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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

Eye infections might seem like a minor complaint – but in some cases they can cause blindness and even death

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a> When you think of eye infections, what comes to mind? Puffy, swollen bruised feeling eyelids that get glued together with gunk overnight? That feeling of having grit in your eye that can’t be cleaned away? Eye infections may seem like a relatively minor – if unsightly and inconvenient – complaint, but they can also be far more serious. Take the deadly outbreak of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022785/">antibiotic resistant</a> bacteria <a href="https://www.cff.org/managing-cf/burkholderia-cepacia-complex-b-cepacia">Burkholderia cepacia</a> in 2023-24, for example. Between January 2023 and February 2024, contaminated brands of lubricating eye gel were linked to the infection of at least 52 patients. <a href="https://www.independent.co.uk/news/health/contaminated-eye-gel-outbreak-death-b2523446.html">One person died</a> and at least 25 others suffered serious infections. The outbreak has now subsided and products are <a href="https://www.gov.uk/drug-device-alerts/specific-brands-of-carbomer-eye-gel-recall-of-aacarb-eye-gel-aacomer-eye-gel-and-puroptics-eye-gel-potential-risk-of-infection-dsi-slash-2023-slash-11#update-2-april-2024">back on the shelves</a> but it isn’t the first time that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335909/">medicinal products</a> have led to outbreaks of B cepacia. The bacterium is an opportunistic pathogen known to pose a significant risk to people with cystic fibrosis, chronic lung conditions and weakened immune systems. The infection likely progresses from the mucous membranes of the eyelids to the lungs where it leads to pneumonia and septicaemia causing <a href="https://erj.ersjournals.com/content/17/2/295">death in days</a>. But it’s not just B cepacia that can threaten our health. Something as simple as rubbing our eyes can introduce pathogens leading to infection, blindness and, in the worst case, death. Bacteria account for up to <a href="https://pubmed.ncbi.nlm.nih.gov/16148850/">70% of eye infections</a> and globally <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032492/">over 6 million people</a> have blindness or moderate visual impairment from ocular infection. Contact lens wearers are at <a href="https://www.aao.org/eye-health/diseases/contact-lens-related-eye-infections">increased risk</a>. <figure><iframe src="https://www.youtube.com/embed/pWsx8i1kaxs?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The eye is a unique structure. It converts light energy to chemical and then electrical energy, which is transmitted to the brain and converted to a picture. The eye uses about <a href="https://www.ncbi.nlm.nih.gov/books/NBK11556/">6 million cones and 120 million rods</a> which detect colour and light. Eye cells have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775779/">no ability to regenerate</a> so, once damaged or injured, cannot be repaired or replaced. The body tries its best to preserve the eyes by encasing them in a <a href="https://www.ncbi.nlm.nih.gov/books/NBK531490/">bony protective frame</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK482428/">limiting exposure</a> having eyelids to defend against the environmental damage and ensure the eyes are kept lubricated. Despite our bodies’ best efforts to shield the eyes from harm, there are a number of common eye infections that can result from introducing potential pathogens into the eyes. <h2>Conjunctivitis</h2> The outer-most layer of the eye, the sclera, bears the brunt of exposure and to help protect it, it is lined by a thin moist membrane called the <a href="https://my.clevelandclinic.org/health/body/24329-conjunctiva">conjunctiva</a>. <figure><iframe src="https://www.youtube.com/embed/RZ4danuJwd0?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The conjunctiva is <a href="https://innovations.bmj.com/content/9/4/253">highly vascularised</a>, which means it has lots of blood vessels. When microbes enter the eye, it is this layer that mounts an immune response causing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328962/">blood vessels to dilate</a> in the conjunctiva. This results in <a href="https://www.cdc.gov/conjunctivitis/about/symptoms.html">“pink eye”</a>, a common form of conjunctivitis. Conjunctivitis can be caused by bacteria, allergens or viruses and typically heals by itself. <h2>Blepharitis</h2> Blepharitis is an inflammation of the eyelid and usually affects both sides. It can cause itchy eyes and dandruff-like flakes. It’s most commonly caused by <a href="https://www.tandfonline.com/doi/pdf/10.3109/09273948.2013.870214">Staphylococcus bacteria</a>, or the <a href="https://cks.nice.org.uk/topics/blepharitis/background-information/causes/">dysfunction of the glands</a> of the eyelids. It can be treated by <a href="https://www.nhs.uk/conditions/blepharitis/">cleaning the eyes</a> regularly. <h2>Stye</h2> A stye (also called <a href="https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/hordeolum">hordeolum</a>) is a painful infection of the upper or lower eyelid. