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• After gaining 50 pounds, Dustin Gee set out to get help from his primary care doctor.
• Gee started taking Wegovy in 2023 and has lost over 50 pounds.
• To maintain weight loss and prepare for going off the medication, he is participating in a lifestyle behavioral program.

In January 2023, Dustin Gee went for his annual checkup with his primary care doctor, concerned about the 50 pounds he had gained over the past three years. At 5 feet 8 inches, he weighed 225 pounds.

“It was the largest I had ever been in my life. I was concerned because during the pandemic and becoming a father to three foster children, I just knew that these stressors were kind of compiling,” he told Healthline.

His family history worried him, too, as diabetes and obesity run on his mom’s side and heart conditions on his father’s.

“I was borderline pre-diabetic, and my doctor said if I didn’t make changes, I would most likely become diabetic in the next few years,” he said. “And a lot of men in my dad’s family died in their early to mid-40s due to cardiovascular issues.”

While anti-obesity medication was not on his radar, Gee’s doctor suggested Wegovy along with lifestyle changes.

He started taking Wegovy in February 2023, starting at the lowest dose and increasing in dosage. He checked in with his doctor every month.

“At the top dose, I had little side effects, which has allowed me to remain on Wegovy,” Gee said.

During the first 9 months on the medication, he lost 45 pounds. However, by October 2023, he hit a plateau and remained the same weight for 6 weeks.

In January 2024, Gee began participating in the Mayo Clinic Diet, a companion program for those taking GLP-1 medications, in an effort to continue his weight loss and prepare for the time when he will no longer be taking Wegovy.

Since then, he’s lost an additional 6 pounds, now weighing his goal weight of 175 pounds.

Preparing for “rebound weight gain”

Studies show that once people stop taking semaglutide medications like Wegovy, they gain back two-thirds of the weight they lost within a year. This is often referred to as “Ozempic rebound.”

To many obesity doctors like Dr. Daniela D. Hurtado Andrade, physician-scientist at Mayo Clinic, this proves the importance of staying on the medication.

Because obesity is a chronic, relapsing, and incurable disease that requires continuous treatment, just like any other disease, Hurtado said once an anti-obesity medication is started, it is anticipated that it will be continued long-term or for life.

“To put things into perspective, we never question the length of therapy for the treatment of diabetes and hypertension, for example. For these and all other chronic conditions, patients, and society in general, understand that without continuous treatment, their disease will not be well controlled and lead to complication,” Hurtado told Healthline. “This concept also applies for the treatment of obesity.”

She added that the root cause of obesity is complex and heterogeneous.

“Anti-obesity medications target the biological basis of the disease as they target the pathways that regulate energy balance, particularly energy intake,” said Hurtado.

People planning to come off anti-obesity medication should not abruptly stop it but rather de-escalate the dose to see if dose reduction is a viable option to maintain some weight loss, said Dr. Rekha B. Kumar, associate professor of medicine at Cornell and Chief Medical Officer at Found.

She also suggests having a structured meal plan to manage increased appetite once the medication is reduced.

“I would encourage people to really confirm that they feel confident in their ability to adhere to a behavioral routine of reduced calorie diet and exercise,” she told Healthline.

Kumar explained that GLP-1 drugs don’t permanently change the body.

“Keeping off all the weight that was lost on the medicines is not realistic for most people who have struggled with metabolic health,” said Kumar. “If someone wants to come off medicine, it’s okay to accept some weight gain if metabolic biomarkers stay in an improved state.”

Aside from people who want to quit taking GLP-1 medications, there are also those who are forced to stop. An analysis by Prime Therapeutics found that only 27% of people taking GLP-1 drugs were still taking the medication a year later due to side effects or the cost of prescriptions.

While Hurtado advises against discontinuing medication, she noted that dietary, exercise, and behavior support should be offered to everyone throughout their weight loss journey.

“Needs will be different depending on what phase patients are in, e.g., weight loss phase versus weight loss maintenance phase,” she said.

Embracing lifestyle changes before going off Wegovy

To maintain his weight loss, Gee plans to partake in the Mayo Clinic Diet program for 6 months while he continues to take Wegovy, and for an additional 6 months after he stops the medication.

Tara Schmidt, MEd, RDN, LD, lead registered dietitian at Mayo Clinic Diet, said the goal of the program is to support people like Gee.

“Our program emphasizes a holistic approach to health, focusing not just on weight loss but on establishing long-term habits that can sustain your health for a lifetime,” she told Healthline.

While anti-obesity medications suppress appetite, Schmidt said they don’t inherently instill healthy habits. The program provides guidance on nutrition and lifestyle changes.

“This ensures that as individuals experience reduced appetite from the medications, among other side effects, they are simultaneously adopting a healthier lifestyle, which is essential for long-term well-being and weight management,” she said.

Through a digital platform, the program offers webinars, meal plans, exercise routines, and financial incentives.

“I’m trying to develop the lifestyle habits I know I need to start to lean into and be able to maintain because once I go off the medication, the biggest fear is that I’ll gain it back… resorting back to what got me to 50-plus pounds in January 2023,” said Gee.

Through his weight loss journey, he discovered the need to improve his knowledge about healthy food choices and how to adopt healthy eating habits. He has also become aware of his proneness to emotional eating.

“There was this compilation effect of these things that kept on happening, and as a result, I kind of lost myself,” said Gee. “I think [this is true] for a lot of parents in their late 30s and 40s…when you have children, it becomes less about you and more about your family…but I  realized that I can’t be fully present for my family if I’m not taking care of myself and sacrificing my health through poor choices with food and inactivity.”

Stigma feeds into the notion that GLP-1 drugs are a quick fix

While doctors like Hurtado continue to stress the importance of anti-obesity medication being prescribed for people who are, in fact, living with obesity or overweight with health complications, the notion that taking these medications is a quick fix continues to exist.

