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• Mosquitoes can carry viruses or parasites that cause a number of diseases in people.
• When a mosquito carrying a virus or parasite bites a person, it can pass on the microbe.
• The most common mosquito-borne diseases in the U.S. are West Nile, malaria, and eastern equine encephalitis.

More than just a summertime annoyance, mosquitoes can also spread disease. When mosquitoes bite and drink blood from a person or animal, they can pick up a virus or parasite. If they bite another person or animal, they can pass on that microbe.

The recent rise in mosquito-borne illnesses across the U.S. has many people concerned about the potential risks to their health and how they can best protect themselves.

“Minimizing excessive mosquito exposure is probably the only thing people can do to protect themselves,” said Marc Siegel, MD, a professor of medicine in the Division of Infectious Diseases at the George Washington School of Medicine and Health Sciences. 

“So avoid the times that mosquitoes tend to feed more, which is dusk to dawn,” he told Healthline.

If you do have to be outside, wear pants and a long-sleeved shirt or jacket, and wear mosquito repellent, he said—especially in wooded or swampy areas.

However, Siegel points out that not every mosquito that bites a person will be carrying a virus or parasite.

Over 200 types of mosquitoes live in the continental United States and U.S. territories, according to the CDC. Yet, only about 12 can spread a virus or parasite that makes people sick.

“Most mosquito bites are not going to result in West Nile virus because the vast majority of mosquitoes are not infected with West Nile virus,” he said.

Climate change, though, has led to the spread of mosquito-borne illnesses to new parts of the world, which will increase people’s exposure to these diseases.

Below are the four most common types of mosquito-borne illnesses, the risks they can pose, and how health experts recommend you can best protect yourself.

West Nile virus

Birds are the natural hosts of West Nile virus. Mosquitoes that become infected by biting and drawing blood from a bird can pass on the virus when they bite a person.

Only about one in five people infected with West Nile virus will have symptoms, which can include fever, headache, body aches, and vomiting. In addition, about one in 150 infected people will develop a serious, sometimes deadly, illness.

West Nile is the most common mosquito-borne disease in the continental United States, according to the CDC. There have been 289 West Nile cases reported to the CDC in the country so far this year. In 2023, there were over 2,566 cases in the country.

This year, cases have occurred in 33 states in the Northeast, South, Midwest, and Southwest.

“There are probably a higher number of total infections, many of which are not diagnosed,” said David Sullivan, MD, a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health.

However, “this is still less than the chance of being hit by lightning,” he told Healthline.

There are no specific medications to treat West Nile virus disease or vaccines that can prevent it.

People of any age can develop severe illness if they are infected with West Nile virus. But those 60 years of age or older are at greater risk for more serious disease.

Dr. Anthony Fauci, once the top US infectious disease expert, recently became infected with West Nile virus. After being hospitalized for a week, Fauci, 83, is recovering at home, reports STAT.

Other people with a greater risk for severe illness include those with cancer, diabetes, high blood pressure, an immunocompromising condition, or other medical conditions.

In an effort to reduce the risk of West Nile virus to the public, the New York City Health Department has been spraying pesticides in parts of the city to control the mosquito population.

Eastern equine encephalitis

Eastern equine encephalitis, or EEE, is a rare but potentially deadly disease caused by a virus passed onto people through the bite of an infected mosquito. Most people infected with the virus don’t develop symptoms.

Those who do become infected may develop symptoms such as fever, chills, body aches, and joint pain. Some people may develop more serious inflammation of the membranes surrounding the brain and spinal cord. About one-third of people who develop severe eastern equine encephalitis die from their illness.

“In worse cases, the virus infects the tissue of the brain, and that’s when we call it encephalitis,” said Siegel. “That is more serious and is much more likely to lead to death or long-term neurological deficits in patients who survive.”

Sullivan said both very young children and older adults are at higher risk of severe illness from eastern equine encephalitis. In contrast, West Nile virus tends to affect older adults more than young children, he said.

Most cases of eastern equine encephalitis occur in eastern or Gulf Coast states. So far this year, four cases have been reported to the CDC, with 38 reported in 2019.

The virus passes between mosquitoes and birds found in freshwater hardwood swamps. Another mosquito species is needed to pass the virus from infected birds to people or horses.

There is no vaccine treatment for eastern equine encephalitis. People with severe symptoms will be given medications and other therapies to manage their symptoms. 

In Oxford, Massachusetts, about 50 miles west of Boston, a man in his 80s was exposed to the virus, health officials announced on Aug. 16.—the first reported human case of eastern equine encephalitis this year in the state.

To minimize further risks to the public, Oxford health officials recommended an outdoor curfew from dusk to dawn, the peak biting time for many mosquitoes. 

Similarly, Plymouth, about 40 miles south of Boston, said all public parks and fields will be closed from dusk to dawn after a recent eastern equine encephalitis infection diagnosed in a horse.

Malaria

Around 247 million malaria cases occurred worldwide in 2021, with around 619,000 malaria deaths. This disease is caused by a parasite that infects a certain kind of mosquito. Malaria cases mainly occur in tropical parts of the world, especially Africa.

Malaria was once common in parts of the United States but was eliminated from the country in the mid-1950s. However, around 2,000 malaria cases are imported into the United States each year by people traveling to other parts of the world.

In 2023, several locally acquired malaria cases occurred in Florida and Texas for the first time since 2003.

Symptoms of malaria, which can include flu-like illness and headache, range from mild illness to severe disease.

Prescription drugs are available to treat and cure malaria. A malaria vaccine is also available in parts of the world where malaria regularly occurs, such as in parts of Africa.

Dengue

Each year, up to 400 million people worldwide are infected with a dengue virus, according to the CDC. Not everyone gets symptoms, which can include aches, eye pain, muscle or joint pain, nausea, vomiting, and rash.

Dengue is most commonly found in tropical and subtropical areas of the world. So far this year, over 4,000 Dengue cases have been reported to the CDC, with cases occurring in most states.

However, most cases reported in the continental United States occurred in travelers infected in other areas. Limited local spread of dengue has been reported in Arizona, California, Florida, Hawaii, and Texas.

There is no specific treatment for dengue, but people may be given medication to relieve pain. In the United States, a dengue vaccine is available for use in children ages 9 through 16 with laboratory confirmation of a previous dengue infection who live in an area where dengue is common.

Takeaway

Over 200 types of mosquitoes live in the continental United States and US territories. Only about 12 can spread a virus or parasite that causes illness in people. When mosquitoes bite and draw blood from an animal or person, they may pick up a disease-causing microbe.

The most common mosquito-borne diseases in the United States are West Nile, malaria, dengue, and eastern equine encephalitis. Some cases occur in returning travelers who were infected in other parts of the world.

West Nile is the most common mosquito-borne disease in the United States, with thousands of reported cases each year. Around 80% of people infected with West Nile virus will have no symptoms. However, some people with symptoms may develop a serious, sometimes deadly, illness.

