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• An alarming new report reveals racial disparities in unnecessary C-section rates in New Jersey hospitals.
• The data show that Black women are 25% more likely to undergo a C-section than white women.
• The researchers suggest that implicit racial bias among providers may play a role in this rate and that there may be a “financial incentive” in some hospitals to fill operating rooms.
• Many factors may be responsible, experts say, and more research is needed to determine whether this disproportionate rate carries over to other states.

As racism within the healthcare system persists, a large new study reveals startling disparities in unscheduled C-sections among Black women.

A National Bureau of Economic Research (NBER) report of nearly 1 million births at 68 hospitals in New Jersey found that Black women are 25% more likely to undergo unnecessary C-sections compared to white women. 

While more research is needed to determine whether these disparities are found in other states, the data point to the potential for implicit racial bias occurring in hospital delivery rooms at a provider’s discretion. 

“The findings from the new study are alarming — it is concerning that these disparities exist and are so stark,” said Mark Simon, MD, chief medical officer at Ob Hospitalist Group (OBHG).

“The CDC has released data that clearly highlights national differences in C-section rates across each state, with New Jersey ranking on the high end. But this problem is not unique to New Jersey — disparities in maternal mortality, particularly along racial and socioeconomic lines, are also well-documented,” Simon told Healthline. Simon wasn’t affiliated with the research.

Why do Black women have higher rates of C-sections?

Cesarean delivery (C-section) rates have been increasing in the United States in recent years.

Many C-sections are scheduled in advance, leaving experts concerned about whether these are medically necessary.

Planned and unplanned C-sections account for roughly 1 in 3 births in the U.S., well above the 10–15% target rate recommended by the World Health Organization (WHO).

As the new research suggests, these figures include a disproportionate number of Black women. The causes for this disparity, however, is less clear.

NBER researchers suggest that more unscheduled C-sections may be occurring in Black women due to doctors who are “exercising their discretion and are more likely to conduct unnecessary C-sections on Black mothers.” 

They cite in their report previous research showing that Black women are more likely to feel “pressure from a clinician to take medication to start or speed up labor and to have a C-section.”

“I do think this points to implicit bias,” Simon said. “It’s crucial that healthcare workers receive training on implicit bias to help recognize and reduce disparities in patient care. Additionally, we know a diverse clinical workforce leads to improved outcomes for Black patients. When health systems prioritize equitable outcomes for maternal patients, everyone benefits,” Simon said.  

What are the risks of C-sections?

Cesarean deliveries, whether planned or unplanned, carry risks for both the birthing person and their baby. In emergency situations, however, C-sections can be lifesaving.

C-section deliveries can raise the risk of bleeding, blood clots, infection, and injury to other organs, Simon noted. “Additionally, they pose increased risks for future pregnancies, including conditions like abnormal placentation,” he added.

As NBER researchers note, Black women tend to have worse health outcomes overall than white women. However, experts point out there are underlying factors to consider that may affect the health outcomes of Black women following C-sections.

“If Black women undergo more cesarean deliveries, their exposure to associated risk increases,” Simon said. “These risks are compounded by the fact that Black women already experience higher rates of pregnancy complications and are more likely to have underlying chronic health conditions.”

Kecia Gaither, MD, MPH, double board certified OB-GYN and maternal fetal medicine specialist and director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, agreed that comorbidities often influence C-section outcomes. Gaither wasn’t involved in the new report.

“Is there a high concentration of obesity,  hypertension,  diabetes, substance abuse, [or] HIV?” Gaither questioned.  “[It’s a] difficult question to answer.” 

Multifactorial issues, such as racism, bias, poor attention to the clinical status of postoperative Black women, or the quality of the health facility, could all impact health outcomes following a C-section delivery, Gaither said.

The long-term risks of C-section delivery are not fully understood, but research has shown that short-term effects of Cesarean delivery may include:

• altered immune development
• increased risk of allergy, atopy, and asthma
• reduced intestinal gut microbiome diversity

“Cesarean sections are not benign procedures — the risk of hemorrhage, damage to the internal organs, [and] infection run high for the mother,” Gaither said. 

“Babies born via cesarean may have breathing issues. Babies swim in amniotic fluid, this fluid fills the lungs. With a vaginal birth, this fluid is ‘squeezed out’ as the baby transits the birth canal. With an operative delivery, this lung fluid isn’t expressed, and it takes a while for that process to occur. As such, the baby breathes rapidly in an attempt to clear this fluid from its lungs,” she explained.

Is there a financial incentive to perform C-sections?

NBER researchers suggest there may be a financial incentive for healthcare providers to perform C-sections, thus pushing more Black women into the OR for the procedure.

“I don’t believe labor and delivery units prioritize keeping their operating rooms constantly occupied,” Simon said. “In my experience, labor and delivery staff do everything in their power to keep at least one OR open in case there is an emergency.” 

Gaither was also cautious to ascribe to this theory. “I think there are many factors to consider when looking at the picture,” she said.

“Is there a high preponderance of early prenatal care [and] pre-conceptual counseling, or are patients showing up late in gestation, effectively ‘crashing and burning’ with some disease process that might have had a better outcome if caught in earlier stages?” Gaither pointed out.

“Is there a high utilization of reproductive technologies contributing to the population served? Reproductive technologies contribute to multiples (twins, triplets, quadruplets, etc.). These higher-order pregnancies increase the Cesarean section rate,” she noted.

When looking at C-section rates within hospitals, Gaither said the following factors should be considered:

• Does the population being served have insurance?
• Is the population serviced in a rural or urban setting?
• What is the mindset of the physicians servicing the population? Are they likely to perform an operative delivery so they can make a social engagement in time?
• What is the financial status of the hospital/hospitals involved?
• What impact does the environment play in the health of the populace?
• What role do bias and racism play?

Takeaway

A concerning new report shows that unnecessary C-sections are 25% more common in Black women compared to white women.

The researchers suggest that implicit racial bias could play a role, and there may be a “financial incentive” to fill operating rooms.

Experts say the reasons for this alarming disparity are multifactorial. More research is needed to determine whether the high number of C-section rates persist in other states.

• Lemme, the supplement brand founded by Kourtney Kardashian Barker, is releasing an “all-natural” weight loss supplement called Lemme GLP-1 Daily.
• In spite of the name, the product is not a GLP-1 receptor agonist like Ozempic or Wegovy.
• The product contains natural ingredients such as Eriomin lemon fruit extract, Supresa saffron extract and Morosil red orange fruit extract.

Lemme, the supplement brand founded by Kourtney Kardashian Barker, announced that it is releasing a supplement called Lemme GLP-1 Daily aimed at providing consumers with an “all-natural” way to manage their weight.

In spite of its name, however, the product does not contain a synthetic GLP-1 hormone and is not a GLP-1 receptor agonist like Ozempic or Wegovy.

Ozempic and other GLP-1 drugs mimic the actions of the hormone GLP-1 by activating its receptor, which leads to weight loss and lower blood sugar, among other benefits.

