Author name: Admin

• New research analyzed seven data points to reveal the worst states for mental health care.
• Texas topped the list as the worst state for mental health care for a second time in two years, while Vermont was ranked as the best state for mental healthcare.
• Experts offer advice on what to look for in health insurance plans regarding mental health coverage and how to access mental healthcare without insurance.

Where you live may determine the kind of mental health care you can access.

For instance, if you’re in Vermont, you’re in good shape, but if you’re in Texas, not so much, according to Forbes Advisor Health Insurance, which analyzed seven data points to reveal the worst states for mental health care.

For the second year in a row, Texas tops the list of worst states due to having a large population of uninsured adults with mental illness and having significant barriers to mental health resources. Vermont ranks as the best.

Six of the top 10 worst states for mental health care are located in the South, whereas five of the top 10 best states for mental health care are in the Northeast.

“Research reports that mental health care is significantly influenced by a person’s beliefs and their place of residence, with urban and northern states having more positive overall mental health,” Deborah Serani, PsyD, psychologist and professor at Adelphi University, told Healthline.

The top 5 states for the worst and best mental healthcare

Below are the top rankings, according to Forbes Advisor Health Insurance.

The disparity between the South and the Northeast underscores the need for more investment and attention to mental health infrastructure in the most underserved states, said Jason Metz, lead insurance editor at Forbes Advisor.

“It’s a positive federal policy that health insurance plans cover mental health, but the study emphasizes significant gaps still exist when it comes to regional access to care,” he told Healthline.

Why Texas ranks the lowest for mental health care

Texas tops the list as the worst state for mental health care for the second time in two years due to a combination of factors that create significant barriers to accessing treatment, said Metz.

“The state has a high rate of uninsured adults with mental health illness, 21.4%, the second highest in the U.S. Additionally, nearly 75% of youth with depression do not receive mental health services, and 19.4% of youth with private insurance lack coverage for mental health problems,” he told Healthline.

Financial barriers also factor into the ranking, with nearly one-third of those with a mental illness unable to afford a doctor’s visit.

“Texas has a limited mental health infrastructure, ranking the third lowest in the number of treatment centers, with only 8.4 per 10,000 businesses,” said Metz. “Overall, two-thirds (62.3%) of adults with mental illness in Texas go untreated, highlighting the state’s challenges in mental health care.”

Serani noted that socio-cultural beliefs with regard to mental health care also play a part. Statistically speaking, she said people who live in the South tend to have beliefs that seeking help for mental health suggests personal weakness and would harm their reputations.

“Clinically called public stigma and self-stigma, these assumptions prevent others from getting the help they need,” she said.

Why Vermont ranks highest for mental health care

Vermont has great access to services, comprehensive insurance coverage, and strong support for mental health initiatives, said Metz.

“The state has a well-developed mental health care system, with 34 treatment centers per 10,000 businesses—only bettered by 4 states,” he said. “Vermont also has lower rates of uninsured individuals with a mental illness (6%), with more residents having health insurance that covers mental health services, reducing financial barriers to care.”

The state also has one of the lowest percentages of untreated mental illnesses (43%), demonstrating its healthcare system’s ability to meet the mental health needs of its population.

Reduced stigma around mental health may also have influence, noted Serani.

“People in the Northeast are socialized in ways that asking for help is not viewed as a vulnerability, so mental health care and treatment are accessed more,” she said.

Does stigma affect how well states treat mental health care?

Sarah Davis, senior managing editor at Forbes Health, said while the stigma traditionally associated with mental health conditions is beginning to dissipate, it still exists and can impact insurance coverage.

She pointed to a 2024 study in The Lancet that found structural stigma of mental health disease refers to the “inequitable deprioritization, devaluation, and othering of mental health and substance misuse health (compared with physical health)” in healthcare systems.

“The study notes an example of this as a hospital emergency department having a patient-to-nurse ratio of 3:1 for physical health patients but a 6:1 ratio for mental health patients,” Davis told Healthline.

The 2008 Mental Health Parity and Addiction Equity Act requires certain health plans to provide physical and mental health benefits equally.

“[But] the National Alliance of Mental Health points out parity laws mean nothing if there are factors like inadequate provider network coverage in certain geographical areas, which you can see in our survey findings,” said Davis.

What to consider when choosing a mental health insurance plan

To ensure proper coverage, Metz said consider the following.

Confirm the health plan covers local mental health providers

If you have a provider in mind, it’s always best to confirm it’s in-network with the plan you’re considering.

“In-network versus out-of-network providers will make a difference on how much you pay for care,” Metz said.

Consider all the associated costs of the plan

Health insurance costs include both your monthly premium and all of your out-of-pocket costs.

“So when comparing health insurance quotes, review all costs like copays, deductibles, coinsurance, and out-of-pocket maximums,” said Metz.

Review the plan’s prescription drug coverage

Many health insurance companies include prescription drug coverage, but the covered medications and your copay can vary by plan.

“If you’re already taking medication, confirm its coverage with the potential plan,” said Metz.

Consider virtual healthcare coverage

While treatment for mental health services is generally preferred to occur in person, Serani said the pandemic proved that virtual therapy can be effective too.

“So, if you’re homebound, live too far from mental health resources, or can’t find a mental health practitioner that has a specialty in your concerns, the option to get treatment virtually opens many more possibilities,” she said.

Know if you need a referral for mental health care

Some health insurance plans require a referral from a primary care provider for mental health services.

“For example, an HMO usually requires referrals for most types of specialized coverage, while a PPO and EPO do not,” said Metz.

What mental health coverage typically includes

When choosing an insurance plan for mental health care, Serani said to choose a plan with an out-of-network benefit so you can go to a specialist.

“You really want to find someone who has training in the issues with which you are struggling,” she said.

If you must stay in-network, Serani said there are ways to access expert mental health care if there isn’t a specialist in your network.

“The insurance term called a single case agreement can help you work with a trained mental health specialist that you may not be able to find in your HMO network,” she said.

Below are some of the services that the best insurance plans for mental health cover, said Metz.

Talk therapy includes specific therapy modalities like general counseling, cognitive behavioral therapy, and dialectical behavioral therapy. “If you’re meeting one-on-one with a therapist or psychologist, the session is typically covered by insurance, less out-of-pocket costs,” said Metz.

