healthmedicinet

A patient casually remarked, “My husband beats me,” when she entered my wife Clare’s doctor’s office a few years ago, shocking her.’

The patient genuinely claimed that she and her husband started the 5:2 diet at the same time and that he dropped more weight than she did. Fortunately, there was no marital violence.

Clare made the point that although though women don’t normally lose as much weight as men do when they diet, they still benefit from it in terms of their health, particularly in terms of important areas like blood sugar control.

But surprisingly, new research shows that women seem to fare better than men when given new weight loss drugs such as semaglutide (brand names Wegovy or Ozempic).

This is important given that earlier this week Rishi Sunak announced a ?40 million pilot project to enable GPs to prescribe them.

So why do men lose more weight when they diet? It’s probably because we’re generally more muscular and have a higher metabolic rate, which means we burn more calories when we’re sitting and even when we’re sleeping.

A higher testosterone level also helps: studies have shown that giving men with low testosterone levels a hormonal boost leads to significant weight loss.

But curiously, recent research has shown that with the new weight-loss drugs, the situation is reversed, with women losing a higher percentage of body weight than men.

Drugs like semaglutide work by mimicking the action of the GLP-1 hormone, which is released in your gut in response to eating. It prompts your body to produce more insulin, which lowers blood sugar levels. That’s why it was originally developed for people with type 2 diabetes.

But these drugs also act on your brain and suppress appetite. People who have tried them say that one of the biggest changes is that the drugs stop drug cravings. The result is impressive weight loss, but once you stop taking the drug, there is often significant weight gain.

One of the first large studies to look at semaglutide found that the men and women given the drug lost an impressive 2nd 6 pounds (15.3 kg) over 66 weeks.

But less positive was a follow-up study, published in April in the journal Diabetes, Obesity and Metabolism, which found they had regained two-thirds of that weight within a year of stopping the drug ? whether this means people have to go on medication for ever. clearly become a problem.

Also notable was that the women in the trial lost a higher percentage of their initial weight than the men, about 18 percent versus 13 percent, according to a reanalysis of the data by Dr. Alyssa Susanto, a researcher in the Faculty of Medicine and Health. at the University of Sydney.

Dr. Susanto, who presented her findings at the recent International Congress on Obesity in Melbourne, did not speculate why this might be so. However, I suspect it’s because these new drugs work so powerfully on the brain and reduce cravings – and research shows that women are more prone to cravings than men.

For example, a 2005 study titled Eating and Dieting Differences in Men and Women (published in the Journal of Men’s Health & Gender) concluded that men tend to overeat because they are “pleasure-oriented” (while cravings for something is more intense and dominates your thoughts).

Men also tend to go on a diet for health reasons, often dictated by a doctor or partner. Women, meanwhile, are more likely to struggle with cravings for high-calorie tempting treats.

Dr. Susanto suggested that studying gender differences in weight loss could lead to better, more personalized treatments.

While these differences between men and women are interesting, this research really points to the importance of first identifying and addressing the reasons why you are overeating.

Here’s what researchers at the Mayo Clinic in the US looked at: They identified four different types of overeaters based on various tests, including how many calories people ate at a buffet meal and how long it took for their guts to empty.

The four types are:

• Hungry brain: These people have to eat more than average to feel full, because the hunger center in their brain stays ‘on’ for longer than average.
• Hungry Guts: This describes those who feel hungry soon after eating and need frequent snacks. This seems to be because food passes through their stomach faster than average.
• Emotional Eaters: As the name implies, they eat when they are stressed.
• Slow burners: they have a slower than average metabolism.

In a recent clinical study of 165 overweight volunteers, the Mayo researchers linked the different type of overeater to a particular approach to weight loss.

Those with “hungry brains” were put on a time-restricted diet, packed with fiber to fill them up. The thinking was that encouraging people to eat their food within a limited time period would “turn off” their brain hunger center.

Those with ‘hungry gut’ were given protein supplements with meals to keep them feeling full longer. Here was the thinking that consuming more protein would slow their stomach emptying and lead to an earlier release of gut hormones that tell you when you’re full.

DR. MICHAEL MOSLEY: Those with “hungry brains” were put on a time-restricted diet, packed with fiber to fill them up. The thinking was that encouraging people to eat their food within a limited time period would ‘turn off’ their brain hunger center (file image)

The emotional eaters received emotional support and were asked to practice mindfulness, while the slow-burners took protein supplements, such as the hungry gut group, but also a HIIT (high-intensity interval training) program, as this has been shown to be helpful in speeding metabolism on .

The results were interesting. Compared to a control group on a standard low-calorie program, those on a tailored diet lost more than twice as much weight in 12 weeks.

They also lost more inches around the waist, experienced a greater improvement in mood and a greater drop in blood fat levels.

Larger and longer studies are needed, but what this research shows is that when it comes to weight loss, one size doesn’t fit all.

Hidden risk in water

At this time of year, there’s nothing I like more than an evening swim in the nearby Thames. So far I haven’t, mainly because of stories about raw sewage being pumped into our rivers.

But there is another more insidious threat, the so-called “forever chemicals” or PFAS (per- and polyfluoroalkyl substances), which have been used for decades to make non-stick food containers and cookware.

Unfortunately, once released into the environment, they stick around for a very long time, which is bad news since some PFAS, even at low levels, can lead to problems such as infertility and cancer.

In the UK, the official limit for PFAS in tap water is 100 nanograms (ng) per litre, but in the US it’s only 25 ng for some PFAS. Meanwhile, the European Union plans to ban almost all PFAS within ten years.

In the meantime, filter your water and avoid microwaving meals in the plastic containers of your takeout. I will probably also swim alone in the sea.

Don’t be fooled by the title ‘junior doctor’

My son Jack returns to the UK next week after a few years working as a Physician Assistant in Melbourne where he broadened his medical horizons and recharged his batteries after a long stint on a Covid ward.

Despite the name, most “junior doctors” are highly trained professionals. It can take ten years or more to become an NHS consultant, meaning that after your medical training you will remain classified as a junior doctor well into your thirties or even forties.

DR. MICHAEL MOSLEY: My son Jack returns to the UK next week after a few years as a trainee doctor in Melbourne, where he went to broaden his medical horizons and recharge his batteries after a long spell on a Covid department

So I wasn’t surprised that “one of the most talked about motions” at the recent Junior Doctors Conference was the term “junior doctor,” says the BMJ ? it’s “misleading the public … of all walks of life.”

As they search for a more appropriate name, their strike action continues.

I have immense sympathy for the patients whose lives are disrupted by these strikes, but my heart also goes out to the junior doctors who have seen significant pay cuts in real terms over the past decade.

If this is not resolved there is a risk that we will see a flight of young doctors to places like Australia where they have better wages and working conditions.

We urgently need to train more doctors, but also nurture the ones we have.

I just hope the lure of friends and family is enough to deter Jack and others from booking a flight to work where they are more valued.