Gee imposed this stigma on himself initially. However, when his doctor explained that the weight loss brought on by medication could serve as inspiration to make lifestyle changes, he understood its value.

“Before I went into my meeting with my doctor in 2023, I thought, this is just how I am. I’m in my mid-30s, I’m a dad, I have a dad bod, and I got to be comfortable with that because I’m never going to be back to where I was when I was 25 years old,” said Gee.

However, he accepted that his weight came with the risk of serious health complications and was motivated to make changes.

“You don’t have to accept where you are at today. GLP-1 medication combined with a great health, nutrition, and lifestyle program can support you in getting there,” he said. “Seeing the early signs of progress can be incredibly motivating, but while you’re doing it, there also has to be a commitment to making changes.”

• One in eight American adults have used a GLP-1 agonist.
• This class of drugs are prescribed for weight loss, to treat diabetes, and to reduce the risk of heart attack and stroke in adults with heart disease.
• Use of GLP-1 drugs solely for weight loss was higher among younger adults than those 65 years or older.

One in eight or about 13% of American adults have used a GLP-1 agonist, a class of drugs prescribed for weight loss, to treat diabetes, or to reduce the risk of heart attack and stroke in adults with heart disease, a new survey found.

Half of those people or about 6% report they are currently taking one of these drugs, which includes Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro and Zepbound, among others.

“I suspect a large driver of this drop-off [of people currently using the drugs] is cost,” said Beverly Tchang, MD, endocrinologist and Ro advisor. More than 50% of those surveyed identified cost or insurance coverage as their biggest concern in KFF’s survey.”

The latest KFF Health Tracking Poll, conducted April 23 to May 1, also found higher rates of GLP-1 drug use among people whose doctor told them they have diabetes (43%) or heart disease (26%).

In addition, higher rates were seen among people whose doctor told them they have obesity or are overweight with 22% of those people taking the drug.

“The majority of people who have taken a GLP-1 drug have taken it for diabetes mellitus and now heart disease,” said Katrina Mattingly, MD, chief medical officer of Options Medical Weight Loss. 

“However, “[these drugs] are still being grossly underutilized for overweight and obese populations, which is a major risk factor for the development of diabetes mellitus and cardiovascular disease (CVD),” she told Healthline. “Once people get the weight off, the risk for diabetes and CVD, and the complications from those conditions, goes down with it.”

Differences were also seen among racial and ethnic groups. In the survey, nearly two in 10 Black adults (18%) reported ever taking a GLP-1 drug, compared to one in 10 white adults (10%) and around one in eight Hispanic adults (13%).

”Black Americans typically suffer from disproportionate rates of chronic disease, so it makes sense there would be more utilization in this population for chronic disease management,” said Mattingly.

However, “it would be interesting to see what the use for weight loss versus chronic disease would be across demographics,” she said. “As we know, minority populations do not always have access to the same quality healthcare or the financial capacity to afford these powerful drugs.”

GLP-1 drugs like Ozempic can be too expensive for many patients

Around 62% of people who have taken GLP-1 drugs did so as a treatment for diabetes, heart disease or another chronic condition, with 38% saying they did so mainly to lose weight.

The fact that these drugs are not utilized for weight loss may be because health insurers may be less likely to cover the cost of high-priced GLP-1s if they are prescribed solely to help with losing weight. These restrictions leave people to pay out of pocket for all or most of the cost of the drug.

The list prices for GLP-1 drugs range from around $900 to $1,400 per month. This is the price before insurance coverage, coupons or rebates.

Around half of adults or 54% who have taken a GLP-1 agonist reported having difficulty affording the medication, with 22% saying it was “very difficult,” according to the KFF poll.

Even 53% of those people with some insurance coverage for GLP-1 drugs found it difficult to afford these medications.

“The cost of GLP-1 medications for uninsured patients and those that get caught in the coverage gap is not sustainable for the average American who cannot even afford a $400 emergency expense,” said Mattingly.

“[GLP-1] drugs should be seen as a necessity and not a luxury,” she said. “I would like to see the costs associated with GLP-1 medications eventually hit the same level of affordability as generic blood pressure medications.”

What to know about Medicare and GLP-1s

The KFF survey also found that younger adults are more likely than older adults to report taking GLP-1 drugs just for weight loss.

For 18- to 29-years, 7% used a GLP-1 drug for weight loss, and for 30- to 49-year-olds, the rate was 6%.

In comparison, among adults ages 65 and older, 8% say they have taken a GLP-1 drug for diabetes, heart disease or another chronic condition. However, only 1% report using a GLP-1 drug to lose weight.

”Younger adults often have the discretionary cash to spend on these drugs for weight loss, which many times are not covered by insurance,” said Mattingly. “But adults 65 and older are more likely to be retired, on a fixed income and the recipients of Medicare benefits.”

Medicare, by law, cannot cover the cost of GLP-1 drugs when prescribed solely for weight loss. 

“This is why we’re seeing it more for chronic conditions — which supplemental insurance may be helping to cover — versus solely for weight loss,” said Mattingly. 

However, there is strong public support for broader coverage of GLP-1 drugs by Medicare.

About 61% of adults say they think Medicare should cover the cost of GLP-1 drugs for weight loss when people are overweight. The rates were similar for all age groups. 

In contrast, higher numbers of Democrats (66%) and Independents (63%) say Medicare should cover GLP-1 drugs for weight loss, compared to Republicans (55%).

“You rarely see Democrats and Republicans agree on an issue, so it’s particularly impactful that majorities agree on this,” Tchang told Healthline. “Medicare should cover GLP1s for obesity.”

What if the use of GLP-1s keeps rising?

Sue Decotiis, MD, a NYC-based medical weight loss doctor, expects more Americans will start taking GLP-1s for weight loss, especially now that Zepbound and Wegovy are FDA-approved for that use. She expects more doctors will also feel comfortable prescribing these medications solely for weight loss. 

