Latest news with #weightmanagement
Medscape
a day ago
- Health
- Medscape
Managing Weight in Older Adults Isn't About Weight at All
While weight loss is often the goal of weight management, weight management in older adults should go beyond weight loss to focus on functional health outcomes, comorbidity improvements, and harm reduction. Beverly Tchang, MD Weight management in older adults requires greater mindfulness and clinical nuance than in younger populations, owing to the increased risk of potential harm. Aging is commonly accompanied by a rise in medical complexity — older adults are more likely to live with multiple chronic conditions and to take several medications, which adds important layers of consideration when pursuing weight loss interventions. Over 50% of older adults have three or more chronic diseases. These overlapping conditions demand coordinated, multidisciplinary care. Within this context, clinicians must consider how meaningful weight loss might improve obesity-related complications, while also weighing the potential for unintended consequences that can arise from rapid or unmonitored changes in health status. Polypharmacy is a common concern in geriatric care and adds to the complexity of weight management. Among adults aged 65 and older with Medicare insurance, the median number of prescription medications was four. Older patients may be prescribed medications associated with potential weight gain, such as first-generation antihistamines or beta-blockers. Polypharmacy not only increases the risk of adverse drug-drug interactions but also necessitates vigilant monitoring during weight loss, particularly when medications are weight-dependent. A case report on thyrotoxicosis in the setting of 30% weight loss with tirzepatide highlighted the importance of adjusting weight-based medications like levothyroxine. Because obesity is the root cause or contributor to several other cardiometabolic diseases, obesity treatment has been demonstrated to improve several weight-related consequences. The Look AHEAD trial of adults with type 2 diabetes reported an average 8.6% weight loss and associated improvements in blood pressure, lipid profiles, and glycemic status. Obesity pharmacotherapy advances, which now grants access to 15%-20% weight loss thresholds, have been associated with de-escalation of antihypertensive and lipid-lowering therapies. In a secondary analysis of trials for semaglutide 2.4 mg, 34% vs 15% of participants experienced a discontinuation or dose reduction in their anti-hypertensive medication, while maintaining normal blood pressures. While such observational data is insufficient to establish recommendations, they implore attention: As weight loss is achieved, medication regimens should be regularly reviewed for potential deprescribing to reduce the risk of overtreatment, adverse effects, and polypharmacy-related complications. Beyond cardiometabolic disease, sarcopenia— the age-related decline in muscle mass and function — is another critical consideration. Clinicians should focus on evidence-based nutrition and physical activity recommendations demonstrated to preserve lean mass and function. Higher protein intake has been consistently demonstrated to preserve lean mass or improve body composition in the setting of weight loss. High protein diets (ie, greater than 0.8 g/kg/d) are commonly recommended alongside a progressive strength training program. In a weight loss study of adults with obesity, participants were randomized to a high protein supplement vs an isocaloric supplement and participated in a resistance exercise program 3 times/week for 13 weeks. While weight loss and fat mass loss between groups did not differ, those on the higher protein supplement (1.1 g/kg/d of protein) gained 0.4 kg +/- 1.2 kg of appendicular muscle mass while those on the isocaloric supplement (0.85 g/kg/d of protein) lost 0.5 +/- 2.1 kg ( P =.03). Similar studies focusing on resistance training have replicated these benefits across studies. A systematic review and meta-analysis of six randomized controlled trials that enrolled older adults with obesity compared weight loss via caloric restriction alone vs weight loss via caloric restriction plus resistance training; resistance training reduced 93.5% of the lean body mass loss associated with calorie restriction. Additionally, the strength-to-lean body mass ratio improved when resistance training accompanied calorie restriction compared to calorie restriction alone (20.9% vs -7.5%). However, muscle preservation is only half the story. Bone health is an equally important concern during weight loss in older adults. Rapid or sustained weight reduction can have unintended effects on bone density, which in turn can increase the risk of fractures. Few studies have examined the incidence of fracture rate after long-term and sustained weight loss. In the aforementioned Look AHEAD study of adults with type 2 diabetes, no significant difference in incident fracture rate was observed over a median of 9.6 years (373 participants randomized to intensive lifestyle intervention vs 358 randomized to standard diabetes education), but a composite of the first occurrence of a hip, upper arm, or shoulder fracture was found to be 39% higher in the intervention group. Long-term outcome studies examining risk of fractures with medical weight management have not been conducted, but the increased risk of fractures observed among individuals who have undergone bariatric surgery informed guidelines to recommend earlier, repeated osteoporosis screening and higher vitamin D supplementation to optimize bone health. Overall, obesity management in older adults requires a careful and tailored approach that is attentive to comorbidity management and that prioritizes risk mitigation. Increasingly, the effects of obesity on all aspects of a person's quality of life is being recognized, and patients should be informed on how weight loss may interact with coexisting medical conditions, medication regimens, and musculoskeletal health. Clinicians who treat obesity in older adults should be prepared to manage patients across these intersections, or coordinate care with registered dietitian-nutritionists, exercise physiologists, endocrinologists, and primary care professionals.
