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Home and Away star accused of "stomping" on woman's head

A former Home and Away star, who has been accused of "stomping" on a woman's head during a violent altercation, was cast to appear on Seven's reality show SAS while battling “declining mental health and escalating drug use” according to court documents. Orpheus Pledger has been accused of the violent alleged assault that took place on March 25th, and was arrested on Thursday following a three-day manhunt by police after he absconded from a Melbourne hospital on Tuesday while on remand. At a bail application that lasted two days, the court heard details of Pledger's years-long deterioration of his mental health, in addition to his alleged prolonged and increasing drug use. A police statement submitted to the court alleged that Pledger was dealing with “declining mental health and escalating drug use” between February 2021 and his alleged attack in March this year. Court documents also alleged that Pledger has been “refusing to engage with mental health services and appears to spend his Centrelink payments on drugs” and had been known to police for many years. During a difficult period with his mental health and drug use, Pledger was cast on Seven's reality show SAS, before he abruptly quit after just two episodes over concerns of his "erratic behaviour". At the bail application, documents alleged the accused is at an “extreme risk of further assaulting” the alleged victim, although Pledger’s lawyer Jasper MacCuspie argued his client’s mental health would deteriorate if he were to remain in custody. Pledger’s matter will be heard again by the Melbourne Magistrates Court in May, where he will face the charges of assault. Image credits: Seven

Legal

"No-brainer": Call for Jack's law to be introduced nationwide

A Queensland father whose son was stabbed on a night out is pushing for Jack's Law to be introduced nationwide in the wake of the <a href="https://www.oversixty.com.au/health/caring/family-of-bondi-killer-break-silence" target="_blank" rel="noopener">Bondi Junction attack</a> and <a href="https://oversixty.com.au/finance/legal/teenage-boy-in-custody-after-stabbing-at-sydney-church" target="_blank" rel="noopener">Wakeley Church stabbing</a>. Brett Beasley is urging NSW premier Chris Minns and other states to introduce the anti-knife law which allows police officers to conduct random searches for knives at public transport hubs and Safe Night precincts using metal detecting wands. “It’s an absolute no-brainer,” he told news.com.au. “It’s absolutely extraordinary how well it’s working here in Queensland. I believe every single police officer Australia-wide should have the same powers.” Beasly and his wife Belinda have spent years campaigning for the law following the tragic death of their son Jack, who was stabbed by a group of teens outside a Surfers Paradise convenience store during a night out in 2019. It's been three years since the law was introduced in Queensland, and since then 55,000 people have been searched, 800 weapons have been confiscated and 1400 people have been charged. “It’s the same as being pulled over for a random breath test, it’s exactly the same and it’s working,” Beasly said. “I can guarantee the NSW government, if they were to adopt Jack’s Law, then they will start finding thousands of weapons. It’s scary to think how many of these young offenders are walking around actually armed and getting away with it.” Beasly, who was “absolutely devastated” after hearing about the Bondi Junction stabbing spree, said that the NSW premier should waste no time introducing the law. “Chris Minns shouldn’t even contemplate it. He should just say, ‘Absolutely. Let’s do this’. “I get thousands of messages from people in New South Wales who say ‘We want Jack’s Law down here, we need it down here’.” “To lose a child in any way is absolutely horrendous, and to lose a child to murder is the worst way possible. Your child’s life is taken from them.” Beasly is keen to meet with Minns to discuss rolling out Jacks law in NSW saying: “if Chris Minns is open to a meeting with me, I’ll be on the next flight to Sydney because this government need to make this happen. It’s as simple as that." A NSW government spokesperson has told news.com.au that they “need to look carefully at our current policies to ensure the public is safe”. “The NSW Sentencing Council is currently undertaking a review of the sentencing laws for firearms, knives and other weapons offences. The NSW Government will also look at knife laws,” they said. “We will await the review findings and consider all recommendations carefully.” Beasly is also planning to meet with the Governor of Western Australia on Monday and hopes that they will also adopt the law. While waiting for other states to adopt the law, Beasly and the Jack Beasley Foundation are delivering free presentations about knife crime in schools. “Let’s work on this together and bond together and make a change and see if we can stop this,” he said. Image: Jerad Williams/ news.com.au

Legal

Woman baffled by mother-in-law’s insane ask over baby name

A woman has gone head-to-head with her mother-in-law over the name she has chosen for her unborn child. The pregnant woman took to Reddit to share her unusual predicament, explaining how her mother-in-law has demanded she change the name of her baby. The soon-to-be mum shared how she recently had dinner with her husband’s family, where she decided to reveal the baby’s gender and name. She had been keeping the information secret, but with only a few weeks of her pregnancy left, she decided to share the happy news that she was having a baby boy and had chosen the name Shawn for her son. But not everyone shared her happiness over the moniker, as her mother-in-law went pale with shock and demanded she choose a new name. “My in-laws got quiet for a moment before asking if there were other options we'd considered. Apparently, Shawn is the name of my 17-year-old sister-in-law Ashley's former bully who tormented her [for years],” the pregnant woman explained on Reddit. While she empathised with her in-laws, she didn’t want to change the name as it was the only one her and her husband agreed on for their son. She also explained that she hadn’t known about the family connection when they picked the name, and hadn’t picked it out of any malicious intent. “We took forever to pick a name,” she said. “Shawn is the only one we could agree on.” The dinner party soon ended after the argument began, but the mother-in-law didn’t back down, sending the expecting mum demanding messages. “She texted me and my husband again to ask us to find a new name for Ashley's sake.” “Would I be the a**hole for not wanting to change it? We were only able to agree on it a few weeks ago.” Commenters were torn over the subject, with many rushing to the pregnant woman’s defence, saying she can pick whatever name she wants for her son. “My spouse and sibling have the same name. Somehow, you just compartmentalise it,” one shared. “I feel like if a new baby in my family shared a name with my bully I'd just adapt,” another wrote. “After all, Shawn is a VERY common name, so I can't freak out every time I hear it and survive in this world.” However, a select few sided with the mother-in-law, sharing how stunned they were that the couple couldn't find enough compassion to pick another name. One person said, “I understand the difficulty of finding a name that feels right, but for me, after learning this, Shawn would quickly become another name that didn't work. It's only been decided on it for a few weeks so I'd just go back to the drawing board.” Image credits: Shutterstock

Family & Pets

What happens when I stop taking a drug like Ozempic or Mounjaro?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger. But does weight come back when you stop using it? The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people. So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far. <h2>It’s a long-term treatment, not a short course</h2> If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone. For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns. Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.) Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less. <h2>Why do people stop?</h2> Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>. But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons. Understanding what stopping does to the body is therefore important. <h2>So what happens when you stop?</h2> When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen: <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars </li> <li> over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back </li> <li> weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle. </li> </ul> While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat. <h2>Is stopping and starting the medications a problem?</h2> People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>. When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual. Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight. <h2>How can you avoid gaining weight when you stop?</h2> Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include: <ul> <li> getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a> </li> <li> exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it </li> </ul> <ul> <li> addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies </li> <li> eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes. </li> </ul> Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224972/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>. </div>

Body

If you squat in a vacant property, does the law give you the house for free? Well, sort of

