What to know about the ‘oat-zempic’ weight loss trend growing on social media
Jessica Mendoza – April 1, 2024
With the use of drugs like Ozempic, Wegovy and Mounjaro growing in popularity for weight loss, some people are trying to get similar results using a lower-cost and easily accessible option, dry oats.
Experts say this trend does not mimic the way these drugs used for weight loss work and could have negative health impacts.
Anita Soth of California told “Good Morning America” she decided to try a meal replacement drink known as “oat-zempic” in order to lose weight for an upcoming trip.
“I’ve been struggling with my weight loss journey for a little while,” Soth said. “I have a trip in a couple weeks so I needed to lose a little extra pounds, so I just said, ‘I’m going to give it a try.'”
Soth told “GMA” she lost around four pounds in several days by following the “oat-zempic” routine along with intermittent fasting, or time-restricted feeding, where you limit the times during which you eat, typically only in an eight-hour time period.
The meal replacement drink known as “oat-zempic” is made by blending a mix of oats, lime and water with a sprinkle of cinnamon.
PHOTO: A video shared by TikTok user @withlove.renita shows her making an ‘oat-zempic’ meal replacement drink. (@withlove.renita/TikTok)
Brandy Frasier, a mom of three, told “GMA” she has found that combining the drink with low-calorie, high-protein meals each day has helped get her closer to her goal weight.
“I needed a pick-me-up because often when losing weight, it’s very slow. And when you don’t see progress on the scale, you get discouraged,” Frasier said, adding that the weight loss she’s seen has given her “energy back.” “And I’m able to walk longer, my knees are not hurting as much. So hopefully that all will continue.”
Ozempic, Mounjaro and Wegovy and other drugs used for weight loss can cost more than $1,000 a month without insurance coverage.
Both Ozempic and Mounjaro are approved by the U.S. Food and Drug Administration to treat Type 2 diabetes, but some doctors prescribe the medication “off-label” for weight loss, as is permissible by the U.S. Food and Drug Administration.
PHOTO: An Ozempic injection pen is seen on a kitchen table, Aug. 6, 2023, in Riga, Latvia. (Arriens/NurPhoto via Getty Images, FILE)
Wegovy, a medication that contains the same main ingredient as Ozempic, semaglutide, is FDA-approved for weight loss.
In November, the FDA approved Zepbound as a weight loss management treatment for people with obesity, or those who are overweight with at least one related underlying condition, such as high blood pressure — the same prescribing guidance as Wegovy. As a diabetes drug, Zepbound is sold under the brand name Mounjaro, as the two medications contain the same active ingredient, tirzepatide.
The medications work by slowing down movement of food through the stomach and curbing appetite, which can lead to weight loss.
Side effects of the drugs can include severe nausea and constipation.
When it comes to “oat-zempic” as a substitution for a medication like Ozempic, Maya Feller, a registered dietitian and nutritionist, said people should not be confused.
“It absolutely does not mimic what Ozempic gives you,” Feller said Monday on ‘GMA.” “This is a drink based in oats, water, a squeeze of lime juice and perhaps a dash of cinnamon. It is not a medication and it does not mimic Ozempic.”
Feller noted that oats have important nutritional benefits, but she said, as a whole, the ingredients in the “oat-zempic” drink do not have all the nutritional benefits of a meal.
Feller said that people should seek the advice of a healthcare provider before starting a meal replacement drink to lose weight.
“If you’re looking for a meal replacement, it needs to be done under clear medical supervision,” she said. “I would not use this because you’re not going to get all the nutrients that your body needs. You’re essentially starving your cells of what they want so they can function optimally. It’s simply not worth it.”
Feller also said she encourages people to think of their “why” when it comes to losing weight and avoid following a crash diet to quickly lose pounds.
“I understand that folks out there really want to engage in weight loss. I get it,” Feller said. “But we have to be thoughtful about how we do it and not go to the extreme.”
We took Ozempic thinking we’d lose weight — we didn’t, and here’s why
Alex Mitchell – April 1, 2024
Turns out drugs like Ozempic may not be the wonder cure many praised them to be for weight loss.
Here’s a sad jab of the truth.
More evidence is coming out that pricey semaglutides like Ozempic and Wegovy — diabetes medications lauded for secondary weight loss capabilities through appetite suppression — aren’t necessarily helping as many people shed pounds as previously thought.
“There was appetite suppression the first 1½ months but it’s kind of just fallen off after that,” Nashville, Tennessee, resident Melissa Traeger, 40, told the Wall Street Journal regarding her lack of success on the medication type, also known as GLP-1s.
At first, the 300-pound Traeger quickly dropped 10 pounds, but the next five came more stagnantly — and then she said no more weight was lost.
Another man, Anthony Esposito, 68, of Austin, Texas, saw no success on either Ozempic or Wegovy, just feelings of sickness while he took them.
“It did not budge the needle,” he said.
Traeger and Esposito are among many frustrated users, according to the Journal, which also cited a trial that showed only about 14% of patients cut more than 5% of bodyweight, while only one-third lost 10% of it.
Another report published on Epic Research saw that 17.7% of semaglutide users regained all of their weight — if not more — upon stopping.
Ozempic apparently isn’t helping as many people as typically thought. Wild Awake – stock.adobe.com
Doctors have also observed many “non-responders” — about 10% to 15% of people who lose 5% or less of their body weight.
“There’s going to be extreme variability in how people respond,” Dr. Eduardo Grunvald, an obesity-medicine physician at UC San Diego Health, told the Journal.
Grunvald added that issues of weight gain may go beyond something in hormones that the drugs imitate to regulate appetite. He also said that peoples’ other medical issues may play a factor, such as how those with Type 2 diabetes typically lose less than those without the disease.
The doctor added that prior exercise and eating habits before starting the drugs are also highly influential factors.
Those who have made healthy lifestyle changes and already lost weight likely don’t get that much added bonus from the medications.
People who have struggled with obesity for a lifetime may additionally have a genetic mutation that prevents the drugs’ potency, according to Dr. Steven Heymsfield of Louisiana State University’s Pennington Biomedical Research Center.
Some patients on drugs like Ozempic aren’t losing weight. myskin – stock.adobe.comDrugs like Ozempic reportedly aren’t showing be-all, end-all impacts on patients’ lives. Natalia – stock.adobe.com
He added that those who can metabolize drugs quickly also might not see much out of them in this case.
Taking other medications as well, especially antipsychotics or antidepressants, can be associated with weight gain as a side effect.
“You could have some other drug interactions that prevent the effect of the GLP-1 drugs from working,” Heymsfield told the Journal.
5 Sneaky Signs You Have Insulin Resistance, According to Dietitians
Allison Knott, MS, RDN, CSSD – April 1, 2024
Some of the symptoms on this list are easy to miss.
Getty Images
Reviewed by Dietitian Emily Lachtrupp, M.S., RD
Four out of 10 adults between the ages of 18 and 44 have an often-overlooked health condition that can lead to type 2 diabetes, according to research published in 2022 in The Journal of Clinical Endocrinology & Metabolism: Insulin resistance.
