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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.

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Rapid Weight Loss a Diabetic Retinopathy Risk? - Medpage Today

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Perhaps you set yourself the New Years resolution to

This research, published in Frontiers in Sports and Active Living, has shown that people who continue to run are more likely to keep off the weight in later life. It compared the lean mass and fat mass of males aged 20-39 and 70-89, who were then further grouped as sprinters, endurance runners, strength athletes or fit, athletic individuals who did not necessary take part in competitive sports.

The results demonstrated that fat mass was significantly lower in sprint and endurance athletes compared to strength athletes across both age groups. In other words, consistent running helps to prevent weight or fat gain in subsequent years so, if you havent done so already, theres no better time to weave regular running into your routine.

'Our data clearly shows that lifelong running exercise, be it long distance or repeated short distance sprinting, maintains lower fat mass levels than a typical physically active lifestyle and also more than participating in competitive strength sports,' says Dr Simon Walker, a Docent in Exercise Physiology at the University of Jyvskyl who co-led the research. 'Absolutely, this result motivates me to continue running. I'd certainly be happy with a fat percentage of 16-18% when I'm in my 70s and 80s.'

On the flip side and perhaps unsurprisingly the same study found that the participants who engaged in long term strength training preserved more muscle mass than their sprinting or long distance-running counterparts. In fact, of those studied, weight-wielders in the older group even had a similar amount of muscle mass as the younger strength trainers.

As such, for maximum long term physical benefit, Walker suggests supplementing running activities with plenty of strength training sessions. 'In terms of enhancing body composition through both heightened muscle mass and maintenance of a non-health affecting fat mass, it seems that a combined approach is recommendable,' he says.

Whether you prefer to do bodyweight exercises at home or strength-based work at the gym, regular resistance training of this kind can greatly improve both your current running performance and the overall shape and wellness of your body in later years.

While this new study considered only males, Walker believes that similar results would be shown for females, too, especially considering age-related effects such as the menopause. He believes that the most important finding from this research is that exercising now will do wonders for your future self, no matter what your gender.

'The key is perhaps to prevent a rise in fat mass or loss in muscle mass in the first place and maintain exercise throughout the lifespan,' he says. 'Thus, lifelong engagement in regular exercise does help to maintain a healthy body composition. That is no myth.'

If you want to lose a bit of weight or simply safeguard a lean, strong body, you can be assured that running will stimulate good health for the long haul. As per the findings of this study, running is as beneficial for your future physiological state as it is for your present one so keep going.

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Run to reduce long term fat gain - Runner's World UK

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No matter how much work you do to unlearn diet cultures brainwashing or feel comfortable in your skin, there are going to be days when you feel bad about your body. Think about it: We live in a society that constantly tells us smaller is better, and that getting as close as possible to the thin ideal will earn you love, acceptance, and dignified treatment.

Humans are deeply relational and need to feel a secure sense of belonging, Amber Stevens, PsyD, clinical director of Galia Collaborative in Cincinnati, Ohio, tells SELF. The constant pursuit of shrinking our bodies through dieting has historically been one of the more effective ways to reduce the threat of judgment from others.

But the reality is that dieting rarely leads to long-term weight loss (in fact, it tends to cause weight gain, research shows). In my experience as a dietitian who helps people recover from eating disorders, Ive seen firsthand how food restriction tends to do far more harm than good. Ive also seen how easy it is for folks to fall for the big promises of every new weight-loss fad and dive in headfirst, forgetting about all the ways diets have failed (and hurt) them in the pastor believing that this time will be different.

Thats where a little self-reflection can help: Remembering your past experiences is a powerful tool for resisting the (understandable) temptation to follow food rulesand working toward the food and body peace you deserve. The next time youre feeling like crap about your body and thinking a diet might be the answer, try the exercise below to see the full picture of how this same scenario has played out in the past.

