In later life, weight loss can be a double‑edged sword. A few pounds off the joints can be both helpful and risky. Shedding a few pounds may ease joint pain, but losing weight without meaning to can be a warning sign. Fast weight loss can also lead to muscle loss, which is key to staying independent.

Experts also point out practical issues: injections need good vision, steady hands, and a regular routine. Stomach and bowel side effects can be tougher for seniors, especially if they’re already losing weight without trying. complicate life for older adults — and how to approach them with a “safety first” mindset.

1) Aging changes the risk–benefit math (even when a drug “works”)

Older adults, especially those who are frail or have several health issues, are often left out of clinical trials. This is important because average trial results may not match the real-life experience of a 75-year-old who takes several medications and needs to manage appetite and hydration.

A 2024 debate paper on GLP-1 drugs in older patients, including those with kidney disease, points out that limited trial data and multiple medications make it harder to judge safety and effectiveness for frailer seniors. Clinicians need to make decisions based on each person, not just on averages. In simple terms, the real question is not whether GLP-1s are good or bad, but whether they help this specific older person with their unique health needs.

There’s another subtle issue: in later life, the goal is often less about chasing an ideal weight and more about protecting function—walking safely, rising from a chair, maintaining balance, staying hydrated, and maintaining enough strength to live independently. So for older adults, the most important question isn’t “How much weight will I lose?” It’s “What will this do to my strength, my nutrition, and my ability to stay steady on my feet?”

2) Common side effects can become serious for older adults.

GLP-1s often cause nausea, vomiting, diarrhea, constipation, and less appetite. Younger people may find these symptoms unpleasant but manageable. For older adults, though, these issues can quickly lead to dehydration, dizziness, and falls, especially if they also take blood pressure medicines or diuretics.

Current FDA labeling for semaglutide products highlights this pathway: stomach and bowel side effects can lead to volume depletion, and acute kidney injury has occurred, including in postmarketing reports. The label advises monitoring kidney function when starting or increasing doses in people who develop severe gastrointestinal reactions, and it notes that dehydration has been part of reported kidney injury cases.

This is how many real-life problems start: a few days of not being able to eat or drink much, then feeling lightheaded, falling, or needing emergency care for dehydration. Older adults may not feel as thirsty and may have less ability to recover. So, it’s important to watch hydration, electrolytes, blood pressure, and kidney function, especially in the first months of treatment and after increasing the dose.

3) Muscle and frailty: losing weight does not always mean better health.

The headline benefits of GLP‑1s often focus on pounds lost. But the body doesn’t lose only fat. Lean mass (including muscle) can drop, too. This matters in older adults because age‑related muscle loss (sarcopenia) is already common — and it’s tightly linked to frailty, falls, and loss of independence.

A 2025 mini-review on older adults warns that starting and stopping GLP-1s repeatedly can change body composition, sometimes leading to ‘sarcopenic obesity’ — having too much fat and too little muscle. The authors are not saying to avoid GLP-1s, but to remember that weight loss does not always mean better health for older people.

More pointedly, a 24‑month retrospective cohort study in older adults with type 2 diabetes reported that semaglutide use was associated with muscle loss and functional decline, particularly at higher doses and in patients who already had sarcopenia. The authors emphasize individualized risk–benefit assessment and the need for monitoring and intervention.

If you’re reading this as an older adult, it may help to translate the research into plain questions to bring to your next appointment: “If I lose weight, how will we protect my muscles?” “How will we check whether I’m getting weaker?” “What would make us stop or change course?” An older adult who becomes “smaller but weaker” has not gained health — only risk.

4) Other complications: gallbladder, pancreas, vision, and low blood sugar

Gallbladder and bile duct problems can be an unexpected issue. Losing weight already increases the risk of gallstones, and GLP-1s seem to increase it even further. A large review found that using GLP-1 drugs increases the chance of gallbladder or bile duct disease, especially at higher doses, for longer periods, or when used for weight loss.

For older adults, this might present as sudden pain in the upper right side of the belly, nausea, fever, or pain spreading to the back or shoulder. These symptoms should be checked by a physician right away.

GLP-1 drug labels also warn about the risk of sudden pancreatitis and say to get medical help for severe, ongoing belly pain. The overall risk is low, but older adults may have additional risk factors, such as gallstones or high triglycerides. Severe belly pain in later life should always be checked quickly.

Then there’s the risk of blood sugar dropping too low. GLP‑1s don’t usually cause hypoglycemia by themselves, but the risk rises when combined with insulin or sulfonylureas. Semaglutide labeling warns that concomitant use with an insulin secretagogue or insulin may increase the risk of hypoglycemia and may require dose reductions of those agents.

In older adults, hypoglycemia can be particularly dangerous: it can cause falls, confusion, fainting, and cardiac stress. It’s also easier to miss, because symptoms may look like “just being tired” or “a little off today,” especially in someone who already has memory or balance problems.

Eyes and vision deserve special attention. Semaglutide labeling includes a warning about diabetic retinopathy complications and recommends monitoring patients with a history of retinopathy. Beyond labeling, post‑marketing safety monitoring continues to explore visual signals.

A 2025 analysis of FDA adverse event reporting data found a potentially elevated risk of vision‑impairment reports with semaglutide use compared with some other diabetes and weight‑loss medications, and it called for vigilant surveillance and further research. That doesn’t prove the drug causes vision loss in an individual patient, but it is enough to justify a cautious posture: new blurring, blind spots, or sudden changes deserve a same‑week medical call, not a “let’s see if it passes.”

5) Surgery and sedation: delayed stomach emptying can cause problems

GLP‑1 medications slow stomach emptying — one reason people feel full sooner. But that same effect can complicate anesthesia and deep sedation if food remains in the stomach despite standard fasting. A 2024 review describes the connection between GLP‑1 medications, delayed gastric emptying (including gastroparesis), and increased risk of aspiration during anesthesia, as well as possible effects on the absorption of other medications.

This issue has become important enough that several medical groups have created guidelines for surgery. The 2024 guidance says many people can continue taking GLP-1s, but doctors should look for higher-risk situations, such as people with stomach problems or other risks of food entering the lungs, and adjust plans as needed.

This is important for older adults because they are more likely to undergo procedures requiring sedation, such as colonoscopies, joint injections, cardiac procedures, dental work, or surgeries. The easiest and most often missed safety step is to tell every physician involved — surgeon, anesthesiologist, endoscopist, dentist — that you are taking a GLP-1 medication and when you last took it. Do not assume it will be clear in your medical chart.

6) A senior‑friendly “yes, with a plan” approach

If you’re an older adult considering a GLP‑1 (or already taking one), a safer approach often looks like “yes, with monitoring.” That means starting with function, not just the scale: tracking energy, steadiness, and strength in everyday life, not only pounds.

It also means treating hydration as a real medical concern. Ongoing nausea, vomiting, or diarrhea is not just part of getting used to the medicine. These symptoms can affect blood pressure and kidney function, especially when changing doses.

Because muscle matters so much in later life, protecting it should be part of the prescription. That can include discussing protein intake, adding a realistic strength plan (even chair‑based work or physical‑therapy guided resistance), and reassessing the medication if weight loss is accompanied by weakness, poor balance, or reduced stamina.

Older adults should also have their medications reviewed with a focus on preventing low blood sugar. If insulin or a sulfonylurea is being used, doses may need to be adjusted as appetite decreases and blood sugar improves.

Finally, it is important to take symptoms seriously. New stomach pain, ongoing vomiting, or sudden vision changes should be checked by a doctor right away. Before any procedure with anesthesia or deep sedation, make sure to tell the medical team about your GLP-1 use — do not assume they already know.

The GLP-1 medications can help some older adults, but there is less room for mistakes. Side effects can quickly lead to dehydration, frailty, falls, or problems during procedures. The safest approach is not just ‘yes’ or ‘no,’ but ‘yes, with a plan’ — one that protects hydration, nutrition, muscle, vision, and safety during medical care.

