Semaglutide’s Surprisingly Unexamined Effects

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Semaglutide’s Surprisingly Big Research Gap

GLP-1 receptor agonists like Ozempic, Wegovy, and other semaglutide drugs. are fast becoming a health industry standard go-to tool in the weight loss toolbox. When it comes to recommending that patients lose weight, “Have you considered Ozempic?” is the common refrain.

Sometimes, this may be a mere case of kicking the can down the road with regard to some other treatment that it can be argued (sometimes even truthfully) would go better after some weight loss:

How weight bias in health care can harm patients with obesity: Research

…which we also covered in fewer words in the second-to-last item here:

Shedding Some Obesity Myths

But GLP-1 agonists work, right?

Yes, albeit there’s a litany of caveats, top of which are usually:

  • there are often adverse gastrointestinal side effects
  • if you stop taking them, weight regain generally ensues promptly

For more details on these and more, see:

Semaglutide For Weight Loss?

…but now there’s another thing that’s come to light:

The dark side of semaglutide’s weight loss

In academia, “dark” is often used to describe “stuff we don’t have much (or in some cases, any) direct empirical evidence of, but for reasons of surrounding things, we know it’s there”.

Well-known examples include “dark matter” in physics and the Dark Ages in (European) history.

In the case of semaglutide and weight loss, a review by a team of researchers (Drs. Sandra Christenen, Katie Robinson, Sara Thomas, and Dominique Williams) has discovered how little research has been done into a certain aspect of GLP-1 agonist’s weight loss effects, namely…

Dietary changes!

There’s been a lot of popular talk about “people taking semaglutide eat less”, but it’s mostly anecdotal and/or presumed based on parts of the mechanism of action (increasing insulin production, reducing glucagon secretions, modulating dietary cravings).

Where studies have looked at dietary changes, it’s almost exclusively been a matter of looking at caloric intake (which has been found to be a 16–39% reduction), and observations-in-passing that patients reported reduction in cravings for fatty and sweet foods.

This reduction in caloric intake, by the way, is not significantly different to the reduction brought about by counselling alone (head-to-head studies have been done; these are also discussed in the research review).

However! It gets worse. Very few studies of good quality have been done, even fewer (two studies) actually had a registered dietitian nutritionist on the team, and only one of them used the “gold standard” of nutritional research, the 24-hour dietary recall test. Which, in case you’re curious, you can read about what that is here:

Dietary Assessment Methods: What Is A 24-Hour Recall?

Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!

It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.

A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.

And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it is to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!

Any other bad news?

While we’re talking research gaps, guess how many studies looked into micronutrient intake changes in people taking GLP-1 agonists?

If you guessed zero, you guessed correctly.

You can find the paper itself here:

Dietary intake by patients taking GLP-1 and dual GIP/GLP-1 receptor agonists: A narrative review and discussion of research needs

What’s the main take-away here?

On a broad, scoping level: we need more research!

On a “what this means for individuals who want to lose weight” level: maybe we should be more wary of this still relatively new (less than 10 years old) “wonder drug”. And for most of those 10 years it’s only been for diabetics, with weight loss use really being in just the past few years (2021 onwards).

In other words: not necessarily any need to panic, but caution is probably not a bad idea, and natural weight loss methods remain very reasonable options for most people.

See also: How To Lose Weight (Healthily!)

Take care!

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  • 6 Signs Of A Heart Attack… A Month In Advance

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many people know the signs of a heart attack when it’s happening, but how about before it’s too late to avoid it?

    The signs

    • Unusual fatigue: persistent tiredness that doesn’t improve with rest
    • Shortness of breath: unexplained breathlessness during light activities or rest, which can be caused by fluid buildup in the lungs (because the heart isn’t circulating blood as well as it should)
    • Chest discomfort: pain, pressure, tightness, or aching in the chest due to reduced blood flow to the heart muscle—often occurring during physical exertion or emotional stress
    • Frequent indigestion: means that heartburn could be heart-related! This is about persistently reoccurring discomfort or pain in the upper abdomen
    • Sleep disturbances: difficulties falling asleep, staying asleep, or waking up abruptly
    • Excessive sweating: unexplained cold sweats or sudden sweating without physical exertion or excessive heat, can be a response to the decreased oxygen levels caused by less efficient blood flow

    Note: this is a list of warning signs, not a diagnostic tool. Any or even all of these could be caused by something else. Just, don’t ignore the signs and do get yourself checked out.

