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Born and raised in Chicago, Illinois. Bogan High School. Worked in Alaska after the earthquake. Joined U.S. Army at 17. Sergeant, B Battery, 3rd Battalion, 84th Artillery, 7th Army. Member of 12 different unions, including 4 different locals of the I.B.E.W. Worked for fortune 50, 100 and 200 companies as an industrial electrician, electrical/electronic technician.
Russia pummels exhausted Ukrainian forces with smaller attacks ahead of a springtime advance
The Associated Press – April 19, 2024
A Su-25 plane is seen firing rockets over Ukraine in a video frame grab. The video was taken from inside another Su-25 plane and released by the Russian Defense Ministry on Jan. 22, 2024. (Russian Defense Ministry Press Service via AP, File)A Ukrainian officer with the 56th Separate Motorized Infantry Mariupol Brigade fires rockets from a pickup truck at Russian positions on the front line near Bakhmut in Ukraine’s Donetsk region on March 5, 2024. The outgunned and outnumbered Ukrainian troops are struggling to halt Russian advances as a new U.S. aid package is stuck in Congress. (AP Photo/Efrem Lukatsky, File)This frame grab from video released by the Russian Defense Ministry on Feb. 20, 2024, shows one of its Su-25 ground attack jets firing rockets during a mission over Ukraine. (Russian Defense Ministry Press Service via AP, File)Ukrainian servicemen with the 28th Separate Mechanized Brigade fire a mortar at Russian forces on the front line near the city of Bakhmut in Ukraine’s Donetsk region, on March 3, 2024. The outgunned and outnumbered Ukrainian troops are struggling to halt Russian advances as a new U.S. aid package is stuck in Congress. (AP Photo/Efrem Lukatsky, File)Ukrainian soldiers carry shells to fire at Russian positions on the front line, near the city of Bakhmut, in Ukraine’s Donetsk region, on March 25, 2024. Ukrainian soldiers with the 22nd Mechanized Brigade prepare to launch the Poseidon H10 Middle-range drone near the city of Bakhmut in Ukraine’s Donetsk region on March 26, 2024. (AP Photo/Efrem Lukatsky, File)
Russian troops are ramping up presure on exhausted Ukrainian forces to prepare to seize more land this spring and summer as muddy fields dry out and allow tanks, armored vehicles and other heavy equipment to roll to key positions across the countryside.
With the war in Ukraine now in its third year and a vital U.S. aid package for Kyiv slowed down in Congress, Russia has increasingly used satellite-guided gliding bombs — which allow planes to drop them from a safe distance — to pummel Ukrainian forces beset by a shortage of troops and ammunition.
Despite Moscow’s advantage in firepower and personnel, a massive ground offensive would be risky and — Russian military bloggers other experts say — unnecessary if Russia can stick to smaller attacks across the front line to further drain the Ukraine military.
“It’s potentially a slippery slope where you get like a death by a thousand cuts or essentially death by a thousand localized offensives,” Michael Kofman, a military expert with the Carnegie Endowment, said in a recent podcast to describe the Russian tactic. If the Russians stick to their multiple pushes across the front, he said, “eventually they may find more and more open terrain.”
Last summer’s counteroffensive by Ukraine was doomed when advancing Ukrainian units got trapped on vast Russian minefields and massacred by artillery and drones. The Russians have no reason to make that same mistake.
UKRAINIAN FORCES EXPOSED
Last November, Ukrainian President Volodymyr Zelenskyy ordered his forces to build trenches, fortifications and bunkers behind the more than 1,000-kilometer front line, but analysts say construction work moved slowly, leaving areas unprotected.
“If the defensive lines had been built in advance, the Ukrainians wouldn’t have retreated in such a way,” Ukrainian military expert Oleh Zhdanov said. “We should have been digging trenches through the fall and it would have stemmed Russian advances. Now everything is exposed, making it very dangerous.”
In a recent podcast, Kofman also said that Kyiv is “quite behind on effectively entrenching across the front” and “Ukraine does not have good secondary lines.”
After capturing the Ukrainian stronghold of Avdiivka, Russian troops are zeroing in on the hill town of Chasiv Yar, which would allow them to move toward Sloviansk and Kramatorsk, key cities in the Kyiv-controlled part of the Donetsk region in eastern Ukraine. Russia illegally annexed Donetsk and three other regions in 2022, and the Kremlin sees fully controlling that region as a priority.
Zhdanov said Ukraine doesn’t have the firepower to repel Russian attacks.
“They promised to have a defensive line 10 kilometers (6 miles) behind Avdiivka where our troops could get and dig in, but there is none,” he said.
Gen. Christopher Cavoli, head of U.S. European Command, sounded the alarm before Congress last week, warning that Ukraine will be outgunned 10 to one by Russia in a matter of weeks if Congress does not approve more military aid.
IN RUSSIA’S SIGHTS
After securing another term in a preordained election in March, President Vladimir Putin vowed to carve out a “sanitary zone” to protect Russia’s border regions from Ukrainian shelling and incursions.
Putin didn’t give any specifics, but Russian military bloggers and security analysts said that along with a slow push across the Donetsk region, Moscow could also try to capture Ukraine’s second-largest city of Kharkiv, which Russia tried and failed to take in the opening days of the war.
In a possible sign of a looming attack on Kharkiv, a city of 1.1 million about 30 kilometers (some 20 miles) south of the border, Russia has ramped up strikes on power plants in the area, inflicting significant damage and causing blackouts.
Ukraine doesn’t have enough air defense to protect Kharkiv and other cities, and the constant Russian strikes are part of Moscow’s strategy to “suffocate” it by destroying its infrastructure and forcing its residents to leave, Zhdanov said.
Retired Lt. Gen. Andrei Gurulev, now on the defense committee of Russia’s lower chamber of parliament, acknowledged that capturing Kharkiv is a major challenge, and he predicted the military would try to surround it.
“It can be enveloped and blockaded,” he said, adding that taking Kharkiv would open the way for a push deep into Ukraine and require more Russian troops.
After Putin’s order for “partial mobilization” of 300,000 reservists last fall proved so unpopular that hundreds of thousands fled abroad to avoid being drafted, the Kremlin tried a different approach: It promised relatively high wages and other benefits to beef up its forces with volunteer soldiers. The move appears to have paid off as Defense Minister Sergei Shoigu said the military recruited 540,000 volunteers in 2023.
“There are no plans for a new wave of mobilization,” Viktor Bondarev, deputy head of defense affairs committee in the upper house of parliament, said in remarks carried by state RIA Novosti news agency. “We are doing well with the combat capability that we have.”
Can drinking a blend of oats, water and lime juice help you lose weight? Here’s what nutritionists think about the ‘oatzempic’ trend.
Maxine Yeung – April 10, 2024
Experts say “oatzempic” doesn’t offer a balanced or sustainable approach to weight loss. (Getty Images) (izhairguns via Getty Images)
Weight loss drugs continue to gain in popularity, but not everyone who wants them can afford these medications, leaving some people hunting for more cost-effective alternatives. While natural options may seem promising, their effectiveness can be unpredictable. Berberine, for example, has been labeled “nature’s Ozempic,” though it may help more with managing blood sugar levels than aiding in actual weight loss. Meanwhile, psyllium husk — an inexpensive fiber supplement — is sought-after for its ability to temporarily suppress appetite by promoting a sense of fullness, but it’s important to note that fiber alone does not directly cause weight loss.
