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Seafood lovers, beware: A new study suggests that regularly eating certain marine species may increase the risk of exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS), commonly referred to as forever chemicals.

For the study published April 12 in the journal Exposure and Health, researchers examined the seafood consumption habits of more than 1,800 Portsmouth, New Hampshire residents, as well as the PFAS levels in a variety of seafood items found at a market there. They discovered the presence of PFAS in a range of products, with shrimp and lobster having the highest concentrations.

PFAS are manufactured chemicals used in everything from clothing to electrical wiring insulation. They dont fully break down and therefore end up in the air and bodies of water, contaminating our food and beverages. Scientists have linked the chemicals with several human health effects, including growth and development disruptions, liver injury, and an increased risk of certain cancers.

We hope that this brings attention to the fact that seafood consumption could be an important route of PFAS exposure for high seafood consumers, Celia Y. Chen, PhD, study coauthor and research professor in the Department of Biological Sciences at Dartmouth College, told Health. We do hope that this study will spur others to look more closely at this issue in their states and regions.

Previous research has shown dangerous levels of PFAS in freshwater fish, but Megan Romano, PhD, study coauthor and associate professor of epidemiology at Dartmouths Geisel School of Medicine, told Health that her team was surprised to discover that researchers hadnt investigated PFAS in marine seafood as widely.

This struck us as odd because most of the fish and shellfish that people eat tend to come from the sea rather than freshwater, she said. We recognized that in order to understand how much PFAS people may be exposed to when eating marine seafood, we needed to ask three key questions: How much seafood do people eat? What kinds of seafood do people eat? How much PFAS is present in the types of seafood that people eat?

To answer the questions, the team surveyed the seafood consumption habits of 1,829 Portsmouth adults and children aged two to 11. They also measured levels of 26 types of PFAS found in fresh cod, haddock, lobster, salmon, scallops, shrimp, and tuna. The seafood originated in various regions and ended up in a Portsmouth market.

Researchers found that Portsmouth residents tended to be high consumers of seafood. Of the adults surveyed, 95% reported eating seafood within the last year.

Men in the state reported eating a little over an ounce of seafood daily, while women consumed just below an ounce. These amounts are 1.5 times the national average for both men and women, per the National Health and Nutrition Examination Survey. Children consumed around 0.2 ounces, the highest end of the national range.

Shrimp, haddock, salmon, and canned tuna were the most commonly consumed items.

The scientists also discovered that basket shrimp and lobster had the highest average PFAS concentrationsas high as 1.74 and 3.30 nanograms per gram of flesh, respectively. Concentrations in other products analyzed generally measured less than one nanogram per gram.

Our findings suggest that for very frequent seafood consumers, there may be a risk of excessive PFAS exposure from certain seafood items with shrimp and lobster, Romano said. This study suggests that we should be gathering additional data to establish fish consumption advice more broadly.

The research builds on other studies that have found high PFAS levels in certain seafood species, Tracey Woodruff, PhD, MPH, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, told Health. Those studies have examined seafood from coastal waters in the United States, Europe, and elsewhere, according to Romano.

The study authors noted, however, that there is still much to learn about the connection between PFAS and seafood, including the interplay of factors that lead to the accumulation of PFAS in the tissues of aquatic animals. Romano said its currently believed that an animals levels depend on how much PFAS is in the water and sediment where it lives, how it feeds, where it lives in the water column, and whether or not it eats smaller marine life.

Experts stress that you dont have to nix seafood altogether to avoid unsafe PFAS exposure. Instead, simply be mindful when choosing which ones to eat.

Seafood is an excellent source of lean protein and omega fatty acids, but it may also contain PFAS or mercury, so it is important to be a conscientious consumer, Romano said. This is especially important for vulnerable populations, such as pregnant people and young children.

Opt for species that researchers found to contain lower amounts of PFAS, such as tilapia, recommends Woodruff. Smaller fish like tilapia or sardines generally tend to be lower in contaminants. Those can be a win-win for consumers, she said.

Its also important not to rely too heavily on one seafood option, Romano said. The key is really to eat a balanced diet that includes a wide variety of healthy foods and protein sources.