    For more details on each of these, enjoy:

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    Want to learn more?

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  • Slow-Cooker Moroccan Tagine

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    Tagine (طاجين) (tā-jīn) is a traditional dish named after, well, the traditional dish that it’s cooked in. Here’s an example tagine pot on Amazon. It’s a very nifty bit of kit, and while it’s often used for cooking over charcoal, one of its features is that if you have a hot sunny day, you can just leave it out in the sun and it will cook the contents nicely. Today though, we’re going to assume you don’t have one of these, and are going to give instructions for cooking a tagine-style dish with a slow cooker, which we’re going to assume you do have.

    You will need

    • 2 large red onions, finely chopped
    • 2 large red peppers, cut into 1″ chunks
    • 2 large zucchini, cut into ½” chunks
    • 1 large eggplant, cut into ½” chunks
    • 3 cups tomato passata
    • 2 cups cooked chickpeas
    • 16 pitted Medjool dates, chopped
    • ½ bulb garlic, finely chopped
    • 1 tbsp ras el-hanout
    • A little extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Let your slow cooker heat up while you chop the things that need chopping

    2) Add a splash of olive oil to the slow cooker; ensure the base is coated and there’s a little oil spare in there too; a thin coat to the base plus a couple of tbsp should do it nicely.

    3) Add the onions and garlic, and leave for an hour.

    4) Add the passata, dates, ras el-hanout, stir it and leave for an hour.

    5) Add the chickpeas, peppers, and eggplant; stir it and leave for an hour.

    6) Add the zucchini, stir it and leave for an hour.

    7) Serve—it goes great with its traditional pairing of wholegrain couscous, but if you prefer, you can use our tasty versatile rice. In broader culinary terms, serving it with any carb is fine.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Safe Effective Sleep Aids For Seniors

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    Safe Efective Sleep Aids For Seniors

    Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:

    Review of Safety and Efficacy of Sleep Medicines in Older Adults

    Let’s break it down…

    What’s not so great

    Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.

    Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.

    Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.

    See also: Benzodiazepine and z-drug withdrawal

    (and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)

    Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.

    What about cannabis products?

    We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.

    How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.

    Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.

    See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

    Melatonin: a powerful helper with a good safety profile

    We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.

    Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:

    Melatonin: A Safe Natural Sleep Supplement

    Herbal options: which really work?

    Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.

    See: Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

    Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).

    But here’s one study that found it helped significantly:

    The effects of chamomile extract on sleep quality among elderly people: A clinical trial

    Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!

    Technological interventions

    We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:

    White Noise Is Good; Pink Noise Is Better

    Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.

    We reviewed some sleep apps; you might like those too:

    The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

    Enjoy, and rest well!

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  • What’s the difference between miscarriage and stillbirth?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    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.


    Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.

    Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.

    Here are some similarities and differences between miscarriage and stillbirth, and why they matter.

    christinarosepix/Shutterstock

    Let’s start with some definitions

    In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).

    This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.

    However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.

    The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.

    Internationally, definitions of stillbirth vary depending on the jurisdiction.

    How common are they?

    It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.

    Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.

    Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.

    Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.

    Who’s at risk?

    Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.

    Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.

    Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.

    For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.

    Pregnant woman sitting on lap of man, man's arms around woman's belly
    An older dad can be a risk factor for stillbirth, but not miscarriage. Elizaveta Galitckaia/Shutterstock

    Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.

    Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.

    So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.

    Why do they happen?

    Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.

    Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.

    Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.

    Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.

    Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.

    In many cases, however, the specific cause of pregnancy loss is not known.

    How about the long-term health risks?

