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AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts inmedicineon COVID-19, medical education, advocacy issues, burnout, vaccines and more.

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Fatima Cody Stanford, MD, MPH, MPA, MBA, an obesity medicine physician at Mass General Hospital and associate professor at Harvard Medical School in Boston, talks about redefining obesity as a brain disease rather than a consequence of poor health choices. American Medical Association Chief Experience Officer Todd Unger hosts.

Unger: Hello and welcome to the AMA Update video and podcast. Today we're talking about redefining obesity as a brain disease rather than a consequence of poor health choices. I'm joined today by Dr. Fatima Cody Stanford, an obesity medicine physician at Mass General Hospital and associate professor at Harvard Medical School in Boston, who is leading this charge. I'm Todd Unger, AMA'S Chief Experience Officer in Chicago.

Dr. Stanford, thanks so much for being here today.

Dr. Stanford: Thanks so much for having me, Todd. It's a delight to be with you.

Unger: Well, I've seen you all over the news in the past few weeks. I appreciate you taking the time to talk with us today. Well Dr. Stanford, let's jump right in here. Most of us have been given this message that if we eat right and we exercise and of course, have a decent amount of willpower, that we're going to be able to achieve and maintain a healthy weight. But your research has shown that the reason that some people can't lose weight may have more to do with brain chemistry than anything else. Let's talk about that.

Dr. Stanford: I think this is an extremely important question, Todd. I'm so glad that you asked this. And let me tell you, I was part of that camp that believed that it was just about how much exercise you did, how you ate. And I would even say this to my patients in the past without me understanding how complex the brain is in regulating our weight.

And I'm just going to talk about this in terms of two pathways. There's a pathway of our brain called the POMC pathway that tells us to eat less and store less. For people that signal really great down this pathway, they tend to be very lean, not struggle with their weight in the same way that people that have excess weight do, and they travel down an alternate pathway. It's called the AgRP or the agouti-related peptide pathway, and that pathway tells us to eat more and store more.

Now when we talk about the brain, we have to recognize that the brain is interacting with our environment. So some people are very sensitive to the environment. So one person might walk down the street, pass a pizza place, and they feel like just walking past that pizza place, they gained five pounds, right? That's a bit of an exaggeration and not actually the case, but what they are honing in on is that their body is more sensitive to the environment in which they exist than maybe another individual, someone that signals well down that POMC pathway. And so that's part of the complexity of this disease that we call obesity.

Unger: Now it's interesting, I want to talk about this concept of the set point, which I pay a lot of attention on this and I always think about the set point as being something about your body that it does. But in your words, it's really about the brain telling us how much fat to store. Can people develop a new set point if they gain or lose weight, and like all those millions of people who gained weight during COVID, did they develop a new set point?

Dr. Stanford: You know, absolutely. The set point can be changed. And I actually want to look at itI know set point sounds better, but it's more of a set range. And so let's think about ourselves. Just think about yourself, whoever you are, and you might notice that you tend to stay within a five to ten pound range of what your baseline is.

Now there are times when you might go up. Maybe during the holiday season, you're like, ooh, I'm a little bit outside of that range. And your body kind of recalibrates and you get back into that zone of what the body sees as comfortable. Even if you carry excess weight, let's say that your baseline is 250 pounds and you get up to about 260, and your body is like nope, I'm pushing it down back to 250. So you may not have had to do anything really significant except to shift back into whatever your norm is. And so this is the idea of set point.

Now notice, I didn't say anything about what the person did. A lot of the body's recalibrating them back to a certain weight, and so when we talk about people that have really a lot of excess weight, let's say those patients that come into me that weigh 500 poundsmost of us, no matter how hard we tried couldn't push ourselves up to 500 pounds. Our body would do something. And maybe we'd get to 300, but not 500. For most of us, our bodies will push us back into a range like, yeah, you may have gained 100 pounds, I can't make you gain 300 pounds. It's just a certainit's like the body is tightly defining itself to where it wants to be.

So what happens often, particularly with lifestyle interventions, let's say you go on a diet, which I'm not a fan of going on a diet, but let's just say you do that. You notice you lose weight, you're feeling really great, but then as you get down to this lower what you feel is a different set point, your body is resisting it. And you start noticing weight gain. And you're like, well, wait a minute, but I'm doing all the right things.

What happens is your resting metabolic rate drops dramatically. And when it drops dramatically, the body can't defend itself down there. The brain is like, this isn't where we're supposed to be anyway. And so your body typically creeps back up to where it was before, much to your dismay, not because you did something wrong, but because it deviated from where the brain felt it should be. And so that's the concept of set point or as we're redefining it, set range.

Unger: So just hearing you, it just brings all the challenges that we hear about in terms of weight loss. So I guess the question is, how do we treat obesity? I know a lot of the news these past few weeks and months is focused on how some physicians are approaching that with pharmaceuticals. Let's talk a little bit about what are these drugs, and what do they do in the brain to help patients who have obesity?

Dr. Stanford: So different ways to treat obesityI know the media has kind of made it seem like it's one-sided or one thing, but there are different things that different people need. We have to recognize that we're heterogeneous. None of us are exactly alike. The two of us sitting here, there may be some things that are similar, we're both human. But there may be other things that are very, very different that make our bodies respond differently to different things.

So we have this bucket lifestyle modification, things that we can do from a lifestyle perspective. And then let's go over to this bucket of medications or anti-obesity medications. And all of the medications that are available for use, either short-term or long-term, approved by the FDA, actually are often working on the brain.

The drug class that we hear a lot about is called the GLP-1s, or the glucagon-like peptide 1 receptor agonists. Say that five times fast. And they actually do exactly what we talked about a little bit earlier. Let's talk about the brain and why they are so, on average, effective for many people. Notice I didn't say everybody, and for many means that's not everyone, but for many people, they're effective because they do two key things in the brain. They upregulate that pathway, that POMC pathway that tells us to eat less and store less, and it downregulates that pathway of the brain that tells us to eat more and store more.

So when people take these medications, they'll notice, wait a minute. This doesn't feel like I'm having to work because we've changed how the brain sees weight. And that's how that mechanism works.

Now, there are other drugs that are out there that are outside of that class like phentermine, which has been around since 1959. That drug inhibits something called norepinephrine reuptake within the brain. Or topiramate, which stimulates something called GABA, or gamma-aminobutyric acid in the brain. So notice, we keep getting back to the brain. All of these things are working on different parts of the brain to change how the brain sees weight.

Unger: Now, let's talk a little bit more because I think what's been in the press a lot lately are people that are getting access to drugs like this to lose weight, fit in a dress, whatever you want to say, kind of celebrity-type drugs. The bottom line is they're expensive, and a lot of them are not covered by insurance, and they can become very hard to come by now because so many people are using them, let's just say, for weight loss. How do we make sure that the people who really need drugs like this can get them?

Dr. Stanford: This is a really complicated question, and the reason why it's so complicated is because we do have this issue with access and insurance coverage and the proper prescribing of these medications, right? These are medications that are used to treat two primary conditions, obesity and persons that have a history of type 2 diabetes. There is also some indication for people that have type 1 diabetes, although not as well defined.

So if we know that these are the patient populations that we're targeting, then obviously, there should be preferential use of these medications within those cohorts. We have to recognize that for obesity, these medications aren't often well covered by insurers, whether that's private insurers, public insurers. However, when patients do have type 2 diabetes, they often are covered.

There's the disparity between which disease process is more important, although I will acknowledge that when we're looking at type 2 diabetes, we know that 80% of patients with type 2 diabetes also have obesity. So we have to recognize that there's much of an overlap in these disease processes.

For the Hollywood community and the group that's going to just get on these just to look cute in a dress or look great for a reunion or a wedding, I would really push back on those individuals. There's been a major shortage of these medications for both type 2 diabetes and obesity that's persisted throughout 2022, for example. And as we go into 2023, we're seeing slight improvement in access, but I can tell you that from day-to-day, one of my biggest pain points with my patients is my patients not being able to get the medication that they need, they deserve, and that is used to treat their disease.

