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• Revered actor and former politician Arnold Schwarzenegger shares his passion for physical activity.
• Schwarzenegger is spreading awareness about how regular movement can help with mobility issues.
• The “Terminator” legend recently launched the You’ll Be Back initiative, which allows fans to meet him.

Arnold Schwarzenegger is known for his successful bodybuilding career, his service as Governor of California, and his starring roles in action-packed films like “The Terminator” franchise, “Predator,” and “Total Recall.”

His next move? Earlier this year, Schwarzenegger and the medical technology company Zimmer Biomet announced the launch of “You’ll Be Back.”

The campaign invites people living with limited mobility due to hip, knee, shoulder, or other joint pain to share their stories for an opportunity to meet the illustrious actor and be featured in a motivational docuseries, which will launch later this year.

Members of the You’ll Be Back online community will have access to resources and a “Find a Doctor” tool to connect with local physicians and explore whether joint replacement is right for them.

“It’s important to take joint pain — either hip, knee, or shoulder — seriously because it decreases the quality of life of millions of people,” Schwarzenegger, who joined Zimmer Biomet in 2024 as its Chief Movement Officer, told Healthline.

In the United States, about 53 million adults live with arthritis. Additionally, approximately 1.71 billion people across the world live with musculoskeletal conditions, including:

• low back pain
• neck pain
• fractures and other injuries
• osteoarthritis
• amputation
• rheumatoid arthritis

When people are in pain, they tend to move less, said Leslie Bottrell, MD, a sports medicine physician at Northwell Lenox Hill Hospital. When a known injury causes pain, taking caution with movement is important until a doctor can determine what is causing the pain.

However, pain doesn’t always mean there is a physical injury, she told Healthline.

“Pain is managed by memory and emotions, and oftentimes, stopping completely and not moving can have a detrimental effect and lead to weakening of the muscles and stiffness, which leads to more pain and limited movement and the inability to keep moving,” Bottrell said.

Movement is medicine, Bottrell noted, and helps the body in the following ways:

• Moving promotes synovial fluid, which is the lubricating fluid found in the joints. Synovial fluid provides the joints cushion and eases movement between bones. 
• Moving helps strengthen the muscles, ligaments, and tendons around the joint, which result in less strain on the joint.
• Movement signals the body to send blood to the active area, which helps reduce inflammation.
• Moving triggers endorphins, which are natural pain relievers.

“Also, as we get older, we worry about breaking bones, but if you’re muscles are engaged and you’re strong, you are less likely to fall compared to if you are weak and atrophied,” said Bottrell.

Schwarzenegger relates to this sentiment. He is determined to motivate people to move safely despite fears and past injuries.

“I get it. It is scary. I’ve had my own health issues — shoulder surgery, hip replacement, and all of my heart surgeries for my congenital valve issue, and I think it’s very important that I’m open about it, because I see how it inspires people to act, and not just give in to their pain,” he said.

Schwarzenegger believes life is too short to let pain, fear, or uncertainty hold people back from feeling better. “I believe in the phrase, ‘If you rest, you rust,’” he said.

Healthline got more insight from the legendary actor and former bodybuilder to learn more about his dedication to joint pain and mobility awareness.

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

How do you care for your joints?

Schwarzenegger: I have had to deal with joint pain throughout my life. Whether I’m riding my bike, working out at Gold’s Gym, or skiing every winter, I’m a very active person.

My joints have taken a beating from all the heavy lifting and stunts through the years. I’ve had my fair share of injuries, but being active is important to me, and I wouldn’t change what I’ve done.

I knew when it was time to seek help, and I did.

How do you approach movement?

Schwarzenegger: I have dedicated my life to fitness, so I know the power of movement. My priorities have changed, but my need to never stop moving hasn’t.

Even when I was competing in Mr. Universe, I was taking ballet lessons to perfect the way I moved my body. Now I’m focused on skiing every year with my family, playing with my grandchildren and my animals on the weekends or riding my bike and lifting, but I’ve never wanted to stop moving.

As I’ve gotten older, I have thanked myself for all the work I did in my body in the past because I see how other people who are 78 are moving, and I can tell that the foundation I built has protected me. But I have to keep pushing myself and moving every year so I don’t rust.

I never want to get to a point where I can’t do the things that bring me happiness.

You have to fuel your body so it moves properly — and if there’s something wrong, make an appointment with your doctor. Only you know when changes are happening. Don’t put off these important conversations because you’re afraid.   

Why should you keep moving every day?

Schwarzenegger: I talk about this in my Pump Club newsletter and my podcast all the time. Movement is medicine.

When you stop moving, you put yourself at risk for a lot of health conditions, including osteoarthritis. But inactivity is also a symptom of osteoarthritis because joint pain and stiffness discourage movement. That means many people with osteoarthritis are already inactive, and their pain keeps them inactive. It’s a vicious cycle.

Listen, I’m not a doctor and can’t give medical advice. What I do know is that you have to be honest with yourself about how pain is affecting your life and the lives of those around you. And sometimes, that means putting pride or fear aside and talking with your doctor. 

