Weekly spin class ‘better than physio' for people with common hip issue
It it estimated that the condition affects about 3.2 million people in the UK.
For the trial, experts from Bournemouth University and University Hospitals Dorset (UHD) compared usual physiotherapy care with an eight-week exercise and education programme known as Chain (cycling against hip pain).
The study, published in The Lancet Rheumatology, included 211 people, with roughly half assigned to each group.
The Chain group attended weekly education sessions from a physiotherapist, lasting around 30 minutes, followed by a 30-minute session of static cycling led by a gym instructor.
The effects of treatment on patients were measured by the Hip Disability and Osteoarthritis Outcome Score (HOOS) activities of daily living (ADL) subscale, which assesses how hip problems affect various daily activities.
The study found those who completed the cycling classes had a 'statistically significant improvement in patient-reported function after treatment'.
Researchers said the method 'showed superior outcomes compared with usual physiotherapy care, and the feasibility of delivering a low-cost, community-based intervention within the NHS was shown'.
However, they stress the 'longer-term benefits and broader generalisability warrant further investigation'.
Tom Wainwright, a professor of orthopaedics at Bournemouth University and a physiotherapist at UHD, said: 'For the time it takes to treat one patient using standard physiotherapy, we can treat multiple patients in a group session and provide them with better outcomes.
'This has proved to be more cost-effective than standard treatment and so we hope this will contribute to reducing NHS waiting times for physiotherapy treatment in the future.'
Professor Rob Middleton, of Bournemouth University and an orthopaedic surgeon at UHD, said: 'Hip replacements cost the NHS over £6,000 per patient, so avoiding surgery for hip problems reduces the burden on the NHS, saves money, and provides better outcomes for patients.
'Now with this new study we can also see the potential for static cycling to save further money for the NHS by bringing down waiting lists for physiotherapy.'
Dr Peter Wilson, chief medical officer at UHD, said: 'We are an ageing population and increasingly we are seeing more patients with osteoarthritis that need either surgery or physiotherapy.
'Finding alternative ways to treat these patients could help reduce waiting times and the financial demand on NHS services.'
The Chain intervention was first launched in 2013 and patients who wish to take part are referred to UHD from their GP.
To bolster access on a national level, experts from Bournemouth University had developed a virtual course on their education app, allowing people to follow the programme from their home or local gym.
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Daily Mirror
35 minutes ago
- Daily Mirror
Parents who have children with autism or ADHD can claim up to £16,157 from DWP
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Telegraph
37 minutes ago
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Three diets that are more effective than weight-loss drugs, according to doctors
The weight-loss jab boom is in full swing. With celebrities showing off dramatic transformations, #ozempicbody trending on TikTok, and many buying GLP-1 drugs like Mounjaro, Wegovy and Ozempic to slim down for beach holidays, it's estimated 1.5 million Britons are now using weight-loss drugs – with 95 per cent accessing them privately, from online pharmacies or weight-loss clinics. There was good news recently for anyone hoping to try the latest weight-loss injections: the NHS announced that Mounjaro will now be available through GP surgeries in England for patients with severe obesity and the 'highest clinical need'. Over the next three years, almost a quarter of a million people are expected to benefit. GLP-1 drugs, originally designed to treat type-2 diabetes, are widely hailed as a game changer for tackling obesity. Clinical trials suggest the jabs can help users lose 15-20 per cent of their body weight. They regulate blood-sugar levels and may improve conditions linked to excess weight, including high blood pressure, fatty liver disease and sleep apnoea. However, as the Mounjaro rollout begins, concerns are mounting among doctors and public health experts that the GLP-1 gold rush is distracting from safer, more sustainable solutions for solving the UK's ailing metabolic health. Alongside the soaring demand, reports of GLP-1 side effects are growing: from nausea and constipation to gallbladder problems and, now, hundreds of cases of pancreatitis. 'There's been a rush to embrace GLP-1 drugs as a magic bullet, but we're not talking enough about the risks,' says Dr David Unwin, award-winning GP and scientific adviser to the Public Health Collaboration (PHC), a charity that champions lifestyle-based approaches to metabolic health. 'A BMJ investigation shows there have been 82 deaths associated with these medications. Yet most patients assume the drugs are safe. People are accessing them online, without proper medical supervision. It's like the Wild West.' While he acknowledges GLP-1s have a role to play, he and other doctors are concerned the drugs are being promoted as a fix-all, and are quietly proving that targeted diet and lifestyle programmes can achieve similar results – without side effects. 