However, she thinks cost will remain an issue for some time. Tchang agrees, saying that the use of these drugs will be limited by “barriers to access created by insurance.” 

Mattingly hopes expanded insurance coverage will eventually allow more people to take advantage of these medications.

“Insurance companies will realize it’s cheaper to treat obesity … rather than pay for chronic conditions stemming from being overweight or suffering from obesity,” she said, such as strokes, heart attacks, joint replacements, sleep apnea, depression, and others.

With increased treatment of obesity, “we would expect that healthcare expenditures should eventually go down over the long term,” said Mattingly, “lowering premiums and out-of-pocket costs for all.”

Tchang agrees.

“Medicare is uniquely positioned to be the first to experience the compounding benefits of covering GLP-1s for obesity at age 65,” she said. “Over the subsequent 20-plus years, we’d be able to discover all of the heart surgeries, knee surgeries and hospitalizations that were avoided — and that the system never had to pay for — because of GLP-1 coverage.”

However, the large number of GLP-1 drug prescriptions has meant that there have been major shortages of some of these drugs. And these shortages may get worse, expects Decotiis.

Shortages can affect patients in multiple ways, said Decotiis. First, patients may not be able to take their medication regularly because they can’t find it at a pharmacy. They might also not be able to find the right dose of the drug, even if the pharmacy has other doses in stock.

“[These shortages] are very upsetting for patients,” she told Healthline. “And the doctors are also drawn into it, because we get the phone calls from patients.”

Takeaway

A KFF Health Tracking Poll found that one in eight American adults had used a GLP-1 agonist, with half of those people still taking the medication.

These drugs include Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro and Zepbound, among others. They are prescribed to help people lose weight, to treat diabetes, or to reduce the risk of cardiovascular disease in adults with heart disease.

Cost was a big issue among people who have used a GLP-1 drug, even among those whose insurance covers part of the medication. At this time, Medicare does not cover GLP-1s when prescribed solely for weight loss.

With the recent emergence of a new group of COVID-19 variants, known collectively as FLiRT, some people are asking about how these new strains compare to other variants. The unofficial nickname was inspired by the names of the mutations in …

• A novel, minimally-invasive procedure that targets the “hunger hormone” ghrelin could someday help treat obesity.
• The procedure uses endoscopic ablation to burn targeted areas of the stomach lining to reduce the production of ghrelin.
• Participants in the small, six-month trial showed weight loss, lower fasting ghrelin, and reported being less hungry.

A new minimally-invasive procedure that targets the production of the “hunger hormone” ghrelin in the stomach is showing promise in early-stage trials.

Researchers conducted a six-month trial involving endoscopic ablation of the gastric fundal mucosa — literally the burning of the stomach lining — to reduce ghrelin production and help patients lose weight. 

They will present their findings at Digestive Disease Week (DDW) 2024. This research has yet to be published in a peer-reviewed scientific journal.

“This relatively brief, outpatient, non-surgical procedure can facilitate weight loss and significantly curb hunger, and it could be an additional option for patients who don’t want or aren’t eligible for anti-obesity medications, such as Wegovy and Ozempic, or bariatric surgery,” said lead author Christopher McGowan, MD, a gastroenterologist and medical director of True You Weight Loss, a physician-owned clinic based in North Carolina, in a press release.

Experts contacted by Healthline said that the procedure demonstrates a solid proof of concept, but will need more rigorous trials before it is clear whether the procedure is ultimately safe and effective for weight loss.

“There’s a signal there, but clearly it’s very early data,” Dan Azagury, MD, section chief of Minimally Invasive and Bariatric Surgery and medical director for the Bariatric and Metabolic Interdisciplinary clinic at Stanford Health, told Healthline.

Jihad Kudsi MD, ABOM, a bariatric surgeon, CEO and founder of TeleSlim Clinic, Medical Director of Bariatric Surgery at the University of Chicago, and spokesperson for the Obesity Society, told Healthline, “The initial weight loss results appear promising…However, it’s essential to emphasize that long-term weight maintenance is the paramount consideration in any weight loss intervention discussion. Evaluating the procedure’s long-term results is crucial to fully understanding its effectiveness and sustainability.”

Procedure cut “hunger hormone” levels by 48%

The six-month first-in-human trial involved 10 female patients with obesity, a BMI of 30 or above, and an average age of 38 years old. Each participant received an endoscopic fundic mucosal ablation procedure. 

Endoscopic mucosal ablation is an established minimally-invasive procedure that is used to remove small nodules, growths, and even early cancers in and around the esophagus. The procedure has not previously been established for weight loss.

“This ablation technology is pretty widely used in endoscopy. The difference with this trial is that they go and they aim for this area of the fundus. The idea is that the cells there then no longer have the capacity to secrete ghrelin,” said Azagury.

Doctors target the fundic mucosa for ablation because it is where ghrelin and other hormones are secreted. Ghrelin, aptly called the “hunger hormone,” plays a role in making you hungry when you haven’t eaten and feeling satiated after a meal.

Over the six-month observation period, researchers observed that participants not only lost weight, about 7% on average, but also showed a nearly 50% drop in fasting ghrelin levels. Other positive weight-loss indicators from the trial were also documented, namely that participants self-reported being less hungry, and their stomachs shrank — some by as much as 42%.

There were also no apparent safety issues, as no serious adverse events were reported.

A new way to treat obesity?

The procedure represents a novel, minimally-invasive procedure with the potential to help tackle the obesity epidemic. Bariatric surgery, in which the stomach is manipulated to make it smaller,  is considered the gold standard for weight-loss, but it is still surgery. Endoscopic procedures, on the other hand, can utilize the esophagus or small incisions to be performed.

While some bariatric procedures such as endoscopic sleeve gastroplasty and intragastric balloon placement typically affect ghrelin production indirectly, they do not directly target it like endoscopic ablation. 