The post GLP‑1 Medications in Later Life: Why the “Miracle Shot” Needs a Senior‑Specific Safety Lens appeared first on Medika Life.

SNAP is not an abstract line item. It is a lifeline for nearly 42 million Americans, one in eight citizens. In fiscal year 2024, the program distributed almost $100 billion in benefits, with the average recipient receiving approximately $187 per month. For families living paycheck to paycheck, this is the difference between nourishment and hunger, health and hardship.

War on Poverty

SNAP’s history reveals both bipartisan vision and enduring necessity. The program originated during the early 1960s as a pilot effort to stabilize farm prices and reduce hunger. In 1964, President Lyndon Johnson signed legislation making the Food Stamp Program permanent as part of his War on Poverty. His message to Congress was clear: a nation strong enough to feed the world must also be able to feed its own people.

Through the decades, the program evolved from paper coupons to electronic benefits, and in 2008, it was rebranded as the Supplemental Nutrition Assistance Program to emphasize nutrition and dignity rather than charity. That renaming symbolized an essential truth – food security is fundamental to health, not a handout. SNAP has survived political shifts and economic crises because it reflects a moral consensus: no one in America should go hungry.

Who Relies on SNAP

The faces behind SNAP are as diverse as the nation itself. Nearly 40 percent of participants are children, and another 20 percent are seniors. Millions of adults are living with disabilities, many of whom also qualify for Medicare regardless of age. For individuals managing chronic conditions, experiencing mobility limitations, or living on a fixed income, SNAP assistance serves as a proven vital lifeline for maintaining preventive health.

Often sympathetic to the Administration, a Fox News story shared the fear many are now experiencing. A cancer survivor who depends on disability benefits described how the possible halt in SNAP payments left her anxious and uncertain: “It’s scary. I really need the extra for food, because by the time I pay all the bills, there’s really nothing left.” Her story mirrors that of millions who balance medication co-pays against grocery costs, forced into trade-offs that jeopardize both health and dignity. Let’s not forget paying for housing and transportation.

Working families are also part of this equation. Many SNAP households have at least one employed adult. The wages are not enough to cover rent, childcare, transportation to work and medical bills, so food becomes the only variable expense they can afford to cut. SNAP ensures that food insecurity doesn’t become the hidden cost of low-wage work.

What SNAP Provides

SNAP benefits are issued through an EBT card and can be used to purchase fruits, vegetables, meats, fish, poultry, dairy products, bread, cereals, and even seeds and plants to grow food. They cannot be used for alcohol, tobacco, hot prepared meals or household items. The program supplements, rather than replaces, household food budgets, providing predictability that allows families to direct scarce income toward other essentials.

For the health system, SNAP is prevention in action. Food insecurity fuels chronic disease and poor health outcomes. According to the Centers for Disease Control and Prevention, adults experiencing food insecurity are 2 to 3 times more likely to develop diabetes and more than twice as likely to suffer from depression. Children in food-insecure households face 19% higher odds of hospitalization before age three and significantly higher risks of anemia, asthma, and behavioral problems.

A study published in JAMA Internal Medicine found that SNAP participation was associated with a 14% reduction in emergency department visits and lower overall healthcare expenditures. When families can afford healthy food, chronic illness becomes more manageable, adherence to medications improves, and children achieve better developmental outcomes. Conversely, disruptions in SNAP benefits correlate with spikes in hospitalizations for malnutrition, hypoglycemia and mental-health crises.

SNAP functions as one of this nation’s most effective public-health interventions, less visible than vaccines or prescription drugs, and essential to community well-being.

The Big Apple, Empire State and the Nation

The human impact of this shutdown can be seen most vividly on the streets of New York City, where nearly 1.73 million residents, about one in five New Yorkers, depend on SNAP to make it through the month. Grocery stores in the Bronx, Queens, and across the five boroughs see the direct connection between Federal stability and neighborhood well-being. When SNAP dollars are delayed, the effects ripple far beyond individual households: local grocers lose revenue, food pantries face longer lines, and families already budgeting every dollar must make painful trade-offs between groceries, rent and medicine. Child care for working parents is already an out-of-reach luxury.

At the state level, the scale becomes even more striking. As of January 2025, nearly three million New Yorkers –from Buffalo to Brooklyn – received a combined $655.9 million in SNAP benefits that month. These benefits circulate quickly through communities, sustaining small businesses and providing a stabilizing force in counties where economic opportunity fluctuates with the seasons. The State Comptroller’s office estimates that more than $7 billion flowed to New York households in the last fiscal year through SNAP. This Federal investment fuels local economies while preventing hunger from escalating into a public-health emergency.

Nationally, these numbers paint a powerful and painful picture of need and vulnerability. Across the United States, roughly 42 million people, one in eight Americans, rely on SNAP each month. The Federal government must provide approximately $9 billion monthly to sustain those benefits; however, contingency funds currently fall billions of dollars short of that requirement. That gap is not theoretical. Food banks and community kitchens from California to Kentucky are already bracing for the overflow, warning that their shelves and volunteers cannot absorb the loss of a Federal program that moves food on a national scale.

From a New York City food pantry to a rural supermarket in upstate counties, the story reverberates: SNAP keeps families fed, children nourished and local businesses viable. When the Federal system stumbles, the consequences cascade, turning this government shutdown into a community crisis.

A few days ago, a Federal judge ordered the government to use all available contingency funds to sustain SNAP. Still, those dollars fall short of the roughly $9 billion needed for November benefits. The result is confusion, fear and logistical strain. Governors and mayors across the country are scrambling to respond to the crisis. In New York City, Mayor Eric Adams announced $15 million in emergency funding to bolster food pantries and community kitchens. State agencies are urging residents to call 311 in the city and 211 statewide to find food resources.

Still, no local initiative can replace the Federal infrastructure that delivers food assistance on a national scale. Charity can fill temporary gaps; however, it cannot replace the efficiency, reach and consistency of a program built to prevent hunger in the first place.

Health and Economic Stakes

SNAP is among the most cost-effective anti-poverty and public-health tools the nation has ever introduced. Every dollar in benefits generates approximately $1.50 to $1.80 in economic activity, circulating through local farmers, grocers and supply chains. When benefits are delayed or reduced, families face impossible choices between food and heat, or groceries and prescriptions. Hospitals see higher emergency visits; schools see lower attendance and test scores; local economies contract.

A CNN analysis broadcast this week underscores the link between nutrition and resilience. The report notes that food insecurity not only increases health costs but also reduces life expectancy. People living in food-insecure households have a 32% higher risk of premature mortality from preventable disease. Supporting food banks helps in the short term, but it cannot replace a Federal program designed to prevent hunger on a larger scale.

Without SNAP, the nation’s social safety net frays, leaving millions exposed to physical and psychological harm and the country’s public-health foundation weakened.

The Social Impact

Food assistance is not a partisan favorite; it is a measure of a vibrant society caring for its most vulnerable. SNAP’s durability across administrations reflects a shared American understanding: no child should be hungry because adults can’t agree. The current shutdown tests the consensus and the moral fiber of the nation’s leadership.

From the individual with a disability counting on SNAP to stay fed, to the child trying to learn on an empty stomach, to the local grocer whose shelves depend on steady EBT purchases, the stakes are not political. They are human. As winter approaches, this must not become the season when America’s nutrition safety net blinks and citizens are left in the cold.

The post SNAP at Risk: What a Shutdown Means for Health and America’s Social Contract appeared first on Medika Life.

After cardiac surgery, patients are at risk for both high and low blood sugar, which can lead to serious complications. Managing these fluctuations requires careful insulin dosing, but existing protocols often fall short due to the unpredictable nature of ICU care and differences among patients, say the investigators. 

To address this challenge, the research team created a reinforcement learning model, named GLUCOSE, that recommends insulin doses tailored to each patient’s needs. In tests using data from real-world ICU cases, GLUCOSE matched or even outperformed experienced clinicians in keeping blood sugar levels within a safe range—despite having access to only current patient data, while doctors used full patient histories. 

