting with me saying, ‘We’re kicking it [the speed limit] up to 90km’. And I thought that some d**khead hasn’t updated the sign.” When Jackie asked why he didn’t just follow the speed sign, Kyle replied: “I believed the tech in my vehicle and the Premier of New South Wales.” Image credits: KIISFM

Legal

How often should you really weigh yourself?

<div class="theconversation-article-body"> <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> Few topics are more debated in health than the value of the humble bathroom scale. Some experts advocate daily self-weigh-ins to promote accountability for weight management, particularly when we’re following a diet and exercise program to lose weight. Others suggest ditching self-weigh-ins altogether, arguing they can trigger negative <a href="https://link.springer.com/article/10.1007/s13679-015-0142-2">psychological responses and unhealthy behaviours</a> when we don’t like, or understand, the number we see on the scale. Many, like me, recommend using scales to weigh yourself weekly, even when we’re not trying to lose weight. Here’s why. <h2>1. Weighing weekly helps you manage your weight</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&report=abstract">Research</a> confirms regular self-weighing is an effective weight loss and management strategy, primarily because it helps increase awareness of our current weight and any changes. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588640/?tool=pmcentrez&report=abstract">systematic review of 12 studies</a> found participants who weighed themselves weekly or daily over several months lost 1–3 BMI (body mass index) units more and regained less weight than participants who didn’t weight themselves frequently. The weight-loss benefit was evident with weekly weighing; there was no added benefit with daily weighing. Self-weigh-ins are an essential tool for weight management as we age. Adults <a href="https://pubmed.ncbi.nlm.nih.gov/23638485/">tend to gain weight</a> progressively <a href="https://pubmed.ncbi.nlm.nih.gov/8363190/">through middle age</a>. While the average weight gain is typically between <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031938414001528">0.5–1kg per year</a>, this modest accumulation of weight can lead to obesity over time. Weekly weighing and keeping track of the results helps avoid unnecessary weight gain. Tracking our weight can also help identify medical issues early. Dramatic changes in weight can be an early sign of some conditions, including problems with our thyroid, digestion and diabetes. <h2>2. Weekly weighing accounts for normal fluctuations</h2> Our body weight can fluctuate within a single day and across the days of the week. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192384/">Studies</a> show body weight fluctuates by 0.35% within the week and it’s typically higher after the weekend. Daily and day-to-day body weight fluctuations have several causes, many linked to our body’s water content. The more common causes include: The type of food we’ve consumed When we’ve eaten a dinner higher in carbohydrates, we’ll weigh more the next day. This change is a result of our bodies temporarily carrying more water. We <a href="https://pubmed.ncbi.nlm.nih.gov/25911631/">retain 3–4 grams of water</a> per gram of carbohydrate consumed to store the energy we take from carbs. Our water content also increases when we consume <a href="https://www.ncbi.nlm.nih.gov/books/NBK50952/">foods higher in salt</a>. Our bodies try to maintain a balance of sodium and water. When the concentration of salt in our bloodstream increases, a mechanism is triggered to restore balance by retaining water to dilute the excess salt. Our food intake Whether it’s 30 grams of nuts or 65 grams of lean meat, everything we eat and drink has weight, which increases our body weight temporarily while we digest and metabolise what we’ve consumed. Our weight also tends to be lower first thing in the morning after our food intake has been restricted overnight and higher in the evening after our daily intake of food and drinks. Exercise If we weigh ourselves at the gym after a workout, there’s a good chance we’ll weigh less due to sweat-induced fluid loss. The amount of water lost varies depending on things like our workout intensity and duration, the temperature and humidity, along with our sweat rate and hydration level. On average, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993146/">we lose 1 litre of sweat</a> during an hour of <a href="https://link.springer.com/article/10.1007/BF00421168">moderate-intensity exercise</a>. Hormonal changes <a href="https://theconversation.com/from-energy-levels-to-metabolism-understanding-your-menstrual-cycle-can-be-key-to-achieving-exercise-goals-131561">Fluctuations in hormones</a> within your menstrual cycle can also affect fluid balance. Women may experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">fluid retention</a> and temporarily gain 0.5–2kg of weight at this time. Specifically, the luteal phase, which represents the second half of a woman’s cycle, results in a shift of fluid from your blood plasma to your cells, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154522/">bloating</a>. Bowel movements Going to the bathroom can lead to small but immediate weight loss as waste is eliminated from the body. While the amount lost will vary, we generally eliminate <a href="https://pubmed.ncbi.nlm.nih.gov/1333426/">around 100 grams of weight</a> through our daily bowel movements. All of these fluctuations are normal, and they’re not indicative of significant changes in our body fat or muscle mass. However, seeing these fluctuations can lead to unnecessary stress and a fixation with our weight. <h2>3. Weekly weighing avoids scale obsession and weight-loss sabotage</h2> Weighing too frequently can create an obsession with the number on the scales and do more harm than good. Often, our reaction when we see this number not moving in the direction we want or expect is to further restrict our food intake or embark on fad dieting. Along with not being enjoyable or sustainable, fad diets also ultimately increase our weight gain rather than reversing it. This was confirmed in a <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">long-term study</a> comparing intentional weight loss among more than 4,000 twins. The researchers found the likelihood of becoming overweight by the age of 25 was significantly greater for a twin who dieted to lose 5kg or more. This suggests frequent dieting makes us more susceptible to weight gain and prone to future weight gain. <h2>So what should you do?</h2> Weighing ourselves weekly gives a more accurate measure of our weight trends over time. Aim to weigh yourself on the same day, at the same time and in the same environment each week – for example, first thing every Friday morning when you’re getting ready to take a shower, after you’ve gone to the bathroom, but before you’ve drunk or eaten anything. Use the best quality scales you can afford. Change the batteries regularly and check their accuracy by using a “known” weight – for example, a 10kg weight plate. Place the “known” weight on the scale and check the measurement aligns with the “known” weight. Remember, the number on the scale is just one part of health and weight management. Focusing solely on it can overshadow other indicators, such as <a href="https://theconversation.com/can-you-be-overweight-and-healthy-182219">how your clothes fit</a>. It’s also essential to pay equal attention to how we’re feeling, physically and emotionally. Stop weighing yourself – at any time interval – if it’s triggering anxiety or stress, and get in touch with a health-care professional to discuss this. <hr /> At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223864/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-often-should-you-really-weigh-yourself-223864">original article</a>. </div>