I also know that some mornings, I feel pain and stiffness in my body and all my brain wants me to do is lie in bed —but I get up and do my daily routine of a bike ride and a workout, and 99% of the time, I feel the stiffness melt away. Movement does make us better.

How do you fit movement into your daily life?

Schwarzenegger: I’m always moving, moving, moving! I ride my bike, and I train at the gym for 45 minutes every day when I’m at home in Los Angeles.

Consistency is important. You have to have a routine.

On top of my lifting and biking, I ski every winter for as many days as I can. I have been intense about getting my steps in every single day since we shared studies about the power of movement in Arnold’s Pump Club. I realized that even with a bike ride and a workout, inactivity the rest of the day can set you back.

Have you adjusted your workouts as you’ve aged?

Schwarzenegger: My situation is unique because I have replaced heart valves, and after my first heart surgery, the doctor told me to stop the heavy weights to protect those new valves.

That wasn’t an excuse to stop, though. I used lighter weights, with more reps and less rest between sets. I’m not setting any records anymore, but I can still wear out people half my age with my training and leave ‘schvitzy’ and huffing and puffing.

What motivates you to keep moving?

Schwarzenegger: Vision is important to me and has been since the beginning of my fitness journey 50 years ago.

If I don’t have a vision — a purpose — then I will fail. I think about the person I want to be and why I want to be that person. If I simply say, “I want to be healthy,” that’s not enough.

I have to know why I’m doing it and what I want to accomplish. I have to see it. That’s the key to having anything stick long term, even through challenges. Being active is part of who I am now because I take this approach. And I always feel better after moving. I’ve had my own setbacks, but I see them as opportunities. 

I won’t lie. There are some mornings where I feel off; I want to just stay in bed. But I get on my bike and ride to the gym. And almost every time, by the time I’m riding back from the gym, the world starts to turn to color. I don’t know if it is from the movement or the sense of accomplishment when I didn’t want to do it and did it anyway, but there is something magic about that.

Most people want to be healthy. They want to move, but there are so many obstacles that it’s easy to get overwhelmed. That’s why having a vision is so important — it helps you take the next step.

If your obstacle is pain, I challenge you to envision your life without it. What would you be able to do? How would it affect your work, your hobbies — your life? Use that vision to overcome fear and uncertainty about talking to a doctor. Don’t wait, act! That’s my message. 

I want anyone with pain in their joints to know they are not alone and get the information they need to fuel their comebacks.

It’s also important for me to be useful and use my platform to encourage people to take ownership of their health and to never stop moving.

If you want to go fast, go alone; if you want to go far, go together. I want to create a community with the You’ll Be Back platform so people don’t feel alone.

Is self-care an important part of a fitness routine?

Schwarzenegger: Fitness is self-care. If you aren’t training your body, you aren’t taking care of it. Don’t ever convince yourself otherwise.

Takeaway

Arnold Schwarzenegger is raising awareness about prioritizing joint health and mobility.

The famed actor and experts agree that regular movement and physical activity help you stay healthy and prevent frailty.

Regular exercise can also help reduce the risk of various chronic health conditions.

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• A recent study found that abnormal menstrual bleeding during perimenopause is associated with fatigue.
• If left untreated, heavy menstrual bleeding can lead to iron deficiency anemia, a well-known cause of fatigue.
• Females should report midlife menstrual changes like prolonged or heavy bleeding to their doctor to discuss treatment to help ease discomfort.

Irregular menstrual cycles during midlife, or changes in the amount and duration of menstrual flow, is often a telltale sign of perimenopause.

This phase before menopause, known as the menopause transition, typically affects females in their mid to late 40s and early 50s, though the age of onset may vary significantly.

Unlike menopause, which is confirmed when a person has gone 12 months without a period, perimenopause is often characterized by abnormal menstrual bleeding.

Heavy menstrual bleeding during perimenopause can significantly impact quality of life.

New clues on perimenopause and midlife fatigue

A recent study found that heavy or prolonged menstrual bleeding may lead to fatigue, which helps explain why females are two to four times more likely to experience syndromic fatigue during midlife, which can be debilitating, researchers say.

The results, published online on March 12 in Menopause, the journal of The Menopause Society, note that 1 in 3 perimenopausal females experienced abnormal uterine bleeding.

Despite this prevalence, few studies have examined the issue nor have they explained the link between abnormal uterine bleeding during the menopause transition phase and fatigue or decreased quality of life. 

Heavy bleeding may cause iron deficiency anemia (low red blood cell count), which, while treatable, is a well-known cause of fatigue.

“This study highlights the need for greater clinical awareness of abnormal uterine bleeding, particularly given the increased frequency during the menopause transition and its association with low energy or fatigue symptoms,” said Stephanie Faubion, MD, director of the Mayo Clinic Center for Women’s Health and medical director for The Menopause Society, in a news release.

“Educating women about the possibility of prolonged or heavy menstrual bleeding during the menopause transition and the potential health consequences is also needed,” she noted.