Inpatient hospitalization involves intensive mental health treatment, which can be voluntary or involuntary. “You stay in a hospital or facility for a short period and receive continuous care through individual and group therapy, medication management, and coping strategies,” Metz said.

Partial hospitalization includes a structured program of psychiatric treatments during the day only.

Substance misuse treatment addresses drug and alcohol addiction. “Health insurance plans may cover talk therapy, medication management, 12-step programs, or medical detox for people going through substance abuse treatment,” said Metz.

Emergency psychiatric care or crisis intervention might include self-harm or overdose treatment, however coverage varies by plan.

Medication coverage usually includes at least partial coverage of pharmaceutical treatment for mental health disorders, with some plans requiring a copay or other out-of-pocket costs for these medications.

How to access mental health services without insurance

In Serani’s book, “Living with Depression,” she included the below options for accessing mental healthcare if you don’t have insurance.

Sliding scale and pro-bono services

Many psychotherapists make accommodations to see children and adults at low fees or pro-bono fees.

“Check with local mental health organizations to discover which professionals offer low or no-fee sessions,” said Serani.

University programs

Frequently, university and college programs will offer psychotherapy to children and adults at low fees.

“Generally staffed by graduate students earning degrees in related psychotherapy fields, the treatment takes place in the university setting,” she said.

Postdoctoral or postgraduate psychotherapy centers

Consider working with an already licensed mental health expert who is pursuing a postgraduate degree in psychotherapy. Similar to university centers, they offer low-fee treatment, yet the sessions commonly occur in the therapist’s office.

“By and large, these professionals have a desire to become even more specialized in the field of psychotherapy, and they seek training programs to hone their skills,” Serani said.

State and county clinics

There are over 1,500 free clinics in the United States, providing health services to children and adults who have no health care coverage.

“As a rule, you go through a clinic screening where your overall health is evaluated. With regard to mental health, a case manager helps you get to a therapist,” said Serani.

Non-profit mental health organizations

Reach out to nationwide non-profits such as the National Alliance on Mental Illness, Mental Health America, or Bring Change to Mind to ask for support and resources. Additionally, online services like the 988 Suicide & Crisis Lifeline offer free help around the clock.

• Prescription medication naltrexone is used to treat alcohol use disorder and opioid use disorder.
• The drug works by reducing cravings and the “buzz” associated with the use of alcohol.
• Naltrexone can help people cut back on how much alcohol they drink but is best used alongside behavioral and psychosocial support programs.

A pill that costs less than a dollar has been called the “Ozempic for drinking” after helping people cut back on how much alcohol they consume.

This prescription medication, known as naltrexone, is used to treat alcohol use disorder and opioid use disorder by reducing cravings and feelings of euphoria associated with the use of alcohol or opioids.

Here’s what to know about naltrexone.

What is naltrexone?

Naltrexone is a prescription medication approved by the Food and Drug Administration to treat alcohol use disorder and opioid use disorder. Naltrexone can be prescribed by any health care practitioner licensed to prescribe medications.

“Of the medications that are available [to treat alcohol use disorder], naltrexone is the one with the most clinical research and evidence to support its safety and effectiveness,” said Keith Heinzerling, MD, addiction medicine specialist, and director of Pacific Neuroscience Institute’s Treatment & Research in Psychedelics Program at Providence Saint John’s Health Center in Santa Monica, Calif.

However, “naltrexone works best in combination with significant behavioral support, internal motivation by the patient and psychosocial support,” he told Healthline.

According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use disorder is a “medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences.” Alcohol use disorder can range from mild or moderate to severe or even life threatening, said Heinzerling.

Treatment with naltrexone lasts three to four months. For alcohol use disorder, it is available in pill form or as an extended-release injection, which is given every four weeks.

How naltrexone works

Naltrexone works by binding to opioid receptors in the body. This “helps decrease cravings for alcohol,” which helps them consume less alcohol, said Natalie Klag, MD, assistant professor of psychiatry in the Department of Psychiatry & Behavioral Health at The Ohio State University Wexner Medical Center and College of Medicine.

It “also makes it easier to put the brakes on and stop drinking if there is a return to use,” she told Healthline.

Some people take naltrexone regularly to abstain from alcohol use. 

Others take it in pill form an hour before drinking alcohol to reduce the risk of alcohol overuse. This is known as the Sinclair Method. When done this way consistently over several months, a person may lose the desire to drink entirely.

Is naltrexone effective?

“Naltrexone is an incredibly safe and effective medication,” said Klag. However, “with any medications, but particularly for those used to treat any substance use disorder, the most important factor is working with a provider that you trust and who will work with you in a collaborative relationship.”

The World Health Organization recommends the use of naltrexone and acamprosate for the treatment of alcohol use disorder in adults.

Clinical studies from 2001 found that 78% of people who took naltrexone in pill form one hour before drinking were able to stop drinking altogether or drink very infrequently. This has helped people stay sober for longer periods.

In addition, “if people do return to drinking [while using naltrexone], they drink less, which can be important,” said Heinzerling, “because they might be more likely, if they have a slip-up and begin drinking, to be able to get back on track and not go into a full-blown relapse.”

Klag pointed out that naltrexone does not make you sick if you drink while taking it. “This means that if someone taking it has a return to [alcohol] use, it is helpful to continue taking naltrexone,” she said.

However, the effects of naltrexone can wear off after several hours. In addition, people who continue to drink after taking naltrexone can undo the protective effects of the medication. When that happens, people may feel the alcohol “buzz” again, which can lead to increased alcohol use.

In spite of the studies showing that naltrexone and other medications help people reduce or stop drinking, these drugs are not prescribed very often. In 2023, of the estimated 28.9 million people 12 years of age and older in the United States with alcohol-use disorder over the past year, only 554,000—or 1.9%—received medication-assisted treatment.

Heinzerling recommends that people who are looking for help to stop drinking or reduce their overall intake consider naltrexone as part of a comprehensive treatment approach.

“That should also involve counseling, psychological counseling, and behavioral support,” he said.

Support groups such as Alcoholics Anonymous and others can also help people stay sober.

“Self-help groups are not a professional treatment, but [they can] provide people with ongoing support and accountability,” said Heinzerling.