<a href="https://theconversation.com/profiles/cathy-sherry-466">Cathy Sherry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Nothing excites law students like the idea of a free house. Or alternatively, enrages them. It depends on their politics. As a result, academics condemned to teaching property law find it hard to resist the “<a href="https://classic.austlii.edu.au/au/journals/MelbULawRw/2011/28.html">doctrine of adverse possession</a>”. The fact that a person can change the locks on someone else’s house, wait 12 years, and claim it as their own, makes students light up in a way that the Strata Schemes Management Act never will. The idea of “squatters’ rights” has received a lot of media attention recently amid the grim reality of the Australian housing market. It fuels commentators such as Jordan van den Berg, who <a href="https://www.instagram.com/purplepingers/">critiques bad landlords</a> on social media. Casting back to his days as a law student, <a href="https://www.sbs.com.au/news/the-feed/article/jordan-was-fed-up-with-australias-empty-houses-his-proposal-has-led-to-death-threats/stx6rv6fl">he’s promoting</a> the doctrine of adverse possession as a way of making use of vacant properties. As interesting as the doctrine is, it has little relevance in modern Australia. While it is necessary to limit the time someone has to bring legal proceedings to recover land – typically 12 or 15 years, depending on which state you’re in – most people don’t need that long to notice someone else is living in their house. If a family member is occupying a home that someone else has inherited or a tenant refuses to vacate at the end of a lease, owners tend to bring actions to recover their land pronto. So where did this doctrine come from, and what has it meant in practice? <h2>Free house fetching millions</h2> In unusual circumstances, people can lose track of their own land. Just before the second world war, Henry Downie moved out of his house in the Sydney suburb of Ashbury. Downie died a decade later, but his will was never administered. At the time of his death, a Mrs Grimes rented the house and did so for a further 50 years. Downie’s next of kin did not realise they had inherited the house or that they were Grimes’s landlord. Grimes died in 1998 and Bill Gertos, a property developer, saw the house was vacant. He changed the locks, did some repairs, then leased the house and paid the rates for the next 17 years. He then made an application under <a href="https://classic.austlii.edu.au/au/legis/nsw/consol_act/rpa1900178/s45d.html">NSW property laws</a> to become the registered proprietor. At this point, Downie’s next of kin became aware they may have been entitled to the property and disputed Gertos’s claim. The <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/cases/nsw/NSWSC/2018/1629.html">court held</a> Gertos had been “in possession” of the property since the late 1990s. The next of kin had a legal right to eject him, but they had failed to do so within the statutory time limit of 12 years. Gertos had the best claim to the house. He <a href="https://www.domain.com.au/6-malleny-street-ashbury-nsw-2193-2015821514">promptly sold it</a> for A$1.4 million. Outrageous as this may seem, the law encourages caring for land. If you fail to take responsibility for your land, and someone else does, you can lose it. <h2>An old English tradition</h2> Gertos’s jackpot was unusual, and adverse possession has always been more relevant in a country like England. First, for much of English history, many people did not have documentary title (deeds) to their land. People were illiterate, parchment was expensive, and documents could disappear in a puff of smoke in a house fire. The law often had to rely on people’s physical possession of land as proof of ownership. Second, as a result of feudalism, vast swathes of England were owned by the aristocracy. They and their 20th-century successors in title, often local councils, had a habit of forgetting they owned five suburbs in London. In the post second world war housing crisis, thousands of families, and later young people and students, <a href="https://www.bbc.co.uk/sounds/play/b017cfv4">squatted in vacant houses</a> owned by public and private landlords who lacked the means or motivation to maintain them. <h2>A sign of the times</h2> In contrast, in Australia, for most of our settler history, governments of all political persuasions actively prevented the emergence of a landed class. But now, courtesy of tax policies that <a href="https://www.quarterlyessay.com.au/essay/2023/11/the-great-divide">encourage investment</a> in residential real estate, we have a landlord class of Baby Boomer and Gen X investors. That has caused housing market stress as younger people cannot make the natural transition from being renters to homeowners. They are outbid by older, wealthier buyers whose tax benefits from negative gearing increase with every dollar they borrow to buy an investment property. Money flowing into the market then means that landlords’ greatest benefit is capital gain rather than income, and thanks to John Howard, investors pay <a href="https://theconversation.com/stranger-than-fiction-who-labors-capital-gains-tax-changes-will-really-hurt-109657">no tax</a> on half of that gain. Finally, an almost exclusive reliance by government on the <a href="https://australiainstitute.org.au/post/for-more-affordable-housing-we-need-more-public-housing/">private sector</a> to provide new homes – which it will only do if it is making a profit – has left many people in deep housing stress. While squatters in Australia are likely to find themselves swiftly subject to court orders for ejection, van den Berg’s rallying cry indicates just how inequitable the housing market has become. Baby Boomers and Gen X should be on notice – young people want their housing back. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227556/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cathy-sherry-466">Cathy Sherry</a>, Professor in Law, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-you-squat-in-a-vacant-property-does-the-law-give-you-the-house-for-free-well-sort-of-227556">original article</a>.

Legal

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”. As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”. We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out. Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise. <h2>How does it work?</h2> Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better. GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars. GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating. <iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe> GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action. Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more. GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection. <h2>What can users expect? What does the research say?</h2> Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly). A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs. Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up. Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>. Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up. <h2>Who is eligible for semaglutide?</h2> Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes. However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use. The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia. When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications. <h2>What else do you need to do during Ozempic treatment?</h2> Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials. Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week. STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling. A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>. <h2>But what are the side effects?</h2> Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain. In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos. More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions. To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term. Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.

Body

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

<a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Many have <a href="https://www.economist.com/leaders/2023/03/02/new-drugs-could-spell-an-end-to-the-worlds-obesity-epidemic">declared</a> drugs like Ozempic could “end obesity” by reducing the appetite and waistlines of millions of people around the world. When we look past the hype, this isn’t just untrue – it can also be harmful. The focus on weight, as opposed to health, is a feature of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0277539521001217">diet culture</a>. This frames the pursuit of thinness as more important than other aspects of physical and cultural wellbeing. The Ozempic buzz isn’t just rooted in health and medicine but plays into ideas of <a href="https://butterfly.org.au/weight-bias-fatphobia-diet-culture/#:%7E:text=Weight%20bias%2C%20sometimes%20also%20called,or%20being%20around%20fat%20people.">fat stigma and fat phobia</a>. This can perpetuate fears of fatness and fat people, and the behaviours that <a href="https://link.springer.com/article/10.1186/S12916-018-1116-5">harm people who live in larger bodies</a>. <h2>Not the first ‘miracle’ weight-loss drug</h2> This isn’t the first time we have heard that weight-loss drugs will change the world. Ozempic and <a href="https://www.ncbi.nlm.nih.gov/books/NBK551568/">its family</a> of GLP-1-mimicking drugs are the <a href="https://theconversation.com/ozempic-is-in-the-spotlight-but-its-just-the-latest-in-a-long-and-strange-history-of-weight-loss-drugs-209324">latest in a long line of weight loss drugs</a>. Each looked promising at the time. But none have lived up to the hype in the long term. Some have even been withdrawn from sale due to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126837/">severe side effects</a>. Science does improve <a href="https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30028-8/fulltext">incrementally</a>, but diet culture also keeps us on a cycle of hope for the next <a href="https://sahrc.org/2022/04/diet-culture-a-brief-history/">miracle cure</a>. So drugs like Ozempic might not deliver the results individuals expect, continuing the cycle of hope and shame. <h2>Ozempic doesn’t work the same for everyone</h2> When we talk about the results of studies using Ozempic, we often <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719041/">focus on the average</a> (also known as the mean) results or the maximum (or peak) results. So, studies might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">show</a> those using the drug lost an average of 10.9% of their body weight, but some lost more than 20% and others less than 5% What we don’t talk about as much is that responses are variable. Some people are “<a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769">non-responders</a>”. This means not everyone loses as much weight as the average, and some don’t lose weight at all. For some people, the side-effects will outweigh the benefits. When people are on drugs like Ozempic, their blood sugar is better controlled by enhancing the release of insulin and reducing the levels of another hormone called glucagon. But there is greater variability in the amount of <a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769#bib88">weight lost</a> than the variability in blood sugar control. It isn’t clear why, but is likely due to differences in genetics and lifestyles, and weight being more complex to regulate. <h2>Treatment needs to be ongoing. What will this mean?</h2> When weight-loss drugs do work, they are only effective while they’re being taken. This means that to keep the weight off people need to keep taking them long term. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542252/">One study found</a> an average weight loss of more than 17% after a year on Ozempic became an average net weight loss of 5.6% more than two years after stopping treatment. Short-term side effects of drugs like Ozempic include dizziness, nausea, vomiting and other gastrointestinal upsets. But because these are new drugs, we simply don’t have data to tell us if side effects will increase as people take them for longer periods. Nor do we know if <a href="https://www.medicalnewstoday.com/articles/why-weight-loss-drugs-stop-working-how-to-break-past-ozempic-plateau#:%7E:text=A%20lifetime%20commitment%20to%20Ozempic&text=By%20these%20standards%2C%20such%20drugs,long%2Dterm%20risk%20is%20unknown.">effectiveness will be reduced</a> in the long term. This is called <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/drug-tolerance#:%7E:text=A%20condition%20that%20occurs%20when,or%20different%20medicine%20is%20needed.">drug tolerance</a> and is documented for other long-term treatments such as antidepressants and chemotherapies. <h2>Biology is only part of the story</h2> For some people, using GLP-1-mimicking drugs like Ozempic will be validating and empowering. They will feel like their biology has been “normalised” in the same way that blood pressure or cholesterol medication can return people to the “normal” range of measures. But biologically, obesity <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202176/#:%7E:text=Obesity%20behaves%20as%20complex%20polygenic,about%2080%25%20(3).">isn’t solely about GLP-1 activity</a> with <a href="https://www.worldobesity.org/what-we-do/our-policy-priorities/the-roots-of-obesity">many other</a> hormones, physical activity, and even our gut microbes involved. Overall, <a href="https://www.ncbi.nlm.nih.gov/books/NBK278977/">obesity is complex and multifaceted</a>. Obesity isn’t just driven by personal biology and choice; it has social, cultural, political, environmental and economic determinants. <h2>A weight-centred approach misses the rest of the story</h2> The weight-centred approach <a href="https://butterfly.org.au/body-image/health-not-weight/#:%7E:text=Health%20and%20wellbeing%20are%20multi,on%20their%20size%20or%20appearance.">suggests that leading with thinness means health will follow</a>. But changing appetite is only part of the story when it comes to health. Obesity often <a href="https://www.sciencedirect.com/science/article/pii/S2667368123000335#:%7E:text=Obesity%20related%20malnutrition%20can%20also,%5D%2C%20%5B7%5D%5D.">co-exists with malnutrition</a>. We try to separate the effects in research using statistics, but focusing on the benefits of weight-loss drugs without addressing the underlying malnutrition means we aren’t likely to see the <a href="https://www.wsj.com/articles/ozempic-diet-exercise-healthy-43eee86c">improved health outcomes in everyone who loses weight</a>. <h2>Obesity isn’t an issue detached from people</h2> Even when it is well-intentioned, the rhetoric around the joy of “ending the obesity epidemic” can <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">harm people</a>. Obesity doesn’t occur in isolation. It is people who are obese. And the celebration and hype of these weight-loss drugs can reinforce harmful fat stigma. The framing of these drugs as a “cure” exacerbates the binary view of thin versus fat, and healthy versus unhealthy. These are not binary outcomes that are good or bad. Weight and health exist on a spectrum. Ironically, while fat people are told they need to lose weight for their health, they are also <a href="https://www.dailytelegraph.com.au/news/nsw/ozempic-shame-why-users-are-embarrassed-to-admit-using-weight-loss-wonder-drug/news-story/ee52a819c69459afe6576d25988f9bd6">shamed for “cheating” or taking shortcuts</a> by using medication. <h2>Drugs are tools, not silver bullets</h2> The creation of these drugs is a start, but they remain expensive, and the hype has been followed by <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#:%7E:text=Consumer%20Medicine%20Information%20.-,Why%20the%20Ozempic%20shortage%20happened,label%20prescribing%20for%20weight%20loss.">shortages</a>. Ultimately, complex challenges aren’t addressed with simple solutions. This is particularly true when people are involved, and even more so when there isn’t even an agreement on what the challenge is. Many organisations and individuals see obesity is a disease and believe this framing helps people to seek treatment. Others think it’s unnecessary to attach medical labels to body types and <a href="https://www.forbes.com/sites/geoffreykabat/2013/07/09/why-labeling-obesity-as-a-disease-is-a-big-mistake/?sh=5ca95cc2103b">argue</a> it confuses risk factors (things that are linked to increased risk of illness) with illness itself. Regardless, two things will always remain true. Drugs can only ever be tools, and those tools need to be applied in a context. To use these tools ethically, we need to remain mindful of who this application harms along the way. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation - School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drugs-like-ozempic-wont-cure-obesity-but-they-might-make-us-more-fat-phobic-219309">original article</a>.

