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Feb 13

Billy Gardell Talks Weight Loss: How Much He Lost, How He Did It, & More – Just Jared

Bob Hearts Abishola star Billy Gardell has impressed fans with his major weight loss over the years and he has opened up about how he achieved his goals.

The 54-year-old actor is best known for playing Bob on the CBS series, as well as playing Mike on the beloved sitcom Mike & Molly.

Billy lost the majority of his weight during a three-year period between 2020 and 2023 and he has shared details on how he dropped the weight.

Keep reading to find out more

In a previous interview, Billy revealed that he weighed 370 pounds about a decade ago and he was down to about 205 to 210 pounds in April 2023. That means he lost between 160 and 165 pounds!

I float between 205 [pounds] and 210 [pounds], he told ET. Self-care is important, and I think I finally got there.

Walking around pretty healthy these days, he added. Of course, theres always people online that, you know, when I was heavy, they were like Youre too heavy! And now its like, Are you sick? Can I just walk the earth, please?!

Billy revealed that he no longer suffers from Type 2 diabetes and he was able to lower his resting heart rate from 113 to 68.

Billy says the motivation behind losing the weight was his son. He said, When you hit 50, you start doing that dad math, like, If I can live 25 more years, and hell be 40, You know what I mean? So I want to be here for him. Ive been an example in a lot of good ways for my child, but I feel like I wasnt a good example of health for him. And so I want him to see that. It doesnt matter what age you are, if you are willing to do something a day at a time, you can change anything.

Back in 2022, Billy talked about how he lost the weight, revealing that he did have gastric bypass surgery as a preventive measure for high-risk COVID-19.

I had to make a change, Billy said during his appearance on The Rich Eisen Show. I was diagnosed with Type 2 Diabetes and I was on medicine for that. Ive struggled with my weight for my whole life.

He continued, saying that when COVID hit, I thought that couldve been the end of me. They pulled up that list of conditions [of who are afflicted the most], like overweight, asthma, smoker, diabetesI had everything except over 65.

While Billy had been losing more weight before, he did say that after restrictions lifted, he went and did have weight loss surgery.

Im not saying everyone should do that, but its what I needed to do because I had gotten so big that it hurt to exercise, he explained. I do everything they tell me to do and I follow it daily and its a new way of life.

Billy concluded, Its been a gift. I feel like Im finally free.

Check out recent cast changes to Bob Hearts Abishola.

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Billy Gardell Talks Weight Loss: How Much He Lost, How He Did It, & More - Just Jared

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Feb 13

Football365 readers tell their stories of MAN v FAT weight loss inspired by this very website – Football365

We have been working with MAN v FAT for more than 12 months now on Football365 and were delighted to be able to tell the stories of two readers who were inspired to sign up for the weight-loss programme by this very website.

MAN v FAT was established in 2014 by Andrew Shanahan, who was frustrated at how his local slimming clubs were targeted at women, with MAN v FAT Football following two years later in 2016.

It has been endorsed by the Football Association and Sports England; gained recognition from the National Obesity Forum, Weight Concern and the British Dietetic Association; and in December it got together some of the MAN v FAT Football players at Wembley to kick off its 10-year anniversary celebrations.

In short, its a fantastic programme that were proud to support and even prouder to hear stories from our own F365 readers about how they have benefitted from the discount code MAN v FAT continue to offer:simply add the promo code F365 at checkout to see the cost to sign up reduced from 9.99 to 3.65.

Once signed up, you get assigned a local club, then play weekly games of five, six or seven-aside football.But MAN v FAT results are not calculated only by goals scored on the pitch; teams are awarded and deducted weight loss and weight gain goal bonuses and punishments that are addedbefore points are calculated.

For example, any player to have reached 5% or 10% lost from their registration weight earns their team three goals.You can read more about how MAN v FAT works here, butits open to anyone with a BMI of 27.50 or over and can have a hugely positive impact on mental well-being as well as the obvious physical benefits.

But dont take our word for it here are the experiences of two Football365 readers

Since joining the club in Reading in January 2023, Julian, 43, has lost 10% of his body weight (11.5 kilograms) after deciding to lose weight for the sake of his children, aged five and three.

Chris, meanwhile, is a more recent recruit having signed up to the Peterborough-based club in June but the 39-year-old is already seeing major results having lost almost 17kg in little more than six months.

The moment that made him decide to lose weight will sound familiar to millions.

Since the pandemic, my companys moved to working from home, he says. And I didnt realise how unfit Id become, and how much weight Id put on, until I ran up the stairs once because my phone was ringing.

I was out of breath by the time I got to the top of the stairs. I just thought: Yeah, this needs to change.

That was the catalyst for everything.

Man vs Fat Football players in action Robbie Stephenson/JMP

Motivation and consistency are often seen as barriers to exercise, but MAN v FAT solves that age-old problem by ensuring that weight loss has a direct impact on the outcome of matches as much as goals scored on the pitch with players weighed every week before each game to track their progress.