Lemme GLP-1 Daily instead contains natural ingredients such as Eriomin lemon fruit extract, Supresa saffron extract and Morosil red orange fruit extract. 

The product is meant to “boost the body’s GLP-1 levels, reduce hunger, promote insulin sensitivity and support healthy weight management,” according to a company press release.

The daily capsules will be available for purchase on the brand’s website beginning September 16 and will be sold via a subscription model at $72 for a month’s supply or $90 as a one-time purchase.

But how effective is the product for weight loss? Here’s what to know about the potential benefits of the natural ingredients in Lemme GLP-1 Daily.

Lemon fruit extract

Small clinical trials of Eriomin lemon fruit extract found that this compound didn’t help people lose weight, but it may offer other benefits.

A small study of people with prediabetes and type 2 diabetes who took Eriomin for 12 weeks showed that there was no effect on body weight, body mass index (BMI), lean mass, fat mass or waist-to-hip ratio.

However, those who took Eriomin saw on average a 5% decrease in their blood glucose and a 17% increase in the hormone GLP-1, compared to those who took a non-acting placebo.

Another small 12-week study of people with prediabetes also found that Eriomin had no impact on weight. But there was a 22% increase in blood levels of GLP-1, and an increase in beneficial bacteria in the gut.

Bacteria in the gut can influence your weight by affecting how food is digested, how fat is stored, and whether you feel full or hungry. 

Eating a wide variety of high fiber foods such as whole grains, fruits, vegetables, nuts, and seeds — and limiting intake of added sugars and highly processed foods — can also support healthy gut bacteria.

Saffron extract

An 8-week study of 60 women with overweight found that those who took a saffron extract had decreased snacking, compared to those who took a placebo.

GLP-1 drugs work, in part, by reducing appetite and feelings of hunger, which can help people manage their weight.

However, studies of saffron extract have not shown a large effect on weight when the compound is used alone.

A meta-analysis of 25 earlier studies looking at the benefits of saffron extract found that people with obesity who took this compound saw decreases in their waist-to-hip ratio.

There were also decreases in weight, BMI, waist circumference, and hip circumference. However, these changes were not statistically significant, which means saffron extract may not offer any additional benefits compared to a placebo.

Two other studies, including a review paper of previous studies and a small clinical trial in people with type 2 diabetes, also found that saffron extract didn’t help people lose weight.

Other studies have examined the benefits of saffron extract for people with diabetes, such as improving blood glucose control and cholesterol levels. Some of these studies were done alongside other supplements like cinnamon and ginger or in conjunction with aerobic or resistance exercise.

Red orange fruit extract

The clearest weight loss benefits are seen with Morosil red orange fruit extract.

A six-month study found that people who were living with overweight lost an average of 4.2% of their body weight while taking Morosil, compared to 2.2% in people who took a placebo. The Morosil group also saw larger decreases in hip and waist circumference, fat mass, and fat distribution.

In contrast, one study found that people who took semaglutide — the active ingredient in Ozempic and Wegovy — lost 15.8% of their body weight over 68 weeks.

Are supplements useful for weight loss?

Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif., has concerns about how supplements used for weight loss are sometimes promoted. 

“GLP-1 medications stimulate hormones in the body and have the same effect as those hormones. So when people claim supplements do the same thing, I think that’s a bit deceptive,” he told Healthline.

And while “for some people, a natural, herbal supplement can be effective, there’s no convincing evidence that the supplement is going to have a significant effect on weight loss.”

Libu Varughese, MBBS, an endocrinology physician and medical advisor of Aeroflow Diabetes, told Healthline that he would like to see more scientific evidence before recommending the use of natural GLP-1 supplements.

However, if you do choose to use a dietary supplement, do so with caution, he said, and watch for any negative side effects.

The Food and Drug Administration has information for consumers on safely using dietary supplements.

Amy Lee, MD, head of nutrition for Nucific, suggests that people who want to lose weight naturally, think of supplements as just one component of a weight management program.

People also need to make “behavioral changes that result in decreased caloric intake and increased energy expenditure through movement and exercise,” she told Healthline.

Ali said certain diets have been shown in clinical trials to support weight loss, including ones that involve eating fewer carbohydrates, such as the keto diet and paleo diet.

“These diets are based on minimizing carbohydrate intake to direct the body toward burning fat,” Ali said. “That’s natural. There are no medications involved. No supplements. It’s just eating the right things to promote the burning of fat.”

These kinds of diets are even helpful for people who have had bariatric surgery or are taking a GLP-1 medication, he said, “because if you’re not eating the right things, you won’t see as much results.”

Takeaway

Lemme, the supplement brand founded by Kourtney Kardashian Barker, is releasing a supplement called Lemme GLP-1 Daily to provide consumers with an “all-natural” way to manage their weight.

In spite of its name, the product does not contain a synthetic GLP-1 hormone, and it is not a GLP-1 receptor agonist like Ozempic or Wegovy.

GLP-1 drugs mimic the actions of the GLP-1 hormone to lower blood glucose and promote weight loss.

Lemme GLP-1 Daily contains natural ingredients such as Eriomin lemon fruit extract, Supresa saffron extract and Morosil red orange fruit extract. Clinical studies show that these compounds may promote modest weight loss, decrease hunger and appetite, or boost the body’s GLP-1 levels.

• James Earl Jones, known for roles in Field of Dreams, The Lion King, and Star Wars, died at the age of 93.
• Jones was diagnosed with type 2 diabetes in his mid-60s, a condition he continued to manage in his later years.
• Although known for his deep, commanding voice, Jones overcame a severe stutter, which he had through much of his early life.

James Earl Jones — known for his roles in The Lion King and Field of Dreams, and as the voice of Darth Vader in the Star Wars franchise — has died. He was 93. A cause of death was not immediately released.

Jones, who developed type 2 diabetes later in life, overcame a severe stutter in childhood to become an award-winning actor known for his deep, commanding voice.

Jones was diagnosed with type 2 Diabetes in his 60s

In a 2016 interview on the Rachael Ray Show, Jones revealed that he was diagnosed with type 2 diabetes in the mid-1990s while attending a diet and exercise center.

At the time, he was in his 60s, an age at which many older adults are frequently diagnosed with this condition.

“Diabetes and other age-related diseases like obesity and abnormal cholesterol are more prevalent as we get older,” said Noa Tal, MD, an endocrinologist of the Pituitary Disorders Center at Pacific Neuroscience Institute in Santa Monica, Calif.

Jones told Ray in the interview that his condition was discovered by accident.

“I fell asleep on a bench in the middle of the gymnasium one day,” Jones explained. “And a doctor who was there said, ‘That’s not normal,’ and he encouraged me to go get checked out.”

A laboratory test revealed that Jones had type 2 diabetes.

This kind of delayed diagnosis is not uncommon.

“Unfortunately, [type 2 diabetes] does go under the radar sometimes,” said Tal.

