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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Meditations for Mortals – by Oliver Burkeman
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We previously reviewed this author’s “Four Thousand Weeks”, but for those who might have used a lot of those four thousand weeks already, and would like to consider things within a smaller timeframe for now, this work is a 28-day daily reader.
Now, daily readers are usually 366 days, but the chapters here are not the single page chapters that 366-page daily readers usually have. So, expect to invest a little more time per day (say, about 6 pages for each daily chapter).
Burkeman does not start the way we might expect, by telling us to take the time to smell the roses. Instead, he starts by examining the mistakes that most of us make most of the time, often due to unexamined assumptions about the world and how it works. Simply put, we’ve often received bad lessons in life (usually not explicitly, but rather, from our environments), and it takes some unpacking first to deal with that.
Nor is the book systems-based, as many books that get filed under “time management” may be, but rather, is simply principles-based. This is a strength, because principles are a lot easier to keep to than systems.
The writing style is direct and conversational, and neither overly familiar nor overly academic. It strikes a very comfortably readable balance.
Bottom line: if you’d like to get the most out of your days, this book can definitely help improve things a lot.
Click here to check out Meditations For Mortals, and live fulfilling days!
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Focusing On Health In Our Sixties
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝What happens when you age in your sixties?❞
The good news is, a lot of that depends on you!
But, speaking on averages:
While it’s common for people to describe being over 50 as being “over the hill”, halfway to a hundred, and many greetings cards and such reflect this… Biologically speaking, our 60s are more relevant as being halfway to our likely optimal lifespan of 120. Humans love round numbers, but nature doesn’t care for such.
- In our 60s, we’re now usually the “wrong” side of the menopausal metabolic slump (usually starting at 45–55 and taking 5–10 years), or the corresponding “andropause” where testosterone levels drop (usually starting at 45 and a slow decline for 10–15 years).
- In our 60s, women will now be at a higher risk of osteoporosis, due to the above. The risk is not nearly so severe for men.
- In our 60s, if we’re ever going to get cancer, this is the most likely decade for us to find out.
- In our 60s, approximately half of us will suffer some form of hearing loss
- In our 60s, our body has all but stopped making new T-cells, which means our immune defenses drop (this is why many vaccines/boosters are offered to over-60s, but not to younger people)
While at first glance this does not seem a cheery outlook, knowledge is power.
- We can take HRT to avoid the health impact of the menopause/andropause
- We can take extra care to look after our bone health and avoid osteoporosis
- We can make sure we get the appropriate cancer screenings when we should
- We can take hearing tests, and if appropriate find the right hearing aids for us
- We can also learn to lip-read (this writer relies heavily on lip-reading!)
- We can take advantage of those extra vaccinations/boosters
- We can take extra care to boost immune health, too
Your body has no idea how many times you’ve flown around the sun and nor does it care. What actually makes a difference to it, is how it has been treated.
See also: Milestone Medical Tests You Should Take in Your 60s, 70s, and Beyond
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Celery vs Radish – Which is Healthier?
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Our Verdict
When comparing celery to radish, we picked the celery.
Why?
It was very close! And yes, surprising, we know. Generally speaking, the more colorful/pigmented an edible plant is, the healthier it is. Celery is just one of those weird exceptions (as is cauliflower, by the way).
Macros-wise, these two are pretty much the same—95% water, with just enough other stuff to hold them together. The proportions of “other stuff” are also pretty much equal.
In the category of vitamins, celery has more vitamin K while radish has more vitamin C; the other vitamins are pretty close to equal. We’ll call this one a minor win for celery, as vitamin K is found in fewer foods than vitamin C.
When it comes to minerals, celery has more calcium, manganese, phosphorus, and potassium, while radish has more copper, iron, selenium, and zinc. We’ll call this a minor win for radish, as the margins are a little wider for its minerals.
So, that makes the score 1–1 so far.
Both plants have an assortment of polyphenols, of which, when we add up the averages, celery comes out on top by some way. Celery also comes out on top when we do a head-to-head of the top flavonoid of each; celery has 5.15mg/100g of apigenin to radish’s 0.63mg/100g kaempferol.
Which means, both are great healthy foods, but celery wins the day.
Want to learn more?
You might like to read:
Celery vs Cucumber – Which is Healthier?
Take care!
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Walnuts vs Cashews – Which is Healthier?
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Our Verdict
When comparing walnuts to cashews, we picked the walnuts.
Why?
It was close! In terms of macros, walnuts have about 2x the fiber, while cashews have slightly more protein. In the specific category of fats, walnuts have more fat. Looking further into it: walnuts’ fats are mostly polyunsaturated, while cashews’ fats are mostly monounsaturated, both of which are considered healthy.
Notwithstanding being both high in calories, neither nut is associated with weight gain—largely because of their low glycemic indices (of which, walnuts enjoy the slightly lower GI, but both are low-GI foods)
When it comes to vitamins, walnuts have more of vitamins A, B2, B3 B6, B9, and C, while cashews have more of vitamins B1, B5, E, and K. Because of the variation in their respective margins of difference, this is at best a moderate victory for walnuts, though.
In the category of minerals, cashews get their day, as walnuts have more calcium and manganese, while cashews have more copper, iron, magnesium, phosphorus, potassium, selenium, and zinc.