Abnormal bleeding during perimenopause is common

Perimenopause onset begins with declining ovarian function and reproductive hormone shifts, resulting in a drop in estrogen production and leading to various menopause-like symptoms, such as:

• hot flashes
• sleep difficulties
• chronic pain 
• depression and mood changes

In this new study, researchers examined menstrual tracking calendars for 2,300 midlife females to determine whether they experienced heavy or prolonged menstrual bleeding over the course of six months.

They assessed feelings associated with fatigue (i.e., feeling tired, worn out, low energy).

After adjusting for other possible causes of fatigue, they found a strong link between heavy and prolonged menses and fatigue. 

The researchers suggest that more awareness of abnormal uterine bleeding during perimenopause is needed. 

“Changes in menstrual bleeding are common in perimenopause, Faubion told Healthline. “Periods can become lighter or heavier. This relates to fluctuations in ovarian function and subsequently in brain neurochemicals, such that the brain is trying to get the ovary to respond.”

“When that happens, the ovary is being ‘flogged’ by the brain, which can result in higher levels of estrogen than a woman usually has in her reproductive years. This can lead to thickening of the uterine lining and heavier menstrual blood flow,” Faubion added.

Signs of midlife menstrual changes, such as heavy or prolonged bleeding, may include:

• irregular menstrual cycles
• menses lasting longer than 7 days
• unusually heavy flow needing frequent changing of menstrual products
• passing large blood clots
• bleeding that interferes with everyday activities

Heavy menstrual bleeding is not always related to hormone changes during perimenopause, however. 

Abnormal uterine bleeding may also be related to other causes not associated with menopause transition, such as uterine cancer, Faubion noted.

“It’s always important that abnormal uterine bleeding be evaluated because bleeding could be a sign of something more serious,” Faubion said.

Treating heavy bleeding during perimenopause

The new study’s authors say clinicians should assess energy levels when patients report bleeding changes to determine the right course of treatment, especially if there is a risk of anemia.

“If a woman is experiencing heavy menstrual bleeding in perimenopause, it should be evaluated and treated,” Faubion said.

If you’re concerned about midlife menstrual changes, ask your doctor for guidance to help you navigate this transition.

Treatments for heavy menstrual bleeding may include:

• hormonal treatments​ (i.e., combined oral contraceptives)
• non-hormonal medications (i.e., NSAIDs)
• progestin-containing IUDs
• ​endometrial ablation (a medical procedure that removes the uterine lining to help reduce menstrual flow)
• hysterectomy (in severe cases only)

Your doctor might also advise certain self-care strategies to help ease discomfort, such as:

• tracking menstrual changes
• using menstrual products for heavier flow
• taking iron supplements 
• stress management
• maintaining a balanced diet
• exercising regularly

“There are many options for reducing bleeding during this time,” Faubion said. “In other words, they shouldn’t just ‘put up with it.’”

• A new analysis found that medical misinformation about ADHD is prevalent on TikTok, with the content significantly shaping how young people view the condition.
• The issue could highlight a demographic reaching for answers that may be facing barriers to care, researchers say. 
• For those wondering whether they have ADHD, there are some strategies for identifying medically accurate information and seeking out the support they need.

Information about attention deficit hyperactivity disorder, or ADHD, is abundant on social media platforms like TikTok and Instagram, fueling concern about mis- and self-diagnosis. 

This isn’t a new phenomenon. For the past few decades, public discussions about the neurodivergent condition have centered on arguments about whether it is overdiagnosed or overmedicated.

Social media has only enhanced the debate. As many young adults turn to platforms like TikTok and Instagram to gather information about ADHD, medical professionals often remain critical of any form of self-diagnosis.

A new analysis, published March 19 in PLOS One, found that most of the popular content about ADHD on TikTok is medically inaccurate and that insights provided by some content creators do not mirror those of mental health professionals. 

Vasileia Karasavva, a co-author of the research and a PhD student at the University of British Columbia, told Healthline the study highlights an issue for many young people: they just don’t have the resources to get answers.

“I don’t think there’s anything more human than trying to understand your own experiences and your own self and how you feel. And I think what we’re tapping into is people struggling, but then not having access to places that they can get good support and help. And so they have to rely on themselves. They have to rely on whatever is easily available to them, and that’s social media,” Karasavva said.

More than half of ADHD claims on TikTok are misleading

The new analysis includes two studies. During the first stage, the researchers recorded the first 100 videos listed in order of view count under the hashtag #ADHD. Those videos were then assessed by two authors, both longtime clinical psychologists who sought to determine the accuracy of the claims made in the videos, who then rated them.

The other two authors, PhD students, noted the number and nature of claims made in the videos and the video metrics for each video and also identified when content creators mentioned selling services or asking for money. 

At this stage, the psychologists found that fewer than half (48.7%) of the claims being made about ADHD were accurate and that the majority of the inaccurate claims (68.5%) better described a “normal human experience.”

During the second study, 843 participants — some with a formal ADHD diagnosis, some who were self-diagnosed, and some who did not have ADHD — were asked to watch and rate the top five and bottom five rated videos from the first study.

They were then asked a number of questions, including how they experienced this sort of content on TikTok. They were also asked to rate how much they would recommend these videos to others. 

