Semaglutide for Weight Loss?
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Semaglutide for weight loss?
Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).
Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.
*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!
First things first: does it work as marketed for diabetes?
It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:
- Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
- Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes
As you can see, both of them work wonders for pancreatic function and insulin sensitivity!
And, both of them were quite unpleasant for around 20% of participants:
❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞
What about for weight loss, if not diabetic?
It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:
Once-Weekly Semaglutide in Adults with Overweight or Obesity
The most interesting things here are the positive results and the side effects:
❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞
In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.
❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞
~ ibid.
In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!
Any other downsides we should know about?
If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:
❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞
~ Jan, a trial participant at UCLH
Is it injection-only, or is there an oral option?
An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:
A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science
FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement
Where can I get these?
Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:
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7 Steps to Get Off Sugar and Carbohydrates – by Susan Neal
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We will not keep the steps a mystery; abbreviated, they are:
- decide to really do this thing
- get knowledge and support
- clean out that pantry/fridge/etc and put those things behind you
- buy in healthy foods while starving your candida
- plan for an official start date, so that everything is ready
- change the way you eat (prep methods, timings, etc)
- keep on finding small ways to improve, without turning back
Particularly important amongst those are starving the candida (the fungus in your gut that is responsible for a lot of carb cravings, especially sugar and alcohol—which latter can be broken down easily into sugar), and changing the “how” of eating as well as the “what”; those are both things that are often overlooked in a lot of guides, but this one delivers well.
Walking the reader by the hand through things like that is probably the book’s greatest strength.
In the category of subjective criticism, the author does go off-piste a little at the end, to take a moment while she has our attention to talk about other things.
For example, you may not need “Appendix 7: How to Become A Christian and Disciple of Jesus Christ”.
Of course if that calls to you, then by all means, follow your heart, but it certainly isn’t a necessary step of quitting sugar. Nevertheless, the diversion doesn’t detract from the good dietary change advice that she has just spent a book delivering.
Bottom line: there’s no deep science here, but there’s a lot of very good, very practical advice, that’s consistent with good science.
Click here to check out 7 Steps to Get Off Sugar, and watch your health improve!
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Widen the Window – by Dr. Elizabeth Stanley
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Firstly, about the title… That “window” that the author bids us “widen” is not a flowery metaphor, but rather, is referring to the window of exhibited resilience to stress/trauma; the “window” in question looks like an “inverted U” bell-curve on the graph.
In other words: Dr. Stanley’s main premise here is that we respond best to moderate stress (i.e: in that window, the area under the curve!), but if there is too little or too much, we don’t do so well. The key, she argues, is widening that middle part (expanding the area under the curve) in which we perform optimally. That way, we can still function in a motivated fashion without extrinsic threats, and we also don’t collapse under the weight of overwhelm, either.
The main strength of this book, however, lies in its practical exercises to accomplish that—and more.
“And more”, because the subtitle also promised recovery from trauma, and the author delivers in that regard too. In this case, it’s about widening that same window, but this time to allow one’s parasympathetic nervous system to recognize that the traumatic event is behind us, and no longer a threat; we are safe now.
Bottom line: if you would like to respond better to stress, and/or recover from trauma, this book is a very good tool.
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Better Sex = Longer Life (Here’s How)
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This is Dr. Candice Hargons. She’s a professor of psychology, and has served on the Kentucky Psychological Association Board, the Society of Counseling Psychology Executive Board, and the American Psychological Association (APA)’s Council of Representatives. She also served on the APA Board of Directors, after receiving the APA’s Presidential Citation award for her research and leadership.
She leads the Study of Mental And Sexual Health Equity in Relationships (SMASHER Lab), with a predominant focus on promoting good sex, sexual wellness, and liberation among couples and communities.
In her own words:
❝Sex is one of the most common and normal human behaviors, and yet it remains relatively taboo as a topic. Many people worry about being judged, either for being perceived as too sexual or not sexual enough, and a major focus of my work is to normalize talking and learning about sex to improve sexual functioning across the adult lifespan.❞
~ Dr. Candice Hargons
So, let’s do that!
What does good sex do for health?
We’ve written previously about the health aspects of orgasms specifically:
“Early To Bed…” (Mythbusting Orgasms) ← including resources pertaining to anorgasmia, the inability to orgasm
…but orgasms are not the be-all-and-end-all of sex; see for example:
A Urologist Explains Edging: What, Why, & Is It Safe? ← when the journey is genuinely more of a focus than the destination
And certainly, good sex is simply a very good way to relax and de-stress, which is important, given how important stress management is to general health in very many ways (affecting things ranging from inflammation to heart health and more).