“Our study shows that artificial intelligence can be thoughtfully and responsibly developed to support, rather than replace, the clinical judgment of health care professionals,” says co-senior corresponding author Ankit Sakhuja, MBBS, MS, Associate Professor of Medicine (Data-Driven and Digital Medicine) and a member of the Institute for Critical Care Medicine at the Icahn School of Medicine at Mount Sinai. “In complex and high-pressure environments like the ICU, tools like GLUCOSE can provide real-time data-driven guidance tailored to individual patients. This kind of decision support can enhance safety, reduce the risk of complications, and ultimately allow clinicians to focus more of their attention on critical aspects of patient care.” 

The research team trained GLUCOSE using reinforcement learning, which allowed the system to learn optimal decisions through trial and error. They also used advanced methods—conservative and distributional reinforcement learning—to ensure the model made cautious, reliable recommendations. The model was then rigorously evaluated and compared to real-world clinical practices. 

While the results are promising, the researchers caution that GLUCOSE is not intended to replace doctors. It serves as a clinical decision support tool, offering suggestions that physicians can choose to follow based on their judgment and the broader clinical picture. 

The model could eventually be integrated into electronic health record systems to provide real-time insulin dosing guidance in the ICU, helping reduce complications and improve outcomes. Future steps include adapting the tool for use in other hospital settings, running clinical trials, and exploring ways to integrate it into routine care. 

One current limitation is that the model does not yet factor in nutrition data, which may affect longer-term glucose control. Still, the ability of GLUCOSE to make accurate recommendations based on limited real-time data highlights its potential to enhance safety and efficiency in postsurgical care. 

“Our goal is to develop AI systems that meaningfully augment the capabilities of health care providers and ultimately improve patient outcomes,” says co-senior corresponding author Girish N. Nadkarni, MD, MPH, Chair of the Windreich Department of Artificial Intelligence and Human Health, Director of the Hasso Plattner Institute for Digital Health, and Irene and Dr. Arthur M. Fishberg Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and Chief AI Officer of the Mount Sinai Health System. “By learning from real-world clinical data and delivering personalized recommendations in real time, models like GLUCOSE represent an important advance toward integrating trustworthy data-driven tools into the clinical workflow. This study offers a glimpse of how AI can be thoughtfully embedded into care to support providers in delivering safer, more precise treatment.” 

The paper is titled “A Distributional Reinforcement Learning Model for Optimal Glucose Control After Cardiac Surgery.” 

The study’s authors, as listed in the journal, are Jacob M. Desman, Zhang-Wei Hong, Moein Sabounchi, Ashwin S. Sawant, Jaskirat Gill, Ana C. Costa, Gagan Kumar, Rajeev Sharma, Arpeta Gupta, Paul McCarthy, Veena Nandwani, Doug Powell, Alexandra Carideo, Donnie Goodwin, Sanam Ahmed, Umesh Gidwani, Matthew A. Levin, Robin Varghese, Farzan Filsoufi, Robert Freeman, Avniel Shetreat-Klein, Alexander W. Charney, Ira Hofer, Lili Chan, David Reich, Patricia Kovatch, Roopa Kohli-Seth, Monica Kraft, Pulkit Agrawal, John A. Kellum, Girish N. Nadkarni, and Ankit Sakhuja. 

The study was funded, in part, by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health grant 5K08DK131286, and by the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. Research reported in this publication was also supported by the Office of Research Infrastructure of the National Institutes of Health under award numbers S10OD026880 and S10OD030463.  

See the journal paper for conflicts of interest: https://www.nature.com/articles/s41746-025-01709-9. 

About Mount Sinai’s Windreich Department of AI and Human Health   

Led by Girish N. Nadkarni, MD, MPH—an international authority on the safe, effective, and ethical use of AI in health care—Mount Sinai’s Windreich Department of AI and Human Health is the first of its kind at a U.S. medical school, pioneering transformative advancements at the intersection of artificial intelligence and human health.  

The Department is committed to leveraging AI in a responsible, effective, ethical, and safe manner to transform research, clinical care, education, and operations. By bringing together world-class AI expertise, cutting-edge infrastructure, and unparalleled computational power, the department is advancing breakthroughs in multi-scale, multimodal data integration while streamlining pathways for rapid testing and translation into practice.  

The Department benefits from dynamic collaborations across Mount Sinai, including with the Hasso Plattner Institute for Digital Health at Mount Sinai—a partnership between the Hasso Plattner Institute for Digital Engineering in Potsdam, Germany, and the Mount Sinai Health System—which complements its mission by advancing data-driven approaches to improve patient care and health outcomes.  

At the heart of this innovation is the renowned Icahn School of Medicine at Mount Sinai, which serves as a central hub for learning and collaboration. This unique integration enables dynamic partnerships across institutes, academic departments, hospitals, and outpatient centers, driving progress in disease prevention, improving treatments for complex illnesses, and elevating quality of life on a global scale.  

In 2024, the Department’s innovative NutriScan AI application, developed by the Mount Sinai Health System Clinical Data Science team in partnership with Department faculty, earned Mount Sinai Health System the prestigious Hearst Health Prize. NutriScan is designed to facilitate faster identification and treatment of malnutrition in hospitalized patients. This machine learning tool improves malnutrition diagnosis rates and resource utilization, demonstrating the impactful application of AI in health care.  

For more information on Mount Sinai’s Windreich Department of AI and Human Health, visit: ai.mssm.edu  

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I have about seven weeks to the competition.

This approach is my battle plan, not a quick fix.

Here are my five tips for getting rid of belly fat.

1. I Am Reducing Calories in a Smart Way

We’ve all heard the “eat less, move more” mantra, but it’s not about punishing yourself.

Generally, weight loss should lead to a drop in abdominal fat.

I target my entire body and health, not my belly in isolation.

I think of my body as an engine needing the right fuel to run efficiently.

Instead of drastic cuts, I focus on swapping out the junk for the good stuff.

The cutting phase is when I try to pile my plate with brightly colored, lean protein like chicken and fish and healthy fats from avocados and nuts.

This approach keeps me full and satisfied, which is key.

As the American memoirist, poet, and civil rights activist Maya Angelou observed,

“Nothing will work unless you do.”

And smartly doing it is even better.

2. Protein: My Belly Fat’s Kryptonite

Protein is my not-so-secret weapon.

It boosts those “full” hormones, keeping me away from the snack drawer. Less snacking means less belly fat.

I admit it’s not that simple.

I imagine protein as my body’s construction crew.

It repairs and builds muscle, which burns more calories.

As bodybuilder Arnold Schwarzenegger opined,

“Strength does not come from winning. Your struggles develop your strengths. When you go through hardships and decide not to surrender, that is strength.”

Protein helps me build that strength and, in turn, helps me shed belly fat.

3. Fruits and Vegetables: Nature’s Candy & Cleansers

Then, there is the nutrient-dense nature and fiber content of fruits and vegetables.

Fruits and vegetables keep my gut happy while filling me with fewer calories.

I think of fruits and vegetables as nature’s multivitamins.

My apologies, but I can’t resist loading today’s piece with quotes, so here is another one (from Hippocrates):

“Let food be thy medicine and medicine be thy food.”

4. Move Your Body, Change Your Body.

Small changes — like taking the stairs or parking further away — add up.

Exercise Snacks: 7 Tiny Workouts for Big Results

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However, I aim for a weekly minimum of 300 minutes of moderate activity for serious fat loss.

That’s double the standard recommendation, but I aim for a competition-ready physique.

I also incorporate HIIT (high-intensity interval training) — short bursts of intense activity — to burn calories.

HIIT and Fitness: The Verdict is In

DO SHORTER VERSIONS of high-intensity interval training improve health? Researchers have recently analyzed short…

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Think of exercise as your daily dose of energy and confidence.

You guessed it: I am going to offer another quote, this one from Muhammad Ali:

“I hated every minute of training, but I said, ‘Don’t quit. Suffer now and live the rest of your life as a champion.’”