The results show that the participants, all young adults, rated the accurate videos significantly lower and the less accurate videos higher significantly than the psychology professionals involved in the study.

The study also showed that, of the 100 videos, none of the creators listed shared a credential at the doctoral level, and only 1.6% of creators shared a Master’s level of education. The vast majority of creators (83.6%) cited lived experience as the foundation of their content. 

Karasavva said the research team was surprised that half of the content creators making these videos incorporated some form of sales tactic via links to sites like Venmo and Amazon.

“While some of these product requests may be legitimate, I think it also raises some important questions about how ADHD has been commercialized online, on social media, and we also have to question if viewers are getting reliable and science-backed information, or [if] they are just being seen as potential customers, encouraged to buy things that might not actually help them,” she noted.

Don T. Galbadage, PhD, MPH, an associate professor at Texas Christian University whose work focuses on public health education, said the study highlights the need for social media consumers to use formalized informational resources from organizations like the Centers for Disease Control and Prevention (CDC) and the National Institute of Mental Health.

He told Healthline the article provides a key question for those in public health to ask themselves as they work to provide the best information about conditions like ADHD.

“How can we help empower our consumers to know what is good content [and] what is reliable content? This study helps show there is a disconnect between good information versus more popular information,” Galbadage noted.

Self-diagnosing ADHD isn’t reliable

Ashwini Nadkarni, MD, an assistant professor of psychiatry at Harvard Medical School and the faculty’s interim vice chair of faculty development, said those who rely on ADHD-related content online could have other symptoms that are missed or not attended to by a physician. 

“I think what the study tells us is that what people see on TikTok probably should not be experienced as gospel,” Nadkarni told Healthline.

“You know, it’s ultimately anecdotal content, and it can lead to people misattributing normal behaviors or behaviors that can be explained by other conditions to be signs of ADHD.”

Jess Rauchberg, PhD, a digital media scholar and former social media content creator who is now an assistant professor at Seton Hall University, noted the study’s findings reflect a social media algorithm shaping what users continue to see.

“TikTok’s algorithmic recommendation system is saying, this person wants to hear about ADHD or diagnosis and self-diagnosis,” Rauchberg told Healthline.

“I think it [the study] shows that self-diagnosis is really, really complicated. It’s an important moment to think about media literacy. Media isn’t reality but can shape our understanding of what’s real. And so I think that’s an important thread in this panic about self-diagnosis and digital platforms that is often missing from the media hype around these conversations or debates.”

Ask your doctor about ADHD

If social media users are inundated with inaccurate ADHD-related content, how can they best educate themselves?

Rauchberg, who authored a research article on TikTok and autism, suggested looking to creators who have professional credentials and also understand the platform’s nuances (e.g., using the green screen feature or stitching from another person’s video) to help inform without disregarding other people’s lived experiences.

“I think medical professionals can use the affordances of these platforms and they have a responsibility to utilize them to help people understand information,” Rauchberg said.

“Because I want to clarify that TikTok isn’t necessarily the problem; it’s how you’re using TikTok to create content that can tell people about diagnosis or these ideas. And what this study shows is that there’s a role that these practitioners can play in helping young people… understand what they can find and information that they can empower themselves with.”

Nadkarni said those who see their experiences reflected in this content could seek support from a medical professional who can help sort fact from fiction. This could help distinguish between anecdotal evidence on social media and science-backed diagnostic procedures.

“If you’re really curious or concerned about something, the key next step is to make an appointment to see your doctor and really ask them the question,” Nadkarni said.

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• A retrospective study found that cannabis users were six times as likely to have a heart attack compared to non-users.
• A meta-analysis of 12 previous studies showed that cannabis users had a 50% higher risk of a heart attack than non-users.
• Both studies lacked sufficient information to determine whether the risk was different for inhaled cannabis versus ingested products.

As legal use of cannabis in the United States has increased in recent years, so have concerns about potential negative health effects.

This includes the impact on the heart. Two new studies found that people who use cannabis are more likely to have a heart attack compared to people who do not use the drug.

These findings are from a retrospective study that will be published in the journal JACC Advances and a meta-analysis of 12 previously published studies being presented on March 29 at the American College of Cardiology’s Annual Scientific Session.

In the retrospective study, researchers found that cannabis users under the age of 50 were more than six times as likely to have a heart attack compared to non-users. The meta-analysis showed that cannabis users had a 50% increased risk of a heart attack.

The meta-analysis included 12 previous studies, with over 93,000 cannabis users and 4.5 million non-users. This is the largest pooled study of its kind to date.

“Asking about cannabis use should be part of clinicians’ workup to understand patients’ overall cardiovascular risk, similar to asking about smoking cigarettes,” study author Ibrahim Kamel, MD, clinical instructor at the Boston University Chobanian & Avedisian School of Medicine, said in a news release.

In addition, “a fair warning should be made so that the people who are consuming cannabis know that there are risks,” he said in the release.

Effects of cannabis use on heart health

The retrospective study used patient data from TriNetX, a global health research network that provides access to electronic medical records. 