Plus, while the level of athleticism deployed may vary, sex is a physical activity, and physical activity is, as a rule, good.
There’s more to it than that though! It also can help us bind closely to our loved ones, in a positive way, which—critically—has a very positive impact on healthy longevity:
Only One Kind Of Relationship Promotes Longevity This Much! ← this is about the seriousness of the relationship, not the sex, but for most people, a strong and fulfilling relationship will include having good sex.
The scientific relationship between sex and longevity also got a whole chapter in this excellent book that we reviewed all so recently:
Age Proof: The New Science of Living a Longer and Healthier Life – by Dr. Rose Anne Kenny
What makes it “good”?
Dr. Hargons considers (and her opinion is backed by extensive research in the SMASHER Lab, if you’ll pardon the mental image that that might conjure) that first and foremost… It has to feel good to all parties involved.
In contrast, oftentimes, one partner’s pleasure is prioritized over another’s, and that becomes a problem.*
*assuming that’s not part of an established kink dynamic with enthusiastic affirmative consent, such as if the partner whose pleasure is being deprioritized is enthusiastically requesting to be denied orgasms, for example. Yes, that’s a real kink and even a popular one, but it’s not what’s happening in most sexually uneven relationships.
This kind of unplanned disparity often goes undiscussed by the couple in question—especially in heterosexual couples if the man is getting what he wants/needs and the woman isn’t, because there’s a rather lop-sided societal expectation in that regard. And even a loving, well-intentioned man can simply not know how to do better and be afraid to ask. And for that matter, it’s also entirely possible for his partner to not know either.
Dr. Hargons lists the four main keys as:
- Communication
- Intimacy
- Passion
- Pleasure
And communication indeed comes first, so to speak. For example, she advises:
❝Begin by identifying what you like and don’t like sexually. An easy way to do this is to create a “Yes, No, Maybe So” list. You can use paper or a Notes app on your phone.
Create three columns: one for Yes, No, and Maybe So sections. In the Yes section, write all the things you enjoy and want to keep doing sexually, as well as things you have not tried yet that you want to try. In the No section, write all the things you don’t enjoy and do not want to do anymore. It can also include things you haven’t tried that you’re uninterested in trying. Finally, in your Maybe So list, write all the things you’re curious about and/or are only willing to try in specific settings or circumstances.
You can share this list with your partner, but even if you are not ready to do that, you will already have enhanced your sexual self-awareness and be better positioned to talk with your sexual partner about what you want.❞
This represents an important shift from “whatever” to taking an active role in your sex life at your own pace.
And from there, it’s just a matter of exploring, together, and learning as you go. Could anything be more exciting than that?
“What if I’m single?”
We talked about this a little previously, more relationally than sexually specifically, though:
Now, a single person can of course still have an active sex life if you so choose, in which case, the above advice still applies, just, it’ll be conversations with your partner-of-the-moment rather than with a life partner. And that’s important too! Just because something is casual, doesn’t mean it need not be entered into mindfully and with a sense of what you want out of it, and communicating that effectively (while encouraging the same from others, and of course actually listening to, and caring about, what they say too).
And if you are, perchance, single and decided on a life of celibacy now, you can and (if you are sexual at all) should still figure out what you like and don’t like sexually, because even if it’s going to be you-on-you action, it will be good for you to love yourself enough to do it right.
Seriously, treat yourself at least as well as you would any other lover.
On which note, corded wand-style vibrators like the famous “Magic Wand” kind are much more powerful than the battery kind, and you will feel the difference, in a good way.
And if you really want to invest in your sexual wellness and you like the idea, saddle-style vibrators like this one will rock your socks off in ways handheld vibrators couldn’t dream of.
Want to know more?
You might want to check out Dr. Hargons’ book:
Good Sex: Stories, Science, and Strategies for Sexual Liberation – by Dr. Candice Hargons ← this covers so many important areas, more than we have room to here. Just check out the table of contents, and you’ll see what we mean.
…which we haven’t reviewed yet, but here are some excellent related books that we have:
- Come Together: The Science (and Art) of Creating Lasting Sexual Connections – by Dr. Emily Nagoski
- Better Sex Through Mindfulness: How Women Can Cultivate Desire – by Dr. Lori Brotto
Enjoy!
