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Obesity is defined as a BMI greater than or equal to 30 by the CDC and is currently among the most prevalent diseases in the world, in addition to being an important risk factor for many other diseases. It has high rates of morbidity and mortality21,22 and, in this context, weight loss can bring countless positive impacts to the individual. Currently, there are several treatments for obesity, and we can divide them into non-surgical or surgical.

Non-surgical treatments include non-drug and drug treatments. Among the non-medicated, we can highlight the change in eating habits, regular physical exercise, and cognitive behavioral therapy8. Ideally, these measures should be implemented for all patients living with obesity, even for those who will undergo drug or surgical treatment. Recently, in addition to lifestyle change, neuromodulation with deep transcranial stimulation has also been studied and has shown effectiveness in weight loss reduction23.

A systematic review carried out in 2021, which analyzed 64 articles concluded that among the most effective non-surgical interventions are low-carbohydrate or low-fat diets and combined therapies. This study also showed that non-drug interventions, such as physical exercise, when used alone, are not very effective in reducing the weight of these patients Therefore, a combination of two or more therapies should be chosen24.

Pharmacological treatment must be chosen together with the patient. One or more drugs can be used, the main ones used being: Liraglutide, Semaglutide, Tirzepatide, Orlistat, Phentermine and Sibutramine25.

Liraglutide was recently approved for the treatment of obesity and is now one of the most widely used drugs. It acts as a GLP-1 receptor agonist26,27,28, enhancing its effects. This group of drugs is already known in the treatment of Type 2 Diabetes Mellitus, a condition that can often be associated with obesity29,30, since its pathophysiology involves increased insulin resistance. The main actions of this drug are: increased satiety due to a reduction in the speed of gastric emptying, increased insulin release and decreased glucagon release. Semaglutide is a drug with a similar mechanism of action who demonstrated not only a substantial weight loss31, but was also associated with a lower 10-year T2D risk in people with overweight or obesity after 2years of follow up32. More recently, a new drug that combines GLP-1 and GIP receptor agonist, Tirzepatide, has shown even better results in the short term33.

Orlistat, in turn, reversibly inhibits the lipase enzyme34, which has the function of breaking down fat from food for its absorption, as well as inhibiting the absorption of ingested triglycerides. Thus, there is elimination of fat in the feces35. The main adverse effects are gastrointestinal symptoms, however this can be beneficial as it leads to a change in behavior, for example causing a lower consumption of foods rich in fat36.

Phentermine, an amphetamine analogue, can be used in conjunction with topiramate for the treatment of obesity. The mechanism of action of the drugs is not yet known, however, significant weight loss has already been observed, in addition to a reduction in the consumption of hypercaloric foods and a decrease in the speed of gastric emptying with the use of this combination of drugs37,38.

Sibutramine, widely used in the 1990s, acts to inhibit the reuptake of serotonin, norepinephrine, and dopamine34. Serotonin, in turn, activates POMC system neurons and inhibits NPY neurons, thereby promoting reduced appetite and increased satiety. Despite generating weight reduction39, some data show increased cardiovascular risk40, and therefore, it is no longer used as a first-line drug.

Among the possible surgeries, the most performed today are: Roux-en-Y Gastric Bypass (RYGB), Biliopancreatic diversion (BPD), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Adjustable Gastric Band (LAGB). According to the NIH and the American Bariatric Society41,42, some indications for performing bariatric surgery are adults with BMI greater than or equal to 40 and adults with BMI greater than 35 accompanied by some comorbidity such as type 2 diabetes mellitus, obstructive sleep apnea or hypertension.

RYGB is one of the best-known procedures and its complications vary according to the surgical technique used. Some complications include gastric distention, ulcers, cholelithiasis, hernias, dumping syndrome, and hyperammonaemia encephalopathy.

BPD presents long-term nutritional complications, such as anemia, bone diseases and fat-soluble vitamin deficiency. This technique has high mortality rates, mainly due to the complexity of the technique.

Among the procedures described, LSG is the one with the fewest complications, being described in the literature bleeding or stenosis of the stoma. An alternative technique using endoscopy for sleeve gastroplasty has shown to be safe and efficient for weight loss after 104weeks, with important improvements in metabolic comorbidities43.