Both Julian and Chris agree that having their team-mates depend on them to lose weight to give their team a match-winning edge is a huge motivating factor.

Julian says: It certainly provides additional motivation and makes you stop and think before you polish off the kids dinner or pry open the biscuit tin due to the accountability to each other.

Having that consistent accountability and seeing others success also helps motivate you to keep going, as becoming healthier is a journey which has its ups and downs.

Chris adds: Ive tried to lose weight before and Ive lost a little bit and put it back on, its always been a bit of a yo-yo. But thats because Ive never had people depending on me for it as such.

Now I know that if I do my tracking, if I lose weight even if I lose 0.1 per cent, its a loss its helping the team. We can get beat 5-0 on the pitch, but knowing that weve still got a chance to win it [is incredibly motivating].

Through the week, when Im sitting there hungry and Im looking at a chocolate bar and thinking I could have it, Im like: No, no. Ive got people that need me to help out here and sort this out.

So I put it to the back of my mind and have a bit of fruit instead. Having that responsibility for other people is a driver for me.

Even if youre not the greatest footballer on the pitch, you can still win it because if you lose that weight and youre consistent enough you do the business for the team and for yourself as well.

The reach of MAN v FAT extends way beyond the pitch with online exercise classes, webinars and recipes available for players.

Julian has found himself giving a lot more thought to what he eats and drinks and has taken up swimming to supplement his weight-loss journey, while Chris credits MAN v FAT with boosting his well-being after being left in a really bad place following hernia surgery in early 2023.

I was quite down about everything because I thought all the weight is going to go back on, he says. And it did all the weight Id lost prior to that went back on.

But joining up with MAN v FAT gives you that something to look forward to every week.

Football has always been great to have a laugh, just having a kickabout on the field with your mates, and its that sort of memory and enjoyment that you get from it that just gives your mental health a boost.

Im going on holiday soon and normally Id be wearing t-shirts and hoodies and things like that, but Im actually taking some basketball jerseys with me this time because Ive lost that bit of weight and Im feeling a bit more confident to go: Im on holiday, I should wear something a bit more comfortable and a bit more realistic for the weather.

Its definitely helping my self-esteem and my body image as well as my mental health.

Action from the MAN v FAT National Finals Day 2022

And if youre reading this, considering joining up but a little hesitant about taking the plunge? Chris has a message for you: Dont hesitate.

The first week I went down, I thought: Im going to walk in, Im going to be the biggest guy there, Im going to be the worst footballer there, Im going to be the outlier, Im not going to be up to speed, Im going to let the team down.

And you go down there and its actually the complete opposite. Youll be supported. Theres guys that will be a lot further on their journeys than you, but started where youre starting.

And theyll be able to give you that help and motivation: If that guy was my weight and now hes down to that, and hes looking like that and running around for half an hour because hes got the fitness and energy to keep running, I can do it too.

Thats a big thing for me. Ive met guys that are nearing the end of their journey that were where I was. Theres no barrier to it. If you want to do it, you can do it.

MAN v FAT has been the best weight-loss programme Ive ever done. Ive had the best results of anything Ive ever tried and Ive made friends out of it as well.

Its not just on the Monday night when we meet up and chat, were chatting through the week. Its a real community and a real family that weve got down there.

The main thing Id say is dont hesitate, pull the trigger, get on it and start the journey now.

You wont regret it.

MAN v FAT are offering Football365 readers a discount on new memberships simply add the promo code F365 to see the cost reduced from 9.99 to 3.65.

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Feb 13

Litesport VR is a fun and decent workout, but it’s trying too hard – Mashable

As a former athlete, Ive spent a lot of time trying different types of fitness. From running to powerlifting, CrossFit classes, martial arts, hot yoga, and more there arent many things I dont like when it comes to staying active. However, when it comes to home workouts, I find that I get bored easily, and no matter how many apps and fitness programs I try nothing hits quite like getting out of the house.

Obviously, the pandemic changed things. Running was my only solace until a nasty ankle injury left me searching for another option, and while my trusty exercise bike was great during my injury recovery, I also hated every second of it. So, when the opportunity to test the virtual reality experience, Litesport, I was eager to jump into the world of VR fitness and see if a game-like exercise experience was exactly what I needed to stay active at home.

Formerly known as Liteboxer, Litesport is branded as a VR fitness experience that offers boxing, full-body, and strength workouts all within the convenience of your own home. Available on Metas Quest 2, Quest 3, and Quest Pro, Litesport boasts a library of more than 1,000 on-demand classes with options including mitt drills, boxing punch tracks, battle rope workouts, and strength training with real dumbbells.

While that might sound scary, especially for anyone familiar with other VR games and experiences, Litesport relies on augmented reality (AR) technology to create a mixed-reality experience that utilizes things like hand tracking to make these workouts, well, work. So instead of doing your workout in a virtual reality space, the headset allows you to keep seeing the same environment like your living room except now theres a certified personal trainer leading the workout right in front of you.