Naltrexone side effects

Common side effects of naltrexone may include:

• nausea
• sleepiness
• headache
• dizziness
• vomiting
• decreased appetite
• painful joints
• muscle cramps
• cold symptoms
• trouble sleeping
• toothache

Naltrexone may also cause serious side effects such as liver damage, severe reactions at the injection site, severe allergic reactions, pneumonia, or depressed mood.

Klag emphasized that while naltrexone is suitable for many people who live with alcohol use disorder, it’s not recommended for everyone.

People with existing liver impairment need to be monitored closely while taking naltrexone, she said. If their liver impairment is severe enough, they may not be able to take naltrexone.

Also, because naltrexone is an opioid blocker, it can cause problems for people who are using opioids, either prescription medicines or illegal drugs, she said. So people taking naltrexone would not be able to use opioid pain medications if they needed them for surgery or other pain.

And people with a history of depression may find that naltrexone can worsen their mood, she added.

How much does naltrexone cost?

Your cost for naltrexone will depend on your treatment plan and insurance coverage. You may also have to pay for an office visit with a doctor to receive an injection of naltrexone or a prescription for the pill form.

Optum Perks lists the cost of 30 tablets of naltrexone as low as $11.99 with a coupon from the site. This coupon can be presented to the pharmacist when filling or refilling your prescription.

The cost for a naltrexone injection is around $1,738 for a one-month supply, according to Drugs.com.

Takeaway

Prescription medication naltrexone is used to treat alcohol use disorder and opioid use disorder. It works by reducing cravings for alcohol and the “buzz” associated with alcohol use. This can help people stop or control their alcohol use.

Naltrexone is available in pill form or as an extended-release injection, which is given every four weeks. Some people take naltrexone regularly. Others take it in pill form an hour before drinking alcohol to reduce their risk of overusing alcohol.

Naltrexone has been shown to help people reduce or stop drinking. However, doctors recommend that it be used in combination with behavior support and psychosocial support programs. This may include support groups such as Alcoholics Anonymous.

The number of mpox-related deaths in Africa has surpassed 1,000, prompting health officials to call for increased international support to combat the ongoing outbreak. The Africa Centers for Disease Control and Prevention (Africa CDC) reported that 50 deaths occurred in just the past week, raising the total to 1,100. This alarming surge highlights the significant

• New CDC data shows a resurgence in whooping cough, with cases returning to “pre-pandemic levels.”
• Experts believe that missed routine vaccinations during the COVID-19 pandemic may be partially driving the increase in whooping cough cases.
• Symptoms of whooping cough include cough seizures and difficulty breathing, which may be life threatening for infants.
• Following the recommended routine immunization schedules is the best way to protect yourself against this bacterial infection.

A preventable illness that causes cough, seizures, and difficulty breathing is rising in the United States.

New data from the Centers for Disease Control and Prevention (CDC) indicates a resurgence of whooping cough, also known as pertussis, a bacterial infection that spreads through respiratory droplets and close contact.

As of October 5, around 17,579 whooping cough cases have been reported, with the highest numbers in the Middle Atlantic states. By comparison, there were only 3,962 whooping cough cases around this time last year. 

In June, the CDC warned that whooping cough cases were increasing, “returning to its more typical pre-pandemic cyclic patterns of more than 10,000 cases a year.”

According to experts, the five-fold increase in pertussis cases over the past year is partially linked to missed routine immunizations during the COVID-19 pandemic.

Infants are most at risk for severe illness and death, but whooping cough can affect older children and young adults. Vaccination against whooping cough with the DTaP or Tdap vaccine (depending on age) reduces the risk, but protection can wane over time, leading to outbreaks.

As the current whooping cough surge dovetails with winter respiratory virus season, cases are relatively low compared to influenza, RSV, or COVID-19. Still, the rising cases of whooping cough remain a public health concern.

“The numbers are smaller, but they’re not trivial because we don’t wish whooping cough on anyone,” said William Schaffner, MD, professor of preventive medicine and infectious diseases in the Department of Health Policy at Vanderbilt University Medical Center in Nashville.

Healthline spoke with Schaffner to learn more about what’s driving the surge in whooping cough cases and why following routine vaccination schedules is crucial for preventing infectious diseases. 

This interview has been edited and condensed for clarity and length.

What is whooping cough?

Schaffner: We have substantially reduced whooping cough over the years, and it has that overtone of an infection from the history books because we don’t hear it talked about very often. 

Pertussis, or whooping cough, is a bacterial infection transmitted through close contact via respiratory droplets. The infection can lead to inflammation of the throat and the bronchial tubes, and because the patient’s airways are so tiny, they can get swollen and have difficulty breathing. 

What happens in the body is that the bacteria, as it multiplies, produces a series of proteins that then go out into the body, and it’s these toxins that produce the illness. The persistence of those toxins in the body is what produces these long-term cough seizures.

The Tdap vaccine protects us against the effects of those toxins. We routinely include vaccination against whooping cough among the shots that children start to receive very early in life, but what happens is the protection can wane over time, so you have to keep up your protection. Even mild whooping cough is still a very nasty, troubling infection.  

What are the symptoms of whooping cough?

Schaffner: Whooping cough produces cough seizures, not the conventional kind of cough, but a whole series of coughs together, such that you may have difficulty breathing during the cough seizures. When they stop, you inhale, and that’s the ‘whoop.’ 

The illness is called the ‘cough of 100 days’ because these cough seizures can last for a long period of time. 

During the cough seizure, sometimes they are so severe you can faint, and if you fall, you can injure yourself.

Furthermore, these cough seizures can occur at any time and are very disruptive to your life. If they interrupt your sleep, you’re not going to feel good the next day, and you’re not functioning optimally. So, these are very troubling infections. 

Why are whooping cough cases surging? 

Schaffner: I think the major reason is that during COVID, we began to get a lot of medical care through telemedicine because we were staying at home and not going to the doctor for fear of acquiring COVID. 

As a consequence, both children and adults fell behind in their vaccination schedules, and in order to keep up your protection against whooping cough, you have to keep up your routine vaccinations. 

The current surge is affecting children who have not had a complete Tdap series or missed the Tdap vaccine completely. Younger adults who also missed the series may also be affected. 

Who should get vaccinated against whooping cough?

Schaffner: Whooping cough can be life threatening for infants. However, this bacterial infection can also impact older adolescents and young adults who don’t keep up with their vaccinations. 