Finally, Chen emphasized the importance of examining your unique eating habits. Then you can investigate how they might contribute to PFAS exposure and make potential changes.

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A High Seafood Diet Might Put You at a Higher Risk of Exposure to 'Forever Chemicals' - Health.com

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The carnivore diet, according to Cleveland Clinic, is as simple as it sounds: You eat meat or animal products for every meal, and mostly avoid every other food group.

Health has reported that the all-meat diet is attractive to those wanting to lose weight. Adherents keep their daily carbohydrate intake to a minimum and eat only small amounts of plant-based foods, such as low-carb vegetables. The bottom line is that people following a carnivore diet focus on getting calories strictly from meat and animal products.

But is the carnivore diet actually healthy? Healthline and other outlets have reported that the diet is too restrictive and not well-balanced, and that its not completely backed up by research.

According to Health, several researchers and health professionals have examined the meat-based diet over hundreds of years.

In 1797, Dr. John Rollo reportedly treated patients with Type 2 diabetes through a meat-and-fat based diet after studying the low-carb diet of indigenous people in St. Lucia. Low-carb diet treatments became widely adopted for managing diabetes until 1921 with the discovery of insulin, Health reported.

The carnivore diet enjoyed a surge in popularity in 2018 with the rise of The Carnivore Diet, a book by Dr. Shawn Baker, who recommended the complete version of the diet after claiming to benefit from it, per Health.

Healthline reported that aspects of a high-protein, low-carb diet may result in select benefits.

Protein can help you feel more full and simultaneously increase your metabolic rate, enabling you to not only reduce your calorie intake, but potentially burn more calories.

These aspects of following the carnivore diet promote weight loss, but they may not last, health experts say.

A 2021 study examining self-reports of the carnivore diet found that participants who followed the diet for nine to 20 months reported improvements in their overall health, physical and mental well-being, and some chronic medical conditions, according to Health.

These findings might have resulted from cutting out foods and drinks associated with poor physical and mental health, so health experts say more research is needed to see how the carnivore diet impacts long-term health.

According to CNBC, people following the carnivore diet do not get enough carotenoids, polyphenols and fiber, which are cancer-preventing substances abundant in fruits and vegetables.

Registered dietitian Kate Patton told Cleveland Clinic that the lack of fiber will cause a lot of constipation, and that the diet, which is potentially high in saturated fats and sodium, could lead to health complications.

Even if you have digestive issues, this diet can make things worse with all that protein and fat, which takes a lot longer to digest, Patton said.

In addition, the diet limits consumption of certain micronutrients and plant compounds. While meat does provide some micronutrients, the carnivore diet may result in the deficiency of some nutrients, and the overconsumption of others.

Diets rich in plant-based foods, unlike the carnivore diet, have been associated with lower risks of long-term conditions, such as heart disease and Alzheimers, per Healthline.

Walter Willett, a professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health, said to CNBC, Its possible that some people who have been eating a lot of refined starch and sugar may get better in the short run. ... But this sounds like a diet that is going to be very unhealthy in the long run.

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Is the carnivore diet healthy? Here's what to know Deseret News - Deseret News

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When will we see through the haze of drugs like Ozempic and Wegovy?

Hopefully soon. These drugs might reach 30 million U.S. users by 2030. Surging, off-label demand has come with unintentional overdoses, rising prices and medication shortages. Further expansion seems likely with the Food and Drug Administrations recent approval of another class of medications to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and either obesity or overweight.

These medications, called GLP-1 receptor agonists or semaglutides, have gotten the attention of the New York City Council. One member has proposed a law requiring the city health department to release information on the consequences of off-label use of these medications for weight loss.

About 20% of patients taking GLP-1s for weight loss experience nausea and vomiting; 30% get diarrhea. Add headaches, swelling of nasal passages, allergic reactions, pancreatitis, and fatigue to the list, along with rare cases of thyroid cancer in laboratory animals.

Admittedly, bariatric surgery, my area of expertise, also poses risks, like any surgical procedure. Still, it remains a safe, long-term option offering better long-term control of weight and glucose levels than medical therapies for patients with Type 2 diabetes. Patients need accurate information about the risks and benefits of all options.