Im not going to lie, I was pretty thrilled to try Litesport. Ive had a VIVE VR headset for years, and I still grin like an idiot every time I play Beat Saber. After trying the XREAL Air AR glasses, however, I was excited to don the Meta Quest 2 to try a more robust AR experience. And if it got me a good workout? Even better.

Straight away, I was pretty pleased with the Litesport experience. It was easy to get everything started, and considering Litesports original offering was VR boxing I quickly selected a trainer-led mitt drills workout to test everything out.

The easiest way to describe Litesports boxing is virtual reality meets Dance Dance Revolution. Armed with my headset and two controllers, there was a punching target in front of me that would light up as the trainer barked out a series of punch combinations to hit in sync with the music. While the lights were helpful, it took me a minute to get used to the punches with each circle on the target corresponding with a different punch number but before I knew it, my first workout was over leaving me eagerly jumping straight into the next.

As a former kickboxing instructor, there was something nostalgic about having a trainer shout out punch combinations for me in virtual reality. While its similar to shadowboxing, I was worried the experience wouldnt quite be as satisfying without something physical to strike, but I was surprised by how easily I got into the groove.

The trainer-led boxing workouts and mitt drills were fun, exciting, and easy to search through with different lengths, instructors, and difficulty levels available meaning you could do back-to-back mitt drills or mix and match with other types of workouts available in Litesport for a more unique experience. Plus, thanks to Litesports partnership with Universal Music Group, there were plenty of great tunes to keep the energy up during your sweat sesh.

Ive seen a few other reviews of Litesports VR experience, so I know this might not be a popular opinion, but I wasnt a huge fan of some of the other workout types. It was cool to try a mixed-reality strength training workout, letting me use real dumbbells with a virtual trainer, but I didnt love the experience. Even though Ive always been athletic, Im pretty accident-prone, and the AR strength workout didnt really feel like it added anything compared to following a workout video on YouTube or the Forme fitness mirror.

I wasn't the biggest fan of the dumbbell experience. Credit: Litesport

The total body workouts felt reminiscent of Beat Saber, but I felt like I was sacrificing proper form to keep up with the speed of the workout. Instead of a fun game that kept me active, I couldnt wait for the total body workout to be over. And even though I loved the boxing workouts and mitt drills, the punch tracks werent great for me either. They got boring and repetitive faster than I thought, so I found myself gravitating to the mitt drills each time I picked up the VR headset.

Unfortunately, the more I played around with Litesport, the more frustrated I got. The experience was buggy here and there, with certain screens freezing, and I had to restart the app more than once. There were parts of Litesport that were ridiculously fun and a great workout, but at $18.99 per month for a premium membership, I wasnt as impressed as Id hoped.

If you already have the headset, its definitely worth the free trial but Im on the fence about the premium membership. There is a standard plan for $8.99 per month, but is has a lot fewer workouts available.

For some people, Litesport might be exactly what you need to get active at home. Its fun and unique, theres a good amount of workout variety, and other people might enjoy the total body and strength training workouts far more than I did.

For me, however, the whole experience fell flat. I found myself wishing Id discovered it back when it was still Liteboxer, so I could just stick to the parts I enjoyed. And while the monthly subscription is less than a gym membership, it paled in comparison to other workout subscriptions like the Peloton app when it comes to workout quality and the size of the workout library.

Litesport clearly tried to do something incredibly ambitious by bringing a robust workout experience into VR, and while its definitely got potential, the current experience doesnt quite meet the mark.

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Litesport VR is a fun and decent workout, but it's trying too hard - Mashable

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Feb 13

Providing effective falls prevention in aged care – Mirage News

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New research from Flinders University has revealed that devastating falls in residential aged care homes could be prevented by using gold standard approaches of regular exercise and a personalised falls prevention plan.

Falls in older adults cost Australia's health systems $2.5 billion each year and can have devastating personal consequences, with 130,000 older Australians hospitalised for a fall and 5,000 Australians dying from a fall each year.

There is no current national strategy on preventing falls.

In residential aged care homes (often called nursing homes), falls are even more common and more frequently serious. The Royal Commission into Aged Care Quality and Safety has highlighted the urgent need to address falls in this setting and falls have become a mandatory quality indicator and contributing to the star rating of nursing homes.

To date, evidence on how to prevent these falls has been extremely limited. However, Flinders University researchers Dr Suzanne Dyer and Dr Jenni Suen have now produced two new research papers that reveal clear guidance on how to successfully reduce falls for residents in aged care homes.

"We have found that both regular exercise and a personalised falls prevention plan based on each resident's individual needs should significantly reduce the likelihood of a fall," says Dr Dyer.

"We know that exercise programs designed for older people can reduce falls by building strength and balance, but they must be consistent, if they stop exercising, the benefits are lost.

"Much like any exercise program, it should include a combination of exercise types such as balance and resistance and be tailored, allowing for individual abilities and preferences," says Dr Dyer.

The research also highlights the importance of having an individual falls risk assessment for each person, allowing for the flexibility of care home staff to make adjustments where required says Dr Jenni Suen from the College of Medicine and Public Health.