The procedure with the lowest mortality rate is the LAGB44. Despite this, it can present complications such as obstruction, band erosion, band slippage and gastric prolapse, esophagitis, hernia, in addition to having a high rate of reoperation, reaching 50% of patients who underwent this surgery45.

In this article, we compare data on weight loss through intensive drug treatment, which includes changes in eating habits, physical exercise, and medications, and through surgical treatment. Both treatments showed that weight loss caused an improvement in the lipid panel, with a reduction in total cholesterol, triglycerides and LDL, an increase in HDL, improvement in systolic and diastolic blood pressure, decrease in glycated hemoglobin and insulin resistance (accessed through HOMA), in addition to reducing the risk for cardiovascular diseases.

Our systematic review confirmed the findings of individual studies that bariatric surgery has a greater potential for weight reduction, BMI and waist circumference, as already described in individual articles and widely in the literature. It should be noted that even in the long term, this difference remained. Similarly, a 2014 Cochrane systematic review46 comparing RCT with more than 1year of follow-up showed that all 7 articles included demonstrated an advantage of the surgical group. An article47 on the use of pharmacological treatment for obesity showed that even recent drugs approved, including GLP 1 agonists, are not able to reduce weight to levels similar to those of bariatric surgery to date, despite the emergence of new drugs still in initial phase48. It is worth mentioning that in these studies the comparison time is relatively short (12months) and that we do not have data on the long-term impact. Thus, in relation to long term weight loss, bariatric surgery is still the best option.

Most articles were not able to individually demonstrate that surgical treatment is superior to non-surgical in terms of pressure reduction. However, the result of the meta-analysis showed a superiority of the surgical group in relation to both systolic and diastolic pressure, more pronounced in the BPD group. Wang49 performed a systematic review focused on the impact on pressure and demonstrated that there was a reduction in systolic and diastolic values, but the subgroup analysis showed that this occurs only in the RYGB groups for systolic pressure. Similarly, Schiavon also demonstrated a significant reduction in the need of blood pressure medication after 3years in the RYGB group when compared intensive medical treatment for obesity50. This difference found in only one subtype of surgery seems to be just a reflection of the sample size, which can be interpreted that surgical treatment in general tends to reduce pressure to a greater extent than non-surgical treatment. The fact that different types of surgery are significant may reflect the studies selected in our meta-analysis, which have longer follow-ups.

In relation to both HOMA-IR and glycated Hb, there was a more significant improvement in the group that underwent surgery. The way in which the data on diabetes remission was reported in the articles did not allow a meta-analysis to be carried out with these data and, therefore, it was not included. However, individual data from the Mingrone 2015, Mingrone 2021 and Schauer articles showed that the surgery group had better results. A network meta-analysis from 202151 comparing the different types of metabolic surgery for the treatment of obesity and diabetes showed that RYGB was 20% more likely to result in remission of type 2 diabetes compared to SG. There was no significant difference between the other groups. Moreover, the effects of bariatric surgery on diabetes is not exclusive for patients with obesity, as shown by a study with patients with a BMI of 2732kg/m2 that had a better glycemic control when treated with RYGB20. Regarding the lipid profile, Schauer's study was not able to demonstrate superiority in relation to LDL and HDL parameters. However, by combining the data from Mingrone's articles, it is possible to demonstrate that surgical treatment is superior. Regarding cholesterol reduction, Mingrone's studies showed that although RYGB and BDP were better in relation to non-surgical treatment, the BDP technique had a statistically greater reduction in relation to RYGB. This can be explained by the greater intestinal exclusion in BDP and, therefore, having a greater impact on lipid absorption. Despite Sayeed's study52 et al. was not included in this meta-analysis due to the inadequate way of separating the groups for analysis, the results regarding the lipid profile showed that the group that received both interventions was superior to the exclusive non-surgical treatment. It is important to point out that despite a statistically significant difference between the groups, the effect size of this difference is probably not clinically significant.