    Miscarriage and stillbirth can be early indicators of health issues later in life.

    For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).

    Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.

    Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.

    We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.

    Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.

    Woman of Asian heritage sitting in living room coughing, hand to mouth
    Long-term health risks of recurrent miscarriages or stillbirths include developing lung disease later in life. PRPicturesProduction/Shutterstock

    Why is all this important?

    Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.

    Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.


    More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.

    Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland

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

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  • What is reformer pilates? And is it worth the cost?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Reformer pilates is steadily growing in popularity, with new studios opening regularly in major cities all over the world.

    But what exactly is reformer pilates? And how does it compare with regular pilates and other types of exercise?

    Classes aren’t cheap so let’s look at the potential benefits and drawbacks to help you decide if it’s right for you.

    Ahmet Kurt/Unsplash

    Pilates with special equipment

    Pilates is a mode of exercise that focuses on core stability and flexibility, while also addressing muscular strength and endurance, balance and general fitness. At first glance, it might look a bit like yoga, with some more traditional weight training components thrown in.

    Reformer pilates uses a piece of equipment called a “reformer”. This looks like a narrow bed that slides along a carriage, has straps to hold onto, and has adjustable springs that add resistance to movement. You perform pilates on the reformer to target specific muscle groups and movement patterns.

    The reformer was first designed to help people recover from injuries. However, it has now become common for general fitness and even sports performance.

    Unlike normal pilates, also known as “mat pilates”, which only uses your body weight, the reformer adds resistance, meaning you can change the difficulty according to your current level of fitness.

    This not only provides a way to overload your muscles, but can make the exercise session more aerobically demanding, which has been proposed to improve cardiovascular fitness.

    Man stretches while his pilates instructor repositions his back
    Mat pilates uses your body weight. Kampus Productions/Pexels

    What are the benefits of reformer pilates?

    Despite being around for decades, there is surprisingly little research looking at the benefits of reformer pilates. However, what we have seen so far suggests it has a similar effect to other modes of exercise.

    Reformer pilates has been shown to help with weight loss, cause some small increases in muscle mass, and enhance cognitive function. All of these benefits are commonly seen when combining weight training and cardio into the same routine.

    Similarly, among older adults, it has been shown to improve strength, enhance flexibility and may even reduce the risk of falling.

    From a rehabilitation perspective, there is some evidence indicating reformer pilates can improve shoulder health and function, reduce lower back pain and increase flexibility.

    Finally, there is some evidence suggesting a single session of reformer pilates can improve two key markers of cardiovascular health, being flow-mediated dilation and pulse wave velocity, while also improving cholesterol and insulin levels. This suggests reformer pilates could lead to long-term improvements in heart and metabolic health, although more research is needed to confirm this.

    Man pulls straps of reformer, with his physio looking on
    Reformer pilates was first designed to help people recover from injuries. Kampus Productions/Pexels

    However, there are some key things to consider when discussing these benefits. Most of this research is quite exploratory and comes from a very small number of studies. So we do not know whether these findings will apply to everyone.

    Very few studies compared reformer pilates to other types of exercise. Therefore, while it can improve most aspects of health and function, it’s unlikely reformer pilates provides the optimal mode of exercise for each individual component of physical fitness.

    Traditional weight training, for example, will likely cause larger improvements in strength than reformer pilates. Similarly, stretching will probably make you more flexible. And running or cycling will make you fitter.

    However, if you want a type of exercise that gives you broad overall health benefits, it could be a good option.

    What are the downsides of reformer pilates

    Reformer pilates is not for everyone.

    First and foremost, classes can be expensive compared to other fitness options. You need to be doing at least two to three sessions per week of any type of exercise to maximise the benefits. So even if you can find a class for A$20 or $30, paying for two or three classes a week (or buying a weekly or monthly subscription) is a significant outlay.

    Second, it’s not as accessible as other exercise. Even if you can afford it, not every town or suburb has a reformer pilates studio.

