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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Applesauce vs Cranberry Sauce – Which is Healthier?
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Our Verdict
When comparing applesauce to cranberry sauce, we picked the applesauce.
Why?
It mostly comes down to the fact that apples are sweeter than cranberries:
In terms of macros, they are both equal on fiber (both languishing at a paltry 1.1g/100g), and/but cranberry sauce has 4x the carbs, of which, more than 3x the sugar. Simply, cranberry sauce recipes invariably have a lot of added sugar, while applesauce recipes don’t need that. So this is a huge relative win for applesauce (we say “relative” because it’s still not great, but cranberry sauce is far worse).
In the category of vitamins, applesauce has more of vitamins B1, B2, B5, B6, B9, and C, while cranberry sauce has more of vitamins E, K, and choline. A more moderate win for applesauce this time.
When it comes to minerals, applesauce has more calcium, copper, magnesium, phosphorus, and potassium, while cranberry sauce has more iron, manganese, and selenium. Another moderate win for applesauce.
Since we’ve discussed relative amounts rather than actual quantities, it’s worth noting that neither sauce is a good source of vitamins or minerals, and neither are close to just eating the actual fruits. Just, cranberry sauce is the relatively more barren of the two.
While cranberries famously have some UTI-fighting properties, you cannot usefully gain this benefit from a sauce that (with its very high sugar content and minimal fiber) actively feeds the very C. albicans you are likely trying to kill.
All in all, a pitiful show of nutritional inadequacy from these two products today, but one is relatively less bad than the other, and that’s the applesauce.
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Enjoy!
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Rapamycin Can Slow Aging By 20% (But Watch Out)
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Rapamycin’s Pros & Cons
Rapamycin is generally heralded as a wonderdrug that (according to best evidence so far) can slow down aging, potentially adding decades to human lifespan—and yes, healthspan.
It comes from a kind of soil bacteria, which in turn comes from the island of Rapa Nui (a Chilean territory best known for its monumental moai statues), hence the name rapamycin.
Does it work?
Yes! Probably! With catches!
Like most drugs that are tested for longevity-inducing properties, research in humans is very slow. Of course for drugs in general, they must go through in vitro and in vivo animal testing first before they can progress to human randomized clinical trials, but for longevity-inducing drugs, it’s tricky to even test in humans, without waiting entire human lifetimes for the results.
Nevertheless, mouse studies are promising:
Rapamycin: An InhibiTOR of Aging Emerges From the Soil of Easter Island
(“Easter Island” is another name given to the island of Rapa Nui)
That’s not a keysmash in the middle there, it’s a reference to rapamycin’s inhibitory effect on the kinase mechanistic target of rapamycin, sometimes called the mammalian target of rapamycin, and either way generally abbreviated to “mTOR”—also known as “FK506-binding protein 12-rapamycin-associated protein 1” or “FRAP1“ to its friends, but we’re going to stick with “mTOR”.
What’s relevant about this is that mTOR regulates cell growth, cell proliferation, cell motility, cell survival, protein synthesis, autophagy, and transcription.
Don’t those words usually get associated with cancer?
They do indeed! Rapamycin and its analogs have well-demonstrated anti-cancer potential:
❝Rapamycin, the naturally occurring inhibitor of mTOR, along with a number of recently developed rapamycin analogs (rapalogs) consisting of synthetically derived compounds containing minor chemical modifications to the parent structure, inhibit the growth of cell lines derived from multiple tumor types in vitro, and tumor models in vivo.
Results from clinical trials indicate that the rapalogs may be useful for the treatment of subsets of certain types of cancer.❞
…and as such, gets used sometimes as an anticancer drug—especially against renal cancer. See also:
Research perspective: Cancer prevention with rapamycin
What’s the catch?
Aside from the fact that its longevity-inducing effects are not yet proven in humans, the mouse models find its longevity effects to be sex-specific, extending the life of male mice but not female ones:
Rapamycin‐mediated mouse lifespan extension: Late‐life dosage regimes with sex‐specific effects
One hypothesis about this is that it may have at least partially to do with rapamycin’s immunomodulatory effect, bearing in mind that estrogen is immune-enhancing and testosterone is immunosuppressant.
And rapamycin? That’s another catch: it is an immunosuppressant.