Reflect on your previous experiences with diets to remind yourself that they ultimately didnt deliver on their promises. Maybe you went on a low-carb plan that left you dreaming of baguettes every nightand eventually binging on chocolate chip cookies every weekend. Maybe you had some success with calorie counting for a couple of months several years ago, only to find yourself obsessed with your tracking app, turning down dinner invitations with friends, and back at your starting weight a few months later.

The more we look at the evidence that diets have failed us, the more we can come to terms with the fact that theyre a money-making ruse, Dr. Stevens says. We have been sold a bill of lies that eventually dieting will work, and that if it doesnt result in permanent weight loss, its our fault rather than the fact diets are designed to fail. The shame that this creates can be incredibly difficult to climb out of. Use your list of the ways diets have failed you as proof that theyre to blame, not you.

Equally important is thinking about all the things you could gain from unlearning diet cultures BS, which can be hard to imagine if youve never actually given yourself a chance to experience them. So heres another quick exercise to try:

Think about what youd do differently in your day-to-day life if you werent worried about what would (or wouldnt) happen to your body as a result. If people have spent countless hours trying to adhere to strict eating or exercise rules, they realize they have a lot more free time when they give these things up, Abby Chan, RD, co-owner of Evolve Flagstaff in Flagstaff, Arizona tells SELF.

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Try This 5-Minute Mental Exercise the Next Time You Feel Crappy About Your Body - Self

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Gastric bypass surgery in people with severe obesity was associated with sustained improvements in cognitive function, inflammation, and comorbidities, according to results of a cohort study in the Netherlands.

At 2 years post-surgery, neuropsychological tests showed improvements of 20% or higher in global cognition (43% of patients), ability to shift attention (40%), episodic memory (32%), verbal fluency (24%), and working memory (11%), reported Amanda J. Kiliaan, PhD, of Radboud University Medical Center in Nijmegen, the Netherlands, and colleagues.

"Lower inflammation and adipokine secretion, remission of comorbidities, higher physical activity, and better mood" may have played a role in the sustained improvement in global cognition for that subset of patients, the researchers suggested in JAMA Network Open.

Compared with baseline, improvements at 2 years post-surgery were noted for inflammation, as indicated by decreases in high-sensitivity C-reactive protein (4.77 vs 0.80 g/mL, P<0.001).

Furthermore, patients were less likely to use antihypertensives at this point (36.1% vs 16.7% at baseline), had a reduction in depressive symptoms (Beck Depression Inventory scores of 9.0 vs 3.0, P<0.001), and increased their physical activity (mean Baecke score of 7.64 to 8.19, P<0.001).

Previous studies have linked bariatric surgery-induced weight loss with improved brain function and structure, Kiliaan and co-authors noted in their study introduction.

"However, results are contradictory, underlying mechanisms remain largely unknown, and it is uncertain whether outcomes are long-lasting," they wrote. "Imbalance of adipokines and proinflammatory cytokines may be involved, as they impair CBF [cerebral blood flow] and therewith cause neurodegeneration, which may be reversible after bariatric surgery."

The researchers considered the stabilization of cerebral structures and functions the most noteworthy finding of their study.

"Despite the lower CBF in several regions, volumes of hippocampus, nucleus accumbens, frontal cortex, white matter, and white matter hyperintensities remained stable after surgery," they wrote. "Notably, the temporal cortex exhibited not only higher cortical thickness but also higher vascular efficiency after surgery, as indicated by a lower sCOV [spatial coefficient of variation]. These results highlight beneficial vascular responses occurring in conjunction with bariatric surgery. Accordingly, nucleus accumbens and parietal cortex demonstrated stable CBF and cerebrovascular efficiency."

Using data from the Bariatric Surgery Rijnstate and Radboudumc Neuroimaging and Cognition in Obesity study, Kiliaan and colleagues analyzed outcomes of 133 patients eligible for Roux-en-Y gastric bypass from September 2018 to December 2020.

Patients were ages 35 to 55 years (mean 47), with a body mass index (BMI) over 40, or a BMI over 35 with comorbidities. Most patients in the cohort (84%) were women.