• New research has found that six herbal supplements that are popular on TikTok may cause liver damage. 
• Researchers at the University of Michigan concluded that supplements, including Ashwagandha, Green Tea Extract, and Garcinia cambogia, may be hepatoxic. 
• However, experts say in most cases, these risks only occur if you’re taking high doses of these supplements. 
• It’s best to do your research before adding any supplement to your health and wellness routine.

Numerous users on social media platforms like TikTok have espoused the benefits of herbal supplements, leading to a surge in their popularity.

However, a new study conducted by researchers at the University of Michigan found that six popular herbal supplements, including green tea extract, turmeric, and ashwagandha, are linked to liver risks.

Furthermore, the researchers estimated that 15.6 million U.S. adults have taken at least one herbal supplement in the last 30 days that might be hepatotoxic or damaging to their liver.

Healthline spoke with experts to help clarify what you need to know about the reported benefits and potential risks to your liver that have been linked with these six popular herbal supplements.

Ashwagandha

“Ashwagandha can help reduce serum cortisol levels, which can lead to people getting better, more restful sleep,” says Pedram Kordrostami, MD, founder and CEO of supplement company Omre. 

“Ashwagandha’s ability to calm the brain is mostly due to the compounds it contains. Considered an adaptogen, ashwagandha is a kind of herb that, when consumed, helps the body deal with stress,” he explains. 

Kordrostami says the benefits will be more pronounced in people who experience insomnia. 

As for the potential risks to your liver?

Kordrostami says it’s rare, but the effects can range from mild to moderate. 

Severe liver injury has been reported by some who have used ashwagandha. In other cases, symptoms arose and then resolved after the supplement was stopped.

He says people need to be wary of commercially available herbal supplements marketed as only containing ashwagandha. 

“These supplements usually are a mixture of multiple different herbs and nutritional products, which are often mislabeled,” he explains. 

Black cohosh

Black cohosh is a plant native to North America that has been traditionally used for various medicinal purposes.

Samael Tejada, a functional medicine expert and founder of Liquivida, says its potential benefits include managing symptoms associated with menopause and hormonal imbalances and reducing hot flashes, night sweats, changes in mood, and sleep disturbances. 

It’s also used to manage menstrual cycles and alleviate PMS symptoms.

“Several case reports have linked black cohosh use to liver damage, including cases of hepatitis and liver failure, necessitating liver transplants,” Tejada notes. 

Risks include jaundice, elevated liver enzymes, and acute hepatitis. 

“The cause is not entirely understood but may involve individual susceptibility, dosage, duration of use, or contamination of supplements. Women with a history of liver disorders should be particularly cautious,” he warns. 

Garcinia cambogia

Garcinia cambogia is a tropical fruit that is commonly used as a weight loss supplement.

Tegada says it contains hydroxycitric acid (HCA), which is believed to help suppress appetite and block an enzyme in the body used to produce fat.

“It’s known for potential weight loss benefits, improved cholesterol levels, reduced appetite, increased stamina, and reduced fatigue, making it popular among athletes,” he explains. 

However, the potential liver risks may outweigh the benefits. 

“Reports of acute liver failure and hepatitis-like symptoms have been associated with Garcinia cambogia, often in individuals who combine it with other weight loss supplements,” Tejada notes. 

“Severe cases can lead to the need for liver transplantation, possibly related to the supplement’s chemical properties or interactions with other supplements.” 

Green tea extract

Green tea extract is derived from the leaves of the Camellia sinensis plant and is rich in antioxidants known as catechins.

Tejada says its high anti-oxidant content helps combat oxidative stress, which is linked to chronic diseases such as cancer, diabetes, and cardiovascular disease.

“It’s believed to improve metabolism and aid in weight loss, improve brain function, including memory loss and focus, reduce cholesterol levels, and may have potential anticancer properties for certain cancers,” he notes. 

As for liver risks, Tejada says risks include liver toxicity, hepatitis, and liver failure, with toxicity believed to be dose-dependent and possibly due to excessive accumulation of catechins in the liver, leading to oxidative damage and inflammation.

Red yeast rice

Red yeast rice is a traditional Chinese medicine made by fermenting rice with a type of yeast called Monascus purpureus.

“It contains compounds known as monacolins, which are similar to statins and may help lower cholesterol levels,” Tejada explains. “It may also improve heart health and lower the risk of cardiovascular disease. Some studies suggest it also has anti-oxidant and anti-inflammatory properties.” 

But there are risks.

“Red yeast rice may cause elevated liver enzymes, liver inflammation, and, in rare cases, acute liver failure,” Tejada notes. “The risk increases with higher doses and prolonged use, especially when combined with other statins or hepatotoxic drugs.” 

Turmeric

Turmeric is a spice commonly used in Indian cuisine and traditional medicine. It contains a compound called curcumin, which has powerful anti-inflammatory and antioxidant properties. 

These properties can help with conditions like arthritis or inflammatory bowel disease.

“Turmeric’s antioxidant properties help neutralize free radicals and reduce oxidative stress,” Tejada explains.  “It also supports digestive health, is believed to enhance cognitive function, and even potentially reduce the risk of certain cancers.” 

However, he says high doses of turmeric supplements have been associated with liver toxicity, leading to elevated liver enzymes and, in rare cases, liver damage. 

Takeaway 

A new study from researchers at the University of Michigan found that six popular herbal supplements that have soared in popularity due to content on TikTok can pose risks to your liver.

The herbal supplements studied included ashwagandha, turmeric, red yeast rice, green tea extract, garcinia cambogia, and black cohosh.

Health experts warn that just because an herbal supplement is popular or “natural” doesn’t mean it’s without risk.

If you are taking supplements, it’s important to ensure you’re taking the correct dose to avoid liver damage.

It’s also a good idea to speak with a healthcare professional before you begin taking any herbal supplement.

• Eli Lilly officials announced a new program that provides consumers with single-dose vials of the weight-loss drug Zepbound at a discount price of 50% or more.
• Consumers who pay for these medications out of pocket must purchase Zepbound through the LillyDirect program. They must also have a valid prescription from their healthcare provider.
• Experts praised the new program for its ability to get weight-loss medications to more people in an affordable manner.

The weight-loss drug Zepbound is about to become significantly less expensive for a select group of people who take the medication.

Officials at Eli Lilly, the manufacturer of the drug, have announced plans to sell Zepbound in 2.5 milligram and 5 mg single-vial doses at a discount of 50% or higher compared to the list price of all GLP-1 medications for obesity.

Here’s the pricing details on the new plan:

• A four-week supply of 2.5mg doses will be $399 ($99.75 per vial).
• The cost for a four-week supply of 5mg doses will be $549 ($137.25 per vial).
• The plan does not include the delivery pens typically used for the weekly injections or syringes needed to extract the medication from the vials.

The discount plan is available only to Eli Lilly’s self-pay customers who purchase pharmaceuticals through the company’s LillyDirect program. These customers pay out of pocket for medications rather than going through an insurance company.

Company officials said the cost savings are similar to those offered to people who are uninsured, but they noted the new program will expand the number of customers who can get Zepbound at a lower cost.