So I think equity is important. So we need to make sure that the people that need and deserve these medications, the people that actually have indication for the use of these medications are getting them. But that is going to take a bigger community. It's going to take insurers, private insurers, public insurers really making sure that the people that deserve and need access actually get them and not just the people that have the wherewithal, the means by which to acquire these medications.

Unger: Dr. Stanford, obviously drugs are not the only option, especially if a person can't afford a prescription or if it interferes with other medications or they just don't want to take a pharmaceutical approach. You've outlined a lot of the challenges here that are reality. What are the non-pharmaceutical forms of treatment that you recommend?

Dr. Stanford: Absolutely. This is a really great question, and I think it's important for us to recognize that medications, pharmacotherapy for obesity are not the only treatment option. We do start with obviously looking at lifestyle considerations. I mean, this is always our first go-to, looking at things like diet quality, where we have lean protein, whole grains, fruits and vegetables, and optimizing that to fit the individual person, recognizing that different people require different macronutrients than others.

Looking at physical activity, one of my favorite pastimes, and recognizing that we need at least 150 minutes of moderate intensity physical activity per week. But for some of us, we may get even more than that. We may see, for me, I'm a big high-intensity interval training person. But think about finding the right workout for the individual. A lot of times, particularly as physicians, we impose on individuals what we think they should do, as opposed to listening to them about what things they enjoy doing so that they can do them long-term.

It's important to recognize that sleep quality and duration plays a large role. A lot of people have disordered or disregulated sleep or changes in their circadian rhythm. And by that, maybe they're night shift workers, and they notice that as a night shift worker, they have gained weight. And so sometimes it's shifting into a normal pattern, being awake when it's bright outside, and asleep when it's dark outside that we see weight shifts.

Medications that we as doctors and other health care providers prescribe can lead to major weight shifts. Medications like lithium, Depakote, Tegretol, Celexa, Cymbalta, Effexor, Paxil, Prozac, Ambien, trazodone, Lunesta, gabapentin, glyburide, glipizide, glimepiride, long-term insulin, long-term prednisone, just to name a few medications that can lead to weight disregulation. Many of those medications acting on the brain, remembering that the brain is the primary regulator in where our bodies see weight. So those are important.

It's also important not to discount the role of metabolic and bariatric surgery for those with very severe obesity. We find that that implementation and/or intervention has the highest impact on changing weight status for individuals across the age and life course that struggle with severe obesity and obesity-related disease. And so there's different strategies.

Now, for many of my patients Todd, I will tell you that they have a combination of all of the things we just mentioned. Maybe they had surgery, maybe they are on medications, maybe they have lifestyle interventions, and maybe they may have been resistant to considering any of those things at the outset, and then over time, they recognize their body's resistance to change with any one intervention.

Unger: And that's quite a list of different interactions that you laid out in that list of drugs. You've obviously had practice in saying that. Something we talked about earlier, too, you mentioned the overlap between obesity and diabetes, in that case. Let's talk a little bit about what we're facing here. I mean, there's obviously a public health problem with both hypertension and pre-diabetes that's now exceeding 90 million people in the U.S.

And that's why, at the AMA, we've been working with clinical teams and health systems to address these two conditions. What are your thoughts on how physicians can help their patients with these conditions and obesity, and if obesity is a brain disease, how do lifestyle-change programs fit into that comprehensive total treatment plan?

Dr. Stanford: This is a great question, and I think one of the key things I want to point out, Todd, is the overlay between all of these conditions. We have over 110 million adults with obesity in this country as of today. You talked about 90 million with pre-diabetes, hypertension, et cetera. But what we do know is that there's a lot of overlay and a lot of interaction between each of these individual entities, these different disease processes.

And so we have to recognize that, first of all, we have two different camps of individualsthose that were trying to prevent developing more significant disease, and then those that already have these diseases that now intervention is key. And so we have to recognize that we want to prevent those that are in the pre-obesity range, the pre-diabetes range from developing more significant disease, but we can't discount the fact that we have these huge numbers of individuals that already have these conditions. And as physicians we have to be at the forefront of really setting the charge and treating these patients with dignity, respect, valuing them and where they are today, and making sure that they have the best and healthiest life going forward. So I think that's really key for us to recognize.

We can't assume that one thing that works for one person will work for everyone. We have to recognize, going back to that heterogeneity of who we are, different things, even within the same family, may work differently. And it's OK. It's just about finding the right treatment for the right person at the right time to get them to the healthiest person they can possibly be.

Unger: And we're just been talking really primarily about adults, but we know that obesity is not just an adult problem. In fact, again, lots in the news recently about thisit's affecting one in five children, and I'm sure a lot of parents out there have questions about how to help their children live a healthy life. What should pediatricians be telling parents about how to manage their children's weight, and also how to talk to their kids about it?

Dr. Stanford: As a pediatrician also, I'm going to put on my pediatrician hat, and I guess you guys can see the pediatrician hat now is on. I spend a lot of time talking with parents and families. And what I have found, particularly when you're dealing with pediatric patients with obesity, is to take this from a family approach. This is not just focused on the child and what they can do and what they've done wrong or what they could potentially do better. It's what can the family do better.

And when we focus on the family as a whole unit, I can tell you that we have much better outcomes, and the data supports this. So I think that's first and foremost. Can we work on those things that we talked about in the lifestyle realm? Absolutely. But the new pediatric guidelines do speak to the need to address and treat obesity more aggressively and sooner.

This is something that I've done in my practice for over 15 years, and I'm happy to see the AAP recognizing that if I have a 12-year-old come in, and he's four standard deviations above what's considered a healthy weight, that me telling him just to drink skim milk is likely not going to have a huge intervention or shift him into a healthier weight range. And so I think using the treatment modalities that are based on the evidence, and that's what we're using is the evidence to inform our treatments to recognize that for some, lifestyle measures will be enough, and that's great. But for those that need more aggressive therapiesmedications, surgical intervention, a combination thereofthat we should be supportive and embrace the idea that we can treat these people early.

And why is that important? Because if you struggle with disease, whether it be obesity or hypertension or type 2 diabetes, as a child and start very early, you can imagine it's much worse as they cross the threshold over into adulthood. If you're getting these diseases at the age of 40 compared to the age of 12, what do you think your life expectancy is? What do you think the quality of life will be for those individuals? And these are really important conversations to have.

Todd, I recently had a 12-year-old that I've been taking care of for the last two years have a really important conversation with her parents, who I also take care of. And they said to her, well, what do you think about the work that you're doing with your weight doctor? And she was like, who are you talking about? And they were oh, your weight doctor. And she was like, I don't go to a weight doctor. And they were like, well, what about Dr. Stanford? She was like, oh, that's what she does? And I think that's really important because she had no idea

Unger: Wow.

Dr. Stanford: that she's been seeing for two years, and that I am an obesity medicine physician. Why? Because while I do focus on weight and weight regulation, I do that at the very beginning of the visit, and then I just talk about her, her as part of that family unit. What can we do to make her life better? So much so that for two years that I've been treating her she had no idea that I was an obesity medicine physician.

And how do you do that? Well, it's by not hyper-focusing on the number on the scale, the number on the growth chart. Yes, it's there. We see it at the beginning of the visit, then let's focus on how to optimize her, him, they, them, theirs, whoever. I think this is really important. And I take significant pride in knowing that she had no idea what I do for a living and didn't feel like this was a combative visit, a visit that she has to be embarrassed of when she looks back at her 12-year-old self in 20, 30, 40 years.

Unger: That's a great segue into the next question I want to ask you because obviously, there's a lot of skill and experience that goes into the background of that story. And despite the prevalence of obesity, physicians aren't going to have that same understanding as you do, and they're not going to have that same ability to understand how to speak to a patient like that. And I think the estimates are pretty high percentage of doctors do have some bias toward individuals who are overweight or have obesity. So this is a real issue.

I want to talk a little bit more about that. And you also have got insurance companies that won't cover obesity drugs like they would medications for heart disease and hypertension, and that implies that they don't consider obesity a disease, either. So in the face of this, a lot of education that's needed. There's bias. There's a lot working against patients here. How do you see, coming out of your research and your work, physicians needing to have conversations like the one you just had?