There is no denying: Semaglutides are a powerful class of drugs helping push back on the obesity epidemic. They offer weight loss, reduced appetite, and slower emptying of the stomach that makes patients feel full faster.

Ive also seen at my Great Neck-based practice what can happen when patients stop taking semaglutides. It can trigger weight (re)gain, a greater appetite, a surge of blood sugar, and lean muscle mass loss with body fat percentage gain. There can be withdrawal symptoms.

Data, physician awareness, and patient education can help us assess whats best for each patient, medication or bariatric surgery. The lack of knowledge translates into only about 200,000 patients per year pursuing weight-loss surgery about 1% of those who qualify for it.

Physicians need to share that bariatric surgery remains an effective, long-term tool that has become safer and less invasive. It can be highly effective for weight loss and management of obesity-induced complications, especially when surgeons use minimally invasive procedures. This approach, used in 90% of bariatric surgeries, results in shorter hospital stays, less blood loss during procedures, less postoperative pain, and fewer pulmonary complications and wound infections.

We need to review data comparing outcomes for patients who have undergone gastric bypass, sleeve gastrectomy, and intensive medical therapy alone. Of patients who underwent medical therapy, 12% achieved the desired diabetes targets after a year, but positive effects of metabolic surgery lasted longer and also improved cholesterol and triglyceride levels. Those advantages must be considered against potential post-surgical drawbacks like anemia or gastrointestinal problems.

Its clear semaglutides have tremendous potential, though we dont yet know their full impact. If we can find optimal ways to wean patients off those them, perhaps they might help patients maintain weight loss after bariatric surgery.

Semaglutides also have opened the door to reframing obesity as a medical condition without shame. When we can consider weight-loss options without stigma, patients are better positioned to receive information from their doctors and make decisions. The less starry-eyed we are, the better we can focus on the positive, long-term health outcomes each patient deserves.

THIS GUEST ESSAY reflects the views of Dr. Aurora Pryor, system director for bariatric surgery at Northwell Health and surgeon in chief at Long Island Jewish Medical Center.

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Given their side effects, weight-loss drugs might not be good for all - Newsday

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Its that hold-your-breath moment, often at the start of the day: The numbers on the scale can have so much influence on your sense of self-worth. Each one of us is so much more than the figure that flashes upyet research has shown that consistently weighing yourself is one of the most effective ways to lose weight and subsequently keep it off.

But when can you take a step back from all that vigilance over your food intake, exercise, and weight? A study conducted by researchers from the University of Florida and the University of Virginia set out to determine how often an individual should weigh themselves to effectively keep weight off.

The results and analysis were published in March 2024 in the journal Obesity. Led by scholars of metabolism, cardiovascular health, and psychology, the study followed 74 adults who were overweight or obese with an average age of 50. The study tracked these participants throughout a nine-month maintenance period after completing a three-month-long weight loss plan, asking them to monitor their weight, food intake, and activity and to report on the days they tracked every week.

What Is Your Set Point Weight? Heres How To Gauge ItAnd Why a Doctor Says Youll Want To

The researchers found that weight re-gain correlated with the frequency per week that the participants monitored their weight. Those who continued monitoring their weight, diet, and activity at least three days per week were likelier to have maintained their weight at the end of the nine months. Participants who tracked their values for five days or more each week were more likely to continue losing weight. And interestingly, tracking for one to two days per week was associated with significant weight gain.

The researchers were encouraged by the results because in this study, maintenance was attainable with just three to four days of monitoring per week. These results provide support for using modified schedules of self-monitoring during maintenance, with the potential to lower self-monitoring burden and ultimately improve long-term adherence and weight-loss maintenance, they said.

Additionally, they note that the data support the idea that a slow and steady approach is more effective than bursts of weight monitoring. Also, consistently reporting metrics three to four days per week worked much better than reporting seven days one week and then only one day on another week.

This modified maintenance is encouraging for people who want to be a little more flexible, but still mindful, with their diets after weight loss.