This goes in rapamycin’s favor for its use to avoiding rejection when it comes to some transplants (most notably including for kidneys), though the very same immunosuppressant effect is a reason it is contraindicated for certain other transplants (such as in liver or lung transplants), where it can lead to an unacceptable increase in risk of lymphoma and other malignancies:
Prescribing Information: Rapamune, Sirolimus Solution / Sirolimus Tablet
(Sirolimus is another name for rapamycin, and Rapamune is a brand name)
What does this mean for the future?
Researchers think that rapamycin may be able to extend human lifespan to a more comfortable 120–125 years, but acknowledge there’s quite a jump to get there from the current mouse studies, and given the current drawbacks of sex-specificity and immunosuppression:
Advances in anti-aging: Rapamycin shows potential to extend lifespan and improve health
Noteworthily, rapamycin has also shown promise in simultaneously staving off certain diseases associated most strongly with aging, including Alzheimer’s and cardiac disease—or even, starting earlier, to delay menopause, in turn kicking back everything else that has an uptick in risk peri- or post-menopause:
Effect of Rapamycin in Ovarian Aging (Rapamycin)
👆 an upcoming study whose results are thus not yet published, but this is to give an idea of where research is currently at. See also:
Pilot Study Evaluates Weekly Pill to Slow Ovarian Aging, Delay Menopause
Where can I try it?
Not from Amazon, that’s for sure!
It’s still tightly regulated, but you can speak with your physician, especially if you are at risk of cancer, especially if kidney cancer, about potentially being prescribed it as a preventative—they will be able to advise about safety and applicability in your personal case.
Alternatively, you can try getting your name on the list for upcoming studies, like the one above. ClinicalTrials.gov is a great place to watch out for those.
Meanwhile, take care!
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How Does Fat Actually Leave The Body? Where Does It Go?
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Fat loss is often misunderstood, with many believing it simply “vanishes” through exercise, is simply excreted in solid form in the bathroom, or materially disappears when converted for energy. However, the principle of conservation of mass plays out here, in that the mass in fat doesn’t disappear—it changes its arrangement:
In and out
Fat is composed of carbon, hydrogen, and oxygen atoms, with an example common form of fat in the body being C55H104O6. That’s a lot of Cs and Hs, and a few Os.
When fat leaves the body, it has been primarily converted into carbon dioxide (CO2) and water (H2O).
According to a 2014 study by the University of South Wales, 84% of the mass of fat exits the body as CO2 exhaled through breathing, while 16% leaves as water through sweat, urine, and other bodily fluids (all of which contain H2O).
You’ll notice there are a lot more Os going out, proportionally, than we originally had in the C55H104O6. For this reason, the process requires oxygen intake; for every 10 kilograms of fat burned, by simple mathematics the body needs around 29 kilograms of oxygen.
Physical activity plays a crucial role in fat loss. When the body exerts itself, it naturally switches to a higher oxygen metabolism necessary for fat breakdown. This effect is amplified during intermittent fasting, which boosts human growth hormone (HGH), a hormone that aids in fat metabolism.
However, simply hyperventilating won’t work; exercise is essential to activate these processes—otherwise it’s just a case of oxygen in, oxygen out, without involving the body’s chemical energy reserves.
Consequently, one of the best diet-and-exercise combinations for fat loss is intermittent fasting with high-intensity interval training.
And, as for what to eat, this video says raw vegan, but honestly, that’s not scientific consensus. However, a diet rich in unprocessed (or minimally processed) fruits and vegetables definitely is where it’s at, with the plant-heavy Mediterranean diet generally scoring highest—which can be further improved by skipping the mammals to make it pesco-Mediterranean. Current scientific consensus does not give any extra benefits for also omitting moderate consumption of fish and fermented dairy products, so include those if you want, or skip those if you prefer.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Are You A Calorie-Burning Machine? (Calorie Mythbusting)
Take care!
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Castor Oil: All-Purpose Life-Changer, Or Snake Oil?
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As “trending” health products go, castor oil is enjoying a lot of popularity presently, lauded as a life-changing miracle-worker, and social media is abuzz with advice to put it everywhere from your eyes to your vagina.
But:
- what things does science actually say it’s good for,
- what things lack evidence, and
- what things go into the category of “wow definitely do not do that”?
