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A new experimental drug found to be more effective than Wegovy and Mounjaro for weight loss could also stop fatty liver disease in its tracks, according to new clinical trial data.

At this weeks Liver Meeting the annual conference of the American Association for the Study of Liver Diseases experts revealed that a retatrutide treatment regimen was capable of reducing liver fat by as much as 85%.

Retatrutide, which is under development by Eli Lilly for weight loss, is in the same family of drugs as Ozempic and Mounjaro, as they are all GLP-1 agonist drugs. However, retatrutide is also an agonist of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon receptors.

In the phase 2 trial, patients who were given weekly injections of 8 mg and 12 mg retatrutide resulted in 24% weight loss and between 81% and 86% reduction of fat in the liver. Whats more, 89% and 93% of patients receiving retatrutide 8 mg and 12 mg had less than 5% liver fat after 48 weeks of treatment, meaning that there was no longer enough fat in their liver to meet fatty liver disease criteria.

Arun J. Sanyal, M.D., chair of the division of gastroenterology, hepatology and nutrition at Virginia Commonwealth Health, who presented the findings at the annual meeting, said that the results are quite dramatic.

Between 80-90% of patients and actually by week 48, at the high dose, 93% of patients lost so much fat in the liver that they were below the cutoff for having fatty liver disease, which is quite dramatic, because in the overweight-obese population, we first said that 70-75% of them will have excess fat in the liver, Dr. Sanyal said in an interview with HCPLive during the meeting. But now we have a treatment that can treat obesity, and you can wipe out the liver fat in 90% of these people.

People with fatty liver disease, also called steatotic liver disease, have excess fat build-up in their liver. Things like type 2 diabetes, obesity and chronic heavy alcohol consumption can cause the excess fat to accumulate. Often fatty liver disease will not cause issues, but if left untreated, long-term problems like hepatitis, fibrosis and cirrhosis can develop. Between 80 and 100 million adults in the United States are affected by the condition.

While clinical findings on retatrutide are positive thus far, Dr. Sanyal notes that there is a caveat the people involved in the phase 2 trial had early stage liver disease and were not considered at risk of advanced liver disease during the time of their enrollment. That makes it challenging to understand whether retatrutide would benefit patients who might be at risk of developing conditions like cirrhosis and hepatitis.

More clinical trials are needed to assess retatrutides utility in advanced liver disease, but in the meantime, Dr. Sanyal suggests that the drug could still help to delay the onset of severe liver scarring.

Here, the implication is that by treating the underlying obese state and by getting rid of all the fat in the liver, there's at least a reasonable assumption that you might in the future be able to say that this population that no longer has fat in the liver, they're not going to progress to significant scarring of the liver, or they will not develop fibrosis or fibrosis-related outcomes, Dr. Sanyal said.

Originally posted here:
New Weight Loss Drug Could 'Wipe Out' Liver Disease - The Messenger

Weight-loss medications, including the popular glucagon-like peptide-1 (GLP-1) receptor agonists semaglutide (Wegovy) and tirzepatide(Mounjaro), look like a promising option for people with HIV, although data are limited and more studies are needed.

Weight gain is a growing concern for people living with HIV and their health care providers. Not only do many people find weight gain and body shape changes distressing, they also raise the risk for cardiovascular disease and other health problems. HIV-positive people are often urged to take steps to manage their weight, but this is easier said than done.

Lifestyle changes, exercise and diet are incredibly important for your health, but to shift weight downwards in someone with established weight gain is next to impossible, Professor Francois Venter of the University of Witwatersrand in South Africa said at the International AIDS Society Conference on HIV Science (IAS 2023) in July. You really do need pharmaceutical or surgical help.

As aidsmap has reported, research has yielded conflicting data about weight changes after starting or switching antiretrovirals, especially integrase inhibitors. Numerous studies have found that people who start a new regimen can gain weight, sometimes as much as 5-10kg. This appears to be more likely when people switch away from tenofovir disoproxil or efavirenz, which have a weight-suppressing effect. But in general, changing antiretrovirals in an effort to lose weight does not seem to have much effect. Weight gain among people with HIV may also be attributable to a return to health after starting treatment or normal changes that occur with age.

A group of diseases characterized by high levels of blood sugar (glucose). Type 1 diabetes occurs when the body fails to produce insulin, which is a hormone that regulates blood sugar. Type 2 diabetes occurs when the body either does not produce enough insulin or does not use insulin normally (insulin resistance). Common symptoms of diabetes include frequent urination, unusual thirst and extreme hunger. Some antiretroviral drugs may increase the risk of type 2 diabetes.

Pertaining to the internal organs. Visceral fat is fat tissue that is located deep in the abdomen and around internal organs.

A pill or liquid which looks and tastes exactly like a real drug, but contains no active substance.

A class of antiretroviraldrugs. Integrase strand transfer inhibitors (INSTIs) block integrase, which is an HIV enzyme that the virus uses to insert its genetic material into a cell that it has infected. Blocking integrase prevents HIV from replicating.

In cell biology, a structure on the surface of a cell (or inside a cell) that selectively receives and binds to a specific substance. There are many receptors. CD4 T cells are called that way because they have a protein called CD4 on their surface. Before entering (infecting) a CD4 T cell (that will become a host cell), HIV binds to the CD4 receptor and its coreceptor.

The use of weight-loss medications has skyrocketed in recent years. The European Medicines Agency (EMA) has authorised the use of Wegovy for people with obesity or overweight. (The same drug was previously approved for the treatment of type 2 diabetes under the brand name Ozempic.) On 9 November, theEMAs Committee for Medicinal Products for Human Use recommended expanding the indication for tirzepatide, previously approved for diabetes, to include weight management. (In the United States, tirzepatide was recently approved for weight management under the brand name Zepbound.)

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics a natural hormone that suppresses appetite, regulates insulin and blood sugar levels and slows emptying of the stomach. Tirzepatide mimics the action of both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). Other related drugs, including orforglipron and retatrutide (which mimics three hormones), are currently in the pipeline.

Semaglutide and tirzepatide are generally safe, but they can cause side effects including nausea, vomiting, diarrhoea, constipation, abdominal pain and bloating. More serious adverse events may include gastroparesis (stomach paralysis) and pancreatitis. They can lead to loss of lean muscle mass as well as fat, which may be a concern for older people. Whats more, the drugs are expensive and they may need to be used long term, as weight typically rebounds after they are discontinued.

