• The majority of prescriptions in the United States for GLP-1 drug semaglutide were paid with commercial insurance.
• Semaglutide is the active ingredient in anti-diabetes drugs Ozempic and Rybelsus, and the weight loss drug Wegovy.
• Smaller numbers of people paid for GLP-1 prescriptions with Medicaid and Medicare, and even fewer by cash.

A new study shows that commercial health insurance paid for the majority of prescriptions in the United States for the anti-diabetes drugs Ozempic and Rybelsus and the anti-obesity drug Wegovy. This trend was especially true for Wegovovy.

In contrast, much smaller numbers of prescriptions for these drugs were filled using Medicare Part D or Medicaid, with a tiny fraction of people paying with cash.

“Despite the disproportionate burden of obesity in Medicaid and Medicare Part D populations and recent increases in public spending on weight-loss medications, most Wegovy fills were for the commercially insured,” wrote study author Dima M. Qato, PharmD, MPH, PhD, director for the Program on Medicines and Public Health at the USC School of Pharmacy, and her colleagues.

The study was published August 2 in JAMA Health Forum.

Commercial insurance is most commonly used to cover GLP-1 prescriptions

In the study, researchers examined data from IQVIA’s National Prescription Audit PayerTrak. This system covers 92% of prescriptions filled and dispensed at retail pharmacies in the United States.

They looked specifically at prescriptions for semaglutide. This drug is the active ingredient in anti-diabetes medications Ozempic and Rybelsus, and anti-obesity drug Wegovy.

They also examined the type of payment used for the prescriptions — commercial health insurance, Medicaid, Medicare Part D, or cash.

Researchers found that between January 2021 and December 2023, the number of prescriptions filled for semaglutide increased by over 442% (from 471 ,876 to 2, 555 ,308). Of these, over 70% were for Ozempic.

During this period, semaglutide prescriptions increased for all types of payment. However, most of the prescriptions were filled using commercial insurance, particularly for Wegovy.

In 2023, commercial insurance accounted for 61.4% of prescriptions filled for Ozempic, 89.5% of Wegovy prescriptions, and 58.1% of Rybelsus prescriptions.

In contrast, Medicare Part D accounted for only 28.5% of prescriptions filled for Ozempic, 32.9% of Rybelsus prescriptions, and 1.2% of Wegovy prescriptions.

Medicaid accounted for less than 10% of prescriptions filled for all three drug brands in 2023.

A small number of people paid cash for Ozempic and Rybelsus, less than 1% of all prescriptions each.

A larger percentage paid cash for Wegovy — 12.7% of prescriptions in 2021, 2.6% in 2022 and 1.2% in 2023.

This trend may represent increased insurance coverage of this medication over time.

What the new study reveals about GLP-1 medication coverage trends

Robert Klitzman, MD, professor of psychiatry and director of the Master of Science in Bioethics program at Columbia University, said that the results of the new study are important, but they don’t give us the whole picture. Specifically, why these prescription trends are happening. 

For example, are people with Medicare and Medicaid less comfortable asking their doctor to prescribe one of these drugs for weight loss? And how many people stop taking the drug after a few months, and does it vary by the type of insurance?

“There’s room for more research here to find out why there are differences in the number of people on Medicare, Medicaid, and private insurance taking these medications,” said Klitzman.

However, he pointed out that in 2022, 54.5% of Americans had commercial insurance, 18.8% had Medicaid and 18.7% had Medicare, according to the US Census.

“So the distribution of prescriptions found in the JAMA Health Forum article is not as alarming as one might initially think,” Klitzman, author of Doctor, Will You Pray for Me?: Medicine, Chaplains, and Healing the Whole Person, told Healthline.

Also, he said the fact that patients on Medicare are more likely than others to be on Ozempic or Rybelsus is not surprising “since these people are older and hence more likely to have heart disease or stroke, which would make them eligible for these medications.”

A glimpse into how the U.S. is tackling the obesity epidemic

Overall, Klitzman thinks this study only provides a glimpse into how well the United States is handling the obesity epidemic.

More than two in five American adults are living with obesity, according to the Centers for Disease Control and Prevention. Rates are higher among Black adults and adults with lower levels of education.

Newer GLP-1 drugs have been shown to be very effective at helping people lose weight and keep the weight off — as long as they keep taking the medication — but Klitzman thinks this is only part of the solution.

“You certainly want to have a good treatment [such as GLP-1s] available to everyone,” he said, “but I wouldn’t want people to think, ‘all we need is for everyone to take a medication and we’ll all be treated.’”

Eating healthy, staying physically active and learning to  deal with stress can also help people lose weight, while offering other benefits.

“Exercise helps you not just lose weight, but it helps with your cognitive thinking and it helps with your heart,” said Klitzman.

However, Lydia C. Alexander, MD, president of the Obesity Medicine Association and chief medical officer of Enara Health, cautions against thinking that people should skip the GLP-1 drugs and only try to lose weight with diet and exercise, something that fuels the stigma surrounding obesity.

People with obesity sometimes get judged for “not taking good care of themselves” or “not trying as hard as they can to maintain a healthy weight,” she told Healthline.

“This thinking is very common, even among primary care physicians,” she added.

While nutrition, physical activity and lifestyle changes are essential to treating obesity, “obesity is a disease,” Alexander said, “and just like any other disease, a medication may also be needed.”

“Because obesity is a metabolic dysfunction, where the body is no longer getting the correct signals to maintain a healthy weight,” she said.

GLP-1 coverage varies across healthcare plans

One limitation of the new study is researchers did not have information on why people were prescribed semaglutide, which may have affected prescription rates.

Ozempic was initially approved for the treatment of type 2 diabetes, and later to reduce the risk of serious heart problems in adults with cardiovascular disease who living with overweight or obesity.

This drug is also sometimes prescribed off-label to help people lose weight, something that was especially common before Wegovy was approved in June 2021 by the Food and Drug Administration as an anti-obesity drug.

The extent of coverage for semaglutide and other GLP-1 medications depends upon the type of health insurance — and the condition it is prescribed to treat.

“Medicare Part D will cover GLP-1 medications when they are used to treat type 2 diabetes or people with pre-existing cardiovascular disease who need to lose weight,” said Alexander.

But “there’s an actual clause that prohibits treating obesity [alone] as part of Medicare,” she said. As a result, the Medicare population does not have GLP-1s readily available to them for all uses.

With Medicaid, GLP-1 coverage varies from state to state since these are state-run programs.

“For example, in Arizona, it’s relatively more difficult to have Medicaid cover anti-obesity medications,” said Alexander, “but in California, these drugs are included as part of Medicaid coverage, and many times without prior authorization needed.”

Among commercial insurance plans, coverage also varies. 

However, a recent survey found that one-third of employer health plans said they are covering GLP-1 drugs for both diabetes and weight loss. This is an increase from around one-quarter in 2023.

In addition, over half of employer health plans cover GLP-1 drugs only as a treatment for type 2 diabetes, the report from the International Foundation of Employee Benefit Plans found.

However, of employers with GLP-1 coverage only for diabetes, almost one-fifth said they are considering offering the drugs for weight loss.

How to find out if your insurance covers GLP-1 drugs like Ozempic

To find out if your health insurance plan covers GLP-1s for weight loss, check the plan’s formulary and summary of benefits and coverage (SBC). This information should be available on your insurance company’s website.

Ro, a direct-to-patient healthcare company, also recently launched the GLP-1 Insurance Coverage Checker, a free tool to help people find out if their insurance covers treatment with GLP-1 medications.

The company said in a news release that nearly half of its patients have coverage for GLP-1s for weight loss, and most have coverage for more than one medication.

In addition, about two-thirds of patients with coverage paid less than $100 per month, the company said. However, most companies require people to get prior authorization before accessing the drugs.