Body

“Grief eats you away”: Prince Harry's candid interview about losing his mother

Prince Harry has spoken candidly about his ongoing struggles with grief following the death of his mother, the late Princess Diana, when he was just 12 years old. Upon his brief return to the UK, the Duke of Sussex opened up in a new interview as part of his role as global ambassador for Armed Forces charity Scotty’s Little Soldiers, who work to support children who have lost parents in the military, admitting that “grief eats you away”. Harry detailed how difficult it was losing his mother at such a young age, admitting he spent nearly two decades “not thinking” about her death and was forced to eventually get help after years of “total chaos”. He added that learning how to celebrate a late loved one is difficult for a child, as it made them “sad”. “But realising if I do talk about it, and I’m celebrating their life, then things become easier,” he said. Harry went on, “You convince yourself that the person you’ve lost wants you, or you need to be sad for as long as possible to prove to them that they are missed … Especially when every defence mechanism in your mind, nervous system and everything else is saying ‘do not go there.” <iframe title="YouTube video player" src="https://www.youtube.com/embed/YY-W6VEXlZM?si=SBQyGGCKAOhELxlv" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> "But then there’s this realisation of, no, they must want me to be happy”. The 39-year-old royal shared how, after decades of silent mourning, he learned suppressing grief was “in fact not” the best form of coping with loss. “It can be for a period of time,” he went on to say. “But…if you suppress this for too long, you can’t suppress it forever it’s not sustainable and it will east away at you inside." “Once realising that if I do talk about it and I’m celebrating their life then actually things become easier.” Image credits: YouTube

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“Grief eats you away”: Prince Harry's candid interview about losing his mother

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