In 2021, 38.1 million American adults had diabetes, according to the Centers for Disease Control and Prevention. More than one-fifth of these people had undiagnosed diabetes.

The rate of diagnosed diabetes is highest among American Indian or Alaska Native adults, followed by Black adults, Hispanic adults, and Asian adults, CDC data shows. White adults have the lowest rate of diabetes.

Regular screening, such as during routine doctor’s appointments, can catch diabetes early.

She recommends that everyone ask their primary care physician to screen them for diabetes at age 40 or age 35 if they have other health conditions such as high blood pressure.

“Depending on a person’s ethnicity or any [other health conditions] a patient has, screening can be either yearly or every three years,” Tal said.

How Jones learned to manage living with type 2 diabetes

Jones told Healthline’s Diabetes Mine in a 2016 interview that, after his diagnosis, there were “tough changes, like not having my favorite strawberry shortcake.” 

Depending on the severity of the diabetes, some people may be able to control their blood glucose level with changes in lifestyle, said Tal, such as healthy diet and regular physical exercise.

Others may need an oral or injectable medication like metformin, Ozempic or insulin, she said.

Jones had a doctor who suggested he try Invokana. This medication works by eliminating excess glucose through the urine.

“I’ve found that [Invokana] was very helpful in balancing my blood sugar,” he told Diabetes Mine.

Diabetes can sometimes be a lot for patients to manage. In addition to the treatment burden and needing to take care of yourself, there is also an increased risk of complications due to diabetes, especially when it is uncontrolled.

These complications may include heart disease, stroke, kidney disease, nerve damage and foot ulcers.

“When diabetes is not well controlled, it can impact the entire patient,” said Tal. “It affects basically any system in the body.”

How a strong support system can help a person manage type 2 diabetes

One thing that Jones learned by managing his diabetes is that “it comes down to being in tune with your body, and I’m sure the body tells us things long before we’re aware of what’s happening,” he told Diabetes Mine. “Since then, it’s become my job to be more aware of what my body is telling me.”

He also said his wife and son helped him stay “in line” with his healthy eating. “[My son] would count the cookies in the kitchen, and he could smell it on my breath if I snuck some,” he told Diabetes Mine. “They’ve both helped keep me in line.”

“I realized when I was diagnosed with diabetes, my whole family became diabetics,” he explained. “Not that they suffer the same things that I do, but they understand, and we have to work as a family in living with diabetes. They became my support group, as well as my doctors.”

Tal said a strong support system can help people with diabetes successfully manage their condition.

“If I have patients with diabetes who have some issues with memory or if their treatment regimen is complex, I always ask if there is any family support or other social support,” she said.

How Jones overcame a severe stutter

Although Jones is well-known for his voice work, he revealed in a 1986 interview that a severe stutter largely kept him from talking throughout much of his early life.

“I was mute from first grade through freshman year in high school,” he said, “Mute because I just gave up on talking.”

Jones explained to Charlie Rose in 1993 that he learned to speak clearly through reading his own poetry and the poetry of others, even before he had become an actor.

It was his high school English teacher, Donald Crouch, who helped Jones find a way to express himself verbally.

“Donald said, ‘Jim, this poem is so good I don’t believe you wrote it.’ Accused me of plagiarism. ‘And the only way you can prove it is to get up in front of the class and recite it from memory,’” Jones recalled in the interview. When he stood up and recited the poem word for word, they were both shocked, he said.

Jones went on to work in the film industry and on stage for many years.

In spite of that, his stutter “is always there,” he told Rose. “It’s there right now.”

“Stutterers often seem like they are ponderous and deep thinkers,” he went on to explain. “We’re not. We’re simply looking for the word we can say without tripping on it.”

Throughout his career, he continued to struggle with alliteration, and would go through scripts and ask screenwriters to take out any, such as multiple words in a row beginning with vowels, he told Rose.

In the 1986 interview, when asked if he minds talking about his stutter, Jones said he doesn’t. 

“It’s just another example of, you find yourself with a weak muscle and you exercise it. And sometimes that becomes your strong muscle,” he said. 

Takeaway

James Earl Jones, known for his roles in The Lion King, Field of Dreams, and as the voice of Darth Vader in Star Wars, died at the age of 93. No cause of death was immediately given.

The actor revealed in a 2016 interview that he was diagnosed with type 2 diabetes in the mid-1990s, after he fell asleep in the middle of the day at a diet and exercise center. His family and doctors helped him manage this condition throughout his later years.

As a child and teenager, Jones had a stutter severe enough to keep him from speaking from first grade through freshman year of high school. He credited a high school English teacher for helping him overcome his stutter by encouraging him to read his own poetry out loud.

• New research offers an alternative to daily insulin shots for the 8 million people in the United States with type 2 diabetes.
• Eli Lilly’s once-weekly insulin injection is just as effective as daily insulin shots for managing A1C levels in diabetes, according to the latest results from two phase 3 clinical trials.
• Experts say a weekly injection could make life easier for people who administer insulin on a daily basis.

The race between drug manufacturers Novo Nordisk and Eli Lilly to develop a once-weekly insulin shot continues.

On September 5, officials at Eli Lilly announced the latest results of two phase 3 clinical trials — QWINT-1 and QWINT-3 — involving a new insulin injection that would allow people with type 2 diabetes to take insulin once a week instead of daily. These results have not yet been published yet in a peer-reviewed journal.

Still, the new data builds on prior results released in May about the effectiveness of the company’s once-weekly shot during the QWINT-2 and QWINT-4 clinical trials. Those results were published in the New England Journal of Medicine, Lilly announced on Tuesday. They’re are also being presented at the European Association for the Study of Diabetes (EASD) Annual Meeting 2024 this week in Spain.

During the phase 3 trials, scientists studied the effectiveness of Lilly’s once-weekly insulin efsitora alfa (efsitora) in adults with type 2 diabetes taking insulin for the first time. They compared their progress with people who require daily insulin injections.

Eli Lilly officials said their product was effective in controlling A1C levels in all four clinical trials.

“Once weekly insulins, like efsitora, have the potential to transform diabetes care as we know it,” said Jeff Emmick, MD, senior vice president of product development at Eli Lilly, in statement last week.

“Many patients are reluctant to start insulin because of the burden it places on them. With a simple fixed-dose regimen, once-weekly efsitora could make it easier for people with diabetes to start and manage insulin therapy, while reducing the impact it has on their day-to-day lives,” Emmick continued.

How effective is Lilly’s once-weekly insulin shot?

The goal of both the QWINT-1 and QWINT-3 studies were to show equal efficacy to the currently approved insulin products. In the QWINT-1 phase 3 clinical trial, 796 participants were randomly selected to receive either the weekly efsitora injection or a daily injection of insulin glargine for 52 weeks.

At the end of the trial period, researchers reported that A1C levels on average were reduced by 1.31% in the efsitora cohort compared to 1.27% in the insulin glargine group. People taking efsitora ended the study with an average A1C level of 6.92% compared to an average of 6.96% for those taking insulin glargine.