“ESG not only reduces the size of the stomach but also decreases ghrelin and enhances GLP-1 secretion…Intragastric balloons have been associated with changes in hormone levels, including ghrelin, which may contribute to their weight loss effects,” said Kudsi.

Breakthrough GLP-1 drugs like Ozempic, Wegovy, and Zepbound, have proven to be incredibly effective at treating obesity, but do so through a separate hormonal pathway. They don’t target ghrelin, but work on the “GLP1” or the glucagon-like peptide 1 hormone of the gut, which also plays a role in hunger and satiety.

With obesity, picking the right therapy is rarely an either/or situation; instead, doctors must rely on a variety of treatment options to ensure patients are successful over the long term.

“Obesity is a very complex disease. It’s a very difficult disease to treat. It’s a lifelong disease. So this is something that you need multiple modalities in order to be able to treat successfully,” said Azagury. 

“Having this armamentarium of different options is really necessary.”

The bottom line

A minimally-invasive endoscopic procedure that targets the “hunger hormone” ghrelin appears promising after an initial six-month trial.

Participants in the first-in-human trial showed weight loss, lower fasting ghrelin levels, and reported less hunger compared to baseline.

Experts say that there’s still much more work to be done before it’s clear if the procedure is safe and effective over the long term.

• A comment Barbra Streisand left on Melissa McCarthy’s Instagram has sparked a debate about weight loss conversations.
• Streisand asked McCarthy, “Did you take Ozempic?” and was called out for fat-shaming. 
• Experts say questions about weight loss can feel incredibly intrusive and spark feelings of shame, embarrassment, and pressure. 

Barbra Streisand recently sparked controversy when she left a comment on one of Melissa McCarthy’s Instagram posts. 

McCarthy shared two photos of herself attending a gala. In the comments section, Streisand wrote, “Did you take Ozempic?” referencing the GLP-1 medication, one of several popular drugs that can aid with weight loss.

Streisand was quickly called out for her comment, which many said was fat-shaming. 

In an Instagram story posted hours later, she wrote, “OMG – I went on Instagram to see the photos we’d posted of the beautiful flowers I’d received for my birthday! Below them was a photo of my friend Melissa McCarthy who I sang with on my Encore album. She looked fantastic! I just wanted to pay her a compliment. I forgot the world is reading!”

It appears McCarthy took the comment in good spirits. In an Instagram post, she wrote, “The takeaway? Barbra Streisand knows I exist. She reached out to me and she thought I looked good. I win the day.”

Nevertheless, Streisand’s comment has many people debating: Is asking someone about their weight loss ever okay? 

Should you comment on someone’s weight loss?

Registered counselor Georgina Sturmer says it’s rarely, if ever, okay to ask someone about weight loss or weight gain.

Questions about whether you achieved weight loss with medication are also off-limits, she believes.

“The way that we feel about our bodies, and the way that we look is deeply complex and personal,” she explains.  “It’s built on so many layers, like the messages that we heard when we were growing up, our interactions with friends, family, and romantic partners, and social expectations about what is and isn’t deemed attractive.” 

Because our shape and size are part of who we are, Sturmer says questions about them can feel deeply personal. 

“They can make you feel as though your body is public property, and often they come across as a judgment on who we are as a person,” she surmises. 

Psychotherapist Kamalyn Kaur agrees. “Commenting on weight loss is insensitive because weight can be a sensitive topic for so many people and is often tied up with self-esteem, body image, self-worth, past traumas, childhood memories, and even medical conditions,” she notes. “Asking about it can trigger painful and uncomfortable feelings, from the past or present.” 

If you’ve used medication to lose weight, questions about your weight loss may feel particularly intrusive. 

“It can come across as though they are making an assumption or judgment about your decisions, lifestyle, habits, and health,” Kaur reasons. “It might leave you feeling criticized, judged, and inferior, and as though you are doing something wrong or inadequate.” 

The impact of prying questions about weight loss

Sturmer points out that when people comment on weight loss, it’s often framed as a compliment. You might ask someone, “Have you lost weight? You look fantastic!” 

While these comments may seem innocent and well-intentioned, Sturmer says they are inherently fat-shaming. 

“There’s an implicit suggestion that weight loss is something to be curious about, something to be commended on.  We comment on it in a way that we don’t publicly comment on weight gain because the suggestion is that weight gain is something to be ashamed of,” she notes. 

“If someone has lost weight and another person points it out, it can make them worry about how they used to look before and whether other people were talking about them then,” she added. “It can leave them feeling worried or anxious about re-gaining the weight and how people might respond to this,” she adds. 

Feelings of embarrassment, shame, and added pressure can be common for people who face these questions. 

“You might feel embarrassed and worried about other people’s view of your body shape or weight loss, and this embarrassment about your body can lead to a sense of shame about who you are,” says Sturmer. 

In turn, she says this can add weight to any negative thoughts you already have about yourself and have an impact on your confidence and self-esteem. 

How to prepare for comments about your weight loss

If you’ve recently lost weight, you might find it hard to avoid questions like these. You might also find that people assume you’ve taken a medication like Ozempic, whether or not that is the case. 

How can you prepare yourself for these kinds of comments? First things first, remember you have a right to privacy, says Sturmer. 

“No one has a right to know your private medical information, and that’s exactly what this is,” she points out. “If you view it as private, personal information, then it will make it easier for you to reject other people’s questions if you wish to do so.”

It can be helpful, too, to think about the perspective of the person asking these probing questions. People ask about weight loss for all sorts of reasons, for example, curiosity or because they are projecting their own insecurities. 

Sturmer says a culture of “Ozempic shaming” has emerged, too, where people criticize others for using medication in this way. 

“It’s helpful to remember the motivation behind the question,” she notes. “Did they set out to make you squirm or feel uncomfortable? Or perhaps they were simply making small talk or issuing a well-meaning ‘compliment.’” 