When you have insulin resistance, your body doesn’t respond effectively to insulin, a hormone that pushes blood glucose into your cells where it can be used for energy, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Because of this, the body demands more insulin to help the cells absorb glucose. “This leads to higher levels of both insulin and glucose in the bloodstream,” says Emily Cornelius, RD, a registered dietitian and insulin resistance expert. “Over time, this can lead to various health complications like prediabetes and type 2 diabetes,” she explains.
The catch? Insulin resistance often doesn’t have any signs or symptoms. This can make it difficult to identify before it progresses to prediabetes or type 2 diabetes. But the good news is that insulin resistance can be managed and even reversed when addressed early. That’s why paying attention to the signs of this condition—many of which are sneaky—is so important. Here’s what you need to know.
Changes to the skin are one of the lesser-known signs of insulin resistance. In some people, insulin resistance can lead to the development of skin tags or acanthosis nigricans (dark patches of skin on the neck or under the armpits), both of which are thought to be related to excess insulin production, according to the NIDDK. If you have questions about your skin, talk to a dermatologist.
2. You May Have Gained Weight
Weight gain may be a sign of insulin resistance, particularly if you have excess abdominal fat called visceral fat, according to the Journal of Clinical Medicine in 2019. Weight gain alone puts you at risk for developing insulin resistance, but insulin resistance itself can also lead to weight gain resulting in a cycle that can progress over time. That said, it doesn’t have to be a large amount of weight gain, either. Data in The Journal of Clinical Endocrinology & Metabolism in 2022 found that half of adults with insulin resistance did not have weights that were considered obese.
3. You Experience Brain Fog
Being insulin resistant means that glucose isn’t as readily available to provide energy for cells, including those in the brain. Because of this, you may feel what’s commonly referred to as “brain fog.” Research suggests that people who have insulin resistance may have worse cognitive performance compared to those who don’t have the condition, found a study in Diabetes Research and Clinical Practicein 2020. Insulin resistance may impair important brain processes that affect mental clarity.
4. You’re Always Hungry
Hunger is influenced by a combination of hormones, one being insulin. With insulin resistance, you may experience frequent hunger. Why? Insulin resistance causes high blood sugar, a symptom of which is increased hunger.
Because the cells don’t get the energy they need from glucose, you may also feel fatigued. It’s important to note that many other health conditions can affect energy levels. Be sure to talk to your doctor about persistent fatigue.
How Is Insulin Resistance Diagnosed?
Many of the tests to diagnose insulin resistance are time-consuming and expensive. For this reason, they’re often only used in research studies and not in medical offices, according to the NIDDK. Prediabetes is a condition that is diagnosed, which is done through blood testing like a fasting plasma glucose test or A1C test. The Centers for Disease Control and Prevention points out that having a combination of high blood sugar, high triglycerides, high “bad” LDL cholesterol and low “good” HDL cholesterol can alert you to the fact that you probably have insulin resistance.
Strategies to Improve and Prevent Insulin Resistance
Balance Meals
The foods you eat have a significant effect on blood glucose and can help to stabilize levels throughout the day. “When working on reversing insulin resistance, it’s critical to look at it from a holistic perspective, but the diet plays a foundational role,” says Cornelius. “Eating a balanced diet that includes protein, fat and fiber helps to lessen spikes during meals,” she says.
Focus on Minimally Processed Foods
Many processed foods—fast food, packaged desserts, snack mixes, sodas, chicken nuggets, hot dogs and more—are rich in saturated fat or sugar or both, and are calorically dense, making them easy to overeat, something that can lead to weight gain and the development of visceral fat.
“Prioritizing whole-nutrient dense foods such as fresh fruits, vegetables, whole grains and lean proteins along with controlling portion sizes and consistent and spaced meal timings can help improve insulin sensitivity,” says registered dietitian nutritionist Cari Riker. Eating this way can also help with weight management.
Don’t Fear Carbohydrates
Fiber-rich carbs are the way to go. “Carbohydrates often get a bad reputation when it comes to blood sugar discussions; however, fiber is a type of carb that doesn’t get fully digested and absorbed. So its impact on your blood sugar levels is significantly different than that of added sugars,” says registered dietitian Alyssa Pacheco. Choose high-fiber foods often as part of a balanced diet. Foods like whole grains, beans, vegetables and fruits, nuts and seeds can all contribute to the recommended 25 to 38 grams of daily fiber.
Eat Magnesium-Rich Foods
Foods that are a good source of fiber are also often a good source of magnesium, a nutrient that plays a critical role in glucose metabolism. “Magnesium is another nutrient to make sure you’re getting enough of, since a deficiency can worsen insulin resistance. Good food sources of magnesium include beans, spinach, almonds, pumpkin seeds, cashews and avocados,” says Pacheco.
Fit in Physical Activity
It’s time to get on the move. “Another important strategy is moving your body throughout the day, since it lowers blood sugar,” says Cornelius. Physical activity improves insulin sensitivity, according to the American Diabetes Association, helping to manage or reverse insulin resistance. Find an activity you enjoy and do it regularly to combat insulin resistance.
According to the CDC, no single test can determine if you have insulin resistance. Having health conditions like high blood sugar levels, high LDL (“bad”) cholesterol, low HDL (“good”) cholesterol and high triglycerides may indicate insulin resistance.
What is the main cause of insulin resistance?
A family history of type 2 diabetes, being overweight or having obesity and a sedentary lifestyle can all increase the risk of developing insulin resistance.
How do you fix insulin resistance?
Strategies like increasing activity, weight loss, a healthy diet, improving sleep quality and reducing stress can all help improve insulin resistance.
The Bottom Line
Maintaining a healthy blood sugar range is essential for longevity and the prevention of chronic disease. Regular physical activity and eating a balanced diet can help with preventing insulin resistance, but because many other factors are at play in the development of this condition, it’s equally as important to know the signs and symptoms for early detection. If you suspect you have insulin resistance, reach out to your doctor or registered dietitian to help you develop a plan to manage or reverse it over time.
Gastrointestinal (GI) symptoms affect most people from time to time. The gastrointestinal tract is the body’s digestive system. Common GI symptoms include bloating, indigestion, and heartburn. Other symptoms that may indicate a health problem may include sudden abdominal pain, constant diarrhea, and bloody stool.
This article discusses serious GI symptoms that should never be ignored, their possible causes, and what to do about them.
Kate Wieser / Getty Images
Stomach Cramps
Stomach cramps are a common GI symptom that often feels like a dull, aching pain. The discomfort may be constant or come and go. Common causes of stomach cramps include constipation, gas, diarrhea, a virus, hormonal medication, a menstrual period, pregnancy, and ovulation.