Originally posted here:
The Best Way to Keep Weight Off? Weigh Yourself This Often, Says New Study - The Healthy

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My mother did try to prepare healthy meals for me, and once served me millet, but it looked like birdseed and I refused to eat it.

When he was a teenager, Carroll developed high blood pressure, and although he was prescribed medication, he continued to eat the same way.

By the time he graduated from high school at 18, he weighed 136kg, considered obese for his 1.67-metre (5 foot 5 inch) frame.

In his twenties, a typical lunch for Carroll consisted of half a rotisserie chicken plus side dishes like creamed spinach, cheesy pasta and mashed potatoes with gravy.

Dinner was often one-and-a-half or two whole pizzas, followed by burritos, quesadillas, nachos and dessert from his favourite Mexican fast-food restaurant.

I was on a first-name basis with the staff I never had to place my order because they always knew what I wanted, he says.

The big risks of leaving high blood pressure untreated doctors explain

At the peak of his addiction, Carroll was consuming about 10,000 calories a day and would get cranky if he did not get his fast-food fix.

He often binged in secret, out of shame, and would be consumed with guilt afterwards.

I didnt want people to know how much I was eating. At work, Id eat at my desk behind locked doors so nobody could barge in on me. And if I went out for a meal with others, Id always order a salad because I was too embarrassed to eat anything else.

At the time I was also depressed, but it never once crossed my mind that the food was largely to blame, he adds.

Chest pains were setting in and I knew I wouldnt live to 30 with the way I was going, he says.

Id tried every low-carb and calorie-restrictive diet, but whatever weight I lost on them always came back. I thought, If I get bariatric surgery, I could lose some weight for good and at least make it to my 30th birthday.

The surgery, in 2009, was a success: Carrolls stomach was considerably smaller and, as he was unable to eat much, he lost a substantial amount of weight, dropping to about 70kg. Around this time, he also decided to quit eating fast food completely.

My doctor told me not to have it for three to six months after the surgery, to avoid getting violently ill, Carroll says.

I couldve resumed eating it after this time, in small amounts, because I was told that I could eat small amounts of whatever I wanted, he says. But I was a fast-food addict and I knew I couldnt enjoy it in moderation; I had to stop eating it altogether.

Ultra-processed food: what it is and why its bad for us

Still, that did not mean he ate healthily. He ate processed foods like cheese-and-ham rolls and protein bars. Over the next few years, the weight piled back on and he got up to 81kg.

Around this time, Carroll was approached by the Washington-based, non-profit health organisation Physicians Committee for Responsible Medicine (PCRM) to take part in a healthy eating campaign called Teaming Up for Health.

A couple of years later, when he was 34, Carroll stopped eating all animal products. He had interviewed a former WWE wrestler who had followed a plant-based lifestyle and he suggested that Carroll look into this way of eating.

He and traffic news anchor Julie Wright wed in 2015, and he managed to convince her to switch to a plant-based diet, too. It did not take long for him to lose the extra weight he had gained after his surgery.

10 surprising ways a whole food, plant-based diet will benefit your health

He is no longer ashamed to be seen eating large amounts of food, and will proudly tuck into oversized platters of veggies, beans and grains in front of others.

Today, seven years after adopting a whole-food, plant-based diet, Carroll is a svelte 63kg (140lbs). His blood pressure reading is excellent and he is not on any medication. The back pains are gone, he is not depressed and he has more energy.

I still wake up every morning and think, Its so freeing to not have to worry about my weight any more. Eating this way has changed my life, he adds.

He still craves unhealthy foods from time to time, but he has found a way to deal with this.

Snacking on pineapple chunks or baby carrots with hummus helps, but if the cravings are intense, I dont fight them. Instead, I sit with them, knowing that theyll be gone in 15 minutes, he says.

How to prevent heart disease: health checks, stay active and dont smoke

Carroll was able to combine his media career with his passion for health and nutrition and now hosts a vegan podcast called The Exam Room by the Physicians Committee.

It is a job that allows him to share his knowledge about plant-based eating with others and hopefully make a positive difference in their lives.