"Falls were reduced when different interventions (such as exercise programs, mobility aids, glasses, changing medications or modifying the environment) were given based on an individual's falls risk assessment.

"However, this was only true when the care home staff and managers were able to modify the strategies according to specific circumstances, for example considering whether they had dementia or not," says Dr Suen.

The research papers have been pivotal in informing the soon to be released, newly updated Australian Falls prevention guidelines that are currently open for consultation.

"Given the serious consequences for residents and the associated high costs of falls, it is critical that adequate resources are provided to ensure that falls prevention programs can be ongoing in aged care homes, particularly including exercise tailored to residents, "says Dr Dyer.

"By combining consistent and appropriate exercise with a personalised falls prevention strategy that can be adapted by care home staff, we should see a reduction in falls for older people living in residential care," says Dr Suen.

"These simple additional considerations for both residents and staff appear to differentiate between successfully preventing falls or not. Therefore, considering these factors when planning a falls prevention program in residential aged care, could make all the difference," adds Dr Suen.

Critical features of multifactorial interventions for effective falls reduction in residential aged care: a systematic review, intervention component analysis and qualitative comparative analysis by Jenni Suen, Dylan Kneale, Katy Sutcliffe, Wing Kwok, Ian D Cameron, Maria Crotty, Catherine Sherrington, and Suzanne Dyer was published in Age and Ageing journal. DOI: 10.1093/ageing/afad185

Exercise for falls prevention in aged care: systematic review and trial endpoint meta-analyses by Suzanne M Dyer, Jenni Suen, Wing S Kwok, Rik Dawson, Charlotte McLennan, Ian D Cameron, Keith D Hill, and Catherine Sherrington was published in Age and Ageing journal. DOI:10.1093/ageing/afad217

Acknowledgements: This research was a collaborative effort between researchers at Flinders University, University of Sydney, and University College London and funded by the NHMRC-funded Prevention of Falls Injury Centre for Research Excellence.

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Feb 13

Testosterone Ineffective in Preventing Diabetes in Men with Hypogonadism – MD Magazine

Shalender Bhasin, MBBS

Credit: UKMC

A substudy of the TRAVERSE trial revealed the progression from prediabetes to diabetes did not significantly differ between testosterone replacement therapy (TRT) or placebo treatment among middle-aged and older men with hypogonadism.1

The nested TRAVERSE Diabetes Study, an intention-to-treat analysis within the placebo-controlled randomized clinical trial, was conducted at 316 trial sites in the United States. Among the more than 5200 randomized participants, TRT did not improve glycemic control in those with hypogonadism and prediabetes or diabetes.

The findings of this study suggest that TRT alone should not be used as a therapeutic intervention to prevent or treat diabetes in men with hypogonadism, wrote the investigative team led by Shalender Bhasin, MBBS, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Womens Hospital, Harvard Medical School.

Evidence has linked low testosterone to an increased risk of prediabetes and type 2 diabetes (T2D) in men.2 Men with prediabetes and diabetes have a high prevalence of hypogonadism, while a substantial portion of individuals receiving TRT have diabetes or prediabetes.3 TRT in men with hypogonadism can reduce whole-body and visceral fat mass, increase muscle mass, and improve insulin sensitivity.

As it is not well-understood, Bhasin and colleagues suggested further knowledge on testosterones efficacy in preventing progression from prediabetes to diabetes or in inducing glycemic control would be beneficial for clinicians, as well as patients weighing the benefit-risk profile of TRT.1

Men aged 45 to 80 years with hypogonadism and prediabetes, or diabetes were enrolled in TRAVERSE between May 2018 and January 2023. Participants were randomized 1:1 to receive 1.62% testosterone gel or placebo gel until the end of the study. All participants, the study staff, and those assessing outcomes were blinded to randomization.

The primary endpoint of the TRAVERSE Diabetes Study was the risk of progression from prediabetes to diabetes, assessed at all post-randomization time points using repeated-measures log-binomial regression. Secondary endpoints consisted of the risk of glycemic remission in those with diabetes at baseline, defined as a hemoglobin A1c level of 6.5% or two fasting glucose measurements <126 mg/dL without antidiabetic medication use.

Of the 5246 individuals randomized in TRAVERSE, 5204 were included in the analysis set for the nested substudy. Among this population, 1175 had prediabetes (607 randomized to TRT), and 3880 had diabetes (1917 randomized to TRT). Baseline characteristics were similar between the testosterone- and placebo-treated cohorts with prediabetes or diabetes the mean age was 63.8 years, and the mean HbA1c level was 5.8%.

Upon analysis, investigators found the relative risk of progression from prediabetes to diabetes did not significantly between testosterone and placebo groups. Progression risk was identified in 4 of 598 (0.7%) vs. 8 of 562 (1.4%) at six months, 45 of 575 (7.8%) vs. 57 of 533 (10.7%) at 12 months, 50 of 494 (10.1%) vs. 67 of 460 (14.6%) at 24 months, 46 of 359 (12.8%) vs. 52 of 330 (15.8%) at 36 months, and 22 of 164 (13.4%) vs. 19 of 121 (15.7%) at 48 months (omnibus test, P = .49).