Body

Astonishing drug and prostitute claims surface as Lehrmann case reopened

The ongoing defamation case involving Bruce Lehrmann, a central figure in the Brittany Higgins saga, has been thrust back into the spotlight with shocking new allegations. The reopening of the case stems from claims made by former Seven Network producer Taylor Auerbach, which seek to shed light on a series of dealings surrounding Lehrmann's interactions with various media outlets. The allegations put forth by Auerbach paint an astonishing picture of Lehrmann's recruitment by Seven Network for an exclusive tell-all interview. It's alleged that Lehrmann, in a bid to secure his cooperation, was lavishly reimbursed for expenses that included not only extravagant meals and travel but also expenditures on illicit drugs and prostitutes. The details emerged through affidavits filed by Auerbach with the Federal Court, just days before a judgment was expected in Lehrmann's defamation case against Network Ten and journalist Lisa Wilkinson. The case originated from a February 2021 report on The Project, where Brittany Higgins accused Lehrmann of rape within a Parliament House office in 2019. According to Auerbach's affidavits, Lehrmann breached a so-called Harman undertaking by leaking private and confidential texts from Higgins to Seven Network, violating an agreement that restricted the use of evidence from an abandoned criminal case against him. These texts allegedly facilitated Lehrmann's negotiations with Seven Network and formed a crucial part of his interview on the Spotlight program. The allegations take a darker turn with claims of financial reimbursement for illicit activities. Auerbach asserts that Seven Network reimbursed Lehrmann for expenses related to drug purchases and visits to brothels, implicating the network in what can only be described as deeply troubling conduct. "I recall that monies paid by (Lehrmann) for illicit drugs and prostitutes that evening at the Meriton and the following evening at a brothel in Surry Hills were reimbursed to (Lehrmann) by Seven," Auerbach states in his affidavit, according to <a href="https://au.news.yahoo.com/lehrmann-defamation-case-reopened-evidence-163000287.html" target="_blank" rel="noopener">Yahoo News</a>. The reopening of Lehrmann's defamation case underscores the gravity of these allegations and their potential implications. Justice Michael Lee's decision to admit fresh evidence indicates the seriousness with which the court regards these claims and the need for a thorough examination of the facts. In response to these allegations, both Lehrmann and Seven Network have vehemently denied any wrongdoing. Lehrmann maintains his innocence, asserting that he did not leak texts to Seven Network and denying any involvement in the misconduct alleged by Auerbach. Seven Network, for its part, denies authorising or condoning the alleged payments to Lehrmann and says that any unauthorised expenses were promptly rectified. Image: Getty

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Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs. As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns. But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug. <h2>Potential benefits</h2> 1) It’s likely to help you lose weight The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity. The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight). In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg. Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication. 2) It may reduce your chronic disease risk factors When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases. In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels. In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels. 3) It might improve your quality of life, emotional wellbeing or sense of achievement The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health. Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image. <h2>What about the risks?</h2> 1) You may experience gastrointestinal symptoms In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%). In the UK study, nausea and diarrhoea were also commonly reported. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living. Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study. 2) You might feel fatigued Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants. 3) You might be among the minority who don’t tolerate the drug Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia. In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects. In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing. More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period. A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period. Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions. 4) It might be difficult to access Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024. To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication. 5) You might not always get clear information from vested interests Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>. Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications. <h2>Bottom line</h2> Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.

Body

"Lincoln's Law": Grandma's important safety crusade after tragic loss

The tragic loss of three-year-old Lincoln in September 2020 has sparked a passionate plea for immediate changes to safety standards in rental properties across Australia. Lincoln's grandmother, Kerrie Shearer, has been relentless in her pursuit of ensuring that no other family suffers the heartache they have endured. Lincoln's untimely death occurred when he became entangled in a blind cord while innocently playing on a windowsill at his Melbourne home. Despite the family's vigilance, the accident claimed the life of their beloved Lincoln, leaving them shattered and grief-stricken. Now, Shearer is determined to turn her pain into action by advocating for legislative changes to prevent similar tragedies. As a renter, Lincoln's family had little control over the safety features of their dwelling. They are now calling for new laws mandating older rental homes to comply with modern blind safety standards. Shearer says that the need to address loose hanging blinds is crucial, labelling them as potential accidents waiting to happen. By campaigning for legislative reforms, she hopes to spare other families from experiencing the same devastation. While guidelines stipulate that window furnishings in homes built after 2010 must adhere to strict safety measures, there are no such regulations for older properties. Shearer finds it astonishing that many people remain unaware of the dangers posed by unsecured blind cords. She recounts her experiences of visiting various accommodations, including Airbnbs and hotels, where she noticed inadequate safety measures and felt compelled to alert the hosts. "I'm constantly amazed how people aren't aware," she told <a href="https://www.9news.com.au/national/victoria-news-grandmother-warns-of-blind-safety-risk-after-grandson-dies/83accc08-8cf2-463a-8cc7-6f87fa905a5b" target="_blank" rel="noopener">9News</a>. "I go to AirBnBs and hotels now and I'm at them, 'Hey your blinds aren't attached to the wall.'" Shearer's advocacy has gained momentum via her collaboration with Kidsafe, a prominent nonprofit organisation dedicated to preventing unintentional injuries and deaths among children. Together, they aim to broaden safety requirements for older homes, advocating for what Shearer passionately refers to as "Lincoln's law". She insists that any looped or hanging cords present a significant danger to children and must be securely affixed to the wall to prevent entanglement accidents. The impact of Shearer's tireless efforts is already evident, with reports indicating that the state government is considering the introduction of mandatory blind cord safety standards for all rental properties, regardless of their age. This potential development marks a significant step towards ensuring the safety and well-being of children in rental accommodations across the country. In the wake of her family's tragedy, Shearer's determination to effect change not only honours the memory of Lincoln but also holds the potential to prevent countless other families from enduring similar heartbreak – ensuring that his tragic passing was not in vain. Images: 9News