Researchers followed patients for an average of over three years. Compared to non-users, cannabis users had a:

• six times higher risk of heart attack
• four times higher risk of ischemic stroke (which occurs when a blood clot or plaque blocks blood flow to the brain)
• two times higher risk of heart failure
• three times higher risk of cardiovascular death, heart attack or stroke.

Participants were younger than 50 and did not have any cardiovascular-related health problems at the start of the study.

Their blood pressure and low-density lipoprotein (LDL) cholesterol levels were within a healthy range. They did not have diabetes or prior coronary artery disease and did not use tobacco products.

For the meta-analysis, researchers included 12 previously published studies, which they rated as being of moderate to good quality. One study was conducted in Canada, one in India, and the rest in the U.S.

The average age of participants in these 12 studies was 41 years. However, some studies did not include information about the participants’ ages.

Of these studies, seven found that cannabis use was linked to a higher risk of heart attack. Four studies showed no difference in heart attack risk between cannabis users and non-users. One study found that cannabis users had a slightly lower risk of heart attack.

When researchers combined the data from all the studies and analyzed this pooled data, they found that active cannabis users were 1.5 times more likely to have a heart attack compared to people who were not current users.

One study included in the meta-analysis found the heart attack risk peaked about one hour after cannabis use.

However, because of differences in the data among the studies, researchers were not able to account for several factors that might affect the results, such as how much and how long participants had used cannabis, and their use of tobacco or other drugs.

“A confounding factor, as indicated in this study, is whether other forms of drug use may contribute to adverse cardiovascular effects,” said Hoang Nguyen, MD, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the research.

For example, “cocaine has been known to be detrimental to the heart as it may cause heart attacks and weaken heart muscles, leading to heart failure,” he told Healthline.

Risks of inhaled versus ingested cannabis

Sameer Amin, MD, cardiologist and chief medical officer at L.A. Care Health Plan, who was not part of the research, said more research is needed on the health risks of cannabis.

But “based on [this] early information showing an association of cannabis with an increased risk of worse cardiovascular outcomes, there appears to be an emerging concern,” he told Healthline.

The possible mechanisms for how cannabis might damage the cardiovascular system is not fully understood. 

The researchers suggest that cannabis may affect heart rhythm regulation, increase the heart muscle’s need for oxygen, and contribute to dysfunction of the lining of the arteries. This could make it harder for blood vessels to relax and expand properly, which might interrupt the flow of blood.

In terms of whether inhaled cannabis or ingested cannabis may have a bigger impact on heart attack risk, Kamel said both the meta-analysis and the retrospective study lacked detailed information to determine this.

So “an interesting aspect to look at [in future studies] is whether there are differences between the inhaled form of cannabis versus consumables such as brownies, gummies and candies,” said Nguyen.

Research on other chemicals, though, suggests that inhalation may carry certain health risks.

“We know that chronic inhalation of tobacco and other chemicals damages the lungs and increases several respiratory risks, including things like COPD and lung cancer,” said Andrew Meltzer, MD, MS, professor of emergency medicine and attending physician at the GW School of Medicine & Health Sciences, who was not involved in the new research. 

“But we don’t know for sure if that’s also true with cannabis, because those studies haven’t been done,” he told Healthline.

Is any amount of cannabis ‘safe’?

“It would be challenging to determine the safety of any amount [of cannabis] without conducting clinical trials or bench work,” said Kamel. “However, given the available data, we believe that the risk exists.”

Nguyen suggests that the effects of cannabis on the heart may depend on how often and how much people use it, but more research would be needed to determine that.

Given that it’s not clear what a safe amount of cannabis is, Amin recommends that people “avoid use of any substance that would increase your risk of cardiovascular disease.”

Less chronic use, though, may have a much lower risk.

“Intermittent, relatively low-dose use of cannabis is mostly benign,” said Meltzer, but “we don’t have a lot of data on the health effects of long-term cannabis use.”

In fact, “some of the reactions we see are paradoxical. For instance, in patients who are undergoing chemotherapy, cannabis in short doses actually reduces nausea and stimulates appetite,” he said. “But for some people, chronic daily use of cannabis can actually cause nausea and abdominal discomfort.”

In a recent study, he and his colleagues found that these kinds of symptoms — which occur with cannabinoid hyperemesis syndrome — could represent a costly and largely hidden public health problem.

With the increased legalization of cannabis in the U.S., Meltzer said there’s essentially an active public health experiment going on, one that requires cannabis users to stay up to date about research on the health risks of this drug.

“Unless we carefully monitor this, there’s the possibility that we might find out in 10 years that there are increased medical problems related to long-term use of cannabis,” he said. 

• The FDA has ordered compounding pharmacies to stop making less expensive versions of popular weight loss medications like Ozempic and Zepbound.
• The order comes after federal officials determined there was no longer a shortage of GLP-1 drugs.
• People who rely on compounded medications say they may have to stop taking the drugs because the brand-name versions are too expensive.

A ban on so-called copycat versions of weight loss drugs that contain the active ingredient trizepatide took effect on March 19.

