What you need to know about the new weight loss drug Zepbound
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In a recent poll, KFF found that nearly half of U.S. adults were interested in taking a weight management drug like the increasingly popular Ozempic, Wegovy, and Mounjaro.
“I can understand why there would be widespread interest in these medications,” says Dr. Alyssa Lampe Dominguez, an endocrinologist and clinical assistant professor at the University of Southern California. “Obesity is a chronic disease that is very difficult to treat. And a lot of the medications that we previously used weren’t as effective.”
Now, there’s a new option available: In November 2023, the FDA approved Zepbound, another weight management medication, developed by the pharmaceutical company Eli Lilly. Zepbound is different from other drugs in many ways, including the fact that it’s proven to be the most effective option so far.
Keep reading to find out more about Zepbound, including who can take it, its side effects, and more.
What is Zepbound?
Zepbound, one of the brand names for tirzepatide, is an injectable drug with a maximum dosage of 15 mg per week. It’s based on incretin, a hormone that’s naturally released in the gut after a meal. (Mounjaro is another brand name for tirzepatide.)
Tirzepatide is considered a dual agonist because it activates the two primary incretin hormones: the glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP) hormones.
According to Dr. Katherine H. Saunders, an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth, tirzepatide is involved with several processes that regulate blood sugar, slow the removal of food from the stomach, and affect brain areas involved in appetite.
This means that people taking the medication feel less hungry and get fuller faster, leading to less food intake and, ultimately, weight loss.
How is Zepbound different from Ozempic?
The medications are different in many ways. Ozempic and Wegovy, which are both brand names for semaglutide, only target the GLP-1 hormone. Studies have shown that Zepbound can lead to a higher percentage of total body weight loss than semaglutide medications. In addition to being more effective, there is some evidence that Zepbound is overall more tolerable than Ozempic or Wegovy.
“I have seen overall lower rates in severity of side effects with the tirzepatide medications. Mounjaro [tirzepatide] in particular is the one that I’ve used up until this point, but there’s a thought that the GIP component of the medication actually decreases nausea,” adds Lampe Dominguez. “Anecdotally, patients that I have switched from semaglutide or Ozempic to Mounjaro say that they have less side effects with Mounjaro.”
How is Zepbound different from Mounjaro?
Zepbound and Mounjaro are the same medication—tirzepatide—but they’re approved for different conditions. Zepbound is FDA-approved for weight loss, while Mounjaro is approved for type 2 diabetes. (However, Mounjaro is also at times prescribed off-label for weight loss.)
What are some of Zepbound’s side effects?
According to the FDA, side effects include nausea, vomiting, diarrhea, constipation, stomach discomfort and pain, fatigue, and burping. See a more comprehensive list of side effects here.
Who can take Zepbound?
Zepbound is FDA-approved for adults with obesity (a BMI of 30 or greater) or who have a BMI of 27 or greater with at least one weight-related condition, like high blood pressure, type 2 diabetes, or high cholesterol.
“I tend to advise patients who don’t meet those criteria to not take these medications because we really don’t know what the risks are,” says Lampe Dominguez, adding that people with lower BMI weren’t included in the medication’s studies. “We don’t know if there are specific risks to using this medication at a lower body mass index [or] if there might be some negative outcomes.”
Both doctors agree that it’s important for people who are interested in starting any weight loss medication to talk to their doctors about the potential risks and benefits. For instance, the FDA notes that Zepbound has caused thyroid tumors in rats, and while it’s unknown if this could also happen to humans, the agency said the medication shouldn’t be used in patients with a personal or family history of medullary thyroid cancer.
“Zepbound is a powerful medication that can lead to severe side effects, vitamin deficiencies, a complete lack of appetite, or too much weight loss if prescribed without the appropriate personalization, education, and close monitoring,” says Saunders.
“With all of these medications, and particularly with Zepbound, we would want to make sure that [patients] don’t have a family history of a specific type of thyroid cancer called medullary thyroid cancer,” says Lampe Dominguez.
How long should people take Zepbound for?
“Anti-obesity medications like Zepbound are not meant for short-term weight loss, but long-term treatment of obesity, which is a chronic disease,” explains Saunders. “We prepare our patients to be on the medication (or some type of medical obesity treatment) long term for their chronic disease, which is only controlled for the duration of time they’re being treated.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Women seem to feel pain more acutely and often feel ignored by doctors.
ShutterstockMedical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Exercises for Aging-Ankles
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Can Ankles Deterioration be Stopped?