5. Strength Training: Build Muscle and Burn Fat

Lifting weights isn’t just for building muscle; it helps shrink belly fat too.

Combining aerobic and strength training leads to the biggest reduction in visceral fat for me.

Think of strength training as building your fat-burning furnace.

Yes, I offer another quote!

Henry Ford:

“Whether you think you can, or you think you can’t — you’re right.”

So think of strength training as a way to say “I can” to a leaner, healthier you.

Bonus Tips for Maximum Impact

Finally, here are some additional things I do to get my abs ripped:

• Limit sugary drinks: Water is my best friend. I ditch the sugary sodas and juices.
• Get sugar from whole foods: An apple is better than apple juice. Fiber is my friend.
• I avoid ultra-processed foods, including crackers, chips, and frozen dinners, which contain unhealthy fats, sugar, and sodium.
• Add in healthy fats: Nuts and avocados reduce inflammation.
• Eat more probiotic-rich foods: Yogurt, kefir, and sauerkraut improve gut health.
• Limit stress: Cortisol is a belly fat magnet. Yoga and meditation may help.
• Focus on sleep: I aim for 7 to 8 hours of quality sleep.

Consistency is key.

These tips aren’t magic bullets but are a solid plan for reaching my fitness goals.

The post 5 Tips For Getting Rid of Belly Fat appeared first on Medika Life.

GLP-1 agonists have also shown promise in reducing the risk of major adverse cardiovascular events, such as stroke and heart attack. This adds to their potential benefits in managing obesity and its related health complications.

Clinical Trial of Semaglutide and Bimagrumab

One promising avenue of research involves combining existing GLP-1 receptor agonists with experimental drugs designed to preserve muscle mass. A clinical trial, known as the BELIEVE Phase 2b study, is currently underway to test the combination of semaglutide and bimagrumab. Bimagrumab is a first-in-class, fully humanized monoclonal antibody developed by Versanis Bio, a clinical-stage biopharmaceutical company recently acquired by Eli Lilly. It targets activin type II receptors, which play a role in regulating muscle growth and fat storage. This trial aims to assess the efficacy and safety of bimagrumab in preserving or increasing muscle mass while promoting weight loss with semaglutide in non-diabetic patients with overweight or obesity.

To be eligible for the BELIEVE study, participants must have a body mass index (BMI) greater than or equal to 30, or greater than or equal to 27 with one or more obesity-related comorbidities. Key exclusion criteria include a history of hypersensitivity to monoclonal antibody drugs, treatment with any medication for obesity within 30 days before screening, and a diagnosis of diabetes requiring current use of any antidiabetic drug.

Pre-clinical studies have shown that blocking activin type II receptors with bimagrumab leads to increased lean mass and decreased fat mass in mice. In a Phase 2 study, bimagrumab produced a 22% reduction in fat mass and a 4.5% increase in lean mass in patients with type 2 diabetes and obesity. Notably, no weight regain was observed after stopping bimagrumab treatment, unlike the rebound effect often seen with GLP-1 therapies. This suggests that bimagrumab may offer long-term benefits in maintaining weight loss even after treatment cessation.

The ongoing clinical trial will provide valuable insights into the potential of combining semaglutide and bimagrumab to achieve superior fat loss while preserving muscle mass. This combination therapy could offer a more comprehensive weight management approach, addressing fat loss and muscle preservation.

Semaglutide and Bimagrumab: Mechanisms of Action

Semaglutide and bimagrumab work through distinct mechanisms to achieve their therapeutic effects. Semaglutide, a GLP-1 receptor agonist, mimics the action of GLP-1, a natural gut hormone crucial in regulating blood sugar and appetite. GLP-1 agonists work by

• Triggering insulin release from the pancreas
• Blocking glucagon secretion
• Slowing stomach emptying
• Increasing feelings of fullness

Semaglutide helps lower blood sugar levels, reduce appetite, and promote weight loss by mimicking these effects.

Bimagrumab, on the other hand, is a human monoclonal antibody directed against type II activin receptors (ActRII). Upon administration, bimagrumab binds to ActRII, which prevents binding the natural ligands, myostatin and activin, to activin receptors and blocks ActRII-mediated signalling. This increases protein synthesis, decreases protein degradation, stimulates skeletal muscle cell growth, and increases muscle function and strength10. Overstimulation of the ActRII-mediated signalling pathway is associated with muscle loss and weakness.

Other Anti-Obesity Drugs in Development

The success of semaglutide and tirzepatide has fueled a surge in the development of new anti-obesity drugs. These drugs target various biological pathways and aim to improve upon the limitations of existing therapies. Targeting multiple pathways simultaneously could allow for lower doses that achieve the same weight loss with fewer side effects. Some of the key areas of development include:

GLP-1 and GIP Receptor Agonists

Tirzepatide is a dual GLP-1 and GIP receptor agonist that has shown superior weight loss results compared to semaglutide in a large head-to-head trial by Eli Lilly. Participants who took tirzepatide lost an average of 20% of their body weight, outpacing the 14% reduction achieved with semaglutide. Tirzepatide is already available under the brand names Mounjaro and Zepbound.

There are two main strategies for modulating GIP activity: activation and blocking. While both approaches can lead to weight loss, they have different potential benefits and drawbacks. As seen with tirzepatide, GIP activation can further enhance energy metabolism and promote weight loss. However, some concerns blocking GIP signalling could adversely affect bone health, as GIP also plays a role in bone metabolism.

Amylin Analogues

Amylin is a hormone co-secreted with insulin that regulates blood sugar and appetite. CagriSema, a combination therapy developed by Novo Nordisk that pairs a long-acting analogue of amylin (cagrilintide) with semaglutide, has shown promising results in clinical trials. Participants in a 68-week, phase 3 trial lost an average of nearly 23% of their body weight.

Glucagon and GLP-1 Receptor Co-agonists

Glucagon is a hormone that raises blood sugar levels, while GLP-1 lowers them. Combining these two hormones in a single drug could offer a balanced approach to weight loss by increasing energy expenditure while maintaining blood sugar control. Survodutide, a glucagon and GLP-1 receptor co-agonist developed by Boehringer Ingelheim, is currently in clinical trials.

Triple-Hormone Receptor Agonists

Retatrutide, a triple-hormone receptor agonist developed by Eli Lilly that targets GLP-1, GIP, and glucagon receptors, has shown impressive weight loss results in Phase 2 trials. This drug, dubbed “triple G,” delivered an average weight reduction of 24% after 48 weeks, setting a new benchmark for obesity treatments.

Alternative Delivery Methods for Anti-Obesity Drugs

Companies are also exploring alternative delivery methods to once-weekly injections, which can be challenging to incorporate into people’s routines and come with manufacturing challenges. Once-monthly injectables are in the works, but oral formulations of GLP-1 receptor agonists, such as orforglipron produced by Eli Lilly, could arrive first.

Another potential alternative is oral semaglutide. In a phase 3 study called OASIS 1, people taking oral semaglutide 50 mg once daily lost up to 15% of their initial body weight after about 15 months (68 weeks) of use. This is comparable to the weight loss benefits of Wegovy, the injectable version of semaglutide.

Potential Side Effects of Anti-Obesity Drugs

While anti-obesity drugs offer a promising approach to weight management, they can also cause side effects. Some of the common side effects of GLP-1 receptor agonists include nausea, vomiting, diarrhoea, and constipation. More serious side effects, such as pancreatitis and gallbladder problems, are rare but can occur.

Specific side effects associated with semaglutide include nausea, vomiting, diarrhoea, abdominal pain, constipation, heartburn, and burping. In rare cases, semaglutide can cause more serious side effects such as pancreatitis, kidney problems, and changes in vision.

Tirzepatide can cause similar side effects, including nausea, diarrhoea, decreased appetite, vomiting, constipation, and stomach pain. Serious side effects, such as pancreatitis, gallbladder problems, and low blood sugar, can also occur.

Another concern with GLP-1 and GIP drugs is the potential risk of pulmonary aspiration during anaesthesia. These drugs can cause delayed gastric emptying, which may increase the risk of residual gastric contents despite preoperative fasting. This can lead to aspiration, where food or liquid gets into the lungs during surgery.