Kidney stones: hard deposits that may become lodged in the urinary tract or ureter
Diverticulitis: occurs when small sacs or pouches in the colon become inflamed and cause pain and cramping
Appendicitis: an inflammation of the appendix that causes significant abdominal pain and cramping
Pancreatitis: an inflammation of the pancreas that causes abdominal pain, cramping, and vomiting
Endometriosis: when endometrial tissue grows outside the uterus and causes significant pain and cramping during the menstrual cycle
Swollen Belly
If you notice a swollen belly, it is likely due to bloating. Common causes of bloating are gas, indigestion, premenstrual syndrome (PMS), IBS, or lactose intolerance, which causes bloating, gas, and diarrhea after ingesting lactose (dairy products).
Serious causes of a swollen belly include:
IBD
Ascites: a buildup of fluid in the abdomen caused by chronic liver disease
Gallstones
Pancreatitis
Ovarian cyst: a fluid-filled sac on or in the ovary that causes abdominal pain and swelling
Bloody vomit indicates bleeding somewhere in your digestive tract. Never ignore bloody vomit because the cause of the bleeding requires treatment. Possible causes of bloody vomit include:
Bleeding ulcer: a sore on the lining of the stomach or small intestine that may bleed and cause vomiting
Chronic pancreatitis: may lead to bleeding in the upper part of the GI tract
Tumor: a tumor in the GI tract may irritate the tissues and cause bleeding
Traumatic injury: an injury to the abdominal area that may lead to internal bleeding (see a healthcare provider immediately if this happens)
Blood in the stool or urine means you are bleeding somewhere in your lower GI or urinary tract. A small amount of bright red blood with straining may indicate hemorrhoids. Serious causes of bloody stool may include:
Anal fissure: a small tear in the lining of the rectum that causes drops of red blood when you wipe after using the bathroom
Diverticulitis: a condition that can lead to diverticular bleeding
Infectious colitis: an infection in the colon that causes inflammation and bleeding
Colon polyps: growths on the lining of the colon and rectum that may become irritated and start bleeding
Colorectal cancer: cancer of the colon or rectum in which cancerous growths may cause bleeding
A small amount of blood in the urine after a procedure on the bladder or urinary tract is common. For example, you may experience a small amount of bleeding after having a catheter. People who menstruate may notice blood in their urine caused by their menstrual period. Serious causes of bloody urine may include:
Sexually transmitted infections (STI): Blood in the urine is a possible sign of chlamydia or gonorrhea
Bladder or kidney cancer: the cancerous growth may cause irritation and bleeding
Sickle cell disease: an inherited red blood cell disorder that causes pain and bleeding
Pain in the Upper Stomach
Pain in the upper area of your stomach may indicate indigestion or heartburn. Sudden upper abdominal pain may indicate a problem with the organs located in that area. The stomach, pancreas, spleen, liver, gallbladder, and bile ducts are in the upper abdomen. Serious causes of upper stomach pain may include:
Splenomegaly: an enlarged spleen may cause upper abdominal pain
Gallstones
Cholecystitis: an inflammation of the gallbladder that often causes nausea and upper abdominal pain
Hepatitis: Inflammation of the liver is usually caused by an infection; one sign of hepatitis is upper abdominal pain
Cancer: cancer of the stomach, pancreas, liver, gallbladder, or bile ducts may cause pain
Lower Right Abdominal Pain
Pain in the lower abdominal area may indicate constipation, diarrhea, or menstrual cramps. If you notice pain localized in the right side of the lower abdomen, it may be your appendix. Lower right quadrant pain could mean inflammation in your appendix (appendicitis). Rarely, it could indicate appendix cancer.
Constantly Feeling Full
Feeling full without eating or after eating only a small amount is not normal. Temporary causes of feeling very full could be eating habits, indigestion, or constipation. More serious causes of constantly feeling full may include:
Gastroparesis: a disorder that causes the stomach to empty slowly
Gastritis: an inflammation of the stomach lining that may cause you to feel full
Pancreatitis
Black Stool
Black stool usually means that there is bleeding in the digestive tract. Certain foods and supplements, such as blueberries or iron supplements, can make stool appear darker. Black stool could mean esophagus, stomach, or small intestine bleeding. It may also mean that you have a bleeding ulcer.
Sudden Pulsing Pain
It is possible to feel a pulsing sensation in the abdomen because of a large blood vessel called the abdominal aorta. You may feel the abdominal aorta pulse when there is more blood flow due to pregnancy, eating, or positioning (lying down). An abdominal aortic aneurysm could cause sudden pulsing pain in the abdomen.
Strong Hunger Pangs
It is normal to feel hunger pangs when you have gone a long time without eating. Hunger is your body’s way of communicating that it is time to eat. Common causes of hunger pangs include hunger, dehydration, and constipation. Serious causes of intense hunger pangs may include:
IBS
Peptic ulcer
Anxiety: causes physical symptoms, including stomach discomfort and intestinal spasms that may feel like hunger pangs
Medications: including antidepressants, antipsychotics, diabetes medications, steroids, and anticonvulsants (seizure medications), which can cause hunger and weight gain
Constant Diarrhea
Most people experience diarrhea or loose stools from time to time. If you have been experiencing constant or chronic diarrhea, see a healthcare provider. The types of diarrhea that may indicate a health problem include:
Watery: may be caused by an infection, food poisoning, or IBS
Inflammatory: occurs when the colon is inflamed from infection, IBD, diverticulitis, or cancer
Bloody: indicates inflammation or colon cancer
Summary
Gastrointestinal symptoms are common and often include heartburn, indigestion, bloating, and cramping. Other GI symptoms are more serious and may indicate a health problem. If you ever experience bleeding with vomiting, urinating, or releasing stool, see a healthcare provider. Seek medical attention if you notice sudden abdominal pain that does not improve.
The pandemic played a role in increased consumption, but alcohol use among people 65 and older was climbing even before 2020. (Luisa Jung/The New York Times)
The phone awakened Doug Nordman at 3 a.m. A surgeon was calling from a hospital in Grand Junction, Colorado, where Nordman’s father had arrived at the emergency room, incoherent and in pain, and then lost consciousness.
At first, the staff had thought he was suffering a heart attack, but a CT scan found that part of his small intestine had been perforated. A surgical team repaired the hole, saving his life, but the surgeon had some questions.
“Was your father an alcoholic?” he asked. The doctors had found Dean Nordman malnourished, his peritoneal cavity “awash with alcohol.”
Doug Nordman, a military personal finance author living in Oahu, Hawaii, explained that his 77-year-old dad had long been a classic social drinker: a scotch and water with his wife before dinner, which got topped off during dinner, then another after dinner, and perhaps a nightcap.
Having three to four drinks daily exceeds current dietary guidelines, which define moderate consumption as two drinks a day for men and one for women, or less. But “that was the normal drinking culture of the time,” Doug Nordman, now 63, said.
At the time of his hospitalization, though, Dean Nordman, a retired electrical engineer, was widowed, living alone and developing symptoms of dementia. He got lost while driving, struggled with household chores and complained of a “slipping memory.”