Legal

Does the royal family have a right to privacy? What the law says

<a href="https://theconversation.com/profiles/gemma-horton-1515949">Gemma Horton</a>, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> From court cases to conspiracy theories, the royal family’s right to privacy is, somewhat ironically, nearly always in the spotlight. The latest focus is Kate Middleton, Princess of Wales, whose whereabouts have been the subject of <a href="https://www.townandcountrymag.com/society/tradition/a60008117/kate-middleton-health-speculation-conspiracy-theories-online/">online speculation</a> after it was announced she was undergoing abdominal surgery and would be away from public duties until after Easter. This comes just weeks after King Charles <a href="https://www.bbc.co.uk/news/uk-68208157">revealed that he is undergoing treatment for cancer</a>, and a legal settlement between Prince Harry and Mirror Group Newspapers over <a href="https://www.bbc.co.uk/news/uk-68249009">illegal phone hacking</a>. Interest in the personal lives of the royals and other celebrities <a href="https://www.tandfonline.com/doi/full/10.1080/1461670X.2016.1150193">is a constant</a>, driving newspaper sales and online clicks for decades. You only needs to consider the media frenzy that followed Princess Diana to <a href="https://www.tandfonline.com/doi/full/10.1080/17512786.2013.833678">see this</a>, and its potentially devastating consequences. From a legal perspective, the British courts have ruled that everyone – the royal family included – is entitled to a right to privacy. The Human Rights Act incorporates into British law the rights set out by the European Convention on Human Rights. This includes article 8, which focuses on the right to privacy. In the years after the Human Rights Act came into force, courts ruled on a string of cases from celebrities claiming that the press invaded their privacy. Courts had to balance article 8 of the convention against article 10, the right to freedom of expression. Rulings repeatedly stated that, despite being in and sometimes seeking the limelight, celebrities should still be afforded a right to privacy. Some disagree with this position, such as prominent journalist <a href="https://www.independent.co.uk/news/uk/home-news/prince-harry-hacking-piers-morgan-b2336442.html">Piers Morgan, who has criticised</a> the Duke and Duchess of Sussex asking for privacy when they have also released a Netflix documentary, a broadcast interview with Oprah Winfrey and published a memoir. But the courts have made the position clear, as in the case concerning Catherine Zeta-Jones and Michael Douglas after Hello! Magazine published unauthorised photographs from their wedding. The <a href="https://eprints.whiterose.ac.uk/190559/3/Final%20Edited%20Version%20-%20Celebrity%20Privacy%20and%20Celebrity%20Journalism-%20Has%20anything%20changed%20since%20the%20Leveson%20Inquiry_.pdf">court stated</a> that: “To hold that those who have sought any publicity lose all protection would be to repeal article 8’s application to very many of those who are likely to need it.” There is no universal definition of privacy, but scholars have identified key concepts encompassing what privacy can entail. In my own research, I have argued that the <a href="https://eprints.whiterose.ac.uk/190559/3/Final%20Edited%20Version%20-%20Celebrity%20Privacy%20and%20Celebrity%20Journalism-%20Has%20anything%20changed%20since%20the%20Leveson%20Inquiry_.pdf">notion of choice</a> is one of these. Privacy allows us to control the spread of information about ourselves and disclose information to whom we want. <h2>Privacy and the public interest</h2> There are exceptions to these protections if the person involved had no reasonable expectation of privacy, or if it was in the public interest for this information to be revealed. There is no solid, legal definition of the “public interest”, so this is decided on a case-by-case basis. <a href="https://www.tandfonline.com/doi/full/10.1080/17577632.2021.1889866">In the past</a>, the public interest defence has been applied because a public figure or official has acted hypocritically and the courts have stated there is a right for a publisher to set the record straight. When it comes to medical records and information concerning health, case law and journalistic <a href="https://www.ipso.co.uk/editors-code-of-practice/">editorial codes of conduct</a> are clear that this information is afforded the utmost protection. Model Naomi Campbell was pictured leaving a Narcotics Anonymous meeting and these images were published by the Daily Mirror. The court found that there had been a public interest in revealing the fact she was attending these meetings, as she had previously denied substance abuse. The House of Lords accepted that there was a public interest in the press “setting the record straight”. Nonetheless, the publication of additional, confidential details, and the photographs of her leaving the meeting were a <a href="https://www.theguardian.com/media/2004/may/06/mirror.pressandpublishing1">step too far</a>. The House of Lords highlighted the importance of being able to keep medical records and information private. <h2>Royal health</h2> When it comes to the royals, the history of <a href="https://www.townandcountrymag.com/society/tradition/a23798094/lindo-wing-st-marys-hospital-facts-photos/">publicity</a> around royal births, often posing with the newborn royal baby outside of the hospital, has set a precedent for what the public can expect about the royals’ medical information. When they choose to go against this tradition, it can frustrate both royal-watchers and publishers. King Charles made the choice to openly speak about his enlarged prostate to “assist public understanding”. And, as Prostate Cancer UK noted, this has worked – they noted a <a href="https://www.independent.co.uk/news/uk/home-news/king-charles-cancer-statement-treatment-b2494190.html">500% increase in people visiting their website</a>. However, he has chosen to not to divulge information about his cancer diagnosis beyond the fact that he is receiving treatment. This is his right. While revealing further information might stop speculation and rumours about his health, it is not the king’s duty to divulge private, medical information. However, if his health begins to impact his ability to act as monarch, the situation could change. It might be that the press finds more information about his health without his knowledge, but unless they have a genuine public interest in publishing this information, privacy should prevail. You would no doubt want your private medical information kept secret, not shared around your workplace and speculated on unless it was absolutely necessary. It is thanks to these laws and court precedent that you don’t have to worry about this. The royal family, regardless of their position, should expect the same standard. <a href="https://theconversation.com/profiles/gemma-horton-1515949">Gemma Horton</a>, Impact Fellow for Centre for Freedom of the Media, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-the-royal-family-have-a-right-to-privacy-what-the-law-says-224881">original article</a>.

Legal

“My sister-in-law announced she was pregnant at my child’s funeral”

A woman has asked for advice on how to navigate her relationship with her sister-in-law, after the woman overheard an inappropriate conversation at her child’s funeral. The grieving mother, a 28-year-old named Melissa, took to Reddit to share the heartbreaking story of how her toddler passed away after a battle with cancer. Melissa described the time as the “hardest in my life”, explaining how she felt she lost “a part of herself” after the funeral. While Melissa expected her toddlers’ memorial service to be difficult, she never predicted a family member would make it even harder. The mother said that when she heard her sister-in-law telling people about her pregnancy, she thought the move was just cruel. “She didn't make a big announcement but more than ten people at the service 'heard' and it's what everyone was talking about. To understate it, I was livid,” Melissa wrote on Reddit. Melissa’s post then asked social media users for advice, as she was unsure how much of a relationship she wanted to have with her sister-in-law after the stunt. The 28-year-old shared that she had fallen pregnant herself, and was facing pressure to have a party in celebration, but she didn’t want her whole family in attendance. “I've been working on who I want to invite, and I really don't want my SIL there,” she said. “Besides what she did, she's a vindictive and mean person and I cannot stand her.” “I mentioned it to my husband and he says he couldn't care less whether she's there or not. But for the sake of saving face, I want opinions before I do this.” She asked the online forum if she would be “an a**hole” for not inviting her, addin that she would still be inviting her husband's other sister and husband's brother's wife. “The original SIL will be the only one not invited,” she clarified. The post was flooded with comments as many backed up Melissa, slamming the sister-in-law for her selfish behaviour. “I wouldn't want someone like that around me. Announcing a pregnancy at a child's funeral is insane,” one said. “Cut her off and ignore everyone close to her. You are right to have nothing to do with her. She's totally classless.” However, others encouraged her to have an adult conversation with her sister-in-law in an attempt to mend their relationship. “Please let it go,” one person began. “This happened on a terrible day during a bad time for you. It's possible that could be clouding how you're looking at this, she may not have been malicious at all.” Image credits: Shutterstock

