What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

The term “man flu” takes a humorous poke at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms.

According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him.

But is man flu real? Is there a valid biological reason behind men’s symptoms or are men just malingering? And how does man flu differ from flu?

What are the similarities?

Man flu could refer to a number of respiratory infections – a cold, flu, even a mild case of COVID. So it’s difficult to compare man flu with flu.

But for simplicity, let’s say man flu is actually a cold. If that’s the case, man flu and flu have some similar features.

Both are caused by viruses (but different ones). Both are improved with rest, fluids, and if needed painkillers, throat lozenges or decongestants to manage symptoms.

Both can share similar symptoms. Typically, more severe symptoms such as fever, body aches, violent shivering and headaches are more common in flu (but sometimes occur in colds). Meanwhile sore throats, runny noses, congestion and sneezing are more common in colds. A cough is common in both.

What are the differences?

Flu is a more serious and sometimes fatal respiratory infection caused by the influenza virus. Colds are caused by various viruses such as rhinoviruses, adenoviruses, and common cold coronaviruses, and are rarely serious.
Colds tend to start gradually while flu tends to start abruptly.

Flu can be detected with laboratory or at-home tests. Man flu is not an official diagnosis.

Severe flu symptoms may be prevented with a vaccine, while cold symptoms cannot.

Serious flu infections may also be prevented or treated with antiviral drugs such as Tamiflu. There are no antivirals for colds.

OK, but is man flu real?

Again, let’s assume man flu is a cold. Do men really have worse colds than women? The picture is complicated.

One study, with the title “Man flu is not a thing”, did in fact show there were differences in men’s and women’s symptoms.

This study looked at symptoms of acute rhinosinusitis. That’s inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain.

When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster.

But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly.

All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start.

Why is this happening?

It’s not straightforward to tease out what’s going on biologically.

There are differences in immune responses between men and women that provide a plausible reason for worse symptoms in men.

For instance, women generally produce antibodies more efficiently, so they respond more effectively to vaccination. Other aspects of women’s immune system also appear to work more strongly.

So why do women tend to have stronger immune responses overall? That’s probably partly because women have two X chromosomes while men have one. X chromosomes carry important immune function genes. This gives women the benefit of immune-related genes from two different chromosomes.

Oestrogen (the female sex hormone) also seems to strengthen the immune response, and as levels vary throughout the lifespan, so does the strength of women’s immune systems.

Men are certainly more likely to die from some infectious diseases, such as COVID. But the picture is less clear with other infections such as the flu, where the incidence and mortality between men and women varies widely between countries and particular flu subtypes and outbreaks.

Infection rates and outcomes in men and women can also depend on the way a virus is transmitted, the person’s age, and social and behavioural factors.

For instance, women seem to be more likely to practice protective behaviours such as washing their hands, wearing masks or avoiding crowded indoor spaces. Women are also more likely to seek medical care when ill.

So men aren’t faking it?

Some evidence suggests men are not over-reporting symptoms, and may take longer to clear an infection. So they may experience man flu more harshly than women with a cold.

So cut the men in your life some slack. If they are sick, gender stereotyping is unhelpful, and may discourage men from seeking medical advice.

Thea van de Mortel, Professor, Nursing, School of Nursing and Midwifery, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The weight-loss drug Wegovy is now available in Australia.

Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used in combination with a reduced-energy diet and increased physical activity.

So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?

Let’s look at what the science says.

What is Wegovy?

Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.

Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.

Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for several years to treat type 2 diabetes.

How does Wegovy differ from Ozempic?

Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.

But there are two differences:

1) They are approved for two different (but related) reasons.

In Australia (and the United States), Ozempic is approved for use to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.

Wegovy is approved for use alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.

Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.

2) They are both injected but come in different strengths.

Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.

Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.

While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still anticipated to be in low supply for the remainder of 2024.

Is Wegovy effective for weight loss?

Given Wegovy is a semaglutide, there is very strong evidence it can help people lose weight and maintain this weight loss.

A recent study found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.

For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is regained.

What are the side effects of Wegovy?

The most common side effects are nausea and vomiting.

However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human scientific literature.

In the four-year Wegovy trial, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).

Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.

Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.

Recently, concerns about suicidal thoughts and behaviours have been raised, after a global analysis reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.

There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.

Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. Anecdotal and scientific evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.

How can people access Wegovy?

Wegovy is available for purchase at pharmacists with a prescription from a doctor.

But there is a hefty price tag. Wegovy is not currently subsidised through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is estimated at around A$460 per month dose.

If you’re considering Wegovy, make an appointment with your doctor for individual advice.

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.