Whatever their motivation, Sturmer says it’s important to remind yourself that you can not control what other people are thinking or feeling. Often, their comments are more a reflection on them than they are on you. 

How exactly should you respond if questions like these make you uncomfortable? There’s no right or wrong way, but it may help to have some ready-made phrases up your sleeve. 

Kaur advises saying something like, “I appreciate your concern, but I prefer to keep my medical information private,” or, “I understand your curiosity, but I’d rather not get into that topic right now.”

If you do want to respond, Kaur says to keep it brief, concise, and to the point and make sure that you stick to your own personal boundaries.

“Only share what you are comfortable with sharing, and do not hesitate to stop the conversation if you begin to feel uncomfortable with the questions,” she advises. 

If you’re using a GLP-1 drug like Ozempic or Wegovy as part of your weight loss plan and want to address that, Kaur advises using a phrase like, “I’m making some changes to support my health, and my medical practitioner/doctor has prescribed this medication as part of that plan.”

Takeaway 

Ultimately, Kaur says asking questions about a person’s weight loss and how they might have achieved it is intrusive because “everyone has the right to control their own body and health decisions.” 

“You shouldn’t put someone in the awkward position of answering a personal question or pressuring them to justify their actions,” she says. 

If you’re worried about being asked uncomfortable questions, it can be helpful to have a few responses prepared.

• A new study found that consuming ultra-processed foods may be linked to a slightly higher mortality risk.
• Ultra-processed foods include a wide variety of items including instant noodles, ready-made meals, and other packaged snacks like chips or cookies that have been processed industrially.
• Previous research suggests that ultra-processed foods account for up to 58% of daily calorie intake in high-income countries like the United States.

Consumption of ultra-processed foods like ready-to-eat meat, poultry, and seafood products, sugary drinks like sodas, dairy-based desserts, and processed breakfast cereals or other foods, may be linked to a slightly higher risk of early death, a new study found.  

The study, published in The BMJ on May 8, examined data from two surveys that both spanned more than 30 years: 74,563 female registered nurses from 11 states in the U.S. who participated in the Nurses’ Health Study from 1984 to 2018, and 39,501 male health professionals from every state who participated in the Health Professionals Follow-up Study from 1986 to 2018. The participants had no history of cancer, cardiovascular diseases, or diabetes when the studies started, and they submitted information about lifestyles and health every two years and diet information every four years.  

Overall dietary quality was assessed using the Alternative Healthy Eating Index-2010 (AHEI) score.

Over the period of consistent follow-ups, researchers identified 48,193 deaths: 

• 13,557 due to cancer 
• 11,416 due to cardiovascular diseases,  
• 3,926 due to respiratory diseases 
• 6,343 due to neurodegenerative diseases 

Participants’ consumption of ultra-processed food was divided into quarters. Compared to those in the lowest quarter, those in the highest quarter, with a median intake of about 7 daily servings, had a 4% higher risk of death from any cause. They also had a 9% higher risk of death from causes other than cardiovascular disease or cancer, including an 8% higher risk of death related to neurodegenerative diseases. 

Ultra-processed foods also include instant noodles, ready-made meals, and other packaged snacks like chips or cookies have been processed industrially, with added flavors and colors, and have high amounts of salt, fat, and sugar and low amounts of vitamins and fiber that are essential to a healthy diet. 

Researchers did not indicate causality, only association, and they do not recommend an absolute elimination of such foods from anyone’s diet. But “the findings provide support for limiting consumption of certain types of ultra-processed food for long term health,” they write. “Future studies are warranted to improve the classification of ultra-processed foods and confirm our findings in other populations.” 

As noted in a study published in February of this year, the consumption of ultra-processed foods accounts for up to 58% of daily calorie intake in high-income countries like the United States. Middle- and low-income countries have also notably increased their consumption of them in recent years. 

The people who ate more of these foods were at increased risk for depression, type 2 diabetes, and death related to heart disease. 

How are ultra-processed foods linked to cancer?  

Mingyang Song, MD, an associate professor of clinical epidemiology and nutrition at the Harvard T.H. Chan School of Public Health and one of the study authors, told Healthline that the direct association with ultra-processed foods and cancer is hard to pin down. He pointed to a study from last year that examines the connection.  

“UPF[ultra-processed food] is just one component of the overall diet, which has not yet been strongly associated with many cancers due, possibly, to a combination of methodological and biological issues. Methodologically, diet (esp. UPF) is difficult to assess, especially when it comes to cancer for which long-term exposure is likely to be critical and can be more difficult to measure with high accuracy,” Song said. “Also, diet is intricately related to other lifestyle factors, making it difficult to identify the independent causal effect of diet. Biologically, we may not yet capture the critical time window during diet [that] can be particularly important for cancer, again because it takes years or even decades for cancer to develop.” 

David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told Healthline that there are a number of factors in the consumption of ultra-processed foods that can create conflicting results in studies about cancer. 

“One possible explanation is that some ultra-processed foods might actually offer protection against cancer and cardiovascular disease. A common candidate for this assumption is dark chocolate which has high calories, low nutritious value but an association with lower cardiovascular mortality. So, while most ultra-processed foods might lead to higher mortality, some may lead to lower mortality, confounding the study results,” Cutler said. “Another explanation lies in the association between consumption of ultra-processed foods and neurodegenerative diseases like multiple sclerosis and Parkinson’s disease. Respiratory diseases also seem to be increased in those with diets high in ultra-processed foods. So, these other causes of death may be more marked than the more common cancer and cardiovascular deaths.” 

When the researchers considered the overall quality of participants’ diets, the link between eating more ultra-processed foods and an increased risk of death became weaker, highlighting the importance of considering the nutritional quality of foods, not only their level of processing.