In clinical trials of HIV-negative people, non-diabetic adults with obesity who used semaglutide reduced their weight by around 15% on average, while those who used higher doses of tirzepatide lost around 20%. Semaglutide may also improve fatty liver disease, and a recent study showed that it reduced the risk of heart attacks and strokes in non-diabetic people with obesity and cardiovascular disease.

To date, there has not been much specific research on weight loss medications for people with HIV, but data are starting to emerge.

As reported at the IAS conference, Marisa Brizzi of the University of Cincinnati and colleagues evaluated the effect of GLP-1 receptor agonists on metabolic outcomes in HIV-positive and HIV-negative people with type 2 diabetes. They hypothesised that GLP-1 might be depleted during HIV infection and that integrase inhibitors might disrupt fat cells, affect hormones that regulate glucose and lipid metabolism, stimulate appetite or reduce insulin sensitivity.

This retrospective cohort study included 15 adults with HIV matched with 30 HIV-negative people. Nearly 90% were men and the mean age was 57 years. Most of the HIV-positive people were on integrase inhibitors. Nearly three quarters used dulaglutide (Trulicity) and 13% used liraglutide (Victoza for diabetes or Saxenda for weight loss), two older and less effective drugs; only 13% used semaglutide and none used tirzepatide.

HIV-positive people with diabetes lost 10.4kg, on average, compared with 1.7kg for HIV-negative people, or 8.0% versus 1.5% of their baseline body weight. Whats more, 60% of people with HIV achieved at least 5% weight loss, compared with 33% of HIV-negative participants.

In this cohort, people with HIV and diabetes had significantly greater weight loss compared to people with diabetes alone, the researchers concluded. The greater weight loss observed in people with HIV may be related to differences in the mechanistic pathways leading to weight gain.

While these results appear to suggest that people with HIV might benefit more from weight-loss drugs, most participants used older medications and the amount of weight lost in the HIV-negative group was substantially lower than that seen in pivotal trials of semaglutide and tirzepatide for people without diabetes.

In a related study, presented at IDWeek in Boston in October, Quynh Nguyen of the University of California San Diego and colleagues looked at prescribing practices and clinical outcomes among people with HIV who used weight-loss drugs. This retrospective cohort study included 225 adults who were classified as overweight or obese and who were prescribed GLP-1 receptor agonists between February 2021 and February 2023. A majority were men and the average age was 54 years. Most were on integrase inhibitors, 90% had an undetectable viral load and CD4 counts were high.

In this study, 53% received injectable semaglutide, 31% used dulaglutide, 8% used an oral formulation of semaglutide, 6% used tirzepatide and 3% used liraglutide. Ninety-nine people (43%) received the drugs for weight management alone, while the rest also had type 2 diabetes.

People who received GLP-1 drugs lost 5.4kg, on average. Nearly a quarter achieved greater than 5% weight loss, body mass index (BMI) fell by 1.8 and 18% went from obesity to overweight classification; blood glucose (haemoglobin A1C) also decreased.Those without diabetes tended to lose more weight. People with a higher baseline BMI and longer duration of treatment were more likely to experience greater than 5% weight loss, while those who used dulaglutide were less likely to do so. Age, sex, race/ethnicity, HIV viral load, CD4 count and antiretroviral regimen were not predictive of weight change.

Use of GLP-1 receptor agonists led to improvements in weight, BMI and haemoglobin A1C among people with HIV and offers an additional strategy to address weight gain and related metabolic complications, the researchers concluded.

In another study presented at IDWeek, Professor Grace McComsey, of Case Western Reserve University in Ohio and colleagues assessed the effects of semaglutide on lipohypertrophy, or abnormal fat accumulation. McComsey noted that its not just weight that matters but also where fat is located. Visceral fat within the abdomen is more strongly associated with cardiovascular disease and other health problems than subcutaneous fat under the skin.

This trial enrolled 108 non-diabetic adults on stable antiretroviral therapy with viral suppression. A majority (60%) were men and the median age was 52 years. More than 80% were on integrase inhibitors and CD4 counts were high. They had a BMI of 25 or higher (indicating overweight or obesity), a large waist circumference or waist-to-hip ratio and reported that they developed increased abdominal girth after starting antiretrovirals. They were randomly assigned to receive semaglutide or a placebo once weekly for 32 weeks. CT and DEXA scans weredone to measure total, visceral, subcutaneous, trunk and limb fat, lean body mass and body composition.

Body weight fell by 8.3% in the semaglutide group while rising by 0.2% in the placebo group. A majority (65%) of people taking semaglutide, but only 4% of those taking the placebo, achieved at least 5% weight loss. BMI also decreased significantly in the semaglutide group.

" HIV-positive people are often urged to take steps to manage their weight, but this is easier said than done."

Total fat fell by 15% in the semaglutide group but rose by 0.2% in the placebo group. Visceral and trunk fat fell by 13% and 17% in the semaglutide group but increased by 5% and 0.4%, respectively, in the placebo group. Subcutaneous and limb fat both fell by 13% in the semaglutide group; in the placebo group, subcutaneous fat rose by 1.5% and limb fat was unchanged. Lean body mass fell by 5.4% in the semaglutide group compared with just 0.6% in the placebo group. However, fat accumulation in the liver and around the heart did not change much in either group.

Semaglutide was safe and well tolerated, McComsey reported. Side effects were common, but severe or serious adverse events were rare. Adherence was good despite the COVID-19 pandemic and the need for weekly injection visits. (Outside of clinical trials, most people use self-injection pens.)

Semaglutide significantly decreased central fat in people with HIV with lipohypertrophy, primarily driven by reductions in visceral adipose tissue, the researchers concluded. Semaglutide may offer an effective treatment to decrease visceral adiposity and reduce comorbidity risk.

McComsey noted that the loss of lean body mass could be a problem for a population prone to losing muscle mass over time, and there is concern that lipoatrophy, or fat wasting in the face and limbs, could potentially worsen.

A study presented at the recent European AIDS Conference (EACS 2023) in Warsaw raised another potential concern. Dr Sebastian Noe of MVZ Mnchen am Goetheplatz and colleagues assessed the effect of GLP-1 receptor agonists on circulating CD4 cells in people living with HIV with sustained viral suppression. Based on previous studies of related drugs, they hypothesised that these medications might lead to a decrease in CD4 counts.