A similar prohibition on copycat weight loss medications that contain the active ingredient semaglutide is scheduled to take effect as early as April 22.

The bans follow the Food and Drug Administration’s updated guidance for compounding pharmacies manufacturing less expensive versions of Eli Lilly’s weight-loss medications Zepbound and Mounjaro as well as Novo Nordisk’s Ozempic and Wegovy.

The FDA announced the updated guidance after a federal judge ruled against the Outsourcing Facilities Association (OFA), which had filed a lawsuit on behalf of compounding pharmacies selling copycat trizepatide medications.

A similar lawsuit is being considered on behalf of pharmacies that produce the less expensive versions of semaglutide drugs.

Compounded drugs are not approved by the FDA, so the agency does not verify their safety, effectiveness, or quality. However, they can be sold under certain circumstances.

Telehealth providers such as Eden, Mochi, Ro, and Hims & Hers have been allowed to sell alternative versions of drugs since December 2022 due to a shortage of weight-loss drugs caused by increased demand for the products.

However, in December 2024, FDA officials announced that the medication shortage had ended. They ordered a transition period for compounding pharmacies to stop manufacturing the drugs, which are still protected by patents, and give Eli Lilly and Novo Nordisk exclusive rights to their products.

People who take these less expensive medications are concerned about losing a product that has helped them lose weight. They say they now have to decide whether to pay significantly more for a brand-name medication or stop taking GLP-1 drugs and risk regaining the weight they’ve lost.

Experts say the FDA decision could result in people being denied an important medical tool.

“The reason there is so much demand is because at this time these drugs are the most effective medications for weight loss,” said Mir Ali, MD, a general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA.

What will happen to weight-loss drug supply?

A big question is whether Eli Lilly and Novo Nordisk will be able to produce enough of their GLP-1 medications to meet demand if compounding pharmacies cease manufacturing the drugs.

There’s also the question of whether prices for Ozempic, Zepbound, Wegovy, and Mounjaro will rise without the competition of copy cat medications.

Officials at Eli Lilly and Novo Nordisk did not respond to Healthline’s request for comment on this article.

Companies that sell compounded weight loss drugs vowed to continue to help their customers.

“We will continue to work to ensure that our patients can access the best treatments for their individual needs and goals, and follow applicable FDA rules and regulations on compounding,” said a statement provided to Healthline by Ro officials.

 “GLP-1s are helping millions of Americans improve their health. Continued access to safe, affordable, and consistently available treatment options are critical as we fight against obesity, which impacts over 40% of Americans,” added a statement sent to Healthline by officials at Hims & Hers, which, like Ro, sells a compounded semaglutide product.

Officials at Hims & Hers have released a new report stating that a shortage of GLP-1 drugs still exists in the United States.

Nonetheless, Ali said he expects that Eli Lilly and Novo Nordisk will be able to manufacture enough of their weight loss drugs to meet the demand.

People rely on compounded GLP-1s for affordability

Ali said he doesn’t expect the price on brand-name GLP-1 drugs to increase significantly because of the pressure on these companies to make the medications relatively affordable.

However, he said even if there is enough supply and the price doesn’t increase, that doesn’t mean people can afford them.

“Even if the medications are available, health insurance companies don’t cover these medications for a lot of people,” Ali told Healthline.

He added he is also concerned that consumers might purchase less expensive weight loss drugs in markets outside the U.S. Those products, he said, can be of dubious quality and sometimes even dangerous.

“People might not get what they pay for,” Ali said.

He noted that some people might be eligible for gastric bypass surgery as an alternative to losing weight without using drugs.

Minnesota resident Bailey Fields, 27, has polycystic ovarian syndrome (PCOS), a condition that, among other things, can lead to weight gain and potentially type 2 diabetes.

Fields told Healthline her current semaglutide medication from Hims & Hers costs $199 per month compared to the $675 per month she spent previously on Mounjaro.

Because she has PCOS and is at risk for diabetes, Fields’ doctor prescribed Mounjaro. Despite this, Fields noted her health insurance company would only cover the cost of a weight loss drug treatment if she were to develop type 2 diabetes.

Fields intends to maintain her weight but she is concerned she won’t be able to do that if she can no longer purchase the copy cat semaglutide product.

“I don’t know what will happen if I stop taking it,” she said.

Fields is not alone. Tennessee resident Todd Kennedy, 45, relies on compounded semaglutide for weight maintenance and hopes to lose more weight. He’s concerned the ban on compounded semaglutide may endanger that goal.

Kennedy now pays $165 per month for the Hims & Hers product. He said a brand-name version of the same drug would cost him $1,500 per month. He told Healthline he simply can’t afford the more expensive versions and called the FDA decision “short-sighted.”

“It gives people a tool,” Kennedy said. “I feel that taking away a valuable and effective tool isn’t benefitting anybody.”

How GLP-1s like Ozempic, Zepbound aid weight loss

Wegovy and Zepbound have been approved by the FDA as a weight loss treatment.

Ozempic and Mounjaro are FDA-approved as a treatment for type 2 diabetes. Ozempic is frequently prescribed off-label for weight loss, however.