Dr. Stanford: I think the key tenetand this is something we learn, regardless of our religious background, et cetera, is to treat people how we want to be treated. So when you're going into that office visit as a physician, as another health care provider, what would you want if you were in the receiving end of that conversation said to you that would make you feel whole?

If you aren't doing that as a physician, then I want you to reconsider what you're doing. What would you want to be said to you at that moment? So that you can look back and be like, that was a really great interaction I had with that physician. That made me feel empowered, that I am not necessarily the problem, and that there's part of my biology that's working with this problem.

It's unfortunately something that we don't really learn in our medical training, but it's a simple tenet that you can use by just thinking about if you were on the receiving end, what would you want to hear? What would make you feel whole, valued, and somewhat feel like this is not the end of the road? And so that's really what I think about when I'm working with my patients. What would I want to be receiving?

And if I say anything or think about anything that doesn't quite fit that mold, then I need to change my thought process. And I can tell you that I didn't start there when I started my career. I would say, people are like, oh, I want to be happy and healthy, and I want to weigh this. And I'd be like, oh, well, I do P90X. I do Insanity. I do all of these things, and a focus on me, me, me and what I did, not recognizing that I also wasn't coming from a place of having struggle with obesity.

So I was doing these things that were maintaining me, but I wasn't coming from a place of having 100 pounds in excess or 200 pounds in excess, or whatever. I wasn't coming from that place. And so when I talked about what I did, so that my patients could say, oh well, I did this, I wasn't recognizing what their struggle was. I wasn't empathizing. I wasn't living in their shoes. And now, having taken care of thousands, tens of thousands of patients with obesity, I feel, I hear, and I try to live what it is that they live, and then think about what I can do better.

And each day, I work to improve. I don't know if that conversation that I had with that 12-year-old, such that she has no idea what I did, if you go back to me in residency, is that the same conversation that people that I took care of then thought? Because I didn't know about this disease. I was telling those kids, if you can justI know you're working out for an hour a day, maybe an hour and 15 minutes, you know? Yes, and maybe, yes, you can just drink more water and these types of things, not recognizing that their degree of obesity was so severe that those interventions would likely not yield any measurable outcome for them.

Unger: Well, last question for you. You were recently appointed to the U.S. Dietary Guidelines Advisory Committee. How do you hope an appointment like this helps you further your work?

Dr. Stanford: Absolutely. Well, first of all, I'll acknowledge that of the 20 of us that are appointees, only three of us are physicians, and I think I may be one of the only two that are actually practicing medicine. And so I think this brings a different perspective to what the work is. There's one thing to do this in science, and there's one thing to actually care for patients.

And one of the things that I have seen as a person that's now in the middle of my 40s is that sometimes the dietary guidelines can be confusing for those with health literacy issues, with those from diverse backgrounds where some of the recommendations may not quite fit what their native culture is. These can feel a bit isolating. And so I'm hoping that my appointment brings that patient element. That element of looking at diverse populations across the age range.

This time I was nominated by the National Council on Aging, but previously, I have been nominated for this, was not selected by the American Academy of Pediatrics, they nominated me previously. So I think that speaks to being able to talk about the pediatric side, talk about the aging population, and then bring this work into particularly those that have struggled with this disease of obesity and who have been told to do these things that are doing these things that are still struggling with the disease, not assuming that they aren't doing the right things, but maybe we can do things to help them be their best self.

And so that's what I'm hoping my appointment brings to the committee as we do our work.

Unger: Are we going to see changes to the food pyramid?

Dr. Stanford: I don't know because there's 20 of us. I can't speak to what's going to happen. I will tell you that we have an upcoming meeting with just in the next week with the committee, and it'll be interesting because our first meeting as a group. We'll have two years to work on the 2025 guidelines, and it will be a lot of work. And I recognize that we come from different perspectives, different backgrounds. I mean, I'm hoping that we're able to coalesce these backgrounds and understandings of what we see and things that can improve to make the best possible recommendations to the U.S. people.

Unger: Just throughout this conversation, it just strikes me over and over again how much there is to learn about the situation that we face ourselves and the challenges that we didn't anticipate. It's just so important to do what you're recommending, which is to reframe the discussion and really think differently about this.

So thank you so much, Dr. Stanford, for joining us here today and for all the work that you're doing on this important topic. We're going to be back soon with another AMA Update. You can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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Obesity, weight loss treatments, set point theory & more with Fatima ... - American Medical Association

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It's 2023, and we're in the midst of a weight loss 'revolution'.

While the body positivity movement has exploded over the years, on the flip-side, weight loss medication has swiftly become more in demand than ever before.

The force behind the shift? The use of a drug called 'semaglutide'.

It's what doctors are calling the 'miracle cure' for obesity. The magic bullet. The 'medical breakthrough'.

Studiesnow tell us that things like calorie restriction and dieting do not work for long-term weight loss. In fact, 95 per cent of individuals end up regaining the weight, if not more. We know this for a fact.

With this in mind, the possibility of a weight loss drug that experts say is actually effective almost doesmake it seem like a 'magic pill'.

Designed for people suffering from diabetes, it's now being used off-label to restrict hunger and lose weight.

But is it a one time 'cure', and what are the long-term effects? All questions that need answering - but we've only just begun to scratch the surface.

Dubbed 'Botox for weight loss', celebrities, influencers, models and those in Hollywood's elite social circles have made the popularity of the drug - popularised under the brand name Ozempic - go mainstream.

As stated by The Guardian, it's 'Hollywood's worst-kept secret'.

Chelsea Handler was on it. Elon Musk as well. Khloe Kardashian denies taking it. So too does Kyle Richards from TheReal Housewives of Beverly Hills.

To meet overwhelming demand, the weekly injectable is now slowly multiplying under different manufacturers, with pharmaceutical companies scrambling to become part of the race (*insert dollar signs here*).

In the US, brands like Wegovy, Mounjaro and Reybelsus have cropped up among others.

And these new drugs are only the beginning. We're currently sitting on the cusp of a new wave of medication for weight management.

In Australia, the Therapeutic Goods Administration (TGA) has recently approved Wegovy for weight loss for those with a body mass index (BMI) over 30. Though it's not yet available.

Globally, there's been a shortage of the drug for the past year - meaning people with diabetes have struggled to access it. This is simply because the demand exceeded the capacity to produce it, by quite a large margin, making the supply constrained.

However, with a massive injection in the drug's manufacturing, experts are saying the supply crunch will ease very soon.

It's predicted that not only will the drug become more widely available, but soon, we're also going to have a variety of choices for weight loss medication.

In fact, within the next five years, experts say we'll see a slew of new drugs aiming to combat unwanted weight gain.

So, what will this look like?

Doctors in Australia, desperate to treat what is widely seen as an obesity crisis (obesity currently affects two out of three adults), are widely on board with the drug.

As Dr Brad Mackay told podcast host Claire Murphy on The Quicky, the medical profession hasbeen promised a miracle weight loss drug for decades.

Listen: Is Ozempic Really A Weight Loss Wonder Drug? Post continues below.

Dr Mackay said: "I've been waiting for medication like this to come along my whole career, even at university."

"My university lecturers promised that just around the corner, we would have amazing weight loss drugs - and we'd be able to make a big dent in helping the obesity crisis that was starting around the world many, many years ago."

Of course, weight management pills, programs and treatments have cropped up throughout the decades, some gaining massive popularity - but according to Dr Mackay, semaglutide is unlike any weight loss medication we've seen in the past. The evolution of this medication has been a game-changer.

The reason is that up until now, medications that suppress appetites have been limited, and have historically had very negative side effects.

In the late '90s, Fen Phen diet pills were THE answer to weight loss. Until they werelinked to heart damage. Then there was DMAA in the early 2000s - which was removed from the market due to fatal health risks.

"We've had medication that works as stimulants - it speeds up your metabolism, but also increases your blood pressure and gives people anxiety. So, it's not a great drug for a lot of people. There have been other medications that stop you from absorbing fat in your gut - meaning you just end up with fatty diarrhea, which isn't the best for anyone."

"We've had other medication that's been taken off the market because it was causing heart attacks to occur. This class of medication that we're using for diabetes doesn't seem to be causing those other problems. There's a high safety profile on it - they need to go through rigorous studies to make sure that they're not causing any adverse effects."