This retrospective analysis included 76 people with HIV treated with semaglutide or dulaglutide for type 2 diabetes or obesity at two HIV clinics in Germany. Most were white men in their fifties and about half had diabetes. The median current CD4 count was high, above 800, but the median nadir (lowest-ever) count was just under 300. The data suggested that GLP-1 receptor agonist use might be associated with a non-time-dependent decrease in CD4 cells, with a median decrease of 64 cells, but not everyone was equally affected. Further research is needed to confirm our findings and to identify people living with HIV at risk of a relevant decrease in CD4 cells, the researchers concluded. The clinical relevance of these findings merits further investigation.

Finally, another study at IDWeek evaluated the effect of tesamorelin (Egrifta) on visceral fat in people taking integrase inhibitors. Tesamorelin, a synthetic growth hormone-releasing factor analogue, works differently from GLP-1 receptor agonists, acting on the pituitary gland in the brain to stimulate growth hormone production. It is approved in the United States, but its EMA application was withdrawn.

A previous study showed that tesamorelin reduced visceral adipose tissue by about 15% in HIV-positive people with lipohypertrophy, but the research was done before integrase inhibitors were the preferred treatment for HIV. Therefore, Dr Taryn McLaughlin of Theratechnologies and colleagues asked whether it would have a similar effect for people taking newer regimens. The researchers drew on data from a previous trial that enrolled 61 HIV-positive participants with fatty liver disease. Of these, 39 (64%) were on integrase inhibitors, most commonly dolutegravir. They were randomly assigned to take tesamorelin or a placebo for 52 weeks.

At baseline, demographics, HIV-related variables and body composition measurements were similar for integrase inhibitor recipients and those taking other antiretrovirals. Over a year of treatment, BMI did not change significantly in either the tesamorelin or placebo groups. Integrase inhibitor recipients assigned to receive tesamorelin saw an 8.3% reduction in visceral adipose tissue, while placebo recipients had a 10.8% increase. Furthermore, the tesamorelin group experienced a 5% decline in liver fat from baseline while the placebo group saw no change. People taking integrase inhibitors in the placebo group experienced a gain in visceral fat despite no change in BMI, while tesamorelin reduced both visceral and liver fat, the researchers concluded.

Taken together, these studies indicate that weight-loss medications hold promise for people with HIV who struggle to lose weight or reduce abdominal fat. But the medications are not without drawbacks, including side effects and cost.

GLP-1 agonists are revolutionizing the treatment of obesity in the general population, and I have no doubt they will do the same in people with HIV, Dr Rajesh Gandhi of Harvard Medical School, commented in a New England Journal of Medicine IDWeek conference update.

Because some people with HIV have fat maldistribution, with disproportionate central adipose tissue hypertrophy, the finding that semaglutide reduces visceral adipose tissue is particularly welcome, he continued. We have known for years that excessive visceral fat is associated with an increased risk for cardiac disease, so the impact of GLP-1 agonists on cardiometabolic health in people with HIV could be substantial.

Venter, however, took a more cautious tone, noting that advocacy will be needed to get the greatest benefits from weight-loss medications for people living with HIV.

In the last few weeks alone, theres been an explosion of new agents, but they are eye-wateringly expensive in rich countries and completely unavailable in low- and middle-income countries, he said at the IAS conference. The levels of cost of these agents and the levels of overweight that were seeing in these communities are going to require some focussed activism in terms of access to these drugs, because theres no way were going to be able to deal with thisWe need to start testing these agents in the HIV-positive population so that we can get access to these drugs for our patients as quickly as possible.

One such study, the SWIFT trial (NCT04174755), is currently underway in Ireland. It compares semaglutide plus a lifestyle intervention against lifestyle changes alone; results are expected in 2025.

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New weight-loss drugs appear safe and effective for people living ... - aidsmap

When you think of building a toned midsection and boosting your strength, complex workout routines and endless crunches often come to mind. Fortunately, that's not necessarily the case. We're here to offer a more holistic, sustainable approach to a slender waistline and increased strength. We consulted Michael Masi, CPT, a certified personal trainer at Garage Gym Reviews, who shares his expert wisdom and pro tips on how to get a slim waist and improve your strength without extreme measures.

Maintaining a healthy weight is more critical than ever. According to the Centers for Disease Control and Prevention (CDC), around one out of three U.S. adults are overweight and 42% are obese. The good news, however, is that fad diets and intense workouts aren't a prerequisite for a trim waistline. You can achieve long-term weight loss through healthy lifestyle habits, like regular exercise and a nutritious, well-balanced diet. And if you want to get stronger, strength training that includes weights or body weight is your answer. Moreover, studies show that strength training is an effective weight-loss strategy.

Your journey toward a slimmer waist doesn't mean compromising your strength or following restrictive diets. The following strategies will reveal the secrets of effective strength training exercises, balanced nutrition, and healthy lifestyle changes that can contribute to your fitness goals.

Read on to learn Masi's pro tips regarding how to get a slim waist and improve your strength. Gear up toembrace a more balanced, strength-focused approach to weight loss. And up next, check out the 7 Best Fast-Digesting Carbs That Will Boost Your Workout.

Losing weight isn't about depriving yourself; it's about making smart choices that create a gap between what you consume and burn, paving the way for a slimmer midsection. "Consume a diet rich in lean meats, fruits, vegetables, whole grains, and healthy fats like nuts, nut butters, and olive oil," recommends Masi. "These foods are much harder to overeat, and if most of your calorie intake comes from these sources, it should help make dieting slightly easier. The ideal strategy for success is a small caloric deficit over one to two months, followed by a small caloric increase to maintain weight. This can be repeated over time to get to lower body weights and reduce more belly fat."

RELATED: People Swear by the '12-3-30' Workout for Weight Loss: 'I Lost 30 Pounds in 10 Weeks'

Say goodbye to crunches and hello to strength training. A 2018 study published in the International Journal of Sports Nutrition and Exercise Metabolism found that a regular strength training routine combined with a balanced diet significantly impacted weight management, regardless of resting metabolic rate.

"Engage in regular resistance training exercises. This will be a stimulus for building or maintaining muscle mass during a diet. Muscle is more metabolically active tissue than fat, so the presence of muscle helps increase metabolism. Muscle is also the tissue responsible for force production, which will be the main stimulus for strength gains," Masi explains.