“We are excited to share that the Zepbound single-dose vials are now here, further delivering on our promise to increase supply of Zepbound in the U.S.,” Patrik Jonsson, executive vice president and president of Lilly Cardiometabolic Health and Lilly USA, said in a statement.

“These new vials not only help us meet the high demand for our obesity medicine, but also broaden access for patients seeking a safe and effective treatment option.”

Growing demand for Zepbound, other weight-loss drugs

Company officials said they hope the new plan will help ease shortages of Zepbound supplies and other GLP-1 weight-loss drugs.

Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, agreed that the new program should be helpful since there is still more demand than supply for weight-loss medications.

“Making the medication more affordable will increase the number of people who can access it,” Ali told Healthline.

Other experts also praised the program as a way to help meet the demand for weight-loss drugs.

“People living with obesity have long been denied access to the essential treatment and care needed to manage this serious chronic disease,” said James Zervios, the chief operating officer of the Obesity Action Coalition, in a statement.

“Expanding coverage and affordability of treatments is vital to people living with obesity. We commend Lilly for their leadership in offering an innovative solution that brings us closer to making equitable care a reality. Now, it’s time for policymakers, employers and insurers to work with pharmaceutical companies to ensure no one is left behind in receiving the care they deserve and need,” Zervios continued.

Caroline Apovian, MD, a professor of medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Massachusetts, told Healthline that although the new Eli Lilly Zepbound plan isn’t optimal, it still should make the weight- loss drug more affordable and more accessible.

“I hope other companies will try to lower the price of self-pay drugs for our new obesity medications as well as for type 2 diabetes,” Apovian said.

Zepbound prescription required for discount

Consumers who utilize Eli Lilly’s savings plan must have a valid, on-label prescription for Zepbound from their healthcare provider.

Company officials said this requirement is necessary to ensure that customers are not using the medication for cosmetic weight loss.

They added they hope the easier access to Zepbound will discourage people from using untested, knock-off drugs to treat obesity.

Ali urged companies to stay vigilant about consumers using alternative medications or using the drugs for purposes other than treating obesity and other serious weight management issues.

“The medication still requires a prescription from a legitimate provider. That being said, there will always be people seeking this medication for inappropriate use,” he said.

Novo Nordisk on making medications more affordable

Officials at Novo Nordisk, the manufacturers of the weight loss drugs Ozempic and Wegovy, told Healthline that the key to making these medications more affordable is by expanding consumer coverage through insurance companies and government programs.

“The most effective way for the millions of Americans living with obesity to access affordable medication is by ensuring coverage through government and commercial insurance plans,” a Novo Nordisk spokesperson told Healthline.

“We will not stop advocating for insurance coverage until all Americans have full coverage for obesity medicines and that becomes the standard, not the exception.”

“Novo Nordisk supports additional legitimate options as it creates more safe supply for Americans living with obesity and is a testament to the significant unmet need of addressing obesity as a serious, chronic disease,” the spokesperson added.

What to know about GLP-1 drugs

Zepbound and Mounjaro contain the active ingredient tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. Both are manufactured by Eli Lilly.

Zepbound is approved for use as a weight-loss medication. Mounjaro is approved as a treatment for type 2 diabetes.

Novo Nordisk has two injectable weight-loss medications, both of which include the active ingredient semaglutide, a GLP-1 drug. Ozempic is prescribed to treat type 2 diabetes while Wegovy is used as a weight-loss medication.

Novo Nordisk also manufactures Rybelsus, a daily pill that contains semaglutide that is used to treat type 2 diabetes in adults.

All these medications have performed well in clinical trials.

Last week, researchers reported that in a clinical trial Zepbound and Mounjaro were effective in helping people with obesity or weight management issues maintain weight loss over a 3-year period as well as significantly reducing their chances of progressing from prediabetes to type 2 diabetes.

In May 2023, researchers reported that Wegovy helped reduce obesity in half of teens in a 68-week clinical trial.

In addition, Ozempic has been shown to lower the risk of death from kidney disease as well as reduce the risk of certain cancers.

Some research has indicated that medications containing trizepatide might be more effective for weight loss than those containing semaglutide.

Takeaway

Eli Lilly announced that single-dose vials of the weight-loss drug Zepbound will be sold at a discount price of 50% or more.

Consumers who pay for medications out of pocket without insurance must purchase these products through the LillyDirect program and must also have a valid prescription from their healthcare provider.

Experts say the new program is a step forward for making weight loss drugs more accessible and affordable.

• A study in overweight individuals concludes that misaligned body clocks are associated with raised metabolic risk factors.
• The findings show these metabolic changes vary between males and females.
• Realigning the body clock with sufficient sleep could help reduce the negative health implications of overweight and obesity, researchers say.

Circadian rhythms are 24-hour cycles that the body goes through each day — an internal “body clock.” These cycles include fluctuations in levels of hormones and neurotransmitters and drive the daily sleep-wake cycle.

A recent study from researchers at Oregon Health & Science University (OHSU) shows that people with overweight or obesity whose circadian rhythms are poorly aligned may experience negative metabolic effects.

The findings, published August 20 in The Journal of Clinical Endocrinology & Metabolism, suggest these negative effects vary significantly between males and females.

Readjusting the body clock could potentially reduce some of the risks associated with overweight and obesity, researchers say, although more evidence is needed to determine these effects.

How does overweight or obesity affect sleep?

Scientists have known for many years that getting enough good quality sleep is essential for good health. However, many people in our modern society are getting fewer hours of shuteye than ever.

Research has also shown a close relationship between inadequate sleep and weight gain.

For instance, the authors of a review on the subject concluded that short sleep duration was significantly associated with the risk of developing obesity in the future, but that long sleep duration was not. Research also suggests that circadian misalignment may be linked to increased energy intake and obesity risk.

Jacob Teitelbaum, MD, a board-certified internist and expert in chronic fatigue syndrome, fibromyalgia, sleep, and pain, explained why circadian rhythms are so important. 

“The circadian rhythm is the critical ‘orchestra conductor’ for your body,” he told Healthline. “It regulates the proper timing of your hormonal and immune systems, and numerous other functions.” Teitelbaum was not involved in this study.

Studies have shown that circadian misalignment — which could mean feeling awake while the internal body clock is promoting sleep or eating when the body should be sleeping — is associated with less energy expenditure during the day.

In other words, people in this misaligned state burn fewer calories. Not sleeping enough is also linked to consuming more calories throughout the following day.

The relationship is complex, though, and researchers are still trying to understand precisely how body clock misalignment and insufficient sleep impact metabolic health.

What’s the relationship between circadian rhythm and obesity?

In the latest study, the scientists recruited 15 females and 15 males, all with overweight. They measured their body composition and took blood samples.

They also assessed their dim-light melatonin onset (DLMO). Melatonin is an important hormone that helps maintain circadian rhythms. As the day draws to a close and light levels fall, the brain produces melatonin. As levels increase, the individual becomes increasingly sleepy.

DLMO measures when melatonin release begins in dimly-lit conditions. Because melatonin release is a sign that the body clock is preparing an individual for sleep, scientists use DLMO as a marker of circadian rhythm phase.