Further results showed the risk of glycemic remission among those with diabetes at baseline did not significantly differ between the testosterone and placebo groups. Changes from baseline in fasting glucose or HbA1c concentrations were also similar among testosterone- and placebo-treated groups in those with either prediabetes or diabetes at baseline. Post-hoc sensitivity analysis of the primary and secondary events occurring within 30 days or 365 days after stopping treatment exhibited similar results to the primary analyses.

Based on these data, Bhasin and colleagues indicated the study results do not support the use of TRT alone in the prevention or treatment of diabetes in men with hypogonadism. Still, they could help weigh its benefit-risk profile for each individual.

The trials findings may be useful in weighing the potential benefits of TRT in middle-aged and older men with hypogonadism who have prediabetes or diabetes, investigators wrote.

References

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Feb 13

Testosterone Replacement Therapy (TRT) and Diabetes: What Recent Research Reveals – Medriva

In recent years, testosterone replacement therapy (TRT) has been considered a potential treatment for hypogonadism, a condition characterized by low production of the male hormone testosterone. Some studies suggested that TRT could possibly slow the progression of prediabetes or diabetes. However, recent research contradicts these assumptions, finding no evidence that TRT benefits metabolic health in men with hypogonadism.

Published in JAMA Internal Medicine, the study evaluated whether TRT could prevent progression from prediabetes to diabetes or improve glycemic control among those already diagnosed with diabetes. The study involved 5204 participants with hypogonadism across 316 trial sites. The results were clear: there was no difference in the progression to diabetes between the testosterone and placebo groups. Furthermore, there were no differences in glycemic improvement among men with diabetes.

Another significant study, the TRAVERSE Diabetes Study, produced similar findings. The study showed that TRT for men with hypogonadism and prediabetes is not associated with a significantly lower rate of progression to diabetes. The research found no significant differences in terms of glycemic remission and the changes in glucose and A1c levels between the testosterone- and placebo-treated men with prediabetes or diabetes.

The findings of the TRAVERSE randomized trial suggest that TRT alone should not be used as a therapeutic intervention to prevent or treat diabetes in men with hypogonadism. These findings could be pivotal in weighing the potential benefits of TRT in middle-aged and older men with hypogonadism who have prediabetes or diabetes.

A substudy of the TRAVERSE trial found that TRT does not increase the risk for cardiovascular events, fracture, or prostate cancer, and may only improve anemia, but not cognitive function. According to the research, the only indication for TRT in men with hypogonadism remains treatment of bothersome symptoms of hypogonadism, generally sexual dysfunction.

In conclusion, these studies highlight the importance of careful consideration before prescribing TRT for the management of prediabetes or diabetes in men with hypogonadism. The findings suggest that TRT does not slow the progression of these conditions, nor does it significantly improve glycemic control. Therefore, it is crucial for healthcare professionals to make informed decisions based on the latest research when considering different treatment options.

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Testosterone Replacement Therapy (TRT) and Diabetes: What Recent Research Reveals - Medriva

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Feb 13

Testosterone Replacement Therapy (TRT) and Diabetes: What You Need to Know – Medriva

Testosterone replacement therapy (TRT) is a commonly sought treatment for men suffering from hypogonadism, a condition characterized by low levels of testosterone. While TRT has been linked to various benefits including increased sex drive, improved bone density and muscle mass, and alleviation of hypogonadism symptoms, recent studies challenge the belief that TRT can play a role in preventing the progression of prediabetes or diabetes in these men.

The TRAVERSE Diabetes Study, a comprehensive research endeavor involving 5204 participants across 316 trial sites, has provided crucial insights into the effectiveness of TRT for metabolic health. The primary aim of the study was to explore whether TRT could halt the progression from prediabetes to diabetes or enhance glycemic control among those already diagnosed with diabetes.

Contrary to previous evidence, the study found that TRT did not significantly affect the risk for progression to diabetes, glycemic remission, or changes in glucose and A1c levels. Furthermore, the progression to diabetes did not differ between groups, and no significant differences were observed in glycemic improvement among men with diabetes.

This indicates that while TRT may be beneficial in treating the symptoms of hypogonadism and improving overall quality of life, it does not appear to have metabolic benefits. As such, the authors of the study concluded that TRT should not be used as a singular therapeutic intervention to prevent or treat diabetes in men with hypogonadism.

Interestingly, the study also highlighted the high rates of testosterone use, even in the absence of proven metabolic benefits. This suggests that men and healthcare providers may need to reassess the use of TRT, particularly if the primary goal is to prevent or manage diabetes. Moreover, it underscores the importance of holistic treatment plans that encompass lifestyle changes and other medical interventions.