In the QWINT-3 clinical trial, 986 participants have been randomly selected to receive either the weekly efsitora injection or a daily injection of insulin degludec.

At the 26-week mark of this 78-week trial, researchers reported that participants using efsitora had an average reduction of 0.86% in their A1C levels compared to 0.75% for the insulin degludec cohort.

People taking efsitora had an average A1C level of 6.93% at 26 weeks compared to 7.03% for the degludec group.

“Based on all the available information about the new once weekly insulin, the results consistently show the similar degree of reduction in hemoglobin A1C level to the currently available insulins and even in patients who were new to insulin, without increasing in risk of severe hypoglycemia, defined as blood glucose less than 54 mg/dl,” Marina Basina, MD, a clinical professor of endocrinology, gerontology, and metabolism at Stanford University, told Healthline.

Once-weekly injection could improve diabetes management

Noa Tal, MD, an endocrinologist at the Pituitary Disorders Center at the Pacific Neuroscience Institute in California, said the clinical trials offer hope for people with type 2 diabetes.

“The QWINT studies represent a significant advancement in diabetes management, particularly with the development of a weekly insulin injection,” Tal told Healthline. “This long-acting formulation could help address adherence issues associated with daily insulin regimens, offering a more convenient option for patients.”

Tal added that more than 8 million people in the United States with type 2 diabetes need insulin therapy, so a new weekly injection could make a major difference.

“A product like this weekly injection could have a profound impact,” Tal said.

“It could simplify diabetes management for those struggling with compliance or who are currently not using insulin due to the burden of daily injections. By reducing the frequency of injections, this weekly insulin might enhance patient adherence, improve overall glucose control, and potentially lead to better long-term health outcomes,” she noted.

Basina agreed with the importance of the clinical trials. “The more tools we have available in the treatment of diabetes, the better it is,” she said. 

Basina noted an important advantage of a once-weekly shot of long-acting insulin could benefit people also taking GLP-1 receptor agonists once a week, streamlining the frequency of their injections or making travel easier.

“Another important point is that in patients who have been on insulin for a prolonged period of time and developed scar tissue from long-term insulin injections, it will allow less frequent insulin injections and sparing some of the injection sites,” Basina added.

Are there disadvantages to once-weekly shots?

Lilly competitor Novo Nordisk is also in the process of developing a weekly insulin injection.

However, a Food and Drug Administration (FDA) advisory panel stated in May that it appears the benefits of the company’s insulin icodec lack sufficient clinical data and do not clearly outweigh the risks of the product, which may cause low blood sugar.

Novo Nordisk officials have said they are evaluating the FDA panel’s decision.

Basina cautioned that once-weekly insulin injections may not be convenient for everyone.

“It does not provide flexibility for patients who have variable day-to-day schedules with being more physically active on some days than other day. This insulin might increase the risk of low blood sugars on more physically active days,” she noted.

“There is also a concern for patients who may need urgent surgical procedure for which we usually recommend taking half of the long-acting insulin dose on the night before the procedure which will be not possible with weekly insulin administration,” Basina added.

Health risks of type 2 diabetes

Type 2 diabetes is a chronic medical condition that causes a build-up of glucose, also known as blood sugar, in the bloodstream. This happens because a person’s body can’t react to insulin effectively or doesn’t produce enough of it.

About 38 million people in the United States have diabetes. More than 90% of them have the type 2 variety.

About 25% of people with type 2 diabetes need to take insulin. That requires them to administer injections every day, much like people with type 1 diabetes.

Symptoms of type 2 diabetes include:

• constant hunger
• excessive thirst
• lack of energy
• frequent urination
• blurry vision

Symptoms can become more severe as the disease progresses.

Type 2 diabetes that is not properly managed can lead to serious complications, such as:

• cardiovascular disease
• nerve damage
• poor circulation
• eye damage
• hearing impairment

People who don’t need insulin for type 2 diabetes can manage and sometimes reverse their condition with a healthy diet and regular exercise. Maintaining a healthy weight is considered one of the most important ways to avoid or manage type 2 diabetes.

For people who don’t need insulin, medications such as metformin can be prescribed to help manage their condition.

Why is insulin important?

Insulin is a hormone created by the pancreas that helps move glucose from a person’s bloodstream to their cells. The body then uses the insulin in the cells for energy.

Insulin also helps store glucose in the liver and helps control how the body metabolizes carbohydrates, proteins, and fats.

Insulin helps keep blood sugars in a healthy range and ensures a person’s body is provided with sufficient energy.

The most common results of insulin insufficiency are type 1 diabetes and type 2 diabetes.

They are several different types of insulin therapy available. They are:

• rapid acting
• short acting
• intermediate acting
• long acting

Medical professionals prescribe an insulin treatment that works best for a particular individual. Sometimes a combination therapy involving insulin injections and non-insulin oral medications are used.

Tal said people with diabetes need to be vigilant in managing their condition.

“For individuals with prediabetes or type 2 diabetes, focusing on lifestyle changes is essential,” Tal said. This includes:

• maintaining a healthy diet
• exercising regularly
• monitoring blood glucose levels

“Early intervention and adherence to prescribed medications are also critical for effective management of the condition. Staying informed about new treatment options and discussing them with healthcare providers can help in making well-informed decisions regarding disease management,” Tal continued.

“Regular check-ups and personalized care plans tailored to individual needs contribute to better overall management and improved health outcomes. For patients using insulin, it is particularly important to be aware of hypoglycemic symptoms and to have strategies in place to prevent and address them,” she concluded.

Basina had similar advice: “Healthy lifestyle, diet, and exercise are all extremely important for prediabetes individuals to prevent conversion into clinical insulin,” she said. “For individuals with type 2 diabetes, take care of diabetes from the start. It is easier to prevent the complications than treat them if they develop.”

Takeaway

Eli Lilly says phase 3 clinical trials indicate that its new weekly insulin injections were as effective as daily injections in managing A1C levels in people with type 2 diabetes.

About 8 million people in the United States with type 2 diabetes need to take insulin on a regular basis.

Experts say a weekly injection could make managing the disease easier for people with the condition and improve their overall quality of life.

On the roof of a UK Health Security Agency (UKHSA) lab, at Chilton’s Harwell Science Campus in Oxfordshire, a new chapter in artificial intelligence (AI) and pollen monitoring is unfolding. In this blog post we’ll explore how our team of Toxicologists are working to better understand and monitor what we’re breathing in and how this may impact our health.

• TikTok’s viral “blackout challenge” (also known as the “choking challenge) is responsible for at least one death this year.
• The challenge encourages viewers to asphyxiate themselves until they lose consciousness.
• Asphyxiation is incredibly dangerous and can lead to permanent brain damage and death in less than five minutes.

Following the death of her son, a mom is warning others about the “blackout challenge” (also known as the “choking challenge”), a dangerous viral TikTok trend.