By measuring the time difference between melatonin beginning to rise and the participant going to sleep, the researchers gauged the level of circadian rhythm misalignment.

Study co-author Brooke Shafer, PhD, a postdoctoral researcher with the Sleep, Health, & Chronobiology Laboratory at OHSU Portland Campus School of Nursing explained why this is important: 

“Your body has a time that it starts to signal the brain to fall asleep, and if we try to sleep really close to that time, we may have trouble sleeping or have a lower quality sleep,” Shafer told Healthline.

Following the week-long study, the researchers identified sex-specific effects of body clock misalignment.

Misaligned males had:

• higher levels of abdominal fat
• higher levels of blood fat (triglycerides)
• a greater risk of metabolic syndrome

Misaligned females had:

• a higher percentage of overall body fat. 
• higher blood sugar levels.
• a higher resting heart rate.

Shafer shared that she was surprised by the sex differences. “These findings really emphasize that there is no one-size-fits-all approach to maintaining healthy behaviors,” she said.

In particular, she explained, “the sex-specific differences in how sleep habits affected glucose and triglyceride levels were quite notable.”

This is important because individuals who have high levels of blood fat or blood sugar have an increased risk of heart disease.

These findings suggest that “circadian disruption may not only promote a trajectory of weight gain but could also contribute to negative health consequences in a sex-dependent manner in those already with overweight/obesity,” the study authors wrote.

The researchers hope that optimizing circadian alignment could help reduce the risk of poorer health outcomes, particularly in people with overweight or obesity.  

Shafer said the team will continue to study the impact of circadian rhythm misalignment.

“Our next steps are to look at sex-specific differences in health markers for individuals who are vulnerable to extreme sleep disturbances, such as those who work during nighttime hours,” she said.

How to realign circadian rhythm

The current study is small-scale, so scientists need to carry out more work to confirm the results. However, a number of studies have shown that a misaligned body clock is linked to negative health outcomes.

The good news is that most people can readjust their body clock with good sleep habits. 

This could mean that an individual with overweight might be able to reduce their risk of metabolic diseases by working to realign their circadian rhythms. However, trying to maintain a healthy weight should still be the primary goal.

Chelsea Perry, PhD, owner of Sleep Solutions in Westborough, MA, not involved in the study, and member of the American Academy of Sleep Medicine, suggested the following tips to for getting your internal body clock back on track:

• Maintain a consistent sleep schedule, even on weekends.
• Get exposure to natural light, especially in the morning. 
• Limit screen time and bright lights in the evening. This helps signal to your body that it is time to wind down. 
• Gradually adjust your bedtime and wake time by 15–30 minutes each day to help ease your body back into its natural rhythm.

Cherilyn Davis, MD, a board-certified pediatrician with Elliston Pediatrics, likewise not involved in the study, offered additional tips to optimize sleep:

• Avoid things that may disrupt sleep, like drinking caffeinated drinks before bedtime. 
• Make your sleeping space comfortable, cool, and dark. 
• Avoid napping or exercising late in the day, as this may make you less tired at night and disrupt circadian rhythm.

Takeaway

A new study concludes that people with overweight and have a misaligned body clock may be at a greater risk of metabolic disease. Conversely, the authors hope that realigning circadian rhythms might help reduce these risks.

• About 2% of people in the United States have an unruptured brain aneurysm.
• Most aneurysms don’t show any signs or symptoms.
• Peggi Wegener shares her story of experiencing an aneurysm.

It was a typical Saturday afternoon in January for 65-year-old Peggi Wegener as she enjoyed one of her favorite pastimes, crocheting. However, the day took a turn when she suddenly experienced a “popping” sensation in her head.

“[When] I looked up, I had double vision and remember thinking, Wow, that’s really weird,” she told Healthline.

At first, she thought it might be related to the one contact she wore to enhance her distance vision, but she quickly began to worry that she might be experiencing a stroke. After she found her way to the bathroom, she examined her face looking for signs of stroke.

“[The feeling] didn’t last a long time, but it lasted long enough for me to end up sitting down on top of the toilet and just kind of sitting there thinking, What is happening? What is going on? It cleared, and so again, I kind of sat there thinking, Do I feel okay? Does anything hurt?”

Because the sensation passed, Wegener moved on with her day. The next morning, she woke up with a headache but went to church as usual. Her headache continued to get worse, and when she got home, she felt queasy. She decided to call her brother, a retired primary care physician.

“[Whenever I call him], he usually does the typical ‘Ahuh, ahuh. Just go to your primary care doctor tomorrow’ like no big deal…This time, I tell him, and he says, ‘You need to go to the emergency room right now,’” said Wegener.

How an aneurysm diagnosis ignited self-advocacy

By the time Wegener arrived at the ER, her headache had intensified. She stayed overnight and underwent several tests, including an MRI, which discovered an aneurysm.

“The word aneurysm is scary to me. I don’t know much about it, but my colleague’s 20-something son [suddenly died] of an aneurysm that ruptured,” she said.

Unlike Wegener’s case, the majority of aneurysms often show no symptoms and are discovered by accident when medical workups for unrelated causes are performed, said Dimitri Laurent, MD, an endovascular neurosurgeon at Norton Neuroscience Institute.

However, he said subarachnoid hemorrhage (a bleed into the space around the brain) may be the first presentation of a brain aneurysm.

Signs of subarachnoid hemorrhage include:

• severe headache
• neck stiffness
• seizure
• loss of consciousness

“When aneurysms grow to a large size, they may cause compression on the surrounding brain and cranial nerves. Symptoms are dependent on the aneurysm location and the critical structures that are affected. This can result in double vision, restricted eye movements, gait instability, difficulty with speech or swallowing,” Laurent told Healthline.

Similar to Wegener, many people describe feeling a “pop” at the onset of the headache due to the subarachnoid hemorrhage, said Patrick Youssef, MD, a neurosurgeon at The Ohio State University Wexner Medical Center.

“This can then be followed by nausea, vomiting, double vision, or loss of consciousness,” he told Healthline. “The headache can persist long after the aneurysm is treated and the patient is stabilized.”

After learning about her aneurysm, Wegener was discharged from the hospital and told to follow up with a cardiologist, stroke clinic, and endovascular surgeon, who had a 5-week waiting time.

With some help from her brother, she advocated to get into the endovascular surgeon sooner.

The support of her adult children also inspired her to push for proper treatment.

“All I have is a word that is scary, and I have my child staying with me, and so…every night I would go to bed saying, ‘Please do not let me die and my child have to find me,’” she said.

Treatment, recovery, and finding hope

A week after seeing the endovascular surgeon, Wegener underwent surgery in February 2024 with a Medtronic Pipeline device that is a neurovascular stent designed to divert blood flow away from the aneurysm through a minimally invasive procedure. The device was paired with endovascular coils, which are also designed to prevent blood flow into the aneurysm.

“The basic process of aneurysm treatment involves elimination of the aneurysm from the normal arterial flow. Essentially, if blood cannot enter the aneurysm, then the aneurysm cannot rupture and bleed,” said Youssef.