While TRT may not be effective in preventing diabetes progression, it is important to note its role in managing male fertility in hypogonadal patients. Testosterone plays a key role in regulating body functions in men. However, traditional TRT can have negative effects on male fertility. Recent advances in research have shed light on new methods of administration and the usage of ancillary medications to maintain fertility in hypogonadal patients.

TRT can be administered in various forms such as gel, injections, patches, buccal patches, capsules, nasal gel, and pellets. Each type has its own set of advantages and disadvantages, and the choice of administration should be tailored to the individuals needs and lifestyle. As with any medical intervention, the potential benefits and risks must be weighed carefully.

In conclusion, while TRT can help manage symptoms and improve the quality of life for men with hypogonadism, it does not show any significant benefit in slowing the progression of prediabetes or diabetes. It is essential for healthcare providers to convey this to patients and to develop comprehensive treatment plans that address the patients overall health and wellbeing.

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Testosterone Replacement Therapy (TRT) and Diabetes: What You Need to Know - Medriva

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Feb 13

Understanding Andropause: Men’s Answer To Menopause | Lifestyle | theweeklyjournal.com – The Weekly Journal

Menopause is something we usually associate with women and is a condition that marks the end of the female menstrual cycle. However, male menopause, or andropause, is a condition that involves aging-related hormone changes in men, according to the Mayo Clinic. The new phenomenon sees testosterone levels gradually decrease by one percent every year once a man reaches the age of 40. The symptoms are similar to those experienced by women during menopause, like, reduced libido, fatigue and decreased muscle mass. There are solutions to mitigate the decline in testosterone levels like injections, oral medication, creams and over-the-skin patches. Natural solutions to maintain testosterone levels include certain lifestyle changes like regular exercise, healthy eating and adequate sleep. Research in Obesity Reviews shows that obesity can lead to lower testosterone levels, with weight loss being another to manage symptoms.

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Understanding Andropause: Men's Answer To Menopause | Lifestyle | theweeklyjournal.com - The Weekly Journal

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Feb 13

Opinion: Weight-loss drugs like Ozempic can’t fix America’s obesity crisis alone : Shots – Health News – NPR

Amr Bo Shanab/Getty Images/fStop

Amr Bo Shanab/Getty Images/fStop

The headlines are compelling, with phrases like, "The Obesity Revolution," and "A new 'miracle' weight-loss drug really works." The before-and-after pictures are inspiring. People who have struggled for decades to shed pounds are finally finding an effective strategy.

The last few years saw breakthroughs in treatments for obesity, with new weight-loss medicines dominating recent news reports. The medicines, semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), work by slowing stomach-emptying and decreasing appetite. They're usually administered by weekly injection.

Clinical trials boasted success comparable to surgery. Celebrities like Oprah Winfrey shared encouraging personal stories.

The scientific literature behind the headlines is impressive as well. Those taking the medicines lose, on average, 10% to 20% of their body weight. Originally developed for Type 2 diabetes, the drugs are well known to improve control of blood sugar. In December, we also learned that in people with cardiovascular disease who are overweight or obese, semaglutide appears to reduce major adverse cardiac events by 20%.

For primary care doctors like me, who have counseled thousands of patients often unsuccessfully about their weight, this news is welcome. For many of those living with obesity, these medicines can feel like a game changer.

Excess body weight is tied to a range of medical problems, including diabetes, heart disease, osteoarthritis, sleep apnea and many types of cancer. It's linked to shorter life expectancy and higher rates of disability. With about 40% of U.S. adults now classified as obese and another 30% considered overweight many doctors and patients are embracing the new drugs as a solution.

Yet even as many may adopt the newest medications, we need to recognize and address their limitations, including a lack of long-term safety data and potential side effects like nausea, vomiting and, rarely, pancreatitis and gallbladder disease. Poison control centers are reporting an increase in calls due to medication overdoses, which can lead to low blood sugar and associated symptoms, like dizziness, irritability and in severe cases confusion and coma.

The high price of the weight-loss medicines usually over $1,000 per month for each patient is especially troubling in a nation that already far outspends the rest of the world in health care costs and faces major disparities in care. The cost concerns are amplified by studies showing that the drugs usually need to be taken long term to prevent weight regain.

"While these drugs are powerful and wonderful tools, they are not a panacea," said Jonathan Bonnet, a board-certified obesity, lifestyle, family and sports medicine physician who serves as program director of medical weight loss at the Palo Alto VA's Weight Management Center Clinical Resource Hub.

He is seeing positive results among his patients but recognizes cost as a significant barrier. "Treating everyone with obesity in the U.S. with medications will bankrupt the country and still not cultivate the type of health and vitality we actually want," he said.

More than half of employer insurance plans in the United States, as well as Medicare, don't cover the medicines for weight loss.

Medications also fail to address the root causes of the problem. Rates of obesity have increased substantially over the last few decades and have continued to climb since the COVID-19 pandemic. A Gallup survey released in December showed the obesity rate increased by 6 percentage points from 2019 to its current level of 38.4%. The prevalence of Type 2 diabetes a known consequence of obesity in many individuals increased from an estimated 10.3% of U.S. adults in the 2001-2004 time period to 13.2% in the 2017-2020 time period.