Additionally, the researchers found that certain subtypes of ultra-processed foods had the strongest associations with increased mortality risk. These foods included meat, poultry, and seafood-based ready-to-eat products.

How much consumption of ultra-processed foods is healthy?  

The study authors didn’t recommend a full exclusion of ultra-processed foods from any diet, saying that a balanced diet was the optimal one for overall health and wellness. Cutler said that one of the greatest risks for bowel cancer is processed meats, but also suggested that it’s generally not recommended to consume a lot of anything that’s been heavily processed.  

“While there seems to be a strong association between bowel cancer and processed meats, no other close association between specific causes of cancer and specific diets have been identified. This makes it challenging to conclude that any specific diet holds a marked advantage over another. The emphasis should be on adhering to a diet that prevents obesity (fewer calories), heart disease (by lowering cholesterol and blood pressure), diabetes (less sugar), and bowel cancer (avoid processed meats),” Cutler said. “Even though the mortality effect of a diet high in ultra-processed foods is modest, the importance of avoiding sugary and poorly nutritious foods, especially in children, needs to be emphasized. There are many adverse health outcomes in addition to death which can [be] avoided by following a prudent diet which is low, but not necessarily totally avoiding ultra-processed foods.” 

Takeaway 

A new study that examined data from two different surveys that spanned more than 30 years found that consumption of ultra-processed foods was associated with a slightly higher risk of death.

Consumption of ultra-processed food was divided into quarters; the highest quarter, which was designated as those with a median intake of 7 daily servings, had a 4% higher risk of total deaths and a 9% higher risk of deaths from causes other than cancer or cardiovascular disease, including an 8% higher risk of neurodegenerative deaths. 

While the study authors did not recommend a full exclusion of ultra-processed foods, experts say it’s generally not advisable to consume a lot, with processed meats contributing to bowel cancer and many sugary drinks and snacks contributing to diabetes. 

Whooping cough cases (also known as the ‘100 day cough’) are rising sharply across England. Between January and March 2024 there have sadly been 5 infant deaths. Vaccination is the best protection.
In this blog post, Catherine Hughes, Founding Director at The Immunisation Foundation of Australia, shares the story of her son Riley Hughes and how their family lost Riley to Whooping cough (pertussis)

• Independent presidential candidate Robert F. Kennedy Jr. told the New York Times that a parasitic worm infected his brain and may have caused some of his past health problems.
• The pork tapeworm can cause a condition called neurocysticercosis, which leads to symptoms such as seizures and headaches and can occasionally be fatal.
• While neurocysticercosis is common in many parts of the world, only 1,300 to 5,000 new cases are reported in the United States each year. Some cases, though, may not cause any symptoms.

Some of Independent presidential candidate Robert F. Kennedy Jr.’s past health issues may be due to a parasitic worm that entered his brain and died, The New York Times reported on May 8.

His symptoms, which occurred in 2010, included severe memory loss and mental fog. These were severe enough to affect his earning power, according to the Times.

A New York doctor who reviewed a scan of Kennedy’s brain told him his health issues could be “caused by a worm that got into my brain and ate a portion of it and then died,” the Times reported. The parasite did not require treatment, he told the paper, and his memory loss and brain fog cleared up. 

Around the same time, the Times reported, Kennedy suffered from mercury poisoning, which can lead to movement issues, memory loss, and vision, hearing, and speech problems.

Kennedy didn’t indicate which parasite had infected his brain.

However, the pork tapeworm can cause a condition called neurocysticercosis, which can lead to symptoms such as seizures and headaches. In some cases, people may experience cognitive problems, although this is less common.

What is neurocysticercosis?

Cysticercosis is a parasitic infection caused by the larvae, or juvenile form, of the pork tapeworm, also known as Taenia solium. This infection can occur in the muscle, brain or other parts of the body. When it affects the brain and spinal cord, it is known as neurocysticercosis.

“The main manifestation of neurocysticercosis is seizures,” said Clinton White, MD, a professor of infectious diseases at the University of Texas Medical Branch at Galveston in Texas. “It also is associated with headaches, and in a minority of cases, can cause what’s called hydrocephalus.”

Hydrocephalus is a blockage that causes the accumulation of cerebrospinal fluid in the brain, a potentially fatal condition.

The symptoms of neurocysticercosis are mainly due to the body’s inflammatory response to the worm rather than the parasite itself.

“When the parasite gets into the brain, it usually doesn’t cause any problems. It sits there and tries to prevent the inflammatory response from attacking it,” White told Healthline. “But eventually, when the inflammation attacks the parasite, it can cause some damage in the brain associated with seizures and headaches.”

This condition “can range from something that is asymptomatic — meaning the patient is not aware of it — to causing severe cases and sometimes death,” said Walavan Sivakumar, MD, a neurosurgeon and director of neurosurgery at Pacific Neuroscience Institute-South Bay in Torrance, Calif.

In some people, when the parasite dies, it can form a calcified cyst, or scar, in the brain. “When this scarring is present, it can be associated with seizures that recur over a long period of time,” said White. “So, in essence, people have a chronic epilepsy.”

Memory loss or other cognitive problems are not a common occurrence with neurocysticercosis, said White, unless someone had recent seizures or hydrocephalus, both of which can damage the brain.

How do you get it?

Cysticercosis occurs when someone swallows the eggs of the pork tapeworm, which are present in the feces of someone with a tapeworm in their small intestine. 

The eggs are spread through food, water and surfaces contaminated with feces. For example, this can happen if a person infected with a tapeworm doesn’t wash their hands properly while preparing food for others. People living in the same household with someone with an intestinal tapeworm are at higher risk of infection.

Once in the intestine, the eggs develop into spheres that pass through the wall of the intestine and into the bloodstream. These travel to the muscles, brain, or other tissues and form larval cysts.