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Clams vs Oysters – Which is Healthier?
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Our Verdict
When comparing clams to oysters, we picked the clams.
Why?
Considering the macros first, clams have more than 2x the protein, while oysters have nearly 2x the fat, of which, a little over 5x the saturated fat. So, in all accounts, clam is the winner here.
In terms of vitamins, clams have more of vitamins A, B1, B2, B3, B5, B6, B7, B9, B12, and C, while oysters are not higher in any vitamins. Another win for clams.
The category of minerals is more balanced; clams are higher in manganese, phosphorus, potassium, and selenium, while oysters are higher in copper, iron, magnesium, and zinc. This makes for a 4:4 tie, though it’s worth noting that the margin of difference for zinc is very large, so that can be an argument for oysters.
Nevertheless, adding up the sections makes for a clear win for clams.
A quick aside on “are oysters an aphrodisiac?”:
That zinc content is probably largely responsible for oysters’ reputation as an aphrodisiac, and zinc is important in the synthesis of both estrogen and testosterone. However, as the synthesis is not instant, and those sex hormones rise most in the morning (around 8am to 9am), to enjoy aphrodisiac benefits it’d be more sensible, on a biochemical level, to eat oysters one day, and then have morning sex the next day when those hormones are peaking. That said, while testosterone is the main driver of male libido, progesterone is usually more relevant for women’s, and unlike estrogen, progesterone usually peaks around 10pm to 2am, and is uninfluenced by having just eaten oysters.
So, in what way, if any, could oysters be responsible for libido in women? Well, the zinc is still important in energy metabolism, so that’s a factor, and also, we might hypothesize that oysters’ high saturated fat and cholesterol content may increase blood pressure which, while not fabulous for the health in general, may be considered desirable in the bedroom since the clitoris is anatomically analogous to the penis, and—while estrogen vs testosterone makes differences to the nervous system down there that are beyond the scope of today’s article—also enjoys localized increased blood pressure (and thus, a flushing response and resultant engorgement) during arousal.
Want to learn more?
You might like to read:
Does Eating Shellfish Really Contribute To Gout? ← short answer is: it can if consumed frequently over a long period of time, but that risk factor is greatly overstated, compared to some other risk factors
Take care!
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The Mental Health First-Aid That You’ll Hopefully Never Need
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Take Your Mental Health As Seriously As General Health!
Sometimes, health and productivity means excelling—sometimes, it means avoiding illness and unproductivity. Both are essential, and today we’re going to tackle some ground-up stuff. If you don’t need it right now, great; we suggest to read it for when and if you do. But how likely is it that you will?
- One in four of us are affected by serious mental health issues in any given year.
- One in five of us have suicidal thoughts at some point in our lifetime.
- One in six of us are affected to at least some extent by the most commonly-reported mental health issues, anxiety and depression, in any given week.
…and that’s just what’s reported, of course. These stats are from a UK-based source but can be considered indicative generally. Jokes aside, the UK is not a special case and is not measurably worse for people’s mental health than, say, the US or Canada.
While this is not an inherently cheery topic, we think it’s an important one.
Depression, which we’re going to focus on today, is very very much a killer to both health and productivity, after all.
One of the most commonly-used measures of depression is known by the snappy name of “PHQ9”. It stands for “Patient Health Questionnaire Nine”, and you can take it anonymously online for free (without signing up for anything; it’s right there on the page already):
Take The PHQ9 Test Here! (under 2 minutes, immediate results)
There’s a chance you took that test and your score was, well, depressing. There’s also a chance you’re doing just peachy, or maybe somewhere in between. PHQ9 scores can fluctuate over time (because they focus on the past two weeks, and also rely on self-reports in the moment), so you might want to bookmark it to test again periodically. It can be interesting to track over time.
In the event that you’re struggling (or: in case one day you find yourself struggling, or want to be able to support a loved one who is struggling), some top tips that are useful:
Accept that it’s a medical condition like any other
Which means some important things:
- You/they are not lazy or otherwise being a bad person by being depressed
- You/they will probably get better at some point, especially if help is available
- You/they cannot, however, “just snap out of it”; illness doesn’t work that way
- Medication might help (it also might not)
Do what you can, how you can, when you can
Everyone knows the advice to exercise as a remedy for depression, and indeed, exercise helps many. Unfortunately, it’s not always that easy.