Our society's easy access to ultraprocessed, calorie-dense foods and our high levels of inactivity contribute to excessive weight gain and related health impacts. A health care system designed for "sick" care supported by a multibillion-dollar pharmaceutical industry that stands to benefit when we fall ill does not prioritize disease prevention.

And while we should embrace a culture of acceptance of all body types, we also can't ignore the fact that rising rates of obesity are part of a growing health crisis.

Enter lifestyle medicine. This burgeoning field focuses on prevention and treatment of chronic disease through adoption of healthy habits including a minimally processed diet rich in vegetables, fruits and whole grains; regular physical activity; restorative sleep; stress management; positive social connection; and avoidance of harmful substances.

Lifestyle medicine practitioners partner with patients to understand their core values and help them achieve goals whether it's to lose 20 pounds, control high blood pressure or boost mood and energy.

Lifestyle medicine is cheap and low risk. Its proven benefits extend far beyond weight loss and can be lifelong. Those who make positive lifestyle decisions, including exercising, eating well and not smoking, may reduce their incidence of coronary artery disease by over 80% and Type 2 diabetes by more than 90%. They take fewer medications. They live longer and experience improved mental health and lower rates of cancer, chronic disease and disability.

And a diet that emphasizes whole, plant-based foods is also better for our planet, reducing deforestation, air and water pollution and greenhouse gas emissions related to meat and dairy production.

Lifestyle medicine and the new weight-loss medications are not mutually exclusive. In fact, the package inserts explicitly state these drugs should be prescribed in combination with increased physical activity and a reduced-calorie diet.

Yet the lifestyle piece is usually glossed over. It's not a quick fix; it requires commitment and a reexamination of personal values. It encourages us to cut back on the ultraprocessed foods we like, high in added sugars and salt, that still raise the risk of heart disease, stroke and some cancers, even in those who aren't overweight.

According to the American Heart Association, fewer than 1% of U.S. adults and adolescents engage in all practices recommended to achieve ideal cardiovascular health, which include most tenets of lifestyle medicine.

New anti-obesity medicines are an important tool. But true health is not just about a number on the scale. Widespread adoption of the principles of lifestyle medicine would reduce health care costs, reverse recent declines in U.S. life expectancy and transform lives.

Because more than 82% of Americans see a health professional every year, incorporating lifestyle medicine into these visits is an obvious way to reach those who need support. But health care providers are often unprepared to offer the kind of intensive coaching that's required.

A 2017 survey indicated that 90% of cardiologists, for example, reported receiving minimal or no nutrition education during fellowship training.

Medical schools and residency programs need to teach the next generation of doctors to promote healthy behaviors and to implement those practices in their own lives.

Time is another constraint. In my years working in community clinics, I was routinely expected to see patients in 20-minute increments, leaving almost no opportunity to address lifestyle changes in a meaningful way. I might encourage patients with heart disease to eat more fruits and vegetables, but I didn't have time to understand the underpinnings of their dietary choices, often influenced by a complex combination of culture, finances and personal preferences.

Nor could I refer patients to supportive colleagues, such as dieticians, behavioral health counselors and health coaches my clinic didn't have them.

Doctors need time for difficult conversations to understand the drivers behind patient choices and what might motivate them to change. They need to be able to partner with other professionals who can offer support and expertise.

But even more important and more difficult is the need to adjust cultural norms and public policies to make it easier for individuals to adopt healthy behaviors.

For example, SNAP (Supplemental Nutrition Assistance Program), formerly known as food stamps, should be reformed to reduce taxpayer-subsidized consumption of sugar-sweetened beverages and ultraprocessed foods. Even small acts, like moving healthy foods to the front of the grocery store, can have an impact.

"Our environments are optimized for unhealthy living." Bonnet said. "Willpower will only get us so far." What we need, he told me, is to design communities that make healthy choices the default, less-expensive option.

Such communities would have more green space and walkable streets, easier access to fresh produce, plant-based entres in restaurants and increased opportunities for face-to-face social connections. By removing the reliance on willpower and financial resources to live well, we can reduce health disparities and improve quality of life for everyone.

This story comes from Public Health Watch, a nonprofit, nonpartisan investigative news organization that focuses on threats to America's well-being.

Lisa Doggett is a columnist for Public Health Watch, a family and lifestyle medicine physician at UT Health Austin's Multiple Sclerosis and Neuroimmunology Center and senior medical director of Sagility. She is the author of a new memoir, Up the Down Escalator: Medicine, Motherhood, and Multiple Sclerosis. The views expressed in her columns do not necessarily reflect the official policies or positions of Public Health Watch, UT Health or Sagility. Doggett can be reached through her website.

Original post:
Opinion: Weight-loss drugs like Ozempic can't fix America's obesity crisis alone : Shots - Health News - NPR

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Feb 13

Rapid Weight Loss a Diabetic Retinopathy Risk? – Medpage Today

While rapid weight-loss with bariatric surgery or drugs might temporarily worsen diabetic retinopathy as blood sugar levels are rapidly corrected, the low overall risk likely doesn't outweigh the benefits of weight loss, according to a review.