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370090/">Internal styes</a> are caused by infection of an oil-producing gland inside the eyelid, whereas <a href="https://pubmed.ncbi.nlm.nih.gov/28723014/">external styes</a> develop at the base of the eyelash because of an infection of the hair follicle. Both are caused by bacteria, typically <a href="https://jamanetwork.com/journals/jamaophthalmology/fullarticle/1874715">the S aureus form of the Staphylococcus species</a>. <figure><iframe src="https://www.youtube.com/embed/INKrGOdy824?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Styes can be treated by holding a clean flannel soaked in warm water against the affected eye for five to ten minutes, three or four times a day. Do not try to burst styes – this could spread the infection. <h2>Keratitis</h2> Keratitis is the inflammation of the cornea, the transparent part of the eye that light passes through. The cornea is part of the eye’s main barrier against dirt, germs, and disease. Severe keratitis can cause ulcers, damage to the eye and even blindness. The most common type is bacterial keratitis; however, it can also be caused by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998329/">amoeba</a>, which can migrate to other parts of the body – including the brain – and cause infection and <a href="https://theconversation.com/nasal-rinsing-why-flushing-the-nasal-passages-with-tap-water-to-tackle-hay-fever-could-be-fatal-225811">even death</a>. Noninfectious keratitis is most commonly caused by wearing contact lenses for too long, especially while sleeping. This can cause scratches, dryness and soreness of the cornea, which leads to inflammation. <h2>Uveitis</h2> <a href="https://www.nhs.uk/conditions/uveitis/">Uveitis</a> is inflammation of the middle layer of the eye. Although relatively rare, it is a serious condition and usually results from viral infections such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501150/">herpes simplex</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29023181/">herpes zoster</a> or <a href="https://link.springer.com/chapter/10.1007/978-3-319-09126-6_40">trauma</a>. Depending on where the inflammation is in the eye, the symptoms can be anything from redness, pain and floaters to blurred vision and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772296/">partial blindness</a>. <h2>Exogenous endophthalmitis</h2> This is a rare but serious infection caused by eye surgery complications, penetrating ocular trauma (being stabbed in the eye with a sharp object) or foreign bodies in the eye. Foreign bodies can be anything from dirt and dust to small projectiles such as shards of metal from drilling, explosives or soil from farm machinery and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286045/">many other sources</a>. <h2>Dacryocystitis</h2> Dacryocystitis is the inflammation of the nasolacrimal sac, which drains tears away from the eye into the nose. This condition can be <a href="https://pubmed.ncbi.nlm.nih.gov/8443113/">acute</a>, <a href="https://www.nature.com/articles/6700662">chronic</a> or <a href="https://www.jebmh.com/articles/a-study-of-congenital-dacryocystitis.pdf.pdf">acquired at birth</a>. Most cases are caused by <a href="https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-020-01792-4">Streptococcus pneumoniae and Staphylococcus aureus</a> bacteria. The condition mainly affects newborns and those over 40. Seventy-five per cent of cases are women and it’s most commonly found in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039673/">white adults</a>. It can lead to the stagnation of tears, creating a breeding ground for microbes. <h2>Careful with contacts</h2> Proper eye hygiene reduces the risk of all these conditions – and this is even more important for contact lens wearers. <figure><iframe src="https://www.youtube.com/embed/uENHAntJOIA?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Appropriate hygienic cleaning of lenses is paramount. <a href="https://pubmed.ncbi.nlm.nih.gov/30789440/">Non-sterile water</a>, <a href="https://www.aao.org/eye-health/glasses-contacts/contact-lens-care">spit</a> and other fluids can transfer <a href="https://www.science.org/content/article/bacteria-living-your-contact-lens-solution">potentially dangerous</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482476/">microbes</a> into the eye – a warm, moist environment that makes an ideal breeding ground for bacteria – leading to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542356/">localised infection</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972779/">blindness</a> or progress to a more serious <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835757/">systemic infection or death</a>. Any persistent and painful redness or swelling of eyes should be checked by a registered health professional.<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/227252/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster 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/eye-infections-might-seem-like-a-minor-complaint-but-in-some-cases-they-can-cause-blindness-and-even-death-227252">original article</a>. </div>