In an editorial for Huffpost, Joann Bogard describes the tragedy of losing her son Mason in 2019. Like other kids his age, he’d shown an interest in social media “challenges.” Challenge videos encourage social media users to copy an activity from social media and then perform it themselves, posting the video for all to see. Many can be relatively innocuous, but some are far more dangerous.

The “blackout challenge,” which encourages individuals to asphyxiate themselves to the point of losing consciousness, falls into the latter. It is extremely dangerous. Mason lost his life after attempting the challenge and accidentally choking himself to death. Now Bogard is helping other parents to become better educated about social media and online trends.

“What worries me most today is that what happened to Mason and our family can happen to anyone — and has happened to others. Families are desperately seeking answers on how to protect their children online,” she wrote for Huffpost.

What is the “blackout challenge?”

The “blackout challenge,” or “choking challenge,” is an online challenge proliferated through social media apps such as TikTok that encourages viewers to asphyxiate themselves until they lose consciousness. The loss of consciousness is believed to be associated with a “high” or feeling of euphoria. Challenge videos may be particularly appealing to teens and adolescents.

Unlike other dangerous trends that have come and gone over the years, such as the Tide pod challenge, variations of challenges related to asphyxiation tend to crop up every couple of years.

“This is a trend that seems to come of age with each progressive generation,” said Mary Beth Howard, MD, MSC, a Pediatric Emergency Medicine Physician at Johns Hopkins Children’s Center.

“It’s very dangerous to begin with, and the other issue at hand is that we have social media and these very powerful algorithms that are propagating these very dangerous behaviors,” she said.

Benjamin Morse, BA, a Visiting Lecturer in New Media and social media expert at the University of Nevada, Las Vegas, told Healthline, “These trends take off, and they accelerate at such a speed that something tragic can happen before a parent is even aware of what their kids are watching.”

The dangers of asphyxiation

Asphyxiation is extremely dangerous and can quickly lead to brain damage and death. There is also the added risk that an individual may take part in the “blackout challenge” by themself, without any form of supervision, greatly increasing the danger.

“When you deprive the brain of oxygen and you go unconscious, that’s it, you’re not able to stop the event,” said Marla Levine, MD, an Associate Professor of Clinical Pediatrics and Director of Emergency Medicine at Vanderbilt University Medical Center.

“You have a brief period of time where you can then reestablish blood supply or oxygen to your brain to prevent cerebral death,” she said.

Asphyxiation leads to a condition known as cerebral hypoxia, literally depriving the brain of oxygen.

The brain can be deprived of oxygen with as little as 4.4 pounds of pressure and can cause loss of consciousness in just ten seconds. When hypoxia begins, permanent brain damage can occur within just four minutes. Brain death can occur within five minutes of hypoxia.

“We’re not talking about a long period of time here,” said Levine.

There are also no hard rules for how asphyxiation may affect one individual to the next.

“Everyone’s response to these challenges is variable. So someone could pass out within seconds, someone may take closer to a minute,” said Howard. That variability makes the challenge even more dangerous since an individual may lose consciousness much faster than they anticipate.

Other dangers from asphyxiation include:

• Damaging the larynx, tissue, and blood vessels of the neck.
• Heart attack and cardiac arrest
• Aspiration (vomit in the airways)

If an individual is asphyxiating and has lost consciousness, immediately contact emergency services such as 911.

How to talk with adolescents about social media trends

Speaking to a child about social media and dangerous online challenges may not be easy, but prevention should be a top priority for all parents.

How parents, companies, and lawmakers monitor and regulate social media can be a thorny issue. While some advocate for greater responsibility and censorship from social media companies themselves, Morse recommends a more pragmatic approach.

“Waiting for the platforms to do the work is not going to happen,” he said.

Instead, he recommends parents actively engage with the platforms and apps that their children are using and set appropriate boundaries.

“If your kids are on TikTok, you need to be on TikTok. I know that’s not a fun answer for parents, but you need to understand what your kids are doing,” he told Healthline.

“It’s so incredibly important that parents are vigilant in having conversations with their children and vigilant about what they’re consuming in social media,” said Levine.

The bottom line

A dangerous social media trend known as the “choking challenge,” which encourages viewers to asphyxiate themselves until they lose consciousness, has resulted in at least one death.

Asphyxiation can result in brain damage and death in as little as four minutes.

Parents are encouraged to have open and informed conversations with their children about social media to help set safe boundaries.

• A new study has found that taking semaglutide (Ozempic) was linked with less severe COVID-19.
• People were also less likely to die from any cause while using this drug.
• Semaglutide does not appear to directly affect COVID-19, however.
• Experts say the accompanying weight loss helps make you healthier in general.
• Even with semaglutide, you still need to take precautions like vaccines and masking.

According to a study published online on August 30, 2024, in the Journal of the American College of Cardiology, people using 2.4-milligram semaglutide were less likely to have severe cases of COVID-19 when using this drug.

They were also less likely to die from any cause, cardiovascular or otherwise.

The study authors further noted that the reduced rate of non-cardiovascular deaths was mainly due to fewer people dying from infections.

Semaglutide is available under the brand names Ozempic for type 2 diabetes and Wegovy for weight loss.

However, while Wegovy is available in the 2.4-milligram dose, Ozempic tops out at 2 milligrams.

How semaglutide use may affect COVID-19 risks

The authors state that people with overweight and obesity are at greater risk for dying, both from cardiovascular disease and other causes.

Their goal was to see if semaglutide might help prevent these deaths, looking at both cardiovascular deaths and deaths from other causes, including deaths from COVID-19.

The researchers randomly selected over 17,000 individuals to participate.

Participants were ages 45 and up with a body mass index (BMI) that established them as living with either overweight or obesity.

The study participants also had been diagnosed with cardiovascular disease but not diabetes.

Over a period of 3.3 years, these people received weekly injections of either semaglutide or a placebo.

During this time, any deaths that occurred were recorded based on the cause of death.

They found that 833 people died during the course of the study, with 58% of these being related to cardiovascular disease, while the remainder were due to other causes.

After analyzing the data, the researchers reached the conclusion that there were fewer deaths from any cause in the group that was treated with semaglutide.

Another salient finding was that, while semaglutide did not reduce the rates of COVID-19, those who contracted the virus had fewer adverse events related to the disease.

How semaglutide might help reduce COVID-19 severity

Dr. Ramit Singh Sambyal, a General Physician associated with ClinicSpots who was not involved in the study, said that GLP-1 receptor agonists, like semaglutide, were originally designed to treat diabetes.

However, they can improve overall metabolic health by making it easier for people to lose weight, he said.

“When we think about this in the context of COVID-19, there’s a fascinating link: obesity is a known risk factor for severe outcomes from the virus,” Sambyal explained. “So, anything that helps reduce obesity-related issues might also lower the risks if you get infected.”

Sambyal went on to explain that obesity isn’t just about added weight.

“[I]t also put a lot of stress on the body, including chronic inflammation, which makes it harder for your immune system to fight off infections like COVID-19,” he said.