Endpoints were assessed at baseline (before bariatric surgery), and at 6 months and 2 years after surgery. Kiliaan and co-authors calculated the 20% change index -- an indication of clinically meaningful and significant cognitive improvement -- at 2 years after surgery to exclude practice effects.

Patients' body weight, BMI, waist circumference, and blood pressure were all significantly lower both at 6 months and 2 years after bariatric surgery. Meanwhile, the percentage of total body weight-loss increased from a mean 27% at 6 months to 34% at 2 years (P<0.001).

At 2 years after surgery, the proportion of patients with Beck Depression Inventory scores showing mild or moderate depressive symptoms at baseline declined from 42.3% to 9.4%, and from 3.1% to 1.6%, respectively.

The group noted that the high mean baseline score of 27 on the Montreal Cognitive Assessment (MoCA) and other neuropsychological assessments suggested that "obesity did not impair cognitive performance in clinical sense."

Regarding the mechanism behind the observed cognitive improvements during the study, "stabilization of volume, CBF, and sCOV in brain regions, together with larger cortical thickness and higher vascular efficiency in the temporal cortex, might be involved," Kiliaan and colleagues suggested.

Limitations acknowledged by the authors included the lack of a control group, an unequal sex distribution (although representative of the general bariatric surgery population), and failure to include cortical surface and curvature parameters, which they noted "could improve our understanding of change in cortical volume and thickness after bariatric surgery."

Kate Kneisel is a freelance medical journalist based in Belleville, Ontario.

Disclosures

The study funded by a grant from the Rijnstate-Radboudumc Promotion Fund and others.

Kiliaan reported no disclosures. Co-authors reported relationships with Dutch Top Sector Life Sciences and Health and the GLoBAL-1 consortium (Netherlands Organisation for Applied Scientific Research TNO, Radboud University Medical Center, Rijnstate Hospital, and Nordic Bioscience), among others.

Primary Source

JAMA Network Open

Source Reference: Custers E, et al "Long-term brain structure and cognition following bariatric surgery" JAMA Netw Open 2024; DOI: 10.1001/jamanetworkopen.2023.55380.

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Bariatric Surgery Tied to Long-Term Cognitive Benefits - Medpage Today

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Diabetic retinopathy, a common complication of diabetes, has long been a subject of study in medical research. Recent studies have focused on the possible impacts of rapid weight loss and glycemic control on this condition. However, these studies present conflicting evidence, leading to insufficient conclusions. In some cases, rapid blood sugar correction has been linked to a temporary worsening of retinopathy, while other studies indicate no connection between weight loss drugs and the condition.

Despite the potential temporary worsening of retinopathy, the long-term benefits of weight loss and glycemic control cannot be overstated. An 18-month longitudinal study found that rapid weight loss can lead to a significant reduction in the risk of developing diabetic retinopathy, especially in patients with poorly controlled diabetes. This highlights the importance of weight management in the treatment of type 2 diabetes mellitus.

Another critical aspect of managing this condition is glycemic control. It has been proven to reduce microvascular and macrovascular complications. Different organizations recommend varying HbA1c targets, but the underlying theme is the necessity of maintaining controlled blood sugar levels. This can be achieved through a combination of lifestyle modifications and the use of glucose-lowering pharmacotherapy.

GLP-1 agonists have emerged as a crucial tool in the battle against diabetes and its complications. Some studies have shown cardiovascular benefits associated with these drugs. However, theres also a link to retinopathy complications. In particular, semaglutide has been associated with worsening diabetic retinopathy.

Weight loss drugs, on the other hand, have been shown to have no direct link to retinopathy. The new generation of weight-loss drugs is anticipated to be valuable in decreasing the long-term implications of diabetic retinopathy. This does not negate the need for caution, however. Baseline retinal examinations and continued monitoring are recommended for patients undergoing rapid weight loss and glycemic control.