Body

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

"Finally felt like the right time": John Farnham's huge announcement

John Farnham has announced his triumphant return one year on from his cancer surgery, sharing the news of a highly anticipated project. The 74-year-old Aussie music icon is set to tell his story in his own words with the release of his own candid memoir titled The Voice Inside. The autobiography, which will be released on October 30th, is co-written by Poppy Stockwell, who is the award-winning writer and director of the critically acclaimed biopic Finding the Voice. The book documents Farnham's early life and stardom growing up in Melbourne in the 1960s, to his comeback 1986 album Whispering Jack. It will recall the highs and lows of fame, including when his stellar career stalled, record companies turned their backs and he faced financial ruin. The Voice Inside will also detail his shocking diagnosis of mouth cancer in 2022 which turned his life upside down. The book was announced on Farnham's Facebook page, with a statement sharing how he felt it was "the right time" to tell his story. <iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fjohnfarnham%2Fposts%2Fpfbid02tZwog7QbEW6AxDUxNMp3Kn5msAghjd9yUQe56optBdyX8ZL1DQFm4qvpUYsSjo2Rl&show_text=true&width=500" width="500" height="728" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe> "Having been asked many times, it finally felt like the right time to sit down and tell my story," he said. "It is a very strange feeling looking back on my life, on the good and the bad, and now that I have started, it is all rushing back. I hope the book engages and entertains, because that’s what so much of my life has been about." The book will "chart John Farnham’s very personal and public journey, told in his own words and with his inimitable humour, insight, and humility." The post was quickly flooded with comments from fans eager to get their hands on the memoir, while many shared their well wishes as he continues his lengthy recovery from cancer. Image credits: Getty Images

Caring

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>.

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"There's no place like home": Marcia Hines and her amazing cat share sweet message

Australian music icon and Australian Idol judge Marcia Hines recently took to social media to express her heartfelt gratitude to those who supported her during a <a href="https://www.oversixty.com.au/health/caring/marcia-hines-rushed-to-hospital" target="_blank" rel="noopener">recent medical incident</a>. The beloved singer and performer shared a touching message on Instagram, reflecting on the challenges she faced and the overwhelming support she received from healthcare professionals, family, friends and fans – but mostly from her amazing-looking cat, Sistah! <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C5AeYisL9Pu/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C5AeYisL9Pu/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Marcia Hines (@themarciahines)</a> </div> </blockquote> The incident unfolded backstage at Sydney’s Coliseum Theatre just before last Sunday night’s Australian Idol finale. Hines, known for her vibrant presence and insightful critiques on the talent show, collapsed, prompting concerns among the show's crew and audience. As a result, she had to miss the episode, with fellow musician Guy Sebastian stepping in as a guest judge. Following her collapse, Hines was swiftly taken to the hospital, where she received treatment for head injuries, including stitches. Despite the setback, she was able to make a remarkable recovery <a href="https://www.oversixty.com.au/entertainment/tv/marcia-hines-returns-as-australian-idol-fans-cry-foul-over-upset-win" target="_blank" rel="noopener">in time to return</a> for the Grand Finale show on Monday night. In her Instagram post, Hines expressed profound gratitude for the exceptional care she received during her hospital stay, particularly praising Brad Ceely and the entire team at Blacktown Hospital. "There’s no place like home….." Hines wrote. "Especially when Sistah is here to greet me 🐾 What an action-packed week ❤️ I’ve experienced so much care and love, and none moreso than the exceptional treatment that Brad Ceely and his entire team at Blacktown Hospital gave me during my stay with them. "We are so fortunate to live in a country with such incredible healthcare, and the amazing facilities we have in our Western Sydney suburbs - wow! I’m so grateful to all of the hospital staff - from the tireless nurses to the wonderful administration staff. A special thanks to all of the staff at Mount Druitt Emergency Department, all of the Ambulance teams who got me safely to-and-from hospitals this weekend, and of course Dr Kit Rowe for stitching me up so nicely after my fall. Ouch lol 🤕Thank you for being you and keeping us all safe 🫶🏾 "Thank you also to Kyle, Amy and all the team at @australianidol for your love, and also to my @greaseoztour family who I’ll be seeing soon. Thank you also to my family and friends - you’re always there when I need you most 💝" The response to Hines' message was overwhelmingly positive, with fans and well-wishers flooding the comments section with messages of support, encouragement and excitement for her upcoming projects. Many expressed relief at her recovery and eagerly anticipated her return to the stage, particularly in her role in Grease the Musical. Images: Instagram

Caring

What will aged care look like for the next generation?