However, is there then good reason to believe that other side effects will surface in years to come?

We already know that the main side effects are things like nausea, vomiting and diarrhea. We also know that once you stop injecting the medication,it stops working.

Meaning? It's something ofan indefinite prescription.

So then, as we don't really know what the effects are until long-term users grow, is it possible there's a whole list of other complications?

Mamamia spoke to dietician, TV nutritionist and author of Your Weight Is Not The Problem, Lyndi Cohen, who thinks we are severely underestimating the long-term side effects of these drugs.

She said, "There is research to say that these drugs can increase tumour growth, that they can result in acute kidney failure - this is a huge deal."

"We have this whole trend in wellness culture of compromising one part of you so that you can fit in more aesthetically. A lot of the buzz surrounding these drugs is around people who are trying to lose the last few kilos. I feel like there's such potential for misuse, where people who don't need to fix their body are going to be taking long-term lifelong drugs, with huge financial and physical costs, simply to achieve this ideal."

As it becomes more widely used, will we see underlying issues we couldn't see before? Not just physically, but mentally and socially, too?

What are we willing to sacrifice as a culture to get the number we want to see on a scale?

While some people are calling this a 'miracle drug', others, like Cohen, are questioning the medication for weight loss issues.

As Cohen tells Mamamia, for people who suffer from eating disorders and disordered eating behaviours, these kinds of 'quick fixes' don't help to heal a person's relationship with food.

"I find it really problematic. And I'm worried about early future generations coming through with this kind of culture."

"Of course, there are going to be use cases where someone has a clinical need to use a drug like this. However, I feel like for years we've been trying to treat eating disorders with a kind of physical BandAid," she shares.

"It's a bit like giving someone gastric banding, but not treating the underlying cause of the issue, which is a deeply unhealthy relationship with food, compounded by years and years of dieting."

"Instead, we go and give them a physical solution without fixing the fundamental psychology that's driving them to eat compulsively and feel out of control around food."

"For me, it feels a bit like we're trying to place a BandAid on a headache. There's a mismatch between the way we're trying to treat the problem. Like gastric banding - you have someone who still has the exact same disordered relationship with food, but now it's even trickier for them to eat. I query whether we are making this problem worse than it already is."

While the drug has been approved for patients with a body mass index above 30, as Dr Crowley told Claire Murphy on The Quicky, "doctors can prescribe what we call off-label, which is outside the TGA approval - if they believe it's in the patient's best interest."

Now, this is where it gets murky. Because the question that arises is, who should be allowed to use it?

"Is the decision to prescribe this drug in the patient's best interest? I think we know that weight loss is beneficial for people who are obese and overweight," said Dr Cowley.

"Where the line comes - we don't know whether weight loss from a BMI of 25 is beneficial. I think the question is, are doctors prescribing it for people who are not overweight? And I would hope not."

While medical professionals in Australia are saying there isn't a lot of evidence of it being used off-label in Australia at the moment - in America, it certainly is.

In a recent Instagram post, actress and presenter Jameela Jamil very explicitly blames this drug for the return of 'heroin chic'.

She said that it's now become a mainstream craze in Hollywood, widely being used by influencers and celebrities to whittle themselves down.

She writes: "Slim women in my industry are buying it off prescription for 1k, to 1.5k and using it to get super skinny to conform to FASHION DESIGNERS WHO JUST WON'T MAKE THE SAMPLES WE HAVE TO WEAR FOR WORK BIGGER. The samples are getting smaller post pandemic, and coincidentally "heroin chic" is "back in"."

However, the predicament seems to be this: Should the influencer or celebrity, or someone who is abusing the drug, be thrown in the same basket as the person who has been struggling with their weight for their entire life?

As Dr Mackay shared onThe Quicky: "In my experience, the people who have been inquiring in Australia are morbidly obese. They are really struggling with their weight. And they know that the medication can reduce their weight and it can be life-saving in its own way."

"So if you're able to reduce your weight, you're able to exercise a lot better, you're able to decrease your cholesterol, you're able to decrease your blood pressure - these are all longer-term gains."

"I'm a little bit empathic for people who are using it for weight loss. Because people are often desperate, they've tried every diet under the sun, and it hasn't worked. We know that metabolism is just self-sabotage. Your body wants to keep you fat. Often people will need to go on medications to help them get to a much safer weight for their future."

Undoubtedly, one of the major differences between what we're seeing today compared to ten years ago has a lot to do with the transparency we now see on social media.

For example, years ago, you didn't hear or see celebrities talking openly about their gastric band surgery. Orsharing what procedures they have on their face or bodies. It was just not the done thing.

Fast forward to 2023, and you'll find celebrities and influencers alike sharing everything from what they eat in a day to the different cosmetic treatments they've undergone.

But are we happier that some influencers and celebrities are now opening up and discussing the use of weight loss drugs?

Does transparency around weight loss actually make us feel better?

Well, it's a double-edged sword.

On the one hand, we can find comfort in knowing that celebrities aren't 'perfect' - that they too can battle with their appearance and weight.

"They're just like us!"

However, on the other hand, it still makes us feel like we have to be a certain way. To fit in with another standard or ideal.

Further to this, the normalisation and accessibility of the drugparticularly once it becomes more widely availableadds an extra layer of pressure. Will it just become the 'done thing'?

Because eventually, these drugs will be everywhere.

As Mia Freedman asked in a recent episode of MamamiaOut Loud, how do we feel about the fact that someone we know might want to 'just lose five kilos'? Will it eventually become like the actualBotox of weight loss?

Similarly to other weight management solutions, these drugs can be seen as further exacerbating the issue ofweight discrimination - instead of removing the stigma around weight, they're essentially just adding to it.

Are we moving from discriminating against overweight people for their body composition and eating habits, to now telling larger people to just take the 'magic cure'? And blaming them if they don't?

Then, there's still that stigma around "cheating" weight loss. The idea of not losing body fat "the old-fashioned way" through diet and exercise.

No matter what way you want to look at it, one thing rings true: In 2023, the future of weight loss might feel different - but it sure looks and feels a lot like it did in the past.

What are your thoughts? Where do you see our relationship with weight loss medication going? Share your thoughts with us in the comment section below.

Feature image: Getty

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Weight loss is a process that involves reducing body weight by decreasing body fat or muscle mass. Losing weight can be achieved through a combination of healthy eating habits and regular physical activity. Weight loss occurs when the body burns more calories than it consumes, resulting in a calorie deficit. This deficit can come from a reduction in calorie intake, an increase in physical activity, or a combination of both.

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Losing weight can be challenging, and it's easy to make mistakes that can slow down your progress or even hinder your weight loss efforts altogether. Maintaining a healthy weight is important for overall health and well-being.

1. Improving overall health: Maintaining a healthy weight can help reduce the risk of chronic diseases such as heart disease, diabetes, and certain cancers.

2. Boosting self-confidence: Losing weight can improve self-esteem and body image, which can have a positive impact on overall well-being.

3. Enhancing athletic performance: Losing weight can help improve athletic performance by reducing the amount of weight that needs to be carried during physical activity.

4. Preparing for a special event: Some people may want to lose weight to prepare for a special event, such as a wedding or vacation.

5. Addressing a health condition: People with certain health conditions, such as high blood pressure or sleep apnea, may be advised to lose weight to manage their condition.

6. Fitting into clothing: Some people may want to lose weight to fit into smaller clothing sizes or to wear certain types of clothing.

1. Setting unrealistic goals: Setting goals that are too ambitious or unrealistic can lead to frustration and disappointment, which can eventually lead to giving up altogether.

2. Skipping meals: Skipping meals or drastically reducing your calorie intake can slow down your metabolism and make it harder to lose weight in the long run.

3. Relying on fad diets: Fad diets are diets that promise quick weight loss through drastic changes in eating habits. Fad diets may promise quick weight loss, but they often lack the nutrients your body needs and can be difficult to maintain in the long term.

4. Not getting enough sleep: Lack of sleep can disrupt your metabolism and increase your appetite, making it harder to lose weight.

5. Overestimating calorie burn: Overestimating the number of calories you burn during exercise can lead to overeating, which can hinder your weight loss efforts.