In short: unless you’re allergic, we recommend enjoying both of these nuts (and others) for a full range of benefits. However, if you’re going to pick one, walnuts win the day.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Veg in One Bed New Edition – by Huw Richards
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We all know that growing our own veg is ultimately not only healthier on the plate, but also a very healthy activity. Cheaper too. So why don’t more of us do it?
For many of us, it’s a matter of not having the skills or knowledge to do so. This book bridges that knowledge-gap.
Richards gives, as promised, a month-by-month well-illustrated guide to growing a wide variety of vegetables. He does, by the way, assume that we are in a temperate climate in the Northern Hemisphere. So if you’re not, you may need to make some adjustments.
The book doesn’t assume prior knowledge, and does give the reader everything we need from an initial basic shopping list onwards.
A particular strength of this book is that it’s about growing veg in a single raised bed—this ensures keeping everything very manageable.
Bottom line: if you have ever thought it would be good to grow your own veg, but didn’t know where to start and want something practical for a beginner, this is an excellent guide that will get you going!
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The Insider’s Guide To Making Hospital As Comfortable As Possible
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Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
This is Dr. Chris Bonney. He’s an anesthesiologist. If you have a surgery, he wants you to go in feeling calm, and make a quick recovery afterwards, with minimal suffering in between.
Being a patient in a hospital is a bit like being a passenger in an airplane:
- Almost nobody enjoys the thing itself, but we very much want to get to the other side of the experience.
- We have limited freedoms and comforts, and small things can make a big difference between misery and tolerability.
- There are professionals present to look after us, but they are busy and have a lot of other people to tend to too.
So why is it that there are so many resources available full of “tips for travelers” and so few “tips for hospital patients”?
Especially given the relative risks of each, and likelihood, or even near-certainty of coming to at least some harm… One would think “tips for patients” would be more in demand!
Tips for surgery patients, from an insider expert
First, he advises us: empower yourself.
Empowering yourself in this context means:
- Relax—doctors really want you to feel better, quickly. They’re on your side.
- Research—knowledge is power, so research the procedure (and its risks!). Dr. Bonney, himself an anesthesiologist, particularly recommends you learn what specific anesthetic will be used (there are many, and they’re all a bit different!), and what effects (and/or after-effects) that may have.
- Reframe—you’re not just a patient; you’re a customer/client. Many people suffer from MDeity syndrome, and view doctors as authority figures, rather than what they are: service providers.
- Request—if something would make you feel better, ask for it. If it’s information, they will be not only obliged, but also enthusiastic, to give it. If it’s something else, they’ll oblige if they can, and the worst case scenario is something won’t be possible, but you won’t know if you don’t ask.
Next up, help them to help you
There are various ways you can be a useful member of your own care team:
- Go into surgery as healthy as you can. If there’s ever a time to get a little fitter, eat a little healthier, prioritize good quality sleep more, the time approaching your surgery is the time to do this.
- This will help to minimize complications and maximize recovery.
- Take with you any meds you’re taking, or at least have an up-to-date list of what you’re taking. Dr. Bonney has very many times had patients tell him such things as “Well, let me see. I have two little pink ones and a little white one…” and when asked what they’re for they tell him “I have no idea, you’d need to ask my doctor”.
- Help them to help you; have your meds with you, or at least a comprehensive list (including: medication name, dosage, frequency, any special instructions)
- Don’t stop taking your meds unless told to do so. Many people have heard that one should stop taking meds before a surgery, and sometimes that’s true, but often it isn’t. Keep taking them, unless told otherwise.
- If unsure, ask your surgical team in advance (not your own doctor, who will not be as familiar with what will or won’t interfere with a surgery).
Do any preparatory organization well in advance
Consider the following:
- What do you need to take with you? Medications, clothes, toiletries, phone charger, entertainment, headphones, paperwork, cash for the vending machine?
- Will the surgeons need to shave anywhere, and if so, might you prefer doing some other form of depilation (e.g. waxing etc) yourself in advance?
- Is your list of medications ready?
- Who will take you to the hospital and who will bring you back?
- Who will stay with you for the first 24 hours after you’re sent home?
- Is someone available to look after your kids/pets/plants etc?
Be aware of how you do (and don’t) need to fast before surgery
The American Society of Anesthesiologists gives the following fasting guidelines:
- Non-food liquids: fast for at least 2 hours before surgery
- Food liquids or light snacks: fast for at least 6 hours before surgery
- Fried foods, fatty foods, meat: fast for at least 8 hours before surgery
(see the above link for more details)
Dr. Bonney notes that many times he’s had patients who’ve had the worst thirst, or caffeine headache, because of abstaining unnecessarily for the day of the surgery.
Unless told otherwise by your surgical team, you can have black coffee/tea up until two hours before your surgery, and you can and should have water up until two hours before surgery.
Hydration is good for you and you will feel the difference!
Want to know more?
Dr. Bonney has his own website and blog, where he offers lots of advice, including for specific conditions and specific surgeries, with advice for before/during/after your hospital stay.
He also has a book with many more tips like those we shared today:
Calm For Surgery: Supertips For A Smooth Recovery
Take good care of yourself!
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