Daily Mail
26-05-2025
- Health
- Daily Mail
Is this finally a cure for the awful side effects of weight loss jabs? KATIE JOHNSTON was so sick on Mounjaro she had to stop. Now a tonic is said to stop the unbearable nausea, muscle loss and brain fog
For millions who've battled with weight loss, drugs like Ozempic and Mounjaro have succeeded where everything else failed - but their well-documented side effects remain a major deterrent. Katie Johnston is one such example of a woman in her thirties who long struggled to maintain a healthy weight, only to find the solution came with a host of downsides.
Globe and Mail
22-05-2025
- Business
- Globe and Mail
Better Weight Loss Stock: Amgen or Viking Therapeutics?
Investors looking to cash in on the fast-growing market for weight management medicines will naturally turn to the two leaders in this area, Eli Lilly and Novo Nordisk. However, several other companies seem to have somewhat promising prospects in this field. This group includes Amgen (NASDAQ: AMGN) and Viking Therapeutics (NASDAQ: VKTX), two drugmakers that have produced phase 2 clinical trial data for their leading weight management candidates. Despite these positive clinical developments, Amgen and Viking Therapeutics have performed poorly on the stock market in the past 12 months, though progress in this area might eventually help them bounce back. But which of these two biotechs should investors trying to profit from the rapid spending on anti-obesity medicines put their money in? Where to invest $1,000 right now? Our analyst team just revealed what they believe are the 10 best stocks to buy right now. Learn More » The case for Amgen Amgen's leading weight loss candidate is called MariTide. In November, the biotech reported that in a phase 2 study, the medicine led to an average weight loss of about 20% in overweight or obese patients after 52 weeks, with no weight loss plateau observed. Importantly, MariTide is administered subcutaneously once a month -- the current weight management leaders are taken once weekly. A less frequent dosing could appeal to many patients. The market expected greater weight loss in this study. That's why Amgen's shares fell after it released its phase 2 results. However, the company's data still makes it somewhat likely that it will go on to carve out a solid niche in the rapidly growing weight loss area, although it won't dethrone the leaders. Further, Amgen's prospects go well beyond its work in the anti-obesity market. The company's deep lineup allows it to generate consistent revenue and profits. In the first quarter, Amgen's sales increased by 9% year over year to $8.1 billion, while its adjusted earnings per share came in at $4.90, 24% higher than the year-ago period. Amgen has several growth drivers. Tezspire, an asthma medicine, is performing well, as is Prolia, a treatment for osteoporosis (a bone disease) in postmenopausal women. Amgen also has a deep pipeline of investigational products besides MariTide that will eventually lead to brand-new medicines. Lastly, it is an excellent dividend stock. It offers a forward yield of 3.5% -- compared to the S&P 500 index's average of 1.3% -- and has increased its payouts by 201.3% in the past 10 years. Amgen could generate strong returns over the long run even if MariTide doesn't pan out. The case for Viking Therapeutics Viking Therapeutics is a clinical-stage biotech. The company's VK2735, its weight management candidate, looks promising. Last year, it reported that at the highest dose, the drug led to a placebo-adjusted mean weight loss of 13.1% (or 14.7% from baseline) after a mere 13 weeks. VK2735 is in the same class of drugs as Eli Lilly's Zepbound. It mimics the action of two gut hormones: GLP-1 and GIP. That doesn't guarantee that it will achieve the same kind of success, but so far, the data looks highly encouraging. Viking Therapeutics has other candidates. The company's VK2809 targets metabolic dysfunction-associated steatohepatitis. It delivered solid phase 2 results last year. Viking Therapeutics is also developing an oral formulation of VK2735 that is currently in mid-stage studies, while VK0214 is an investigational treatment for a rare, nervous system disorder called X-linked adrenoleukodystrophy. There