The increased demand for GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists has led to temporary product shortages. This has resulted in the emergence of compounded formulations of these drugs, which produce entities that bypass regulatory measures. The American Diabetes Association recommends against using non-FDA-approved compounded GLP-1 and dual GIP/GLP-1 receptor agonist products due to concerns regarding their safety, quality, and effectiveness. The FDA has also issued an alert on dosing errors associated with compounded semaglutide injectable products, which have led to adverse events and hospitalisations in some cases.

It is important to note that the potential side effects of anti-obesity drugs vary depending on the specific medication and individual factors. Patients should discuss these medications’ possible risks and benefits with their healthcare provider to determine the most appropriate treatment option.

Alternative Treatments for Obesity: Bariatric Surgery

For some individuals, bariatric surgery may be an alternative treatment option for obesity. Bariatric surgery involves making changes to your digestive system to help you lose weight. It is typically considered for people with a BMI of 40 or higher or those with a BMI of 35 or higher who have obesity-related health problems.

There are several types of bariatric surgery, including

• Roux-en-Y gastric bypass: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing most of the stomach and the first section of the small intestine
• Sleeve gastrectomy: This procedure involves removing about 80% of the stomach, leaving a long, tube-like pouch
• Biliopancreatic diversion with duodenal switch (BPD/DS): This is a two-part surgery that involves performing a sleeve gastrectomy and then connecting the end of the small intestine to the duodenum, bypassing most of the small intestine

Bariatric surgery can be very effective for long-term weight loss and can also improve or reverse obesity-related conditions such as diabetes, high cholesterol, and sleep apnoea. However, it is a major surgical procedure with potential risks and complications, such as bleeding, infection, and leaks in the gastrointestinal system. Patients should carefully consider the risks and benefits of bariatric surgery with their healthcare provider.

Emerging Applications of GLP-1 and GIP Drugs

While GLP-1 and GIP drugs are primarily known for their role in treating obesity and type 2 diabetes, research is exploring their potential applications in other disease areas. These include:

• Neurodegenerative diseases: Conditions such as Parkinson’s and Alzheimer’s disease involve protein misfolding and chronic inflammation. Studies have found that GLP-1 mimetics can cross the blood-brain barrier and have neuroprotective effects, including reducing oxidative stress and chronic inflammatory responses in the brain.
• Liver disease: GLP-1 and GIP receptor agonists have shown potential in improving liver health, particularly in individuals with nonalcoholic fatty liver disease (NAFLD).

These emerging applications highlight the versatility of GLP-1 and GIP drugs and their potential to address a wide range of health challenges beyond obesity and diabetes.

Conclusion

The field of anti-obesity drug development is rapidly evolving, with new therapies emerging that offer the potential for more effective and personalised weight management. While GLP-1 receptor agonists like semaglutide and tirzepatide have revolutionised the field, ongoing research is exploring new targets and combination therapies to address the limitations of existing medications. These advancements, such as the combination of semaglutide and bimagrumab, the development of triple-hormone receptor agonists like retratrutide, and the exploration of alternative delivery methods, hold promise for improving the lives of millions of people struggling with obesity and its related health complications.

However, it is crucial to acknowledge the potential side effects of these therapies, including gastrointestinal issues, pancreatitis, and the risk of pulmonary aspiration during anaesthesia. Patients should carefully consider the risks and benefits of these medications with their healthcare provider to determine the most appropriate treatment option.

Developing new anti-obesity drugs has significant implications for public health and the future of obesity management. These advancements offer hope for a more comprehensive and personalised approach to weight loss, potentially reducing the burden of obesity and its associated health problems.

The post The Evolving Landscape of Anti-Obesity Drugs appeared first on Medika Life.

“First 100 days,” said Means, a former consultant to Big Pharma who uses the social platform X to focus attention on chronic disease. “What should be done to reform the FDA?”

The question was more than rhetorical. Means is among a cadre of health business leaders and nonmainstream doctors who are influencing President Donald Trump’s focus on health policy.

Trump’s return to the White House has given Means and others in this space significant clout in shaping the nascent health policies of the new administration and its federal agencies. It’s also giving newfound momentum to “Make America Healthy Again,” or MAHA, a controversial movement that challenges prevailing thinking on public health and chronic disease.

Its followers couch their ideals in phrases like “health freedom” and “true health.” Their stated causes are as diverse as revamping certain agricultural subsidies, firing National Institutes of Health employees, rethinking childhood vaccination schedules, and banning marketing of ultra-processed foods to children on TV.

Public health leaders say the emerging Trump administration’s interest in elevating the sometimes unorthodox concepts could be catastrophic, eroding decades of scientific progress while spurring a rise in preventable disease. They worry the administration’s support could weaken trust in public health agencies.

Georges Benjamin, executive director of the American Public Health Association, said he welcomes broad intellectual scientific discussion but is concerned that Trump will parrot untested and unproven public health ideas he hears as if they are fact.

Experience has shown that people with unproven ideas will have his ear and his “very large bully pulpit,” he said. “Because he’s president, people will believe he won’t say things that aren’t true. This president, he will.”

But those in the MAHA camp have a very different take. They say they have been maligned as dangerous for questioning the status quo. The election has given them an enormous opportunity to shape politics and policies, and they say they won’t undermine public health. Instead, they say, they will restore trust in federal health agencies that lost public support during the pandemic.

“It may be a brilliant strategy by the right,” said Peter McCullough, a cardiologist who has come under fire for saying covid-19 vaccines are unsafe. He was describing some of the election-season messaging that mainstreamed their perspectives. “The right was saying we care about medical and environmental issues. The left was pursuing abortion rights and a negative campaign on Trump. But everyone should care about health. Health should be apolitical.”

The movement is largely anti-regulatory and anti-big government, whether concerning raw milk or drug approvals, although implementing changes would require more regulation. Many of its concepts cross over to include ideas that have also been championed by some on the far left.

Robert F. Kennedy Jr., an anti-vaccine activist Trump has nominated to run the Department of Health and Human Services, has called for firing hundreds of people at the National Institutes of Health, removing fluoride from water, boosting federal support for psychedelic therapy, and loosening restrictions on raw milk, consumption of which can expose consumers to foodborne illness. Its sale has prompted federal raids on farms for not complying with food safety regulations.

Means has called for top-down changes at the U.S. Department of Agriculture, which he says has been co-opted by the food industry.

Though he himself is not trained in science or medicine, he has said people had almost no chance of dying of covid-19 if they were “metabolically healthy,” referring to eating, sleeping, exercise, and stress management habits, and has said that about 85% of deaths and health care costs in the U.S. are tied to preventable foodborne metabolic conditions.

A co-founder of Truemed, a company that helps consumers use pretax savings and reimbursement programs on supplements, sleep aids, and exercise equipment, Means says he has had conversations behind closed doors with dozens of members of Congress. He said he also helped bring RFK Jr. and Trump together. RFK Jr. endorsed Trump in August after ending his independent presidential campaign.

“I had this vision for a year, actually. It sounds very woo-woo, but I was in a sweat tent with him in Austin at a campaign event six months before, and I just had this strong vision of him standing with Trump,” Means said recently on the Joe Rogan Experience podcast.

The former self-described never-Trumper said that, after Trump’s first assassination attempt, he felt it was a powerful moment. Means called RFK Jr. and worked with conservative political commentator Tucker Carlson to connect him to the former president. Trump and RFK Jr. then had weeks of conversations about topics such as child obesity and causes of infertility, Means said.

“I really felt, and he felt, like this could be a realignment of American politics,” Means said.

He is joined in the effort by his sister, Casey Means, a Stanford University-trained doctor and co-author with her brother of “Good Energy,” a book about improving metabolic health. The duo has blamed Big Pharma and the agriculture industry for increasing rates of obesity, depression, and chronic health conditions in the country. They have also raised questions about vaccines.