The list price for Wegovy is almost $1,350 for a month’s supply. This is the amount people without insurance coverage would pay before any discounts or rebates. Drugmaker Novo Nordisk also offers a savings card that allows people to pay cash for a one-month supply for $650.

Takeaway

Researchers found that between 2021 and 2023, the majority of prescriptions in the United States for anti-diabetes drugs Ozempic and Rybelsus, as well as the anti-obesity drug Wegovy, were paid with commercial health insurance. The trend was especially strong for Wegovy.

Smaller numbers of people paid for prescriptions with Medicare or Medicaid, which may reflect fewer Americans having these health plans. However, Medicare does not offer coverage for Wegovy, and Medicaid coverage of GLP-1 drugs varies across states.

The study provides a glimpse into how well the country is tackling the obesity epidemic, but experts say more information is needed. For example, why are there differences in prescription rates across insurance, and how many people are prescribed these drugs solely for weight loss?

• Cannabis use is associated with greater risk of developing head and neck cancer, according to a new study.
• Participants had to meet criteria for cannabis use disorder, but the study didn’t include specific information on cannabis consumption.
• Prior research on the association between cannabis consumption and head and neck cancer has been inconsistent.

Cannabis use is strongly associated with the development of head and neck cancer, concludes a sweeping retrospective study of two decades of medical records.

Tobacco and alcohol are already two well-known risk factors for developing head and neck cancers, which include oral and throat cancer. Yet prior research on the risks of cannabis on these cancer types has been inconsistent.

Like tobacco, smoking is a popular way to consume cannabis. Smoking cannabis is known to result in some of the same chemical components as tobacco smoke, which can cause inflammation in the mouth, throat, and lungs — a known cancer risk factor.

A new study published August 8 in the journal JAMA Otolaryngology-Head & Neck Surgery found that cannabis users who met the criteria for cannabis use disorder (CUD) were between 3.5 and 5 times more likely to develop any form of head and neck cancer than those without CUD.

“Our study is the first and the largest to show that there is this association,” said Niels Kokot, MD, a head and neck surgeon with Keck Medicine of USC, and senior author of the study.

“I would consider this a starting point to truly define what the risk is of developing head and neck cancer from cannabis use. It creates an association, but we definitely have more work to do in terms of truly defining what those risk levels are,” Kokot told Healthline.

Head and neck cancer risk 5 times higher among cannabis users

Kokot and his team utilized health records for millions of patients across 64 healthcare organizations in the United States over 20 years.

Among the patients included in the study, 116,076 had a diagnosis of CUD, while nearly 4 million did not. 

Patients had no prior history of head and neck cancer. However, there were some demographic differences between those with CUD and those without.

The CUD group skewed younger, with an average age of 46 years old, compared with an average age of 60 in the other group. There were also slightly less women among those diagnosed with CUD (44.5% versus 54.5%).

Researchers then investigated the risk of developing any form of head and neck cancer and site-specific cancers in the two groups.

To strengthen any association, the study used multiple timeframes: 1 year and 5 years between cancer development and CUD diagnosis, and any amount of time between the two events. 

Depending on the timeframe, patients with CUD were 3.5 to 5 times more likely to develop any form of head and neck cancer.

Laryngeal cancer, a form of throat cancer, had the strongest individual association with CUD and carried more than an 8-fold increased risk.

Oropharyngeal cancer, a throat cancer that affects the pharynx, showed a nearly 5-fold increase. These findings are similar to prior studies that examined the risk of smoking tobacco and head and neck cancer risk.

Other cancers, including oral, salivary gland, and nasopharyngeal, were associated with a 2–3 times increased risk.

Cannabis consumption, dosage not understood

Despite the strength of the findings, the study does contain some significant limitations, which Kokot acknowledged.

Hospital health records do not contain specific information about a patient’s cannabis use frequency, dose, or route of administration, only that they were diagnosed with CUD. 

The authors also note that CUD is likely associated with tobacco and alcohol use, a potential confounding factor. Although they attempted to control for these variables, they note “differences in dosage…may remain” between those diagnosed with CUD and those who were not.

John B. Sunwoo, MD, director of Head and Neck Cancer Research at Stanford Medicine, told Healthline the study was robust but agreed it had limitations. Sunwoo wasn’t affiliated with the research.

“They tried to control for other factors by taking the two different cohorts and balancing out all of the different potential variables like smoking and alcohol. But alcohol use and smoking use was higher proportionally in the cannabis use group,” Sunwoo said.

Since the study relied only on medical records that indicated a patient had CUD, additional details about cannabis use, including frequency, potency, and route of consumption are not present. As a result, the different types of cannabis consumption, such as smoking versus eating were not able to be differentiated.

“In terms of actually looking at the type of usage, such as edibles versus inhaled, or the amount per day or the amount per week and the number of years, we didn’t have that information within the database that we looked at,” Kokot said.

Questions surrounding whether smoking cannabis is more harmful than ingesting it remain unanswered. There is also no clear threshold for the frequency of cannabis use and an association with increased risk of head and neck cancer.

“We can’t draw any conclusions about those factors,” Kokot said. “That’s where additional information would be needed in the next step of research to try to really parse out the risk level in different types of consumption and quantity of consumption.”

Prior research on cannabis, head and neck cancer inconsistent

Tobacco is recognized as the greatest risk factor for developing head and neck cancer. Alcohol consumption is associated with up to a 5-fold increase in risk for various forms of head and neck cancer.

Individuals who consume both alcohol and tobacco together have a substantially higher risk of developing head and neck cancer.

Meanwhile, studies investigating the association between cannabis and head and neck cancer have been inconsistent, explained Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws (NORML). This lack of robust evidence is also acknowledged by the study authors.

For instance, a 2015 study found no association between cannabis usage and the development of head and neck cancer. Another study from 2009, found an inverse relationship between the two, indicating that “moderate” cannabis consumption was associated with reduced risk of developing head and neck cancer.

“Given these historically inconsistent results and the potential issue of confounding, further research is necessary before drawing any sort of definitive conclusions,” Armentano told Healthline.

“In the interim, those who consume cannabis regularly — such as medical cannabis patients — may wish to consider alternative delivery methods that either reduce or eliminate the intake of combustive smoke,” he noted.

Sunwoo shared a similar opinion. “There are limitations for the study, and I think people should be aware of those limitations,” he said. “But I also think it should encourage people to investigate this further because we just don’t know.

Understanding cannabis use disorder

CUD is recognized as a psychiatric disorder, however, the criteria for meeting the diagnosis can be murky, leaving the diagnosis largely at the discretion of a doctor.

To meet the criteria, a patient must meet 2 out of 11 criteria. These include:

• taking large amounts of cannabis
• cravings for cannabis
• withdrawal symptoms when not using cannabis
• persistent desire to cut down with unsuccessful attempts
• continued usage despite social or interpersonal problems
• tolerance

Frequency or quantity of use are not objectively defined as part of CUD diagnosis.

Takeaway

New research found that cannabis use disorder (CUD) was associated with a 3.5 to 5 fold increase in risk of developing head and neck cancer. 

Certain site-specific forms of cancer, such as throat (laryngeal), showed up to an 8-fold increase in risk associated with CUD.

Prior studies on the association between cannabis use and these cancer types have been inconsistent. More studies are needed to determine whether ingesting cannabis could have the same impact on head and neck cancer risk as smoking it.

• Actor Daisy Ridley spoke in an interview about her Graves’ disease diagnosis.
• Graves’ disease is an autoimmune condition that causes excess thyroid hormone.
• Symptoms can include rapid heartbeat, weight loss, and protruding eyes.
• It might be caused by a genetic predisposition combined with environmental triggers.
• Treatment can involve medications, surgery, and lifestyle changes.