is no approved treatment for the disease yet. Viking Therapeutics carries above-average risk, as do all biotech companies without a single product on the market. But if VK2735 aces phase 3 results and earns approval -- and Viking's other candidates pan out as well -- the stock could deliver substantial returns. The verdict Amgen is a well-established company that generates consistent financial results. It also pays a dividend. It is a far better option for low-risk, income-seeking investors. There is no contest there. However, Viking Therapeutics has far more upside potential. If the smaller biotech can deliver solid pipeline and regulatory progress in the next few years, its shares will likely skyrocket. Note that the company also has significant potential drawbacks. It could be more appealing for investors with a higher tolerance for volatility. Should you invest $1,000 in Amgen right now? Before you buy stock in Amgen, consider this: The Motley Fool Stock Advisor analyst team just identified what they believe are the 10 best stocks for investors to buy now… and Amgen wasn't one of them. The 10 stocks that made the cut could produce monster returns in the coming years. Consider when Netflix made this list on December 17, 2004... if you invested $1,000 at the time of our recommendation, you'd have $644,254!* Or when Nvidia made this list on April 15, 2005... if you invested $1,000 at the time of our recommendation, you'd have $807,814!* Now, it's worth noting Stock Advisor 's total average return is962% — a market-crushing outperformance compared to169%for the S&P 500. Don't miss out on the latest top 10 list, available when you join Stock Advisor. See the 10 stocks » *Stock Advisor returns as of May 19, 2025 Prosper Junior Bakiny has positions in Eli Lilly, Novo Nordisk, and Viking Therapeutics. The Motley Fool has positions in and recommends Amgen. The Motley Fool recommends Novo Nordisk and Viking Therapeutics. The Motley Fool has a disclosure policy.
Telegraph
22-05-2025
- Health
- Telegraph
Why eating less carbs burns just as much fat as fasting
Intermittent fasting is now one of the most-followed dietary patterns in the developed world. According to a 2022 survey, about 10 per cent of American adults practise intermittent fasting, and while the same stats for Britain don't exist, we all know someone who now skips breakfast to maintain their eight hour 'eating window' each day. It's a fact that pleases nutritionists, doctors and diabetes experts alike. Keeping our eating to a tight timeframe 'can help your body shift from burning food as fuel to burning fat, helping with weight management or weight loss, regulating your blood sugar levels and giving you more energy throughout the day,' says nutritionist Rhian Stephenson, founder of the supplement brand Artah. But there is an obvious downside to time-restricted eating. The hours spent waiting for the eating window to open are often spent feeling ravenous, miserable and totally drained, and the early dinners that are necessary on this diet – as eating typically stops at 8pm sharp – can become anti-social. What if there was a way to get all of the health benefits of intermittent fasting, and at the same time enjoy both a filling breakfast and a late evening meal? New research suggests that this could be possible after all – if you're willing to cut carbohydrates out of some of your meals. A study from the University of Surrey, published in April, suggests that 'by restricting carbohydrate intake, without restricting calorie consumption, people can potentially reap all the same benefits that are associated with short-term fasting,' says Dr Adam Collins, an associate professor of nutrition who led the research. A recent study led by Dr Collins found that by reducing the amount of pasta, potatoes of bread you eat and following a low-carb diet, it can bring all the benefits that we've come to associate with fasting. Most importantly, a switch to burning fat rather than food for fuel, which can lower blood sugar and inflammation and potentially make us less prone to heart disease and diabetes in the long run 'Cutting down on carbs for a few days each week could therefore be a more sustainable but equally effective way for people to manage and improve their metabolic health,' he adds. 