Losing weight with semaglutide allows your body to function better, said Sambyal.

“Blood pressure drops, blood sugar becomes easier to control, and inflammation decreases,” he said. “This makes you healthier overall and less vulnerable to severe complications if you contract COVID-19.”

Sambyal additionally emphasized that drugs like semaglutide do not appear to have any direct effect on the COVID-19 virus, although ongoing research is investigating whether GLP-1 drugs could impact it.

“So, while they can make you healthier and possibly less likely to suffer severe outcomes, they’re not a miracle cure for COVID-19,” he concluded.

Why you should still take precautions against COVID-19

Dr. Michael Lahey, a physician with My Weight Loss Partner, added to Sambyal’s thoughts by noting that while drugs like Ozempic and Wegovy can aid with treating obesity and obesity-related diseases, they do not free you from taking precautions against COVID-19.

“These drugs are intended for controlling certain illnesses and must be regarded only as useful adjuncts to a particular disease control program,” he explained.

If you have obesity or accompanying diseases that put you at higher risk for COVID-19 complications — such as cancer, chronic kidney, liver, lung, or heart disease; diabetes; or a compromised immune system — you still need to follow measures such as vaccination, physical distancing, and masking to protect yourself, according to Lahey.

“These medications, when taken, truly lower the risk of severe COVID-19, but they do not eliminate the need for every preventive measure,” he stated.

Sambyal added that it’s important to think of these drugs as “a piece of a bigger puzzle.”

“Yes, they can help reduce your risk by improving your overall health, but they don’t prevent the virus from infecting you,” he said.

Vaccines help train your immune system to fight off the virus. Taking additional precautions can help keep you from getting the virus in the first place, said Sambyal.

Takeaway

A new study has found that people using semaglutide experienced less severe cases of COVID-19.

Additionally, they were less likely to die from any cause during the study.

Experts say this is because weight loss makes you healthier overall, reducing your risk for COVID-19 complications.

Even if you are using drugs like Ozempic or Wegovy, you still need to take precautions against COVID-19 — such as vaccinations, physical distancing, and masking — to reduce your risk.

• Brian May, guitarist for the rock band Queen, revealed he recently experienced a minor stroke.
• Although he is now recovering and in good health, he briefly lost the ability to use his left hand, leaving him unable to play guitar.
• A stroke, no matter the severity, is always a medical emergency. Individuals should know the warning signs of a stroke and seek medical attention.

Brian May, guitarist for the legendary rock group Queen, revealed this week that he experienced a “minor stroke.” 

In a video posted on his personal Instagram account, May explained that the incident required medical attention and briefly left him unable to use his left arm. Fortunately, the rocker is back in good health and, importantly, playing guitar again.

“Good news is that I can play guitar after the events of the last few days and I say this because it was in some doubt,” he said in the video. 

“All of a sudden, out of the blue, I didn’t have any control over this arm,” May recounted.

The incident is an important reminder that strokes can vary drastically in severity and presentation of symptoms. But don’t let the term “minor stroke” mislead you: strokes are a serious medical issue. Even minor strokes, if left untreated, can lead to serious health outcomes and death.

Here’s what you need to know.

What is a minor stroke?

A stroke refers to when areas of the brain are not receiving blood flow, which can result in damage to brain tissue. A minor stroke is a non-scientific term that a doctor may use to describe the general severity of a stroke. However, the term doesn’t make specific reference to the type (ischemic or hemorrhagic) or etiology (cause) of the stroke.

“There’s no specific definition of minor stroke. A minor stroke for one person might be much more significant for somebody else. Presumably, the way it’s being used here is that it’s a stroke that hasn’t led to significant or lasting neurologic deficits,” Neil Schwartz, MD, PhD, a Clinical Professor of Neurology at Stanford Medicine, told Healthline.

A minor stroke shouldn’t be confused with a transient ischemic attack (TIA), which is often described as a “ministroke” or “warning stroke.” A TIA causes stroke-like symptoms, such as limb weakness and drooping face, but resolves on its own without damage to the brain. It is called a “warning stroke” because it may be an early sign of a stroke.

“The difference between a TIA and a minor stroke is that with a TIA, the symptoms go away, and the person recovers before there’s any actual injury to the brain. In other words, the lack of blood flow that is contributing to the problem resolves before there’s any permanent damage to the brain,” Mitchell Elkind, MD, MS, the Chief Clinical Science Officer of the American Heart Association, told Healthline.

“A minor stroke, conversely, is when there may actually be a permanent injury to a small part of the brain, leaving a little scar, but the person’s brain reorganizes, and they’re able to recover from it very quickly,” added Elkind.

Recognizing signs of a stroke

Both TIA and stroke are serious medical conditions. A TIA may resolve on its own, but because it manifests with similar symptoms to a stroke, there is no way of knowing the severity without seeking medical attention. 

A minor stroke may also become a major one without treatment. So, if you are experiencing symptoms of a stroke, always seek aid.

Brian May’s experience of a sudden lack of control over his left arm is one of the classic symptoms of a stroke.

“We often just see one side of the body or the other affected,” said Schwartz. “We typically see a loss of function, such as weakness or numbness, and facial droop. Those are kind of the classic stroke symptoms,” he added.

The hallmark stroke warning signs can be identified through the acronym FAST:

• Face: Part of the face is drooping or numb. The individual may not be able to smile or may have an uneven smile.
• Arm: An arm is weak, numb, or lacking coordination. The individual may not be able to raise their arm, or it may drift downward.
• Speech: An individual has difficulty speaking or slurred speech.
• Time: A stroke is a medical emergency. If any of these symptoms are present, call 911 immediately. Note the time that the symptoms first appeared.

Other symptoms of stroke include:

• Confusion
• Difficulty walking
• Severe headache
• Numbness
• Trouble seeing

Elkind points out that, unlike a heart attack, individuals experiencing a stroke may not experience any pain. 

“Strokes often don’t cause any pain. So, people sometimes get misled because they think of a heart attack and think they should have pain. The brain doesn’t have any sensation itself, so it doesn’t feel pain, it just stops functioning,” he said.

What to do after a minor stroke

What a doctor prescribes for a patient following a stroke will differ based on the severity of the stroke, as well as other health and lifestyle factors.

Brian May says that his doctors “grounded” him, advising him to stay off of airplanes, avoid driving, and keep his heart rate down. However, this advice isn’t generalizable to everyone who has experienced a stroke. Instead, patients should work with their doctors to develop a personalized recovery plan.

Following a stroke, a doctor will order a diagnostic workup, likely including a brain MRI, to determine the cause and extent of the stroke. Depending on the findings, they may prescribe drugs, such as anticoagulants.

A patient’s specific lifestyle and health factors are also key to recovery. During recovery, a doctor will want to address stroke comorbidities such as diabetes, cholesterol, and blood pressure. 

Patients may also need to modify lifestyle factors, including diet, exercise, and smoking following a stroke.