The choice of treatment for obesity can also have an impact on several other patient comorbidities. Hossain et al.53 performed a systematic review with 26 studies that showed that bariatric surgery appears to be more effective in the treatment of asthma. Similarly, a study by Crawford et al.15 showed that there is a greater increase in bone turnover in groups undergoing bariatric surgery in relation to pharmacological treatment. Other than that, bariatric surgery is also demonstrated to be superior in the treatment of other obesity related pathologies, such as Non-Alcoholic Steatohepatitis (NASH), and in the treatment of obesity in adolescents54,55.

The effect of major cardiovascular adverse events (MACE) and mortality56 have also been promising for bariatric surgery. A recent cohort comparing bariatric surgery in patients with obesity and use of GLP1-agonists inpatients with diabetes showed a lower risk of MACE in the surgical group57. The surgical treatment has also shown superiority when compared to medical treatment regarding the prevention of diabetic kidney disease in 5years for patients with diabetes and obesity58. Boyers et al. evaluated the cost-effectiveness of surgical and pharmacological treatment in the treatment of obesity and found that RYGB should be the treatment of choice only if the optimization of health system costs is considered59.

Another important consideration is the fact that pharmacological and surgical treatment for obesity are not mutually exclusive. Most clinicians choose to combine both treatment modalities in practice to improve results. Weight gain after bariatric surgery is a known possibility, and for those patients, two-thirds of the weight regain can be safely lost with GLP1 agonist, providing clinicians with a therapeutic option for this clinical challenge.

Despite the large number of articles in the literature on the treatment of obesity, there are few RCTs comparing non-surgical and surgical treatment, and most of them only follow up in the short term. In addition, many articles do not adequately describe the strategy used in non-surgical treatment. This lack of data and standardization in this type of treatment can lead to bias and possibly the formation of extremely heterogeneous groups for analysis.

Most of the studies included in our systematic review have diabetes as an inclusion criteria. In this circumstance, our findings may not be generalized to patients with obesity without diabetes.

Another important limitation of our systematic review refers to pharmacological treatment in the non-surgical group. The use of GLP 1 agonists has great potential in the treatment of obesity, but they have only started to be used recently. As the purpose of our article is to assess the long-term impact, there are still few articles available that used this drug. The use of the most recent medications, such as Tirzepatide, could not be evaluated in our study, once there are no RCTs in the literature presenting its long-term effects. Those drugs proved to be very efficient and might have similar effect in the long term. Future systematic reviews may reveal a different results when including the new generation of weight loss medication.

Finally, choosing the most appropriate treatment often involves individual characteristics of each patient, and the impact on quality of life can be extremely subjective and difficult to assess.

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Surgery is associated with better long-term outcomes than pharmacological treatment for obesity: a systematic review ... - Nature.com

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When the financial analyst Emily Field was commissioned by Barclays to predict the likely economic implications of the new generation of weight-loss drugs, she came back with a startling answer: this will be comparable to the invention of the smartphone. For 40 years, people have been gaining weight, with a trebling in global obesity rates since 1975 but that trend now looks likely to be slammed into reverse. These new drugs, working in a very different way to previous weight-loss drugs, cause remarkable levels of physical shrinking: for Ozempic and Wegovy, people lose on average 15 per cent of their body weight in a year, while for the newer drugs coming down the line, its a staggering 24 per cent. As these drugs become

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I've lost three stone taking Ozempic. But am I at risk? - The Times

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If you put a lab mouse on a diet, cutting the animals caloric intake by 30 to 40 percent, it will live, on average, about 30 percent longer. The calorie restriction, as the intervention is technically called, cant be so extreme that the animal is malnourished, but it should be aggressive enough to trigger some key biological changes.

Scientists first discovered this phenomenon in the 1930s, and over the past 90 years it has been replicated in species ranging from worms to monkeys. The subsequent studies also found that many of the calorie-restricted animals were less likely to develop cancer and other chronic diseases related to aging.

But despite all the research on animals, there remain a lot of unknowns. Experts are still debating how it works, and whether its the number of calories consumed or the window of time in which they are eaten (also known as intermittent fasting) that matters more.

And its still frustratingly uncertain whether eating less can help people live longer, as well. Aging experts are notorious for experimenting on themselves with different diet regimens, but actual longevity studies are scant and difficult to pull off because they take, well, a long time.

Heres a look at what scientists have learned so far, mostly through seminal animal studies, and what they think it might mean for humans.