Family & Pets

Mother bans in-laws from seeing her baby after they go against her wishes

A woman has banned her in-laws from seeing her newborn daughter after they “betrayed her trust” and directly went against her wishes. The new mum shared the story to Reddit, as she explained why she was cutting contact with her husband’s parents after they pierced her child’s ears without their knowledge or consent. “My husband is from a culture where it's not uncommon to pierce baby girls' ears and his mother started pestering me about getting my daughter's ears pierced a few days after she was born,” the 32-year-old mum began. “I made it clear that I would not be doing that, and that I'd be waiting until she's old enough to ask for it herself. We live in my country where piercing a baby's ears isn't common at all.” The new mum's world soon came crashing down after the baby spent a weekend with her grandparents, before she went back to her parents red in the face and screaming. “My mother-in-law was looking after her over the weekend and decided to pierce her ears without my knowledge or consent.” “When I saw this I threw a fit. My baby was crying in pain, and I actually took her to the doctor to get their advice on whether or not to take them out.” The doctor advised the parent to take the earrings out as they were irritating the baby, but the issue didn’t end there. “I decided at that moment that my mother-in-law and everyone else on that side of the family (except for my sister-in-law, who's on my side about this) is going to have no alone contact with my daughter ever again - or at least until she's a teenager.” “My worry is that she'll do the same thing again, and to be frank, she's lost my trust entirely. I told her that if she had a problem with that, I'd report what she did to the police.” The husband of the baby girl reluctantly sided with his wife over the issue, despite saying it wasn’t a big deal and suggesting everyone move on from the incident. The story prompted a mixed response online, with some people saying the woman was overreacting and should work towards rebuilding trust with her in-laws. Others, however, had the opposite opinion, with one person saying, “Forget rebuilding trust, I'd be having them charged with assault.” Another person said, “They mutilated a child and they knew it was against the parents wishes. These people have serious problems. Not that I'd press charges, but getting holes poked in someone else's kid is a huge thing.” Image credits: Getty Images

Family & Pets

Drug regulator investigates deaths tied to weight loss injections

Australia's drug regulator is investigating further into three different deaths possibly linked to the use of Ozempic and other weight loss injections. Tim Ramsay, 58, started using Saxenda because he wanted to lose weight so he could confidently walk his daughter down the aisle. But, he tragically passed away just 19-days after he started taking the injections, and now his family want answers, after a coroner ruled his cause of death as undetermined. "I don't believe that anybody should die without an explanation, you just don't expire, there has got to be a reason for Tim's death," Ramsay's wife, Sue, told 60 Minutes. "19 days between his first injection and the day he left us, alarm bells in our heads, in the TGA's heads, and the coroner's head should be ringing," his daughter Elyse said. Leonie Margetts is also looking for answers, and is angry at the ease in which the injections could be accessed, following her daughter's death after taking Ozempic injections she'd ordered online. Margetts' daughter Naomi wanted to be a mum, but was told she needed to lose weight to to have any chance of falling pregnant. "You just do not expect to find your daughter on her knees in front of the toilet bowl dead," Margetts said. "She was a week away from turning 40 and that's a big thing for any female, she was feeling very vulnerable," she added. The Therapeutic Goods Administration's Chief Medical Advisor, Professor Robyn Langham has responded, and told 60 minutes that the TGA has a responsibility to the families of the deceased. "It's a very serious and a very tragic problem for the families that are concerned and we don't wish to minimise that at all," Langham said. She added that they are carefully monitoring reports of severe gastrointestinal side effects caused by the medication, and will withdraw the drug if necessary. "If we do see that there is a need to change the messaging or the information that goes with the drug or even in some cases to withdraw the drug, then we have the power to do so," Langham said. Some people have been using Ozempic for weightloss, which has caused it to "explode" in popularity. "I liken this to when the [Model] T Ford was first invented and suddenly we had changes in transportation and the horse and cart went," Professor of medicine and endocrinologist Dr Katherine Samaras said. But, the professor has warned that Ozempic is only approved in Australia for diabetes, and should only be used when supervised by a doctor. "We don't leave matches in the hands of children," she said. "We shouldn't leave these drugs in the hands of people, it has to be supervised." Images: 60 minutes

Legal

How dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders

<a href="https://theconversation.com/profiles/samantha-withnell-1504436">Samantha Withnell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> Up to 72 per cent of women and 61 per cent of men are dissatisfied with their weight or <a href="https://doi.org/10.1016/j.eatbeh.2014.04.010">body image</a>, according to a U.S. study. Globally, millions of people <a href="https://doi.org/10.1111%2Fobr.12466">attempt to lose weight</a> every year with the hope that weight loss will have positive effects on their body image, health and quality of life. However, these motivated individuals often struggle to maintain new diets or exercise regimens. The rise of medications such as semaglutides, like <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101298">Ozempic</a> or <a href="https://dhpp.hpfb-dgpsa.ca/dhpp/resource/101765">Wegovy</a>, <a href="https://www.cbc.ca/news/health/ozempic-weight-loss-1.6772021">might be viewed as an appealing “quick fix”</a> alternative to meet weight loss goals. Research led by our team and others suggests that such attempts to lose weight often do more harm than good, and even increase the risk of <a href="https://osf.io/9stq2">developing an eating disorder</a>. <h2>Weight loss and eating disorders</h2> Eating disorders are <a href="https://doi.org/10.1002/eat.20589">serious mental health conditions</a> primarily characterized by extreme patterns of under- or over-eating, concerns about one’s shape or body weight or other behaviours intended to influence body shape or weight such as exercising excessively or self-inducing vomiting. Although once thought to only affect young, white adolescent girls, eating disorders do not discriminate; eating disorders can develop in people of <a href="https://doi.org/10.1002/erv.2553">any age, sex, gender or racial/ethnic background</a>, with an estimated <a href="https://nedic.ca/general-information/">one million Canadians</a> suffering from an eating disorder at any given time. Feb. 1 to 7 is <a href="https://nedic.ca/edaw/">National Eating Disorders Awareness Week</a>. As a clinical psychologist and clinical psychology graduate student, our research has focused on how eating disorders develop and what keeps them going. Pertinent to society’s focus on weight-related goals, our research has examined associations between weight loss and eating disorder symptoms. <h2>Eating disorders and ‘weight suppression’</h2> In eating disorders research, the state of maintaining weight loss is referred to as “weight suppression.” Weight suppression is typically defined as the difference between a person’s current weight and their highest lifetime weight (excluding pregnancy). Despite the belief that weight loss will improve body satisfaction, we found that in a sample of over 600 men and women, weight loss had no impact on women’s negative body image and was associated with increased body dissatisfaction in <a href="https://doi.org/10.1016/j.bodyim.2023.01.011">men</a>. Importantly, being more weight suppressed has been associated with the <a href="https://doi.org/10.1093/ajcn/nqaa146">onset of eating disorders</a>, including anorexia nervosa and bulimia nervosa. <a href="https://doi.org/10.1007/s11920-018-0955-2">One proposed explanation</a> for the relationship between weight suppression and eating disorders is that maintaining weight loss becomes increasingly difficult as body systems that <a href="https://doi.org/10.3945/ajcn.110.010025">reduce metabolic rate and energy expenditure, and increase appetite</a>, are activated to promote weight gain. There is growing awareness that <a href="https://doi.org/10.1136/bmj.g2646">weight regain is highly likely following conventional diet programs</a>. This might lead people to engage in more and more extreme behaviours to control their weight, or they might shift between extreme restriction of food intake and episodes of overeating or binge eating, the characteristic symptoms of bulimia nervosa. <h2>Ozempic and other semaglutide drugs</h2> Semaglutide drugs like Ozempic and Wegovy are part of a class of drug called <a href="https://pdf.hres.ca/dpd_pm/00067924.PDF">glucagon-like peptide-1 agonists (GLP-1As)</a>. These drugs work by mimicking the hormone GLP-1 to interact with neural pathways that signal satiety (fullness) and slow stomach emptying, leading to reduced food intake. Although GLP-1As are indicated to treat Type 2 diabetes, <a href="https://www.cbc.ca/news/canada/london/ozempic-off-label-1.6884141">they are increasingly prescribed off-label</a> or being <a href="https://www.bbc.com/news/health-67414203">illegally purchased</a> without a prescription because of their observed effectiveness at inducing weight loss. Although medications like Ozempic do often lead to weight loss, the rate of weight loss may <a href="https://doi.org/10.1001/jama.2021.3224">slow down or stop over time</a>. Research by Lindsay Bodell, one of the authors of this story, and her colleagues on weight suppression may help explain why effects of semaglutides diminish over time, as <a href="https://doi.org/10.1016/j.physbeh.2019.112565">weight suppression is associated with reduced GLP-1 response</a>. This means those suppressing their weight could become less responsive to the satiety signals activated by GLP-1As. Additionally, weight loss effects are only seen for as long as the medication is taken, meaning those who take these drugs to achieve some weight loss goal are <a href="https://doi.org/10.1111/dom.14725">likely to regain most, if not all, weight lost</a> when they stop taking the medication. <h2>Risks of dieting and weight-loss drugs</h2> The growing market for off-label weight loss drugs is concerning, because of the exacerbation of <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">weight stigma</a> and the serious <a href="https://doi.org/10.1016/j.jand.2022.01.004">health risks</a> associated with unsupervised weight loss, including developing eating disorders. Researchers and health professionals are already raising the alarm about the use of GLP-1As in children and adolescents, due to concerns about their possible <a href="https://doi.org/10.1017/cts.2023.612">impact on growth and development</a>. Moreover, popular weight-loss methods, whether they involve pills or “crash diets,” often mimic symptoms of eating disorders. For example, intermittent fasting diets that involve long periods of fasting followed by short periods of food consumption may mimic and <a href="https://doi.org/10.1016/j.eatbeh.2022.101681">increase the risk of developing binge eating problems</a>. The use of diet pills or laxatives to lose weight has been found to increase the risk of <a href="https://doi.org/10.2105/AJPH.2019.305390">being diagnosed with an eating disorder in the next one to three years</a>. Drugs like Ozempic may also be <a href="https://doi.org/10.1002/eat.24109">misused by individuals already struggling with an eating disorder</a> to suppress their appetite, compensate for binge eating episodes or manage fear of weight gain. Individuals who are already showing signs of an eating disorder, such as limiting their food intake and intense concerns about their weight, may be most at risk of spiralling from a weight loss diet or medication into an eating disorder, <a href="https://doi.org/10.1002/eat.24116">even if they only lose a moderate amount of weight</a>. People who are dissatisfied with their weight or have made multiple attempts to lose weight often feel pressured to try increasingly drastic methods. However, any diet, exercise program or weight-loss medication promising a quick fix for weight loss should be treated with extreme caution. At best, you may gain the weight back; at worst, you put yourself at risk for much more serious eating disorders and other health problems.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221514/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/samantha-withnell-1504436">Samantha Withnell</a>, PhD Candidate, Clinical Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> and <a href="https://theconversation.com/profiles/lindsay-bodell-1504260">Lindsay Bodell</a>, Assistant Professor of Psychology, <a href="https://theconversation.com/institutions/western-university-882">Western University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dieting-weight-suppression-and-even-misuse-of-drugs-like-ozempic-can-contribute-to-eating-disorders-221514">original article</a>.