“Star Wars” star Daisy Ridley revealed in the August 6, 2024, issue of Women’s Health that she was diagnosed with Graves’ disease in September of 2023.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Graves’ disease is an autoimmune disorder affecting the thyroid, a small gland in the front of the neck often described as being shaped like a butterfly.

Graves’ disease occurs when the immune system begins to attack the thyroid as if it is an outside invader, causing the gland to become overactive. NIDDK explains that this can cause the body’s functions to speed up.

Ridley told the magazine that she first realized that something was not right when she began to experience hot flashes and fatigue after the completion of her movie Magpie, in which she plays a woman involved in a troubled relationship.

“I thought, Well, I’ve just played a really stressful role; presumably that’s why I feel poorly,” she told Women’s Health.

Upon learning of her symptoms — which also included hand tremors, a racing heart, and weight loss — her primary care doctor referred her to an endocrinologist, who diagnosed her as having the autoimmune condition.

Ridley additionally described to the publication how it felt to finally understand why she had felt so bad: “It was funny, I was like, ‘Oh, I just thought I was annoyed at the world,’ but turns out everything is functioning so quickly, you can’t chill out.”

Ridley has also previously spoken about her diagnoses of endometriosis and polycystic ovarian syndrome (PCOS), which research suggests are linked with a higher risk for Graves’ disease.

What are the symptoms of Graves’ disease?

Micheal O. McKinney, MD, a physician with Healthy Outlook, said that Graves’ disease results in the excessive production of thyroid hormone, a condition known as “hyperthyroidism.”

When this occurs, it can have various metabolic and systemic complications, he explained.

Some of the symptoms you might experience, per McKinney, include:

• Unusual or very fast heartbeats
• Weight loss, even if you eat more than you need
• Anxiety and being easily annoyed
• Trembling hands or fingers
• Inability to tolerate heat accompanied by perspiration for no reason
• Protruding eyes (Graves’ ophthalmopathy)
• Fatigue and muscle weakness
• Enlarged thyroid gland, also known as “goiter”

“It’s worth mentioning that these symptoms develop gradually over time, so they may resemble other illnesses,” he added, “thus demanding specific testing for accurate diagnosis.”

How to reduce your risk of Graves’ disease

John Lowe, MD, a physician at Restore Care, explained that the exact causes of Graves’ disease are unknown.

However, certain factors such as genetic predisposition and environmental triggers may contribute to its occurrence, he said.

To minimize your risk, Lowe said, “Relax through practicing yoga, meditation, and physical exercises effectively.”

“Avoid smoking since it increases the risk and severity of Graves’ ophthalmopathy,” he added. Graves’ ophthalmology is a condition in which swelling around the eyes makes them bulge out.

Additionally, you’ll want to be consistent about getting medical checkups of your thyroid health, especially if you have a family history of thyroid conditions, said Lowe.

Treatments for Graves’ disease

Lowe described several medical treatments for Graves’ disease. Among these are:

• Antithyroid Medications. “These drugs reduce the production of thyroid hormones and may then bring their levels back to normal,” he said.
• Radioactive Iodine Therapy. This treatment involves taking radioactive iodine by mouth in order to destroy the overactive cells, per Lowe.
• Beta-Blockers. “Such medications are useful in managing symptoms like fast heartbeats and tremors,” he said, “but they do not address the underlying cause of hyperthyroidism which is associated with them.”
• Surgery. Lowe said that sometimes, if other treatments haven’t worked or are not appropriate for the patient, it may be necessary to perform a thyroidectomy to remove all or part of the gland.
• Lifestyle Adjustments: “Eating healthy foods, regular exercise, and stress management techniques can help to promote overall well-being as well as alleviate some of the symptoms,” he said.

Lowe concluded by noting that Graves’ disease is treatable through both medical intervention and lifestyle changes.

“It is important to diagnose and treat it early enough since any delay may lead to complications as well as affect one’s quality of life significantly,” he said.

Takeaway

“Star Wars” actress Daisy Ridley revealed in a Women’s Health interview that she had been diagnosed with Graves’ disease, an autoimmune thyroid condition that causes an overproduction of thyroid hormone.

It can lead to symptoms of thyroid hormone excess, such as weight loss, rapid heartbeat, and protruding eyes.

The causes of Graves’ disease are unknown, although it may be due to a combination of genetic predisposition and environmental triggers.

However, it can be treated with medications, surgery, and lifestyle adjustments.

• A new study compared the keto diet with a diet low in added sugars and found that both diets reduced fat mass compared to a control diet.
• However, the keto diet was associated with negative metabolic changes, such as raised “bad” cholesterol and changes in the gut microbiome.
• The diet low in added sugars was not linked to negative health outcomes.

A diet low in added sugars is recommended for overall health. The World Health Organization (WHO) recommends that free sugars make up less than 10% of total energy intake because of their links to chronic diseases.

Studies have shown that reducing intake of free sugars helps reduce fat mass. Similarly, carbohydrate restriction, as with the ketogenic diet, is a proven weight loss method that has recently exploded in popularity.

A new study published in the journal Cell Reports Medicine investigates how the low carb, high fat keto diet compared to a diet low in free sugars (sugar added to foods or drinks) and a control diet. The researchers wanted to find out how these eating patterns influenced weight loss and metabolism. The study involved 53 participants and ran for 12 weeks.

According to a news release, the scientists also found that compared with the control diet, the low-free sugar diet and keto diet reduced fat mass by 2.1 and 2.9 kilograms, respectively. They determined this weight loss was unrelated to changes in physical activity — all groups maintained similar activity levels.

However, the scientists found the keto diet increased levels of “bad” cholesterol and other markers associated with cardiovascular disease risk compared to the low-free sugar diet and the control diet. The keto diet was also linked to reduced “good” gut bacteria.

Meanwhile, the diet low in free sugars did not have these negative side effects.

Can a keto diet cause high cholesterol?

Participants following the keto diet had elevated levels of low-density lipoprotein (LDL) cholesterol, sometimes called “bad” cholesterol. 

In particular, they had higher levels of small and medium-sized LDL particles. When it comes to cholesterol, the smaller the particle, the worse it is for health.

In contrast, the low-sugar diet significantly reduced LDL cholesterol.

Participants following the keto diet also had increased levels of a molecule called apolipoprotein B (apoB), a compound found in LDL cholesterol. This protein is linked to atherosclerosis, where the lining of blood vessels develops plaques, increasing the risk of cardiovascular disease.

“This is a meaningful reduction,” study author Javier Gonzalez, PhD, a professor at the University of Bath in the United Kingdom, told Healthline.

“We observed a 0.5 millimoles per liter (mmol/L) reduction. Genetic studies indicate that if the levels of LDL cholesterol were reduced by just 0.35 mmol/L, then over a lifetime, this would equate to a 21% lower relative risk of atherosclerotic cardiovascular disease, including heart disease and stokes,” Gonzales said.

How does the keto diet affect gut health?

Unlike the reduced-sugar and control diets, the keto diet significantly affected the gut microbiome — the trillions of bacteria that live in the lower intestine.

In particular, they found reduced Bifidobacteria, a “good” gut bacteria. Reduced numbers of these species are linked to increased risks of metabolic, immune, and gut issues.

Bifidobacteria also produce important B vitamins and other compounds that support overall health.

Fiber — a carbohydrate that the digestive system cannot break down — feeds our gut bacteria. Fiber intake is severely reduced on the keto diet, which may explain why this dietary pattern would impact the microbiome.

Keto diet impairs glucose tolerance

Carbohydrates are broken down into glucose in the gut. Glucose then enters the bloodstream and travels around the body. This is healthy, but if levels stay too high for too long, blood vessels may become damaged.

In response to rising blood glucose levels, the body releases insulin, which helps the liver and muscles take up the glucose and reduces the levels in the blood.

In this study, those following the keto diet had lower glucose levels in their blood before eating.