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Could a Calorie-Restricted Diet or Fasting Help You Live Longer? - The New York Times

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Billie Jean King is opening up about using weight loss injections to help "quiet the noise" of her eating disorder.

The tennis legend, 80, appeared on the April 24 episode of Julia Louis-Dreyfus podcast Wiser Than Me, where she discussed her decision to try the popular weight loss aid.

I'm a binge eater. Every morning I wake up, I tell myself I have an eating disorder. I still go to therapy. I still think about it, she said on the show. It's interesting with the new injections, you know, with the Ozempics of the world. It's very interesting because my doctor wants me to try it.

Ozempic is an FDA-approved prescription medication for people with type 2 diabetes. It's one of the brand names for semaglutide also known as Wegovy (FDA-approved for chronic obesity) which works in the brain to impact satiety. Ozempic and Wegovys competitors are Mounjaro and Zepbound brand names for tirzepatide, which works by reducing appetite and improving how the body breaks down sugar and fat.

The four medications taken by injection in the thigh, stomach or arm have been trending in Hollywood due to celebrities using it for weight loss when not medically necessary.

King, a longtime advocate for womens and LGBTQ+ rights, revealed that she's actually taken a few injections now. However, she said she doesnt want to lose weight fast because she thinks its unhealthy.

My therapist asked me, Has it quieted your mind? With an eating disorder, I have two voices in my head sometimes that argue, she explained. Let's say I want a quart of ice cream. One side will say, Yeah, baby, I'm going to have that ice cream no matter what. And the other side says, No, don't do that. It's not healthy. You don't need it. So I have this discussion that goes on in my head and sometimes it's very elevated.

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It was such a great question because if [weight loss medication] does quiet the voices if that's a part of it now Im [interested in] it because that would be really great, she added. Because that gets exhausting and tiring. And I don't wanna fight over these things.

In addition to going to therapy and trying the weight loss injections, King said on the podcast that in the past, she went to The Renfrew Center, an inpatient eating disorder clinic, for help.

When I was around 50 and I was going through all my sexuality, oh my God, it was a mess. And that I think caused a lot of my eating disorder as well, she said. I went to Renfrew in Philadelphia back in 95-ish. I went to therapy and I lived there for six weeks. I would go to therapy three times a week.

Although she still deals with a few health struggles, King said getting older has allowed her to be happier than ever.

[Aging] is tough physically, there's no question, and also for your mind. I don't want to get dementia, for instance. I'm scared of that because my parents had it, she said. But I'll tell you, whats really been fantastic, and that is that, emotionally, I am so happy compared to my young days. I've worked at it through therapy, through thinking, through just going through tough times. But I just emotionally am in such a great place now.

If you or someone you know is struggling with an eating disorder, please go to NationalEatingDisorders.org.

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Billie Jean King Says She Has 'Taken a Few Injections' to Quiet the Noise of Her Binge Eating Disorder - PEOPLE

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Billie Jean King is trying weight loss medication to address her binge eating disorder (BED), revealing on the April 24 episode of actress Julia Louis-Dreyfuss Wiser Than Me podcast that it was recently recommended by her doctor. The 80-year-old tennis icon told Louis-Dreyfus shes had a few injections to start and is waiting to see how it affects her thoughts about food. (While King referred to Ozempic as a catch-all term for weight loss drugs, she didnt specify which medication she is taking.)

What has King said about her struggle with binge eating, and how might weight loss drugs have an impact? Heres what to know.

King wrote about her experience with eating disorders in her 2021 memoir, All In, saying that she was formally diagnosed with BED which involves a loss of control over eating behavior, eating large amounts of food in a specific period of time and then feeling depressed, disgusted, ashamed, guilty or upset at age 51. Speaking to Louis-Dreyfus, King provided more details about what she was going through at the time, including coming to terms with her sexuality after being publicly outed in 1981. I think that caused a lot of my eating disorder, she said, along with the attention paid to her diet as an elite athlete. Around 1995, King sought out inpatient treatment at The Renfrew Center in Philadelphia.

I went to therapy and I lived there for six weeks, she told Louis-Dreyfus. It led her into recovery at the time, although she continues to deal with her eating disorder to this day. I still go to therapy, I still think about it.