He had waved off his two sons’ offers of help, saying he was fine. During that hospitalization, however, Doug Nordman found hardly any food in his father’s apartment. Worse, reviewing his father’s credit card statements, “I saw recurring charges from the Liquor Barn and realized he was drinking a pint of scotch a day,” he said.
Public health officials are increasingly alarmed by older Americans’ drinking. The annual number of alcohol-related deaths from 2020 through 2021 exceeded 178,000, according to recently released data from the Centers for Disease Control and Prevention. That is more deaths than from all drug overdoses combined.
An analysis by the National Institute on Alcohol Abuse and Alcoholism shows that people over 65 accounted for 38% of that total. From 1999 to 2020, the 237% increase in alcohol-related deaths among those over age 55 was higher than for any age group except 25- to 34-year-olds.
Americans largely fail to recognize the hazards of alcohol, said George Koob, director of the institute. “Alcohol is a social lubricant when used within the guidelines, but I don’t think they realize that as the dose increases it becomes a toxin,” he said. “And the older population is even less likely to recognize that.”
The growing number of older people accounts for much of the increase in deaths, Koob said. An aging population foreshadows a continuing surge that worries health care providers and elder advocates, even if older people’s drinking behavior doesn’t change.
But it has been changing. The proportions of people over 65 who report using alcohol in the past year (about 56%) and the past month (about 43%) are lower than for all other groups of adults. But older drinkers are markedly more likely to do it frequently, 20 or more days a month, than younger ones.
Moreover, a 2018 meta-analysis found that binge drinking (defined as four or more drinks on a single occasion for women, five or more for men) had climbed nearly 40% among older Americans over the past 10 to 15 years.
What’s going on here?
The pandemic has clearly played a role. The CDC reported that deaths attributable directly to alcohol use, emergency room visits associated with alcohol, and alcohol sales per capita all rose from 2019 to 2020, as COVID-19 arrived and restrictions took hold.
“A lot of stressors impacted us: the isolation, the worries about getting sick,” Koob said. “They point to people drinking more to cope with that stress.”
Researchers also cite a cohort effect. Compared with those before and after them, “the boomers are a substance-using generation,” said Keith Humphreys, a psychologist and addiction researcher at Stanford. And they’re not abandoning their youthful behavior, he said.
Studies show a narrowing gender divide, too. “Women have been the drivers of change in this age group,” Humphreys said.
From 1997 to 2014, drinking rose an average of 0.7% a year for men over 60, while their binge drinking remained stable. Among older women, drinking climbed by 1.6% annually, with binge drinking up 3.7%.
“Contrary to stereotypes, upper-middle-class, educated people have higher rates of drinking,” Humphreys explained. In recent decades, as women grew more educated, they entered workplaces where drinking was normative; they also had more disposable income. “The women retiring now are more likely to drink than their mothers and grandmothers,” he said.
Yet alcohol use packs a greater wallop for older people, especially for women, who become intoxicated more quickly than men because they’re smaller and have fewer of the gut enzymes that metabolize alcohol.
Seniors may argue that they are merely drinking the way they always have, but “equivalent amounts of alcohol have much more disastrous consequences for older adults,” whose bodies cannot process it as quickly, said Dr. David Oslin, a psychiatrist at the University of Pennsylvania and the Veterans Affairs Medical Center in Philadelphia.
“It causes slower thinking, slower reaction time and less cognitive capacity when you’re older,” he said, ticking off the risks.
Long associated with liver diseases, alcohol also “exacerbates cardiovascular disease, renal disease and, if you’ve been drinking for many years, there’s an increase in certain kinds of cancers,” he said. Drinking contributes to falls, a major cause of injury as people age, and disrupts sleep.
Older adults also take a lot of prescription drugs, and alcohol interacts with a long list of them. These interactions can be particularly common with pain medications and sleep aids like benzodiazepines, sometimes causing oversedation. In other cases, alcohol can reduce a drug’s effectiveness.
Oslin cautions that while many prescription bottles carry labels that warn against using those drugs with alcohol, patients may shrug that off, explaining that they take their pills in the morning and don’t drink until evening.
“Those medications are in your system all day long, so when you drink, there’s still that interaction,” he tells them.
One proposal for combating alcohol misuse among older people is to raise the federal tax on alcohol, for the first time in decades.
“Alcohol consumption is price-sensitive, and it’s pretty cheap right now relative to income,” Humphreys said.
Resisting industry lobbying and making alcohol more expensive, the way higher taxes have made cigarettes more expensive, could reduce use.
So could eliminating barriers to treatment.
Treatments for excessive alcohol use, including psychotherapy and medications, are no less effective for older patients, Oslin said. In fact, “age is actually the best predictor of a positive response,” he said, adding that “treatment doesn’t necessarily mean you have to become abstinent. We work with people to moderate their drinking.”
But the 2008 federal law requiring health insurers to provide parity — meaning the same coverage for mental health, including substance use disorders, as for other medical conditions — doesn’t apply to Medicare. Several policy and advocacy groups are working to eliminate such disparities.
Dean Nordman never sought treatment for his drinking, but after his emergency surgery, his sons moved him into a nursing home, where antidepressants and a lack of access to alcohol improved his mood and his sociability. He died in the facility’s memory care unit in 2017.
Doug Nordman, whom his father had introduced to beer at 13, had been a heavy drinker himself, he said, “to the point of blackout” as a college student, and a social drinker thereafter.
But as he watched his father decline, “I realized this was ridiculous,” he recalled. Alcohol can exacerbate the progression of cognitive decline, and he had a family history.
He has remained sober since that pre-dawn phone call 13 years ago.
PCOS symptoms are still difficult for doctors to diagnose and treat. Here’s why
Caroline Hopkins – March 31, 2024
Every morning, Jeni Gutke swallows 12 pills. In the evening, she takes 15 more, then another before bed. She also takes an injectable medication once weekly, and two other medications as needed.
Gutke, of Joliet, Illinois, has polycystic ovary syndrome, or PCOS, and the medications and supplements help the 45-year-old cope with migraines, high blood pressure, diabetes, high cholesterol, anxiety and depression that come with the complex hormonal condition.
Not one of Gutke’s medications are technically “PCOS drugs.”
portrait (Courtesy Jeni Gutke)
The Food and Drug Administration has not approved a medication specifically for PCOS, which is often linked to infertility, irregular or missed periods, weight problems, and other debilitating symptoms. Gutke’s array of medications is typical of how many of the estimated 5 million women in the U.S. diagnosed with PCOS deal with it.
“It’s such a vast syndrome that affects everything from your head to your toes,” she said. She was diagnosed with endometrial cancer — another risk linked to PCOS — at age 37.
After nearly a century of disagreements over what, exactly, defines the condition, as well as a lack of research, PCOS is still poorly understood. The symptoms vary so widely that any single drug would be unlikely to help all patients, said Dr. Heather Huddleston, a reproductive endocrinologist at the University of California, San Francisco and director of UCSF’s PCOS Clinic.