'That could take the form of having a 'carb window' instead of a food window, or something similar to the 5:2 diet, which is where people eat normally five days a week, and on the remaining two they eat one meal or five to six hundred calories.' How it works Dr Collins' study followed the same group of 32 people, all of whom were overweight according to their BMI, across three different days (with five 'washout' days in between). On day one, the participants ate enough calories to meet their daily needs, ranging from 1,800 to 3,000 based on their weight and gender. On day two, they ate a low-carb, low-calorie diet: women in the study were restricted to around 550 calories, while men ate around 650 calories, and both groups ate 50g of carbohydrates (roughly the amount of carbs in a small portion of cooked pasta). On the third day, the group could eat as many calories as they needed, but had to keep their carbohydrate consumption to 50g a day. 'Both low-carb days led to improvements in the participants' metabolic health markers, including a shift into a fat-burning state, and how well they could process a high-fat meal after we observed them,' Dr Collins says. 'Essentially, all the benefits you usually get from fasting were still observed when people just ate fewer carbs.' The Surrey University team were 'tease out the effects of carb restriction from those of calorie restriction,' explains Dr Collins. Crucially, the study didn't look at weight loss – 'you can't measure that after just one day,' he points out. But in the real world, 'when people eat fewer carbohydrates, they take on fewer calories,' leading to a loss in weight, primarily in the form of fat. This is important to understanding metabolic health as a whole, not only for those who want to lose weight. 'Restricting your carb intake for a few days each week means that you avoid over-fuelling your body and will only ever be burning food as fuel. Being able to switch into fat-burning mode is crucial to avoiding health complications as you age, like diabetes, heart disease and weight gain,' Dr Collins says. Though you'll only get visibly slimmer if you eat fewer calories than you burn, fasting and carb-restricted eating in any amount 'could both potentially burn some of the fat that develops inside of your organs when you consistently eat more carbohydrates than you burn,' a huge health boost as this kind of fat has been linked to increased risk of heart disease, stroke, and Type 2 diabetes. As Naveed Sattar, a professor of metabolic medicine from the University of Glasgow points out, 'this study is small, and you'd need a big, long-term study to see exactly what the effects of this type of eating would be'. But 'it's very exciting, and potentially could do a lot to inform the dietary advice we give to people at risk of diabetes and heart disease in future'. This study only involved people who are over a healthy weight range for their height, 'but we'd expect to see similar impacts in people who are a healthy weight too,' says Dr Collins, 'though the less metabolically healthy someone is, the more exaggerated the effect will be'. This is good news if you're attempting to turn your health around quickly. Intermittent fasting vs low-carb diets For all the benefits that come with intermittent fasting there are also drawbacks, and more serious ones than raging hunger. 'When people practise intermittent fasting consistently for weeks or months, they often put themselves at risk of nutrient deficiencies,' says Stephenson. 'The fewer calories you eat every day, the harder it is for you to get all of the nutrients you need – and keeping a small eating window doesn't mean that you will eat healthily.' There are also groups of people who don't get on well with fasting for reasons other than hunger. 'I don't recommend fasting to perimenopausal or menopausal women, because fasting can disrupt your hormones and put more strain on your body at a time when it is already under a lot of stress,' she says. A carb-cycling diet could give these women 'some of the same benefits of fasting without the drawbacks,' Stephenson adds. And while fasting can be good for all of us, not everyone wants – or needs – to lose weight. 