RELATED: 9 Best Low-Calorie Breakfasts for Weight Loss

Protein isn't just for bodybuilders; it's your secret weapon for a slim waist. Several studies have demonstrated that increasing your protein intake above the recommended dietary allowance promotes weight loss and improves body composition, regardless of total calorie intake. Plus, ensuring you get enough protein helps support muscle growth and repair, enhancing your strength training efforts and promoting a lean physique.

Masi tells us, "Proteins are made up of amino acids, the building blocks of muscle. Asking your body to build or repair muscle without adequate protein is like asking someone to build a house without lumber or bricks. A good range to shoot for is 0.6 to 1.0 grams of protein per pound of body weight."

RELATED: People Are 'Souping' for Weight Loss & Say It Can Get You a Flat Belly Fast

Prioritizing quality sleep is non-negotiable if you want to achieve a slim waist and improve your strength. Research suggests that insufficient sleep can negatively impact weight loss efforts and impede your body's ability to recover following strength training, an essential component of enhancing strength. That's why it's critical to maintain a consistent sleep schedule to support your body's recovery, hormonal balance, and overall well-being. "Aim for seven to nine hours of quality sleep per night," Masi advises. "Poor sleep is linked to weight gain and decreased muscle mass. A consistent sleep schedule helps regulate metabolism and improves recovery, which will be important down the road for diet and exercise consistency."

RELATED: 10 Best Resistance Band Exercises for a Slimmer Stomach

Stress and a slim waist don't go hand in hand. Incorporate stress management techniques into your routine, whether it's meditation, yoga, or a hobby you enjoy. A calm mind contributes to a healthier body, helping you achieve that enviable waistline. According to a 2016 study, reducing stress helps regulate hunger hormones and prevent obesity. 6254a4d1642c605c54bf1cab17d50f1e

"High-stress situations increase cortisol, a chemical commonly referred to as the stress hormone. Chronically high levels of this can lead to difficulty building muscle and weight gain, especially in the abdominal area. Techniques such as meditation, yoga, or simply engaging in stress-relieving hobbies can help you in this department," says Masi.

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How To Get a Slim Waist & Improve Your Strength - Eat This, Not That

We hear so much about people wanting to lose weight, but there are plenty of folks out there looking to add pounds too! Too often, people who are underweight and want to put on weight end up getting left behind in conversation. That may sound easier said than done, but theres a great difference between gaining weight and gaining weightcorrectly.

Certainly, there are no shortage of less healthy ways to gain weight especially if you love junk food. Sure, indulging in soda, chips, and lots of fast-food can do the trick quite easily. Even though this is effective, it is not a long-term fix because doing this increases risk of gaining too much weight, along with higher odds of heart disease, diabetes, and hypertension.

Gaining weight intentionally is fine, but making sure its healthy is imperative.

Everyone has different goals. Simply maintaining weightcan be a great challenge for some. A lot of times, people who want to put on weight may want to do so for three big reasons, although there could be others:

Whether you are underweight in the setting of medical issues or want to put on some weight for the gym gains, the main ideas and ways to get there are the same. Of course, there may be some variation depending on individual circumstances. For this reason, always work with a dietitian on the best course of action for your lifestyle and unique needs.

You hear weight loss fanatics preach the importance of a calorie deficit, but you want to do the opposite if youre looking to gain weight. To do this, youll first need to find your total daily expenditure (TDEE), which measures the amount you need to eat to maintain your weight. There are several different sites, but TDEE Calculator is one of the most reliable tools.

Keep in mind that it is only able to provide an estimate, though. Try to take in 300500 calories more than the number generated for you on a daily basis.

We are not talking about fried foods, but healthy fats. Foods like avocado, olive oil, peanut and almond butters, are all great sources that contain virtually all of their calories from fat.

You dont need a lot to get this benefit, which makes high-fat foods a good choice for someone who wants to take in more calories without feeling super full.

If you usually drink skim milk and eat non-fat Greek yogurt, it may be time to make some changes. For the purposes of weight gain, try whole milk and whole milk yogurt instead. Cheese and full-fat cream are also good dairy choices to include in your diet.

If you are dairy-free, hemp milk typically contains the most calories per cup, coming in at 140 calories.

People struggle with a calorie surplus because they think they are eating more than they actually are, largely because they try to throw food back during three meals and end up feeling full. If you are trying to gain weight, you may find it more beneficial to eat snacks throughout the day to give you more calories and make being in a surplus less intimidating. Nuts, cheese, granola, and dried fruit are all snack ideas that can help.

Protein is the building block of the body. Its imperative for muscle growth, maintenance, and overall development. Protein-rich foods include meats, seafood, eggs, tofu, beans, and more. At the same time, its important to not overdo it as it is the most filling macronutrient.

If you end up being a little too full and satisfied from the protein overload, you may not take in as many calories to support your weight gain.

You may want to gain weight for several reasons, whether fitness, medical-related, both, or something else entirely. Sometimes it can feel difficult to gain weight when there isnt a clear plan on how to do it effectively. Having an idea of your TDEE and eating above that, along with making some dietary tweaks like eating more fat, protein, and eating more often, are some of the most effective nutrition tools. Individualized advice varies, so this is just general guidance. Work with a registered dietitian to establish a path with your unique needs in mind.

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Trying to gain weight? 5 tips from a dietitian for adding on pounds - Study Finds

Many of us already have our daily routines set in stone. In these routines, there are certain habits we religiously followsome of them good, others not-so-good. We here at Eat This, Not That! did some digging and spoke with an expert who calls out some of the most surprising habits that can seriously damage your body.

In order to lead a healthy lifestyle and avoid injury or long-term damage, it's important to kick these bad habits to the curb. Keep reading to learn all about them, and when you're finished, be sure to check out People Swear by the 30/30/30 Plan for Weight Loss: 'Completely Changed My Body'.

Some of the more surprising habits that can damage your body and hinder long-term fitness or weight loss progress happen at the gym. Tyler Read, BSc, CPT, the founder of PTPioneer.com and a personal trainer who has been involved in the health and fitness world for the past 15 years, explains, "Focusing too much on isolation exercises (like bicep curls or leg extensions) and neglecting compound movements (like squats or deadlifts) can lead to muscle imbalances and a lack of functional strength. Over time, these imbalances can cause postural issues and increase the risk of injury during everyday activities."