Body

"I was terrified": Law & Order star reveals traumatic past

Warning: This story contains graphic content. Mariska Hargitay, who plays Olivia Benson, a character that investigate rapists on Law & Order: Special Victims Unit, has revealed that she too is a victim of sexual assault. The actress opened up about her traumatic past in a powerful essay written for <a href="https://people.com/mariska-hargitay-experience-rape-renewal-reckoning-8424247" target="_blank" rel="noopener">People Magazine</a>, where she revealed that she was raped by “a friend" when she was in her thirties. "A man raped me in my thirties," she bravely revealed in the essay. "It wasn’t sexual at all. It was dominance and control. Overpowering control." The actress revealed that he was a friend who "made a unilateral decision" and recalled the fear she felt when the incident occurred. "He grabbed me by the arms and held me down. I was terrified," she said. "I didn’t want it to escalate to violence. I now know it was already sexual violence, but I was afraid he would become physically violent. "I went into freeze mode, a common trauma response when there is no option to escape. I checked out of my body," she recalled. Hargitay, who is the daughter of the late actress Jane Mansfield, said that she never thought of herself as a "survivor", and often "minimised" what happened to her when she talked about it with others. "My husband Peter remembers me saying, “I mean, it wasn’t rape," she wrote. "Then things started shifting in me, and I began talking about it more in earnest with those closest to me. They were the first ones to call it what it was." The actress said that she wants other survivors to feel "no shame" about sexual assault and wants "this violence to end." She added that justice "may look different for each survivor," but for her she wants "an acknowledgment and an apology" after what happened. "This is a painful part of my story. The experience was horrible. But it doesn’t come close to defining me, in the same way that no other single part of my story defines me," she concluded, adding that she feels for all sexual violence survivors. "I’m turning 60, and I’m so deeply grateful for where I am. I’m renewed and I’m flooded with compassion for all of us who have suffered. And I’m still proudly in process." Hargitay started her own foundation, the Joyful Heart Foundation, in 2004 to help survivors of sexual assault. Image: Getty

Caring

Do you really need antibiotics? Curbing our use helps fight drug-resistant bacteria

<a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Antibiotic resistance occurs when a microorganism changes and no longer responds to an antibiotic that was previously effective. It’s <a href="https://thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00502-2/fulltext">associated with</a> poorer outcomes, a greater chance of death and higher health-care costs. In Australia, antibiotic resistance means some patients are admitted to hospital because oral antibiotics are <a href="https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance">no longer effective</a> and they need to receive intravenous therapy via a drip. Antibiotic resistance is rising to high levels in certain parts of the world. Some hospitals <a href="https://www.reactgroup.org/news-and-views/news-and-opinions/year-2022/the-impact-of-antibiotic-resistance-on-cancer-treatment-especially-in-low-and-middle-income-countries-and-the-way-forward/">have to consider</a> whether it’s even viable to treat cancers or perform surgery due to the risk of antibiotic-resistant infections. Australia is <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-aura/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one of the highest users</a> of antibiotics in the developed world. We need to use this precious resource wisely, or we risk a future where a simple infection could kill you because there isn’t an effective antibiotic. <h2>When should antibiotics not be used?</h2> Antibiotics only work for some infections. They work against bacteria but <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/do-i-really-need-antibiotics">don’t treat</a> infections caused by viruses. Most community acquired infections, even those caused by bacteria, are likely to get better without antibiotics. Taking an antibiotic when you don’t need it won’t make you feel better or recover sooner. But it can increase your chance of side effects like nausea and diarrhoea. Some people think green mucus (or snot) is a sign of bacterial infection, requiring antibiotics. But it’s actually <a href="https://www.safetyandquality.gov.au/sites/default/files/2023-11/aura_2023_do_i_really_need_antibiotics.pdf">a sign</a> your immune system is working to fight your infection. <h2>If you wait, you’ll often get better</h2> <a href="https://www.tg.org.au/">Clinical practice guidelines</a> for antibiotic use aim to ensure patients receive antibiotics when appropriate. Yet 40% of GPs say they prescribe antibiotics <a href="https://doi.org/10.1071/HI13019">to meet patient expectations</a>. And <a href="https://pubmed.ncbi.nlm.nih.gov/35973750/">one in five</a> patients expect antibiotics for respiratory infections. It can be difficult for doctors to decide if a patient has a viral respiratory infection or are at an early stage of serious bacterial infection, particularly in children. One option is to “watch and wait” and ask patients to return if there is clinical deterioration. An alternative is to prescribe an antibiotic but advise the patient to not have it dispensed unless specific symptoms occur. This can <a href="https://doi.org/10.1002/14651858.CD004417.pub5">reduce antibiotic use by 50%</a> with no decrease in patient satisfaction, and no increase in complication rates. <h2>Sometimes antibiotics are life-savers</h2> For some people – particularly those with a weakened immune system – a simple infection can become more serious. Patients with life-threatening suspected infections should receive an appropriate antibiotic <a href="https://www.safetyandquality.gov.au/our-work/clinical-care-standards/antimicrobial-stewardship-clinical-care-standard">immediately</a>. This includes serious infections such as <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/bacterial-meningitis#:%7E:text=What%20is%20bacterial%20meningitis%3F,can%20cause%20life%2Dthreatening%20problems.">bacterial meningitis</a> (infection of the membranes surrounding the brain) and <a href="https://clinicalexcellence.qld.gov.au/priority-areas/safety-and-quality/sepsis/adult-sepsis#:%7E:text=Adult%20patients%20with%20sepsis%20also,adult%20emergency%20department%20sepsis%20pathway.">sepsis</a> (which can lead to organ failure and even death). <h2>When else might antibiotics be used?</h2> Antibiotics are sometimes used to prevent infections in patients who are undergoing surgery and are at significant risk of infection, such as those undergoing bowel resection. These patients will <a href="https://www.tg.org.au">generally receive</a> a single dose before the procedure. Antibiotics may also <a href="https://www.tg.org.au">be given</a> to patients undergoing chemotherapy for solid organ cancers (of the breast or prostate, for example), if they are at high risk of infection. While most sore throats are caused by a virus and usually resolve on their own, some high risk patients with a bacterial strep A infection which can cause “scarlet fever” are given antibiotics to prevent a more serious infection like <a href="https://www.rhdaustralia.org.au/">acute rheumatic fever</a>. <h2>How long is a course of antibiotics?</h2> The recommended duration of a course of antibiotics depends on the type of infection, the likely cause, where it is in your body and how effective the antibiotics are at killing the bacteria. In the past, courses were largely arbitrary and based on assumptions that antibiotics should be taken for long enough to eliminate the infecting bacteria. More recent research does not support this and shorter courses are <a href="https://www.acpjournals.org/doi/full/10.7326/M19-1509">nearly always as effective as longer ones</a>, particularly for community acquired respiratory infections. For <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736742/">community acquired pneumonia</a>, for example, research shows a three- to five-day course of antibiotics is at least as effective as a seven- to 14-day course. The “take until all finished” approach is no longer recommended, as the longer the antibiotic exposure, the greater the chance the bacteria will develop resistance. However, for infections where it is more difficult to eradicate the bacteria, such as tuberculosis and bone infections, a combination of antibiotics for many months is usually required. <h2>What if your infection is drug-resistant?</h2> You may have an antibiotic-resistant infection if you don’t get better after treatment with standard antibiotics. Your clinician will collect samples for lab testing if they suspect you have antibiotic-resistant infection, based on your travel history (especially if you’ve been hospitalised in a country with high rates of antibiotic resistance) and if you’ve had a recent course of antibiotics that hasn’t cleared your infection. Antibiotic-resistant infections are managed by prescribing broad-spectrum antibiotics. These are like a sledgehammer, wiping out many different species of bacteria. (Narrow-spectrum antibiotics conversely can be thought of as a scalpel, more targeted and only affecting one or two kinds of bacteria.) Broad-spectrum antibiotics are usually more expensive and come with more severe side effects. <h2>What can patients do?</h2> Decisions about antibiotic prescriptions should be made using <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">shared decision aids</a>, where patients and prescribers discuss the risks and benefits of antibiotics for conditions like a sore throat, middle ear infection or acute bronchitis. Consider asking your doctor questions such as: <ul> <li>do we need to test the cause of my infection?</li> <li>how long should my recovery take?</li> <li>what are the risks and benefits of me taking antibiotics?</li> <li>will the antibiotic affect my regular medicines?</li> <li>how should I take the antibiotic (how often, for how long)?</li> </ul> Other ways to fight antibiotic resistance include: <ul> <li>returning leftover antibiotics to a pharmacy for safe disposal</li> <li>never consuming leftover antibiotics or giving them to anyone else</li> <li>not keeping prescription repeats for antibiotics “in case” you become sick again</li> <li>asking your doctor or pharmacist what you can do to feel better and ease your symptoms rather than asking for antibiotics.</li> </ul> <a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, Antimicrobial Stewardship Pharmacist, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, Research Assistant, College of Health, Medicine and Wellbeing, School of Biomedical Science and Pharmacy, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-really-need-antibiotics-curbing-our-use-helps-fight-drug-resistant-bacteria-217920">original article</a>.