The vaccination routine for children starts when they are very young. They get a series of doses of diphtheria, tetanus, and acellular pertussis (DTdap) vaccine at 2, 4, and 6 months of age, then their fourth dose at 15 months, and another dose at 4 to 6 years of age. 

Adults should get Tdap updates every 10 years. Whooping cough doesn’t affect older adults as much, because now we use a different vaccine that works very well in the relatively short term, and it has many fewer side effects than the previous Tdap vaccine. However, the duration of protection is not as prolonged as the older vaccine.

Another group of people who should be vaccinated is pregnant people. The recommendation is that you get a dose of Tdap during every pregnancy. That’s not so much for the mother’s benefit because that protection goes across the placenta and begins to protect newborns and young infants before we start vaccinating them. 

Once the baby is born, anyone who wants to visit that baby should be up to date with their Tdap vaccinations because we want to create a cocoon of protection around those vulnerable babies.

Is vaccine hesitancy contributing to the whooping cough surge?

Schaffner: Vaccine hesitancy and skepticism are undoubtedly contributing to the current increase in whooping cough cases. 

We hope that if people keep up with their vaccination schedules, we will see the number of whooping cough cases reduce to virtually zero.

While the greatest problem is the risk of death in infants, this is a very troublesome, nasty infection.

Takeaway

New CDC data shows whooping cough cases have increased five-fold over the past year, returning to pre-pandemic levels.

Experts say missed routine immunizations during the COVID-19 pandemic may be partially responsible for the increase. Ongoing vaccine hesitancy may also be driving rising whooping cough cases.

Following routine immunization schedules offers the best protection against whooping cough, which can be deadly for infants.

Recent research indicates that popular weight loss medications, specifically semaglutide (found in drugs like Ozempic and Wegovy), may have significant benefits in treating alcohol and opioid addiction. A study published in the journal Addiction highlights how these drugs could potentially reduce cravings and lower the rates of substance use disorders. Key findings from the study

• For a limited time, Burger King is offering a free Big Dip with its sandwiches.
• The Big Dip is an 8oz tub of Hidden Valley Ranch dressing for dipping.
• Nutritionists say the Big Dip adds excess calories, fat, and sodium to your meal.
• Eating like this regularly can increase your risk of obesity and heart disease.
• Better choices include healthier dressings, portion control, and not eating dip at all.

Burger King has announced that on October 16, 2024, it will collaborate with Hidden Valley Ranch to offer a limited-time offering of what it calls the “Big Dip,” an 8-ounce tub of Hidden Valley Ranch dressing.

To put the size of the Big Dip into perspective, a regular dip cup is only 1 ounce.

However, it won’t be available everywhere. Only BK customers from New York, Chicago, Dallas, Houston, Los Angeles, Miami, and San Francisco will be able to request a Big Dip.

For those who can get it, however, it will be free with the purchase of any sandwich from Burger King’s lineup, including its signature Whopper.

While ranch dressing is delicious — and who doesn’t enjoy a freebie? — we asked our nutritionists to share whether this is actually a good deal when you consider the potential effects on your health.

Whopper vs the Whopper with the Big Dip: A nutritional comparison

First, let’s take a look at how a Whopper with and without an added Big Dip changes the nutritional value of the sandwich. Assuming that a full 8-ounce tub is eaten, this is what you’d be getting:

How adding a Big Dip to your Whopper might impact your health

Dr. Krutika Nanavati, who is a Registered Nutritionist and Dietician with Nutrition Society New Zealand as well as a Consultant at ClinicSpots, said that a Whopper is “already a fairly heavy meal, but adding the full 8-ounce cup of Hidden Valley Ranch dressing changes things drastically.”

Your calorie intake would be nearly what a person should eat in an entire day, she said.

Additionally, you would be taking in a large portion of the maximum daily 2,300 mg of sodium advised by the American Heart Association.

You would also exceed the 44 to 78 grams of fat and 22 grams of saturated fat that the Dietary Guidelines for Americans suggest as an appropriate upper intake for a person eating 2,000 calories per day.

According to Nanavati, this can have “real consequences” for your health.

“Eating meals like this regularly can contribute to weight gain because those extra calories add up quickly,” she said.

Also, eating this much fat, especially saturated fats, can raise your cholesterol levels and increase your risk of heart disease, according to Nanavati.

“And don’t forget about the sodium,” she added. “[T]oo much can lead to high blood pressure, which puts extra stress on your heart and kidneys.”

Why adding dressing can make even healthy food unhealthy

Nanavati said that even if you are making healthier choices — like a salad or a grilled chicken sandwich — if you’re pouring on copious amounts of dressing, it can cancel out the health benefits.

“Dressings, especially creamy ones like ranch, are packed with calories, unhealthy fats, and often hidden sugars,” she said. “Adding too much means you’re turning a healthy meal into something more calorie-heavy than you might realize.”

Catherine Gervacio, a Registered Nutritionist-Dietitian and a certified exercise nutrition coach with WOWMD, agreed with Nanavati, emphasizing the need to be aware of the nutritional content of what you are adding to your healthier choices.

“It’s easy to forget that sauces and dressings also have calories and fats,” she noted. “They come as hidden fats and sugars which can lead to overeating without realizing it.”

What you can eat that is healthier

Gervacio said there are many brands of dressing that offer low fat or low calorie versions of ranch and other dressings.

“These can cut down on fat and calories without sacrificing taste,” she said.

However, if you really want to have regular ranch dressing, another option is portion control. So, for example, rather than eating the entire 8-ounce Big Dip, follow Gervacio’s advice and opt for a much smaller amount.

“This gives you the flavor without all the extra calories,” she said.

Or, better yet, pass on the Big Dip altogether since you’re only adding unwanted calories, fat, and sodium.

As Nanavati pointed out, “[I]t’s not just a matter of enjoying a tasty treat; it’s also about the long-term impact on your health.”

Takeaway

For a limited time, Burger King will offer a free Big Dip with any of its sandwiches upon request.

The offer, which is only available in a limited number of cities, provides customers with an 8-ounce tub of Hidden Valley Ranch dressing for dipping.

However, nutrition experts say eating the entire tub of dressing with your sandwich will add large amounts of calories, fat, and sodium to your meal.

Eating like this regularly can contribute to weight gain and heart disease.