Pigs can also get cysticercosis by eating the feces of a person with an intestinal tapeworm, with the larval cysts ending up in the pigs’ muscles and other tissues.

In fact, “neurocysticercosis is found pretty much anywhere in the world where pigs are raised and have access to human fecal material,” said White.

However, you can’t get cysticercosis by eating raw or undercooked pork. But if the pork contains larval cysts, those cysts can attach to the wall of the small intestine and develop into a tapeworm. Cooking pork fully kills the parasite.

“So, getting the tapeworm in your [gastrointestinal] tract really isn’t going to pass worms to your head,” said Sharon Nachman, MD, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital in Stony Brook, New York. “You have to eat the eggs of someone else’s worms.”

A person with an intestinal tapeworm can also develop cysticercosis by eating worm eggs passed in their own feces, what’s known as auto-infection. However, Nachman said this is less likely to occur.

How common is it?

Tapeworm infection and cysticercosis are more common in parts of Latin America, Asia, and Africa where free-roaming pigs have access to human feces and there is poor sanitation. In low-income countries, neurocysticercosis is a major cause of seizures that begin in adulthood.

“[Cysticercosis] is a common disease around the world, and we should be able to eradicate it,” said White. “We have the tools to do that. But so far, there hasn’t been the political will because it mainly affects poor people and large rural populations in poorer countries.”

A program in northern Peru, funded by the Bill and Melinda Gates Foundation and others, showed that elimination of cysticercosis from communities is possible. The strategies used by public health officials included vaccinating all pigs for the tapeworm and treating people who may be carrying the tapeworm.

In the United States, an estimated 1,300 to 5,000 new cases of neurocysticercosis occur every year, although accurate information is not available because people with no symptoms or mild symptoms may not realize they are infected.

“Most of the [U.S.] cases are in immigrants [from areas where neurocysticercosis is endemic],” said White, “and a few are in people who have lived extensively overseas.”

Nachman said the low rate of this condition in the United States is due, in part, to government oversight of the food industry. All meat sold commercially in the country undergoes inspections, as does meat being imported.

In addition, in this country, “people who prepare food, for the most part, have to be healthy, have to wash their hands, and have to wear gloves,” she told Healthline, “and those things are all going to prevent the passing of any worms to other people.”

So, “unless you have your own farm and are killing your own pork and then eating it raw or undercooked, [neurocysticercosis] is not really an issue,” said Nachman.

How is it diagnosed?

If you have possible symptoms of neurocysticercosis, your doctor will ask about your travel history and what foods you ate, said Nachman.

Your eating history is important because, in some countries, there may not be a lot of oversight of how street vendors prepare food. So “thinking about where you’re going and what you’re eating is probably the best way to protect yourself,” she said.

Blood tests or imaging tests may also be needed. This condition is usually diagnosed by MRI or CT scan, although Nachman said sometimes both tests are needed.

“These exams reveal different things about the brain,” she said. “Together, they will tell us if it’s one or more worms present, if they’re dead or alive, where they are located, and if there is inflammation around them.”

How is it treated?

Treatment for neurocysticercosis depends upon several factors, but in general, has multiple phases, said Nachman.

“We almost always give you steroids because the inflammation around the dead worm is causing the headaches and seizures,” she said. “Steroids will cool that [inflammation] down.”

A doctor may also prescribe an anticonvulsant to help control the seizures. Or other medication to treat symptoms such as headache.

And if the worm is still alive, “we’ll give you something called albendazole,” said Nachman, “which is available in pharmacies across the country.”

This drug, which is taken by mouth, works by killing the worms. It is usually taken for eight to 30 days. However, “in some patients, longer, or repeat, courses of medication may be needed, depending on how extensive their disease is,” said Nachman.

After treatment, your doctor will monitor you to see how you are progressing. Steroids are not usually given long-term, she said, although some people may need to stay on anti-seizure medication longer.

In some cases, surgery is necessary to remove cysts from the brain. “That’s where I get involved,” Sivakumar told Healthline.

“Because the infection can happen anywhere in the brain, there can be risks with surgery,” he said, “but we use minimally invasive approaches to minimize the collateral damage to the brain.”

In general, people recover well after surgery, although it depends on how extensive the infection and inflammation were.

“Oftentimes, you can have a near complete or complete recovery after surgery,” said Sivakumar, especially “if you get to them early enough and the surgery goes well, meaning you remove the cause of the infection, the inflammation, and the blockages of spinal fluid flow that can be caused by the cysts.”

With medical treatment, “for the most part, the long-term outlook is [also] excellent,” said Nachman. “We know how to treat it, we know how to cool [your inflammatory response] down, and we know how to treat the side effects of the inflammation.”

Takeaway

The New York Times reported that Independent presidential candidate Robert F. Kennedy Jr.’s past health issues may be due to a parasitic worm that infected his brain. Kennedy’s symptoms included memory loss and brain fog.

While Kennedy didn’t indicate which parasitic worm had infected his brain, the pork tapeworm can cause a condition called neurocysticercosis. The main manifestation of this condition is seizures, although headaches and more serious symptoms can also occur.

Treatment for this condition involves using steroids to reduce inflammation in the brain, which is the main cause of seizures and headaches. Some people may also need medication to kill the tapeworm.

The outlook for most people is good, although some people may require surgery, which also generally has good outcomes.

• “Ozempic breasts” is the latest reported side effect of GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound.
• The term is being used to refer to unexpected changes in breast size or shape as a result of rapid, extreme weight loss.
• The most common symptoms include loss of volume, sagging, and tenderness.

GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have become popular weight loss tools.

However, people can also experience a wide variety of side effects while taking these drugs, including some that are associated with extreme weight loss.

Like “Ozempic face” and “Ozempic butt,” “Ozempic breasts” is the latest term gaining popularity as a way to describe a loss in volume and decrease in skin elasticity that people often experience while taking GLP-1 drugs, which can lead to a change in shape and appearance in specific parts of the body.