However, participants also had reduced glucose tolerance. In other words, glucose was removed from their blood less efficiently after eating, which would cause a longer blood sugar response.

What are the long-term effects of the keto diet?

When asked what these keto-related metabolic changes might mean in the long run, Gonzales explained this is a “challenging question to answer.”

Some metabolic changes determined by this study were beneficial (i.e., lower fasting glucose levels), and some were negative (i.e., the increase in apoB).

“This may mean that the long-term effects on health depend on the status of the individual,” Gonzales said. “For example, does someone have a particular problem with controlling their fasting glucose or their blood lipids?” 

Gonzalez said he plans to continue this research. “We are keen to explore if there are individual responses to ketogenic diets that may warrant personalized use and whether we can mitigate against some of the unfavorable effects with targeted supplementation strategies,” he said.

“We have just received a large Medical Research Council grant for some of this work and are actively seeking more funding for the rest.”

Sarah Herrington, a nutritionist for Brio-Medical, explained the potential long-term implications of following the keto diet: “Long-term effects of a ketogenic diet may include more significant changes to the gut microbiome, potentially leading to less overall diversity.” 

“It may also worsen glucose tolerance — the body will be more sensitive to sugars and carbohydrates when they are reintroduced into the diet,” Herrington continued.

“A ketogenic diet is more likely to alter the way the body uses energy, increasing fat metabolism and making positive short-term improvements in blood sugar regulation, but may have implications in the health of the microbiome long- term.”

Takeaway

Restricting free sugars or following the keto diet can lead to weight loss. But a new study shows the keto diet may have negative health consequences, such as raising bad cholesterol and harming gut health.

However, a diet low in added sugars did not appear to harm health.

“The free sugar restriction achieves this with almost entirely favorable health effects, whereas the ketogenic diet achieves the weight loss with some trade-offs we may need to be cautious about,” Gonzales said.

• TikTokers are drinking Ricezempic – a drink made from discarded rice water – to aid weight loss. 
• They claim that the drink is full of resistant starches that suppress appetite and help you feel full for longer, similar to GLP-1 drugs like Ozempic and Wegovy.
• Experts say resistant starches may aid feelings of fullness but that Ricezempic isn’t a viable weight loss aid.

Another weight loss hack has gone viral on TikTok. This time, it’s Ricezempic, a homemade drink that users claim mimics the effects of GLP-1 weight loss drugs like Ozempic, Wegovy, and Zepbound.

The drink is made by soaking uncooked rice in water for a short period of time, removing and discarding the rice, and then drinking the water.

TikTokers say it’s best consumed first thing in the morning before you eat. 

The claim? Proponents say the drink triggers weight loss because it contains resistant starches. They claim that this suppresses your appetite and allows you to feel fuller for longer, similar to Ozempic. 

One TikToker even claims that they have lost 27kg (59 lbs) in two months by drinking Ricezempic. 

So, can this drink really mimic the effects of GLP-1 drugs and trigger significant weight loss? Health experts aren’t convinced. 

Ricezempic and weight loss: is there a link?

Lisa Moskovitz, registered dietitian, CEO of Virtual Nutritionists, and author of The Core 3 Healthy Eating Plan, isn’t surprised to see people turning to Ozempic alternatives like this, but she doesn’t believe Ricezempic is a viable weight loss solution. 

“Ozempic hacks are on the rise, and Ricezempic is another example of how many people are searching for magic bullets for weight loss,” she said. “But weight loss is not so simple for the vast majority of people. It’s often due to stressful lifestyles, genetics, and other impeding factors.” 

Moskovitz described the trend as “low-hanging fruit, instilling a false sense of hope” in people who are living with obesity or overweight. 

Registered dietitian Kim Shapira echoed these thoughts. She said Ricezempic feels like a “reach.” 

“There is that great quote that you can’t outrun a bad diet, and I think if we can start talking about the sum total of a person’s diet and lifestyle choices in a positive, empowering way, we won’t see as many fads or have the need for Ozempic at all,” she noted. 

One of the reasons so many people are claiming that Ricezempic works as a weight loss aid is because of starch. The rice water is said to contain a naturally occurring resistant starch found in rice. 

“Resistant starch can slow down digestion, leading to better blood sugar levels and a longer sense of fullness,” Moskovitz explained. “This can make it easier to eat less and promote a calorie deficit, which is necessary for fat-burning.” 

Moskovitz said drugs like Ozempic and Wegovy work through similar mechanisms, although they are much stronger and also target areas in the brain that regulate appetite.

Similarly, Shapira pointed out that Ozempic is a medication that works on the emotional centers of the brain, turning down food noise, too. 

“This means when a person experiences discomfort, their mind is now able to differentiate hunger vs emotional needs for food,” she said. 

You won’t get the same effects by drinking rice water. 

Crucially, rice water isn’t food. “It’s a watery drink full of who knows how much actual resistant starch,” Shapira said. 

Potential benefits of drinking Ricezempic

So, Ricezempic is unlikely to promote significant weight loss, but it may have some other health benefits. 

“The main benefit of Ricezempic is consuming more resistant starch,” said Moskovitz. “Resistant starch not only promotes better blood sugar levels, but it can also benefit your gut health and bolster good gut bacteria proliferation.” 

This can increase the amount of good bacteria in your digestive tract, which is important for proper digestion, immunity, mental health, and metabolic health. 

Shapira said starches have so many benefits, but she says you’re better off getting them from food rather than rice water. 

“Eating rice as part of a balanced meal is beneficial,” she says. “So many people fear starches but we need these types of foods to be part of our diet to improve our immune function, heart, gut and brain health.” 

Shapira said starches that are resistant are essentially a dietary fiber. “Dietary fiber can improve our gut health in many ways, enhancing digestion and regulating bowels, insulin spikes, and blood sugar.” 

Potential health risks of Ricezempic  

That said, Ricezempic is not without potential health risks. In fact, Moskovitz said there are several risks involved with jumping on the Ricezempic bandwagon. 

“First, consuming anything uncooked or raw always leaves the possibility of food-borne illnesses, and rice is no exception,” she explained. “Second, rice is one of the leading sources of arsenic, and drinking rice-infused water can increase the concentration and exposure of this toxic heavy metal.” 

Moskovitz also said that replacing food with water means you’re reducing the amount of nutritious foods in your diet, which is never ideal.

Additionally, Shapira points out that drinking rice water can increase gas, bloating, and constipation if the rest of your diet isn’t balanced. 

The good news is that there are many ways to mimic the effects of Ricezempic in your diet without succumbing to this potentially dangerous trend.

“Eating a higher fiber and antioxidant-rich diet is the best way to boost gut health, promote more stable blood sugar levels, and make it easier to keep calories down and promote healthy, sustainable weight loss,” said Moskovitz.  

“You can also supplement with potato starch, which contains a significant amount of resistant starch, even more so than Ricezempic,” she added. 

Takeaway 

Ricezempic has been touted as an effective alternative to Ozempic, but it’s unlikely to mimic the effects of the drug.

It may slow digestion and improve gut health, but it’s unlikely to lead to significant weight loss, and it’s not the healthiest way to lose weight.

• Singer Lance Bass revealed that he has type 1.5 diabetes, also known as latent autoimmune diabetes in adults (LADA).
• This is a form of diabetes that develops in adulthood, generally over age 30, and slowly worsens over time, similar to type 2 diabetes.
• Unlike type 2 diabetes, LADA is an autoimmune disease, so it can’t be reversed with changes in diet and lifestyle.

Singer Lance Bass revealed in an Instagram reel that his recent diabetes journey comes with a twist.

“As all of you know, I was diagnosed with type 2 diabetes a few years back,” the singer said in a sponsored post for a continuous glucose monitor. “But when I was first diagnosed, I had a difficult time getting my glucose levels under control, even though I made adjustments to my diet, my medications and my workout routine.” 