They advise substituting healthier versions of your favorite dressings or exercising portion control if you do eat regular ranch dressing.

Better still, prioritize your health and forego asking for the Big Dip.

• More than half of Americans who are living with obesity or overweight can’t stop thinking about food.
• Food noise helps explain constant, intrusive thoughts about eating.
• Experts say there are ways to help ease food noise.

Since she was a teenager, 32-year-old Sophia Pena has experienced persistent thoughts about food.

“In my head, I thought it meant I was just weak; I was gluttonous. I’d wonder what’s wrong with me. Why am I always this concerned about my next meal?” she told Healthline. “I might not even need food immediately, but it’s always there…it’s like background noise.”

Throughout her life, the constant thoughts about food ebbed and flowed, and they often intensified during stressful times or when she was trying to lose weight.

“I had to think about the calories or what I’m going to eat. Is it healthy enough, not healthy enough? Am I going to need to justify that meal later?” she said. “It also happened early on when I was pregnant. Is this too much for the baby? It’s always there.”

While she was aware of the persistent thoughts, sharing them with her doctor a little over a year ago helped her identify the intrusive thoughts as “food noise.”

What is food noise?

While there is no clinical definition of the term, some experts refer to “food noise” as a heightened or persistent manifestation of food cue reactivity.

This can lead to intrusive thoughts about food and maladaptive eating behaviors.

“Food noise is part of the pathophysiology driving obesity in many people, perhaps similar to how we understand some of the neurobiochemical adversity in mental health disorders,” Karl Nadolsky, DO, a clinical endocrinologist and obesity specialist at Holland Hospital and clinical assistant professor of medicine at Michigan State University, told Healthline.

Food noise affects many people

Pena found relief when her doctor explained more about food noise and that others who are challenged with weight management often experience food noise, too.

“It’s relieving to know that there is a term for it because it kind of makes you feel weak-minded and that you’re just letting it control you. [In fact], I’m not choosing to think about this. I’d rather not think about this,” she said.

One study found that 57% of people living with overweight or obesity experience continuous and disruptive thoughts about food, yet only 12% are familiar with the term “food noise.”

Nadolsky finds this to be accurate with the patients he treats, as does Katherine H. Saunders, MD, an obesity physician at Weill Cornell Medicine and co-founder of FlyteHealth.

“The majority of individuals with obesity, especially those who have tried different strategies to treat their obesity, can tell you that food noise is a real part of their disease,” Saunders told Healthline.

What causes food noise?

Because obesity is a heterogeneous disease, Saunders said different people experience different symptoms at different times.

Saunders explained that increases in hunger and food thoughts can happen because of dysregulated hormonal pathways that result from obesity itself and metabolic adaptation that happens when a person with obesity loses weight.

Medication can help quiet food noise

Until Pena learned about food noise, she assumed she lacked willpower and felt shame about her weight. Over the years, she tried to lose weight with various methods including regular exercise, the Keto diet, and attending a weight loss clinic.

Each of these worked to some degree in helping her reach a healthy weight, but then she would regain it.  

“But even when I was given a plan and able to stay on track…that noise was still in the back of my mind,” said Pena.

At one point, her doctor prescribed her a weight loss medication that helped stop food noise.

“It didn’t tell me not to eat, it just reminded me not to worry about it,” she said. “[You] think it’s just food, but no, it was something that I was constantly thinking about. It was annoying. I didn’t choose it to be there, but it was there all the time.”

Anti-obesity medications like GLP-1s are effective in helping with food noise, said Nadolsky.

“We are very fortunate to now have a variety of medications in our armamentarium to treat obesity with benefits on the subjective, food noise, along with surgery,” he said.

Semaglutide, the active ingredient in anti-obesity medications like Ozempic and Wegovy, helps people feel full and empty their stomachs more slowly. It also activates receptors for the hormone GLP-1, which are found in parts of the brain connected to motivation and reward.

Both these functions might explain why these medications help quiet food noise.

“I would view food noise as a symptom of someone’s disease or a result of someone’s body fighting weight loss, so managing food noise is a part of treating obesity effectively,” said Saunders.

Nadolsky agreed and noted that providers should have empathy for patients who are challenged by food noise when approaching their medical care.

Natural ways to help manage food noise

In addition to medication, Nadolsky said nutritional efforts may help with food noise, particularly minimizing processed food and focusing on high quality, “volumetric,” whole foods. He suggested vegetables, beans, legumes, pulses, fruit, and high fiber grains, as well as low fat protein and quality fat from nuts, seeds, fish, and plants like olives or avocados.

For Pena, listening to music or podcasts has helped her drown out food noise.

“I don’t physically feel hungry, I’m more mentally thinking of food, so I needed to quiet the thoughts,” she said. “[Doing] something while listening…gave me a moment to just quiet or focus on something else and help me release that obsession in that moment, whatever is triggering me to have those thoughts.”

Make a plan to quiet food noise

Four months ago, she gave birth to twins, making her a mother of four. While she plans on giving her body time to heal, she eventually will focus on getting to a healthy weight again. When food noise interferes, Pena plans to lean on music again.

However, she knows that this will be one part of a bigger plan for her weight and health.

While finding various ways to ease food noise as Pena did is healthy, Saunders said managing food noise won’t end the obesity epidemic, which reveals that more than 100 million adults live with obesity, and more than 22 million adults live with severe obesity.

“Medically treating the underlying cause of the food noise with dietary strategies, behavioral techniques, obesity medications, and/or metabolic surgery is the way to address the epidemic,” she said.

• Researchers say males and females respond differently to their breakfast choices.
• Males do better with high-carbohydrate breakfasts.
• However, females have a better metabolic response to higher-fat breakfasts.
• Differences in muscle, hormones, and nutrient needs may play a role.
• Personalized nutrition based on metabolism can aid in weight loss, energy, and health.

An October 2024 study published in Computers in Biology and Medicine suggests what males and females eat for breakfast can affect them in very different ways.

The researchers found that males do best with carb-rich breakfasts.

Females, on the other hand, had a better metabolic response to a breakfast heavy in fat.

The researchers suggested that these differences could be used to tailor people’s diets to their needs, helping to support weight loss and improve energy.

How the effect of breakfast choices on metabolism was studied

The team reached this conclusion after creating a mathematical model of metabolisms for both males and females.