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"Like the cash cow had come out": Commuters puzzled by money bundles on motorway

Motorists in Perth have been left puzzled after bundles of cash were spotted flying across a motorway. On Monday evening, several members of the public called Western Australia police after up to $40,000 in cold hard cash was seen flying across the Mitchell Fwy in Connolly, in the city’s northern suburbs. According to Commissioner Col Blanch, honest civilians bundled up some of the mysterious money and “came forward with large wads of cash”. “We believe that up to $40,000 has been recovered,” he said. Police believe that the money came from an alleged drug deal gone wrong, but the incident is still under investigation. "It looks like it was a total fiasco by the person involved and probably not one of our smartest (alleged) offenders," Mr Blanch said. "It's like the cash cow had come out, and there was cash flying everywhere." "There's no more money on the freeway … let's not go there." After police attended the scene, they arrested a man close by who had another $8,000 in his possession, along with 51g of cocaine. Despite some people stopping to retrieve the money to hand over to police, the free money prompted some motorists to stop their cars to retrieve a share for themselves. Talk on social media suggested one commuter even pocketed about $10,000. Image credits: WA Police

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COVID wave: what’s the latest on antiviral drugs, and who is eligible in Australia?

<a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Australia is experiencing a <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">fresh wave of COVID</a>, seeing increasing cases, more hospitalisations and a greater number of prescriptions for COVID antivirals dispensed over recent months. In the early days of the pandemic, the only medicines available were those that treated the symptoms of the virus. These included steroids and analgesics such as paracetamol and ibuprofen to treat pain and fever. We now have two drugs called <a href="https://www.health.wa.gov.au/%7E/media/Corp/Documents/Health-for/Infectious-disease/COVID19/Treatment/COVID19-PAXLOVID-Patient-information.pdf">Paxlovid</a> and <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/abefa4a4-ecaa-4c26-8713-d80c90388545/COVID-19+Treatment+Fact+Sheet+-+Molnupiravir+-+Prescribers+20220428.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-abefa4a4-ecaa-4c26-8713-d80c90388545-oIRWpvB">Lagevrio</a> that treat the virus itself. But are these drugs effective against current variants? And who is eligible to receive them? Here’s what to know about COVID antivirals as we navigate this <a href="https://www.smh.com.au/national/a-slightly-more-dangerous-place-australia-is-in-its-eighth-covid-wave-20231030-p5eg5k.html">eighth COVID wave</a>. <h2>What antivirals are available?</h2> <a href="https://www.tga.gov.au/resources/artg/389801">Paxlovid</a> is a combination of two different drug molecules, nirmatrelvir and ritonavir. The nirmatrelvir works by blocking an enzyme called a protease that the virus needs to replicate. The ritonavir is included in the medicine to protect the nirmatrelvir, stopping the body from breaking it down. Molnupiravir, marketed as <a href="https://www.tga.gov.au/resources/artg/372650">Lagevrio</a>, works by forcing errors into the RNA of SARS-CoV-2 (the virus that causes COVID) as it replicates. As these errors build up, the virus becomes less effective. This year in Australia, the <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">XBB COVID strains</a> have dominated, and acquired a couple of key mutations. When COVID mutates into new variants, it doesn’t affect the ability of either Paxlovid or Lagevrio to work because the parts of the virus that change from the mutations aren’t those targeted by these two drugs. This is different to the <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/E8kMVn">monoclonal antibody-based medicines</a> that were developed against specific strains of the virus. These drugs are not thought to be effective for any variant of the virus <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">from omicron XBB.1.5 onwards</a>, which includes the current wave. This is because these drugs recognise certain proteins expressed on the surface of SARS-CoV-2, which have changed over time. <h2>What does the evidence say?</h2> As Lagevrio and Paxlovid are relatively new medicines, we’re still learning how well they work and which patients should use them. The latest <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/L0OPkj">evidence</a> suggests Paxlovid decreases the risk of hospitalisation if taken early by those at <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals">highest risk of severe disease</a>. Results from <a href="https://www.nejm.org/doi/10.1056/NEJMoa2116044">a previous trial</a> suggested Lagevrio might reduce COVID deaths. But a more recent, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4237902">larger trial</a> indicated Lagevrio doesn’t significantly reduce hospitalisations or deaths from the virus. However, few people at highest risk from COVID were included in this trial. So it could offer some benefit for patients in this group. In Australia, Lagevrio is not routinely <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/L0OPkj">recommended</a> and Paxlovid is preferred. However, not all patients can take Paxlovid. For example, people with medical conditions such as <a href="https://www.paxlovidhcp.com/moderate-renal-impairment">severe kidney or liver impairment</a> shouldn’t take it because these issues can affect how well the body metabolises the medication, which increases the risk of side effects. Paxlovid also can’t be taken alongside some <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0020/702821/Information-for-patients-family-and-carers-nirmatrelvir-and-ritonavir.PDF">other medications</a> such as those for certain heart conditions, mental health conditions and cancers. For high-risk patients in these cases, Lagevrio can be considered. Some people who take COVID antivirals will experience side effects. Mostly these are not serious and will go away with time. Both <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0020/702821/Information-for-patients-family-and-carers-nirmatrelvir-and-ritonavir.PDF">Paxlovid</a> and <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0008/702818/Information-for-patients-family-and-carers-molnupiravir.PDF">Lagevrio</a> can cause diarrhoea, nausea and dizziness. Paxlovid can also cause side effects including muscle aches and weakness, changes in taste, loss of appetite and abdominal pain. If you experience any of these, you should contact your doctor. More serious side effects of both medicines are allergic reactions, such as shortness of breath, swelling of the face, lips or tongue and a severe rash, itching or hives. If you experience any of these, call 000 immediately or go straight to the nearest emergency department. <h2>Be prepared</h2> Most people will be able to manage COVID safely at home without needing antivirals. However, those at higher risk of severe COVID and therefore <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals#:%7E:text=Both%20are%20available%20in%20NSW,Lagevrio%C2%AE%20(molnupiravir)launch.">eligible for antivirals</a> should seek them. This includes people aged 70 or older, people aged 50 or older or Aboriginal people aged 30 or older with one additional risk factor for severe illness, and people 18 or older who are immunocompromised. If you are in any of these groups, it’s important you <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/translated/plan-ahead-covid-flu-english.pdf">plan ahead</a>. Speak to your health-care team now so you know what to do if you get COVID symptoms. If needed, this will ensure you can start treatment as soon as possible. It’s important antivirals are started within <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals#:%7E:text=Both%20are%20available%20in%20NSW,Lagevrio%C2%AE%20(molnupiravir)launch.">five days of symptom onset</a>. If you’re a high-risk patient and you test positive, contact your doctor straight away. If you are eligible for antivirals, your doctor will organise a prescription (either an electronic or paper script). These medicines are available under the Pharmaceutical Benefits Scheme (PBS) and subsidised for people with a Medicare card. The cost for each course is the standard <a href="https://www.pbs.gov.au/info/about-the-pbs#:%7E:text=Patient%20co%2Dpayments,you%20have%20a%20concession%20card.">PBS co-payment</a> amount: A$30 for general patients and A$7.30 for people with a concession card. So you can rest and reduce the risk of spreading the virus to others, ask your pharmacy to deliver the medication to your home, or ask someone to collect it for you.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218423/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/covid-wave-whats-the-latest-on-antiviral-drugs-and-who-is-eligible-in-australia-218423">original article</a>.