And she still often struggles with obsessive thoughts about food. I have, like, two voices in my head, sometimes that argue, said King. Lets say I want a quart of ice cream one side will say, Yeah, baby, Im gonna have that ice cream no matter what! And the other side says, No, dont do that, its not healthy. You dont need it, youre not gonna miss it. The other side says, Screw you! Im having this ice cream. So I have this discussion that goes on in my head and sometimes its very elevated. [It] gets exhausting and tiring and I dont want to fight over these things.

Although King didnt use the term herself, the thoughts she describes having are commonly referred to as food noise something weight loss medications may be able to suppress.

I dont want to lose weight fast because I think it looks horrible. I dont think its healthy, she said of starting her drug regimen. I would like to lose slowly. But the important thing my therapist asked me, which I hadnt thought about, is that she said, Has it quieted your mind? Because that would be really great.

How might that work? Heres what experts say about food noise and what experts say about using weight loss drugs to address it.

Its the experience of having frequent thoughts about food that a person finds to be intrusive, according to Dr. Melanie Jay, director of NYU Langone's Comprehensive Program on Obesity. People describe it as always thinking about the next thing they will eat, spending a lot of time trying to decide whether to eat something they are craving, thinking about lunch while they are eating breakfast, she tells Yahoo Life.

A 2023 review of the term by nutritional scientists determined that theres little research available on food noise. Psychologist Samantha DeCaro, director of clinical outreach and education at The Renfrew Center, where King previously received treatment in the '90s, tells Yahoo Life that food noise isnt an official medical or clinical term with a clear definition.

The experience of food noise is a subjective experience that likely varies significantly between people. These thoughts can be cognitive symptoms of a clinical eating disorder, but they can also be the brains attempt to fight against a chronic state of dieting, excessive exercise, malnourishment or food insecurity, she says. Its not uncommon for people to experience frequent thoughts about food when they restrict their intake, eat irregularly, struggle to access adequate amounts of food or consistently deny themselves the foods they enjoy. In certain cases, this can simply be a survival strategy or a helpful signal from our brains that we need more food or more variety.

Food noise has also been associated with the "destructive thoughts about food" Jay and other experts have seen among those with binge eating disorder.

The term food noise may be an attempt to describe the distressing experience of having obsessive, intrusive or simply unwelcome thoughts about food. For people with eating disorders, these obsessive and intrusive thoughts are frequently part of the clinical picture and fuel disordered cycles and symptoms such as restricting, bingeing and purging, says DeCaro. Irregular eating patterns can certainly contribute to an experience of food noise and can contribute to a binge eating episode.

But experts also note that BED is a mental health diagnosis that requires intervention of symptoms and behaviors far beyond food noise.

Dr. Jennifer Kraker, a psychiatrist with expertise in metabolic health and eating disorders, tells Yahoo Life that shes found weight loss medications very effective for treating BED patients.As the New York Times has reported, many people who take Ozempic have credited it with helping to silence food noise.

Beyond the component of food noise, however, Kraker says that dopamine dysregulation and satiety signaling are underlying components of binge eating disorder. Liraglutide and semaglutide (the active ingredients in medications like Victoza and Wegovy) have been shown to reduce the effect of dopamine released while eating, allowing for better control around food. The medications appetite-suppressing effects also contribute.

The studies illustrating these effects are limited but promising, with one study suggesting that semaglutide may be more effective at treating BED than lisdexamfetamine (Vyvanse), which is FDA-approved for the eating disorder.

A growing number of physicians, including Kraker, are also reporting positive changes with patients. Dr. Michael Lutter, a psychiatrist focused on depression, anxiety and eating disorders, told the Wall Street Journal that hes been prescribing weight loss medications to BED patients since 2019 and has found that they respond amazingly well. He said that their bingeing is brought under control when using the drugs in conjunction with treatment by therapists and dietitians.

Weight loss, however, does occur, which is cause for concern among experts like Jay, who says, More studies are needed to make sure that it doesnt worsen eating disorders.

DeCaro is also wary, and says that eating disorders are more complex and require more comprehensive treatment than weight loss medications alone would provide.