The model included feeding and fasting scenarios in healthy young people.

It additionally addressed metabolic responses to both high-carbohydrate and high fat meals at the organ and whole-body levels.

Specifically, they modeled the activities of the brain, heart, skeletal muscle, gastrointestinal tract, liver, and adipose tissue (fat).

The study’s stated goal was to examine how carbohydrates and fats are metabolized throughout the body and in the various organs.

They also wanted to learn more about what might be driving the metabolic differences.

The authors said the purpose of creating a mathematical model was to use existing data to quickly test hypotheses and refine studies without having to conduct more involved human studies.

Research like this helps bridge a gap in the scientific literature, the authors wrote, explaining that more tends to be known about metabolic responses to food in males.

Examining gender differences in metabolism can help us learn more about customizing nutrition recommendations for the unique needs of females.

Why breakfast choices can affect men and women differently

Catherine Gervacio, a Registered Nutritionist-Dietitian and a certified exercise nutrition coach with WOWMD, who was not a part of the study, said one reason that males and females respond differently is that males tend to have more muscle mass.

She said this means men tend to use carbohydrates for quick energy, while females tend to use more body fat.

The result is that a female’s long-term energy reserve burns fats more efficiently, according to Gervacio.

“This means men usually rely on carbs for energy, especially during activities, while women’s bodies are better at using fat, especially in times of rest or fasting,” she explained.

Hormonal differences can also play a role, per Gervacio.

“Hormones like estrogen in women promote fat storage and fat burning, particularly during fasting or when energy is needed over a longer time,” she said. “On the other hand, men’s hormones, such as testosterone, support more muscle growth, so their metabolism is more geared toward breaking down carbs for immediate energy.”

Finally, Gervacio pointed to the different energy and nutrient needs of males versus females.

“Due to different muscle-to-fat ratios and how organs use energy, men’s and women’s bodies prioritize different nutrients,” she said. “This results in women being more efficient at conserving and using fats for energy, while men’s bodies burn through carbs faster for quick bursts of energy.”

How personalized nutrition can support your health

Akanksha Kulkarni, a Registered Dietitian Nutritionist at Prowise Healthcare, who was also not involved in the study, explained that differences in biological sex, hormones, age, and physical activity must all be taken into account, whether you are looking to lose weight or simply to have more energy and better health.

For example, weight loss diets for males might be higher in complex carbohydrates, while females might incorporate more healthy oils.

“Custom nutrition helps people gradually adjust and tailor their meals to provide lasting energy,” she said.

Finally, Kulkarni said that personalized nutrition, especially if it is derived from analyzing the individual metabolic profile, could improve a person’s overall health.

“Taking into account the gender aspects of the metabolism helps with controlling the degree of inflammatory response and blood sugar levels in a better way and managing excess body weight successfully in the future, which translates to better health,” she concluded.

Takeaway

A new study using a mathematical model has found that males and females have different metabolic responses to their breakfast choices.

Males responded more favorably to carbohydrate-rich breakfasts.

Females, however, responded better to breakfasts higher in fat.

Experts say factors such as differences in muscle mass, hormones, and nutrient needs can all play a role in a person’s metabolic responses to food.

However, personalized nutrition plans that take this into account can help people lose weight, have more energy, and have better overall health.

 The Regenerative Power of Caffeine on Vascular Health Coffee, rich in bioactive compounds like caffeine, chlorogenic acids, and polyphenols, has been found to possess regenerative powers that benefit vascular health. Here’s a closer look at how caffeine contributes to this positive impact: Mechanisms of Action Adenosine Receptors Antagonist: Caffeine works primarily by acting as an

Presidential candidates Kamala Harris and Donald Trump have starkly different approaches to solving the nation’s biggest healthcare issues. Here’s a side-by-side comparison of where they stand.

The state of healthcare has reached a critical stage in the United States, and issues such as the Affordable Care Act (ACA) and prescription drug prices are some of the focal points of this presidential election.

A research paper released by the Commonwealth Fund in mid-September reports that the U.S. ranks last among 10 developed nations in terms of healthcare. The report notes that, compared with the other nine nations studied, the United States experiences the most avoidable deaths, and more people die at younger ages.

Democratic presidential candidate Kamala Harris and Republican presidential candidate Donald Trump have starkly different approaches to solving the country’s biggest healthcare issues.

Many of Harris’s positions are listed on the issues page of her campaign website, while Trump’s can be found on his 20 Core Promises platform and Agenda 47 campaign sites.

To help clarify where each candidate stands on seven key healthcare issues as voters head to the polls, Healthline provides a summary of their positions and analysis by experts on how their different approaches could shape the future of healthcare.

Affordable Care Act (ACA)

The Affordable Care Act (ACA) was signed into law by former President Barack Obama in 2010. The program, commonly referred to as Obamacare, provides a marketplace for consumers to buy health insurance with relatively low monthly premiums.

It requires insurance companies to provide coverage to people with preexisting health conditions, including pregnancy, without additional charges. It also allows children to stay on their parents’ insurance coverage until they are 26 years old. It mandates that everyone have some sort of health insurance or face a financial penalty.

What healthcare experts think of the candidates’ stances on the Affordable Care Act

Rosemarie Day, a health reform expert and the founder and CEO of Day Health Strategies, said that the Affordable Care Act has more popular support today than ever before due in large part to its protection of people with preexisting conditions, which is one of the law’s most popular provisions.

“Repealing the ACA would be extremely damaging to the health of millions of Americans who depend on its subsidized coverage through health insurance marketplaces and its protection of people with preexisting conditions,” Day said. “Millions of people would become uninsured. Uninsured people are more likely to die from their illnesses, many of which are preventable or manageable with adequate health coverage.”

Day said there is currently no politically acceptable framework for healthcare in the United States that will work as well as the ACA and that the law needs to be enhanced, not replaced.

“To that end, Kamala Harris is supporting the expanded marketplace subsidies that were enacted during the pandemic and extending them beyond 2025. This will help to ensure that those who have health insurance coverage today will be able to maintain that coverage, which will help them stay healthier,” Day said.

Kanwar Kelley, MD, is the co-founder and CEO of Side Health. He said that expanding the ACA would also allow for lower cost plans and decrease the gap in healthcare for people with lower incomes.