RELATED: The #1 Protein to Eat for Weight Loss, According to a Dietitian

Let's be honest: Remembering to take a break from a busy workday to fill up your water glass can be challenging. However, drinking sufficient water during the day is so important. 6254a4d1642c605c54bf1cab17d50f1e

"It's well known that you should stay hydrated, but chronic slight dehydration, which may not be immediately noticeable, can affect your muscles' ability to repair themselves and lead to a gradual decrease in strength and endurance," Read explains. "Over time, this can contribute to kidney stones and even kidney damage due to the increased concentration of urine."

RELATED: 7 Best Ways To Burn 500 Calories, According To Personal Trainers

While many fitness pros advocate for static stretching to increase your flexibility, too much of anything is never a good thing. Over-stretching before strength training can temporarily reduce your muscle strength, along with stability in your joints, potentially resulting in injury, Read says. "Dynamic stretching is generally recommended to prepare for activity," he adds.

RELATED: People Swear by the '12-3-30' Workout for Weight Loss: 'I Lost 30 Pounds in 10 Weeks'

Just as much as you can over-train a muscle group, you can also under-train it. "Everyone knows about the risks of over-training, but under-training can be just as harmful," explains Read. "Neglecting to train the back and core adequately, for instance, while focusing on more visible muscle groups like the chest and arms, can lead to a weak foundation, poor posture, and chronic back pain."

When it comes to workout goals, grip strength likely isn't at the top of your mindbut ignoring it altogether can result in a few pitfalls. "Grip strength is often an afterthought in workouts, but over time, a weak grip can limit your ability to perform key exercises, leading to diminished results and an increased risk of accidents or dropping weights," Read tells us.

RELATED: 10 Things You Should Do Every Morning for All-Day Energy

If you typically utilize a weight belt in your workouts, beware of misuse. "Weight belts are commonly used to support the lower back during heavy lifts, but relying on them too much can lead to weakened core muscles," says Read. "This can paradoxically increase the risk of lower back injuries over time, as the body becomes accustomed to the artificial support."

Many of us are guilty of letting our bed sheets extend a bit beyond a week before tossing them in the wash. However, not washing them for an entire weekand beyondcan seriously harm your body and overall health.

According to research performed by Amerisleep, one-week-old pillowcases contained 3M colony-forming units (CFUs) per square inch17,442 times the amount of bacteria you would find on a toilet seat! Pillowcases that went two weeks without a wash jumped up to harboring 5.98M CFUs. When it came to bed sheets, those that weren't washed for a week contained 5M CFUs24,631 times the amount of bacteria you would find on a bathroom door knob.

Not washing your sheets for a full week, week after week, can lead to a vicious cycle of hurting your health and wellness. The research also pointed out that one of the types of bacteria you could find on your bed is called "gram-negative rods," which can result in antibiotic resistance.

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Alexa Mellardo

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7 Surprising Habits That Seriously Damage Your Body - Eat This, Not That

People with type 2 diabetes (T2D) lost more weight by eating whatever they wanted, but only during an eight-hour window, than people who were instructed to cut their calories by 25 percent, according to a new study published today in JAMA Network Open.

Both groups had similar reductions in long-term blood sugar levels, as measured by a test of hemoglobin A1C, which shows blood sugar levels over the past three months.

Our findings show that time-restricted eating [also called intermittent fasting] is a good alternative to calorie counting for people who cant do the traditional diet or are burned out on it, says the study's senior author,Krista Varady, PhD, a professor of nutrition at the University of Illinois in Chicago. For many people trying to lose weight, counting time is easier than counting calories, she says.

This study demonstrates that time-restricted eating can lead to modest weight loss in individuals with type 2 diabetes, says Sun Kim, MD, an associate professor of medicine and an endocrinologist who specializes in the treatment of T2D at Stanford University Medical Center in California. Given that the instructions for time-restricted eating are fairly simple to give and follow, this is a nice option to discuss with patients, says Dr. Kim, who was not involved with the research.

It's estimated that about 1 in 10 U.S. adults has T2D, according to the Centers for Disease Control and Prevention (CDC). If current trends continue, by 2050, 1 in 3 people will have the disease.

Weight loss achieving a healthy weight through dietary changes, physical activity, weight loss medications or procedures like bariatric surgery can reduce blood glucose levels and in some cases even lead to T2D remission. Thats why innovative strategies to help people achieve and maintain a healthy weight are critically needed, according to the authors.

To explore whether time-restricted eating is a more effective way to lose weight and improve blood sugar than calorie restriction, investigators enrolled 75 participants with an average age of 55 years old, an average BMI of 39, and an HbA1C level of 8.1 percent.

As the name suggests, time-restricted eating is when food and liquids containing calories are consumed only during certain hours of the day. Most time-restricted eating studies to date have looked at eating windows between 4 and 12 hours long.

A total of 53 subjects were women, 40 percent were Hispanic, 53 percent were Black, 5 percent were white, and 1 participant was Asian. The higher-than-normal percentage of Hispanic and Black participants in the study is notable because diabetes is prevalent among those groups, so having studies that document the success of time-restricted eating for them is particularly useful, the researchers said.

According to the American Diabetes Association, the rates of diagnosed diabetes are:

Participants were split into three groups: those who followed the time-restricted eating rules, those who restricted calories, and a control group who didnt change how they ate.

The time-restricted eating group ate whatever they wanted between 12 p.m. and 8 p.m. each day they werent asked to count calories or eat certain types of food. During the 16-hour window of fasting, they were encouraged to drink lots of water and were allowed to drink calorie-free beverages. They kept a log and recorded the times when they started and stopped eating each day.

The people in the calorie restriction group were instructed to reduce their calorie intake by 25 percent according to their baseline energy need, which was calculated at the start of the trial. That means if a person needed 2,000 calories to perform basic life-sustaining function, their goal was to cut that by 500 calories and consume only 1,500 calories per day. People in this group met with a dietitian at the start of the study who helped them develop individualized weight loss meal plans and log their food intake into an app every day.

Participants weight, waist circumference, blood sugar levels, and other health indicators were measured throughout the trial.

In six months, the time-restricted eating group lost 3.6 percent of their body weight, and the calorie-counting group lost 1.8 percent of the body weight compared with the control group. Both groups reduced their HbA1C by 0.9 percent.