More recently, there’s been a viral trend involving the consumption of “oatzempic,” a drink crafted from oats, water and lime juice blended together. Its name cleverly references the prescription diabetes medication Ozempic, which is also well known for its weight loss benefits. This trend has gained lots of attention on platforms like TikTok, with claims suggesting it can help individuals shed as much as 40 pounds in two months.
“The oatzempic trend may seem enticing due to its simplicity and potential for rapid weight loss, but it’s essential to approach it with caution,” Vandana Sheth, registered dietitian nutritionist and author of My Indian Table: Quick & Tasty Vegetarian Recipes, tells Yahoo Life. So what are the downsides — as well as any possible benefits — of oatzempic, and can it really help with weight loss? Here’s what experts have to say.
How do you make oatzempic?
To prepare oatzempic, blend a half cup of raw oats, 1 cup of water and the juice of half a lime together until smooth. Drink it on an empty stomach, aiming for one to two servings a day. If you aren’t a fan of the taste, some people add a dash of cinnamon or honey, though the latter will add some calories and sugar.
Why the lime?
It’s unclear why lime juice is a key ingredient, though many suspect it’s primarily for enhancing the flavor of the drink, which has been described as chalky. Plus, lime juice provides a healthy dose of the antioxidant vitamin C.
Despite what some believe, Sheth clarifies, “there’s a misconception that acidic foods like lime juice can aid in fat burning, which is not supported by scientific evidence.” Dr. Amy Lee, head of nutrition for Nucific, tells Yahoo Life that a stomach’s acidity is greater than that of the fruit anyway.
What are the benefits?
Oatzempic’s benefits have been touted by people on social media trying it out for a 40-day challenge, but its impact on health hasn’t actually been researched. That said, oats alone boast many health advantages: They contain antioxidants and are linked with a reduced risk of cardiovascular disease, lower cholesterol and better blood sugar control. Research also shows potential for oats to help with regulating appetite and maintaining weight.
In just half a cup of oats, there are 5 grams of protein, 4 grams of fiber and a variety of vitamins and minerals. Oats are an excellent source of soluble fiber, particularly beta-glucan, which helps slow digestion, moves food and waste through the gut and promotes regular bowel movements.
Does oatzempic help with weight loss?
Substituting a meal with oatzempic can support weight loss efforts. However, as Julie Pace, functional dietitian and founder of Core Nutrition Health and Wellness, tells Yahoo Life: “It’s important to understand that this weight loss is primarily due to calorie restriction rather than any unique properties of oatzempic’s ingredients.” With just about 150 calories in a half cup of oats, oatzempic is low-calorie. Its fiber content may also promote a feeling of fullness, leading to less overall eating during the day.
Experts advise embracing this trend with caution since oatzempic does not offer a balanced or sustainable approach to weight loss. “Simply substituting high-calorie meals with low-calorie shakes may result in quick weight loss,” Sheth explains, “but without sustainable lifestyle changes, it may lead to health complications and weight regain once regular eating habits resume.”
Lee agrees: “I don’t think it is a long-term solution. Changing just one meal and its composition is a good start, but overall, one has to be mindful of the rest of the day as well.”
What are the downsides?
Pace says that oatzempic “encourages an unhealthy, unsustainable and restrictive approach to weight loss that is not supportive of overall health and well-being. Sustainable weight management involves making gradual, sustainable changes to diet and lifestyle rather than relying on quick fixes or extreme measures.”
Sheth warns that “rapid weight loss through extreme measures can lead to health complications such as nutrient deficiencies, loss of lean muscle tissue, hair loss and hormonal imbalances.” Not only are trends like oatzempic restrictive, especially if done for an extended amount of time, but they also risk promoting disordered eating habits.
While some people recommend using oatzempic as a meal replacement, experts point out it doesn’t contain nearly enough calories, protein or fat to be considered an equal swap. Generally for meals, you want to aim for about 15 to 30 grams of protein and at least twice as many calories as what’s found in a single serving of oatzempic.
“I do see some people adding protein powder and altering it by squeezing in some good oils,” says Lee. However, these additions change the simplicity of oatzempic and resemble more of a balanced breakfast.
Final takeaways
“If one is trying to just feel full in the morning to start their day strong, there are definitely other ways to do so,” says Lee. Instead of drinking oatzempic, aim for a satisfying breakfast of oatmeal, including fruit, seeds (hemp, chia and flax) and nuts (walnuts, almonds) for added protein, fiber and fat. If you prefer the drink version, consider swapping in milk for water or adding nut butter.
Although drinking oatzempic may increase fiber and water intake, experts agree that prioritizing overall health and wellness with sustainable habits is best if weight loss is your goal, and they note that weight loss alone doesn’t always mean improved health.
Maxine Yeung is a dietitian and board-certified health and wellness coach.
25% of U.S. adults say they drink 1 or 2 glasses of water a day — and 8% rarely or never drink it, Yahoo/YouGov poll finds. Here’s how to sneak more hydration into your day.
Kerry Justich, Health and Wellness Writer – April 18, 2024
How much water should you be drinking a day? (Getty Images) (fizkes via Getty Images)
A new Yahoo News/YouGov poll has revealed that many Americans are coming up short in hydration. The survey of 1,746 U.S. adults, conducted from April 11 to April 15, found that 8% say they rarely or never drink water, while 25% are drinking just one to two glasses of water a day. The overwhelming majority of respondents (66%) reported drinking three or more glasses a day.
Is that enough? According to Edwina Clark, a registered dietitian, certified specialist in sports dietetics and owner of Edwina Clark Nutrition, the answer is no. Clark tells Yahoo Life that she’s “concerned” about the 8% of Americans who are getting very little water intake, especially given the popularity of sugary beverages.
How can people who are skimping on their water consumption make sure they’re still getting hydrated — and what’s the ideal water intake we should all be getting? Experts share their recommendations.
How much water should you drink a day?
According to the National Academy of Medicine (NAM), the daily recommendation for water consumption is nine glasses a day for women, totaling 2.2 liters assuming a standard 8-ounce cup size, and 13 glasses, or 3 liters, for men. These guidelines account for “fluid intake from beverages including water, tea, broth and milk,” says Clark. “Food typically provides another 0.5 to 1 liter of fluid intake per day on top of water from beverages.”
But water needs, she adds, can “vary widely depending on age, activity level, size, climate or season, and illness.” People might also need more than what’s been recommended by the NAM when considering water loss through factors like sweat.
“Fluid intake is particularly important before, during and after exercise to combat sweat-related losses,” says Clark. “Some people may need a sports drink during and after exercise to replace electrolytes lost through sweat as well as fluid. However, this is largely dependent on exercise intensity, duration and ambient temperature.”
What are people drinking instead?
Of the 8% of poll respondents who report rarely or never drinking water on a daily basis, 38% indicated that soda is their preferred beverage. Clark says that this is cause for concern.
“While soda may not increase fluid depletion [meaning it won’t contribute to dehydration], drinking sugar-sweetened beverages on a consistent basis is associated with a raft of health problems, including obesity, type 2 diabetes, kidney disease, cardiovascular disease and tooth decay,” she says.