Women with PCOS and the doctors who care for them say they want better options — treatments for the condition’s root causes rather than bandages for individual symptoms. Even as calls for better treatments grow, the lack of investment in PCOS research has limited doctors’ ability to help their patients.
“It gets very messy to try to identify one treatment that’s going to work for everybody,” Huddleston said.
Many women with the condition end up taking off-label prescriptions — meaning drugs technically approved for other conditions, like diabetes or obesity — to help PCOS-related symptoms. Navigating insurance coverage for off-label prescriptions can be challenging.
“There’s no magic pill,” said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. “There are too many components for there to be a one-size-fits-all treatment.”
Hacatoryan was diagnosed with PCOS at age 18 and now works as a diet and lifestyle coach for women with PCOS.
Although research is murky when it comes to the best diet for women with PCOS, the most up-to-date international guidelines recommend exercise and a healthy diet. There’s no evidence that any particular diet improves symptoms, although some women have found lifestyle coaching helpful.
A spokesperson at the NIH said that it’s too early to know which women’s health conditions will receive funding under the new initiative.
“Given how common PCOS is, the amount of funding it’s gotten is proportionately extremely small,” Huddleston said.
Government funding is just one part of the total research budget for a given disease. While it’s tough to pin down a dollar figure for private industry spending, experts say the lack of FDA-approved PCOS treatments reflects a lack of investment from drugmakers, too.
Developing PCOS treatments requires a better understanding of the condition. This, in turn, requires far more research tracking thousands of women over many years, which can be extremely expensive, experts say.
However, there are some promising signs.
Although research is early and only in a few dozen women, there are a handful of small drug companies studying possible PCOS treatments. A Menlo Park, California-based company called May Health, for instance, is developing a one-time surgical procedure it thinks could help with PCOS. Spruce Bio, a San Francisco biotech firm, is running a small clinical trial with a drug called tildacerfont for PCOS. It is not clear yet if the oral drug works. President and CFO Samir Gharib said larger clinical trials will depend on the company’s ability to “secure additional financing” or partner with another drug company.
The FDA recently attended a meeting with advocacy group PCOS Challenge where women shared their experiences with the agency’s scientists and drug companies. No PCOS drug trials were announced after the meeting, but the FDA’s interest shows a growing push for improved treatment, said William Patterson, a spokesperson for PCOS Challenge.
No known cure for PCOS
Doctors recommend hormonal contraceptives — most commonly the birth control pill — to regulate heavy, irregular periods;, acne;, and unwanted hair growth. Others say taking the pill just masks, rather than treats, their PCOS symptoms and the symptoms return as soon as they stop taking it.
“PCOS is unfortunately not curable, so treatment is about managing its symptoms,” said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. Chan said birth control can be a good option for some, but not all, of her PCOS patients.
For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin.
Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS, although studies have been small and early -stage.
Novo Nordisk, the company that makes Ozempic and Wegovy, said it has no plans as of now to seek FDA approval for PCOS. Still, the company mentions PCOS on its Truth About Weight website, part of its marketing campaign for Wegovy
Causes and symptoms of PCOS
“We don’t know the initial spark leading to PCOS or where it arises from,” Chan said.
PCOS affects an estimated 6% to 12% of reproductive-age women in the U.S. The real prevalence is likely higher since an estimated 70% of cases go undetected.
Experts generally agree that PCOS, at its core, is a hormone-related condition. Women with PCOS have higher levels of androgen hormones, which can cause a range of symptoms, including:
Missing, irregular, or heavy periods
Acne
Excess hair growth on the face or body
Thinning or balding scalp hair
According to endocrinologist Dr. Andrea Dunaif, some doctors have been pushing to separate PCOS into two different diagnoses: one having more to do with the reproductive cycle and fertility issues and another having more to do with metabolism, high body weight, and diabetes.
“PCOS looks to be at least two or three different conditions we’re lumping together, but they’re genetically distinct,” said Dunaif, the chief of the endocrinology, diabetes and bone disease division of Mount Sinai Health System and the Icahn School of Medicine.
The confusion surrounding PCOS diagnosis is partly why it’s been hard to get large pharmaceutical companies to invest in PCOS treatment, she said.
In Dunaif’s view, it’s not accurate to call the condition “PCOS” at all, because it has more to do with excess hormones than it does with actual cysts on the ovaries. PCOS got its name from the bumps on the ovaries appearing like cysts on an ultrasound image. These are not cysts, but instead egg follicles that are, as Dunaif described them, “arrested in development.”
As it is, many doctors diagnose the condition based on two of three factors:
Irregular periods
High androgen levels
Multiple follicles on the patient’s ovaries
But these three factors don’t account for some of the most challenging symptoms of PCOS: insulin resistance and stubborn weight gain. Excess androgen hormones can spike insulin levels, which interferes with how the body processes sugar. Doctors aren’t sure whether the hormonal dysregulation causes insulin resistance, or whether insulin resistance causes excess androgen hormones.
Either way, women with PCOS have a higher risk of diabetes, excess weight gain, high cholesterol, and high blood pressure. Yet these metabolic conditions aren’t included in the criteria many doctors use to diagnose PCOS. The result? A missed diagnosis.
This was initially the case for Candice Bolden, 35, who started noticing acne and excess facial and body hair several years before she was diagnosed with PCOS in 2021. Bolden, a lifelong dancer, also had unusually low energy.
portrait (Courtesy Candice Bolden)
“The final straw was excess weight gain that I could not take off no matter what I did,” said Bolden, who lives in Los Angeles. “All the other things I had kind of just stuffed under the rug. I’d just chalked it up to being a hairy, Haitian woman.”
After gaining 35 pounds, the 5-foot-2-inch Bolden, who exercised twice a day and followed strict diets, saw multiple doctors who she said ignored her symptoms.
“Doctors kept telling me I was fine, and to go home, work out, and eat clean,” she said. “It was the most frustrating thing ever.”
‘We don’t have to live underneath this dark cloud’
Women living with PCOS say the rise of online communities, including on social media apps like TikTok and Instagram, has given them a place to speak out, share the treatment approaches working for them, and meet other women with PCOS.
When Bolden finally got a diagnosis, she wasn’t sure what to do next. Gutke and Hacatoryan had similar experiences.
“I was like, ‘Wait, I have so many questions,’ and the doctor just told me, ‘It is what it is,’” Hacatoryan said.
Hacatoryan calls women in her online community her “cysters.”
Bolden said she’s noticed more women turning to social media to learn how others manage their PCOS and share their own stories.
On her own social media accounts, she’s been trying to change the narrative about PCOS being primarily a fertility problem, which she sees as an outdated perception.
“When I was diagnosed, my doctor mentioned PCOS being the No. 1 reason for infertility, and that shattered me,” said Bolden, who was newly engaged at the time and eager to start a family. “I was happy I was diagnosed, because it showed me something was actually happening and I wasn’t just crazy. But I was heartbroken.”