These products work by either targeting the brain or affecting certain hormones to suppress appetite and make a person feel less hungry.

People prescribed the medications are also usually put on a specific diet and exercise routine.

Ali said these drugs are effective because they focus on the source of weight-loss issues.

“By treating the source, they are more likely to produce success,” he said.

Ali noted that the drugs are part of a new strategy in the medical field for treating people with weight management issues.

“There is a slow shift on looking at obesity as a chronic disease and the fact that it needs to be treated that way,” he said.

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• Lorazepam, a common anti-anxiety medication, makes frequent appearances in Season 3 of “The White Lotus” on HBO.
• This type of benzodiazepine used to treat anxiety, panic attacks, and certain types of insomnia.
• The drug slows activity in the brain, promoting physical relaxation and reducing anxious thoughts.
• Lorazepam has the potential for dependence and may cause life threatening problems when used with opioid medications, alcohol, and certain illegal drugs.

HBO’s third season of “The White Lotus” is underway. A mostly new cast of guests flock to Thailand’s Koh Samui to stay at the show’s namesake luxury spa and wellness sanctuary. Here, spirituality and a possible whodunnit are served up to loyal fans of the beloved comedy-drama series.

This season begins similarly to others, with plenty of intrigue, leaving behind a string of mysteries about who died and how. The show opened with gunshots and a dead body, this time floating face down in a lotus pond.

As storylines are introduced, a surprising theme running throughout this season is the frequent mention of lorazepam, a prescription medication used to treat anxiety and certain types of insomnia.

Victoria Ratliff, played by Parker Posey, whose Southern drawl brings a distinctive ring to the word “lorazepam,” can’t seem to get through the day without popping these anti-anxiety pills like candy, sometimes downing them with white wine at dinner.

Her overuse of the pills leaves her slurring her words, zoning out, and dozing off at the dinner table. At one point in episode 4 (which was released on March 9), Victoria’s daughter Piper exclaims, “You don’t have enough lorazepam to get through one week at a wellness spa”

In this episode, Victoria’s husband Timothy (played by Jason Isaacs) steps into lorazepam misuse territory to cope with a work-related scandal that could ruin his reputation. While attending a yacht party with their three children, he steals Victoria’s prescription bottle from her bag, drinks a few glasses of what looks like whiskey and becomes incoherent.

If you’re wondering about this drug and whether it’s safe for anxiety, read on. We’ll break down how the drug is meant to be used, the main risks, and other ways to manage your anxiety.

What is lorazepam?

Lorazepam is the generic name for the prescription medication Ativan. It belongs to a class of drugs called benzodiazepines, which also include:

• Valium
• Xanax
• Halcion
• Klonopin

“Lorazepam is a commonly prescribed medication for anxiety. It’s also used to treat panic attacks and can be used for insomnia,” said David Merrill, MD, PhD, a geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA.

The drug works by slowing the activity in the brain, which promotes relaxation in the body and a reduction in anxious thoughts.

However, “the first-line treatment [for anxiety] is typically antidepressants like SSRIs [antidepressants], plus psychotherapy,” Merrill told Healthline.

“Something like cognitive behavioral therapy or mindfulness-based stress reduction — where you get a better understanding of what’s driving your anxieties and how to manage the anxiety when it comes up, versus just popping a pill like is done on a TV show.”

Victoria L. Leigh, DO, FACOI, an internal medicine specialist with Providence St. Joseph Hospital in Orange, CA, said in certain cases, benzodiazepines may be used first, such as with anxiety experienced by cancer patients and hospice or palliative care patients.

Lorazepam may also be used for short-term anxiety related to a medical procedure, she said, such as when people experience panic symptoms in the confined space of an MRI machine.

One 2024 meta-analysis of previous studies found that benzodiazepines were more effective than SSRIs at reducing the physical symptoms of anxiety. Both drugs were similarly effective at reducing the psychological symptoms. 

However, because benzodiazepines have more severe side effects, including a risk of dependence, SSRIs are often recommended first for generalized anxiety disorder.

Therapy can also benefit people by teaching them to notice internal physiological sensations such as racing heartbeat, shortness of breath, numbness and tingling. These are a normal part of the body’s stress response, said Merrill, not something that is dangerous or harmful.

“If you learn how to counteract those sensations when they come up, whether by taking a deep breath or taking a break from what you are doing, you can keep them from becoming a full-blown panic attack,” Merrill said.

Some people can manage their anxiety without medication, using therapy alone. However, “with more severe cases of anxiety, we see the best outcomes with a combination of meds and therapy, at least over the short-term,” Merrill noted. “Then sometimes people can taper off the medications when their anxiety is under better control.”

Is lorazepam habit forming? 

When used as prescribed, lorazepam can cause the following side effects:

• drowsiness
• dizziness
• tiredness
• weakness
• unsteadiness
• nausea
• diarrhea or constipation
• appetite changes
• restlessness
• blurred vision
• changes in sex drive or ability

More serious problems, such as life threatening breathing problems, sedation, or coma, can occur if lorazepam is used alongside opioid medications such as codeine, oxycodone, and tramadol.