Clark adds that while “the occasional sweetened drink is fine for most,” consistently opting for it over water could pose problems.
The second-most-popular drink among this group was tea, preferred by 21%, which Clark says is a good alternative to water if unsweetened. The 15% who go for coffee, however, could have trouble staying hydrated depending on the amount of caffeine they drink over a day.
“Low to moderate caffeine consumption has not been shown to impact fluid balance,” she says, noting that a 16-ounce Starbucks cold brew won’t leave an average-size adult dehydrated. A 2017 study indicates that higher caffeine intake, amounting to four or more coffees a day, could lead to a diuretic effect.
How can you tell if you’re hydrated?
Ingesting fluids is important for maintaining a good blood pressure, heart rate and electrolyte balance, according to Dr. Amber Robins, a family and lifestyle medicine practitioner at Rochester Regional Health. She tells Yahoo Life that the easiest way to determine if you’re hydrated is taking a look at your urine.
“Having clear urine can mean that you have an adequate amount of fluid intake,” she says. “If your urine is darker in color, this likely means that you are dehydrated.”
Simple ways to increase water intake
If you notice that you might be dehydrated, Clark suggests the following to amp up your fluid intake:
Have water within reach. Keep a large water bottle on your desk, in your gym bag, etc. and sip frequently throughout the day. The more visible water is, the more likely you are to stay hydrated.
Make it fun. Add fruit wedges and herbs to water to make it more appealing; some have even credited the “sexy water” trend with spurring them to sip. If you’re not a water lover, unsweetened tea and sparkling water are good alternatives without added sugar.
Eat your fruits and veggies.Water-rich foods like fruit and veggies can contribute up to 20% of your fluid intake. Make sure you get at least three servings of veggies and two servings of fruit a day to help top off your water tank. Cucumber, iceberg lettuce, bell peppers, watermelon, radishes, tomatoes, spinach and berries are more than 90% water.
Watch out for water depleters like alcohol. Alcohol will make you lose fluids more quickly, which is why bathrooms at bars often have a line.
Other ways to start would be to make a goal of drinking water before each meal or once you wake up in the morning, according to Robins. Clark adds: “People generally wake up dehydrated after consuming little or no fluid overnight, so starting your day with a big glass of water is generally a good idea.”
Many of us turn to food for comfort. But when does emotional eating become an issue?
Ashley Broadwater – April 18, 2024
How to determine and break emotional eating habits. (Photo illustration: Yahoo News; photos: Getty Images)
When Sam Thomas, a writer, speaker and mental health campaigner, was 11 years old, he experienced homophobic bullying at school. To escape the bullies, he would hide in the bathroom and eat the food in his lunchbox. “It was a sanctuary, as it was the only place I knew I wouldn’t be found,” he tells Yahoo Life.
This common and understandable behavior — emotional eating — was a source of comfort for him, and it didn’t end when he left school. Instability in his home life as a child and teen contributed to Thomas’s eating habits and difficult relationship with food. “It helped fill a void that felt like numbness or emptiness,” he explains.
He’s far from alone in that experience. In fact, about 75% of eating is emotionally driven, according to psychologist Susan Albers from the Cleveland Clinic, a nonprofit academic medical center. But Thomas’s experience is reflective of a more significant issue when the quest to become emotionally satiated by food leads to a cycle of shame and guilt, while underlying anxiety or stress remains.
What is emotional eating?
In a nutshell, emotional eating is using food to soothe, numb or cope with (usually difficult) feelings. “The emotional connection that we have to food exists every time we eat, even when we’re eating primarily because we’re hungry,” Christine Byrne, a registered dietitian and the owner of Ruby Oak Nutrition in Raleigh, N.C., tells Yahoo Life. Emotional eating, however, isn’t motivated by hunger. Instead, it is “the act of using food to cope with various feelings you’re experiencing,” she explains. Like turning to McDonald’s to soothe, distract or calm the mind and body after a stressful work day, rather than to feel satiated.
Emotional eating isn’t defined as an eating disorder, according to Healthline. However, it is a pattern of disordered eating that is heavily tied to mental health.
According to Byrne, “it’s tough to say definitively what the signs of emotional eating are, since the same behavior can either be healthy or maladaptive depending on the intention behind it, the intensity of it and how often you engage in it.”
However, some signs of maladaptive (or disordered) eating she encourages folks to look out for include:
Frequently eating because of feelings (such as boredom, sadness, loneliness, stress, happiness) instead of hunger
When eating is the only way you know how to deal with uncomfortable feelings
Frequently eating until you’re uncomfortably full as a way to numb or escape feelings
Why does emotional eating happen?
The connection between food and emotions has been evidenced through culture and science. “As humans, one way we connect and soothe from infancy is through food,” Rachel Heinemann, a therapist who specializes in eating disorders, tells Yahoo Life. “We build community over joint meals, we comfort those who are grieving with food and we welcome new neighbors with food.”
A study in the International Journal of Gastronomy and Food Science also helps to explain the phenomenon of emotional eating, as it points out that sweet, high-calorie foods are often what people crave when experiencing a spike in cortisol from stress. These foods are linked to the release of serotonin, which can boost mood.
Thomas’s go-to foods when he was feeling depressed, for example, were cookies and chips (although he says he’d eat anything he could find in an effort to relieve emotional discomfort). This habit was also informed by past experiences of his mother rewarding and comforting him with sweets. “I associated certain foods with a whole range of emotions,” he says.
Childhood experiences, like being rewarded with sweets, are a notable cause of emotional eating. Other contributors include social influences, boredom, suppressed emotions and stress. Existing body image issues and restrictive dieting are also risk factors, as any one of these can be an emotional trigger that leads to a specific food craving. It’s not inherently a bad thing; however, feeding those feelings doesn’t always bring the intended result or relief.
In Thomas’s experience, food would provide him a kind of high while eating, to eventually experience what he refers to as a “come down” after the fact, in which the difficult feelings return. This is then paired with the discomfort that can come from mindless eating or eating beyond fullness. Breona O’Brien, a licensed mental health counselor with Mindoula, says that that aftermath can perpetuate a negative cycle with body image as well.
“This overeating can lead to weight gain and a feeling of a loss of control. These two things then lead to more negative thoughts about their bodies and can lead to more emotional eating,” she tells Yahoo Life.
When determining events and triggers that lead to emotional eating, it’s important to address the frequency in which it happens. “Frequent emotional eating can be an indication that there is something going on in your life, family, job [or] living environment that is making you distressed,” says O’Brien, “and no one deserves to live in a constant state of discomfort.”
Addressing the root issues
Mindfulness is key to addressing emotional eating and its causes, according to O’Brien. She says it’s important to take a moment to reflect on the messages that our bodies and brains are sending us when it comes to food. This would allow an individual to come to understand if they’re reaching for food because they’re actually hungry or if there’s an emotional reaction at play.
Mount Sinai offers a guide that suggests observing eating patterns and how they relate to certain feelings, situations or places; as well as working on developing new coping skills to handle those moments. This might include reading a book, talking to friends or going for a walk, for example, rather than heading to the pantry.