6. Not tracking progress: Not tracking your progress can make it difficult to identify what's working and what's not, making it harder to adjust your plan accordingly.

7. Lack of consistency: Consistency is key when it comes to weight loss. Skipping workouts or cheat days too often can slow down progress or lead to weight gain.

Remember, losing weight is a journey that requires patience and commitment. It's important to set realistic goals, make sustainable lifestyle changes, and stay consistent over time to achieve lasting results.

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A formerCoca-Colaand pharmaceutical consultant said the push to put kids on weight-loss drugs ignores what he calls the root issue behind obesity added sugars and processed food and will fail to prevent more people from developing the disease.

The American Academy of Pediatrics' (AAP) released guidelines last month encouraging pediatricians to be more proactive in fighting childhood obesity, with treatments including rigorous lifestyle changes or even weight loss drugs, or in some cases, surgery for children as young as 12. Calley Means, who co-founded a company that promotes food as medicine, blamed added sugar that food manufacturers put in products to increase flavor or extend shelf life for the rise in obesity along with other chronic diseases.

"The only thing that will make us healthier, more fertile, less depressed, less obese, is attacking the root cause," the TrueMed co-founder told Fox News. "There are public policy measures that can take the poison out of our children's food supply and stop subsidizing it."

Added sugar intake has long been connected with a variety of health issues. Effects include "higher blood pressure, inflammation, weight gain, diabetes andfatty liver disease," which are "all linked to an increased risk for heart attack and stroke," according to Dr. Frank Hu, a Harvard University nutrition professor.

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Obesity affected around20% of children between the ages of 2 and 19 between 2027 and 2020, according to the Centers for Disease Control and Prevention.When left untreated, obesity can lead to heart disease, diabetes, depression and other chronic conditions.

Ozempic, one of the Food and Drug Administration-approved diabetes medications that doctors prescribe for weight loss, acts as an appetite suppressant. But an April 2022 peer-reviewed study published in Diabetes, Obesity and Metabolism found that patients who went off the drug regained two-thirds of the lost weight within a year.

"Ozempic will not decrease obesity long term," Means told Fox News. "Making teenagers lifetime patients, that's not good for kids."

"Ozempic is a Band-Aid," he added.

While weight-loss drugs may help people shed pounds, Means said it will not stop more people from developing obesity or other illnesses borne from what he calls "poisonous food" consumption. He said good nutrition can prevent chronic illnesses like depression, heart disease and diabetes, while medications can only treat them after the fact.

RUSSELL BRAND INTERVIEWS FAUCI WHISTLEBLOWER ON BIG PHARMA CORRUPTION, FAMILY TIES: MEET THE FAUCIS

American Academy of Pediatrics (AAP) new guidelines recommend pediatricians and primary care physicians combat childhood obesity by prescribing weight loss drugs or advising surgery in some cases for children as young as 12. (iStock)

The American Heart Association (AHA) suggests an added sugar limit ofno more than 24 grams per day for womenand 36 grams for men. But on average, Americans eat 77 grams a day, according to the AHA. A single can of Coca-Colacontains 44 grams of sugar.

Additionally, a high intake of fruits, vegetables and whole grains can reduce the risk of chronic diseases, such asdiabetes, heart disease and some cancers according to a Harvard study.

BIDEN ADMIN EXPERT CLAIMS OBESITY CANNOT BE TREATED WITH EXERCISE AND GOOD DIET

If obesity trends hold, 57% of children between ages 2 and 19 will be obese by 2050, according to the AAP.The newly updated guidelines do not discuss childhood obesity prevention but do recommend treatment facilities for lifestyle interventions as the first treatment option.

"This is one more example of not addressing the core question of why we're getting sick but waiting for people to get sick and drugging them," Means said. "We're being distracted from what is harming kids."

Calley Means said the call for taxpayer-funded weight loss drugs for obese kids is a distraction from the root issue. (Fox News)

Means believes that classifying obesity as a chronic illness sends the wrong message to families, prompting them to seek life-long medical intervention rather than addressing the root issue: food.

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"We would expect the medical leaders to be speaking out about the root cause of why we're sick," he told Fox News. "But they're not calling to reform food stamps to not have processed food by 70%, they're not calling for the FDA to move the sugar recommendation of 2-year-olds from 10% to 0%."

Novo Nordic, Ozempic's manufacturer, did not respond to Fox News' request for comment.

To watch the full interview with Means, click here.

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For the past 13 years, U.S. News & World Report has rounded up a panel of dozens of health and nutrition experts to help rank popular diets in several categories. This year, in addition to best overall, best for heart health, best for weight loss and more, their annual best diets report introduced two new categories: best diets for bone and joint health and the best family-friendly diets. The Mediterranean diet reigned supreme or ranked near the top of every category, and the DASH diet, flexitarian diet, and MIND diet all put up a strong showing across the board, too.

But what about the best diet for runners? Because thats not a category (yet), we tapped our own panel of pros to help us determine what qualities areand arentincluded in the best diets for runners. Read on to find out the main points of a balanced eating plan and how to determine if your diet is serving you or if its one you should run away from.

Before we dive into our official top-ranking diets, lets take a beat to define the criteria. What exactly makes a diet best?

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The answer is simple: The best eating plan is one that fits your lifestyle. Look for an eating style that you could adhere to for the foreseeable future, says Julie Upton, RD, a registered dietitian and co-founder of the nutrition news company Appetite for Health in San Francisco.

Your eating plan should meet your emotional and physical needs, adds Lauren Harris-Pincus, MS, RDN, a New Jersey-based registered dietitian, founder of NutritionStarringYOU.com, and author of The Everything Easy Pre-Diabetes Cookbook.

Before starting a new strategy, ask yourself:

For runners like herself, Frances Largeman-Roth, RDN, a Dobbs Ferry, New York-based registered dietitian and the author of Smoothies & Juices says that energy levels are also important to consider.

Food is supposed to be nourishing, first and foremost, so your eating plan should leave you feeling satisfied and energized. My top diet choices ensure your body is getting all the essential nutrients it needs, as well as allowing a bit of flexibility for fun within an overall balanced eating plan. Lets remember, runners may be regimented, but theyre not robots, Largeman-Roth says.

While some people do take up running with a goal to lose weight, trying to train while restricting calories is not a recipe for success, Largeman-Roth continues. (ICYMI, heres how it feels to run on a calorie deficit. Spoiler: not great.)

Finally, when thinking about healthy eating more holistically, consider these general guidelines:

Ranked by Harris-Pincus, Upton, and Largeman-Roth, these diets all allow for enough flexibility and calories to adequately fuel for exercise and recovery. They also include seafood, which is a great source of protein that also offers essential vitamins and nutrients your body cant make on its own, Largeman-Roth says. And they feature a mix of fruits and vegetables, which not only provide vitamins and nutrients but also contribute to an individuals overall hydrationanother important factor for runners, she adds.)

Its no surprise that the Mediterranean diet tops the list, although its more a pattern of eating than a diet, Harris-Pincus saysand thats part of what makes it such an awesome option. It offers flexibility to adjust portion sizes and calorie intake to meet your needs, she adds.

Going Med involves eating primarily plant-based, with fish at least two times per week and smaller portions of poultry and dairy sprinkled in, with red meat on more rare occasions. Carbs are most definitely allowed, especially whole grains, and it allows for moderate amounts of wine, if thats something you enjoy.

The foods in the Mediterranean diet can help keep inflammation in check to help hasten recovery, Upton says.

Originally designed to help lower or maintain a healthy blood pressure, this eating style emphasizes foods rich in potassium, calcium, magnesium, and fiberall of which can also benefit runners, Largeman-Roth says. Its similar to the Mediterranean diet, just with a keen eye on sodium consumption.

Runners with hypertension or a strong family history can consider implementing this type of sustainable diet [into their lifestyle], Harris-Pincus says. Athletes without those concerns can supplement with higher-electrolyte foods and drinks on intense training days, when you need the sodium.

Registered dietitian Dawn Jackson Blatner coined the term flexitarian in 2009 to act as a mash-up of flexible and vegetarian, and this lifestyle is a fantastic way to encourage the addition of more plant foods without completely eliminating animal foods, Harris-Pincus says.