Brittle diabetes, a particularly difficult form of the disease to manage, can cause severe swings in blood sugar levels. This can lead to hospitalizations and an increased risk of complications. Treatment depends on the underlying cause and may require certain tests. In severe cases, a pancreas transplant may be an option. Regular healthcare provider visits are important to manage brittle diabetes, and with proper treatment and support, many cases are manageable.

In conclusion, while there is conflicting evidence about the impact of rapid weight loss and glycemic control on diabetic retinopathy, the long-term benefits are undeniable. The medical community continues to explore the balance between managing diabetes and its complications, with a focus on overall patient health and quality of life. The emergence of new weight-loss drugs and treatments offers hope for the future, but careful monitoring and management remain essential.

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The Impact of Weight Loss and Glycemic Control on Diabetic Retinopathy - Medriva

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When youre on a

As the name suggests, a 1,200-calorie diet is a type of low-calorie diet plan that restricts daily caloric intake to approximately 1,200 calories a day, says Diala Alatassi, MD, a board-certified internal and obesity medicine physician at Endeavor Health Medical Group. The goal of a 1,200-calorie diet is to create a calorie deficit, which can, in theory, lead to weight loss.

That said, 1,200 calories a day is generally not enough to support your overall health, especially if you include any sort of exercise into your lifestyle, says Alex Larson, RD, a registered dietitian and founder of Alex Larson Nutrition. We'll get into why in just a sec.

Meet the experts: Diala Alatassi, MD, is a board-certified internal and obesity medicine physician at Endeavor Health Medical Group. Alex Larson, RD, is a registered dietitian and founder of Alex Larson Nutrition. Kim Shapira, RD, is a registered dietitian and founder of the Kim Shapira Method.

Curious how many calories you really need in a day? Keep scrolling for everything you need to know about calculating your caloric needs and how to create a balanced, weight loss-friendly meal.

In most cases, no. Prolonged calorie restriction can actually slow metabolism because your body senses that food is scarce and lowers the rate in which it burns existing calories, says Dr. Alatassi. And while you may initially lose weight from a 1,200-calorie diet, transitioning out of this eating plan can lead to rebound weight gain, she explains.

Plus, excessive calorie restriction can lead to bone and muscle loss, brain fog, constipation, dizziness, fatigue, headaches, hormone imbalances, and poor immune function. Read: It throws off your whole bod.

As a result, if youre going to try a 1,200-calorie diet, you *need* to talk with your healthcare provider first, says Dr. Alatassi. Why? Its generally not sustainable for long-term health for the average person and you may run the risk of nutritional deficiencies, she explains. Consulting with a registered dietitian or healthcare professional is crucial to assess individual needs, monitor risks, and ensure the diet is safe and appropriate while prioritizing overall health and well-being.

The number of calories you need in a day depends on your age, sex, weight, activity level, overall health, and basal metabolic rate (BMR), says Dr. Alatassi. FYI: Your BMR is the number of calories you need to maintain basic physiological functions like thinking, going to the bathroom, and taking deep breaths.

On average, a typical adult woman needs about 1,800 calories a day, says Kim Shapira, RD, a registered dietitian and founder of the Kim Shapira Method. Consuming less than that can lead to nutritional deficiencies, a lack of energy, gastrointestinal distress, anxiety, and reduced cognitive function, she adds.

Its always best to consult a physician or dietitian to determine your exact caloric needs, but two nifty formulasknown as the Mifflin-St. Jeor or Harris-Benedict equationscan provide a rough estimate. If your goal is to lose weight, you then subtract around 500 calories per day to theoretically lose one pound per week, adds Larson.

The most popular formula is the Mifflin-St. Jeor equation which calculates your BMR.

For women, the Mifflin-St. Jeor equation is:

BMR = (10 x weight in kg) + (6.25 x height in cm) (5 x age in years) 161.

So, for a 25-year-old woman who is 54 and weighs 150 pounds, this would be: BMR= (10 x 68) + (6.25 x 163) (5 x 25) 161 = about 1,413 calories.