We were surprised that the calorie restriction group did not lose more weight. In most studies looking at people with obesity, the time-restricted eating and calorie restriction groups lose the same amount of weight, says Dr. Varady.

Varady suspects it boils down to three reasons. Looking at the adherence data, the time-restricted eating group was more adherent to their diet than the calorie restriction group, she says. At least part of that may be because patients with diabetes are generally told to cut back on calories by their doctors as a first line of defense, so many of these participants likely had already tried and struggled with that form of dieting, according to the authors.

Also, most participants in the time-restricted eating group reported that the diet was easy to follow, and at least half the participants in the calorie-restriction group reported the diet was difficult to follow, says Varady.

And finally, it could come down to numbers: The calorie-restriction group reduced their intake by an average of only 197 calories per day, while the time-restricted eating group reduced their intake by 313 calories per day.

Intermittent fasting is trendy, and people are eager to try it, says Dr. Kim. I think there is better data for earlier time-restricted eating (eating between 8 a.m. to 4 p.m.). However, this time period is harder to adapt, as dinner is a very social meal in our society, she says.

In Kims experience, the success of intermittent fasting (as with many other weight loss interventions) is variable. Many patients do find it difficult to maintain long term. In the study, people were adherent about six days per week, she says.

The findings also highlight that losing weight isnt easy, says Kim. The weight loss for the time-restricted eating group was modest (less than 4 percent) compared with effects from currently available GLP-1 receptor agonist medications like Ozempic, Wegovy, and Mounjaro, approved for diabetes and weight loss, she says.

Varady and her team were also surprised that even though weight loss was different, the HbA1C reduction and mean glucose reduction was the same. This might be because though the two groups lost different amounts of weight, they had similar reductions in their visceral fat and their waist circumference. We speculate that this might be why their blood sugar improved similarly, even though the weight loss was different on the scale, she says.

Many experts believe that belly fat is just as important as BMI. Too much belly fat not only increases T2D risk, its also associated with a higher risk of heart disease and stroke, per theCDC.

Kim points out that there are many variables that impact blood sugar, including the tweaks made to diabetes medications, which seemed to be greater in the time-restricted eating group. Perhaps the greater surprise is that patients in calorie restriction had a meaningful decline in A1C. This may be a tribute to working with dietitians to reduce carbohydrate intake, she says.

There were no serious adverse events reported during the six-month study. Occurrences of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) did not differ between the diet groups and control groups.

The study was small and should be followed up with larger ones, says Varady. While this acts as a proof of concept to show that time-restricted eating is safe for people with T2D, they should consult their doctors before starting this sort of diet, she adds.

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Intermittent Fasting Leads to More Weight Loss in Type 2 Diabetes ... - Everyday Health

Phentermine-topiramate is the most cost-effective weight-loss treatment approved for adolescents, according to the results of a recent study published in JAMA Open Network. Although semaglutide resulted in more weight loss, the clinical benefits do not outweigh the higher cost, according to the study authors.

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Our findings suggest that, as a weight-loss treatment for adolescents, the relatively low-cost phentermine-topiramate will both place smaller demands on health care budgets and offer better value for money, the study authors wrote.

Childhood obesity increases the risk of adult obesity and serious comorbidities. Currently, more than 50% of children will have obesity by 35 years of age. As of January 2023, American Academy of Pediatrics (AAP) guidelines recommend children aged 12 years and older take antiobesity agents to prevent obesity in adulthood.

Unfortunately, many US insurance plans still do not provide coverage for weight loss drugs. There are still a lot of unknowns associated with this medication class, given the limited hard data supporting long-term efficacy, or studies evaluating post-treatment weight rebound.

Investigators conducted a modeling study of 10,000 pediatric patients aged 12 to 17 years with severe obesity to evaluate the cost-effectiveness of 4 antiobesity drugs (orlistat, liraglutide, semaglutide, and phentermine-topiramate) approved for pediatric use, relative to the cost efficacy of no treatment. Currently, orlistat and phentermine-topiramate cost between $1500 to $8500 annually, with semaglutide and liraglutide costing upward of $12,000.

The team measured cost effectiveness by quality-adjusted life-years (QALYs). Relative to no treatment, the cost effectiveness of phentermine-topiramate was $93,620 per QALY, which was within the average willingness-to-pay threshold ($100,000 to $150,000/QALY) of patients.

Semaglutide, which is the most effective anti-obesity drug with the highest QALYs, had an incremental cost-effectiveness ratio of $1,079,480 per QALY, costing significantly more than the willingness-to-pay threshold. And after further evaluation, the benefits for weight loss did not justify the cost of the product.

In addition, neither orlistat, which cost more than phentermine-topiramate and semaglutide, or liraglutide, which was not as effective as the 2 treatments, can ultimately be considered cost-effective weight loss agents.

AAP guidelines also recommend bariatric surgery for children aged 13 years and older with obesity, therefore, investigators conducted a sensitivity analysis to evaluate the cost-effectiveness of sleeve gastrectomy and gastric bypass surgeries. They also analyzed metformin hydrochloride in this assessment.

Neither type of bariatric surgery was as cost-effective as antiobesity medication, according to the study. In addition, metformin became the least costly agent when compared to the other 4 drugs, but it was also less effective than phentermine-topiramate, making the incremental cost-effectiveness ratio $64,000 per QALY. In addition, it is not FDA-approved for this indication or population and is not currently a plausible weight loss option for adolescents.

The sensitivity analysis also worked to highlight the potential cost effectiveness of medication that lasts into adulthoodin hindsight, investigators suggest that the current cost effectiveness ratios may not be high enough.

Study limitations include the absence of long-term efficacy data and having a majority female and White cohort. In addition, drug efficacy information came from different trials. Previous studies link semaglutide and liraglutide to the risk of thyroid cancer and phentermine-topiramate to birth defects; and the model did not capture all associated benefits of semaglutide.

Further research is needed to determine long-term drug efficacy and how long adolescents continue treatment, the authors concluded.