Going flexitarian involves eating a mainly plant-based diet, with the option to include meat, poultry, seafood, and dairy every so often. Jackson Blatner endorses a mix of calories from carbs, protein, and fat, and because it has few hard and fast rules, many runners will be able to stick with it for a long time, Upton says. Plus, the eating style is linked to reduced risk for chronic diseases, including heart disease, certain cancers, and type 2 diabetes, she adds.

This flexible eating pattern lets you include some animal protein, like eggs and chicken, which means youre never missing out on important nutrients like iron, vitamin B12, and cholineall of which are extra important for female runners, Largeman-Roth says.

MIND stands for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, and its essentially a combo platter of the DASH and Mediterranean diets. This strategy is not originally designed for athletes, but is still a great all-around eating plan for runners as it focuses on plant-based foods, fish, and anti-inflammatory foods, Upton says. The original goal? Eat in a way that reduces risk for dementiacertainly not a bad bonus.

The MIND diet emphasizes leafy greens, berries, beans, whole grains, nuts, olive oil, poultry, and fish, and advises going light on red meat, sweets, and cheese, Harris-Pincus explains.

This is a balanced diet approach for runners, particularly those with a family history of Alzheimers or dementia, Harris-Pincus continues.

Running and other forms of exercise can cause inflammation in the body, Largeman-Roth says, so eating a diet rich in foods that tame that flame can be a boon for both recovery and long-term health. To diversify vitamin and mineral consumption, variety is the name of the game for this diet, according to Andrew Weil, M.D., director of the Andrew Weil Center for Integrative Medicine at the University of Arizona and creator of this eating plan.

Fresh fruits and vegetables, nuts and seeds, fish and seafood, unsaturated fats and whole grains get top billing. Dr. Weil suggests steering clear of ultra-processed and fast foods, and promotes consuming about 40 to 50 percent of your calories from carbs, 30 percent from fat, and 20 to 30 percent from protein.

This is a great ratio of carbs, protein, and fat for runners, Upton says. Also, because its based on a daily intake of about 2,000 to 3,000 calories (depending on your gender, size, and activity level) its not as restrictive as many of the crash diets floating around social media.

No matter how much you run, certain eating strategies are always going to be a wise choice for your health and longevity. A review published February 2020 in the journal Nutrients confirms that these eating plans are all scientifically proven to reduce risk for chronic diseases, including heart disease and certain types of cancer:

Humans are not robots, and as such, were never going to stick to an eating plans pyramid, plate, or other formatted recommendations perfectly. For a diet to work for you and your lifestyle, it should be something you can adhere to about 80 percent of the time, Harris-Pincus says. Allow for flexibility for other 20 percentwhen you enjoy foods outside of your eating plan.

These are some possible signs a diet isnt working for you, according to the dietitians we spoke to:

Theres no one perfect diet for runners, but if youre looking for a way to eat healthier and enjoy following a plan, this list offers a wide range of options and enough flexibility to customize and meet your nutritional needs and personal preferences.

Runners need to take special care to avoid restriction before, during, and after a workout, as a strong run requires sufficient gas in the tank (a.k.a. fuel in form of calories). In general, you also need sufficient calories to avoid more serious issues like RED-S, or relative energy deficiency in sport, which is defined by a lack of period, low energy availability, and bone loss, and stems from inadequate energy intake compared to what you expend.

Beyond eating enough to fuel your running, feel free to choose the eating plan that jives best with your energy levels and personal preferences. Each body is unique and your diet should be too, Harris-Pincus says. If youre feeling confused or conflicted, consult a registered dietitian who can help customize your diet to keep you optimally fueled for your best athletic performance and overall health.

Karla Walsh is a Des Moines, Iowa-basedfreelance writer and level one sommelier who balances her love of food and drink with her passion for fitness. (Or tries to, at least!) Her writing has been published in Runners World and Fitness Magazines, as well as on Shape.com, EatThis.com, WomensHealthMag.com, and more.

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If you have diabetes, monitoring your health can be a lot to manage: checking your blood sugar, making healthy food, finding time to be active, taking medicines, and going to doctors appointments. With all that, your feet might be the last thing on your mind.

Poorly controlled diabetes can cause damage to the nerves and blood vessels going to peoples feet, said Dr. Daniel Lamar, an internal medicine specialist with the 56th Medical Group at Luke Air Force Base in Glendale, Arizona. As a result, people can lose the sensation in their feet. This causes people to change the way they walk and may result in the development of sores on their feet that they dont feel.

Diabetes is the sixth leading cause of death in the United States, with more than 11 percent of the U.S. population having the disease, according to the Centers for Disease Control and Prevention.

According to the National Institutes for Health, foot problems are common in people with diabetes. Checking and taking care of your feet every day can help lower your chances for diabetes-related foot problems. Managing your blood glucose levels can also help keep your feet healthy.

Due to nerve damage in feet, people can develop sores, which then can get infected and be very difficult to treat because of the damage to the blood vessels, according to Lamar. The damaged blood vessels cause decreased blood flow which makes it hard for the immune system to respond and makes it difficult to get high levels of antibiotics to the area of infection. As a result, people can end up with amputations.

When poorly controlled, Lamar notes that diabetes causes complications throughout the body. It can damage all nerve cells including peoples retinas. Diabetes is the most common cause of nontraumatic amputations in the U.S, and is one of the two most common causes of people going on dialysis. It can also cause people to go blind.

If you experience any of these symptoms, you should see your doctor right away:

Prevention is the best way to keep your feet healthy. Complications from diabetes are most associated with diabetes being poorly controlled. If a patient keeps their blood sugar under control, manages their weight, and has regular provider visits, it dramatically decreases the risk of long-term complications, said Rachel Perkins Garner, a disease management nurse at Luke Air Force Base.

Tips to maintain your feet include:

There are two types of diabetes, each with its own set of causes and treatments:

Lamar noted that if someone is not properly controlling their diabetes, they may be thirsty all the time and will urinate a lot. People with poorly controlled diabetes feel generally poorly.

According to the CDC, eating healthy, regular exercise and maintaining a healthy weight can help control your diabetes.

With over 130,000 Department of Defense beneficiaries worldwide affected with diabetes, according to Perkins Garner, the Defense Health Agency sees an urgency in combatting this chronic disease.

One example of this is the DODs focus on promoting and maintaining a healthy lifestyle. The U.S. Air Force has adopted Lifestyle and Performance Medicine to keep their airmen healthy.

According to Perkins Garner, Lifestyle medicine is an evidenced-based lifestyle therapeutic intervention which is based on six pillars: a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections. These interventions practiced, can prevent, treat, and often reverse chronic disease, such as diabetes.

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If youre looking to lose fat and get lean, getting enough protein is key.

Research shows that when you want to build more muscle and lose fat, aggressively cutting calories or entire food groups out of your diet is a recipe for disaster (1).

First, cutting too many calories is unhealthy and can stall your metabolism. It can also lead to nutrient deficiencies and muscle mass loss while leaving you weak, dizzy, and tired.

While we may lose weight with them initially, trendy diets that dont fit into our lifestyle or leave us feeling deprived arent sustainable long-term.

Rather than banishing all carbs, studies show that shifting your focus to prioritizing eating more lean healthy protein, combined with a balanced diet and regular activity, is a better strategy for long-term weight loss (2).

In fact, a major reason many of us arent seeing the scale move or training is that were not eating enough protein. It can also keep us from continuing to build strength while training.

Combined with a balanced, healthy diet and regular activity, this is the way to go.

There are two major reasons:

Protein helps us build muscle. Muscle burns more calories than fat.

So having more muscle mass can increase the number of calories (energy) you burn even while resting, which is known as your basal metabolic rate (BMR).

Eating enough protein in combination with strength and resistance training can help us build more muscle.

How much muscle you put on takes time and depends on various factors, including age, gender, genetics, body size, and composition.

Protein is more satiating than carbs or fat.

When we eat protein, it triggers the body to reduce the hunger hormone ghrelin and instead boosts the levels of a hormone called peptide YY that makes you feel full.

So eating plenty of protein can affect the amount of food we eat overall.