'You can stimulate your own GLP-1, naturally, through food and exercise,' says Dr Unwin, who is known for pioneering the low-carb diet for obesity and diabetes in the UK. 'A low-carb, high-protein diet is shown to boost GLP-1 levels. And it doesn't come with nausea or cost a fortune.' Dr Campbell Murdoch is a GP with a special interest in metabolic health who launched a Metabolic Health 28-Day Plan combining a high-protein, low-carb diet with time-restricted eating, movement, easy lifestyle changes and mindset support. Originally created for NHS patients at his practice in Somerset, the results were so positive, the programme has been made freely available online. 'The GLP-1 boom has at least put metabolic health on the radar,' says Dr Murdoch. 'Now we need to give people complete solutions, including lifestyle, not just the drugs.' Here are the three diets doctors recommend. Low-carb diet Key benefits: simple and sustainable The low-carb diet is proven to get results and can curb food cravings, reverse type 2 diabetes and deliver comparable weight loss to GLP-1s, suggests latest research. Cutting down on sugar and starchy carbs deprives the body of its primary fuel, glucose. It starts burning body fat instead, leading to weight loss. Blood-sugar levels stabilise, appetite regulates, and insulin levels fall, leading to better metabolic health and lower risk of type 2 diabetes and cardiovascular disease. Dr Unwin has been spearheading the low-carb approach at his NHS clinic in Southport for the past 13 years, with striking results. 'On average, patients lose 10kg (22lbs) in the first year,' he says. 'We've helped 151 people achieve drug-free diabetes remission. That's 27 per cent of our diabetic population. We've saved £370,000 on diabetes medication.' In total, 51 per cent of Dr Unwin's patients with type 2 diabetes achieve remission, another 47 per cent get better control over their condition. And over 90 per cent of patients with pre-diabetes return to normal blood-sugar levels. Dr Unwin's approach has been adopted all over the world, through The Low-Carb Program and a free NHS-approved app. The method is simple, says Dr Unwin. 'Eat a nutritionally dense diet that doesn't raise your blood sugar.' Officially, low carb means eating less than 130g of carbs a day (for context, one apple is 25g, a bowl of pasta 40g). However, Dr Unwin recommends focusing less on numbers and more on cutting out sugar and starchy carbs, like bread, cereals and potatoes, while increasing protein and green veg. A typical low-carb meal might be baked salmon with asparagus and cauliflower rice. 'When you eat in a way that doesn't spike blood sugar, and includes enough protein, you stay feeling full, partly through natural, GLP-1 production,' explains Dr Unwin. Kirsten Linaker, 48, turned to the low-carb diet after weight-loss injections failed to help her. 'Dr Unwin gave me simple diet advice and a blood-glucose monitor, so I could see how foods like chocolate spiked my blood sugar,' she says. 'Now, I've lost almost 6st and have gone from size 26 to 14. I'm off my diabetic medication, and my food cravings have gone. I used to sit in bed at night, eating biscuits, now I'm just not hungry anymore. I don't even miss sweet stuff.' If you're following a low-carb diet, be sure to include nutritious foods, rich in fibre. If you have an existing medical problem, see your GP first. Keto diet Key benefit: rapid results The ketogenic, or 'keto' diet, is a more restrictive, high-fat, even lower carbohydrate approach designed to induce a fat-burning state in the body called ketosis. Followers of the diet aim for 20-50g carbs per day (drastically less than the 130g as on the low carb diet). It's proven to offer immediate weight loss and appetite suppression, along with metabolic-health benefits. 'In my experience, the keto diet gives the same benefits as GLP-1s, such as reduced appetite and elimination of food noise, without the side effects,' says Dr Eric Westman, associate professor of medicine at Duke University and director of the Duke Keto Medicine Clinic. When carb intake is drastically restricted, the body switches into ketosis, a metabolic state in which it burns fat for fuel, by converting it to ketones. This reduces blood glucose and insulin, and lowers levels of the hunger hormone, ghrelin. People can lose several pounds in the first week, gradually slowing to a more sustainable rate. Dr Westman's clinical research has shown that a keto diet can put type 2 diabetes into remission. Around 98 per cent of his patients with type 2 diabetes come off insulin. 'Patients typically lose one to two pounds a week,' he says. 'I can safely de-prescribe medications for diabetes, hypertension, heartburn and arthritis.' A meta-analysis of trials, in Nutrients, found that ketogenic diets gave better weight loss and blood-sugar control than a low-carb diet. Sharon Grey, 56, was almost 18st and living with type 2 diabetes, Nash (non-alcoholic fatty liver disease), high blood pressure and depression before she began Dr Westman's keto programme ( After 13 months, her weight had dropped to 12st 8lb. 'I reversed my type 2 diabetes and Nash, and my blood pressure is normal again,' she says. 