As we all know (or have experienced!), Ankle mobility deteriorates with age.
We’re here to argue that it’s not all doom and gloom!
(In fact, we’ve written about keeping our feet, and associated body parts, healthy here).
This video by “Livinleggings” (below) provides a great argument that yes, ankle deterioration can be stopped, or even reversed. It’s a must-watch for anyone from yoga enthusiasts to gym warriors who might be unknowingly crippling their ankle-health.
How We Can Prioritise Our Ankles
Poor ankle flexibility isn’t just an inconvenience – it’s a direct route to knee issues, hip hiccups, and back pain. More importantly, ankle strength is a core component of building overall mobility.
With 12 muscles in the ankle, it can be overwhelming to work out which to strengthen – and how. But fear not, we can prioritise three of the twelve: the calf duo (gastrocnemius and soleus) and the shin’s main muscle, the tibialis anterior.
The first step is to test yourself! A simple wall test reveals any hidden truths about your ankle flexibility. Go to the 1:55 point in the video to see how it’s done.
If you can’t do it, you’ve got work to be done.
If you read the book we recommended on great functional exercises for seniors, then you may already be familiar with some super ankle exercises.
Otherwise, these four ankle exercises are a great starting point:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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The Link Between Introversion & Sensory Processing
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We’ve talked before about how to beat loneliness and isolation, and how that’s important for all of us, including those of us on the less social end of the scale.
However, while we all need at least the option of social contact in order to be at our best, there’s a large portion of the population who also need to be able to retreat to somewhere quiet to recover from too much social goings-on.
Clinically speaking, this sometimes gets called introversion, or at least a negative score for extroversion on the “Big Five Inventory”, the only personality-typing system that actually gets used in science. Today we’re going to be focusing on a term that typically gets applied to those generally considered introverts:
The “highly sensitive person”
This makes it sound like a very rare snowflake condition, when in fact the diagnostic criteria yield a population bell curve of 30:40:30, whereupon 30% are in the band of “high sensitivity”, 40% “normal sensitivity” and the remaining 30% “low sensitivity”.
You may note that “high” and “low” together outnumber “normal”, but statistics is like that. It is interesting to note, though, that this statistical spread renders it not a disorder, so much as simply a description.
You can read more about it here:
Sensory-processing sensitivity and its relation to introversion and emotionality
What it means in practical terms
Such a person will generally seek solitude more frequently during the day than others will, and it’s not because of misanthropy (at least, statistically speaking it’s not; can’t speak for individuals!), but rather, it’s about needing downtime after what has felt like too much sensory processing resulting:
If this need for solitude is not met (sometimes it’s simply not practicable), then it can lead to overwhelm.
Sidenote about overwhelm: pick your battles! No, pick fewer than that. Put some back. That’s still too many 😜
Back to seriousness: if you’re the sort of person to walk into a room and immediately do the Sherlock Holmes thing of noticing everything about everyone, who is doing what, what has changed about the room since last time you were there, etc… Then that’s great; it’s a sign of a sharp mind, but it’s also a lot of information to process and you’re probably going to need a little decompression afterwards:
This is the biological equivalent of needing to let an overworked computer or phone cool down after excessive high-intensity use of its CPU.
The same goes if you’re the sort of person who goes into “performance mode” when in company, is “the life and soul of the party” etc, and/or perhaps “the elegant hostess”, but needs to then collapse afterwards because it’s more of a role you play than your natural inclination.
Take care of your battery
To continue the technological metaphor from earlier, if you repeatedly overuse a device without allowing it cooldown periods, it will break down (and if it’s a certain generation of iPhone, it might explode).
Similarly, if you repeatedly overuse your own highly sensitive senses (such as being often in social environment where there’s a lot going on) without allowing yourself adequate cooldown periods, you will break down (or indeed, explode: not literally, but some people are prone to emotional outbursts after bottling things up).
None of this is good for the health, not in the short term and not in the long term, either:
With that in mind, take care to take care of yourself, meeting your actual needs instead of just those that get socially assumed.
Want to take the test?
Here’s a two-minute test (results available immediately right there on-screen; no need to give your email or anything) 😎
Want to know more?
We reviewed this book about playing to one’s strengths in the context of sensitivity, a while back, and highly recommend it:
Sensitive – by Jenn Granneman and Andre Sólo
Enjoy!
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Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death
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In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.
Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.
You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0
But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.
The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.
In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.
Why is travel so important?
There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.
The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.
Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:
We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.