In addition to flow diversion and flow disruption treatment options like Wegener underwent, he said there are a variety of methods to treat aneurysms, including open surgical procedures such as clipping or bypass and sacrifice of the diseased blood vessel.

“This would involve a craniotomy and surgical procedure. The advantage to open surgical procedures is if there is a space occupying hemorrhage, this can be evacuated at the same time to relieve pressure from the brain,” said Youssef.

He noted that endovascular treatment options are less invasive and can be performed with a needle puncture in the femoral or radial artery.

“These procedures include coiling of the aneurysm by placing platinum coils inside the aneurysm to fill it. This can be balloon or stent-assisted as needed based on the vascular anatomy,” Youssef said.

When Wegener woke up from her surgery, she was surprised she didn’t experience much pain.

“Normally, you wake up from surgery, and you’re real clear that you had surgery, and the only thing was I had a headache,” she said.

She was also elated when her doctor told her she didn’t have any limitations and could resume life as usual.

“I’m like, OK, I had this thing in my brain that could potentially kill me, but I can now do anything I want?” she said. “[It] is amazing and I did go back doing anything I wanted.”

After surgery, she took a blood thinner for three months, followed up with her doctor, and will continue to receive screenings going forward.

“[This] is sounding like an ongoing thing, but at the end of the day, I’m gonna live my life like I’m not gonna sit around and wait to die,” said Wegener.

Living life with gratitude and resilience

About 1 in 50 people in the United States have an unruptured brain aneurysm.

“With an estimated 2% of the population having a brain aneurysm, most of whom are unaware, this means that someone you know probably has a brain aneurysm,” said Laurent.

While aneurysms are often termed “ticking time bombs” as if they are a disaster waiting to happen, he said the majority of brain aneurysms do not rupture. 

“The goal is to identify those aneurysms at high risk of rupture and treat them before such an event occurs,” he said.

Ways to reduce the risk of an aneurysm are to avoid activities and lifestyle choices that could damage your blood vessels, such as smoking and illicit drug use, atherosclerosis (plaque buildup on the walls of blood vessels), having uncontrolled high blood pressure, and being overweight or obese. However, some people may have a family history of brain aneurysms or may have been born with a weakness in the walls of the blood vessels, which puts them at risk for aneurysm.

Before Wegener’s experience, the only thing she knew about aneurysms was that people died from them.

“[To] know that it can be found and can be repaired and you can resume your life, it’s just remarkable…to be able to take a little of the fear out of hearing the word,” she said.

Recovering fully from her aneurysm reinforced a gratitude for life she learned five years earlier after being diagnosed with early stage breast cancer.

“I mean, I’m not saying I didn’t have a meltdown when I was diagnosed with breast cancer, a meltdown when they told me about this aneurysm, but it was being able to right myself and say, ‘OK, hang on, all you know is you have this named something; you don’t know what your future holds, so stay right here, one day at a time, and live it as well as you can,’” she said.

• The authors of a new study identified a link between semaglutide use and suicidal ideation.
• They found that people who use semaglutide and medication for mental health conditions may face a higher risk. 
• Other research has found little to no association between semaglutide use and suicidal thoughts.
• More research in this area is needed since studies on GLP-1 drug use and suicidal ideation have yielded conflicting results.

Recent studies have investigated whether glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide are linked to an increased risk of suicidal ideation. So far, the results have been mixed.

For instance, a new global study published on August 20 in JAMA Network Open found a raised risk of suicidal ideation associated with semaglutide use, while another recent study found no such link.

The authors of the new work find that semaglutide-based GLP-1 medications, sold as Ozempic, Wegovy, and Rybelsus, are linked to a higher risk of suicidal ideation whereas other common diabetes medications were not.

The paper concludes that people with depression or anxiety disorders who take these drugs could face a greater risk.

Do GLP-1 agonists cause suicide thoughts?

GLP-1 agonists, like semaglutide, have revolutionized obesity treatment.

As their popularity skyrockets, there’s been mounting concern over the potential negative side effects of these drugs, including an increased risk of suicidal ideation.

During the approval trials of the GLP-1 agonist liraglutide in 2017, 0.3% of those treated with liraglutide reported suicidal ideation compared with 0.1% of those taking the placebo. This difference was slight enough that the authors concluded there was “no cause for concern.”

Similarly, later research on semaglutide in 2018 and 2021 also found no increase in suicidal ideation in participants with obesity.

However, in September 2023, the European Medicines Agency released a statement to explain they are “reviewing data on the risk of suicidal thoughts and thoughts of self-harm” associated with GLP-1 receptor agonists.

This review is ongoing, and both the Food and Drug Administration (FDA) and the British Medicines and Healthcare Products Regulatory Agency have since announced that they are conducting similar investigations.

So far, neither the FDA nor the British regulatory agency has found a cause for concern.

Why research on GLP-1 drugs and suicidal thoughts is needed

Much of the information about GLP-1 agonists and psychiatric symptoms stems from clinical trials.

However, people with psychiatric conditions are rarely included in clinical trials. 

GLP-1 agonists have become wildly popular with millions of people using them, including those with mental health conditions. Understanding how this drug affects people in the real world is increasingly important.

In the latest study, the scientists analyzed global data from the World Health Organization (WHO).

They focused on the potential relationship between the GLP-1 agonists, liraglutide and semaglutide and suicidal ideation and self-harm.

Are there links between semaglutide and suicidal ideation?

The researchers used the WHO’s database of individual case safety reports (ICSRs).

The ICSR is the largest pharmacovigilance database in the world, containing more than 28 million reports of suspected adverse drug reactions from 140 countries.

“Pharmacovigilance is the science and activities involved in detecting, assessing, understanding, and preventing adverse effects or any other problems related to medicines,” explained study co-author Georgios Schoretsanitis, MD, PhD, a researcher with the Feinstein Institute for Medical Research.

“This ongoing process is essential for ensuring the safety of drugs even after they have been approved for public use,” Schoretsanitis told Healthline.

In this study, the scientists did find a relationship between semaglutide and suicidal ideation, but they did not find this relationship with other medications.

The authors also found evidence that “people with anxiety and depressive disorders may be at higher probability of reporting suicidal ideation when medicated with semaglutide.” 

Should people who take Ozempic be concerned?

Although these results are concerning, it is important to put them into perspective.

For instance, the researchers used a method called disproportionality analysis to conduct their study. “In pharmacovigilance, researchers often compare ‘cases’ to ‘non-cases’ to understand if a drug might be associated with certain adverse events,” Schoretsanitis explained.

Cases are reports where people have experienced a particular adverse event after taking a drug, and non-cases are people who took the same drug but did not experience that adverse event. 

“By comparing these groups, disproportionality analysis aims to detect unusual patterns in the data,” Schoretsanitis said, meaning there is a higher-than-expected number of adverse events happening with a particular drug. 

If this “disproportionate” number of reports is greater than expected, this suggests that there is a “potential link between the drug and that adverse event that needs to be investigated further,” he added.

So, while this relationship certainly warrants a deeper dive, Schoretsanitis explained that the results are “like an early warning system, and should not be immediately viewed as an alarm.”