Drinking alcohol or using certain illegal drugs alongside lorazepam can also increase these risks.

“Benzodiazepines are generally safe when used as directed,” said Merrill, “but they have the potential to be habit forming, so you can become physiologically or psychologically dependent on them.”

People who are using illegal drugs or other substances should not use lorazepam. People with a history of alcohol dependence or abuse should not use lorazepam unless recommended by their doctor.

“Because lorazepam is short-acting, its onset is faster, making addiction more likely,” Leigh told Healthline. In addition, “withdrawals from this medication are more abrupt than the longer-acting medications in this family.”

Once dependence occurs, “if lorazepam is stopped suddenly, withdrawal symptoms can lead to seizures, altered [thoughts], and can be fatal,” she said.

How to recognize lorazepam dependence

Lorazepam and other benzodiazepines can cause physical dependence and withdrawal symptoms, even when taken as directed. 

The severity of withdrawal symptoms depend upon the dose you are taking, how long you’ve been taking the drug, other sedating drugs you are taking, and other factors.

Symptoms of withdrawal include:

• agitation
• poor memory
• insomnia
• anxiety
• panic attacks
• irritability
• headache
• muscle fatigue
• weakness
• tremor
• seizures

Merrill said other signs of lorazepam dependence include:

• needing to fill your prescription early
• using the drug above the amounts or more often than recommended by your doctor
• having to use someone else’s pills because you ran out early
• using the drug alongside alcohol in order to manage your anxiety symptoms
• neglecting your responsibilities at work or in your personal life

If you are experiencing physical dependence or if you had withdrawal symptoms when you tried to stop taking lorazepam, ask your doctor about tapering your dose. Tapering means taking smaller doses over the course of a few or several weeks until you can safely stop the drug.

Other ways to manage anxiety

Many non-medication options have been shown to help relieve anxiety symptoms. Some of these may include:

• psychotherapy
• mindfulness-based stress reduction (MBSR)
• EFT tapping
• acupressure 

“Focusing on exercise can also help to balance the ‘fight or flight’ nervous system response that drives anxiety-related feelings,” said Leigh. “Reduction in alcohol consumption and focusing on a balanced diet can also impact the ‘gut-brain axis’ and can improve mental health as well.”

For Amanda Armstrong, founder of Rise As We and author of “Healing Through the Vagus Nerve,” the missing link to healing from anxiety is often the autonomic nervous system.

This part of the nervous system controls unconscious processes such as breathing, heartbeat and digestion. It’s also in charge of keeping us safe through the body’s fight, flight, fawn and freeze responses.

“Understanding the role of the nervous system really shifts the paradigm from ‘I’m broken,’ to seeing that your symptoms make sense when put into the context of basic biological needs, your past trauma history, and how that gets stored in your body,” said Armstrong, who is based near Washington, D.C.

When viewed through the lens of the nervous system, anxiety symptoms are a survival response, one that makes sense in the context of the human body and a person’s current and past experiences.

Other factors can also contribute to anxiety, such as sleep deprivation, being overstressed or over-caffeinated, suffering from micronutrient deficiencies, or lacking connection to other people and community.

In her practice, Armstrong teaches clients two types of tools for managing their anxiety.

First are tools that people can use in the moment if they are feeling anxious or having a panic attack. This includes visual orienting (slowly looking around your space), biting into a lemon, and certain kinds of breathing.

These help people move up what Armstrong refers to as the autonomic nervous system ladder — away from the sympathetic activation response (also known as fight or flight mode) toward a state of calm and connection.

The other group of tools helps reduce people’s anxiety symptoms long-term. Part of this proactive approach is helping people understand what might be contributing to their anxiety symptoms, including:

• past trauma
• current life stressors
• lifestyle habits
• relationships
• micronutrient deficiencies
• health conditions (i.e., thyroid issues or hormone imbalance)

Once clients have mapped out these factors, Armstrong asks: “What feels meaningful, and what feels accessible for you to take on right now?”

While Armstrong said there’s a time and a place for the use of anti-anxiety medications, she empowers clients by educating them about how their bodies work and giving them tools to manage their anxiety.

This approach can also pave the way for deeper work with a therapist, whether it’s talk therapy, shadow work, or somatic parts (aka inner child) work. If the nervous system is well regulated, therapy is often more productive.

Overall, “the approach I use gives you an entire new framework for understanding yourself, and navigating your world and your symptoms in a way that is not associated with brokenness,” Armstrong told Healthline. “There’s also more space for compassion and curiosity.”

Takeaway

In Season 3 of the HBO series “The White Lotus,” some characters appear to pop lorazepam like candy. This prescription drug is used to treat anxiety, panic attacks, and insomnia due to anxiety or situational stress.

Studies show that benzodiazepines such as lorazepam are effective for treating both the physical and psychological symptoms of anxiety. However, antidepressant SSRIs are more commonly used first because they have a lower risk of severe side effects.

Lorazepam carries a risk of dependence and potential for misuse. This drug can also cause life threatening breathing problems, sedation, or coma when used alongside opioid pain relievers, alcohol, or certain illegal drugs.