Things changed after Bolden moved; found a new doctor; and worked closely with her husband and the online PCOS community to find a system that worked to manage her PCOS symptoms.
Bolden is now pregnant and expecting a baby girl.
“I want people diagnosed with PCOS to know there’s hope, and we don’t have to live underneath this dark cloud all the time,” she said.
‘After Years Of Failed Fad Diets And Workouts, I Started Lifting Heavy Weights At 43′
Jenna Seguin, as told to Andi Breitowich – March 30, 2024
‘I Tried Every Diet, But This Changed Everything’Courtesy of Jenna Seguin
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I’ve always tried to eat well and exercise, but I lacked consistency. Whether it was the Whole30 diet, 75 Hard challenge, or a month-long bootcamp, everything always had a clear start and end date. I was quick to move on and, consequently, never saw lasting results.
In April 2021, I finally had enough. I realized doing the same thing over and over without results is scarier than trying something new, so I set up a meeting with a personal trainer at my local gym. I experimented with lifting weights in my early 20s here and there, but I was never consistent and didn’t follow a program. But I’m a lifelong learner who enjoys getting out of my comfort zone. My goals were simple, yet ambitious: I wanted to master the big lifts—bench press, squat, and deadlift—and I wanted to understand how to increase weight progressively to reach my full potential.
My first session was tough. Everything was hard, my form was all over the place, and the moves felt awkward. I was also nervous that people thought I didn’t belong in the gym. But instead of saying, “This is hard I can’t do it,” I said, “How can I improve?” Approaching this new challenge with curiosity, rather than fear, empowered me. I was determined to get stronger, and I was ready to put in the work.
I committed to training four times a week: two days with my trainer and two days on my own. I wanted to stay consistent, improve my form, and build muscle. I was excited for the challenge and motivated to get better.
After consistently working with my trainer for a year, I was craving more.
On Instagram, I came across a video of Michelle MacDonald bench pressing and was in awe of her form and heavy weight. I wanted to level up, so I applied to Michelle’s personal training community, The Wonder Women.
In August 2022, I started virtual training with The Wonder Women five days a week: three lower body days and two upper body days. I prioritized form and focused on progressive overload, but I also got curious about bodybuilding.
I decided to start training for my first bodybuilding competition in June 2023, but 12 weeks into prep, my competition was canceled. The Wonder Women didn’t have spots available to transfer into the current bodybuilding training group, so I switched teams and joined Dynasty Training.
Now, I train four days a week—two for lower body and two for upper body.
I’m preparing for my first show at the end of 2024, so I recently started my “build phase,” which consists of four days of weight training: two lower body days and two upper body days. My goal is to build muscle, but instead of only focusing on how much weight I can lift, I also prioritize tempo and increasing my reps and sets.
For lower-body workouts: I do a glutes and quads day and a posterior chain day. My workouts are typically an hour and a half, and I do seven to 10 moves per session. The number of reps and sets varies, but most of my current lower-body lifts are based on a ladder model: 12 reps, 10 reps, eight reps, and six reps of each move, increasing weight as the number of reps decreases.
For upper-body workouts: I do a shoulders and back day and a chest and arms day. These workouts are typically an hour, and I do seven to 10 moves per session, including bench press, pullups, man makers, lat pulldowns, and pushups.
I also do 35 minutes of cardio six days a week and have one day designated to core and high intensity intervals, and one day of stretching. Sunday is my day off.
Lower body is my favorite to train and I especially love deadlifts, Bulgarian split squats, and hip thrusts. Now, I can deadlift 195 pounds and thrust 300 pounds. I’m currently working on adding a pause at the top of each hip thrust and let me tell you… it adds a whole other level of intensity.
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I learned to count macros and let go of the belief that I needed to restrict food.
I’ve tried every diet in the book, but nothing was ever sustainable or satisfying. Then, I learned to count macros and realized I could still eat my favorite foods when I paid attention to portion size and nutrition labels.
I eat four to five meals a day and focus on my protein, carb, and fat intake. I always prioritize protein, and chicken, turkey, and fish are my go-to sources. It’s also fun to try new macro-friendly recipes, and meal prepping on Sunday sets me up for success during the week.
That said, it took me a long time to get over the idea of restriction. I was so used to eliminating foods and eating as little as possible, but once I learned nothing is off limits and macros are about balance and variety, I felt better than ever. Instead of a month-long, restrictive, fad diet, I realized the most sustainable plan is listening to my body and eating the foods I love.
These three things were key to my strength transformation success.
1. I let go of the notion that my strength journey needs to be perfect.
When I started strength training in 2021, it wasn’t necessarily the “perfect time” to embark on a new journey. But I decided to stop waiting and took control of my situation. Is every workout perfect? Nope! But that’s okay. I realized if I keep trying and continue to show up it’s going to pay off in the long run.
2. I became more self-aware and understood the value of the mind-body connection.
It’s so easy to operate on autopilot, but I’ve learned to evaluate my *entire* lifestyle when something feels off. If my energy levels are low, I look at my diet and sleeping habits. When I’m stressed, I reflect on why instead of letting anxiety rule my day.
As a result, I’ve learned the importance of the mind-body connection. How I’m feeling physically and mentally can have a direct impact on each other and the overall sense of self-awareness has gotten me closer to my goals.
3. I gave myself the opportunity to be good at something and realized consistency is key.
Most of my life, I participated in diets and fitness programs that had a clear start and end date. Once I understood that people become good at things by being consistent, a light bulb went off. I realized I had never given myself a chance (or the time) to get good. I always expected quick results and a long-term program seemed daunting, but when I challenged myself to start weight lifting without an end date in mind, my whole mindset changed.
Not only do I love that consistency brings me closer to my goals, but I found value and motivation in the process. Whether it’s perfecting my form or mastering a recipe, the sense of accomplishment after nailing a new skill keeps me determined to get better and stronger. It’s fun to show up for yourself and consistency in the gym has given me the opportunity to believe in myself.
Do turmeric supplements really treat pain, boost mood, and improve allergies? Experts say they work best for 2 conditions
Stephanie Watson – March 30, 2024
Getty Images
Americans spend around $50 billion a year on vitamins and supplements. One of the most popular is turmeric, a bright orange root that has its roots in both traditional Eastern medicine and cuisine. Proponents are willing to pay $20 or more for a bottle, hoping to relieve arthritis pain and inflammation, lower cholesterol and blood sugar levels, and treat whatever else happens to ail them. But is it worth the money?
While a lot of research has highlighted turmeric’s antioxidant and anti-inflammatory properties, the wide range of supplement potencies and doses used in studies has made it hard to confirm any health claims.
Dr. Keith Singletary, professor emeritus of nutrition at the University of Illinois Urbana-Champaign, has reviewed the evidence on turmeric. His take? “I think it’s promising,” he says, but he stresses that it isn’t “the cure-all that marketing would make it appear.”