This isn’t to say that people should emotionally detach from food, or that all emotional eating is inherently a bad thing. (In fact, Heinemann emphasizes that food is meant to be a way for people to “connect, soothe and enjoy.”) These interventions, however, may be more helpful — or are at least other options you can turn to.
Other helpful tactics include eating slowly, planning ahead so that you’re not in a situation that feels urgent and working with a professional to avoid further discomfort, body image issues and the threat of an eating disorder.
Seeking therapy is ultimately what helped Thomas. “Having had trauma therapy, I realized my addictions had been with me since a very young age,” he says. “Therapy sessions enabled me to recognize the pattern [of my emotional eating] and find ways to break it.”
Thomas has found that activities such as going to the gym and writing in a journal also help him meet his emotional needs. To say that he hasn’t turned to food for comfort since wouldn’t be accurate. However, he has “a much healthier relationship with food” after ridding himself of guilt and shame surrounding it.
If you or someone you know is struggling with an eating disorder please visit the National Eating Disorders (NEDA) website at nationaleatingdisorders.org for more information.
The latest transformative outcome of the buzzy weight loss drug may be the most profound yet, with a growing number of patients claiming that the GLP-1 medication — and others like it — have caused anxiety, depression and suicidal ideation, even as they shed the pounds.
Looking into the science behind the life-changing jabs, experts revealed why the medications, originally intended to treat diabetes, could be changing people’s personalities and behaviors.
millaf – stock.adobe.com
Ozempic, and other popular treatments like Wegovy, have an impact on dopamine levels, which are responsible for a range of functions.
Along with impacting our emotional and physical drive for food, the brain chemical impacts feelings of reward, pleasure, motivation and movement.
These changing levels could help explain why some users have even claimed the drugs have also reduced their cravings for drugs, alcohol and sex.
Dr Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, explained to The Daily Mail that both addictive substances and food activate the same dopamine signals and reward-learning regions in the brain.
He also noted that: “Cravings for addictive drugs are also amplified by hunger.”
“When researchers are trying to get animals to learn to self-administer cocaine, they often will keep them hungry for a little while, as this helps them learn,” Dr. Berridge explained.
The medical expert added: “Hunger is specifically for food but it’s more general than that, it activates craving for a lot of things. If you’re hungry, the motivational value of things, even that are not food, seems to increase.”
Dr Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, explained to The Daily Mail that both addictive substances and food activate the same dopamine signals and reward-learning regions in the brain. REUTERS
Because these drugs help patients to feel satiated for longer, experts believe they then also lessen cravings for things other than food as well, such as drugs and alcohol.
“Satiety may be not only reducing the craving for food, but potentially for other things,” Dr. Berridge said.
GLP-1 drugs appear to alter the motivational dopamine systems, dampening but not eliminating desires. For example, patients have found that they don’t lose their appetites but eat less while on these medications which experts believe could translate to other vices.
“That would be a possibility — taking the [edge off certain cravings], and those are the ones that are problematic if you’re trying to lose weight or if a person is trying to stop taking drugs,” Dr. Berridge said.
Because these drugs help patients to feel satiated for longer, experts believe they then also lessen cravings for things other than food as well, such as drugs and alcohol. Getty Images
He also shared that a decreased libido while on GLP-1 drugs is “conceivable.”
Dr. Berridge explained that because sex is a pleasurable natural desire, suppressing the reward pathway could lead to a reduced sex drive.
“If you’re suppressing [dopamine activation] a little bit and cutting down those mountain peaks, sexual desire is a natural peak, so that would be plausible,” the medical expert said.
However, he admitted that exacly how GLP-1 drugs are suppressing dopamine systems is still unknown.
The FDA requires that medications for weight management that work on the central nervous system, including Saxenda and Wegovy, carry a warning about suicidal thoughts.
Ozempic, which is only FDA-approved to treat diabetes, does not come with that warning.
Lead study author Dr. Alexis Conason, a licensed psychologist in NYC, noted that triggering experiences such as changes in quality of life and unrealistic expectations also occur to those going through other weight loss treatments such as Ozempic.
“People put so much emotion and hope into weight loss, and are sold this fantasy that if they just lose weight everything’s gonna be okay and all the good things that they want in life will come when they lose weight,” Conason previously told The Post.
However, some patients have reported this changed mindset even when the needle on the scale drops but experts aren’t shocked.
“It’s not necessarily surprising when you see there may be an increase in suicidal ideation and other things like that because you’ve taken away a really important coping mechanism for many people,” Brooke Boyarsky Pratt, CEO and co-founder of weight-inclusive care company Knownwell, told The Post in 2023.
However, the medical expert admitted that how GLP-1 drugs are suppressing dopamine systems is still unknown. myskin – stock.adobe.com
Dr. Gregory Dodell of Central Park Endocrinology also noted that patients on medications that suppress their appetite may not be getting sufficient nutrients, which in turn disrupts their mental stability.
“So much of balancing our body is about what we eat and drink,” he said.
The European Medicines Agency recently said there was no evidence for a causal link between Ozempic and suicidal thoughts. The FDA came to a similar conclusion in January.
But some experts have also warned that they have not been available long enough to study the long-term effects and are likely being misused by some as a quick way to shed a few pounds.
If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, call or text 988 or chat 988lifeline.org.
Internet data centers are fueling drive to old power source: Coal
Antonio Olivo – April 17, 2024
CHARLES TOWN, W.Va. – A helicopter hovers over the Gee family farm, the noisy rattle echoing inside their home in this rural part of West Virginia. It’s holding surveyors who are eyeing space for yet another power line next to the property – a line that will take electricity generated from coal plants in the state to address a drain on power driven by the world’s internet hub in Northern Virginia 35 miles away.
There, massive data centers with computers processing nearly 70 percent of global digital traffic are gobbling up electricity at a rate officials overseeing the power grid say is unsustainable unless two things happen: Several hundred miles of new transmission lines must be built, slicing through neighborhoods and farms in Virginia and three neighboring states. And antiquated coal-powered electricity plants that had been scheduled to go offline will need to keep running to fuel the increasing need for more power, undermining clean energy goals.
“It’s not right,” said Mary Gee, whose property already abuts two power lines that serve as conduits for electricity flowing towardthe biggest concentration of data centers – in Loudoun County, home to what’s known as Data Center Alley.“These power lines? They’re not for me and my family. I didn’t vote on this. And the data centers? That’s not in West Virginia. That’s a whole different state.”
The $5.2 billion effort has fueled a backlash against data centers through the region, prompting officials in Virginia to begin studying the deeper impacts of an industry they’ve long cultivated for the hundreds of millions of dollars in tax revenue it brings to their communities.
Critics say it will force residents near the coal plants to continue living with toxic pollution, ironically to help a state – Virginia – that has fully embraced clean energy. And utility ratepayers in the affected areas will be forced to pay for the plan in the form of higher bills, those critics say.
But PJM Interconnection, the regional grid operator, says the plan is necessary to maintain grid reliability amid a wave of fossil fuel plant closures in recent years, prompted by the nation’s transition to cleaner power.
Power lines will be built across four states in a $5.2 billion effort that, relying on coal plants that were meant to be shuttered, is designed to keep the electric grid from failing amid spiking energy demands.