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Drug resistance may make common infections like thrush untreatable

<a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> We’ve all heard about antibiotic resistance. This happens when bacteria develop strategies to avoid being destroyed by an antibiotic. The consequences of antibiotic resistance mean an antibiotic previously used to cure bacterial infections no longer works effectively because the bacteria have become resistant to the drug. This means it’s getting harder to cure the infections some bacteria cause. But unfortunately, it’s only one part of the problem. The same phenomenon is also happening with other causes of infections in humans: fungi, viruses and parasites. “Antimicrobial resistance” means the drugs used to treat diseases caused by microbes (bugs that cause infection) no longer work. This occurs with antibacterial agents used against bacteria, antifungal agents used against fungi, anti-parasitic agents used against parasites and antiviral agents used against viruses. This means a wide range of previously controllable infections are becoming difficult to treat – and may become untreatable. <h2>Fighting fungi</h2> Fungi are responsible for a range of infections in humans. Tinea, ringworm and vulvovaginal candidiasis (thrush) are some of the more familiar and common superficial fungal infections. There are also life-threatening fungal infections such as aspergillosis, cryptococcosis and invasive fungal bloodstream infections including those caused by Candida albicans and Candida auris. Fungal resistance to antifungal agents is a problem for several reasons. First, the range of antifungal agents available to treat fungal infections is limited, especially compared to the range of antibiotics available to treat bacterial infections. There are only four broad families of antifungal agents, with a small number of drugs in each category. Antifungal resistance further restricts already limited options. Life-threatening fungal infections happen less frequently than life-threatening bacterial infections. But they’re rising in frequency, especially among people whose immune systems are compromised, including by <a href="https://7news.com.au/news/qld/first-heart-transplant-patient-to-die-from-fungal-infection-at-brisbanes-prince-charles-hospital-identified-as-mango-hill-gp-muhammad-hussain-c-12551559">organ transplants</a> and chemotherapy or immunotherapy for cancer. The threat of getting a drug-resistant fungal infection makes all of these health interventions riskier. The greatest <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2017.00735/full">burden of serious fungal disease</a> occurs in places with limited health-care resources available for diagnosing and treating the infections. Even if infections are diagnosed and antifungal treatment is available, antifungal resistance reduces the treatment options that will work. But even in Australia, common fungal infections are impacted by resistance to antifungal agents. Vulvovaginal candidiasis, known as thrush and caused by Candida species and some closely related fungi, is usually reliably treated by a topical antifungal cream, sometimes supplemented with an oral tablet. However, instances of <a href="https://www.theage.com.au/national/victoria/they-can-t-sit-properly-doctors-treat-growing-number-of-women-with-chronic-thrush-20230913-p5e499.html">drug-resistant thrush</a> are increasing, and new treatments are needed. <h2>Targeting viruses</h2> Even <a href="https://theconversation.com/why-are-there-so-many-drugs-to-kill-bacteria-but-so-few-to-tackle-viruses-137480">fewer antivirals</a> are available than antibacterial and antifungal agents. Most antimicrobial treatments work by exploiting differences between the microbe causing the infection and the host (us) experiencing the infection. Since viruses use our cells to replicate and cause their infection, it’s difficult to find antiviral treatments that selectively target the virus without damaging us. With so few antiviral drugs available, any resistance that develops to one of them significantly reduces the treatment options available. Take COVID, for example. Two antiviral medicines are in widespread use to treat this viral infection: Paxlovid (containing nirmatrelvir and ritonavir) and Lagevrio (molnupiravir). So far, SARS-CoV-2, the virus that causes COVID, has not developed significant resistance to either of these <a href="https://www.cidrap.umn.edu/covid-19/low-levels-resistance-paxlovid-seen-sars-cov-2-isolates">treatments</a>. But if SARS-CoV-2 develops resistance to either one of them, it halves the treatment options. Subsequently relying on one would likely lead to its increased use, which may heighten the risk that resistance to the second agent will develop, leaving us with no antiviral agents to treat COVID. The threat of antimicrobial resistance makes our ability to treat serious COVID infections rather precarious. <h2>Stopping parasites</h2> Another group of microbes that cause infections in humans are single-celled microbes such as Plasmodium, Giardia, Leishmania, and Trypanosoma. These microbes are sometimes referred to as parasites, and they are becoming increasingly resistant to the very limited range of anti-parasitic agents used to treat the infections they cause. Several Plasmodium species cause malaria and anti-parasitic drugs have been the cornerstone of malaria treatment for decades. But their usefulness has been significantly reduced by the <a href="https://www.mmv.org/our-work/mmvs-pipeline-antimalarial-drugs/antimalarial-drug-resistance">development of resistance</a>. Giardia parasites cause an infection called giardiasis. This can resolve on its own, but it can also cause severe gastrointestinal symptoms such as diarrhea, nausea, and bloating. These microbes have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207226/">developed resistance</a> to the main treatments and patients infected with drug-resistant parasites can have protracted, unpleasant infections. <h2>Resistance is a natural consequence</h2> Treating infections influences microbes’ evolutionary processes. Exposure to drugs that stop or kill them pushes microbes to either evolve or die. The exposure to antimicrobial agents provokes the evolutionary process, selecting for microbes that are resistant and can survive the exposure. The pressure to evolve, provoked by the antimicrobial treatment, is called “selection pressure”. While most microbes will die, a few will evolve in time to overcome the antimicrobial drugs used against them. The evolutionary process that leads to the emergence of resistance is inevitable. But some things can be done to minimise this and the problems it brings. Limiting the use of antimicrobial agents is one approach. This means reserving antimicrobial agents for when their use is known to be necessary, rather than using them “just in case”. Antimicrobial agents are precious resources, holding at bay many infectious diseases that would otherwise sicken and kill millions. It is imperative we do all we can to preserve the effectiveness of those that remain, and give ourselves more options by working to discover and develop new ones.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, Senior Research Fellow, School of Medicine, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drug-resistance-may-make-common-infections-like-thrush-untreatable-213460">original article</a>.

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Home and Away star accused of "stomping" on woman's head

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Mother bans in-laws from seeing her baby after they go against her wishes

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"Like the cash cow had come out": Commuters puzzled by money bundles on motorway

COVID wave: what’s the latest on antiviral drugs, and who is eligible in Australia?

Drug resistance may make common infections like thrush untreatable

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Home and Away star accused of "stomping" on woman's head

"No-brainer": Call for Jack's law to be introduced nationwide

Woman baffled by mother-in-law’s insane ask over baby name

What happens when I stop taking a drug like Ozempic or Mounjaro?

If you squat in a vacant property, does the law give you the house for free? Well, sort of

No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

Astonishing drug and prostitute claims surface as Lehrmann case reopened

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

"Lincoln's Law": Grandma's important safety crusade after tragic loss

Does the royal family have a right to privacy? What the law says

“My sister-in-law announced she was pregnant at my child’s funeral”

Mother bans in-laws from seeing her baby after they go against her wishes

Drug regulator investigates deaths tied to weight loss injections

How dieting, weight suppression and even misuse of drugs like Ozempic can contribute to eating disorders

"I was terrified": Law & Order star reveals traumatic past

Do you really need antibiotics? Curbing our use helps fight drug-resistant bacteria

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