Health benefits of turmeric
The health properties attributed to turmeric come from natural compounds called curcuminoids. “Curcumin, which is the major one, is believed to be largely responsible for the health benefits of turmeric,” says Singletary.
What might curcumin do? The best evidence centers on two conditions: arthritis and metabolic syndrome.
Arthritis
Considering turmeric’s anti-inflammatory properties, it’s not surprising that researchers have investigated its use for arthritis. The supplement does appear to reduce pain and stiffness from osteoarthritis, the most common form of this achy joint disease.
“It’s not a miracle drug, but it probably works as well as ibuprofen or acetaminophen,” says Dr. Janet L. Funk, professor of medicine and vice chair of research for the Department of Medicine at the University of Arizona College of Medicine-Tucson. Her lab studies plant-derived dietary supplements for inflammatory diseases.
Metabolic syndrome
This isn’t a disease, but rather a cluster of conditions like obesity, high blood pressure, high blood sugar, and high triglycerides that collectively increase the risk for diabetes, heart disease, and stroke. About 1 in 3 American adults have metabolic syndrome, according to the National Heart, Lung, and Blood Institute (NHLBI).
Studies have looked at the effects of turmeric on blood sugar, triglycerides, and insulin levels, as well as on inflammation (which also plays a role in metabolic syndrome). “In general, there was a strong preponderance of evidence that it might help reduce all those things. So it might have some benefit in people who are overweight and concerned about inflammation and diabetes,” Funk says.
But—there’s a very big caveat. “There’s a lot of inconsistency between studies,” Singletary says. And therein lies the problem in evaluating turmeric.
An imperfect science
Though plenty of research is being done on turmeric, the studies aren’t consistent. Researchers have tested different amounts of the supplement in different groups of people for different amounts of time. Some studies added a compound like piperine, found in black pepper, to make turmeric more active in the body (researchers call this increased “bioavailability”).
For example, one study on knee osteoarthritis had participants take 180 milligrams (mg) of curcumin for eight weeks. Another one used doses of 500 mg plus 5 mg of BioPerine (black pepper) extract three times a day for six weeks.
Because most of the studies have lasted four months or less, researchers don’t know what might happen with long-term use. “The bottom line is, there’s no definitive, well-designed studies at this point,” Funk says. She’s skeptical that there ever will be, given that the nutraceutical industry and the National Institutes of Health aren’t funding them.
The risks of turmeric
Turmeric is probably safe if you get it from the spice or you take only the recommended amount in supplements, says the National Center for Complementary and Integrative Health. In larger quantities, it could cause GI side effects like nausea or diarrhea.
Piperine poses its own set of issues, because it increases the bioavailability of curcumin by inactivating an enzyme in the liver that would otherwise break it down. “That enzyme is really important for [breaking down] most drugs people take,” says Funk. Theoretically, piperine might cause a buildup of medications in the body, thus increasing the risk for side effects. “Generally speaking, if you’re taking other medications, I would shy away from any product that has piperine in it, just in case it could interfere with the metabolism of your other drugs,” she adds.
An even bigger concern is a rare but serious risk of liver damage from turmeric supplements, as well as high levels of lead in these products. Several studies, including one that Funk co-authored, found excessive amounts of lead in some turmeric supplements—especially those that contained turmeric root. Exposure to lead in large quantities can have toxic effects on the body, including heart and kidney problems.
Should you take turmeric?
Is it worth taking turmeric? “That’s the million- dollar question,” says Singletary. Given the lack of clear evidence on its benefits and the potential risks, he says you’re safest getting turmeric through your diet. You can add the spice to soups, stews, sauces, and smoothies. Top them with a pinch of black pepper or cook turmeric in oil to enhance its bioavailability.
If you do use turmeric supplements, it can be difficult to know which form is best, or how much to take. The best advice is to ask your health care provider, says Singletary. Start out with a low dose to see how your body responds to it. And don’t expect turmeric to be a “cure-all for all your ailments, which is unlikely to be the case,” he adds.
New report finds striking parallels between tobacco, gas stove campaigns: ‘This is intentional; it’s by design’
Ben Stern – March 22, 2024
For decades, tobacco companies misled the public about the dangers of their products, engaging in multipronged PR campaigns and spreading disinformation.
Today, nicotine and smoking are widely acknowledged to be addictive, and cigarettes are known to cause cancer. But it took years to expose these truths, all while massive tobacco corporations profited from the harm they caused.
In a striking new report titled “Cooking with Smoke: How the Gas Industry Used Tobacco Tactics to Cover up Harms from Gas Stoves,” the Public Health Law Center has revealed how Big Tobacco’s playbook of deception was also used to convince the public that gas stoves are safe.
The beginning of the gas stove fight
While news coverage on the potential dangers of gas stove pollution has recently picked up, researchers have been trying to sound the alarm since at least the 1970s.
Early studies conducted by the Environmental Protection Agency were primarily focused on investigating the health impacts of nitrogen dioxide (NO2) pollution from gas stoves.
After it was determined that such NO2 exposure could cause or worsen asthma and other respiratory problems, the American Gas Association (AGA), fearing public outcry, began to fund its own research claiming that gas stoves weren’t associated with respiratory issues.
Yet the current scientific consensus is that gas stoves are burdening the public with health issues, specifically our children. One peer-reviewed study from the nonprofit think tank RMI found that more than one in eight cases of childhood asthma in America is associated with a gas stove in the home.
The full health impacts of exposure to gas stove pollution are unfortunately not yet known. Pediatrician Dr. Lisa Patel, the Executive Director of the Medical Society Consortium on Climate and Health, believes it’s critical to learn more about gas stoves’ potential dangers sooner rather than later.
“Because the oil and gas industry has been so successful in pulling the wool over our eyes, suppressing the research, we’re still figuring out which of the pollutants [from stoves] is the ‘worst’ in terms of risk,” Dr. Patel told The Cool Down.
Cooking with smoke
The Public Health Law Center’s new report lays out how eerily similar the disinformation campaigns of the gas and tobacco industries are.
“Cooking with Smoke” describes seven of the deceptive tactics used by both the tobacco and gas industries to mislead the American public.
One such tactic is hiring the same scientists and research labs to provide biased or partial information pointing to desired results — namely, downplaying the health impacts of tobacco products and gas stoves. The AGA has hired the exact same laboratory as the Council for Tobacco Research, a tobacco industry trade group, for its sponsored research.
Last year, a New York Times exposé revealed that not only did the AGA hire a toxicologist to obscure the relationship between gas stoves and health impacts, but that same toxicologist was hired by the cigarette company Philip Morris to provide testimony claiming that Marlboro Lights were “safer for smokers.”
Another strategy utilized by both industries is the marketing of deceptive media to children. As outlined in the report, gas companies have used social media influencers to promote gas stoves to young people. Within the past two years, the gas industry has also sent coloring books to schools, telling children that “natural gas [is] your invisible friend,” as the report noted.