<a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Aged care financing is a vexed problem for the Australian government. It is already underfunded for the quality the community expects, and costs will increase dramatically. There are also significant concerns about the complexity of the system. In 2021–22 the federal government spent <a href="https://www.health.gov.au/resources/publications/final-report-of-the-aged-care-taskforce?language=en">A$25 billion</a> on aged services for around 1.2 million people aged 65 and over. Around 60% went to residential care (<a href="https://www.gen-agedcaredata.gov.au/topics/people-using-aged-care#:%7E:text=On%2030%20June%202022%2C%20approximately,and%203%2C500%20using%20transition%20care.">190,000 people</a>) and one-third to home care (<a href="https://www.gen-agedcaredata.gov.au/topics/people-using-aged-care#:%7E:text=On%2030%20June%202022%2C%20approximately,and%203%2C500%20using%20transition%20care.">one million people</a>). The <a href="https://www.health.gov.au/resources/publications/final-report-of-the-aged-care-taskforce?language=en">final report from the government’s Aged Care Taskforce</a>, which has been reviewing funding options, estimates the number of people who will need services is likely to grow to more than two million over the next 20 years. Costs are therefore likely to more than double. The taskforce has considered what aged care services are reasonable and necessary and made recommendations to the government about how they can be paid for. This includes getting aged care users to pay for more of their care. But rather than recommending an alternative financing arrangement that will safeguard Australians’ aged care services into the future, the taskforce largely recommends tidying up existing arrangements and keeping the status quo. <h2>No Medicare-style levy</h2> The taskforce <a href="https://www.health.gov.au/resources/publications/final-report-of-the-aged-care-taskforce?language=en">rejected</a> the aged care royal commission’s recommendation to introduce a levy to meet aged care cost increases. A 1% levy, similar to the Medicare levy, could have raised around <a href="https://www.thenewdaily.com.au/finance/finance-news/2021/03/03/cost-of-aged-care-levy#:%7E:text=Overall%2C%20a%201%20per%20cent%20levy%20would%20raise,necessary%20to%20provide%20decent%20aged%20care%20for%20all.">$8 billion a year</a>. The taskforce failed to consider the mix of taxation, personal contributions and social insurance which are commonly used to fund aged care systems internationally. The <a href="https://www.oecd.org/els/health-systems/Japan-OECD-EC-Good-Time-in-Old-Age.pdf">Japanese system</a>, for example, is financed by long-term insurance paid by those aged 40 and over, plus general taxation and a small copayment. Instead, the taskforce puts forward a simple, pragmatic argument that older people are becoming wealthier through superannuation, there is a cost of living crisis for younger people and therefore older people should be required to pay more of their aged care costs. <h2>Separating care from other services</h2> In deciding what older people should pay more for, the taskforce divided services into care, everyday living and accommodation. The taskforce thought the most important services were clinical services (including nursing and allied health) and these should be the main responsibility of government funding. Personal care, including showering and dressing were seen as a middle tier that is likely to attract some co-payment, despite these services often being necessary to maintain independence. The task force recommended the costs for everyday living (such as food and utilities) and accommodation expenses (such as rent) should increasingly be a personal responsibility. <h2>Making the system fairer</h2> The taskforce thought it was unfair people in residential care were making substantial contributions for their everyday living expenses (about 25%) and those receiving home care weren’t (about 5%). This is, in part, because home care has always had a muddled set of rules about user co-payments. But the taskforce provided no analysis of accommodation costs (such as utilities and maintenance) people meet at home compared with residential care. To address the inefficiencies of upfront daily fees for packages, the taskforce recommends means testing co-payments for home care packages and basing them on the actual level of service users receive for everyday support (for food, cleaning, and so on) and to a lesser extent for support to maintain independence. It is unclear whether clinical and personal care costs and user contributions will be treated the same for residential and home care. <h2>Making residential aged care sustainable</h2> The taskforce was <a href="https://www.health.gov.au/resources/publications/final-report-of-the-aged-care-taskforce?language=en">concerned</a> residential care operators were losing $4 per resident day on “hotel” (accommodation services) and everyday living costs. The taskforce recommends means tested user contributions for room services and everyday living costs be increased. It also recommends that wealthier older people be given more choice by allowing them to pay more (per resident day) for better amenities. This would allow providers to fully meet the cost of these services. Effectively, this means daily living charges for residents are too low and inflexible and that fees would go up, although the taskforce was clear that low-income residents should be protected. <h2>Moving from buying to renting rooms</h2> Currently older people who need residential care have a choice of making a refundable up-front payment for their room or to pay rent to offset the loans providers take out to build facilities. Providers raise capital to build aged care facilities through equity or loan financing. However, the taskforce did not consider the overall efficiency of the private capital market for financing aged care or alternative solutions. Instead, it recommended capital contributions be streamlined and simplified by phasing out up-front payments and focusing on rental contributions. This echoes the royal commission, which found rent to be a more efficient and less risky method of financing capital for aged care in private capital markets. It’s likely that in a decade or so, once the new home care arrangements are in place, there will be proportionally fewer older people in residential aged care. Those who do go are likely to be more disabled and have greater care needs. And those with more money will pay more for their accommodation and everyday living arrangements. But they may have more choice too. Although the federal government has <a href="https://www.abc.net.au/news/2024-03-11/aged-care-task-force-hands-down-recommendations/103573554">ruled out an aged care levy</a> and <a href="https://www.abc.net.au/news/2024-02-15/no-plan-to-touch-aged-care-asset-test/103470442">changes to assets test on the family home</a>, it has yet to respond to the majority of the recommendations. But given the aged care minister chaired the taskforce, it’s likely to provide a good indication of current thinking.<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/225551/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> Image: Getty 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-will-aged-care-look-like-for-the-next-generation-more-of-the-same-but-higher-out-of-pocket-costs-225551">original article</a>.