The Harris-Benedict equation is also used for estimating your caloric needs, and may even be more accurate than the Mifflin-St. Jeor method.

For women, the Harris-Benedict equation is:

BMR = 655.1 + (9.563 x weight in kg ) + (1.850 x height in cm) (4.676 x age in years).

For the same 150-pound woman, this would be: BMR= 655.1 + (9.563 x 68) + (1.850 x 163) (4.676 x 25) = about 1,490 calories.

With that in mind, just remember that any equation is meant to provide a ~loose~ estimate on your caloric needs and is not a hard-and-fast rule. In fact, your results may be slightly different depending on which formula you use, as seen above.

Your caloric needs may also change from one day to the next based on your activity, stress, and overall health, says Shapira. Listening to your body and adjusting your intake accordingly will help with long-term weight loss and management, she explains.

Once you determine your caloric needs, the following tips can help you craft a healthy, weight loss-friendly meal.

Eating high-protein foods can help support muscle maintenance, enhances satiety, and aids in weight loss, so incorporate lean protein like fish, poultry, beans, legumes, tofu, or soy into every meal, says Dr. Alatassi.

Aim to fill up half your plate with fruits and vegetables, says Larson. They are filling to eat, lower in calories, and high in micronutrients such as vitamins, minerals, and fiber, she explains.

Opt for healthy fats such as olive, grapeseed, avocado, or sunflower oil when cooking, says Larson. Not only can healthy fats lower the risk of developing heart disease, but research out of UCLA Health suggests they can also improve cholesterol levels, control blood sugar, and reduce inflammation.

When choosing carbohydrates, Larson recommends looking for whole-grain complex carbs such as quinoa, brown rice, and whole-grain pasta or breads. Theyre more filling since they take longer to digest, are high in fiber, and less likely to cause spikes in your blood sugar.

Base your meals on whole, minimally processed foods, says Dr. Alatassi. Think: lean protein, fruits, veggies, beans, nuts, and legumes. These foods provide essential nutrients and contribute to a feeling of fullness, ultimately supporting weight loss, she adds.

Its easier said than done, but Dr. Alatassi recommends listening to your body's hunger and fullness cues to avoid overeating and choose nutrient-dense options to maximize essential nutrients without excess calories. Using smaller plates can also help manage portion size, she adds.

Practice mindful eating by savoring flavors and chewing slowly, says Dr. Alatassi. Its also best to avoid distractions during meals, like watching TV or scrolling TikTok, as this enhances awareness of satiety signals and prevents overeating, she explains.

Youve likely heard it before, but its crucial to drink at least eight cups of water every day, says Shapira. We need to hydrate to help our cells detox, and water is the secret sauce, she explains. And no, coffee doesnt count! Whenever possible, choose water as your primary bev.

Weight loss does not need to be rooted in restriction. Eat what you love when you are hungry, says Shapira. This can help move away from the notion that foods are either good or bad and sets you up for a long-term healthy lifestyle, she adds.

Ultimately, the 1,200-calorie diet may not be the most sustainable weight loss approach since 1,200 calories is too few for most people. Enjoying nourishing, well-balanced meals is likely more helpfulbut always consult your healthcare provider or a dietitian to determine what's best for you and your body.

Andi Breitowich is a Chicago-based writer and graduate student at Northwestern Medill. Shes a mass consumer of social media and cares about womens rights, holistic wellness, and non-stigmatizing reproductive care. As a former collegiate pole vaulter, she has a love for all things fitness and is currently obsessed with Peloton Tread workouts and hot yoga.

Diala Alatassi, MD,is a board-certified internal and obesity medicine physician atEndeavor Health Medical Groupwith a specialty in diabetes,cholesterol management,high blood pressure, and obesity medicine.