'Weight loss is a product of eating fewer calories than you expend, so if you eat enough or more than enough calories while limiting your carb consumption, you won't lose weight,' Stephenson explains. This could make a few low-carb days 'a particularly good option for people who have lost weight and are looking for a way to maintain it,' says Dr Collins. 'That's very difficult to do, and currently we don't have much to offer people in that position.' That said, restricting carbohydrates could come with its own risks. 'There's some evidence to suggest that low-carbohydrate diets can be bad for your heart, where you replace the carbs primarily with fat,' says Prof Sattar. 'There could be other dangers that we wouldn't be able to identify outside of a large-scale randomised clinical trial.' For this reason, Stephenson suggests cutting your daily carbohydrate intake to no less than 100g, unless you're working with a nutritionist or doctor. 'It's also worth considering counting 'net carbs' rather than total carbs, by subtracting the grams of fibre in your food from the total carb count on the packet,' she adds. This is because your body doesn't use all of the carbohydrates you consume. Net carbs represent the amount of carb that can impact your blood sugar. One day on a low-carb, fat-burning diet Eating a low-carb diet for one or two days each week can be a lot easier than you might think. Here are two plans put together by Rhian Stephenson, so that you can eat well while you give it a go. Option 1 50g of carbohydrates, 1,800 calories 'This is similar to what participants ate in terms of carbohydrates in the study, and is concentrated within one meal to mimic a 'window' style of eating,' says Stephenson. 'It might also lead to weight loss if you follow this plan regularly, depending on your current weight and how much you exercise.' Breakfast: Spinach and egg scramble 2g net carbs Ingredients 150g chicken breast cooked with olive oil, lemon, salt, pepper and herbs 200g lentils cooked with half an onion and olive oil 150g cherry tomatoes 1 kiwi Option 2 Under 100g of carbohydrates, 1800 calories 'This is a more realistic version of a low-carb day that would better support your health if followed regularly, as it involves more carbohydrate intake that is spread throughout the day,' says Stephenson. 'Depending on your weight and how much you move, eating with this plan regularly might also lead to weight loss, but you could reduce some portion sizes or skip the snack to create a calorie deficit if you want to lose weight.' Breakfast: Overnight oats 34g net carbs Ingredients 45g of jumbo oats 1 tbsp peanut butter 200ml unsweetened soy milk 1 tbsp walnuts 100g raspberries Sprinkle of cinnamon 1 boiled egg Lunch: Tuna and chickpea salad 14g net carbs Ingredients Large green salad with mixed veg, cucumber, tomatoes and red pepper 1 can tuna in olive oil 50g chickpeas Oil and vinegar to dress Dinner: Chicken stir fry 12g net carbs Ingredients Half a head of cauliflower (to make cauliflower rice) One head of pak choi 150g chicken 100g mushrooms 35g sugar snap peas Sauce with tamari, sesame oil, vinegar, garlic and ginger Snack: Yogurt and fruit 10g net carb Ingredients 100g Greek yogurt 80g low-sugar fruit (eg Cantaloupe) 2 tbsp sunflower seeds
BBC News
21-05-2025
- Health
- BBC News
Northern Ireland to launch first obesity management service
Northern Ireland's first regional obesity management service has been approved by the health minister. Mike Nesbitt's announcement follows a public consultation by the Department of Health (DOH) on the proposed introduction of such a service. Currently, health service patients in Northern Ireland do not have access to specialist weight management provision. The first phase, which is scheduled to begin in 2026, will focus on the development of a community-based service where patients will have access to lifestyle support as well as obesity medication, if clinically appropriate. The department said: "The service will support access to weight loss medication in line with National Institute for Health and Care Excellence guidance.""Any rollout will be carefully managed in a phased manner to ensure that treatment is provided in a safe and effective manner."