“I recently discovered I was misdiagnosed,” he said. “I actually have Type 1.5, also known as LADA, or latent autoimmune diabetes in adults.”

Here’s what to know about this condition.

What is type 1.5 diabetes?

Type 1.5 diabetes, also called latent autoimmune diabetes in adults (LADA), is a form of diabetes that begins during adulthood and slowly worsens over time.

LADA has some similarities to type 2 diabetes — both develop gradually and are diagnosed when someone is an adult. 

As a result, LADA is often incorrectly diagnosed as type 2 diabetes. In fact, between 4% and 12% of people with type 2 diabetes may have LADA.

Unlike type 2 diabetes, though, LADA is an autoimmune disease, so it can’t be reversed with changes in diet and lifestyle — although these can help a person manage their disease.

LADA happens when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, which causes the pancreas to stop making insulin.

“[This] destruction of beta cells occurs very slowly over many years,” said Saleh Adi, MD, a pediatric endocrinologist and vice president of medical affairs at Willow Laboratories, developer of the Nutu app, which helps people prevent or delay the development of type 2 diabetes.

“This results in a gradual loss of insulin secretion and an increase in blood glucose levels,” he told Healthline. “Patients with LADA remain asymptomatic for years until there is significant loss of beta cells, or there is an increase in insulin resistance.”

This kind of damage to pancreatic beta cells also occurs in type 1 diabetes, a form of diabetes that begins in childhood or adolescence. Damage to the beta cells occurs more slowly in LADA than in type 1 diabetes.

LADA is also more genetically similar to type 1 diabetes than to type 2 diabetes. People who have a close family member with LADA, type 1 diabetes, or an autoimmune disease may have a higher risk of developing LADA.

“Many diabetes organizations, including the American Diabetes Association, consider LADA to be simply a sub-type of type 1 diabetes that develops very slowly due to some differences in the autoimmune processes that attack the beta cells,” said Adi.

What are the symptoms of type 1.5 diabetes?

People usually develop symptoms of LADA after the age of 30. Symptoms may be vague in the beginning. Some people have no symptoms at first.

As with all types of diabetes, the symptoms of LADA are related to high blood glucose, said Adi. They include:

• increased urination
• frequent thirst
• unexplained weight loss
• fatigue
• blurred vision
• tingling in the feet

Because damage to the pancreatic beta cells occurs slowly, people with LADA may not require insulin to help control their blood sugar (glucose) level in the first 6 months or more after diagnosis.

How is type 1.5 diabetes diagnosed?

Because LADA occurs later in life and often has mild symptoms without much weight loss, many patients are mistakenly diagnosed with type 2 diabetes and treated with oral medications, said Adi.

“However, their symptoms do not improve because what they really need is a replacement of insulin,” he said. “It is therefore critical to distinguish LADA from type 2 diabetes.”

He said certain clinical clues indicate a person may have LADA:

• They have another autoimmune condition or a close family member with an autoimmune condition.
• Their blood glucose level doesn’t improve even when taking medications for treating type 2 diabetes.
• They don’t have other signs of type 2 diabetes, such as being overweight or having obesity or having signs of insulin resistance.

The diagnosis of LADA is then confirmed by the presence of at least one pancreatic auto-antibody, Adi said, which provides evidence of beta cells being destroyed.

Another lab test which suggests that someone may have LADA instead of type 2 diabetes is a low level of C-peptide, he said. This is a surrogate for insulin levels in the blood.

How is type 1.5 diabetes treated?

There is currently no way to prevent LADA. 

As a result, “the most critical factor in improving the outcomes of patients with LADA is a correct diagnosis and prompt treatment with insulin,” said Adi.

Early treatment can prevent diabetes-related complications such as kidney disease, cardiovascular problems, eye disease, and nerve problems.

In the beginning, LADA may be managed with lifestyle changes such as maintaining a healthy weight, staying physically active, eating a healthy diet, and quitting smoking. These are also recommended for people with type 2 diabetes.

However, as the body slowly loses its ability to produce insulin, most people with LADA will eventually need to use insulin to control their blood sugar. Monitoring their blood glucose with frequent blood sugar testing will also be needed.

“Patients with LADA who finally start taking insulin describe a marked regain in their energy, physical and mental strength, and healthy weight gain,” said Adi.

Earlier treatment can help in other ways.

“Current evidence is that early initiation of insulin therapy can slow down beta cell loss,” said Adi, “making it easier to manage diabetes without a high risk of hypoglycemia.”

Takeaway

Singer Lance Bass announced that he was diagnosed with type 1.5 diabetes, or latent autoimmune diabetes in adults (LADA). This is a form of diabetes that usually develops after the age of 30 and slowly worsens over time.

Unlike type 2 diabetes, LADA is an autoimmune disease in which the immune system mistakenly attacks and destroys the cells in the pancreas that produce insulin. Type 1 diabetes is also an autoimmune form of diabetes, but it begins in childhood or adolescence.

There is currently no way to prevent LADA, but early diagnosis can ensure that people start appropriate treatment. This can prevent diabetes-related complications such as kidney disease and eye problems.

The most common treatment is insulin, which helps control blood sugar levels.

• Zepbound and Mounjaro have been on the Food and Drug Administration’s shortage list for months.
• Many people who rely on them to treat diabetes or help with weight loss have had trouble filling their prescriptions as a result. 
• In response, manufacturer Eli Lilly has ramped up production, and now, according to the FDA, they are available again.

Weight loss and diabetes GLP-1 drugs like Mounjaro, Zepbound, Wegovy, and Ozempic have flown off the shelves in recent years, outstripping manufacturing and leading to shortages. This has made it challenging for some people to get access to the drugs they need.

In fact, the diabetes medication Mounjaro has been on the Food and Drug Administration’s shortage list since late 2022, while Zepbound, a drug approved for weight loss, appeared on the list in April 2024.

To meet this growing demand, drugmaker Eli Lilly has bolstered their manufacturing to increase supply and make the drugs readily available again.

On August 1, Lilly CEO David Ricks said in an interview with Bloomberg that the shortage would end “very soon,” Reuters reported.

The next day, the Food and Drug Administration updated the status of Mounjaro and Zepbound in its drug shortage database to indicate they are available once more.

Shortages increased demand for compounded versions of GLP-1 drugs

 In 2023, Mounjaro drove more than $5 billion in sales, and in the first four months of 2024, doctors issued 63,000 Zepbound prescriptions weekly.

As supplies of these medications dwindled, some pharmacies began producing compounded versions to fill the gaps.

The FDA Food, Drug, and Cosmetic Act allows pharmacists to produce and sell compounded versions, making them a lifeline for those who need the medication. Due to the drug shortage, compounded versions of GLP-1 drugs have become a billion-dollar enterprise.

Britta Reierson, MD, a board certified family physician and obesity medicine specialist, explained that compounded drugs are “custom-made medications prepared by pharmacists to meet the specific needs of a patient.”

“Compounded versions of drugs are not regulated nor approved by the FDA,” Reierson told Healthline.

Mir Ali, MD, a board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, added that “as long as the source is reputable, this is a viable alternative.”

Still, consumers ought to perform their due diligence when considering compounded GLP-1 drugs.

A news release from Eli Lilly in June 2024 outlines some concerns surrounding compounded versions of tirzepatide (the active ingredient in Mounjaro and Zepbound), some of which contained bacteria: “Sterility is a critical safety concern, given that Mounjaro and Zepbound are administered via under-the-skin injection.”

They also write in the release that “in at least one instance, the product was nothing more than sugar alcohol.”

How shortages of GLP-1 drugs impacted people with diabetes

“The national shortage of Zepbound and Mounjaro undoubtedly impacts many people’s health and wellness,” HaVy Ngo-Hamilton, PharmD, a pharmacist and clinical consultant at BuzzRx, told Healthline.