Did you ever see the 80s kids’ movie “The Neverending Story”? There’s a scene in which the young hero Atreyu must traverse the “Swamp of Sadness”, and while he has a magical talisman that protects him, his beloved horse Artax is not so lucky; he slows down, and eventually stops still, sinking slowly into the swamp. Atreyu pulls at him and begs him to keep going, but—despite being many times bigger and stronger than Atreyu, the horse just sinks into the swamp, literally drowning in despair.
See the scene: The Neverending Story movie clip – Artax and the Swamp of Sadness (1984)
Wow, they really don’t make kids’ movies like they used to, do they?
But, depression is very much like that, and advice “exercise to feel less depressed!” falls short of actually being helpful, when one is too depressed to do it.
If you’re in the position of supporting someone who’s depressed, the best tool in your toolbox will be not “here’s why you should do this” (they don’t care; not because they’re an uncaring person by nature, but because they are physiologically impeded from caring about themself at this time), but rather:
“please do this with me”
The reason this has a better chance of working is because the depressed person will in all likelihood be unable to care enough to raise and/or maintain an objection, and while they can’t remember why they should care about themself, they’re more likely to remember that they should care about you, and so will go with your want/need more easily than with their own. It’s not a magic bullet, but it’s worth a shot.
What if I’m the depressed person, though?
Honestly, the same, if there’s someone around you that you do care about; do what you can to look after you, for them, if that means you can find some extra motivation.
But I’m all alone… what now?
Firstly, you don’t have to be alone. There are free services that you can access, for example:
- US: https://nami.org/help
- Canada: https://www.wellnesstogether.ca/en-CA
- UK: https://www.samaritans.org/
…which varyingly offer advice, free phone services, webchats, and the like.
But also, there are ways you can look after yourself a little bit; do the things you’d advise someone else to do, even if you’re sure they won’t work:
- Take a little walk around the block
- Put the lights on when you’re not sleeping
- For that matter, get out of bed when you’re not sleeping. Literally lie on the floor if necessary, but change your location.
- Change your bedding, or at least your clothes
- If changing the bedding is too much, change just the pillowcase
- If changing your clothes is too much, change just one item of clothing
- Drink some water; it won’t magically cure you, but you’ll be in slightly better order
- On the topic of water, splash some on your face, if showering/bathing is too much right now
- Do something creative (that’s not self-harm). You may scoff at the notion of “art therapy” helping, but this is a way to get at least some of the lights on in areas of your brain that are a little dark right now. Worst case scenario is it’ll be a distraction from your problems, so give it a try.
- Find a connection to community—whatever that means to you—even if you don’t feel you can join it right now. Discover that there are people out there who would welcome you if you were able to go join them. Maybe one day you will!
- Hiding from the world? That’s probably not healthy, but while you’re hiding, take the time to read those books (write those books, if you’re so inclined), learn that new language, take up chess, take up baking, whatever. If you can find something that means anything to you, go with that for now, ride that wave. Motivation’s hard to come by during depression and you might let many things slide; you might as well get something out of this period if you can.
If you’re not depressed right now but you know you’re predisposed to such / can slip that way?
Write yourself instructions now. Copy the above list if you like.
Most of all: have a “things to do when I don’t feel like doing anything” list.
If you only take one piece of advice from today’s newsletter, let that one be it!
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Radishes vs Endives – Which is Healthier?
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Our Verdict
When comparing radishes to endives, we picked the endives.
Why?
These are both great, but there’s a clear winner here in every category!
In terms of macros, radishes have more carbs while endives have more fiber and protein.
In the category of vitamins, radishes have more of vitamins B6 and C, while endives have more of vitamins A, B1, B2, B4, B5, B7, B9, E, K, and choline.
When it comes to minerals, things are not less one-sided: radishes have more selenium, while endives have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc.
You may be thinking: but what about radishes’ shiny red bit? Doesn’t that usually mean more of something important, like carotenoids or anthocyanins or something? And the answer is that the red pigment in radishes is so thinly-distributed on the exterior that it’s barely there and if we’re looking at values per 100g, it’s a tiny fraction of a tiny fraction.
In both cases, their bitter taste comes mostly from flavonols, of which mostly kaempferol, of which endives have about 20x what radishes have, on average.
All in all, an overwhelming win for endives.
Want to learn more?
You might like to read:
Enjoy Bitter Foods For Your Heart & Brain
Take care!
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