'My headaches, backache and knee pain improved, my mood is better and I'm taking fewer medications.' The key to keto success is to keep carbs under 50g a day. Include plenty of protein, says Dr Westman. 'Protein is critical as it helps you feel full, and ensures you lose fat, not muscle,' he says. 'Don't overdo the dietary fat - if you eat too much of it, your body will burn that, rather than body fat.' His top five keto foods are eggs, meat or poultry, seafood, non-starchy veg (like cauliflower or broccoli) and leafy greens. So when should you choose keto, rather than a low-carb diet? 'Keto isn't always necessary, but in severe cases, it can be beneficial,' says Dr Murdoch. 'The keto diet offers rapid results and some patients feel better on it,' adds Dr Unwin. 'However, it's more complicated than a standard, low-carb diet, and not essential for reversing type 2 diabetes.' Transitioning to ketosis can trigger temporary fatigue and nausea, called 'keto flu'. If you're on medication, or have a medical condition, only try keto under medical supervision, advises Dr Westman. Intermittent fasting Key benefits: cheap and effective If you don't like calorie counting, focusing on when you eat, rather than what you eat, could be the solution. Intermittent fasting – alternating periods of eating and fasting, such as the popular 5:2 diet – can lead to an average weight loss of five to nine per cent of body weight over three to 12 months, according to research. 'When we don't eat, the body moves into fat-release mode,' explains Dr Murdoch. 'Fasting gives the body longer to use up stored sugar and burn body fat. That's why it improves blood-sugar control, too.' Among the most effective fasting methods is time-restricted eating (TRE), where you consume your food within a defined window each day, followed by an overnight fast. A study at Manchester Metropolitan University found that just three days on the 16:8 method (eating within an eight-hour window and fasting for 16 hours) significantly improved blood-sugar control in people with type 2 diabetes. 'TRE offers promising benefits for weight loss, glucose regulation and metabolic health – without calorie counting,' says study lead Dr Kelly Bowden Davies. 'While average weight loss is typically less than with GLP-1 drugs, prolonged use of TRE is a cheaper, safer and more accessible alternative – especially when combined with lifestyle changes.' That's the approach taken by Dr Murdoch with his Metabolic Health 28-Day Plan. It combines time-restricted eating (11am-7pm), focusing on lower-carb (often under 70g a day), high-protein (1-2g per kilo of body weight a day) foods, daily movement (for example, squats while the kettle boils) and seven hours' sleep, presented as a tick list of 10 daily habits. 'People often lose half a stone to a stone in the first month,' says Dr Murdoch. 'Blood pressure, blood sugar, mood and energy all improve. It's as effective as GLP-1s, for a fraction of the cost, and with far better sustainability.' Donna Brewer, 48, weighed nearly 22st when she started the plan in April. 'I'd gradually gone from a size 14 to a 24. I felt sluggish, tired, anxious, and my blood pressure was dangerously high,' she says. 'After 28 days, I'd lost almost one-and-a-half stone. Now I'm down more than 2st, my waist's shrunk from 130cm to 118cm, and I'm off medication. I feel so much happier and more energetic. It's not like a diet – more a shift in mindset.' The health risks of GLP-1s Using GLP-1 drugs without nutrition advice or lifestyle support can lead to malnutrition and even accelerated ageing, caution experts. 'GLP-1s reduce appetite but if you simply eat less of a regular, poor diet, you risk becoming deficient in protein and nutrients – and this drives muscle loss,' says Dr Murdoch. 'We're already seeing muscle loss and then weight regain when people stop taking the drugs.' An Oxford University review found that most people regain the weight within 10 months of stopping GPL-1s. 'The drugs are only licensed for two years [and many patients give up earlier],' says Dr Murdoch. 'After that, if you haven't changed your habits, the weight comes back – and you've lost muscle along the way, which is hard to get back.' In a recent clinical trial, 42 per cent of over-60s lost at least 10 per cent of their muscle power – the equivalent of ageing 7.5 years – within six months of taking the GLP-1 drug semaglutide. 'You need to pair these drugs with resistance training and proper nutrition, particularly protein,' says Dr Murdoch. GLP-1s do have a role to play, say the doctors. 'For people addicted to ultra-processed food or who struggle to give up starchy carbs, GLP-1s can be a temporary tool, if combined with nutritional support,' says Dr Unwin. 'I recently had a 75-year-old patient who lost a stone and a half and came off insulin by combining a GLP-1 with a low-carb diet.' However, he and other doctors are concerned the drugs are being promoted as a fix-all. 'The way weight-loss drugs are being pushed as a default solution is worrying,' says Dr David Jehring, chairman of the PHC, chief executive of Black Pear Software and creator of Elevate, a new AI personal health coach, soon to be trialled in the NHS. ' GLP-1s are now so widely available, primary care services are being told they don't need to offer dietary interventions.'