“For a diabetic patient who takes Mounjaro for their blood sugar, not being able to obtain this medication can be detrimental, leading to kidney disease, nervous system issues, and vision problems,” she added.

Ngo-Hamilton explained the issue becomes exacerbated for people who take Mounjaro, as this drug is more frequently used by individuals who cannot tolerate metformin (the most common drug to treat type 2 diabetes) or who do not benefit sufficiently from it.

“Additionally, the uncertainty and stress of not being able to access essential medications has negatively affected their overall well-being and quality of life,” Reierson explained. “The shortage in medications has led to clinicians recommending different medications that may be easier to access, yet may not be as effective for an individual patient.”

Why GLP-1 drug shortages will likely continue

Despite the fact that Mounjaro and Zepbound are no longer in short supply, we may not have seen the end of these shortages.

“I think the shortages are likely to continue for the foreseeable future,” Ali told Healthline. “As long as obesity continues to be a big concern, the demand for these medications will remain high.”

Reierson agreed, explaining that “factors like increased demand, supply chain disruptions, and manufacturing challenges” are likely to continue causing supply challenges.

Ngo-Hamilton said she believes “we are better prepared to prevent shortages now that manufacturers have a clearer understanding of the product demand.”

She also noted that FDA-approved alternatives are now entering the market, easing the pressure on Eli Lilly.

Are too many people taking GLP-1 drugs like Zepbound and Mounjaro?

These medications have been a game-changer in treating obesity, as they can help people lose significant weight.

However, they are not a magic bullet, and many are worried that their popularity may be causing several issues.

“I have concerns about what I see as widespread and uninformed use of these medications,” Reireson said. “There continue to be mixed messages through social media and endorsements by celebrities that may lead people to seek these medications ‘off-label,’ even if not clinically indicated.”

“The soaring demand has led to shortages and manufacturing delays, resulting in a surge in compounded, counterfeit, and fake medications to hit the market,” Reireson continued. “This keeps me up at night, knowing that some people are at risk for serious complications.”

Ngo-Hamilton had similar thoughts: “My primary concern about the widespread use of these medications is the potential implications for patient safety.” 

“With increased marketing, influencer campaigns, patient testimonials, and wall-to-wall media coverage of celebrities experiencing weight loss success using these medications, it can be easy to overlook the potential risks and side effects.”  

The takeaway

After months on the FDA’s shortage list, Eli Lilly’s GLP-1 drugs Zepbound and Mounjaro are once more available.

This is good news, as many people who rely on these medications to treat diabetes or help with weight loss have had difficulty filling their prescriptions.

However, while the drugs are currently available, health experts say the growing demand for them could mean more shortages in the future.

• A study from the American Federation for Aging Research is looking into what contributes to people living until 95 and beyond.
• SuperAgers and their adult children are welcome to enroll in the study.
• 95-year-old Sally Froelich shares her journey as a SuperAger.

At 95 years old, Sally Froelich has a wealth of life experiences.

In 1950, she began working at Macy’s Department store in New York City and eventually landed a role at Bloomingdale’s, where she was hired to interview people during its morning breakfast offerings. Her interactions with customers led to the creation of “The Sally Froelich Show,” which aired for more than 20 years.

“The guests would talk to me, and the audience would ask questions. It was a lot of fun,” she told Healthline.

She recalls a series for the show called “The Vital Years,” in which she talked with different experts about the aging process.

“I was about 60 years old at the time, and it was really about people my age today — second marriages, exercise, different problems, grandchildren, etc.,” said Froelich.

Remembering the series strikes a chord with her as she is currently one of 600 people participating in the SuperAgers Family Study conducted by the American Federation for Aging Research.

The study aims to recruit 10,000 SuperAgers, who researchers define as people 95 and older who are in good physical and mental health.

The study also enrolls the SuperAgers’ adult children and the children’s spouses who do not have SuperAger parents.

“They are just as important as the SuperAgers because we need to draw comparisons in the frequency of the genes,” Sofiya Milman, MD, MS, national expert on aging and Director of Human Longevity Studies at Albert Einstein College of Medicine, told Healthline.

“The ultimate goal of the study is to help us understand what biology contributes to people living long and healthy lives, and specifically, we’re interested in what genes may play a role in contributing to people’s ability to stay disease-free as they get older.”

By identifying the genes that contribute to people’s longevity, Milman hopes that scientists will be able to develop medications and drugs that can mimic the role of genes that SuperAgers possess so that others who do not inherit those genes can also live longer, healthier lives.

She said older research has implicated genes as likely contributors to longevity, including genes that regulate HDL cholesterol and that control growth hormones.

Moreover, she said genes play a more prominent role than lifestyle in SuperAgers. She determined this by comparing the lifestyles of SuperAgers from previous studies to the lifestyles of people from their generation who did not become SuperAgers.

“We found that they had very similar lifestyles — they didn’t differ in smoking, tobacco or alcohol use, or in their diet, or exercise, so there were really no differences, and yet a small group achieved SuperAger status, and another group did not,” said Milman.

Lifestyle still matters for longevity despite your genes

While more Americans are living longer lives today than in past generations, Milman said only about 0.1% live to be 95 or older, most likely due to genetics.

For the other 99.9% of the population, she said lifestyle habits can help stave off age-related diseases like diabetes, heart disease, and cancer.

“The difference is that you can probably delay the onset of age-related diseases with a healthy lifestyle, although it’s unclear whether having a healthy lifestyle will get you to age 95 or 100,” said Milman.

One way to think about it is that 20 to 40% of longevity is due to your genes, which means 60 to 80% is what happens to you when you’re alive, said Rosanne Leipzig, MD, PhD, a geriatrician at Mount Sinai and author of Honest Aging: An Insiders Guide to the Second Half of Life.

Some of that comes down to lucky circumstances, she noted.

“You really don’t have a lot of control over the education you get, prenatal environment, your childhood nutrition, your access to medical care, whether you live in a polluted area — all which can contribute to health and longevity,” Leipzig told Healthline.

She points to the concept of “weathering,” which says that the health of African American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage.

When given access to healthy lifestyle choices, however, how you choose them can make a difference, Leipzig added.

“We have a lot of control,” she said. “Let’s just say you can certainly make sure you die early.”

How to live a longer, healthier life, according to a SuperAger

In addition to genetics, many lifestyle habits that have been touted for years can help keep you healthy. Froelich practices the following:  

• Eat a balanced diet. “I eat three meals a day. I don’t overeat,” she said.
• Don’t smoke or drink excessively. Smokers experience three times the risk of dying prematurely from heart disease or stroke than non-smokers. Additionally, a study found that adults who drink 7 to 14 drinks per week could expect, on average, a six-month shorter life expectancy as of age 40.
• Maintain a healthy weight. Froelich’s weight hasn’t changed in 50 years. “My body certainly has changed; I’ve gotten dumpier, but that’s part of life,” she said.
• Exercise regularly. Froelich played sports most of her life and continues to golf two to three times a week. She also exercises six days a week for 20 minutes by engaging in daily stretches and performing 80 sit-ups in bed when she wakes up. Three days a week, she lifts 8-pound weights with her arms and 5-pound weights with her legs.
• Use your brain. Froelich plays bridge once a week with friends and a few times a week online. She also listens to audiobooks and watches television in the morning and evenings.
• Stay socially connected. In May 2023, the U.S. Surgeon General issued a report stating that half of American adults are lonely and that loneliness poses severe risks to health and longevity. In addition to golfing, to stay connected to others, Froelich goes out to lunch and to dinner on a weekly basis. She also sees her children once a week and tries to visit with her grandchildren in person or via Zoom. “I find that if I’ve been hanging around the house a lot, I just go out and walk around the block,” she said.
• Find joy. Froelich feels lucky to be alive well into her 90s and she said it’s important to “do what you want to do and things that make you happy. Eat ice cream and delicious chocolate.”
• Take care of yourself. Rather than not caring how you look, Froelich said, “Keep your hair done, your nails done, and keep looking nice. And be sure you have somebody that will tell you if you have a spot on you or [if] anything is off.”
• Think about aging as a good thing. A person’s perception of aging influences what their aging will be like, however, not necessarily their longevity, said Leipzig. “There’s good work out there that suggests people with a positive perception of aging live about 7.5 more years and live better,” she said.