However, Kelley explained that Trump’s efforts to repeal aspects of the ACA during his presidency contributed to higher costs.

“Health insurance is subsidized by young and healthy members who utilize fewer health resources,” Kelley said. “During his presidency, Trump tried to strip the policy of the individual mandate, which had financial penalties for not having health insurance. With no penalty, many chose not to purchase insurance, which led to higher premiums for those seeking plans available under the ACA.”

He noted that Trump also cut funding for marketing and outreach, which decreased enrollment and led to reduced membership and high premiums.

“The ACA addresses health disparities by providing insurance to those otherwise locked out of coverage due to chronic illness or cost. With multiple attempts to repeal with no concrete plan, the Trump administration would risk millions of Americans losing their health insurance, increasing health disparities,” Kelley said.

Abortion

There may not be a hotter flashpoint issue in the 2024 presidential election than abortion.

The political heat was triggered in 2022 when the U.S. Supreme Court, in a case known as the Dobbs decision, upheld a restrictive Mississippi law on abortion and overturned the constitutional protections detailed in the court’s 1973 Roe v. Wade ruling.

In the 2 years since the Dobbs decision, 41 states have adopted abortion restrictions of some sort. Eleven of those states restricted abortion at the stage of fetal viability as defined in Roe v. Wade. Another 14 have restricted abortions after conception.

What healthcare experts think of the candidates’ stances on abortion

Day noted that “women’s health is being put at significant risk through not receiving abortion care and related health services.”

“Even women who are experiencing early signs of a miscarriage are experiencing delays in care in states with abortion bans due to doctors’ fears of being prosecuted for providing treatment that could be construed as performing an abortion,” she said.

This has galvanized many people to take action and could be a deciding factor in the 2024 election, as there are 10 states where abortion will be on the ballot, including several swing states.

“In every state where abortion has been on the ballot (seven so far), the side to protect women who need an abortion has prevailed,” Day said. “People are recognizing that they don’t need to support abortions to agree that government shouldn’t interfere with an individual’s freedom to protect their reproductive health.”

Despite this momentum, Day said there is a growing concern that conservatives will try to enact a national abortion ban. While Trump hasn’t committed to vetoing or supporting a national abortion ban, she said, “He has a profound lack of credibility with pro-choice voters on this issue.”

On the other hand, Day noted that Kamala Harris has vowed to support a national law to protect women who are seeking abortion care and has made a point of reaching out to women who are affected by this issue. She’s also connected with the grieving families of those who have lost a loved one due to a lack of abortion care.

“She has vowed to support a national law to protect women who are seeking abortion care,” Day said, who added that Harris is “exceptionally credible on this issue.”

Reproductive health

Reproductive health, including contraception and in vitro fertilization (IVF), are closely tied to the issue of abortion.

That was demonstrated in February when the Alabama Supreme Court ruled that frozen embryos created during the IVF process could be considered “children.”

Supporters of IVF said the decision could make fertility clinics less likely to provide IVF treatments because of fears they could be prosecuted if frozen embryos were damaged or destroyed.

The issue came to the forefront again in mid-September when Senate Republicans blocked a bill that would have provided a nationwide right to IVF treatments.

What healthcare experts think of the candidates’ stances on reproductive health

Kelley said that while both Harris and Trump have signaled that they support opening access to IVF treatments, both camps are light on specifics on funding for the program and how the legislation would require insurance companies to cover the procedures.

“Despite their agreement in this area, logistically, IVF support may be challenging to implement as embryo-protective laws, like that in Alabama, could become more widespread with Republican leadership,” Kelley said.

He also noted that physicians are reluctant to provide treatments related to IVF in some states due to unclear regulations that open medical personnel and facilities to risk of litigation or, worse, criminal charges.

Additionally, Kelley said that reducing access to contraception will negatively affect lower income households by restricting their access to family planning materials. Without policies supporting expanded paid family leave and other family-friendly social programs, this could put extra stress on many families struggling in the current financial market.
 
“Contrary to this, the Harris campaign has championed reproductive health as fundamental healthcare, including the right to contraception and comprehensive reproductive care. By doing so, this would increase accessibility to care for women in low income or rural communities as well as minority populations,” Kelley said.

Learn more about how Harris and Trump differ on abortion and reproductive health with Healthline’s more expansive comparison here.

Maternal health

By most standards, the status of maternal healthcare in the United States is not where it should be.

A June 2024 report by the Commonwealth Fund states that the United States maternal mortality rate — 22 deaths per 100,000 pregnancies — is the highest among the 14 higher income countries it studied. In fact, the U.S. rate was 55% higher than the rate in Chile, the second highest nation on the list.

The report also notes that Black women in the United States have a maternal mortality rate more than double the country’s overall rate.

The report states that differences in health insurance coverage, as well as the use of midwives, contribute to the mortality rate. It also notes that the lack of paid family leave after the birth of a child is another contributing factor because it makes it more difficult for women to receive follow-up care for pregnancy complications.

According to a Centers for Disease Control and Prevention (CDC) study, 80% of U.S. maternity-related deaths are preventable.

Additionally, the United States is one of only six countries worldwide without national paid family or maternity leave. However, 13 states and the District of Columbia currently have laws mandating some sort of paid family or medical leave.

What healthcare experts think of the candidates’ stances on maternal health

Without specific policies and guidance, maternal health disparities will continue to grow, Kelley said.

“The Trump administration has not made maternal health one of the keystone factors of his previous presidency or current campaign. However, it was championed by his daughter Ivanka, as she detailed her struggle with postpartum depression. Ivanka is not involved in this campaign, so it is unclear who will lead the policy charge if Trump is reelected,” Kelley said.

On the other hand, Kamala Harris has been vocal on the campaign trail about maternal mortality, continuing the focal point she has as vice president.

“Harris has proposed initiatives such as implicit bias training, increased standards for hospitals in maternal health outcomes, and research into the race disparity in maternal mortality. She has also suggested increased access to doula and midwife support, possibly supporting those in lower income and rural areas,” Kelley said.

Additionally, he noted that Harris’s policy on extending Medicaid coverage during the postpartum period also increases access to mothers after giving birth.

While the Trump campaign has not directly addressed maternal health during this election cycle, his previous policies tangentially reduced access and availability of maternal healthcare.