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The 1200-Calorie Diet Plan: Definition, Safety, Meal Ideas - Women's Health

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A New Era of Weight Loss Medication

The landscape of weight loss treatments has seen remarkable innovations in recent years. New weight loss drugs such as Wegovy, Zepbound, Ozempic, and Mounjaro, which work by mimicking the hormone glucagon-like peptide 1 (GLP-1), have been approved to treat obesity and type 2 diabetes. These drugs are game changers, helping to decrease appetite, slow down the movement of food through the gut, and prompt the body to release more insulin. Notably, these drugs are specifically indicated for people diagnosed with obesity or type 2 diabetes. They have been effective in helping many people lose weight, with an average weight loss close to 15% for semaglutide and up to 21% for tirzepatide. While these drugs have a relatively long track record for safety, they also come with side effects like nausea, constipation, and acid reflux. Thus, their usage must be carefully monitored.

Interestingly, these new weight loss medications have also been found to significantly lower systolic blood pressure in adults with obesity. For instance, the medication tirzepatide, which mimics two metabolic hormones in the body, has shown to regulate blood sugar levels, slow down digestion, and reduce appetite. In the SURMOUNT 1 weight loss study, significant reductions in systolic blood pressure were observed across different participant subgroups. This reduction in blood pressure was found to rival that of many hypertension medications. However, there are limitations to these studies, and further research is needed to determine the long-term impact on cardiovascular events and the effects of discontinuing the medication.

In two other studies, significant reductions in blood pressure were noted in adults who underwent certain weight loss treatments. One study highlighted the effect of weekly injections of the drug tirzepatide, while the other contrasted the outcomes of participants who underwent bariatric surgery with those who only took hypertension medications. Tirzepatide was shown to significantly lower blood pressure in adults with overweight or obesity who took it for nine months. Furthermore, more than 80% of those who had bariatic surgery were able to reduce the number of blood pressure medications they were taking compared to 14% of those who were only on medications, and almost 50% achieved hypertension remission.

Despite the promising results, questions remain about the long-term impact of these GLP-1 drugs on cardiovascular events and whether the improvements in blood pressure will remain if people stop taking the drug. More studies are needed to provide these answers. Additionally, there are concerns about whether these findings will lead to increased insurance coverage for weight loss drugs like Zepbound and Wegovy. Nonetheless, these new drugs have already made a significant impact on the management of obesity and type 2 diabetes, and their potential blood pressure-lowering effects add another arrow to the quiver in the fight against these widespread health issues. However, experts underline that while these drugs can be beneficial, they should not replace a balanced diet and regular exercise in the pursuit of weight loss and improved health.

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Understanding the Role of New Weight Loss Drugs in Managing Obesity and Blood Pressure - Medriva

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Stevia and monk fruit are typically going to be very mild for people and aren't likely to cause GI issues, says Kimball.

However: Certain artificial sweeteners, like sorbitol, maltitol, and lactitolcould be making you bloated, she says.

These chemicals are found in sugar-free snacks, like candies and gums, as well as in many of the dressings, beverages, and condiments. Theyre also hard for your stomach to properly digest, so they create gas and GI problems (like bloating!).

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How To Reduce Bloating: Causes, Treatment, When To See A Doctor - Women's Health