Cutting through farms and neighborhoods, the plan converges on Northern Virginia, where a growing data center industry will need enough extra energy to power 6 million homes by 2030.
With not enough of those green energy facilities connected to the grid yet, enough coal and natural gas energy to power 32 million homes is expected to be lost by 2030 at a time when the demand from the growing data center industry, electric vehicles and other new technology is on the rise, PJM says.
“The system is in a major transition right now, and it’s going to continue to evolve,” Ken Seiler, PJM’s senior vice president in charge of planning, said in a December stakeholders’ meeting about the effort to buy time for green energy to catch up. “And we’ll look for opportunities to do everything we can to keep the lights on as it goes through this transition.”
A need for power
Data centers that house thousands of computer servers and the cooling equipment needed for them to runhave been multiplying in Northern Virginia since the late 1990s, spreading from the industry’s historic base in Loudoun County to neighboring Prince William County and, recently, across the Potomac River into Maryland. There are nearly 300 data centers now in Virginia.
With Amazon Web Services pursuing a $35 billion data center expansion in Virginia, rural portions of the state are the industry’s newest target for development.
The growth means big revenue for the localities that host the football-field-size buildings. Loudoun collects $600 million in annual taxes on the computer equipment inside the buildings, making it easier to fund schools and other services. Prince William, the second-largest market, collects $400 million per year.
But data centers also consume massive amounts of energy.
One data center can require 50 times the electricity of a typical office building, according to the U.S.Department of Energy. Multiple-building data center complexes, which have become the norm, require as much as 14 to 20 times that amount.
The demand has strained utility companies, to the point where Dominion Energy in Virginia briefly warned in 2022 that it may not be able to keepup with the pace of the industry’s growth.
The utility – which has since accelerated plans for new power lines and substations to boost its electrical output – predicts that by 2035 the industry in Virginia will require 11,000 megawatts, nearly quadruple what it needed in 2022, or enough to power 8.8 million homes.
Thesmaller Northern Virginia Electric Cooperative recently told PJM that the more than 50 data centers it serves account for 59 percent of its energy demand. It expects to need to serve about 110 more data centers by July 2028.
Meanwhile, the amount of energy available is not growing quickly enough to meet that future demand. Coal plants have scaled down production or shut down altogether as the market transitions to green energy, hastened by laws in Maryland and Virginia mandating net-zero greenhouse gas emissions by 2045 and, for several other states in the region, by 2050.
Dominion is developing a 2,600-megawatt wind farm off Virginia Beach – the largest such project in U.S. waters – and the company recently gained state approval to build four solar projects.
But those projects won’t be ready in timeto absorb the projected gap in available energy.Opponents of PJM’s plan say it wouldn’t be necessary if more green energy had been connected to the grid faster, pointing to projects that were caught up in bureaucratic delays for five years or longer before they were connected.
A PJM spokesperson said the organization has recently sped up its approval process and is encouraging utility companies and federal and state officials to better incorporate renewable energy.
About 40,000 megawatts of green energy projects have been cleared for construction but are not being built because of issues related to financing or siting, the PJM spokesperson said.
Once more renewable energy is available, some of the power lines being built to address the energy gap may no longer be needed as the coal plants ultimately shut down, clean energy advocates say – though utility companies contend the extra capacity brought by the lines will always be useful.
“Their planning is just about maintaining the status quo,” Tom Rutigliano, a senior advocate for clean energy at the Natural Resources Defense Council, said about PJM. “They do nothing proactive about really trying to get a handle on the future and get ready for it.”
‘Holding on tight’ to coal
The smoke from two coal plants near West Virginia’s border with Pennsylvania billows over the city of Morgantown, adding a brownish tint to the air.
Nearby sits the 502 Junction substation, connected to those plants and a third one about 43 miles away via existing power lines, which will serve as a terminus for a western prong of the PJM plan for new linesthat will extend to another substation in Frederick, Md., then south into Northern Virginia.
The owner of one of the Morgantown-area plants, Longview LLC, recently emerged from bankruptcy. After a restructuring, the facility is fully functioning, utilizing a solar farm to supplement its coal energy output.
The other two plants belong to the Ohio-based FirstEnergy Corp. utility, which had plans to significantly scale down operations there to meet a company goal of reducing its greenhouse gas emissions by nearly a third over the next six years.
The FirstEnergy plants have been equipped with carbon-capturing technology but they’re still among the state’s worst polluters, said Jim Kotcon, a West Virginia University plant pathology professor who oversees conservation efforts at the Sierra Club’s West Virginia chapter.
The Harrison plant pumped out a combined 12 million tons of coal pollutants like sulfur and nitrous oxides in 2023, more than any other fossil fuel plant in the state, according to Environmental Protection Agency data. The Fort Martin plant, which has been operating since the late 1960s, emitted the state’s highest levels of nitrous oxides in 2023, at 5,240 tons.
After PJM tapped the company to build a 36-mile-long portion of the planned power lines for $392 million, FirstEnergy announced in February that the two plants will continue operating until 2035 and 2040, citing the need for grid reliability.
The news has sent FirstEnergy’s stock price up by 4 percent, to about $37 a share this week, and was greeted with jubilation by West Virginia’s coal industry.
“We welcome this, without question, because it will increase the life of these plants and hundreds of thousands of mining jobs,” said Chris Hamilton, president of the West Virginia Coal Association. “We’re holding on tight to our coal plants.”
Since 2008, annual coal production in West Virginia has dipped by nearly half, to about 82 million tons, though the industry – which contributes about $5.5 billion to the state’s economy – has rebounded some due to an export market to Europe and Asia, Hamilton said.
Hamilton said his association will lobby hard for FirstEnergy’s portion of the PJM plan to gain state approval. The company said it will submit its application for its power line routes in mid-2025.
More than 200 miles to the east in Maryland, environmental groups and ratepayer advocates are fighting an effort by PJM to extend the life of two more coal plants – Brandon Shores and Herbert A. Wagner – just outside of Baltimore, which were slated to close by June 2025.
PJM asked the plants’ owner, Texas-based Talen Energy Corp., to keep them running through 2028 – with the yet-to-be determined cost of doing so passed on to ratepayers.
That would mean amending a 2018 federal court consent decree, in which Talen agreed to stop burning coal to settle a lawsuit brought by the Sierra Club over Clean Water Act violations. The Sierra Club has rejected PJM’s calls to do so.
“We need a proactive plan that is consistent with the state’s clean energy goals,” said Josh Tulkin, director of the Sierra Club’s Maryland chapter, which has proposed an alternative plan to build a battery storage facility at the Brandon Shores site that would cut the time needed for the plants to operate.
A PJM spokesperson said the organization believes that such a facility wouldn’t provide enough reliable power and is not ruling out seeking a federal emergency order to keep the coal plants running.
With the matter still unresolved, nearby residents say they are anxious to see them closed.
“It’s been really challenging,” said John Garofolo, who lives in the Stoney Beach neighborhood community of townhouses and condominiums, where coal dust drifts into the neighborhood pool when the facilities are running. “We’re concerned about the air we’re breathing here.”
Sounding alarms
Keryn Newman, a Charles Town activist, has been sounding alarms in the small neighborhoods and farm communities along the path of the proposed power lines in West Virginia.