Caring

Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>. <a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment. Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it. <h2>Walk, run, lift, or dance away depression</h2> We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together. We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them. Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants. But of these exercises, people were most likely to stick with strength training and yoga. <iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe> Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing. Still, our evidence shows that if you have depression, you should get a psychologist and an exercise plan, whether or not you’re taking antidepressants. <h2>Join a program and go hard (with support)</h2> Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.” But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression. We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results. <h2>Yes, it’s hard to keep motivated</h2> We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results. Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free. We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression. Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result. Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult. A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted. Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it. So, when starting out, it seems wise to avoid going it alone. Instead: <ul> <li> join a fitness group or yoga studio </li> <li> get a trainer or an exercise physiologist </li> <li> ask a friend or family member to go for a walk with you. </li> </ul> Taking a few steps towards getting that support makes it more likely you’ll keep exercising. <h2>Let’s make this official</h2> Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”. Based on our research, this recommendation is withholding a potent treatment from many people who need it. In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression. Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression. I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<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/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> 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/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.

Body

How to navigate a parent’s cancer diagnosis – like Princes William and Harry will now have to do

<a href="https://theconversation.com/profiles/lydia-harkin-1510450">Lydia Harkin</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> King Charles’ <a href="https://www.bbc.co.uk/news/uk-68209998">cancer diagnosis</a> means the royal family has joined the approximately 3 million families in the UK affected by the disease. His family has already gathered around in support. William, Prince of Wales, has taken over some public duties for his father. And younger son Harry, who lives in California, flew to the UK to visit after the diagnosis was announced. If you, like William and Harry, are navigating a parent’s diagnosis, you are not alone. Around 400,000 people are <a href="https://www.macmillan.org.uk/about-us/what-we-do/research/cancer-statistics-fact-sheet">diagnosed</a> each year. This can be a <a href="https://doi.org/10.1002/pon.4287">frightening</a> and difficult time for families, and can change family dynamics. Adult children may find themselves offering emotional and practical support for a parent in a way that has not been required before, through managing medications and symptoms, travel to medical appointments, help with meal preparation and financial support. It can be rewarding to support a loved one and an important way to actively work together, but it can also be stressful. <a href="https://doi.org/10.1002/pon.4056">Studies have found</a> that family caregivers are generally more anxious and more likely to hide their emotional distress when compared with their family member with cancer. <h2>Being a supportive family, even in conflict</h2> Family support can act as a <a href="https://doi.org/10.1002/ejsp.2333">“social cure”</a> against the stress of a life-changing illness. The social cure theory proposes that being a part of a social group (or multiple groups) has benefits for our health and wellbeing. Social groups, particularly those with whom we strongly identify, like families, provide support and help us to combat times of stress. The key psychological component here is that people feel they belong to and identify with their groups. While undergoing cancer treatment, someone may not be able to participate in their usual social groups – through work or hobbies – as much as they used to. These groups may then become incompatible with a person’s new identity as a cancer survivor. Of course, not all families work together harmoniously, and may be in conflict through divorce, separation or estrangement. Social psychologists have <a href="https://doi.org/10.1111/bjso.12155">found that</a> “incompatible” social groups can lead to poorer mental health. Separated families can still come together and be a helpful social group, but they must offer the kind of support that their loved one needs. To figure this out, it is important to think about the person’s <a href="https://doi.org/10.1002/ejsp.2333">identity</a> within the family. For example, a father may view his identity as an advisor, but a cancer diagnosis requires him to be cared for and to seek advice. He may feel a sense of loss for his typical family role, a loss of meaning and of control. However, if his family communicates openly about the difficulties they are all facing, the father may be able to