Still, Rachel Goldberg, an eating disorder therapy specialist in Studio City, CA, not involved in the study, urged caution.

“I believe we are still in the early stages of understanding how these drugs affect mental health, and establishing a clear correlation or cause-and-effect relationship will take more time,” she told Healthline.

“This study highlights that individuals on psychiatric medications who used GLP-1s tended to disproportionately experience suicidal ideation,” Goldberg continued. “This could suggest that GLP-1s may impact how psychiatric medications work, potentially reducing their effectiveness and leading to persistent thoughts that might not have occurred otherwise.”

Conflicting studies about semaglutide and suicidal ideation

Recent studies have found no links between semaglutide and suicidal ideation while others have shown the inverse. Why might this be?

“There is disagreement because the incidence is so rare that it is difficult to accurately assess and try to delineate a possible reason for this,” Mir Ali, MD, board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Healthline. Ali was not involved in the study.

The authors of the new study explain that previous research only included participants with obesity or diabetes. In contrast, the latest study also investigated people who took the drug “off-label.” In other words, their analysis included people without an obesity or diabetes diagnosis. 

Sarah Boss MD, psychiatrist, psychotherapist, and clinical director at The Balance Rehab Clinic expressed similar concerns about off-label use of GLP-1 agonists. Boss was not involved in the study.

“It is essential to understand that these medications are not first-line choices for people who do have type 2 diabetes, let alone people who do not,” she told Healthline.

“If these medications are used for physical or psychological purposes, it has the potential to damage people’s minds and bodies in serious ways. Type 2 diabetes is a metabolic disorder. If the drugs are used appropriately, that is different,” Boss continued.

“These medications can have a significant impact on our very delicate metabolic systems. If you disrupt the gut-brain connection, this can, of course, lead to mental health issues like depression, among other things.”

For anyone taking these drugs and experiencing suicidal ideation, Boss recommended “getting in touch with an internal medicine specialist to help wean them off the medication safely and detox to restore the body’s internal balance.” 

Takeaway

A new study finds evidence of a link between the GLP-1 agonist semaglutide and suicide ideation. Although the relationship is not yet definitive, experts call for caution and more research exploring this potential link.

• Baking soda is generating discussions on TikTok because of its reported health benefits, including weight loss, endurance, and cancer risk reduction.
• Experts say that many of these claims are not supported by research and that consuming baking soda carries health risks.
• Experts stress the importance of speaking with a healthcare professional before trying this — or any —social media health trend at home.

Baking soda. You may have put it in the back of your fridge months ago to help prevent odors or recently used it as an ingredient in a recipe.

However, creators on TikTok are generating millions of views with claims that drinking a small amount of baking soda mixed into a glass of water can provide a number of health benefits, including aiding with weight loss, improving exercise endurance, and reducing cancer risks.

While several claims like these are going viral on social media platforms, health experts are raising concerns that there’s little evidence to back them up, and others can pose health risks.

Healthline spoke with registered dietitians to help explain exactly what baking soda is, as well as how it can react in your body, and how to separate fact from fiction about TikTok’s six most common reported health benefits that drinking it can provide.

What is baking soda

“Baking soda is a powder made up of a compound called sodium bicarbonate, also known as bicarb,” Destini Moody, RD, CSSD, LD, a registered dietitian at Garage Gym Reviews, said. “For those chemistry folks out there, it’s a salt that is composed of sodium and bicarbonate ions.”

Chris Mohr, PhD, RD, a fitness and nutrition advisor at Fortune Recommends Health, explained that its traditional use is to make dough rise. 

“It works by reacting with acids to create bubbles of carbon dioxide,” Mohr says. “Besides baking, it’s also used for cleaning, deodorizing, and even as an antacid.”

Melanie Betz MS, RD, CSR, FAND, of The Kidney Dietitian, said that a key component of baking soda is where it falls on the pH scale, or in other words, a measure of how acidic something is on a scale of 0-14. 

“A pH of 7 is neutral in terms of acid/base balance,” Betz said. “If a substance has a pH above 7, it is more basic or the opposite of acid. If it has a pH of less than 7, it is more acidic.”

She pointed out baking soda’s pH when dissolved in water, which is how those participating in many TikTok trends generally consume it, is around 8.5.

“[This indicates] it is a base and can help neutralize acid,” Betz said. ”The exact pH will depend on the concentration of how much baking soda was dissolved in water.”

And that’s important for several reasons, including, as Betz said, “If taken frequently, baking soda could increase the pH of your stomach, which could have detrimental effects on nutrient absorption.”

Six popular health claims associated with drinking baking soda water

Of the numerous health benefits circulating on TikTok that are currently being linked with drinking baking soda water, the experts that spoke with Healthline reported the following six are the most common:

Baking soda can improve exercise endurance and performance

Some evidence suggests that baking soda may help some people boost endurance.

A small 2021 randomized control trial of 11 trained male cyclists involved participants completing a stimulated cycling race for about three hours, with a 90-second “all-out sprint” at the end.

Results suggested that sodium bicarbonate supplementation could better someone’s all-out performance. A more extensive 2021 review indicated that ingesting sodium bicarbonate might boost performance during high intensity activities like running or cycling lasting up to 12 minutes. 

However, Mohr said this claim requires more nuance than is usually provided in TikTok posts.

“Baking soda can help athletes by reducing acid buildup during intense exercise, which might improve performance,” Mohr said. “Its effectiveness varies from person to person, and too much can actually cause serious GI distress, so it’s important to consult with a qualified sports dietitian before considering it.”

Baking soda can help reduce indigestion

A 2022 review indicated that sodium bicarbonate might help relieve heartburn short term. 

“Reflux is caused by your stomach acid splashing up into your esophagus,” Betz explained. “Taking baking soda would temporarily reduce acid levels in your stomach and help the symptoms of reflux.”

However, Mohr emphasized “temporarily.”

“It’s only a short-term fix and shouldn’t be used frequently and without consulting with a healthcare practitioner for dosing,” he said.

Baking soda can help with weight loss

Every dietitian who spoke with Healthline cautioned that there’s no data that supports this claim.

“There is no reliable research to support baking soda can help with weight loss,” Moody said. “The one mechanism in which this may be possible is taking baking soda in amounts that cause so much stomach upset that an individual no longer has an appetite.”

Which, Moody noted, is not only dangerous, but would still not result in sustainable weight loss.

Baking soda can help slow the progression of chronic kidney disease 

Some research, including a 2021 review, suggests sodium bicarbonate might assist with slowing down chronic kidney disease progression.

More recently, an American Journal of Medicine randomized-control trial published on Aug. 5, 2024, indicated that taking two oral doses of baking soda daily (four to five 650-mg tablets) could slow kidney disease progression over five years but did not link intake with lower blood pressure or cardiovascular disease risk reduction.  

Betz explained that the kidneys are tasked with helping the body maintain pH levels. 

“They do a really good job at it,” Betz said. “If you do not have kidney disease, your kidneys are probably doing a perfect job of getting rid of all the extra acid in your body. There is no need to try to reduce body acid levels and no data to suggest that taking baking soda will help prevent kidney disease.”