Newman, who in the late 2000s waged a successful campaign to stop a plan for a 765-kilovolt line extending through the area into Marylandbefore the data center boom, sees the battle in terms of the more affordable, quieter lifestyle she and her neighbors cherish.
Because FirstEnergy prohibits any structure from interfering with a power line, building a new line along the right of way – which would be expanded to make room for the third line – would mean altering the character of residents’ properties, Newman said.
“It gobbles up space for play equipment for your kid, a pool or a barn,” she said. “And a well or septic system can’t be in the right of way.”
A FirstEnergy spokesperson said the company would compensate property owners for any land needed, with eminent domain proceedings a last resort if those property owners are unwilling to sell.
Some have accepted that more power lines will come through and seem open to selling to FirstEnergy and moving away.
Pam and Gary Gearhart fought alongside Newman against the defeated 765-kilovolt line, which would have forced them to move a septic system near FirstEnergy’s easement. But when Newman showed up recently to their Harpers Ferry-area neighborhood to discuss the new PJM plan, the couple appeared unwilling to fight again.
Next door, another family had already decided to leave, the couple said, and was in the midst of loading furniture into a truck when Newman showed up.
“They’re just going to keep okaying data centers; there’s money in those things,” Pam Gearhart said about local governments in Virginia benefiting from the tax revenue. “Until they run out of land down there.”
In Loudoun County, where the data center industry’s encroachment into neighborhoods has fostered resentment, community groups are fighting a portion of the PJM plan that would build power lines through the mostly rural communities of western Loudoun.
The lines would damage the views offered by surrounding wineries and farms that contribute to Loudoun’s $4 billion tourism industry, those groups say.
Bill Hatch owns a winery that sits near the path of where PJM suggested one high-voltage line could go, though that route is still under review.
“This is going to be a scar for a long time,” Hatch said.
Reconsidering the benefits
Amid the backlash, local and state officials are reconsidering the data center industry’s benefits.
The Virginia General Assembly has launched a study that, among other things, will look at how the industry’s growth may affect energy resources and utility rates for state residents.
But that study has held up efforts to regulate the industry sooner, frustrating activists.
“We should not be subsidizing this industry for another minute, let alone another year,” Julie Bolthouse, director of land use at the Piedmont Environmental Council, chided a Senate committee that voted in February to table a bill that would force data center companies to pay more for new transmission lines.
Loudoun is moving to restrict where in the county data centers can be built. Up until recently, data centers have been allowed to be built without special approvals wherever office buildings are allowed.
“They’re great neighbors, great taxes, all that sort of thing,” Phyllis Randall (D), chair of the county board, said about the industry before a February vote to set that plan in motion. “But somehow, someway, it started to get away from us.”
But such action will do little to stem the worries of people like Mary and Richard Gee.
As it is, the two lines near their property produce an electromagnetic field strong enough to charge a garden fence with a light current of electricity, the couple said. When helicopters show up to survey the land for a third line, the family’s dog, Peaches, who is prone to seizures, goes into a barking frenzy.
An artist who focuses on natural landscapes, Mary Gee planned to convert the barn that sits in the shadow of a power line tower to a studio. That now seems unlikely, she said.
Lately, her paintings have reflected her frustration. One picture shows birds with beaks wrapped shut by transmission line. Another has a colorful scene of the rural Charles Town area severed by a smoky black and gray landscape of steel towers and a coal plant.
“It feels like harassment,” Gee said. “But there’s no one we can call for help.”
Climate impacts set to cut 2050 global GDP by nearly a fifth
Marlowe Hood – April 17, 2024
A new study shows that climate change will cause massive economic damage within the next 25 years (Frederic J. BROWN)
Climate change caused by CO2 emissions already in the atmosphere will shrink global GDP in 2050 by about $38 trillion, or almost a fifth, no matter how aggressively humanity cuts carbon pollution, researchers said Wednesday.
But slashing greenhouse gas emissions as quickly as possible remains crucial to avoid even more devastating economic impacts after mid-century, they reported in the journal Nature.
Economic fallout from climate change, the study shows, could increase tens of trillions of dollars per year by 2100 if the planet were to warm significantly beyond two degrees Celsius above mid-19th century levels.
Earth’s average surface temperature has already climbed 1.2C above that benchmark, enough to amplify heatwaves, droughts, flooding and tropical storms made more destructive by rising seas.
Annual investment needed to cap global warming below 2C — the cornerstone goal of the 2015 Paris Agreement — is a small fraction of the damages that would be avoided, the researchers found.
Staying under the 2C threshold “could limit average regional income loss to 20 percent compared to 60 percent” in a high-emissions scenario, lead author Max Kotz, an expert in complexity science at the Potsdam Institute for Climate Impact Research (PIK), told AFP.
Economists disagree on how much should be spent to avoid climate damages. Some call for massive investment now, while others argue it would be more cost-effective to wait until societies are richer and technology more advanced.
– Poor countries hit hardest –
The new research sidesteps this debate, but its eye-watering estimate of economic impacts helps make the case for ambitious near-term action, the authors and other experts said.
“Our calculations are super relevant” to such cost-benefit analyses, said co-author Leonie Wenz, also a researcher at PIK.
They could also inform government strategies for adapting to climate impacts, risk assessments for business, and UN-led negotiations over compensation for developing nations that have barely contributed to global warming, she told AFP.
Mostly tropical nations — many with economies already shrinking due to climate damages — will be hit hardest, the study found.
“Countries least responsible for climate change are predicted to suffer income loss that is 60 percent greater than the higher-income countries and 40 percent greater than higher-emission countries,” said senior PIK scientist Anders Levermann.
“They are also the ones with the least resources to adapt to its impacts.”
Rich countries will not be spared either: Germany and the United States are forecast to see income shrivel by 11 percent by 2050, and France by 13 percent.
Projections are based on four decades of economic and climate data from 1,600 regions rather than country-level statistics, making it possible to include damages earlier studies ignored, such as extreme rainfall.
– A likely underestimate –
The researchers also looked at temperature fluctuations within each year rather than just averages, as well as the economic impact of extreme weather events beyond the year in which they occurred.
“By accounting for these additional climate variables, the damages are about 50 percent larger than if we were to only include changes in annual average temperatures,” the basis of most prior estimates, said Wenz.
Wenz and her colleagues found that unavoidable damage would slash the global economy’s GPD by 17 percent in 2050, compared to a scenario with no additional climate impacts after 2020.
Even so, the new calculations may be conservative.
“They are likely to be an underestimate of the costs of climate change impacts,” Bob Ward, policy director of the Grantham Research Institute on Climate Change and the Environment in London, commented to AFP ahead of the study’s publication.
Damages linked to sea-level rise, stronger tropical cyclones, the destabilisation of ice sheets and the decline of major tropical forests are all excluded, he noted.
Climate economist Gernot Wagner, a professor at Columbia Business School in New York who was also not involved in the study, said the conclusion that “trillions in damages are all locked in doesn’t mean that cutting carbon pollution doesn’t pay.”
In fact, he said, it shows that “the costs of acting are a fraction of the costs of unmitigated climate change”.