Reference

Mital S, Nguyen H. Cost-Effectiveness of Antiobesity Drugs for Adolescents With Severe Obesity. JAMA Netw Open.2023;6(10):e2336400. doi:10.1001/jamanetworkopen.2023.36400

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New Study Heralds Phentermine-Topiramate as Most Cost-Effective ... - Pharmacy Times

Author: Expert reviewer:

October 24, 2023

Registered dietitian

Registered dietitian

Rachael Ajmera, MS, RD is a registered dietitian and writer based in San Francisco. She holds a master's degree in Clinical Nutrition from New York University and an undergraduate degree in Dietetics.

Expert review by

Registered Dietitian

Lauren Torrisi-Gorra, MS, RD is a registered dietitian, chef, and writer with a love of science and passion for helping people create life-long healthy habits. She has a bachelors degree in Communication and Media Studies from Fordham University, a Grand Diplme in Culinary Arts from the French Culinary Institute, and master's degree in Clinical Nutrition and Dietetics from New York University.

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October 24, 2023

These days, protein powder is synonymous with gym gains and increasing muscle mass. However, mixing protein powder into your shakes and smoothies can assist with weight loss too.

We reached out to a few experts to get the inside scoop (pun very much intended) on protein powder for weight loss, including how it works to improve body composition, how to consume it, and which types are best.

If weight loss is your goal, squeezing extra protein into your diet might be beneficial. That's because a higher protein diet can increase feelings of fullness, which can help prevent overeating, according to Rachel Adamkowski, MPH, R.D., a sports dietitian and assistant director of football nutrition for the University of Florida.

Research also suggests that protein could alter levels of certain hormones in the body that control hunger and appetite, which may translate to decreased food intake.

Stacy Sims, MSC, Ph.D., an exercise physiologist who specializes in nutrition science for women, tells mindbodygreen thatincreasing your intake of protein could also improve your body composition byreducing fat mass while preserving lean body mass. "With higher protein intake, even if [your] calorie intake is too low, the circulating amino acids stimulate the brain to keep and build lean mass," she explains, noting that this can lead to the breakdown of fat.

Plus, Sims says that protein can also boost your energy expenditure, or the number of calories you burn each day at rest, which is partly because protein requires more energy to digest than carbs or fat. "Protein intake [also] prevents a decrease in fat-free mass, which helps maintain resting energy expenditure despite weight loss," notes Sims.

Of course, loading your plate with plenty of protein isn't a sure-fire solution for weight loss. This is because there are lots of other factors at play, including how much you're eating and moving and what the rest of your diet looks like.

At the very minimum, individuals should be getting 0.8 gram of protein per kilogram of body weight (g/kg/bw), which is the recommended dietary allowance (RDA) for protein. However, this is likely far short of what active individuals will need. Many experts now recommend getting roughly 1.2 to 2.0 g/kg/bw. This comes out to upward of 100 grams of protein a day for most people.

Protein can support weight loss by promoting feelings of satiety, helping preserve lean muscle mass, and increasing energy expenditure. However, many other factors affect weight loss, including the amount of exercise you get and the quantity and quality of food in your diet.

While it shouldn't be used to replace other protein-rich foods in your diet, protein powder can be a convenient way to rev up protein intake, notes Mike T. Nelson, CSCS, CISSN, MSME, Ph.D., a human performance specialist.

Nelson says that using protein powder can also make it easier to stick to a high-protein diet, leading to greater results in the long run. Plus, Adamkowski tells mindbodygreen that adding a scoop of protein powder to foods you already eat can help create more balanced meals and snacks, especially if you're having a hard time meeting your protein needs through food sources alone.

Protein powder can also be a great choice after an intense sweat session. "Protein powder can be helpful for getting protein to your muscles after a workout to begin to repair and rebuild, especially if it will be over an hour until your next meal," says Adamkowski.

Of course, keep in mind that not all protein powders are created equal. In fact, many on the market are pumped full of added sugar or other additives that can sneak in extra calories, which can hinder your weight loss efforts. Similarly, going overboard on the high-fat or sugary add-ins when whipping up your protein shake can drive up the total calorie content, contributing to weight gain.

Therefore, it's best to pair protein powder with other nutrient-dense ingredients whenever possible, such as fruits, veggies, nuts, and seeds.

Protein powders are a convenient way to increase your protein intake, especially after a workout. If weight loss is your goal, avoid consuming protein powders with added sugars or other additives.

You can use any type of protein powder you'd like to bump up your protein intake and round out your diet. However, while a lot of the research on protein for weight loss has focused on high-protein diets rather than supplements, some types of protein powder have been more well studied than others. Here are a few of the top varieties to consider:

1 .

2 .

3 .

Egg white protein (sourced from egg whites) is another solid option, especially if you prefer to steer clear of dairy. While there aren't a lot of human studies on its effectiveness, research suggests that egg protein ishighly digestible and rich in essential amino acids, which are amino acids that your body must obtain through food sources. Plus, egg protein might also help reduce appetite, leading to decreased food intake and increased weight loss.

4 .

With so many different choices available, stepping into the supplement aisle can feel overwhelming. It doesn't help that protein powders are also often paired with other supplements, such as creatine, L-carnitine, or caffeine.

Here are a few of the top factors to consider when shopping for a protein powder for weight loss:

If you're looking for an easy way to kick up your protein intake, protein shakes are a great option. Plus, you can also throw in a few other ingredients to help support weight loss, including fiber-rich fruits, veggies, nuts, or seeds. Here are two tasty recipes to try whipping up at home.

Add all ingredients to a blender, pulse until smooth, and enjoy!

Add ingredients to a blender and pulse for at least 30 seconds, or until combined.

Although adding a scoop of protein powder here and there might seem like a simple way to shed a few pounds, many argue that it probably shouldn't be a mainstay in your meal plan.

According to Sims, sticking to a "food first" approach is best, as protein-rich foods provide a variety of other important nutrients, such as fiber. This can help support a diverse gut microbiome,which is critical for weight loss. High-protein foods can also provide other nutrients needed to maintain overall health, including vitamins and minerals.

Additionally, keep in mind that protein is just one piece of the puzzle, regardless of whether it's coming from foods or supplements. While upping your intake can be a useful tool to promote weight loss, there's a good chance it won't have much of an impact if you're not making any other changes to your diet or lifestyle, like doing more resistance training.

Similarly, pairing protein powder with other ingredients high in added sugar, fat, or calories is unlikely to lead to long-term results.

There is strong research to show that increasing your protein intake can help you lose weight while retaining all-important muscle. Protein powder supplements make it easy to reach your protein needs (likely over 100 grams a day) if you're low on time or energy.