    Woman rolls up exercise mat
    Cost and access are major barriers. Or you might get better results with specific modes of exercises. Karolina Grabowska/Pexels

    Third, the effectiveness of your workout is likely to be impacted by how competent your instructor is. There are a host of different pilates qualifications you can get in Australia, and some take much less time than others. With this in mind, it might be best to look for accredited pilates instructors, although this will further reduce the number of options you have available.

    Finally, there is a learning curve. While you will get better over time, the exercise will likely be less effective during those first few weeks (or months) when you are getting used to the machine and the movements.

    Is it right for you?

    Reformer pilates can be a great addition to your fitness routine, especially if you’re looking for a low-impact way to build strength and flexibility.

    But if you have more specific goals, you might need a more specific mode of exercise. For example, if you need to get stronger to improve your ability to manage your daily life, then strength training is probably your best bet. Likewise, if your goal is to run a marathon, you will get more specific benefits from running.

    The cost and availability of reformer pilates make it less accessible for some people. With this in mind, if you are after similar benefits at a lower price point, mat pilates might be a better option. Not only does it have evidence suggesting it can improve strength and fitness, but it is something you can do at home if you find a good resource (YouTube could be a good starting point here).

    Hunter Bennett, Lecturer in Exercise Science, University of South Australia; Jacinta Brinsley, Exercise Physiologist and Postdoctoral Researcher in the Alliance for Research in Nutrition, Exercise and Activity, University of South Australia, and Lewis Ingram, Lecturer in Physiotherapy, University of South Australia

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

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  • Why You Can’t Deep Squat (And the Benefits You’re Missing)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Matt Hsu fought his own battle with chronic pain from the age of 16 in his feet, knees, hips, back, shoulders, elbows, forearms, wrists, hands, and head. Seeking answers, he’s spent a career in corrective exercise, posture alignment, structural integration, orthopedic exercise, sports medicine, and has more certifications than we care to list. In short, he knows his stuff.

    Yes you can (with some work)

    The deep squat, also called Asian squat, Slav squat, sitting squat, resting squat, primal squat, and various other names, is an important way of sitting that has implications for a lot of aspects of health.

    Why it’s so important: it preserves the mobility of our hips, ankles, and everything in between, and maintaining especially the hip mobility makes a big difference not only to general health, but also to reducing the risk of injury. It also maintains lower body strength, making falls in older age less likely in the first place, and if falls do happen, makes injury less likely, and if injury does happen, makes the injury likely less severe.

    An important misconception: there is a popular, but unfounded, belief that the ability or inability to do this is decided by genes—or if not outright decided, that at the very least Asians and Slavs have a genetic advantage. However, this is simply not true. Westerners and others can learn to do it just fine, and on the flipside, Asians and Slavs who grew up in the West may often struggle with it. The truth is, the deciding factor is lifestyle: if your culture involves sitting this way more often, you’ll be able to do it more comfortably and easily than if you’re just now trying it for the first time.

    Factors that you can control: you can’t change where you grew up, but you can change how you sit down now. Achieving the squat requires repeated position practice, and the more frequently you do so (even if you just start with a few seconds and work your way up to longer periods), the better you’ll get at it. And, on the contrary, sitting in chairs weakens and shortens the muscles involved, so any time you spend sitting in chairs is working against you. There are many reasons it’s advisable to avoid sitting in chairs more than necessary, and this is one of them.

    10almonds tip: a limiting factor for many people initially is ankle flexibility, which may result in one’s center of gravity being a bit far back, leading to a tendency to have to change something to avoid toppling over backwards. Rather than holding onto something immobile (e.g. furniture) in front of where you are sitting, consider simply holding an object in front of you in your hands. A book is a fine example; holding that in front of you (feel free to read the book) will shift your center of gravity forwards a bit, and will thus allow you to sit there a little longer, thus improving your strength and flexibility while you do, until you can do it without holding something in front of you. If you try with a book and you’re still prone to toppling backwards, try with something heavier, but do use the minimum weight necessary, because ultimately the counterbalance is just a crutch to get you to where you need to be.

    For more visual advice on how to do it, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

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    Take care!

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