We don’t have the space to go into all of its proposed uses (there are simply far too many), but we’ll examine some common ones:
To heal/improve the skin barrier
Like most oils, it’s functional as a moisturizer. In particular, its high (90%!) ricinoleic fatty acid content does indeed make it good at that, and furthermore, has properties that can help reduce skin inflammation and promote wound healing:
Bioactive polymeric formulations for wound healing ← there isn’t a conveniently quotable summary we can just grab here, but you can see the data and results, from which we can conclude:
- formulations with ricinoleic acid (such as with castor oil) performed very well for topical anti-inflammatory purposes
- they avoided the unwanted side effects associated with some other contenders
- they consistently beat other preparations in the category of wound-healing
To support hair growth and scalp health
There is no evidence that it helps. We’d love to provide a citation for this, but it’s simply not there. There’s also no evidence that it doesn’t help. For whatever reason, despite its popularity, peer-reviewed science has simply not been done for this, or if it has, it wasn’t anywhere publicly accessible.
It’s possible that if a person is suffering hair loss specifically as a result of prostaglandin D2 levels, that ricinoleic acid will inhibit the PGD2, reversing the hair loss, but even this is hypothetical so far, as the science is currently only at the step before that:
However, due to some interesting chemistry, the combination of castor oil and warm water can result in acute (and irreversible) hair felting, in other words, the strands of hair suddenly glue together to become one mass which then has to be cut off:
“Castor Oil” – The Culprit of Acute Hair Felting
👆 this is a case study, which is generally considered a low standard of evidence (compared to high-quality Randomized Controlled Trials as the highest standard of evidence), but let’s just say, this writer (hi, it’s me) isn’t risking her butt-length hair on the off-chance, and doesn’t advise you to, either. There are other hair-oils out there; argan oil is great, coconut oil is totally fine too.
As a laxative
This time, there’s a lot of evidence, and it’s even approved for this purpose by the FDA, but it can be a bit too good, insofar as taking too much can result in diarrhea and uncomfortable cramping (the cramps are a feature not a bug; the mechanism of action is stimulatory, i.e. it gets the intestines squeezing, but again, it can result in doing that too much for comfort):
Castor Oil: FDA-Approved Indications
To soothe dry eyes
While putting oil in your eyes may seem dubious, this is another one where it actually works:
❝Castor oil is deemed safe and tolerable, with strong anti-microbial, anti-inflammatory, anti-nociceptive, analgesic, antioxidant, wound healing and vasoconstrictive properties.
These can supplement deficient physiological tear film lipids, enabling enhanced lipid spreading characteristics and reducing aqueous tear evaporation.
Studies reveal that castor oil applied topically to the ocular surface has a prolonged residence time, facilitating increased tear film lipid layer thickness, stability, improved ocular surface staining and symptoms.❞
Source: Therapeutic potential of castor oil in managing blepharitis, meibomian gland dysfunction and dry eye
Against candidiasis (thrush)
We couldn’t find science for (or against) castor oil’s use against vaginal candidiasis, but here’s a study that investigated its use against oral candidiasis:
…in which castor oil was the only preparation that didn’t work against the yeast.
Summary
We left a lot unsaid today (so many proposed uses, it feels like a shame to skip them), but in few words: it’s good for skin (including wound healing) and eyes; but we’d give it a miss for hair, candidiasis, and digestive disorders.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Take care!
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Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley
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Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.
(In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)
Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).
The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂
Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.
Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!
PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!
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Broccoli vs Red Cabbage – Which is Healthier?
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Our Verdict
When comparing broccoli to red cabbage, we picked the broccoli.
Why?
Both are certainly great! Which is usual for any Brassica oleracea cultivar (as both of these vegetables are). But there is a clear winner:
In terms of macros, broccoli has more fiber and protein, while red cabbage has more carbs. Now, nobody is getting metabolic disease from eating cabbage, but by the numbers, this is a simple win for broccoli, especially on account of the fiber.
In the category of vitamins, broccoli has more of vitamins B1, B2, B3, B5, C, E, K, and choline, while red cabbage has more of vitamins A and B6. Another win for broccoli.
When it comes to minerals, it’s a similar story: broccoli has more copper, magnesium, phosphorus, potassium, selenium, and zinc, while red cabbage has more iron and manganese. They’re equal in calcium, by the way. Broccoli wins again.
Looking at polyphenols, both cultivars have plenty, but broccoli has more in total, as well as more variety, so yet another win for broccoli here.
Now, standing next to broccoli has made red cabbage look bad, but we want to assure you that red cabbage is itself a nutritional powerhouse—broccoli is just even more so.
So of course, by all means do enjoy either or both; diversity is good!
Want to learn more?
You might like:
21 Most Beneficial Polyphenols & What Foods Have Them
Enjoy!
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