Our body requires energy to break down food into smaller, absorbable molecules our cells can use.

We know this process as the thermic effect of food.

Only 5-15% of carbohydrate calories get burned during digestion, while fats are just 5%.

Like fats and carbohydrates, protein is a macronutrient or macro. These nutrients our body uses in the greatest amounts.

When we eat protein, the body breaks it down into amino acids through the process of digestion.

Our cells then use amino acids for a variety of different important functions, including

While there are over 500 amino acids in nature, the tissues of the human body need only about 20 to make all the proteins it requires (3).

Nine of these amino acids are essential, which means the body cant make them on its own and we can only get them through the foods that we eat.

Healthy Fact: Not eating enough protein can cause muscle loss, dry skin, slowed metabolism, hair loss, and brittle nails (4).

Protein is more satiating than fats or carbs.

Lean sources of protein have a lower fat and calorie content and are best for fat loss.

If youre hungry shortly after eating, its your bodys way of telling you it needs more protein (5).

The exact amount of protein in a serving of meat can vary depending on factors, such as the specific cut of meat and how its prepared.

These estimates should give you a good idea of the protein content of a 4-ounce serving of each type of meat.

Besides being a great source of protein, fatty fish like salmon and sardines are also excellent sources of heart-healthy omega-3 fatty acids, which have been linked in studies to a variety of health benefits (6).

Incorporating whole eggs or egg whites into your diet can be a good way to increase your protein intake without consuming a lot of calories

Besides protein, eggs are also a wonderful source of other nutrients, such as vitamin D, vitamin B12, and choline.

Some studies show that eating eggs for breakfast may help promote feelings of fullness and reduce calorie intake later in the day (7).

Eggs are also super versatile!

If youre concerned about the cholesterol in eggs, its important to note that recent research suggests that for most people, dietary cholesterol does not have a significant impact on blood cholesterol levels or heart health (8).

However, if you have high cholesterol or other health concerns, its always a good idea to speak with your doctor or a registered dietitian before changing your diet.

Dairy is a great source of protein, and there are many low-fat and fat-free options available that can help you meet your protein needs while keeping your calorie intake in check.

Greek yogurt is a high-protein dairy style of yogurt and is also a good source of calcium and probiotics, which can benefit gut health.

Choose low or full-fat varieties which are more satiating than fat-free options.

Cottage cheese is also an excellent source of calcium and other nutrients like vitamin B12.

Kefir is a fermented milk drink similar to yogurt but has a thinner consistency. It contains probiotics, which support gut health and immunity.

The exact amount of protein in a serving of cheese can vary depending on the type and brand. Cheese is also an excellent source of calcium and other nutrients.

If youre working on fat loss, eat full-fat cheese in moderation since its high in calories.

Whey and casein are two types of proteins found in milk that you can buy as supplements to support muscle growth and recovery. Add to smoothies, shakes, eggs, yogurt, and baked goods to boost their protein content.

Whey protein is a fast-digesting protein thats absorbed quickly by the body, making it ideal for post-workout recovery.

Casein protein is a slow-digesting protein thats absorbed more slowly, providing a sustained release of amino acids.

Legumes, which include all beans, lentils, and peas, are an excellent source of plant-based protein. They are also high in fiber, which can help keep you feeling full and satisfied.

Beans of all kinds, including black beans and kidney beans, are versatile and nutritious! Theyre high in vitamins and minerals, like folate, iron, and potassium.

Lentils are available in many varieties, such as brown, green, and red lentils, and are also a healthy source of iron and other nutrients.

Chickpeas, also known as garbanzo beans, are a good source of fiber, vitamins, and minerals, like folate and manganese. Use in dishes like hummus and falafel.

Peas are a good source of fiber, vitamins, and minerals, like vitamin C and vitamin K. Add to soups and stews.

Made from yellow peas, this one is a great substitute for dairy-based protein supplements. Its often added to non-dairy milk options to boost their protein content.

Tofu, also known as bean curd, is a soy-based product that is commonly used as a meat substitute. Its a good source of calcium and iron.

Tempeh is a fermented soy product that has a firm texture and a nutty flavor and is also a good source of probiotics.

Seitan, also known as wheat meat, is a high-protein, meat-like food made from wheat gluten and is an excellent source of iron and other nutrients.

A delicious edible seed from South America with a grain-like texture, quinoa is a complete source of plant protein and folate, magnesium, and fiber.

Nuts and seeds, such as almonds, pumpkin seeds, hemp seeds, and chia seeds, are also wonderful sources of protein, fiber, antioxidants, and healthy fats with around 6-8 grams of protein per 1/4 cup.

They are high in calories, so if weight loss or maintenance is your goal, eat them in moderation.

When choosing protein sources, its important to consider the benefits and drawbacks of different options.

For example:

Its important to choose a variety of protein sources to ensure that youre getting a complete range of nutrients and amino acids.

There are many easy ways to incorporate protein into your meals and snacks.

Here are some ideas to get you started:

The amount of protein you need depends on a variety of factors, including your body weight, activity level, and fitness goals (9).

Some experts recommend consuming up to 0.8-1 gram of protein per pound of body weight per day to support muscle growth and repair.

However, if youre looking to lose fat and build lean muscle, you may need to increase your protein intake.

If Youre Sedentary: The recommended dietary allowance of protein for an adult is 0.8 grams per kilogram of body weight.

1 pound = 2.2 kilograms

That means a person weighing 150 pounds (68 kilograms) should eat at least 55 grams of protein per day.

If Youre Over the Age of 40: To avoid losing muscle mass (sarcopenia) your protein needs to increase to about 11.2 grams per kilogram. Or 6080 grams per day for a 150 lb person.

If Youre Active: If you exercise regularly, youll also need about 1.11.5 grams of protein per kilogram.

If You Regularly Lift Weights or Are in Training: Aim for 1.21.7 grams of protein per kilogram.

If Youre Obese: You need to adjust your weight before calculating your needs to avoid overestimating and eating too much protein. Use this online calculator.

Consuming more than 2 grams of protein per kilogram of body weight per day has been linked to potential health risks, such as kidney damage and dehydration. (10)

Use this online calculator to estimate your personal daily protein needs.

Or, download a food-tracking app like MyFitnessPal or MyPlate to calculate your protein requirements and help you keep track of your protein and nutrient intake each day.

You can also see a dietitian to help you develop a personalized plan for your goals.

To lose fat or maintain a healthy body weight, eating more lean protein during meals and snacks can boost metabolism and keep us more satiated, so we eat less.

The amount of protein we need to lose fat or maintain a healthy weight varies from person to person. Age, weight and activity levels are all factors to consider.

Consult with your doctor, healthcare provider, or nutritionist about how much protein you should be eating.

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Report: Alex Verdugo approached Red Sox about long-term contract originally appeared on NBC Sports Boston

This is a make-or-break year for Alex Verdugo. But if the 26-year-old outfielder delivers on his end, he apparently wants the Boston Red Sox to deliver him a new contract.

Verdugo "approached Red Sox leadership" -- including team owner John Henry -- in Fort Myers, Fla., on Monday to "make it clear" he wants to sign a long-term contract with Boston, the Boston Herald's Gabrielle Starr reported Monday.

Verdugo told Sox leadership he has the goal of being an All-Star in 2023 and explained to the group that he adjusted his diet and training to come to spring training in better shape, according to Starr.

It's clear that Verdugo is aware of his own stakes; he and the Red Sox agreed to a one-year, $ 6.3 million contract to avoid arbitration this offseason, but he has just one more year of arbitration in 2024 before hitting unrestricted free agency in 2025. If Verdugo wants a long-term deal, he'll need to show significant improvement in 2023.

Verdugo hit .280 with a .732 OPS in 2022 with 11 home runs and 74 RBIs in 152 games. Those are respectable numbers, but hardly above average and below expectations for the lone major league player the Red Sox received from the Los Angeles Dodgers in the 2020 Mookie Betts trade.

The six-year veteran also regressed defensively as a left fielder in 2022, which manager Alex Cora called him out on after the season.

"I do believe he can be a lot better," Cora said last October. "A lot better regardless of whether he plays left or right, he can be a better defender. ... This is a guy, we envision him to be an impact player not only in the batter's box, but on the other side."