Recent guests on his show included Irish plant-based bassist Tanya OCallaghan, who plays with English rock band Whitesnake. The two of them wore a single pair of Carrolls old denim jeans.

He is also more physically active.

Im doing all the things I used to dismiss when I was overweight. The little things that I thought wouldnt make a difference at all actually make all the difference in the world like taking the stairs instead of the elevator, using the restroom on another floor and taking the stairs, parking in a distant spot in parking lots, he says.

I calculated that by parking in the last spot at work I was walking an extra mile per week with zero effort. Over the course of the year, that was close to 50 miles [80km], and that little effort can make a huge difference.

Since losing weight and getting his health under control, Carroll says that his future looks bright.

I am more optimistic and cant wait to see whats ahead. There was a time when I couldnt even see a future for myself, but now I can totally imagine being in my eighties or nineties and relaxing on my porch with my wife, he says.

Making it to old age is no longer a pipe dream. Its within my grasp.

Originally posted here:
To make it to his 30th birthday, 190kg podcaster lost 127kg heres how - South China Morning Post

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Well aware that she's hot in Cleveland, L.A. or wherever else she happens to be, the actress gave her refreshing take on body image with a February Instagram post.

"This is a 150lb body on a 5'4 frame," the Food Network host wrote, sharing a 2014 bikini photo. "I don't weigh myself anymore because this is considered overweight by who's [sic] standards, I don't know. It's stupid and I believed them for far too long."

Fully removed from the pressures of dieting, "I now, finally, know that I am a kind, considerate, funny, thoughtful woman," she continued. "So please remember, who you are and what your character is, should never be overshadowed by what size you are or how much you weigh. You are enough. Just the way you are."

As for anyone that might not agree, she summed up, "F--k em."

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Victoria Mont Reveals Her Weight Gain Is Due to PCOS in Candid Post - E! NEWS

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Key Takeaways

Shares of Eli Lilly (LLY) gained in intraday trading Wednesday after the pharmaceutical firm said a late-stage study found its weight-loss drug, Zepbound, was effective in treating those who are overweight and suffer from obstructive sleep apnea (OSA).

The company said that in a Phase 3 trial, on average, Zepbound reduced by up to 63% the apnea-hypopnea index (AHI) in the test group, achieving all primary and key secondary endpoints. AHI records the number of times a person's breathing shows a restricted or complete block of airflow per hour of sleep, and is used to measure the severity of OSA. Lilly pointed out that at the top end of the findings, use of Zepbound cut the number of events by 30 an hour.

Dr. Jeff Emmick, senior vice president of development at Lilly, explained that OSA affects 80 million adults in the U.S., with more than 20 million having moderate or severe cases. He added that while other drugs for excessive sleeplessness associated with OSA now exist, Zepbound has the potential to be the first pharmaceutical treatment for the underlying disease.

Lilly noted that based on these results, it plans to submit authorization requests for expanded use of Zepbound for OSA to the Food and Drug Administration (FDA) and other global regulatory bodies beginning in the middle of the year.

Zepbound is sold as Mounjaroin some global markets outside theU.S.

Eli Lilly shares rose 0.5% to $750.30 each as of noon ET Wednesday and have added almost 27% so far this year. The news sent shares of ResMed (RMD), which makes devices to treat sleep apnea, down 6% to $173.39.

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Eli Lilly's Weight-Loss Treatment Found To Help Those With Sleep Apnea - Investopedia

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Carnie Wilson is getting candid about her recent weight loss journey. The Wilson Phillips singer revealed on Instagram that she dropped 40 pounds by avoiding certain foods.

Another before and during ... my health journey! she wrote in the caption of side-by-side photos of herself. This is 40 pounds down.

The 55-year-old said that she feels really different right now. I need to start exercising more to make the scale start to move again, but Im so proud and pumped, she said. Wilson also noted that she lost the weight purely through diet, avoiding gluten, sugar, butter, and keeping fats down, too.

Wilson told

Lately I have indulged in cheese and nuts which have more fat, Wilson continued in her Instagram post. If I chose not to eat corn tortillas, nuts, and cheese, theres no way I could keep this up.