However, if the body’s pH gets too high or low, it cannot function correctly, and the risks can be fatal. Taking baking soda to improve kidney function isn’t a cure-all.

“If you do have kidney disease, your kidneys may not be able to get rid of acid as well, and acid can build up in your body, causing acidosis, which has a negative impact on your bones and kidneys,” Betz said. “Acidosis is closely monitored in kidney disease, and medications, including sodium bicarbonate — aka baking soda — pills are prescribed.”

Betz said it’s critical to discuss consuming baking soda with a healthcare professional to assess your acid levels before trying this therapy at home.

Baking soda can help reduce your risk of cancer

A 2020 minireview suggested that baking soda might have anticancer properties but called for a large-scale clinical trial.

“Tumors survive best in an acidic environment, so many believe that making the body more alkaline by consuming things like baking soda can help treat malignant tumors,” Moody said. “However, the only studies done to support this claim have been in animals, and it is honestly so irresponsible to urge people with cancer, who don’t have time to waste on treatment, to seek any other treatment besides those that are firmly supported by rigorous research.”

Baking soda can help lower inflammation

A 2018 study consisting of rat and human participants suggested that baking soda might reduce inflammation. But, the registered dietitians Healthline spoke with say the study is not enough to endorse using baking soda for reducing inflammation, which can raise a person’s risk for diseases like cardiovascular and Alzheimer’s.

“One two-week study found that drinking baking soda may reduce inflammation, but that is a trial not nearly long enough to warrant a recommendation,” Moody said. “Alkalinity has an ability to reduce inflammation in the body, which is likely where this claim came from. However, this principle only applies to whole foods like fruits and vegetables, foods that are alkaline in nature, that are already known to help prevent inflammation.”

The risks of drinking baking soda water

Consuming baking soda, particularly in high quantities, can pose significant health risks.

One teaspoon of baking soda contains about 1,200 mg. of sodium, nearly the full daily recommended allotment given by the American Heart Association (AHA) for people with high blood pressure (1,500 mg).

The AHA suggests that most healthy adults consume no more than 2,300 mg of sodium daily.

Experts Healthline spoke with say that risks of consuming too much baking soda, especially regularly, include:

• Bloating
• Vomiting
• Cramping
• Electrolyte imbalances
• Hypertension
• Nutrient absorption difficulties 

Moody also stressed the importance of being skeptical about any health trend circulating on social media platforms like TikTok.

“Nearly all users of the platform are there for the goal of getting views and going viral,” said Moody. “Novel and unconventional things, like drinking baking soda, are often promoted because people will click and view out of curiosity.”

“People trying to go viral do not have your health and safety in mind,” Moody added. “They also lack the knowledge and responsibility to caution others to seek medical advice before trying supplementation like this, especially for individuals who are pregnant, breastfeeding, or suffering from a chronic disease that may be exacerbated by ingesting compounds like baking soda.”

Takeaway

While social media is abuzz about using baking soda to lower the risks of some diseases, achieve weight loss, and improve exercise performance, registered dietitians warn that the research is murky (and, in some cases, non-existent).

Moreover, some people — like those with chronic kidney disease or hypertension — may see their condition worsen.

Additionally, baking soda can cause GI upset, such as cramping and bloating.

• A large study has found a link between red and processed meats and type 2 diabetes.
• People who ate these meats had an increased risk of developing the disease.
• Several factors could account for this, such as high saturated fat or preservatives.
• Plant-based foods and fish can be healthier alternatives to red and processed meats.

According to a new study published in the September 2024 issue of The Lancet Diabetes & Endocrinology, eating red meat and processed meat was linked with a greater risk of developing type 2 diabetes.

The research team also looked at poultry. However, it was less clear whether it increased people’s risk.

Type 2 diabetes is a condition in which a person’s blood sugar becomes too high. This disease occurs because of insulin resistance.

Insulin resistance is when there is either not enough insulin or your body becomes unable to use insulin properly. This hinders cells from being able to uptake glucose (blood sugar) for energy production.

It can cause numerous health problems, especially if untreated. These can include damage to the nerves and blood vessels and subsequent damage to various organs and parts of the body.

The authors wrote that eating less red meat and processed meat could be beneficial in reducing the incidence of type 2 diabetes.

How the link between these meats and type 2 diabetes was studied

To conduct the study, the research team from the University of Cambridge analyzed 31 individual studies from 20 different countries.

Altogether, nearly 1.97 million people were included. Of these, 107,271 people went on to be diagnosed with type 2 diabetes during the 10-year follow-up period.

When they examined people’s eating habits, they determined that those who generally ate about 50 grams of processed meat per day (the equivalent of two slices of ham) had a 15% higher risk of developing type 2 diabetes within the next 10 years.

Also, eating 100 grams of unprocessed red meat every day (the equivalent of a small steak) was associated with a 10% higher risk.

Consuming poultry in the amount of 100 grams per day also yielded an increased risk of 8%. However, once further analysis was completed using different assumptions, this association became weaker.

Dr. Silvana Obici, Chief of the Division of Endocrinology at Stony Brook Medicine and Interim Medical Director of the Stony Brook University Hospital Diabetes Center, who was not involved in the research, commented on the findings, saying, “This is an important study that has confirmed with a much more comprehensive analysis of a large cohort of older studies, that there is an association between higher intake of red meat or processed meat and increased risk of type 2 diabetes.”

Obici cautioned, however, that a statistical association does not necessarily imply causation.

Why these meats might increase type 2 diabetes risk

“Also, the cooking methods such as frying in fat/oil or charring meats at high temperature can generate byproducts well known to affect glucose metabolism (e.g., advanced glycation end products),” added Obici.

Jennifer Pallian, a Registered Dietitian and owner of Foodess, further noted that processed meats often contain high levels of saturated fats, sodium, and preservatives, such as nitrates, which have been implicated in causing insulin resistance.

“In particular, researchers believe that nitrosamines—chemicals that form from nitrites and nitrates used in processed meats—might damage DNA and harm the cells in the pancreas that produce insulin, leading to lower insulin levels,” she said.

Red meat’s influence on your gut bacteria could play a role too, Pallian said, pointing to how the Alistipes shahii bacterium has been linked to higher HbA1c levels, an indicator of less favorable blood sugar regulation/management.

“Additionally, red meats are rich in heme iron, which may contribute to oxidative stress and inflammation, both of which are implicated in the development of diabetes,” she concluded.

Healthier substitutes for red and processed meats

Pallian suggested several substitutes for red and processed meats that may help reduce your risk of type 2 diabetes.

First up: plant-based proteins. “Foods like beans, lentils, chickpeas, and tofu are rich in protein, fiber, and essential nutrients without the high levels of saturated fats found in meat,” she said.

Science shows that vegetarian and vegan diets are associated with lower risk for type 2 diabetes as well as heart disease and cancer, Pallian added.

She likes curried chickpea salad with mayo, curry powder, red onion, celery, and dried cranberries as a tasty alternative to processed meats.

The smoky flavor and meaty texture of smoked tofu slices can help satisfy your meat cravings, too.