Though it’s not clear what factors are contributing to the excessive maternal mortality crisis, Kelley noted that Harris has “directly attempted to address these issues with policies increasing access and length of care.”

Medicaid

The Medicaid program was approved in 1965 and is funded by federal and state governments.

States administer Medicaid programs but must follow federal standards. Each state has flexibility in determining who can receive coverage, how healthcare should be delivered, and how much medical professionals who provide services should get reimbursed.

According to health policy organization KFF, in 2021, Medicaid spending accounted for 27% of total state expenditures, second only to education programs. It also accounted for about 20% of personal healthcare spending in the United States.

The Affordable Care Act expanded Medicaid coverage to nearly all non-elderly adults with incomes up to 138% of the federal poverty level. That’s about $20,000 annually for an individual. So far, 41 states have opted in on this Medicaid expansion program.

Overall, the $800 billion public health insurance program now serves more than 90 million people with lower incomes across the country. That’s about 20% of the total population.

The program also provides services for people with disabilities, people in nursing homes, and people with mental health conditions. Medicaid also covers about 40% of all births in the United States.

It is separate from the Medicare program, which primarily provides healthcare services for people 65 years and older.

What healthcare experts think of the candidates’ stances on Medicaid

Kelley said that Harris and Trump have fundamentally different visions for healthcare in the United States, particularly regarding affordable care and expanding access to more Americans.
 
“The Trump administration has tried to reduce spending on government programs, such as Medicaid and Medicare, by proposing eligibility requirements for coverage. This includes proof of employment, education, or volunteer work to remain on Medicaid,” Kelley said.

“However, introducing these requirements will affect lower income individuals disproportionately who are unable to participate in those activities due to disabilities, caregiving responsibilities, or living in rural areas,” he said.

Kelley also noted that Trump repeatedly endorsed repealing or replacing the ACA, which would have caused millions of Americans to lose coverage without other options.

If the ACA were to be repealed without a replacement, Kelley said that low income communities who depend on Medicaid as their primary healthcare would be disproportionately affected.
 
“The need for medical services will not decrease. [These consumers] will likely use emergency services, increasing uncompensated care and putting additional strain on health systems,” he said.

In contrast, Kelley said Harris’s policies focus on expanding and strengthening Medicaid and undoing restrictions put in place during the Trump administration.

“While not universal healthcare, giving greater access to Medicaid will allow lower income Americans to find care. Creating protections for preexisting conditions and additional subsidies will allow for better access to preventive medicine and other medical procedures,” Kelley said.

Prescription drug prices

People in the United States pay more for prescription drugs than just about any other place in the world.

A 2024 Rand study that used 2022 data reports that U.S. consumers paid 278% more for prescription drugs than 33 other countries.

The report also states that the gross price for brand-name originator drugs was 422% higher in the United States than elsewhere. Even after adjusting for manufacturer-funded rebates, brand-name prescriptions were still triple what people in other countries pay.

However, researchers note that U.S. consumers pay 33% less for unbranded generic drugs than consumers in other nations, but this does not fully offset the costs of brand-name prescriptions.

Insurance companies also pick up a significant portion of prescription drug costs, with consumers sometimes paying only a fraction of the actual cost.

Overall, retail prescription drug spending accounts for about 11% of personal healthcare services in the United States.

What healthcare experts think of the candidates’ stances on prescription drug prices

Trump and Harris agree on lowering prescription drug prices, and their campaign promises reflect that.

“Throughout various executive orders during his presidency, Trump aimed to reduce the cost of the most common pharmaceuticals used, primarily for Medicare recipients, to varying degrees of success,” Kelley said.

Kelley also pointed out that the Biden administration also passed prescription cost control measures as part of the Inflation Reduction Act, which allows the Department of Health and Human Services and Centers for Medicare & Medicaid Services to negotiate drug prices for 10 to 20 drugs per year. It’s projected to save billions over the next decade. 

Harris’s policies mostly mirror these priorities.

Kelley noted that Trump has specifically targeted obtaining supplies from foreign companies and directing domestic companies to offer prices similar to those offered to other countries.

“In my practice, several patients admit to going across the border to obtain medication for lower prices. Being able to source from reliable companies in other countries would increase competition and pressure domestic pharmaceutical companies to lower prices,” Kelley said.

“Harris has focused on negotiating prices with companies and capping consumer costs in line with what was passed as part of the Inflation Reduction Act. While this may work on some of the most common and generic pharmaceuticals, newer, brand-name drugs may retain their pricing to offset company losses,” Kelley added.

Mental health

The CDC estimates that more than 1 in 5 U.S. adults live with a mental health condition.

It also notes that 1 in 5 young people 13 to 18 years old, either currently or at some point in their lives, have had a severe mental health condition.

In addition, the agency states that 1 in 25 U.S. adults live with a serious mental health condition, such as schizophrenia, bipolar disorder, or major depression.

Mental Health America reports that 1 in 4 U.S. adults with frequent mental distress are unable to see a medical professional due to cost, and about 10% of adults with a mental health issue are uninsured.

In addition, about 10% of adults and 8% of youth have private insurance that does not cover mental health.

Furthermore, a 2023 report states that more than half of the U.S. population lives in areas that have shortages of mental health professionals. Many of them tend to be reimbursed by insurance plans at lower rates than physical health providers.

What healthcare experts think of the candidates’ stances on mental health

During his presidency, Trump focused his response on the opioid crisis and veteran mental health but failed to address mental health in the larger population, Kelley said.

“His most recent recommendation for the reinstitution of ‘mental institutions,’ to separate those dealing with mental health issues from the general population, will perpetuate the stigma of mental health by branding individuals. It is unclear how these institutions would be funded, if they would include government or private institutions, or how an individual would qualify to be admitted,” Kelley said.

He also noted that the Trump administration’s lack of a comprehensive mental health policy failed to address stigma and educate the public on mental health issues, and that the focus on specific populations left many without access to mental health treatment.

“Harris, however, has made mental health a focus of her public health initiatives. This includes maternal mental health and mental health in underserved communities. Specifically, she aims to extend Medicaid coverage postpartum to expand access to new mothers. This addresses the disparities in low income populations and minorities,” Kelley said.

Harris has also recommended addressing mental health in kids and teens by expanding mental health coverage in schools. This is another area in which increased access could reduce potential mental health crises, Kelley said.