The more straightforward your protein powder, the better. As Nelson notes, most protein supplements aimed specifically at weight loss aren't super effective, and research often focuses on their short-term effects. While some of these ingredients might offer some small benefits, your results can also vary quite a bit depending on how you're using them, the dosage, and your specific goals.

Instead, we recommend sticking with a protein powder that is low on additives and third-party tested. The content of protein powder is also important. Look for ones that have at least 2.5 grams of leucine per serving to engage muscle growth.

Protein powders (and protein in general) can't guarantee fat loss. It's essential to pair them with an overall healthy lifestyle that contains plenty of movement, resistance training, and nourishing foods.

While protein powder is generally considered safe and healthy, it's a good idea to check the label carefully and steer clear of any funky additives or ingredients if you're pregnant or breastfeeding. Additionally, note that a high-protein diet is not typically recommended for people with certain health conditions, such as chronic kidney disease.

If you've been advised by a doctor to scale back on your protein intake, it's probably best to take a pass on the protein powder.

Protein powder can be a great option to help women meet their protein needs, which could be beneficial for weight loss. Because protein requirements tend to increase during certain phases of your menstrual cycle, during pregnancy, and as you get older, it can also help you fill any gaps in your diet to ensure you're meeting your needs.

Increasing your protein intakefrom either foods or supplementscan support weight loss. While whey protein is probably the most well-studied variety of protein powder, the best protein powder for weight loss can depend on many factors, including your dietary preferences, needs, and goals.

According to Adamkowski, consuming protein powder after working out can help repair and rebuild the muscles, which could support muscle growth. Adding a scoop to the foods you already eat or whipping up a protein shake for a healthy snack between meals is also a great way to boost your protein intake, which may promote weight loss.

While protein powder shouldn't be a substitute for a healthy, well-rounded diet, it can be a useful tool to help keep you feeling full between meals, which may lead to weight loss. For best results, be sure to pair your protein powder with a variety of other nutritious ingredients and enjoy it in moderation as part of a healthy diet. Additionally, keep in mind that protein powders don't supply the same essential nutrients as whole foods. Check out this article for a few of the best high-protein foods to add to your diet.

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Protein Powder For Weight Loss: Why It Works & Pro Tips ... - mindbodygreen

Governor Kathy Hochul sanctioned a new state law Thursday, restricting the sale of non-prescription diet pills and weight-loss supplements to those under 18. With this move, New York becomes one of the pioneering states, placing stringent checks on the expanding weight-loss industry from targeting minors. The legislation mandates businesses, inclusive of online retailers, to instate age-verification protocols to deter the sale of these products to children. Violators could face repercussions like a court-mandated sales pause until age-verification is established and fines reaching up to $500 per infringement. Other states, like Colorado, have already instituted similar bans, with California eyeing comparable restrictions.

The concerns propelling this legislation are multi-faceted. An alarming 20 million women and 10 million men in the U.S. grapple with some form of eating disorder. New York alone witnesses over 1.7 million of its residents nearly 9% confronting these challenges at some juncture in their lives. These disorders exact a hefty toll, both emotionally and economically, costing New York an estimated $3.9 billion annually in direct medical expenses and lost productivity. Nationwide, over 10,000 fatalities annually are directly attributed to eating disorders. Added to this, some businesses have been called out for deceptive marketing practices, such as using fabricated celebrity endorsements to push diet pill sales.

While this new law curtails over-the-counter weight-loss solutions, the demand for regulated prescription anti-obesity drugs has surged. The influx of these newer medicines in the market comes with hefty price tags, often upwards of $1,000 monthly per user. Such costs have sparked debates about long-term affordability and insurance coverage. Furthermore, once commenced, these medications necessitate indefinite consumption to maintain weight loss benefits. Concurrently, recent guidelines from medical bodies, like the American Academy of Pediatrics, advocate for aggressive treatments, even suggesting medications for children as young as 12 in certain circumstances.

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Incorporate fibre-rich foods like vegetables, berries, chia seeds to maintain regular bowel

The ketogenic diet, or keto diet for short, is a low-carbohydrate, high-fat diet. Its main principle is to drastically reduce carbohydrate intake and replace it with fat, forcing the body into a state called ketosis. In this state, the body starts utilising fat as its primary energy source instead of carbohydrates.

When carbohydrates are limited, the body starts breaking down stored fat into molecules called ketones, which are then used for fuel. This metabolic process can lead to weight loss as the body burns its fat stores.

Research suggests that the keto diet may help with weight loss, as it can decrease appetite, increase satiety, and enhance fat burning. However, its effectiveness may vary for individuals, and long-term adherence can be challenging. Read on as we share tips to keep in mind when following the keto diet and who should and shouldn't follow it.

Familiarise yourself with the fundamental principles of the keto diet, which involves reducing your carbohydrate intake and increasing your fat consumption.

Determine the appropriate macronutrient ratios for your specific needs. This typically entails consuming around 70-75% of your calories from fat, 20-25% from protein, and 5-10% from carbs.

Opt for healthy fats like avocados, nuts, seeds, olive oil, and coconut oil. Avoid trans fats and heavily processed oils.

Aim for high-quality proteins such as lean meats, poultry, fish, eggs, and plant-based sources like tofu and tempeh.

Strictly limit your daily carbohydrate intake to approximately 20-50 grams to maintain ketosis. Focus on consuming low-carb vegetables and fruits.

Drink plenty of water throughout the day to support digestion, metabolism, and overall health.

Incorporate fibre-rich foods like vegetables, berries, chia seeds, and flaxseed to maintain regular bowel movements and promote gut health.

Many packaged foods may contain hidden carbs, so read labels carefully to avoid accidentally exceeding your daily carb limit.

Adhering to the keto diet consistently is crucial for achieving and maintaining ketosis. Avoid cheating or straying too far from your meal plan.

The ketogenic diet may not be suitable for everyone, and it is always important to consult with a healthcare professional before starting any diet or lifestyle change. However, there are a few situations where it is generally not recommended to follow a ketogenic diet.

Ultimately, it is best to consult with a healthcare professional or a registered dietitian to determine if the ketogenic diet is suitable for individual circumstances and goals.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Weight Loss Tips: Things To Keep In Mind When Following The Keto Diet - NDTV

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