We deserve better
Due to decades of industry disinformation, the health harms caused by gas stoves have largely gone unnoticed or misunderstood by the American public. But just as Big Tobacco couldn’t hide the truth about cigarettes, the gas industry won’t be able to successfully hide the dangers of its stoves from the public forever.
“The gas industry wants us to accept health harms that we don’t have to. This is intentional; it’s by design,” Joelle Lester, Executive Director of the Public Health Law Center, told The Cool Down. “That’s where the gas industry is similar to Big Tobacco. They will continue to resist regulation and restriction to protect their profits.”
Change is coming
Both Lester and Dr. Patel believe that more information about the true health risks of gas stoves will inevitably emerge. When it does, change will follow.
“Jurisdictions will make changes [to transition away from gas stoves],” Lester told The Cool Down, “and once the sky doesn’t fall, and the health benefits can be measured, it will be so powerful.”
And according to Dr. Patel, “in the end, science and wanting to take care of each other will always win out.”
Actions you can take now
For those worried about the impacts of gas stoves, waiting on policy fixes isn’t necessary. The best way for an individual to eliminate the health risks of a gas stove is to replace it with an induction or electric range.
Induction cooktops have already proven to be the superior option in many ways, cooking food more quickly, evenly, efficiently, and safely than gas stoves.
While replacing your gas stove may seem daunting, the federal government, through the Inflation Reduction Act, will offer up to $840 to those who make the switch.
Even renters will be able to take advantage of this point-of-sale rebate by purchasing plug-in induction cooktops.
Some landlords may also be amenable to electrification projects, like installing induction stoves, once they find out how much more energy-efficient the devices are. The nonprofit Rewiring America has an in-depth guide for talking to your landlord about upgrading.
Of course, even with an $840 upfront discount, not every family will be able to make the switch. For those families, many options still exist to protect their respiratory health. Dr. Patel told The Cool Down: “If they can’t get that gas cooktop out, using electric appliances, opening windows, [or] using an overhead vent helps.”
Fast-food companies seeing low-income diners pare orders
Waylon Cunningham – March 27, 2024
McDonald’s Corp. reports fourth quarter earningsA Wendy’s sign and logo are shown at one of the company’s restaurant in Encinitas, California
SAN ANTONIO, Texas (Reuters) – Runaway prices at U.S. fast-food joints and restaurants have made people skittish down the income ladder and executives at chains including McDonald’s and Wendy’s recently said they worry about losing business from those on the tightest budgets.
Roughly a quarter of low-income consumers, defined as those making less than $50,000 a year, said they were eating less fast food and about half said they were making fewer trips to fast-casual and full-service dining establishments, according to polling in February by Revenue Management Solutions, a consulting firm.
The rising price of food is contributing to budget-conscious diners cutting back.
Whether consumed at home or in a restaurant, food prices rose 20% from Jan. 2021 to Jan. 2024, the fastest jump on record. A recent census Household Pulse Survey showed half of people earning less than $35,000 a year had difficulty paying everyday expenses, and nearly 80% were moderately or “very” stressed by recent price increases.
Lauren Oxford, a musician who works part time at a bed-and-breakfast in Tennessee, said she used to stop by McDonald’s after running errands, treating herself to two double hamburgers, fries and a drink, for less than $5. As prices rose, she switched to smaller hamburgers and stopped getting the drink.
But after a year in which McDonald’s franchisees drove prices up about 10% according to the company’s executives, she’s going to McDonald’s less in general. “Now I don’t know if I can justify that.”
In the Fed’s most recent Beige Book compendium of anecdotal reports gathered from business and community contacts around the country, 7 of 12 regional Fed districts reported low-income consumers were changing spending habits in search of bargains, seeking more help from community groups, or struggling to access credit.
About one-third of Black American households, and 21% of white American households, earned less than $35,000 in 2022, according to the latest available U.S. census data.
For fast-food companies that often promote an image of affordability, low-income consumers are a significant portion of the customer base and a bellwether for longer-term trends. But they are typically the first to cut back spending and the last to come back.
But now, chains may be less likely to chase customers as hard as they have in the past because even with a drop in traffic, sales have remained consistent supported by increased prices.
Fast food companies aren’t “in a hurry to take traffic over profit the way they were a decade ago,” said Mike Lukianoff, CEO of SignalFlare.ai and a veteran consultant in the fast food industry.
For example back in 2008, Subway introduced its nationwide $5 footlong, which became the poster sandwich for the Great Recession. That spurred rivals to introduce extreme value deals for budget-conscious customers, such as “$5 Fill-Up Boxes” at Yum! Brands KFC.
In 2016, McDonald’s, after a prolonged slump in sales, introduced a bundle deal it called “McPick 2”, allowing customers to choose 2 items, like a McDouble, for $2. Within months, Wendy’s offered a four for $4 deal. Burger King offered five for $4. Pizza Hut had a $5 “flavor menu.”
APP-DRIVEN DISCOUNTS
Now, instead of across-the-board menu slashes and broad discounts, industry analysts say chains are being more selective, aiming them at specific demographics or limiting them to specific meal times or channels, such as its app or only through delivery.
McDonald’s executives told investors in February that it would rely on its existing “value menu” to appeal to low-income consumers who might be tempted to eat packaged food at home instead. CFO Ian Borden said affordability is core to the brand, and the company would continue “evolving” its value offerings.
“The battleground is certainly with that low-income consumer,” McDonald’s CEO Chris Kempczinski told investors, referring to people making less than $45,000.
Wendy’s recently introduced a limited-time $1 burger — available only through its app. Its CFO Gunther Plosch told investors in February that among lower-income customers, their traffic is down but their share with the general market is unchanged.
For major fast-food companies, loyalty apps are the go-to strategy among major brands to increase retention and the average amount of money spent. The upside for chains, David Henkes, senior principal with Technomic said, is that they capture more transaction data and demographic data for the consumer, “which is a trade-off many are happy to do.”
For example, McDonald’s frequently offers in-app discounts, such as 20% off an order or free delivery with a large enough order.
Domino’s halved the minimum purchase price to get points in its loyalty program, to $5 from $10, its CEO told investors at a conference in January. It also reduced the number of purchases needed to get a free pizza to as few as two from six. “And so essentially, for this lower-income consumer, we’ve made the brand more accessible,” CEO Russell Weiner said.
To be sure, not every chain is seeing weakness among low-income customers. At Taco Bell, which sells a single taco for $1.40 at many of its stores in San Antonio, locations in low-income markets did better than other locations, Yum! CEO David Gibbs told investors in February.
McDonald’s still holds its appeal for Andreas Garay, a retail worker eating at a McDonald’s in westside San Antonio. He said he plans to keep his coffee-and-Big-Mac habit– even if prices continue going up.
(Reporting by Waylon Cunningham in San Antonio and Howard Schneider in Washington, D.C.; Editing by Anna Driver)