Global GDP in 2022 was just over $100 trillion, according to the World Bank. The study projects that — absent climate impacts after 2020 — it would be double that in 2050.
Climate change damage could cost $38 trillion per year by 2050, study finds
Riham Alkousaa – April 17, 2024
FILE PHOTO: French lake dries up due to winter drought, threatening farming and tourism
BERLIN (Reuters) – Damage to farming, infrastructure, productivity, and health from climate change will cost an estimated $38 trillion per year by 2050, German government-backed research finds, a figure almost certain to rise as human activity emits more greenhouse gases.
The economic impact of climate change is not fully understood, and economists often disagree on its extent.
Wednesday’s study from the Potsdam Institute for Climate Impact Research (PIK), which is backed by the German government, stands out for the severity of its findings.
It calculates climate change will shave 17% off the global economy’s GDP by the middle of the century.
“The world population is poorer than it would be without climate change,” Potsdam climate data researcher Leonie Wenz, a co-author on the study, said. “It costs us much less to protect the climate than not to.”
At an estimated $6 trillion, the cost of measures to limit global warming to within 2 degrees Celsius (3.6F) of pre-industrial temperatures by 2050 would be less than a sixth of the cost of the estimated damage caused by allowing warming to exceed that level, the report said.
While previous studies have concluded climate change could benefit some countries’ economies, PIK’s research found almost all would suffer – with poor, developing nations the hardest hit.
Its estimation of damage is based on projected temperature and rainfall trends, but does not take into account extreme weather or other climate-related disasters such as forest fires or rising sea levels.
It is also only based on emissions already released, even though global emissions continue to rise at record levels.
As well as spending too little to curb climate-warming emissions, governments are also under-spending on measures to adapt to the impact of climate change.
For the study, the researchers looked at temperature data and rainfall for more than 1,600 regions over the last 40 years, and considered which of these events were costly.
They then used that damage assessment, along with climate model projections, to estimate future damage.
If emissions continue at today’s rate – and the average global temperature climbs beyond 4C – the estimated economic toll after 2050 amounts to a 60% income loss by 2100, the findings suggest. Limiting the rise in temperatures to 2C would contain those losses at an average of 20%.
(Reporting by Riham Alkousaa, Editing by Rachel More, Katy Daigle and Barbara Lewis)
New study calculates climate change’s economic bite will hit about $38 trillion a year by 2049
Seth Borenstein – April 17, 2024
People watch the sunset at a park on an unseasonably warm day, Feb. 25, 2024, in Kansas City, Mo. A new study says climate change will reduce future global income by about 19% in the next 25 years compared to a fictional world that’s not warming. (AP Photo/Charlie Riedel, File)A man buys a cool drink from a roadside vendor on a sunny day in Mahawewa, a village north of Colombo, Sri Lanka, Feb. 29, 2024. A new study says climate change will reduce future global income by about 19% in the next 25 years compared to a fictional world that’s not warming. (AP Photo/Eranga Jayawardena, File)
Climate change will reduce future global income by about 19% in the next 25 years compared to a fictional world that’s not warming, with the poorest areas and those least responsible for heating the atmosphere taking the biggest monetary hit, a new study said.
Climate change’s economic bite in how much people make is already locked in at about $38 trillion a year by 2049, according to Wednesday’s study in the journal Nature by researchers at Germany’s Potsdam Institute for Climate Impact Research. By 2100 the financial cost could hit twice what previous studies estimate.
“Our analysis shows that climate change will cause massive economic damages within the next 25 years in almost all countries around the world, also in highly-developed ones such as Germany and the U.S., with a projected median income reduction of 11% each and France with 13%,” said study co-author Leonie Wenz, a climate scientist and economist.
These damages are compared to a baseline of no climate change and are then applied against overall expected global growth in gross domestic product, said study lead author Max Kotz, a climate scientist. So while it’s 19% globally less than it could have been with no climate change, in most places, income will still grow, just not as much because of warmer temperatures.
For the past dozen years, scientists and others have been focusing on extreme weather such as heat waves, floods, droughts, storms as the having the biggest climate impact. But when it comes to financial hit the researchers found “the overall impacts are still mainly driven by average warming, overall temperature increases,” Kotz said. It harms crops and hinders labor production, he said.
In the United States, the southeastern and southwestern states get economically pinched more than the northern ones with parts of Arizona and New Mexico taking the biggest monetary hit, according to the study. In Europe, southern regions, including parts of Spain and Italy, get hit harder than places like Denmark or northern Germany.
Only Arctic adjacent areas — Canada, Russia, Norway, Finland and Sweden — benefit, Kotz said.
It also means countries which have historically produced fewer greenhouse gas emissions per person and are least able to financially adapt to warming weather are getting the biggest financial harms too, Kotz said.
The world’s poorest countries will suffer 61% bigger income loss than the richest ones, the study calculated.
“It underlies some of the injustice elements of climate,” Kotz said.
This new study looked deeper than past research, examining 1,600 global areas that are smaller than countries, took several climate factors into account and examined how long climate economic shocks last, Kotz said. The study examined past economic impacts on average global domestic product per person and uses computer simulations to look into the future to come up with their detailed calculations.
The study shows that the economic harms over the next 25 years are locked in with emission cuts producing only small changes in the income reduction. But in the second half of this century that’s when two different possible futures are simulated, showing that cutting carbon emissions now really pays off because of how the heat-trapping gases accumulate, Kotz said.
If the world could curb carbon pollution and get down to a trend that limits warming to 2 degrees Celsius (3.6 degrees Fahrenheit) above pre-industrial times, which is the upper limit of the 2015 Paris climate agreement, then the financial hit will stay around 20% in global income, Kotz said. But if emissions increase in a worst case scenario, the financial wallop will be closer to 60%, he said.
That shows that the public shouldn’t think it’s a financial “doomsday” and nothing can be done, Kotz said.
Still, it’s worse than a 2015 study that predicted a worst case income hit of about 25% by the end of the century.
Marshall Burke, the Stanford University climate economist who wrote the 2015 study, said this new research’s finding that the economic damage ahead is locked in and large “makes a lot of sense.”
Burke, who wasn’t part of this study, said he has some issues with some of the technical calculations “so I wouldn’t put a ton of weight on their specific numerical estimates, but I think the big picture is basically right.”
The conclusions are on the high end compared to other recent studies, but since climate change goes for a long time and economic damage from higher temperatures keep compounding, they “add up to very large numbers,” said University of California Davis economist and environmental studies professor Frances Moore, who wasn’t part of the study. That’s why fighting climate change clearly passes economists’ tests of costs versus benefits, she said.
‘Miracle’ weight-loss drugs could have reduced health disparities. Instead they got worse
Karen Kaplan – April 16, 2024
Wegovy is part of a new generation of weight-loss medications that made some doctors optimistic about reversing longstanding racial and ethnic disparities in obesity. So far, the pricey drugs seem to have made those disparities worse. (Amanda Andrade-Rhoades / Associated Press)
For the record: 9:10 p.m. April 15, 2024: An earlier version of this article misspelled the name of Dr. Serena Jingchuan Guo of the University of Florida as Jigchuan.
Americans are most familiar with their brand names: Ozempic, Wegovy, Mounjaro, Zepbound. They are the medications that have revolutionized weight loss and raised the possibility of reversing the country’s obesity crisis.