“Yeah, I bet that one vaccine probably isn’t causing autism, but what about the 20 that they are getting before 18 months,” Casey Means said in the Joe Rogan podcast episode with her brother.

The movement, which challenges what its adherents call “the cult of science,” gained significant traction during the pandemic, fueled by a backlash against vaccine and mask mandates that flourished during the Biden administration. Many of its supporters say they gained followers who believed they had been misled on the effectiveness of covid-19 vaccines.

In July 2022, Deborah Birx, covid-19 response coordinator in Trump’s first administration, said on Fox News that “we overplayed the vaccines,” although she noted that they do work.

Anthony Fauci, who advised Trump during the pandemic, in December 2020 called the vaccines a game changer that could diminish covid-19 the way the polio vaccine did for that disease.

Eventually, though, it became evident that the shots don’t necessarily prevent transmission and the effectiveness of the booster wanes with time, which some conservatives say led to disillusionment that has driven interest in the health freedom movement.

Federal health officials say the rollout of the covid vaccine was a turning point in the pandemic and that the shots lessen the severity of the disease by teaching the immune system to recognize and fight the virus that causes it.

Postelection, some Trump allies such as Elon Musk have called for Fauci to be prosecuted. Fauci declined to comment.

Joe Grogan, a former director of the White House’s Domestic Policy Council and assistant to Trump, said conservatives have been trying to articulate why government control of health care is troublesome.

“Two things have happened. The government went totally overboard and lied about many things during covid and showed no compassion about people’s needs outside of covid,” he said. “RFK Jr. came along and articulated very simply that government control of health care can’t be trusted, and we’re spending money, and it isn’t making anyone healthier. In some instances, it may be making people sicker.”

The MAHA movement capitalizes on many of the nonconventional health concepts that have been darlings of the left, such as promoting organic foods and food as medicine. But in an environment of polarized politics, the growing prominence of leaders who challenge what they call the cult of science could lead to more public confusion and division, some health analysts say.

Jeffrey Singer, a surgeon and senior fellow at the Cato Institute, a libertarian public policy research group, said in a statement that he agrees with RFK Jr.’s focus on reevaluating the public health system. But he said it comes with risks.

“I am concerned that many of RFK Jr.’s claims about vaccine safety, environmental toxins, and food additives lack evidence, have stoked public fears, and contributed to a decline in childhood vaccination rates,” he said.

Measles vaccination among kindergartners in the U.S. dropped to 92.7% in the 2023-24 school year from 95.2% in the 2019-20 school year, according to the Centers for Disease Control and Prevention. The agency said that has left about 280,000 kindergartners at risk.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

The post Make America Healthy Again: An Unconventional Movement That May Have Found Its Moment appeared first on Medika Life.

Like an endangered species, preventive medicine and chronic disease management—the US primary care system—face extinction. With nearly 30% of American adults lacking a source of care and 28 percent reporting delaying or not getting care due to cost, the consequences are far-reaching.  The focus on chronic disease prevention and addressing its root causes demands greater attention, as the health of the system—and the people it serves—depends on it. If we are frustrated about something, this is worth the outrage.

It has been almost impossible for elected officials, who too often look for singular villains, to grasp the extent of this system-wide dysfunction. This crisis extends beyond consumer comfort with technology or the cost of medicines. Primary care medicine—the basis for health delivery—is marginalized as an honored medical discipline. Somehow, we opt for a national health system prioritizing sick care over healthcare.

Primary care providers are grappling with burnout and inadequate compensation compared to their specialist counterparts, and the system often prioritizes paperwork over quality of care. Economics drives health delivery and access, and it’s simply not working to the advantage of consumers and primary care physicians.  

Finger-pointing and Senate HELP Committee photo ops cannot solve this nation’s care crisis. What’s needed is a fundamental shift in our approach to illness, prevention, and access—one that addresses the root causes of our failing primary care system and ensures that quality healthcare is accessible to all Americans, regardless of zip code or digital literacy. That will reduce our total health costs.

Obesity and Heart Disease: A Multigenerational Threat

America’s waistline is changing—we are adding notches to the nation’s belts. Obesity rates among younger Americans are climbing, creating an abundance of chronic diseases that once seemed confined to older generations. Alarmingly, heart disease, which had been in decline for decades, is creeping back up.

The invention of new weight-loss drugs like GLP-1 receptor agonists helps many struggling with chronic weight issues and mitigates some health risks. Yet, these drugs are not a complete answer to the challenge. They do not adequately address the underlying risks—heart disease, diabetes, and other chronic conditions—that require ongoing, consistent engagement with health professionals. Without this, even those who benefit from these medications – looking trim – may still end up battling old health challenges.

The persistent challenge of obesity across various age groups in the US, which hovers at +/- 40 percent, reinforces worrisome trends that impact people by age, race and region. A rate stable at 40 percent is not something to celebrate – it requires action. It’s a tipping point for illness.

Prediabetes: A Perfect Public Health Storm

Prediabetes is the nation’s silent epidemic. Close to 90 million adults—more than 1 in 3 Americans—have it, and 90% don’t know they do. Left unchecked, some 20 percent of these people “graduate” to Type 2 diabetes and other complications annually. The rise in obesity among younger populations only exacerbates this issue, setting the stage for an earlier onset of chronic diseases that worsen over time.

Prediabetes demands a dedicated behavior-focused treatment plan. Without significant lifestyle changes, individuals are on a fast track to diabetes and its life-altering complications. And yet, the primary care system—our first line of defense—is buckling under pressure, unable to provide the consistent support patients need. It’s not just the use of medications – it’s understanding that obesity is a multi-system condition and a unique disease that transcends more belt notches.

The Limitations of GLP-1 Drugs:

GLP-1 drugs do reduce weight and lower the risk of diabetes and heart disease. But they are not a substitute for comprehensive care. The underlying dangers—poor cardiovascular health, insulin resistance, and other metabolic issues—don’t disappear with weight loss alone. Without engagement with allied health professionals trained to address the complexities of obesity to monitor and address these risks, consumers will face new challenges despite these drugs’ initial success in losing pounds.

We live in what Katherine Saunders, MD, DABOM, a Weill Cornell Medicine’s Comprehensive Weight Control Center and co-founder of FlyteHealth, calls the “Obese-a-genetic” era.  Her efforts at FlyteHealth leverage the latest in science, technology, patient support, and a range of medications to individually tailor weight treatment based on a person’s unique biology alongside the complexity of obesity treatment:

“Overweight and obesity are misunderstood medical conditions that are more complex than calories in and calories out. The advice many patients receive—to eat less and exercise more—often fails to address the problem.”

Saunders and her colleagues are at the cutting edge of results-oriented care, but she is among the handful who have dedicated their careers to this pressing clinical discipline.

Walk-In Clinics are about Convenience

Convenience of care is essential to people’s well-being. Entrepreneurial internists have recognized this, creating “pop-up” vaccination and care centers to bring services closer to those in need and better work/life balance. But convenience alone isn’t enough. Urgent care clinics underscore one of the nation’s most pressing public health threats—the erosion of primary care—has reached a retail-like inflection point.

Walk-in clinics and telehealth check-ins are helpful but do not offer dedicated follow-up. They are geared to address the consumer’s immediate need and are not structured for the longitudinal engagement for the hard-to-tackle considerations that call for comprehensive support.

We are stuck between a system that focuses on its self-preservation and what is in our and national long-term interests – protecting our most important asset – our health.

The Rise of the Make American Health Again Movement

Primary care physicians, the cornerstone of preventive health, are becoming extinct as a medical profession species. The reasons are many: medical school debt driving doctors to higher-paying specialties, they are paid by the number of patients seen daily burnout, and the rise of retail clinics offering quick, transactional care.

While these clinics improve access, their focus is not on a long-term patient-physician relationship. This shift leaves a dangerous gap in the medical safety net, particularly for chronic conditions like obesity, prediabetes, and heart disease. Without a trusted health provider to guide them, patients are left to navigate their health journeys solo—often with devastating consequences.