Eating disorders are complex psychiatric disorders; they arent just about food or weight. Weight loss medications will never address the underlying emotional and psychosocial factors that contribute to the development of eating disorders, says DeCaro. These medications can potentially cause, maintain or worsen binge eating symptoms, especially if someone needs to stop the medication due to an adverse side effect. There is the possibility that these medications can interfere with eating disorder treatment goals, as they may enable restriction, interfere with establishing a consistent eating schedule, shift the clients focus to appearance and reduce a clients willingness to participate in the highly effective food exposure work.

Jay recommends that individuals work with a multidisciplinary team to determine the best course of treatment.

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Tennis legend Billie Jean King says she's using weight loss medication to help treat her binge eating disorder. Experts ... - Yahoo Life

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Delta Burke Shares Dangerous Weight Loss AttemptsJason LaVeris - Getty Images

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Delta Burke opened up about the extreme and dangerous ways she once attempted to lose weight, which included trying crystal meth.

She said she did so because of the public scrutiny she witnessed as a sitcom star in the 80s and 90s.

She ultimately left acting because she was too emotionally fragile to handle the incredibly ugly public narratives about her.

Everyone remembers The Golden Girls, but there was another quartet of women who ran the sitcom scene in the 80s and 90sthey were the cast of Designing Women, led by Delta Burke, who experienced her share of body-shaming by tabloids and critics. The scrutiny pushed the then-twenty-something to go to extreme measures to lose weight. Now, at 67, Burke is sharing the dangerous diet hacks she tried, and what she learned along the way.

Before landing in TV, Burke went to acting school in London, where she was prescribed obscure pills for weight loss, she told Chelsea Devantez on her Glamorous Trash podcast. They made my heart race, she said. But I lost weight.

Fast forward to her time on Filthy Rich in the early 80s, where she was pressured to be smaller. She asked her doctor for more of the aforementioned pills, and discovered that the prescription was illegal in the United States. Eventually, she connected with someone who could sell her the Black Beauties, as she called them, off-market.

Before going to work, she would take them in the morning so you wont eat, she recalled. They were like medicine to me.

Burke said she eventually built up a tolerance, and the Black Beauties stopped working. A colleague then recommended she try methamphetamine, a highly addictive stimulant and appetite suppressant that affects the central nervous system, per the National Institute on Drug Abuse.

Nobody knew about crystal meth at the time, she told Devantez. [They told me,] You chop it up. You snort it. I said, I dont want to snort it. So I put it in cranberry juice and [drank] it and wouldnt eat for five days.

Even then, Burkes weight remained a topic of conversation. They were still saying, Your butts too big. Your legs are too big, she said. And I now look back at those pictures and go, I was a freaking goddess. I didnt have a clue. I wish I had a clue, I wouldve used it.

Ultimately, being put under a very public microscope took a toll on Burkes mental health, as it would for anyone. She said she was emotionally too fragile to deal with the incredibly ugly narratives about her size. In 1986, she was hospitalized. I did have a breakdown, she recalled. It had become too much. I really couldnt handle it and didnt wanna go back. Burke left Designing Women in 1991, per Peopleit ran for two more years.

I thought I was stronger. I tried very hard to defend myself against lies and all the ugliness that was there and I wasnt gonna win. Im just an actress, you know. I dont have any power, Burke explained. Hollywood will mess your head up. And I had always thought, I want to be a famous actress. I thought that meant that you would be a famous and well-respected actress, but thats not what it meant. And the moment I became famous, it was like, Oh no, no, no. This is not what I had in mind at all. I dont think I want to be this anymore. But then its too late.

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.

If you or someone you know is struggling with substance abuse, call the Substance Abuse and Mental Health Services Administrations free 24/7 hotline at 1-800-662-HELP (4357).

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Delta Burke, 67, Shares the Extreme Ways She Tried to Lose Weight - AOL

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By Hub staff report

When it comes to weight loss, how many calories you consume might be more important than when you consume them, challenging the popularity of intermittent fasting, according to a new study of time-restricted eating by researchers at Johns Hopkins University published April 19 in Annals of Internal Medicine.