For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:
So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.
People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.
Whale watching in Queensland was on one person’s bucket list. Uwe Bergwitz/Shutterstock Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:
In the last three years, I think I’ve lived more than a lot of 80-year-olds.
But travel is expensive
Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.
Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.
But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:
We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.
Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.
Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:
This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.
Something we ‘ought’ to do?
Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.
Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.
Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.
Names of study participants mentioned in this article are pseudonyms.
Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Yoga of Breath – by Richard Rosen
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You probably know to breathe through your nose, and to breathe with your diaphragm. But did you know you’re usually only breathing through one nostril at a time, and alternate between nostrils every few hours? And did you know how to breathe through both nostrils equally instead, and the benefits that can bring?
The above is one example of many, of things that make this book stand out from the crowd when it comes to breathing exercises. Author Richard Rosen has a deep expertise in this topic, and explains everything clearly and comprehensively, without leaving room for ambiguity.
While most of the book focuses on the mechanics and physical techniques of breathing, he does also cover some more mindstate-related things too—without which, it wouldn’t be yoga.
If the book has a downside, it’s that its comprehensive nature could be off-putting to readers new to breathing work in general. However, since he does explain everything from the ground up, that’s no reason to be put off this book, iff you’re serious about learning.
Bottom line: if you’d like a deeper understanding of breathwork than “breathe slowly through your nose, using your diaphragm”, this book will teach you depths of breathing you probably didn’t know were possible.
Click here to check out The Yoga of Breath, and catch yours!
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Make Your Negativity Work For You
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What’s The Right Balance?
We’ve written before about positivity the pitfalls and perils of toxic positivity:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
…as well as the benefits that can be found from selectively opting out of complaining:
A Bone To Pick… Up And Then Put Back Where We Found It
So… What place, if any, does negativity usefully have in our lives?
Carrot and Stick
We tend to think of “carrot and stick” motivation being extrinsic, i.e. there is some authority figure offering is reward and/or punishment, in response to our reactions.
In those cases when it really is extrinsic, the “stick” can still work for most people, by the way! At least in the short term.
Because in the long term, people are more likely to rebel against a “stick” that they consider unjust, and/or enter a state of learned helplessness, per “I’ll never be good enough to satisfy this person” and give up trying to please them.
But what about when you have your own carrot and stick? What about when it comes to, for example, your own management of your own healthy practices?
Here it becomes a little different—and more effective. We’ll get to that, but first, bear with us for a touch more about extrinsic motivation, because here be science:
We will generally be swayed more easily by negative feelings than positive ones.
For example, a study was conducted as part of a blood donation drive, and:
- Group A was told that their donation could save a life
- Group B was told that their donation could prevent a death
The negative wording given to group B boosted donations severalfold:
Read the paper: Life or Death Decisions: Framing the Call for Help
We have, by the way, noticed a similar trend—when it comes to subject lines in our newsletters. We continually change things up to see if trends change (and also to avoid becoming boring), but as a rule, the response we get from subscribers is typically greater when a subject line is phrased negatively, e.g. “how to avoid this bad thing” rather than “how to have this good thing”.
How we can all apply this as individuals?
When we want to make a health change (or keep up a healthy practice we already have)…
- it’s good to note the benefits of that change/practice!
- it’s even better to note the negative consequences of not doing it
For example, if you want to overcome an addiction, you will do better for your self-reminders to be about the bad consequences of using, more than the good consequences of abstinence.
See also: How To Reduce Or Quit Alcohol
This goes even just for things like diet and exercise! Things like diet and exercise can seem much more low-stakes than substance abuse, but at the end of the day, they can add healthy years onto our lives, or take them off.
Because of this, it’s good to take time to remember, when you don’t feel like exercising or do feel like ordering that triple cheeseburger with fries, the bad outcomes that you are planning to avoid with good diet and exercise.
Imagine yourself going in for that quadruple bypass surgery, asking yourself whether the unhealthy lifestyle was worth it. Double down on the emotions; imagine your loved ones grieving your premature death.
Oof, that was hard-hitting
It was, but it’s effective—if you choose to do it. We’re not the boss of you! Either way, we’ll continue to send the same good health advice and tips and research and whatnot every day, with the same (usually!) cheery tone.
One last thing…
While it’s good to note the negative, in order to avoid the things that lead to it, it’s not so good to dwell on the negative.
So if you get caught in negative thought spirals or the like, it’s still good to get yourself out of those.
If you need a little help with that sometimes, check out these:
Take care!
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