“Depending on what the doctors think the specific cause is, they may make specific recommendations about rest, additional testing, or even surgery to the neck,” said Elkind.

The bottom line

Brian May, the guitarist for legendary rock group Queen, recently experienced what his doctors described as a “minor stroke.”

During the incident, May lost the ability to use his left hand. He now appears to be in good health and has regained the use of his hand. 

The severity of a stroke may vary from person to person, but individuals are always urged to know the signs of a stroke and to seek medical attention.

• Many Americans turn to social media for sleep advice.
• A survey from the American Academy of Sleep Medicine found that more than 30% of Americans have tried one of this year’s viral sleep trends.
• Experts share the ins and outs of these sleep trends and what you can do to get better sleep.

The battle to get good sleep seems constant. So much so that many Americans turn to social media for advice on the latest sleep trends.

According to a 2024 survey from the American Academy of Sleep Medicine (AASM), 37% of Americans have tried at least one of this year’s trending sleep practices, with 55% of Gen Z survey respondents leading the way.

“I try not to discourage people from feeling active and empowered through the use of online resources to find community, ideas for solutions, and better understanding of their lived experience,” Dr. Anne Marie Morse, Geisinger sleep medicine physician and spokesperson for the American Academy of Sleep Medicine, told Healthline.

“Unfortunately, like with a dress, makeup, or your name, it may look glorious on someone else, but it may not fit just right on you.”

Sleep experts break down the implications of top sleep hacks trending on social media.

Bed rotting

“Bed rotting” refers to staying in bed for extended periods of time to boost rest, often to the point of neglecting responsibilities and social interactions, with the hopes of improving restoration. According to the AASM survey, this has been adopted by nearly a quarter (24%) of Gen Z.

“While spending time in bed can be beneficial for rest and recovery, too much time spent in bed can have negative effects on mental and physical health,” said Morse.

While she encourages the occasional relaxation and restoration efforts, she said protracted periods of time spent lying in bed for any other reason than sleep or sex may jeopardize the health of your sleep, and with that, your medical and mental health could be at risk too.

Sound like an overreaction? Morse said it’s not.

“Your mind can be conditioned to associate things that aren’t meant to be together. So, if you retreat to your bed to ‘rot’ away your anxiety, bad day, recent breakup, or other daily challenge, lying in bed can start to make you revisit these negative emotions and lead to difficulties falling and staying asleep,” she said.

Spending a lot of awake time in bed makes people associate the bed with being awake, “making the bed less of a ‘protected’ place for good quality sleep,” Jade Wu, PhD, sleep medicine psychologist and Sleep Advisor at Mattress Firm, told Healthline.

In extreme cases, and for those who may have other medical risk factors, prolonged inactivity from lying in bed can lead to issues like muscle atrophy, decreased cardiovascular fitness, and increased risk of obesity, added Morse.

Sedentariness generally doesn’t make people feel better and can have a negative impact on mood, sleep, and metabolic health, said Wu.

“Sometimes when we’ve been over-doing it, it can help to give ourselves a chance to rest, though generally, I would reserve that for situations where you’ve truly been doing intensive exercise, working overtime, or going through something extraordinarily taxing,” she said. “I wouldn’t make a general habit of it just for the sake of avoiding starting the day.”

Try this instead: if you’re overwhelmed with work or life, rather than staying in bed for prolonged periods of time to refresh, Wu suggested finding a quiet change of scene in nature, practicing mindful meditation or yoga, or reading a book.

Drinking a magnesium “sleepy girl mocktail”

Nearly 9% of survey respondents have tried drinking magnesium to help with sleep. The “sleepy girl mocktail” trending on social media is made of a half-cup of pure tart cherry juice, a tablespoon of magnesium powder, and sparkling water.

Drinking magnesium or taking magnesium supplements is generally safe when done within recommended guidelines, said Morse. Magnesium is a mineral that is important for multiple body functions, especially neurologic functioning, which affects sleep.

However, research on the impact of magnesium supplements on sleep has not yielded consistent results, but some data shows higher dosing may improve sleep quality.

“The limitations of the research are typically related to the type of magnesium studied and small groups of participants, which raises questions on the ability to apply this information,” said Morse.

For instance, a 2023 systematic literature review made a connection to magnesium status and sleep quality in observational studies and a small study from 2012 reported that people who took a daily dose of 500 mg of magnesium for eight weeks indicated that they had fewer subjective insomnia symptoms than people who received the placebo.

However, large-scale randomized control trials have not shown a specific correlation between supplementing with magnesium and improvements in sleep quality.

Morse said that if you’re going to try magnesium to enhance sleep, take note that magnesium formulations are used medically for stomach issues like constipation, indigestion, and heartburn and can cause loose stools or diarrhea.

Try this instead: Talk with your doctor about magnesium before trying it or about other supplements or medications that may be more effective and tailored to your sleep issues.

Sleeping in 90-minute increments

Of those who took the AASM survey, 9% said they tested the effectiveness of sleeping in 90-minute increments.

The idea of sleeping in 90-minute increments is based on the concept of the sleep cycle, which lasts about 90 to 120 minutes for adults and 50-to-60-minute cycles during early childhood.

Each night, the brain goes through multiple sleep cycles, each lasting 90 to 120 minutes, and the cycles consist of different stages of sleep: REM (Rapid Eye Movement) and non-REM (NREM) sleep, explained Morse.

“Unfortunately, the idea misses out on the fact that each cycle can vary,” said Morse. “While the 90-minute increment idea can be attractive to some who are trying to get a better handle on achieving their best night’s sleep, it will likely miss the mark. When you prioritize a full night of restful sleep, you’re more likely to feel refreshed and energized, regardless of whether you wake up at the end of a specific cycle.”

For those trying to take a daytime nap, Wu said to aim for around 30 minutes and avoid going over one hour because longer naps can negatively impact nighttime sleep. Also, there is evidence linking longer napping to higher risks for heart disease in the long run.

“If you are sleeping at night, there is no reason to purposefully interrupt sleep at the 90-minute mark,” said Wu.

Extraordinary circumstances are an exception, like a soldier on a mission, an ultramarathoner who is running for 24-plus hours, or someone experiencing jet lag.

“Then it’s okay to nap for any amount of time that is needed to catch up on sleep that the body needs, including a 90-minute nap if that’s what’s feasible,” said Wu. “But there is nothing special about 90-minute cycles that warrants trying to sleep in these increments.”

Try this instead: Instead of sleeping in 90-minute increments, Morse recommended focusing on getting into a regular sleep schedule and shooting for seven to nine hours of sleep a night, which is likely to bring a higher return on investment.

Helpful sleep habits to consider

While there are many attractive sleep “hacks” on social media, they are enticing because they don’t require a lot of effort. “But if good sleep health were as simple as taking a supplement or staying in bed all day, we wouldn’t have so many millions of people with sleep problems in the U.S.,” said Wu.