Wilson also shared that shes totally adjusted my eating habits to satisfy my cravings, but in a realistic way. And its a miracle.

Wilson has been open in the past about her weight loss journey, publicly revealing that she underwent gastric bypass surgery in 1999, as well as a Lap-Band procedure in 2012.

But while Wilsons eating plan works for her, nutritionists say its not for everyone.

Wilsons diet is very individualized to her, says Jessica Cording, M.S., R.D., author of The Little Book of Game-Changers: 50 Healthy Habits For Managing Stress & Anxiety. Meaning, this isnt something that everyone should try.

But Cording also says that elimination diets can be tricky, especially if youre not doing them under the guidance of a professional. Sometimes people eliminate foods and they start to feel better, but if they eliminated a lot of foods at once, they might not necessarily know what was causing the symptoms, Cording says. As a result, people may end up limiting more foods than necessary, making it difficult to stick with the eating plan they set up for themselves.

Scott Keatley, R.D., co-owner of Keatley Medical Nutrition Therapy, agrees. Swearing off things like gluten, sugar, and butter without cause is not very sustainable, he says.

While avoiding gluten may be trendy, Keri Gans, R.D., author of The Small Change Diet, says theres no reason to stop consuming foods with these things unless you have an actual gluten intolerance or have Celiac disease. There is also a big difference between added sugar and naturally occurring sugar, she says.

Limiting added sugar, which may cause inflammation in the body, can be smart, Gans says. But swearing off naturally occurring sugar found in fruit would be a health mistake, she says. While butter has a lot of saturated fat, small amounts can fit into a healthy diet, Gans says.

Cording says its important to be mindful about limiting fat, too. Fat can be helpful with feeling satisfied and full after eating, she points out, but focusing on healthy fats and portion sizes matters. Cording lists olives, olive oil, avocado, nuts, and seeds as good healthy fats to consider.

On the mental health side, Cording points out that restricting foods can be a slippery slope with disordered eating. Every person is different in terms of how placing limits around food affects them mentally, she says. Unless someone has a life-threatening allergy, I tend to be cautious around encouraging people to say, I will never eat that, ever or Im not allowed to eat that. When someone is rigid about their food intake, it can create some food anxiety and stress around food, Cording says.

Overall, Keatley says that Wilsons diet isnt unsafe for most peopleits just not for everyone. Realistically, there is no reason to avoid these ingredients unless you have a known intolerance, he says.

Food sensitivities can be tough to figure out, but theyll generally lead to symptoms like gastrointestinal issues, skin problems, or even brain fog, Cording says.

Nutritionists say there are a few reasons why someone might lose weight when theyre managing food sensitivities. Many times, when a person removes foods they are sensitive to, they either dont replace the calories or replace the food with calories that are less, Gans says. Some foods may also cause bloating, which mimics weight gainand once the bloating is gone, several pounds can follow, she says.

The foods youre sensitive to matter as well, Cording says. Cutting out foods that are very calorie-dense and highly processed, and replacing those with more nutrient-dense foods that are less processed can support healthy weight-loss goals, she says. Food sensitivities can also cause bodily inflammation, which can impact metabolism, Cording says.

But eliminating food sensitivities isnt necessarily a slam dunk for weight loss, Keatley says. Food sensitivities would generally not cause weight gain, he says. In fact, they may cause weight loss since people with them tend not to eat as much for fear of having a bad reaction.

If youre interested in losing weight and you suspect that you have food sensitivities, speak with your healthcare provider and connect with a nutritionist. Cording recommends keeping a journal and writing down any symptoms you experience around food. Write down what you ate, what you drank, and any supplements you took, she says. Keeping a journal can help you to notice patterns.

But if weight loss is your goal and you dont have any food sensitivities, Gans doesnt recommend going the restrictive diet route. Focus more on what you should be adding to your diet versus removing, she says. A healthy diet isnt about restriction, but rather addition. She suggests adding more plant-based foods, like fruits, vegetables, 100% whole grains, nuts, and seeds, leaving less room in your diet for foods that are lacking in health benefits.