Obesity — like so many diseases — disproportionately affects people in racial and ethnic groups that have been marginalized by the U.S. healthcare system. A class of drugs that succeeds where so many others have failed would seem to be a powerful tool for closing the gap.
Instead, doctors who treat obesity, and the serious health risks that come with it, fear the medications are making this health disparity worse.
“These patients have a higher burden of disease, and they’re less likely to get the medicine that can save their lives,” said Dr. Lauren Eberly, a cardiologist and health services researcher at the University of Pennsylvania. “I feel like if a group of patients has a disproportionate burden, they should have increased access to these medicines.”
Why don’t they? Experts say there are a multitude of reasons, but the primary one is cost.
The injectable drug Ozempic sparked a revolution in obesity care. (David J. Phillip/Associated Press)
Ozempic, which is approved by the Food and Drug Administration to help people with Type 2 diabetes control their blood sugar and reduce their risk of serious cardiovascular problems such as heart attacks and strokes, has a list price of $968.52 for a 28-day supply. Wegovy, a higher dose of the same medicine that’s FDA-approved for weight loss in people with obesity or who are overweight and have a weight-related condition such as high blood pressure or high cholesterol, goes for $1,349.02 every four weeks.
Mounjaro is a similar drug approved by the FDA to improve blood sugar levels in Type 2 diabetes patients, and it comes with a list price of $1,069.08 for 28 days of medicine. Zepbound, a version of the same drug approved for weight loss, has a slightly lower price tag of $1,059.87 per 28 days. For now, at least, all the new drugs are meant to be taken indefinitely.
Few health insurance programs cover the medications when prescribed to help people reach and maintain a healthy weight. Federal law requires that weight loss drugs be excluded from basic coverage in Medicare Part D plans, and as of early 2023, only 10 states included an antiobesity medication in the formularies for their Medicaid programs.
“If everybody had equal access, then this would be a way to help,” said Dr. Rocio Pereira, chief of endocrinology at Denver Health. “But without equal access — which is what we have now — it’s likely this is going to increase the disparity we see.”
U.S. obesity rates have been rising for decades, and they’re consistently higher for Black and Latino Americans. Among adults 20 and older, 49.9% of Black Americans and 45.6% of Hispanic Americans have a body mass index of 30 or greater, compared with 41.1% of white American adults and 16.1% of Asian American adults, according to age-adjusted data from the Centers for Disease Control and Prevention.
Obesity rates are also associated with income. In 2022, the age-adjusted rate was 38.4% for adults with household incomes between $15,000 and $24,999, compared with 34.1% for those with household incomes of $75,000 or more.
The two are related, said Pereira, who studies health disparities in diseases related to obesity. Black and Latino Americans are more likely to live in lower-income neighborhoods, where fast food is usually cheaper and more convenient than grocery stores.
“If you look at a map of the U.S. and plot out the neighborhoods where there’s no grocery store within a mile and there’s a high percentage of people who have no car, those are the areas where there’s the highest rates of obesity,” she said.
There’s also the time factor, she said: “Can you afford to cook your own meals, or do you have to work two jobs?”
An unusual experiment by the Department of Housing and Urban Development demonstrated the degree to which physical surroundings can influence obesity risk, Pereira said. In the 1990s, hundreds of mothers who were living in public housing were offered housing vouchers they could use only in wealthier neighborhoods. Ten to 15 years later, the women randomly assigned to receive the windfall had significantly lower rates of severe obesity (14.4%) than women in a control group who weren’t offered vouchers (17.7%). They were also less likely to have a body mass index of 35 or higher (31.1% vs. 35.5%).
Two women talk in New York. (Mark Lennihan / Associated Press)
Some people with obesity are able to lose weight by changing their diets and burning more calories through exercise. But that doesn’t work for people who have developed resistance to leptin, a hormone that suppresses appetite.
“If you try to lose weight with diet and exercise, your body is going to fight you,” said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. “Your leptin levels go down, and when leptin goes down, a signal goes to the brain that you don’t have enough fat to survive.” That prompts the release of another hormone, ghrelin, that triggers feelings of hunger.
Leptin resistance also makes exercise less worthwhile.
“Your body fights you by decreasing your total energy expenditure,” Apovian said. “When your muscles work, they work more efficiently. If you want to lose 10 pounds, you’re going to get really, really hungry. And you can’t fight that. Your body thinks it’s starving to death.”
The “breakthrough” drugs counteract this by impersonating a hormone called glucagon-like peptide 1, or GLP-1, that’s involved in appetite regulation. Inside cells, the drugs bind with the same receptors as GLP-1, reducing blood sugar and slowing digestion. They also last longer than their natural counterparts.
Oprah Winfrey credits the new generation of medications for helping her keep her weight under control. (Chris Pizzello / Associated Press)
The first so-called GLP-1 receptor agonist was approved in 2005 to treat diabetes, and early versions had to be injected once or twice a day. Ozempic improved on this by requiring an injection only once a week. After clinical trials showed that the drug helped people with obesity achieve substantial, sustainable weight loss, the FDA approved Wegovy as a weight management drug in 2021.
Linda Morales credits Ozempic and Mounjaro for helping her lose 100 pounds and drop from a size 22 to a size 14. The 25-year-old instructional aide at Lankershim Elementary School in North Hollywood said she started to become overweight in middle school and carried 293 pounds on her 5-foot, 5-inch frame when she was referred to the Center for Weight Management and Metabolic Health at Cedars-Sinai two years ago.
She is no longer breathless when she climbs stairs, has an easier time when she goes bowling and fits comfortably into the seat on the Harry Potter ride at Universal Studios. Thanks to the medications, she is no longer on a path toward Type 2 diabetes.
Her job with the Los Angeles Unified School District comes with health insurance that covers the pricey drugs and charges her a copay of $30 a month for her Mounjaro prescription. She said she could swing a monthly payment of up to $50, but beyond that she’d have to stop taking the drug and hope the lifestyle changes she’d made would be enough to sustain the weight loss she’s achieved so far.
“It would definitely get hard for me, for sure,” Morales said.
In one study, Eberly and her colleagues examined insurance claims for nearly 40,000 people who received a prescription for GLP-1 copycats. Patients who had to pay at least $50 a month to fill their prescriptions were 53% less likely to get most of their refills over the course of a year compared to patients whose copayments were less than $10. Even patients whose out-of-pocket costs were between $10 and $50 were 38% less likely to buy the medicine regularly for a full year, the team found.
In another study of insured patients with Type 2 diabetes, those who were Black were 19% less likely to be treated with these drugs than those who were white, while Latino patients were 9% less likely to get them, Eberly and her colleagues reported.
In some parts of the country, Black patients with diabetes are only half as likely as white patients to get GLP-1 drugs, according to research by Dr. Serena Jingchuan Guo at the University of Florida, who studies health disparities in pharmaceutical access. The disparity was greatest in places with the highest overall usage of the medications, including New York, Silicon Valley and south Florida.
“In those places, the drug is actually widening the gap,” she said.
“We get excited every time a new, effective treatment becomes available,” Gasoyan said. “But we should be equally concerned that this new and effective treatment reduces disparities between the haves and have-nots.”