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Republic of Marshall Islands Martinique Mauritania, Islamic Republic of Mauritius Mayotte Micronesia, Federated States of Moldova, Republic of Monaco, Principality of Mongolia, Mongolian People's Republic Montserrat Morocco, Kingdom of Mozambique, People's Republic of Myanmar Namibia Nauru, Republic of Nepal, Kingdom of Netherlands Antilles Netherlands, Kingdom of the New Caledonia New Zealand Nicaragua, Republic of Niger, Republic of the Nigeria, Federal Republic of Niue, Republic of Norfolk Island Northern Mariana Islands Norway, Kingdom of Oman, Sultanate of Pakistan, Islamic Republic of Palau Palestinian Territory, Occupied Panama, Republic of Papua New Guinea Paraguay, Republic of Peru, Republic of Philippines, Republic of the Pitcairn Island Poland, Polish People's Republic Portugal, Portuguese Republic Puerto Rico Qatar, State of Reunion Romania, Socialist Republic of Russian Federation Rwanda, Rwandese Republic Samoa, Independent State of San Marino, Republic of Sao Tome and Principe, Democratic Republic of Saudi Arabia, Kingdom of Senegal, Republic of Serbia and Montenegro Seychelles, Republic of Sierra Leone, Republic of Singapore, Republic of Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia, Somali Republic South Africa, Republic of South Georgia and the South Sandwich Islands Spain, Spanish State Sri Lanka, Democratic Socialist Republic of St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan, Democratic Republic of the Suriname, Republic of Svalbard & Jan Mayen Islands Swaziland, Kingdom of Sweden, Kingdom of Switzerland, Swiss Confederation Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand, Kingdom of Timor-Leste, Democratic Republic of Togo, Togolese Republic Tokelau (Tokelau Islands) Tonga, Kingdom of Trinidad and Tobago, Republic of Tunisia, Republic of Turkey, Republic of Turkmenistan Turks and Caicos Islands Tuvalu Uganda, Republic of Ukraine United Arab Emirates United Kingdom of Great Britain & N. Ireland Uruguay, Eastern Republic of Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam, Socialist Republic of Wallis and Futuna Islands Western Sahara Yemen Zambia, Republic of Zimbabwe

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The Abdulhamid Han Mosque is starting to attract fitness-conscious faithful from other houses of worship - MDJOnline.com

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Vice President Kamala Harris said in a recent interview published this week that as doubts grow over President Joe Bidens ability to continue to serve as commander-in-chief amid questions about his mental fitness, she is ready to step up and be president.

The remarks from Harris come after Special Counsel Robert Hur concluded in his criminal investigation into Bidens handling of classified material that Biden willfully retained and disclosed classified materials, but no criminal charges were warranted, adding that prosecutors also considered that, at trial, Mr. Biden would likely present himself to a juryas a sympathetic, well-meaning, elderly man with a poor memory.

The report said that Biden could not remember basic details about major events in his life, including when he served as vice president in the Obama administration, and he could not remember within several years when his son died, even though he talks about his sons death often.

Biden then held a press conference to demonstrate his mental fitness for office and ended up yelling at reporters and forgetting numerous key details.

The report and the subsequent press conference ignited alarm bells among top Democrats who are privately panicking over Bidens electability, as a recent poll found that 86% of Americans believe he is too old to be president again, and 76% have concerns about his mental fitness.

In an interview with The Wall Street Journal, Harris was asked if voters concerns about Bidens age and mental fitness meant she must convince them that she is ready to take over.

I am ready to serve. Theres no question about that, Harris responded. She claimed that everyone who sees her on the job walks away fully aware of my capacity to lead.

Jennifer Palmieri, who worked in the Obama and Clinton administrations and for Hillary Clintons failed 2016 campaign, told the Journal that Hurs report has really brought Harris ability to serve into the spotlight as she could be needed sooner rather than later.

There was always going to be a lot of scrutiny and pressure on her in the 2024 campaign, and that moments here now, she said. I think that the special counsels report has sort of accelerated that moment.

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A recent Harvard CAPS / Harris poll found that if Biden decided not to run again, Harris would be the top choice among Democrat voters at 15%. After Harris, 8% of voters wanted Hillary Clinton, 7% wanted Sen. Bernie Sanders (I-VT), 7% wanted Sen. Joe Manchin (D-WV), 5% wanted California Governor Gavin Newsom, and the list thins out from there.

An NBC News poll from last year found that Harris was the lowest-rated vice president in the history of the survey, with a -17 rating. Other vice presidents that were rated included Dick Cheney (+23), Al Gore (+15), Biden (+1), and Pence (-4).

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Harris, As Biden Faces Doubts Over Mental Fitness, Says She's 'Ready' To Be President - The Daily Wire

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