If Verdugo realizes his full potential as a middle-of-the-lineup left-handed bat and above-average defender, he's absolutely keeping around long-term on a team-friendly deal. The Red Sox' outfield is unsettled outside Masataka Yoshida, so signing Verdugo could give the front office one less problem to worry about.

Verdugo will have to prove his worth on the field, however, or run the risk of another year of arbitration next winter.

Read the rest here:
Report: Alex Verdugo seeking long-term contract with Red Sox - Yahoo Sports

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Modified Feb 22, 2023 15:02 GMT

World Series champion Lenny Dykstra was a legendary player on the field but unfortunately Dykstra's personal life was marred by many things, including his arrest due to drug possession charges.

The three-time All-Star once admitted to taking performance-enhancing drugs along with his breakfast and revealed that he did so in order to gain an unfair advantage.

In 2016, Maxim quoted Dykstra replying to a question specifically about HGH (Human Growth Hormone):

Dykstra won the World Series with the New York Mets in 1986 and was a three-time All-Star. Since his retirement, he has been troubled by legal and financial problems.

Dykstra said that when he filed for bankruptcy many years ago, he owed more than $31 million and had only $50,000 in assets. Dykstra allegedly concealed, sold, or destroyed property worth at least $200,000 after filing without the approval of a bankruptcy trustee, according to the prosecution.

For hiding baseball gloves and other artifacts from his playing days that were supposed to be included in his bankruptcy case, Dykstra was given a six-and-a-half-month prison sentence in 2012. Prior to this, he was imprisoned for seven months while he awaited sentencing.

Dykstra allegedly paid private investigators $500,000 to obtain dirt on umpires throughout his playing career, which he subsequently exploited to his advantage.

He claimed in an interview published in 2015 that his attempts at extortion were obvious from the fact that he led the National League in walks, hits, and runs in 1993. Lenny Dykstra also finished second to Barry Bonds in the MVP contest.

Read more:
MLB legend Lenny Dykstra once revealed he used to add steroids to his cereal in order to gain an unfair advantage - Sportskeeda

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In today's post in today's article, we'll look at what exactly is Palumboism. We are trying to find the root of this mystery, we must determine what the cause is, we must first identify it once is done. In the world of bodybuilding, there are a myriad of strange and amazing characters taking over the stages across the globe.

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Although bodybuilding appears to be slowly moving away from the mass-monster style that has dominated the sport from the 1990s. Thanks to the likes of Dorian Yates, Ronnie Coleman, and Markus Ruhl.

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It is important to note that "special supplementation" that bodiesbuilders are said to have taken are becoming more potent with each passing year.

We've seen some truly amazing bodies on stage throughout the years And by freaky we mean the perfect mix of beauty and weight.

Certain bodybuilders have ended up getting reputations for having a bizarre physique in a other sense.

For those who are familiar with bodybuilding, it is a sport that you can enjoy.

The nickname Dave Palumbo is synonymous with the game.

The head of the company and founder of RX Muscle.

Dave Palumbo is a legend in the world of bodybuilding.

The drawback is that.

As well-educated as he is He, however, is referred to as the 'father of the Palumboism'.

What exactly is Palumboism?

This is what we'll examine today.

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Who is Dave Palumbo?

Before we dive into the definition of Palumboism is, let us first introduce you to on the person Dave Palumbo is.

If you're aware of your bodybuilding abilities, you'll have it already.

Just to be sure.

We'll help you bring back your memory, and bring you up.

Dave Palumbo is 50 years old and is among the most admired and well-known individuals in bodybuilding.

He was a bodybuilder in the competitive world who is retired.

However, he's still active in the sport since he manages RX Muscle, the RX Muscle website and forums.

He frequently hosts podcasts with celebrities, bodybuilders and professional athletes from all different walks of life.

He is Nutritionist.

He has also dabbled in personal training.

He is even running his own line of supplements.

Dave remains in great condition, even though at one time Dave had an incredible body.

Before he began bodybuilding,

But, he was extremely athletic.

Dave was interested in athletics and sports at the age of a child.

In reality, in his college days in the early years He competed as an extremely effective long-distance athlete.

He was always working out in order to keep fit to run.

As he began to see improvement in his body.

He started to notice himself becoming less enthralled with running.

and more obsessed with weight training and bodybuilding instead.

He began his training in a serious manner in the hopes of taking part in a competition.

In 1990, he appeared on his first performance.

He weighed about 170 pounds and stood at 5,9 inches tall.

He made a very thoughtful 6 6.

For many, it would be considered a massive success.

However, to Dave this was a complete failure.

He used his first 6 6 place result as an incentive to gain weight and push himself harder than ever before.

In 1995, a brand completely new and better Dave Palumbo came to the forefront.

Today, close to 80 pounds more.

He competed in at the NPC Junior Nationals and took first overall.

His highest-ever finish was in 2003 in the NPC USA Championships where he finished 2 2nd as an extremely heavyweight.

Dave was among the largest and most beautiful bodybuilders to perform on the stage.

As time passed it became apparent that something was happening to his body.

Time is catching up to us every day, except for Dave.

His body seemed to get more and more ill over the course of the week!

His physique was transformed so dramatically that people started referring to this transformation as "Palumboism.".

What is Palumboism?

We now are aware of whom Dave Palumbo is.

We now have to consider what Palumboism is.

We said that he was a professional, but he was never a professional.

Dave was among the most admired and powerful bodybuilders working in the field.

He was large, lean and beautiful.

As time went on but his body was beginning to decline.

There were no obvious injuries and appeared to not miss a moment in the training.

What's the matter?

Images surfaced of Dave appearing on stage, and he began to laugh. image online.

We all know how unfriendly the bodybuilding online community can be.

The picture went viral.

In the picture, Dave's stomach was like it was bloated and twice as large as it was previously.

His muscles appeared like they were swollen and bloated He looked as if the sufferer of an ounce of muscular atrophy, too.

He appeared to be finished He looked shabby, which the truth was that he was.

His performance was severely affected and he was forced leave the stage to look for new opportunities within a short time.

A Palumbo-related Cause:

In reality there isn't a clear reason for the condition referred to as Palumboism.

Although everyone has their own opinion, everyone has their own.

The majority of opinion however is that it's caused by an sensitivity to the humans' growth hormone.

HGH results in what is commonly referred to as what is known as a growth gut in bodybuilders..

This makes slim bodybuilders look fat.

They also appear to be pregnant or have the effects of a beer stomach.

HGH guts are a result of the hormone that causes human growth causes the organs to expand and expand in the abdomen.

As they expand and grow they put pressure onto the abdomen, which causes it to look bloated , and expanding.

There are theories that suggest different causes.

However, HGH abuse and possibly insulin abuse in a certain degree.

It is believed to be the most important factor.

It is important to remember that it was a decade earlier.

Dave Palumbo faced criminal charges for possession and distribution of human growth hormones to other athletes with whom he was training.

He admitted guilt to the accusations and was sentenced to five months in federal prison.

As a result, it appears, he obviously had access HGH.

Then, he was found guilty of facilitating with it.

It's not beyond the realm of possibility that he could use this hormone in the bodybuilding contests he competed in.

Are Palumboism A Cease?

A few people were so stunned to learn that the Dave's body changed drastically and in such a short time.

They believed that they were convinced he was sick and suffering from a plethora of ailments.

His body was transformed, so did the muscle mass levels and even his face appeared to alter.

The truth is, however, that Palumboism isn't an illness.

And , contrary to popular belief.

It's all caused by the use of HGH as well as other hormones, and illegal substances and drugs.

Does Palumboism only affect bodybuilders?

If you're familiar with bodybuilding, you are probably familiar.

You'll be aware the fact that Dave Palumbo is not the only athlete who has suffered the apparent negative effects of HGH as well as other compounds and hormones.

Bodybuilders from other countries, pros and amateur.

I've also experienced pain as well, and will be looking at these issues to conclude the article today.

Then, there is the question as to whether or not Palumboism can be considered a religion.

Read more from the original source:
What Is Palumboism (Bubble Gut)? Causes And The Worst Cases! - Deccan Herald

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