Metro
2 hours ago
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I'm proof 'Ozempic penis' exists — weight loss jabs gave me a huge boost in bed
Standing in front of the mirror, James* admired his new physique. Gone was the middle-aged spread and the gut that had been expanding rapidly since Christmas. Now, he was seeing muscles he'd never noticed before and looking at least 10 years younger. But that wasn't the best bit of his transformation. As he stood stark naked looking at his reflection, James couldn't help but notice that his penis also looked bigger than usual — and it was all down to 'miracle' weight loss drug Wegovy. The 55-year-old tells Metro: 'I'm not one to jump on celebrity fads, but I needed a little bit of an extra push. Dieting is the most painful, boring thing in the world and I'd heard a lot about Ozempic, so I did a lot of research and decided to give it a go. 'If it's good enough for Sharon Osbourne, it's good enough for me.' A semi-professional sportsman of two decades, James stepped back from competing last year, and alongside the fact he no longer had fitness targets helping him stay in shape, he found himself eating – and drinking – out of boredom. Wegovy, a brand name for semaglutide, is a GLP-1 inhibitor medication that targets the parts of the brain that regulate appetite and promotes the release of insulin when blood sugar levels are high. This makes people feel fuller, reducing hunger levels and cravings for high-fat foods. Alongside Mounjaro and Saxenda, it's one of three GLP-1 drugs prescribed by the NHS specifically for weight loss (whereas Ozempic – which uses the same active ingredient as Wegovy – is only approved for the treatment of type 2 diabetes) and is also available to purchase privately through specialist pharmacies. According to the UK Medicines and Healthcare products Regulatory Agency (MHRA), it can help reduce the risk of heart and circulatory disease in people living with excess weight. Wegovy is self-administered weekly with an injector pen, into the upper arms, stomach, thighs or buttocks. It's not a magic cure though. Patients still need to change their diet and reduce the amount of calories eaten to see effects, and regular exercise is also recommended. Additionally, there is evidence of weight regain when people stop using Wegovy. Common side effects of semaglutide include sickness, diarrhoea or constipation, headaches, tiredness, heartburn and bloating, while rarer problems can include gallbladder disease, inflammation of the pancreas, an increased heart rate and kidney issues. Although he was still exercising daily – clocking up an impressive 1,000km every month from cycling alone – when he stepped on the scales after a particularly indulgent Christmas, he decided things needed to change. So, six months ago, James started taking Wegovy. 'I think it's a miracle drug, to be honest,' he says. Getting rid of the dangerous visceral fat around his organs was the primary motivation for changing his lifestyle, but James admits: 'Sure, I wanted to look a little better too.' It was easy to get hold of Wegovy, which is a brand name for semaglutide and works in a similar way to Ozempic (though the latter isn't approved solely for weight loss in the UK, where it's specifically prescribed for the management blood sugar in type 2 diabetes patients). After putting his details into an online pharmacy – James admits he 'lied' on the application form to make sure he qualified – a fancy package of injectables arrived in the post. Describing the process of giving himself a jab in the stomach each week, James says: 'It doesn't hurt at all – you don't even feel it.' He began to feel the effects of the drug almost straight away though, becoming full after less food and having fewer cravings. At £160 to £260 (depending on the dose) per month, it's not cheap, but James reckons he's actually saving money overall. 'My weekly shop went down by £40 or £50 easily, and that's not including wine and Deliveroos which I spent about £80 to £100 a week on,' James explains. 'I've also saved a lot on toilet paper – I only go once a day now.' Since his first injection in February, the tech business owner claims he has lost 20% of his body weight. It's not just about dropping the kilos though, as James's blood pressure and visceral fat are both now back within a healthy range – and he's even sleeping better and not snoring. 'My body is in as good a condition as it's ever been,' he continues. 