What are “Ozempic breasts,” and what causes them?

“Ozempic breasts” isn’t a clinical term, but it has entered the public lexicon.

“Ozempic breasts is a newer term that people are using now to refer to unexpected changes in breast size or shape as a result of rapid weight loss induced by Ozempic,” says Christopher Costa MD, MPH, the founder of Platinum Plastic Surgery.

According to Elie Levine, MD FACS, the director of plastic surgery at Plastic Surgery & Dermatology of NYC PLLC, “The most common symptoms include loss of volume, sagging, tenderness, and rarely, some will describe size fluctuations including swelling.”

While more research is needed, each expert Healthline spoke with pointed to the same likely cause for breast changes.

“In the breast area, rapid fat loss can leave the skin envelope empty, causing the breasts to look deflated and the nipples facing downward,” says Ronald F. Rosso, MD, the medical director at Peninsula Plastic Surgery. “This appearance is very similar to what happens after patients have had more traditional weight loss procedures such as gastric bypass.”

Levine points out that there isn’t research backing breast changes, but that doesn’t mean they don’t happen. In fact, Levine says they likely occur for some patients and echoed Rosso’s sentiments.

“Ozempic can affect weight and hormones in your body,” Levine says. “As a result of shifts in weight and hormones, other changes may occur, such as in the appearance of your breasts. Mostly, however, if one loses considerable weight, it is reasonable to think that the weight loss will include all parts of the body, including the breasts.”

Hormonal effects of GLP-1 drugs

Ozempic and Wegovy use the active ingdedient, semaglutide, a GLP-1 hormone receptor agonist. 

“The hormone, which is naturally produced in the body, plays a strong role in regulating blood sugar levels, appetite, and body weight,” Costa says. “So basically, the medication makes you feel fuller longer, experience no cravings, and not eat as much because you’re less hungry.”

Hormonal changes, such as during pregnancy and a person’s menstrual cycle, can cause temporary breast changes, such as swelling. Since GLP-1 drugs mimic a hormone, could the same be true for these medications?

It’s unclear.

“The effects of Ozempic on testosterone and estrogen are being studied currently, but there is no definitive data on their interactions at this time,” Costa says. “More research is needed to directly link hormonal changes affecting breast tissue to the use of this medication because it is currently understood to primarily affect blood sugar and appetite hormones.”

How to manage or treat “Ozempic breasts”

Costa notes that breast changes don’t appear to be a cause for concern at this time.

“Every individual is different,” Costa says. “However, the changes in breasts are typically correlated to overall weight changes as opposed to Ozempic specifically.”

However, some people may experience physical and emotional discomfort related to these changes and want solutions. First, it’s best to wait before seeking professional procedures.

“I advise my patients to wait until they are able to maintain their desired weight before making any decisions,” Costa says.

Also, doctors only recommend stopping medication after speaking to a healthcare professional first.

Research from 2022 indicated that those who stopped using semaglutide regained about two-thirds of their lost weight within a year. This is commonly referred to as Ozempic rebound.

Still, there are ways to manage physical discomfort while taking GLP-1 medications and, if and when the time is right for a patient, breast appearance, too.

Experts offered the following tips:

At-home care

While procedures may help with breast changes, experts share some remedies for both appearance and pain that can be handled at home.

“Wearing a supportive bra 24/7 except when showering can be helpful in limiting the effects of weight loss combined with the stretch and sagging caused by gravity,” Levine says.

Swelling can also be reduced with minimally invasive steps.

“Although there might be some discomfort with this, massaging the breasts can help increase circulation and reduce swelling,” Levine says. “Furthermore, ibuprofen or Tylenol or applying a cool compress can help relieve some of the discomfort.”

Procedures 

Patients may also consider or opt for a procedure. These may include:

• Breast lift (mastopexy)
• Breast augmentation
• Breast lift with implants

“A breast lift helps to raise and firm the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour,” Costa says. “I notice that patients who feel insecure due to their breasts sagging after rapid weight loss will opt for this procedure to perk up their breasts and give them a full shape.”

Additionally, people who aren’t happy with a smaller breast size may opt for an augmentation to restore volume, Costa says. 

“[It can help people] to feel like themselves again,” Costa says.

Others may opt for both.

“Many patients feel very deterred when I tell them that a breast lift will cause them to lose a cup size,” Costa says. As such, these patients will opt for a combination of a lift and augmentation implants to achieve their desired aesthetic. This is usually the case when the patient has a significant loss of volume and sagging.”

That said, procedures aren’t the best fit for each patient.

“While surgery often addresses the concerns of patients, it is not for everyone,” Levine says.  “I highly recommend speaking to a board certified plastic surgeon to discuss your options even if, in the end, you decide it is not for you or not for you at the current time. There is power in knowledge.”

Embrace it

Doing nothing is a perfectly acceptable solution to “Ozempic breasts.”

“Your body after Ozempic may be completely different,” Costa says. “That means accepting that overall breast volume and shape may be affected. If you’re not ready for a cosmetic procedure, it’s OK to embrace your new look. Go shopping for new clothes to fit your new size and bust to create the best version of yourself.”

Takeaway

“Ozempic breasts” is the latest reported side effect of GLP-1 medications like Ozempic.

The term is being used to refer to unexpected changes in breast size or shape as a result of extreme weight loss triggered by GLP-1 medications.

Sagging, tenderness, and volume loss are among the most common symptoms people are reporting.

Hormonal changes may also trigger swelling, but health experts say they should be temporary.

Surgical procedures like breast lifts and implants can alter the appearance of sagging and lost volume.

Antimicrobial resistance (AMR) occurs when medicines used to fight infections lose their effectiveness because the organisms they target – whether bacteria, fungi, viruses or parasites – have evolved or acquired adaptations to survive. In 2019, AMR was directly responsible for …