Also, fish — especially salmon, sardines, and mackerel — can be a delicious alternative to other meats. They are rich in heart-healthy omega-3 fatty acids, she said.

“I buy frozen salmon portions and cook them straight from frozen to flaky perfection in my air fryer,” said Pallian. You can even save your extra salmon to eat later as sandwiches and wraps.

Takeaway

A large new study has found an association between eating red and processed meats and the risk of type 2 diabetes.

Eating these meats may increase people’s risk.

Experts say this could be due to several factors, such as red meat’s saturated fat content, the formation of advanced glycation end products when meat is cooked at high temperatures, the sodium and preservatives that are present in processed meat, red meat’s effects on gut bacteria, and red meat’s high heme iron content.

Healthier substitutes for red and processed meats can include plant-based foods and fish.

• In a new clinical trial, the GLP-1 drug tirzepatide was effective in helping people maintain weight loss over a 3-year period.
• Researchers reported the resulting weight loss also lowered participants’ risk of progressing from prediabetes to type 2 diabetes.
• Experts agree these medications are effective, but encourage a long-term commitment to weight loss through a healthy diet and regular exercise.

A new clinical trial presents more evidence showing the GLP-1 drug tirzepatide can help people lose weight over a long period of time as well as reduce their risk of developing type 2 diabetes.

Officials at Eli Lilly made that announcement while unveiling the latest results of their 3-year SURMOUNT 1 clinical trial.

Company officials reported that people in the study who received weekly injections of tirzepatide, which is sold under the brand names Mounjaro and Zepbound, reduced the risk of progression from prediabetes to type 2 diabetes by 94% when compared to study participants who were given a placebo.

They also said that tirzepatide treatments led to sustained weight loss during the 3-year period. They noted that study participants who stopped receiving tirzepatide after 176 weeks began to regain weight. These participants also had signs of progression to type 2 diabetes during a 17-week follow-up period.

The company plans to submit the clinical trial results to a medical journal and present the findings at the Obesity Week 2024 conference sessions in November.

“These data reinforce the potential clinical benefits of long-term therapy for people living with obesityand prediabetes,” said Jeff Emmick, MD, senior vice president of product development at Eli Lilly, in a
statement.

Tirzepatide led to long-term weight loss, lowered diabetes risk

In the clinical trial, researchers studied 1,032 adults who had prediabetes as well as obesity or other weight management issues.

The study was a multi-center, randomized, double-blind, parallel, placebo-controlled trial. Participants were put on a reduced-calorie diet and asked to follow a regular physical activity routine.

Participants who received trizepatide were given weekly injections of 5 milligrams (mg), 10mg, or 15mg. The other participants received a placebo. Results from the clinical trial results showed:

• Participants who received tirzepatide for the 176-week period had an overall reduction in risk of
  progression to type 2 diabetes of 94%.
• Those who were given the 15mg dose experienced a nearly 23% decrease in body weight compared to
  about 2% for people who were given a placebo.
• People who received the 10mg dose had an average weight loss of nearly 20%.
• Those on the 5mg dose experienced an average weight loss of about 15%.

Researchers reported that during the 17-week off-treatment follow-up period, the participants who stopped taking tirzepatide began to regain weight and saw their risk reduction to type 2 diabetes fall to 88% compared to the placebo group.

Weight management is a long-term commitment

Experts said the post-treatment data in Eli Lilly’s trial reinforces the notion that weight loss is a long-term commitment.

“The study showed that weight regain is common after stopping these medications,” said Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California. Ali is not affiliated with the study.

“Many doctors are starting to think of obesity as a long-term chronic condition such as diabetes or hypertension; therefore, long term treatment may be required to maintain the weight loss,” Ali told Healthline.

Robert Gabbay, MD, PhD, the chief scientific and medical officer at the American Diabetes Association, agreed with the need for long-term commitment. Gabbay is likewise not affiliated with the study.

“These medications, like most all medications, tend to only be effective when being used. Therefore, it’s not surprising that there is weight regain with cessation of therapy.  We have seen this in other studies with this class of drug,” Gabbay told Healthline.

“Overall, as the full results become available and published, this becomes another consideration for high-risk individuals with prediabetes to help bend the curve on the number of people developing diabetes,” he added.

Health risks of obesity

The Centers for Disease Control and Prevention (CDC) estimates that about 40% of U.S. adults have obesity.

Experts say the weight gain that results from obesity can cost a wide array of health issues, including:

• type 2 diabetes
• high blood pressure
• high cholesterol
• heart disease
• fatty liver disease
• certain cancers
• stroke

In addition, the CDC estimates that obesity accounts for more than $170 million in annual medical expenditures.

GLP-1 drugs successfully aid weight loss

The first GLP-1 drug that received approval from the Food and Drug Administration (FDA) was exenatide. It was given the greenlight in 2005 as a treatment for type 2 diabetes.

The first GLP-1 drug that was approved specifically for weight loss was Saxenda (liraglutide) in 2014.

Wegovy, a semaglutide drug, received FDA approval for weight loss in 2021. Since then, other GLP-1 drugs, including Ozempic as well as the medications containing tirzepatide, have been spotlighted for their ability to suppress appetite and help people lose weight.

In the past two years, there are have been numerous studies lauding the weight-loss benefits of GLP-1 drugs. In addition, researchers have reported that GLP-1 drugs can help:

• reduce the risk of some cancers
• reduce the risk of a heart attack
• curb addictive behaviors such as smoking and alcoholism
• reduce rheumatoid arthritis flare-ups

“The trial results will likely increase the number of people seeking these medications,” Ali said. “Surgical weight loss still has the best long-term results for those who qualify. These medications are currently the most effective alternative to surgery.”

What to know before taking weight-loss drugs

There are side effects to taking weight loss medications. The researchers noted that some participants in the SURMOUNT 1 trial developed gastrointestinal-related symptoms that were mild to moderate in severity.

Specific side effects of GLP-1 drugs may include:

• nausea and vomiting
• diarrhea
• constipation
• abdominal pain
• indigestion

The researchers also pointed out that Zepbound may cause tumors in the thyroid and potentially result in thyroid cancer.

They noted that people should consult with their healthcare provider before taking medications such as Zepbound. They added the people who take medications such as insulin to treat diabetes should monitor their blood sugar levels while taking Zepbound.

They also said that the effectiveness of birth control pills could be diminished while taking Zepbound.

“I advise patients starting these medications to use them as a tool to help change to a healthier diet and lifestyle,” Ali said. “Also, depending on the degree of obesity, the patient may require long-term treatment for
sustained results.”

Takeaway

The latest results from GLP-1 drugmaker Eli Lilly’s clinical trial show that tirzepatide helped people maintain weight loss after 3 years. This resulting weight loss also helped significantly lower participants’ risk of developing type 2 diabetes.

Experts agree GLP-1 medications are effective, and encourage people need to make a long-term commitment to weight loss by following a healthy diet and exercising regularly.

In this blog, we share more information about what mpox is, the different clades, the key symptoms and how UKHSA is working with partners to respond to the outbreak.