'I've got muscles in my forearm I never knew were there, I've lost fat and my muscles have come out. And my thighs look ridiculous.' Some men have claimed that taking GLP-1 injections hasn't just helped them lose inches from their waist, but has also added inches to their manhood — and even improved their performance in bed. The phenomenon, which has been dubbed 'Ozempic penis' on forums like Reddit, may be due to reduced fat around the pubic region which can make the penis appear larger. Dr Nidhi Kansal, an internal medicine physician at Northwestern Medicine in Chicago, tells Daily Mail these welcome side effects may also be caused by increased testosterone levels as a result of weight loss. Obesity in men has been linked to low testosterone, which can make you feel tired, lower your sex drive and impact erection quality, potentially making the penis look smaller. Losing weight (through medication or otherwise) can naturally boost the hormone, with a recent Endocrine Society report revealing a 20% rise in men being treated for obesity with GLP-1 medication. His confidence has been boosted too; a far cry from 'hibernating' at home and feeling self-conscious about his 'gut'. James (who is single and says he's 'blessed' to have never been married), adds: 'I look in the mirror and think, 'F*** me, I look good' these days.' Others have been equally complimentary about the newfound spring in his step too, and his exes remarking 'wow' when they see him now is a welcome consequence. Some people find their sex drive drops on semaglutide, as it can decrease the amount of dopamine (the pleasure neurotransmitter) released by more than just eating. Not for James, though, who says he's having 'better sex' as a result of the drug. 'If you have an impulsive drive for sex, it would affect that,' he explains. 'But I have a normal sexual appetite, so actually it's made me enjoy sex more because I'm not as self-conscious of my body and I've got more energy.' Apparently, Wegovy has also made an impact down below, and any fears people might have about it causing penis shrinkage are unfounded. 'If anything, my penis looks bigger, because you lose body fat around it and your overall mass gets smaller,' James says with a smile. 'It's like when you shave your bush and it makes it look bigger.' Nonetheless, he doesn't feel it's made him more attractive to women, as he believes they 'aren't interested in men's bodies.' 'They're interested in cars and money,' says James. 'The moral of the story is, you can be fat as long as you've got a big wallet and a nice car. You'll still attract women.' While he has managed to avoid the vast majority of potential side effects these weight loss drugs can cause, from diarrhoea to dizziness, James admits there have been some other downsides. His transformation meant he needed to buy a whole new wardrobe, and he finds he gets much colder now, needing to wear thermals and multiple layers in June. And while James did notice his face becoming more sallow as he lost weight, he leaned into the image overhaul and decided to have fillers, which 'made a massive difference' to counteract the telltale 'Ozempic face'. Wegovy impacts your appetite, but you won't go off your food altogether. James says: 'I eat normally – low GI cereal with fruit for breakfast and a protein shake for lunch; I gave up my lunchtime bagel. Dinner is normally a salad of some type with chicken, maybe pitta and hummus. 'On Sunday I had a sausage and a burger, as well as a bottle of wine with friends. Before I would have thought, 'that burger was great', and have a second one. I don't do that now.' You'll likely want fewer fatty foods while taking Wegovy, but it's important to balance eating in a caloric deficit with ensuring you get the nutrients you need. Like many users, James tends not to tell people he's taking Wegovy, as some consider it 'cheating' – a viewpoint he refutes. Instead, he thinks it should be made universally available for free or cheap. 'I think it's a tool, much like you can use anything as a tool,' he says. 'It's impossible to succeed without training and working out and eating more healthily. Yes, I perhaps wanted a bit of a quick fix. But it hasn't been a quick fix.' More Trending After reaching a plateau, James is now looking to come off the medication. But is he worried he'll revert back to his old ways once he does? 'I don't know,' he admits. 'I don't want to be on it for the rest of my life, but it was almost impossible for me to lose the weight I wanted to lose without it. It's like a little guardian angel on your shoulder saying 'Don't eat that!'.' View More » This article was first published on August 8, 2024. Do you have a story to share? 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