Many are aghast at Robert F. Kennedy Jr.’s nomination to the Department of Health and Human Services as Secretary of the nation’s key organization setting national health policy. This justified anxiety centers on his stated positions on vaccines and his off-hand comments dismissing the importance of medicines in preventing more serious illnesses. However, his thoughts about America’s poor health report card grades deserve attention regardless of the outcome of the Senate confirmation hearings.

His Make America Healthy Again movement has an approach that deserves consideration: the need to tackle the chronic disease epidemic, which has become the leading cause of death in the US and, later, drives massive costs in hospitalization.

“There are some things that RFK Jr. gets right,” says Resolve to Save Lives CEO Dr. Tom Frieden, who was appointed Director of the Centers for Disease Control and Prevention during the Obama Administration. “We do have a chronic disease crisis in this country, but we need to avoid simplistic solutions and stick with the science.” Frieden made his comments in an NPR interview on the RFK Jr. nomination.

We need (much) more than medications and pop-up clinics to address America’s growing health crises. The health ecosystem must be reimagined to center around people’s health outcomes – not a one-size-fits-all approach to keeping them well. We must foster long-term patient-provider relationships, ensure easy access to understandable health data, emphasize nutrition and physical education in schools, and make care accessible to people across racial and generational lines.

As the ticking time bombs of obesity, prediabetes, and heart disease continue to warn, the urgency for change cannot be overstated. The frustration over the current complexity of access underscores what happens when we prioritize the system over prevention. Access to care isn’t just a convenience—it’s a matter of survival. To prevent the collapse of this fragile house of cards, we must act decisively and collaboratively to build a health system that sustains us all.

The post Conceptually, the “Make America Healthy Again Movement” Needs a Nod appeared first on Medika Life.

Over a thousand epidemiologic papers were examined, including clinical trials of weight-loss or weight-control therapies. These investigations included observational studies on cancer risk and fat excess. Because of this, the assessments focused on the dangers of being overweight rather than the benefits of preventative measures.

Studies varied in their risk assessments; most focused on adults’ body mass index (BMI), while others looked at childhood or adolescent BMI or body shape, weight or BMI changes over time, or other measures of adiposity, such as waist circumference.

The analysis considered relative-risk estimates where sufficient analyses of observational data were accessible. The absence of extra body fat, it was concluded, reduces the risk of cancer at previously described organ sites. In addition, study results point to the fact that being lean reduces the incidence of eight more cancers: gastric, cardiac, liver, gallbladder, pancreatic, ovarian, thyroid, multiple myeloma, and meningioma. Once again, however, we must understand that correlation does not equal causation. But the indicators are of concern and great interest.

If the newly introduced GLP-1 medication can control obesity, which, in turn, may reduce the incidence of cancer, researchers are now questioning whether these drugs may serve other purposes in healthcare. There is a belief that GLP-1 medication use may extend beyond obesity and weight control. What areas are they currently considering for studies with these medications?

GLP-1 for Addiction?

The World Health Organization (WHO) found that 2.6 million people die each year because of alcohol intake (or 4.7% of all deaths), and 0.6 million people die because of the use of psychotropic drugs. Men accounted for 0.4 million drug-related fatalities and 2 million alcohol-related fatalities. But while alcoholism remains a serious health hazard, there are other addictions to street or prescription drugs that are also of concern to healthcare professionals and patients.

Cocaine use disorder affects an estimated 5 million people. Worldwide, the death toll from cocaine overdoses is rising at a faster rate than that from opiate overdoses.

But there is an intriguing relationship between obesity and addiction. Substantial evidence in the literature linking obesity to substance use disorders supports a link of sorts. Studies have shown that when people are exposed to meals that are very tasty, certain hormones in the brain are triggered, which makes consuming unhealthy choices more likely.

This is analogous to what occurs in the brains of those who suffer from substance abuse disorders. Behaviors comparable to addiction to foods high in fat and sugar have led to studies employing animal models of obesity, discovering typical neurobiological features of addiction in the brain systems. The reward system that is engaged, and that perpetuates a preference for specific types of foods, may also be involved in addiction disorders.

The conclusion, currently, is that there is a viable solution for addiction through the use of the GLP-1 medications. Researchers must further investigate these specific connections and detail their interrelationships.

Since the discovery of GLP-1 medications for obesity, several off-label uses have also been shown to be useful. Researchers are actively exploring the growing number of diseases that these medications might treat, which is extremely promising.

The potential utility of GLP-1 disorders of addiction and others include: food addiction (binge eating), alcoholism, Parkinson’s disease, depression, anxiety, heart disease, hypertension, fatty liver, polycystic ovarian syndrome, chronic kidney disease, inflammation, and opiate and narcotic addictions.

Addiction regulation, inflammation reduction, dopamine pathway modulation, and insulin sensitivity are just a few of the many physiological consequences of these receptor agonists. Because of these processes, they are promising candidates for the treatment of diseases outside of their original indications.

Medical and scientific communities are highly intrigued by the prospect of GLP-1 medicines potentially treating this wide array of illnesses, but research into these uses is still in its early phases.

The future, however, appears promising as new indications come to light, and as research reveals the areas where they may be brought into a treatment regime that is successful. At this juncture, however, it is not always apparent which biological pathways are being affected and that is a remaining question for future research efforts.

The post The Weight Loss Drugs That Refuse to Recognize Boundaries appeared first on Medika Life.

According to the ADA, the diagnosed cost of diabetes in the United States is estimated to be $412.9 billion in 2022, including both direct medical costs and indirect costs like lost productivity. As the prevalence of diabetes continues to rise, costs will climb higher and higher, placing an unsustainable and unnecessary burden on our health system and economy. It points to a stark, uncomfortable realization that the biggest cost burden on the American taxpayer isn’t drugs (11 percent of the total national health spend); it is the cost of manageable disease run amuck.

While the White House and Congress rightly tout their success in lowering the cost of insulin for Americans in need, the policy victory speaks to the persistent problem—akin to closing the barn door after the horse has escaped—that more and more people are being diagnosed with or unaware of their diabetes risks. The bigger “hairy audacious goal” is to reduce the number of people with diabetes in the first place.

A Tale of Two Americas

The Type 2 diabetes epidemic is not an equal opportunity offender. It disproportionately affects racial and ethnic minorities, as well as those with lower educational attainment and socioeconomic status. This is not a coincidence; it results from systemic inequalities plaguing our health-delivery system. It speaks to the long overdue need to use PK-12 education to inform young people about healthy diets.

Black Americans, Hispanic/Latino Americans, and Native Americans bear a heavier burden of this disease because of deeply rooted social determinants of health. Access to quality healthcare, education, and economic opportunities are crucial in determining who develops Type 2 diabetes and who doesn’t.

According to the ADA: “The poorer you are in America, the less likely you are to have a grocery store within walking distance of your home. Diabetes rates are inversely related to income level, and nutrition is critical to diabetes prevention and management. Every American with diabetes and prediabetes must have access to affordable, culturally relevant food and the information they require to eat healthfully.”

At the heart of this crisis lies a fundamental issue raised for years: our relationship with food and education. The lack of basic nutritional literacy in many communities is not just unfortunate; it’s a tipping point for heart disease and diabetes. Many Americans, particularly in underserved communities, make food choices that harm their health because of strained household economics or lack of information. The food label on packaged goods is helpful to those who can translate the percentages listed into actionable decisions. Still, desperation often makes those decisions for people regardless of what the label says.

In urban and rural areas with limited access to fresh, nutritious food, food deserts are not just inconveniences but public health hazards. When the only food options available are processed, high-calorie, or convenient and tasty fast foods, we set up communities for a lifetime of health struggles.

Innovation and Public Policy: Islands of Hope

Traditional approaches are proving inadequate in the face of this growing threat. The health system needs to embrace innovative, policy- and technology-driven solutions that can reach people where they are and provide personalized support.