The bottom line

Living to be a SuperAger may not be in everyone’s genes, but Milman said as people age, disability and disease are not a given.

“There are many people who remain healthy and independent and have a good quality of life as they get older, so we shouldn’t conflate aging always with disease and disability,” she said.

SuperAgers give her hope for discovering “the secret” to aging well.

“We hope this research will help us all live longer…even if we are not that 0.1 percent of the population who inherit genes,” she said.

Visit the organization’s website to enroll in the SuperAgers Family Study.

• People who use aspirin regularly have a lower risk of colorectal cancer compared to those who don’t use aspirin regularly, a new study shows.
• The benefits were greatest for people with an unhealthy lifestyle, such as moderate or heavy smokers, and those with overweight or obesity.
• People with the healthiest lifestyle — whether or not they used aspirin regularly — had a lower risk of colorectal cancer compared to people with the unhealthiest lifestyle who used aspirin.

In the United States, an estimated 152,810 people will be diagnosed with colorectal cancer in 2024, with more than 53,000 deaths this year due to this cancer, according to the National Cancer Institute.

While rates of colorectal cancer in the country declined by about 1% each year from 2011 to 2019, this has been mostly in older adults, the American Cancer Society (ACS) reports. In contrast, ACS said rates among people under 55 years old have increased by 1% to 2% since the mid-1990s.

Genetics plays a role in the development of colorectal cancer. For example, people whose parent, sibling or child had colorectal cancer are at an increased risk.

However, lifestyle factors can also increase a person’s risk of colorectal cancer, including having overweight or obesity, having type 2 diabetes, eating an unhealthy diet, smoking tobacco, and drinking alcohol.

Now researchers from Massachusetts General Hospital and Harvard Medical School have found that regular aspirin use may lower colorectal cancer risk in people with unhealthy lifestyles.

The study was published Aug. 1 in JAMA Oncology.

Mixed evidence on the anticancer effects of aspirin

Previous research showed that regular aspirin use can lower the risk of colorectal cancer.

In 2016, the US Preventive Services Task Force (USPSTF) recommended low dose aspirin for colorectal cancer prevention in adults ages 50 to 59.

However, in 2022, the USPSTF withdrew its recommendation, citing a lack of evidence showing that aspirin reduces a person’s chance of developing or dying from colorectal cancer.

Long-term use of aspirin can also cause gastrointestinal bleeding, ulcers and other complications.

Given that some earlier research showed that aspirin reduced the risk of colorectal cancer, the authors of the new study decided to look at whether this benefit was higher for people with certain lifestyle factors.

For the study, they examined data from more than 107,000 people who participated in the Nurses’ Health Study or the Health Professionals Follow-up Study. 

The average age of participants was 49 years. They were all health professionals, and most were white. Additional research would be needed in more diverse populations to see if the results would be the same.

Researchers followed participants for more than three decades. During this time, participants completed surveys about five lifestyle factors: body mass index (BMI), whether they smoked tobacco or used alcohol, and their physical activity and diet. 

Participants also reported on their use of aspirin or other medications and whether they developed any diseases during the study period, including colorectal cancer. 

Researchers defined regular aspirin use as two or more standard-dose tablets per week or six or more low-dose tablets per week.

Aspirin lowers colon cancer risk for adults with unhealthy lifestyles

Overall, the risk of developing colorectal cancer over a 10-year period was 1.98% among participants who used aspirin regularly, compared with 2.95% for people who didn’t use aspirin regularly.

When comparing these two groups, researchers found that regular users of aspirin had an 18% lower relative risk of being diagnosed with colorectal cancer, compared with people who didn’t use aspirin or used it less often.

Participants with unhealthier lifestyles benefitted the most from regular aspirin use in terms of lowering their relative risk of colorectal cancer. The greatest benefits occurred for moderate or heavy smokers and people with a BMI of 25 or greater.

BMI is a screening measure for having overweight or obesity. Generally, a healthy weight for adults 20 years and older is a BMI of 18.5 to less than 25. However, BMI is not always reliable during pregnancy or for athletes or older adults.

The study also showed that people with healthier lifestyles benefitted from regular aspirin use, but less so. 

It also reinforces the overall benefits of a healthy lifestyle. People with the healthiest lifestyle — whether or not they used aspirin regularly — had a lower 10-year risk of colorectal cancer compared to regular aspirin users with the unhealthiest lifestyle.

The study does not show how regular aspirin use might help. Still, the authors point to previous research suggesting that aspirin may inhibit pro-inflammatory signals contributing to cancer growth.

Given the risks of long-term use of aspirin — such as gastrointestinal bleeding — the authors write that “these results support the use of lifestyle risk factors to identify individuals who may have a more favorable risk-benefit profile for cancer prevention with aspirin.”

A growing need for personalized medicine

Wael Harb, MD, a hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, CA, said the new study’s results might prompt the US Preventive Services Task Force to reconsider the regular use of aspirin for the prevention of colorectal cancer. Harb wasn’t involved in the study.

However, Jason Zell, DO, MPH, a hematology-oncology specialist at the UCI Health Chao Family Comprehensive Cancer Center and associate professor at the UCI School of Medicine, questions whether the study is strong enough to change the USPSTF recommendations. Zell was likewise not involved in the study.

This was not a randomized controlled trial (RCT) that compared people who took aspirin to those who didn’t. “As such, this level of evidence is insufficient to change USPSTF recommendations,” he said.

In addition, “the USPSTF withdrew its recommendations for aspirin use — which was limited to a very small portion of the population anyway — in part due to complications such as bleeding,” Zell said.

The new study did not provide data on how many people taking aspirin regularly had bleeding or other complications, he said. This information could influence the assessment of the risks and benefits of regular aspirin use in people with unhealthy lifestyles.

Overall, “while this level of evidence is not enough to change physician recommendations about aspirin, it certainly could spawn more detailed future research,” Zell said, such as that “related to the benefits and risks of regular aspirin use in those with varying degrees of healthy or unhealthy lifestyles.”

Harb thinks the study, which implies that aspirin’s preventive benefits may vary based on individual lifestyle factors, “could lead to more personalized recommendations from physicians.”

Anton Bilchik, MD, PhD, surgical oncologist, chief of medicine and director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in Santa Monica, CA, agreed. Bilchik wasn’t involved in the study.

“This study shows that taking two regular aspirins a week reduces the risk of getting colon cancer,” he said. “It also identifies groups of patients — particularly those that are obese or smokers — who are more likely to benefit from aspirin.”

Ask you doctor about daily aspirin use

Bilchik emphasizes that patients who are concerned about their risk of colorectal cancer should talk with their doctor before starting to take aspirin regularly.

“Although aspirin is a very safe drug, there is group of patients that may be at higher risk of gastrointestinal bleeding,” he said. “It’s not a common side effect of aspirin, but no one should routinely take two large aspirins a week without consulting their doctor.”

When they do, they should also ask about other ways to reduce their cancer risk.

“This study adds to the growing body of evidence on the importance of diet and lifestyle modifications in preventing colorectal cancer,” Zell said.

These kinds of lifestyle changes can reduce your risk of other types of cancer, cardiovascular disease, and other health problems, pointed out Harb, which is why doctors always recommend that patients reduce these risk factors.