Nisa Maruthur

Johns Hopkins School of Medicine

The Johns Hopkins researchers randomly assigned 41 adults with obesity and prediabetes to either time-restricted eating (TRE) with a 10-hour eating window or a regular eating pattern for 12 weeks to compare weight loss and other measures of metabolic health, according to a study summary provided by Annals of Internal Medicine. Their randomized, controlled trial found that both TRE and a more traditional daily eating pattern resulted in weight loss when calories were held constant in both groups. It did not seem to matter whether participants consumed most of their calories early in the day or in the evening, suggesting that overall calories may be more important than meal timing when it comes to weight loss.

"It makes us think that people who benefit from time-restricted eatingmeaning they lose weightit's probably from them eating fewer calories because their time window's shorter and not something else," said the study's lead author, Nisa Maruthur, an associate professor of medicine at Johns Hopkins University, in an interview with NBC News. Maruthur presented the findings at the inaugural scientific plenary session "New in Annals of Internal Medicine: Hear it First from the Authors" in Boston last week during the annual American College of Physician's Internal Medicine Meeting.

Image caption: Nisa Maruthur

Similar to intermittent fasting, patients using TRE limit their eating to a window of time during the day and then fast for the remaining hours. During the eating window, patients are not required to count calories or monitor food intake and during the fasting window, patients are limited to water and calorie-free beverages. Evidence shows that when adults with obesity limit their eating window to four to 10 hours, they naturally reduce caloric intake by approximately 200 to 550 calories per day and lose weight over two to 12 months. Whether TRE induces weight loss independent of reductions in calorie intake, as seen in rodent studies, is unknown.

At the beginning of the study, the researchers assessed participants' history and activity level to estimate baseline caloric needs. The participants received prepared meals with identical macronutrient and micronutrient compositions based on their individual calorie estimates and instructions on when to consume the meals. They ate the same number of calories daily throughout the study. The time restricted eating group was instructed to eat only between the hours of 8 a.m. to 6 p.m. and consumed most of their calories before 1 p.m. each day. The usual eating pattern group ate between 8 a.m. and midnight and consumed most of their calories after 5 p.m. each day. After 12 weeks, both groups lost about the same amount of weight and there were no real differences in fasting glucose, waist circumference, blood pressure, or lipid levels. According to the authors, these findings suggest that if or when TRE interventions induce weight loss, it is likely in part due to a reduction in calories, and, therefore, clinicians can counsel patients that TRE may help them lose weight by decreasing their caloric intake.

According to the authors of an accompanying editorial from the University of Illinois Chicago, these results have important clinical implications. While TRE was not found to be more effective for weight loss, it may be easier for patients to follow because it allows them to continue consuming familiar foods. This simplified approach to treating obesity could help patients who don't do well counting calories.

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New Johns Hopkins study challenges benefits of intermittent fasting - The Hub at Johns Hopkins

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REAL Housewives of Salt Lake City star Heather Gay has concerned fans after she was spotted in a new social media post.

The 49-year-old reality television star was pictured with a castmate, Whitney Rose, while traveling back from Mexico.

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Heather wore a pink printed Hawaiian shirt which she left open over a white tank top.

She completed the look with a grey baseball cap and left her blond locks completely straight.

Heather looked slimmer than ever and seemed to have shifted the pounds recently.

Whitney smiled and posed for the camera while sitting down in the airplane next to Heather.

"My friend is on a flight with the #RHOSLC cast and I am dyinggggg of fomo. How cute are @heathergay29 and @whitneywildrose wrote a fan on X, formerly Twitter, who took the photo.

A Bravo fan page reposted it onto their story and added the caption "Thats a wrap on the #RHOSLC cast trip to Mexico! Filming for S5 should wrap up very soon!"

Fans flooded to the comment section to express concern for Heather's appearance.

"I didnt even recognize Heather! She looks like the New York housewife Leah!!!" wrote one fan.

"Whoa!! Heather is half the size she was last season!! I didnt even recognize her," added another.

"Is Heather ok???? Omg," asked a third concerned follower.

"THATS NOT HEATHER omg girl put the Ozempic down," noted a fourth.

In November, theRHOSLCstar revealed that she's been using the controversialweight lossdrug Ozempic to lose weight.

Heather's weight loss was apparent on Tuesday when she arrived at Watch What Happens Live inNew York City.