Keatey also recommends against totally removing foods from your diet, unless you have an actual allergy or intolerance. Its all about moderation.

If you believe you are struggling with an eating disorder and need support, call the National Eating Disorders Association helpline at (800) 931-2237. You can text HOME to 741741 to message a trained crisis counselor from the Crisis Text Line for free.

Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Mens Health, Womens Health, Self, Glamour, and more. She has a masters degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.

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Carnie Wilson Details Changes That Led to 40-Pound Weight Loss - Prevention Magazine

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These bills stem from a national campaign led by STRIPED, The Strategic Training Initiative for the Prevention of Eating Disorders, based at the Harvard T.H. Chan School of Public Health and Boston Childrens Hospital. The initiative reflects serious concerns among public health experts about the safety and efficacy of dietary supplements, which can include everything from multivitamins to supposed sexual enhancement elixirs.

Dr. Greg Hagan, past president of the Massachusetts chapter of the American Academy of Pediatrics, called the industry an utterly unregulated Wild West market of products that range from useless to harmful.

However, well-intentioned state bans on the sale of weight loss and muscle building supplements to minors are being stymied by litigation from the dietary supplement industry and the lack of a clear consensus about what products should be age restricted. A better solution would be for Congress to reform the outdated regulations governing all dietary supplements so the Food and Drug Administration can do a better job ensuring supplements are safe for all consumers, whether they are children or adults, and removing products from the market when problems arise.

How did we get here? In 1994, Congress passed a law governing supplements differently from food or medicine. The FDA does not approve supplements before they are sold unless they contain an ingredient not already in food and does not evaluate their efficacy. The agency can ensure that labeling is truthful and products are not adulterated and can investigate reports of serious side effects.

Some supplements are valuable health aids, like iron pills for someone with anemia. But supplements are not harmless. An estimated 23,000 Americans visit emergency departments annually due to adverse effects from dietary supplements, according to a 2015 New England Journal of Medicine report. There is evidence that young women who use diet pills are more likely to be diagnosed with an eating disorder, although it is not clear if supplement use causes or is a symptom of eating disorders.

The efficacy of supplements that make generalized health-related claims is questionable. The American Academy of Pediatrics cautions young athletes against using weight gain or protein supplements, citing the potential for problems with safety, contamination, and quality, while a commentary in the AMA Journal of Ethics says doctors cannot ethically recommend weight loss supplements because these products safety and efficacy are unknown, ingredient lists might not be complete, and advertising could be misleading.

The biggest safety problem is that supplements are frequently adulterated. They might include prescription medication, unapproved drugs, or drugs that were withdrawn from the market.

Between 2007 and 2016, the FDA identified 776 adulterated dietary supplements, mostly intended for sexual performance, weight loss, or muscle building. The FDA in 2021 published a list of 72 weight loss supplements tainted with prescription drugs and chemicals. Several contained sibutramine, a drug withdrawn from the US market because it increased risks of heart attack and stroke. In November 2023, the FDA warned consumers against using products with the unapproved drug tianeptine, also known as gas station heroin, which was being marketed as a mood-enhancement supplement but caused seizures and loss of consciousness.

When the FDA identifies tainted products, it usually relies on companies to voluntarily recall them. A 2018 report by Dr. Pieter Cohen, a Cambridge Health Alliance internist, found that about half the supplements the FDA considered tainted remained on the market, and the FDA almost never used mandatory product recalls. A paper Cohen published in 2021 found that after the FDA warned dietary supplement companies against using phenibut a drug approved in Russia but not the United States due to risks of coma and death three of the four supplement products that advertised as including the drug had increased drug quantity.

Labels can also be inaccurate. Cohen tested generic drugs and dietary supplements containing the active ingredient galantamine, used in drugs to treat dementia and marketed in supplements to improve memory. All the drugs contained an amount of galantamine within 5 percent of the amount listed on the label. The supplements contained between 2 percent and 110 percent of the labeled quantity.

Supplement company representatives say these problems primarily reflect bad actors who sell unreliable products online. Some manufacturers have products certified by third-party verifiers to ensure manufacturing processes and labeling adhere to professional standards.