However, “in reality, even with our best efforts, some of these factors might not be modifiable, or people might not be able to change them,” he said.

“So in the interim, while we’re trying to change this behavior, it’s reasonable to consider regular aspirin use as way to reduce the risk of colorectal cancer, he said.

Takeaway

Researchers examined data from more than 107,000 health professionals who took part in two long-term studies. Participants answered surveys about lifestyle factors and use of aspirin or other medications.

People who used aspirin regularly had a lower risk of being diagnosed with colorectal cancer, compared with people who didn’t use aspirin regularly. 

The largest benefit of aspirin was for people with the unhealthiest lifestyle, including moderate and heavy smokers, and people who had overweight or obesity.

People with the healthiest lifestyle — whether or not they used aspirin regularly — had a lower risk of colorectal cancer compared to people with the unhealthiest lifestyle who used aspirin regularly.

• A new study investigates trends in 34 types of cancer in the United States.
• For 17 cancer types, Generation X and Millennials have a higher risk than previous generations.
• Similarly, for five cancer types, mortality risk is also higher in younger generations.
• Many factors may be involved, but obesity likely plays a substantial role.

A new study published August 1 in The Lancet Public Health takes an in-depth look at cancer rates in the United States. The scientists measured incidence rates of cancer and cancer mortality in different generations.

They found that 17 cancer types were more common in recent generations, noting the incidence rate for some forms was 2–3 times higher in people born in 1990 than in 1955.

While the causes for these increases require more research, the authors cite obesity, diet, and environmental toxins as major contributing factors.

Higher cancer rates in younger generations

In a previous study published in 2019 by the same authors, they found the incidence of eight types of cancer increased in younger generations compared with older generations.

However, no study has looked at both cancer incidence — the number of new cases — and cancer mortality by birth year. The latest study plugs this gap.

As the authors explain, trends in cancer incidence in people aged 50 or younger mostly reflect an increased exposure to carcinogenic factors in early life or young adulthood.

So, they “foreshadow future disease burden as these young cohorts carry their increased risk into older age, when cancers most frequently occur.”

Increases in cancer incidence and mortality

To investigate, the scientists used information from 23,654,000 people diagnosed with 34 types of cancer and 7,348,137 deaths from 25 cancers from 2000–2019.

They found an increased incidence in 17 of the 34 cancers in progressively younger generations:

• cardia gastric: a type of stomach cancer
• small intestine
• estrogen receptor-positive breast
• ovary
• liver and intrahepatic bile duct (in females)
• non-HPV-associated oral and pharynx (in females)
• anus (in males)
• Kaposi sarcoma (in males): a form of cancer that starts in the lining of blood and lymph vessels
• colorectal cancer
• endometrial cancer
• gallbladder and other biliary
• kidney and renal pelvis
• pancreas
• myeloma: a blood cancer
• non-cardia gastric: another type of stomach cancer
• testis
• leukemia: a blood cancer

The increase in incidence was particularly pronounced in cancers of the small intestine, thyroid, kidney and renal pelvis, and pancreas. Compared with people born in 1955, the incidence in those born in 1990 was two- to three-fold greater.

Also, in five cancer types, mortality rates also increased:

• liver and intrahepatic bile duct in females
• endometrial cancer
• gallbladder and other biliary
• testicular
• colorectal cancers

“These findings are sobering as they indicate the increased cancer risk in younger generations is not merely an artifact due to more frequent cancer detection and diagnosis,” explained study author Hyuna Sung, PhD.

“Instead, it points to a genuine increase in cancer risk at the population level, with the increase in incidence being substantial enough to outweigh improvements in cancer survival,” Sung told Healthline.

Why the sharp increase in cancer rates?

While this study was not designed to explain why these cancers increased, the researchers explain that obesity likely plays a substantial role.

10 of the 17 cancers listed in the study are associated with obesity. The authors explain that, since the 1970s, obesity has increased in all age groups, but the swiftest increase has been in younger people, aged 2–19 years.

This is backed up by other research demonstrating that excess weight and obesity at a younger age are associated with an increased risk of 18 forms of cancer.

According to the new paper, beyond overweight and obesity, other factors may also play a role, such as an increase in sedentary lifestyles, altered sleep patterns, and chemicals in the environment. However, much less is known about the importance of these factors.

How diet and the gut microbiome may affect cancer rates

The so-called Western diet, which is high in saturated fats, sugar, refined grains, and ultra-processed foods, is linked to increased cancer risk. 

“Emerging evidence suggests that ultra-processed food increases body weight but is also independently associated with the risk of some cancers, such as breast and colorectal,” Sung said.

Because some cancers affecting the digestive system are not related directly to obesity, the authors suggest that changes in the gut microbiome may also be a factor.

With the two-pronged rise of the Western diet and antibiotic use, the gut microbiome has been severely impacted.

Although scientists do not fully understand the role of gut bacteria in cancer, the authors write that specific microbes and dietary patterns have now been linked to oral and gastrointestinal tract cancers.

How is epigenetics related to cancer?

Jennifer Dunphy, MD, doctor of public Health and co-founder of the Wellness Innovation Network told Healthline she was particularly interested in the potential role of epigenetics on health.

“Epigenetic changes are changes to the expression of proteins from DNA, without changes to the DNA itself — usually as a result of environmental factors,” she explained. In other words, when an individual passes on their genes to their offspring, they also pass on certain changes to how these genes are expressed — how easily they are turned “on” or “off.”

“It seems that epigenetic changes are a large part of the equation here, meaning your DNA isn’t the only thing that matters — your behavior today is probably going to impact your offspring through heritable changes, just like the behavior and exposures of your parents and even your grandparents impact your health today,” Dunphy said.

This adds a fresh and rather bleak twist to the findings.

“While there are many harmful exposures we can and should prevent against,” Dunphy continued. “I do not think that, on average, we are doing all of this extensive damage to our bodies in one lifetime alone, I think we are carrying over vulnerabilities from our predecessors.”  

Exposure to toxins may affect cancer rates

The authors suggest that certain environmental toxins may play a role in increasing cancer rates.

“The most harmful environmental toxin thought to contribute to carcinogenesis is the use of plastics and their breakdown products,” Walter Kim, MD, an integrative medicine physician with Brio-Medical, told Healthline. Kim was not involved in the study.

Dazhi Liu, PharmD, an oncology clinical pharmacy specialist and medical contributor for Drugwatch, not involved in the study, suggested other potential candidates, including:

• aflatoxins
• benzene
• soot
• arsenic
• aristolochic acids
• nickel compounds
• radon
• thorium
• trichloroethylene
• vinyl chloride
• wood dust

Rates of some forms of cancer are declining

Despite the concerning implications of increasing cancer rates in younger generations, Sung noted a few silver linings.

“The accelerated downturn in the trend of cervical cancer incidence shows the effectiveness of HPV vaccination among women born around 1990, who were about 16 years old when HPV vaccination was first approved in the United States,” she said.

Sung added the recent decline in cancers of the lung, larynx, and esophagus was driven by the drop in smoking rates.

Mortality rates are also declining for many cancer types, even those with increased rates. This, the scientists believe, is likely due to early detection due to better screening, advances in treatment, or both.

“The five-year survival rate for pancreatic cancer in young adults increased significantly from 16.5% in 2000 to 37.2% in 2016,” Liu told Healthline. 

Sean Devlin, MD, chief medical officer for Brio-Medical, not involved in the study, told Healthline the silver lining is awareness.

“Further work and funding for earlier screening should be instituted in an effort to catch these diseases in a timely manner so that they can be adequately treated with the tools that we have,” Devlin said.

Takeaway

The incidence rate of 17 cancers and the mortality rate of five cancers is higher in Gen Xers and Millennials than in older generations, a new study reported. These increases are probably due to overweight, obesity, the Western diet, changes in the gut microbiome, and environmental toxins.