Photos captured the reality star ahead of her sit down withBravoboss,Andy Cohen, wearing a silver metallic skirt, white shirt, Valentino belt, and white overcoat.

Heather, 49, confessed that she's on the "Ozempic train" in an interview withPeopleat Variety's Women of Reality TV event inLos Angeles, California.

"I've been on it for a long time, but hadn't really seen much results. And I haven't had massive results, but enough for people to notice, which is great," the Bad Mormon: A Memoir author said.

[I'm on the] Ozempic train

Heather then revealed she found how people treated her after losing weight "discouraging" as they acted "nicer" toward her.

"You lose five pounds, people are nicer to you," the TV personality observed. "I don't know why. It's just the way the world works and that makes me sad for women. But happy that I'm down five."

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RHOSLC star Heather Gay shows off drastic weight loss in new photo but fans are concerned for stars hea... - The US Sun

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Fastest Diet: 'Battle of the Diet' Study Reveals the Winner - Woman's World

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Summary

1000-Lb Sisters star Tammy Slaton looks different in her new photos from her glamorous girls' trip with her soul sister. Tammy is a 37-year-old YouTuber from Dixon, Kentucky, who got her reality TV break on 1000-Lb Sisters season 1 with sister Amy Slaton. Tammy weighed more than 700 pounds but wasnt serious about losing weight at the start. A health scare and a visit to the hospital motivated Tammy to get rid of her bad habits and shed some pounds to qualify for her bariatric surgery. Tammy has lost 440 pounds since her weight loss surgery in July 2022.

1000-Lb Sisters star Tammy Slaton is embarking on new adventures as she slims down and shows off her new figure.

Tammy has become good friends with psychic Haley Michelle, and the two have started spending a lot of time together.

They recently posted a screenshot of them talking on FaceTime where they were perhaps making plans to go on a girls' trip together. Haley shared a photo with Tammy where the two ladies hugged each other. Haley captioned it, Spiritual sisters. She mentioned that her connection with Tammy was powerful and they dont have to explain anything to anyone. She told Tammy she was her best friend. Tammy showed her tattoo in her picture with a slight smile to look mysterious.

Tammys friend accompanied her on the girls' trip where they filmed a hilarious new video. The Instagram Reel posted by Haley showed her, Tammy, and their friend Paola in an outdoor setting reenacting a scene from Alvin And The Chipmunks: The Squeakquel. Tammy was Simon Seville in the Cheeseballs Scene and mouthed the words, Its a food ghost town in here, while Haley pretended to be Alvin. While Tammy hid behind a tree in the video, her slimmer frame was noticeable in a black off-shoulder dress. Tammy was also glammed up for the video, wearing bright red lipstick.

While Tammy seems to be enjoying her new friendship with the TikToker, not all of her fans are pleased with her choices.

Haleys caption for her sisterly photo with Tammy also seemed to be taking aim at fans who think she is a clout chaser. 1000-Lb Sisters fans went to the comments section to question if people are using Tammy to become famous or to get noticed. There seem to be fans who suspect Haley is riding on Tammys coattails, even though some of them think Haley has always been quite famous on social media. Someone even asked Tammy if Haley would still be friends with her if Tammy refused to take photos with her.

Haley herself insists that shes hung out with Tammy hundreds of times, and they havent always taken photos. She claims it's Tammys idea to post the pictures, since she wants to start posting more on social media and even wants to start modeling as a career. Haleys claims are believable because Tammy has dolled up for the pictures and even posed in a swimsuit recently with Haley on the same trip. That photo of Tammy has also gone viral for showing her incredible post-weight loss makeover.

1000-Lb Sisters seasons 1-5 can be streamed on Discovery Plus.

Sources: Tammy Slaton/Instagram, Haley Michelle/Instagram

1000-lb Sisters follows sisters Amy Salton-Halterman and Tammy Slaton in their home in Dixon, Kentucky, covering their daily lives, weight loss attempts, and subsequent weight loss surgery. The show covers such moments as attempts to have children, medical visits, and dramatic emergency room visitations. The family wrestles with supporting their daughters and their weight loss efforts while struggling with their own life troubles.

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1000-Lb Sisters' Tammy Slaton Reveals Weight Loss Transformation On Girls Trip - Screen Rant

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