Altogether, the studies are conflicting and the evidence insufficient, Basil K. Williams Jr., MD, of the University of Miami, and colleagues concluded in Current Opinion in Ophthalmology.

For example, in a 1998 randomized study, diabetic retinopathy worsened at 6 months in 3.5% (25 of 711) of patients treated with intensive insulin therapy compared with 1.2% (nine of 728) of those on conventional insulin therapy (OR 2.98, P=0.006). At 4-year follow-up, though, retinopathy wasn't worse than at baseline in either group.

But a 2020 multicenter case-control study of 3,145 patients with type 2 diabetes found no link between the use of GLP-1 agonists -- a category that includes semaglutide (Ozempic, or Wegovy for weight loss) -- and worsening diabetic retinopathy (P=0.47).

"The goals for diabetic retinopathy treatment are to get blood sugars, blood pressure, and weight under control. This is by far the most important thing to do for the long term, so whatever approach is right for the patient is going to be the ideal treatment," Williams told MedPage Today. "However, it is really important to have a conversation with the patient upfront to let them know that this may worsen retinopathy temporarily. But in the long run, it's going to be beneficial for them."

According to the review, an estimated 9.6 million people in the U.S. have diabetic retinopathy, including about one-quarter of patients with diabetes mellitus.

Clinicians have long suspected that rapidly improving blood sugar can make eye health worse. Back in 1998, the insulin therapy study noted that "there have been many reports of the curious, unanticipated, and seemingly paradoxical worsening of diabetic retinopathy after rapid improvement of blood glucose control."

For the new review, researchers wanted to better understand the effect of rapid weight loss and improvement of HbA1c in light of the new generation of GLP-1 agonists, Williams said.

Some research did show that "when you get the diabetes controlled very, very rapidly, you can get some transient worsening of the diabetic retinopathy that improves over time," he said.

The mechanism appeared to be related to changes in osmotic pressure in the vessels in the vascular system, he said. As blood sugar control improves, "the pressure gradient between inside the vessels and outside the vessels is different. There are more proteins now outside the vessels, and that pulls more fluid outside the vessels. That causes a little bit of additional leakage."

This change stabilizes over time, he said. The review suggested that a sudden 2% or greater drop in HbA1c could impact retinopathy progression for 6 to 12 months. "Then things would be improving from there," Williams noted.

Moving forward, Williams predicted that the new generation of weight-loss drugs "will be really valuable and decrease the long-term implications of diabetic retinopathy on our population. But we do have to consider that there's a small percentage of people who will have some transient worsening. Navigating those small negatives with the overall greater benefit is something we're going to have to deal with more and more."

For now, the review authors recommended that patients undergo a baseline retinal examination before intensive glycemic control that leads to a rapid decrease in weight, followed by continued monitoring.

The review authors examined studies into tight insulin control, bariatric surgery, and GLP-1 agonists. They highlighted a 2022 systematic review and meta-analysis that found that four major randomized controlled trials linked GLP-1 agonists to rapidly worsening diabetic retinopathy but also to cardiovascular benefits.

Also, a 2016 study of semaglutide linked the drug to a higher risk of retinopathy complications (HR 1.76, 95% CI 1.11-2.78, P=0.02), although the numbers of patients affected were small (3% [50 of 1,648] with semaglutide vs 1.8% [146 of 1,649] with placebo).

The review did not include a matched cohort study presented last year at the annual meeting of the American Society of Retina Specialists. Ehsan Rahimi, MD, of Stanford University in California, reported that treatment with GLP-1 agonists almost doubled the likelihood of progression from nonproliferative to proliferative diabetic retinopathy after 3 years (RR 1.585, 95% CI 1.337-1.881, P<0.0001). The drugs were also linked to significantly higher rates of progression to diabetic macular edema.

"We see these patients in our clinics all the time," Rahimi said at the 2023 conference. "They go on these medicines, and their HbA1c crashes, goes down very quickly. That rapid reduction is thought to play some role. But if you look at the basic science literature, it's suggested that there are direct effects of these medications on the retina. That being said, it's also been suggested that there may be a protective effect on the retina. We're getting a lot of mixed signals."

Randy Dotinga is a freelance medical and science journalist based in San Diego.

Disclosures

Williams disclosed no conflicts of interest. One co-author disclosed consulting for Alcon, Alimera, Allergan, Apellis, DORC, Genentech, Iveric, OcuTerra, Regeneron, and Samsara.

Primary Source

Current Opinion in Ophthalmology

Source Reference: Williams BK, et al "Weight loss, bariatric surgery, and novel antidiabetic drugs effects on diabetic retinopathy: a review" Curr Opin Ophthalmol 2024; DOI: 10.1097/ICU.0000000000001038.

Read more from the original source:
Rapid Weight Loss a Diabetic Retinopathy Risk? - Medpage Today

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