The best way to eliminate bad actors and ensure all companies offer safe products is by strengthening federal law. Senators Dick Durbin and Mike Braun introduced a bill in 2022, a version of which is expected to be reintroduced this year, that would require supplement producers to list their products in a new public FDA database with an ingredient list, copy of the label, and any health claims. This bill, supported by industry trade group the Council for Responsible Nutrition and the American Medical Association, is a good start.

It should be paired with additional steps to give the FDA greater oversight authority. This probably means expanding the FDAs oversight budget and clarifying its authority to impose mandatory recalls and fines when a supplement contains an unauthorized ingredient or is inaccurately labeled. (Today, the agencys authority is unclear when a supplement is tainted with a prescription drug.) It means giving the FDA authority to review and act on information submitted to the database for example, to forbid the sale of a product containing a dangerous ingredient like phenibut or tianeptine before sales begin. Congress could also consider requiring supplement companies to use a third-party verifier or tightening standards around when an ingredient counts as a new dietary ingredient that requires FDA approval.

A Massachusetts law requiring adult involvement before a teen buys a weight loss or muscle building supplement would be a reasonable policy. But to truly protect public safety, the federal government must close any loopholes that have allowed dangerous products to reach and remain on the market.

Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.

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FDA needs more oversight of diet pills, other dietary supplements - The Boston Globe

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Everybody was happy except my GI tract

Vicki Webb Pouncey, a 58-year-old breast cancer patient from Melbourne, Florida, tried three of the drugs over the last few years, under the supervision of both her nurse practitioner (who discovered Pouncey was insulin resistant) and her oncologist, who worried her extra weight might drive a recurrence.

She first tried the low-dose pill Rybelsis, but after several weeks had zero results. So she tried Wegovy using a discount coupon for a six-month supply.

On the Wegovy, I lost 40 pounds right away and my numbers all started to improve, she said. Cholesterol, blood sugar, insulin resistance that all looked better. But then the coupon ran out and I couldnt get any more so I went back on the Rybelsis.

Again, her weight loss stalled. So her providers suggested she try Ozempic. Immediately, pounds started to come off again.

I lost weight and my labs looked great, she said. Everybody was happy except my GI tract.

The drugs can have considerable side effects. Ozempic lists the most common as nausea, diarrhea, abdominal pain, vomiting and constipation. Zepbound lists the same plusindigestion, injection site reactions, fatigue, allergic reactions, belching, hair loss and heartburn. It also mentions the potential for kidney failure; gallbladder problems; pancreatitis; low blood sugar; changes in vision and depression.

At first, Pouncey only had nausea and diarrhea a few days after her weekly shot; then it started happening more often.

The drug absolutely diminished her food cravings and her sweet tooth, she said, and she felt healthier, at least for a while. But Ozempic may have been too effective.

There were days when I had to make myself eat, she said. At one point, I think I became malnourished because of all the nausea and diarrhea. But my lab numbers were beautiful so I stayed on it.

After several months, though, the GI issues became a daily ordeal and she started to have pain on her right side. Now, there were only good hours, not good days, she said.

She stopped the Ozempic and went to her doctor about the pain. He ordered a CT scan, thinking shed developed pancreatitis, one of the noted side effects. Instead, the CT scan found metastatic breast cancer in her liver, which led to more scans and more tumors.

The scans also detected nodules on her thyroid, which have yet to be biopsied. The metastatic breast cancer treatment is her primary concern, she said.

She absolutely does not attribute her metastatic recurrence to the weight-loss drugs.

I understand the difference between correlation and causation, she said. The thyroid nodules are the only thing I would associate with it. And it lists that in the risk factors on the label.

Even with the all the suffering, Pouncey said the drugs were beneficial. All told, she lost 80 pounds; her cholesterol, insulin resistance and blood sugar improved dramatically and she was even free of the joint pain caused by her anti-hormone drugs.

Once I got rid of processed sugar and carbs, my joint pain almost resolved itself, she said. And losing the weight took the pressure off my knees.

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The new weight-loss drugs and cancer - Fred Hutchinson Cancer Center

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