More than 41 million people participate in the Supplemental Nutrition Assistance Program (SNAP) and receive an average monthly benefit of $191 per person, or a little over $2 per meal. ​Roughly four out of 10 SNAP participants (42%) are children under age 18; 16% are people 60 and older, and about 12% are people with disabilities. The results are dramatic!

Children receiving SNAP benefits have better health status than youngsters who are not SNAP participants, and their households are less likely to sacrifice health care to pay for other necessary expenses. Older SNAP participants are less likely to be admitted to a nursing home or hospital than their counterparts who do not participate. It seems like common sense. Caring for the chronically ill costs taxpayers more.

Telemedicine and remote monitoring technologies offer potential avenues for diabetes management. These tools can provide real-time data to healthcare providers, allowing for more timely interventions and personalized care plans. AI-powered nutritional guidance apps have the potential to democratize access to customized meal plans, accounting for an individual’s health status, cultural preferences, and economic constraints. These tech tools can only be used as preventive and interventional extensions of the doctor’s office if third-party payers – private and public – ensure it is in the health providers’ interests. 

On the pharmaceutical side of innovation are the GLP-1 receptors – that can help millions of people struggling with obesity – among the key catalysts for the surge in pre- and Type 2 diabetes. GLP-1 receptor agonists mimic the hormone’s action, crucial in regulating blood sugar levels. But here’s the kicker: these drugs don’t just lower blood glucose; they’re a Swiss Army knife of metabolic health. However, private payers often place obstacles in the path of access. Obesity is a complex – tipping point – disease leading to diabetes, mental health challenges, heart disease, and more. Payers often will not authorize GLP-1 use for people who are overweight and have prediabetes – waiting till people (their beneficiaries) graduate to Type 2, citing cost.

The Obesity Society spokesperson Katherine H. Saunders, MD, of Weill Cornell Medicine, New York City, in an interview with Medscape, comments: “What is more expensive than Wegovy (a GLP-1 class drug)? A day in the hospital. This is a particularly important finding for health plans, employers, and any group covering the total cost of care — many of whom are concerned about the cost of Wegovy. Hopefully, this data will encourage more decision makers to recognize not only the significant health benefits associated with Wegovy but also potential cost savings.” Dr. Saunders is among the nation’s top thinkers in the field of obesity and associated conditions, and as an entrepreneur, co-founded FlyteHealth, a community of health providers who specialize in helping people manage their weight.

Health- or Sick-Care – We Must Choose a Path

The economic impact of Type 2 diabetes is staggering. The time for half-measures and incremental change is long past. We need a coordinated, multisectoral response—the health sector, industry, government, and private philanthropy—working together to address the epidemic’s foundational causes.

Five suggestions include:

1. Investing in education at the primary school level and ensuring children understand healthy food choices and have access to in-school meals.
2. Addressing social determinants of health through Federal and state policies that promote economic equity and access to quality health and education
3. Leveraging well-proven approaches in remote patient monitoring to improve diabetes intervention, detection, and management
4. Strengthening the use of Federal and state programs such as SNAP and the Child and Adult Care Food Program (CACFP)
5. Fostering collaboration between health providers, community organizations, national professional health organizations and tech companies to deploy proven solutions.

The Future We Must Embrace

Current efforts to address Type 2 and prediabetes prevention are insufficient. By acknowledging the complex relationship among social, educational, economic, and environmental factors contributing to this chronic illness epidemic, the United States private and public health system must examine drug costs; however, it can develop more effective policies and campaigns for diabetes intervention and management. 

It’s time for a mindset shift in approaching this preventable condition. We must recognize that we have, to date, given lip service and window dressing to address disparities and support the needs of children growing up without sufficient knowledge about food choices or, in the case of cash-strapped families, access to a healthy meal that reinforces what they are learning in school. Half measures were never good enough and are no longer acceptable.

Every step toward managing Type 2 diabetes – or better yet, preventing it entirely – is a step toward a healthier, more equitable society. The challenge is immense, but the ability to make a difference is possible.  There are proven delivery methods for insulin, vastly improved ways to monitor blood glucose and policies that could be tweaked to meet people’s needs.  Together, we can turn the tide on this epidemic and create a future where Type 2 diabetes is no longer a looming threat but a manageable condition.

Pay now or pay later. It’s a decision payers and policymakers must make.

The post The Diabetes Epidemic: A Pressing Public Health Catastrophe appeared first on Medika Life.

Considering that over 40% of U.S. adults have obesity and there are fewer than ten thousand obesity medicine specialists, PCPs are a critical part of the solution as we tackle this epidemic. While PCPs have extremely limited time to delve into the complexities of obesity and provide support between visits, it’s wonderful when they are knowledgeable about evidence-based obesity treatment so that they can at least initiate the conversation and refer their patients to an obesity specialist.

But the collaboration doesn’t stop there. Obesity is not only a chronic disease in its own right; it is also associated with more than 200 other conditions that can affect all body systems. According to data from IQVIA, people ages 40-64 with obesity have 2.4 comorbidities on average. That figure rises to 4.9 for individuals 65 and over (and 7% of people in the latter age group have 10 or more comorbidities). Effective treatment requires taking these comorbidities — and the medications often prescribed for them — into account and communicating with other members of the patient’s care team throughout treatment.

The following are just a few of the subspecialties that obesity touches.

• Cardiology: The impacts of obesity on cardiovascular health — raising the risk of high blood pressure, heart attack and stroke, among other conditions — are among the best known and most thoroughly studied. In fact, the anti-obesity medication, Wegovy, was recently approved specifically to reduce the risk of adverse cardiovascular events in individuals with obesity and established cardiovascular disease.

• Endocrinology: Adipose tissue is an active endocrine organ that produces more than a hundred different hormones, so it’s no surprise that endocrinologists are frequently involved in treating obesity-related conditions — Type 2 diabetes being the most familiar, but also polycystic ovarian syndrome and infertility, among many others.

• Orthopedics: Obesity is a risk factor for the development of soft tissue damage and osteoarthritis in load-bearing joints, particularly the knees, due to both inflammation and mechanical stress. Joint pain then inhibits physical activity, which worsens obesity, creating a vicious circle — while also increasing the risk of complications associated with orthopedic surgery.

• Oncology: Obesity is a risk factor for the development of many types of cancers, including breast, colon, rectal, pancreatic, kidney, esophagus, ovarian, skin, liver, thyroid, gallbladder, brain (meningioma) and endometrial cancer. Researchers believe that excess body fat leads to hormonal and metabolic changes that trigger inflammation and promote tumor growth.

• Gastroenterology: Obesity is associated with many digestive system diseases, including gastroesophageal reflux disease, esophagitis, gallstones, metabolic dysfunction-associated fatty liver disease and cirrhosis, and various related cancers.

• Pulmonology: Individuals with obesity face a higher risk of asthma, obstructive sleep apnea and other respiratory conditions (including, as we observed with COVID-19, potentially worse outcomes from viral infections).

• Psychiatry: Obesity and depression are closely linked, with a bidirectional association, and it’s worth noting that many antidepressants can promote weight gain, so prescribers should be prepared to consider weight-neutral or weight-loss-promoting alternatives for patients with obesity when possible. Other common mental health comorbidities include anxiety and eating disorders.

For many of these obesity-related health complications, losing weight can be the first line of treatment, and the relationship is often dose-dependent, meaning that these conditions worsen as obesity worsens and improve as obesity improves. This correlation may lead us to instinctively reach for GLP-1 medications as the most effective option, since we want to help our patients lose as much of their excess weight as possible and experience the greatest benefit. But especially considering significant cost, coverage and supply constriants, other anti-obesity medications can still bring measurable health benefits and might even be preferable for many individuals. Losing just 5% to 10% of body weight can lead to clinically significant improvements in markers such as blood glucose, cholesterol and blood pressure.

Improving patient health — not just reaching an arbitrary number on the scale — is the ultimate goal. Obesity touches everything, and treating obesity can have a positive, cascading effect on other conditions. If we can help a patient achieve Type 2 diabetes remission, reversal of sleep apnea or improved fertility, we’ll have made a real difference in their life.

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