If you’re at a loss for ways to get better quality sleep, consider the following strategies:

• Don’t force anything related to sleep. Instead, Morse said to uncover what is causing the resistance. “The challenge here is that there are over 70 types of sleep disorders, plus innumerable medical and psychiatric disorders that can contribute to difficulties sleeping,” she said. “Forcing someone to be in bed can actually worsen these issues.”
• Getting lots of bright light exposure during the day, ideally by being physically active outdoors can help boost sleep quality.
• Set a consistent sleep schedule. Going to bed and waking up at the same time, or within an hour of that time, every day helps regulate your body’s internal clock, making it easier to fall asleep and wake up naturally.
• Practice good sleep hygiene. Try to create a relaxing bedtime routine by making your bedroom quiet, keeping the room at a comfortable, cool temperature, and limiting exposure to bright light in the evenings, said Morse.
• Discuss hacks you’re interested in with your doctor. Sharing solutions you find online with your doctor is a good first step. “Sometimes what we find is that the solution you want to discuss actually helps you and your [doctor] uncover what the real problem is. And, now they are able to tailor treatment to your specific situation,” said Morse.

• GLP-1 drugs mimic hormones that help people block food noise and tune into hunger cues.
• When people cease the use of these medications, they may experience extreme hunger.
• There are ways to manage this hunger, including focusing on specific types of foods and deprioritizing others, exercise, and other lifestyle modifications.

While drugs like Ozempic, Wegovy, and Zepbound can help people lose significant weight, individuals who stop using the medications often regain many of the pounds they shed. It’s a phenomenon commonly referred to as Ozempic rebound.

In fact, one clinical trial extension from 2022 indicated that people who ceased 2.4 mg weekly doses of semaglutide (Wegovy) regained about two-thirds of their weight within one year.

One reason people often quickly regain weight is that extreme hunger and food noise blunted by the GLP-1 drugs can return and, in many cases, feel more intense. 

“GLP-1 medications suppress the appetite,” says Dr. Mir Ali, a board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center. “However, when stopped, the appetite returns and there is likely some dysregulation in the appetite hormones, so the appetite can come back even stronger.”

While these medications are designed for long-term use, access, costs, and side effects may not make that possible for everyone.

However, health experts who specialize in treating obesity say that the following seven tips can help people manage extreme hunger after they stop taking GLP-1 drugs like Ozempic and maintain the weight they’ve lost.

Portion control

Balance is important.

“The plate method divides your plate into three categories,” says Dr. Michael L. Glickman, a triple board certified family and obesity medicine physician who founded Revolution Medicine. 

Glickman says these categories are:

• Non-starchy vegetables: Half of the plate and ideally consumed first
• Protein: One-quarter of the plate
• Carbohydrates: One-quarter of the plate

Some products — and even your own body – can serve as a portion guide.

“There is dinnerware available that can help regulate portions,” Ali says. “Your hands are also a rough guide to portions.”

What fits in the palm of your hand is often an approximate portion size, Ali says.

Ali says you can ask for half of a portion or box half of a meal before eating when dining out.

Eat foods that make you feel full longer

A 2015 review indicated that foods high in fiber and protein were satisfying.

Dr. Christopher McGowan, who is triple board certified in internal medicine, obesity medicine, and gastroenterology, says these foods should be a priority, especially after ceasing the use of a GLP-1 drug.

“GLP-1 medications work by curbing appetite through the brain and slowing stomach emptying, leading to prolonged fullness,” says McGowan, who is also the co-founder of True You Weight Loss. “After stopping a GLP-1 medication, the stomach will rapidly return to its baseline emptying rate, meaning you will feel less satisfied after meals. This sudden feeling of rapid emptying and reduced satiety can be counteracted by focusing on satiating, slow-to-digest foods.”

Additionally, Glickman notes that fiber can help regulate blood sugar, helping to suppress appetite and keep insulin levels in check.

McGowan suggests foods like:

• Lean meats
• Beans
• Legumes
• Grains
• Vegetables

Avoid highly processed, high-sugar foods foods

The quality of food also matters. 

“Avoid foods high in sugar and carbohydrates that cause spikes in insulin,” Glickman says. “Elevated insulin thwarts weight loss and can cause a ‘crash,’ prompting the search for more food high in sugar and carbs.”

Think ahead

Processed foods often have longer shelf lives, fewer storage requirements, and are generally more convenient.

Glickman says having nourishing, satisfying foods, like ready-to-eat fruits and veggies, within reach can counteract the desire to opt for highly processed, sugary foods when you’re hungry.

“Keep the fridge stocked with well-rounded meals — investing, at times, in premade meals through a delivery service,” Glickman says. “Ideally, this helps reduce grazing/snacking in between meals and on the aforementioned processed foods.”

A 2017 study suggested that people who engaged in meal planning had improved diet variety and quality and body weight.

Eat slowly and mindfully

Making time for meals — and eating with intention — might also help with satisfaction.

“Eat mindfully with awareness and intention,” Ali says. “Savor the texture, smell, and taste of food. This may allow your body to be satisfied with less food.”

Mindful eating also slows down the process of food consumption, which could be to a person’s benefit.

“Often, people continue to eat beyond when they are full because they have not allowed enough time for the receptors in the stomach to signal the brain that it is full,” Ali says. “Eating slowly gives time to sense your stomach is full.”

Exercise 

Diet and exercise are two lifestyle pillars of weight management. The two might be intertwined, too. 

“Exercise sends natural signals that may counteract extreme hunger,” Ali says. “The goal with exercise is being consistent.”

Ali recommends shooting for 30 minutes of physical activity daily, five days a week. That puts people at 150 minutes per week.

The American Heart Association recommends 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week. McGowan agrees that exercise is essential and adds that resistance training is also beneficial, which the AHA suggests doing at least twice weekly.

Research from 2023 indicated that people who exercised regularly had better appetite sensitivity, which could assist with long-term caloric intake. 

A 2022 animal study that involved putting mice on treadmills suggested that strenuous exercise could reduce hunger, at least for a couple of hours post-workout. 

Find support

While lifestyle modifications and self-help might assist people in managing extreme hunger, you might need or want more support. 

“Working with a professional, registered dietitian, including weight monitoring, can be critical,” says Dr. Seth Kipnis, the medical director of bariatric and robotic surgery at Hackensack Meridian Jersey Shore University Medical Center.

Additionally, Kipnis notes that the National Institutes of Health website has a wealth of information related to weight management people might find useful. He also notes that it’s important to keep in touch with your medical team to rule out any other underlying conditions that might be contributing to extreme hunger (and following treatment plans for any conditions you have).

Takeaway

When people stop taking GLP-1 medications like Wegovy, Ozempic, and Zepbound, they often experience feelings of extreme hunger, which can be challenging to manage and can contribute to weight gain.

However, health experts say there are strategies that can help reduce extreme hunger and maintain weight after quitting a GLP-1 drug.

These include regular exercise, portion control, and eating in a slow, intentional manner.