continue to advise his family, in addition to receiving their advice. This can help to maintain his sense of identity as an advisor within his family, while navigating a new status as a cancer survivor. <h2>Communication and support networks</h2> Cancer throws patients and their loved ones into a complex health system, often for the first time, where medical decisions and terminology become important every day. Understanding <a href="https://doi.org/10.1016/j.ejon.2014.03.012">the “language of cancer”</a> can help families feel more in control after a diagnosis. Equally important is communication within a family. Talking about the cancer, rather than treating it as a taboo topic, can improve <a href="https://doi.org/10.1016/j.ejon.2020.101841">mental health for both patients and their families</a>. It may also be an opportunity to empower patients and their loved ones to seek outside support, such as counselling. Families spread across geographical distances (like the royal family) can offer emotional support through regular phone calls or online tools. During the pandemic, <a href="https://doi.org/10.2196/42172">I developed</a> and trialled an app to help older adults combat loneliness. The app allowed them to see a digital map of their social groups, including family members. Your family member with cancer may feel like a burden. This is a common fear in older adulthood generally. But reminding them of how many people are in their lives – and how many people they support – can combat this feeling. Social media is one way to get more involved in these reciprocal support networks. In my work, families affected by cancer have reported using online communities to <a href="https://doi.org/10.1007/s11764-017-0616-1">better understand what their family is going through</a>. Private social media groups <a href="https://doi.org/10.1177/2055207619898993">dedicated to illness</a> can be helpful spaces to meet other patients and families, share experiences and normalise cancer. Cancer communities exist on <a href="https://doi.org/10.4103%2Fijpvm.IJPVM_36_19">Instagram</a>, on <a href="https://doi.org/10.1007/s00345-018-2254-2">YouTube and X/Twitter</a> and through registered cancer charities like <a href="https://www.macmillan.org.uk/">Macmillan Cancer Support</a>. These online resources all provide a way to build a network following a cancer diagnosis. Just as group identification is important within families, having more groups to connect to can act as a buffer during stressful times and help you all cope with your new reality.<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/223214/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lydia-harkin-1510450">Lydia Harkin</a>, Principal Lecturer in Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent 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-to-navigate-a-parents-cancer-diagnosis-like-princes-william-and-harry-will-now-have-to-do-223214">original article</a>.

Caring

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 have COVID. How likely am I to get long COVID?

<a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron. While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains. So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID? <h2>When COVID becomes ‘long COVID’</h2> For most people, long COVID means not getting better after a COVID infection. The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis. The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems. <h2>How common is long COVID?</h2> Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection. A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID. Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods. The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021. But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes. Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID. <h2>What’s different this time?</h2> Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic. But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms. <h2>Long COVID can affect all aspects of life</h2> Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks. Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals. Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms. <h2>I think I have long COVID, what can I expect from my doctor?</h2> Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding. Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition. As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy. However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should: <ul> <li> validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear </li> <li> diagnose and treat any other health conditions that are part of the picture </li> <li> support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue. </li> </ul> These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities. <h2>We still need to focus on reducing COVID transmission</h2> The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means: <ul> <li> getting vaccinated or boosted, if you’re eligible </li> <li> staying home if you feel unwell </li> <li> wearing a mask to protect yourself and vulnerable community members </li> <li> testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve. </li> </ul> Long COVID is not going away, but we all have a role to play in preventing and responding to it. Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.<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/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <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/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.

Body

Are catnip and treats like it safe for cats? Here’s how they affect their minds and moods

<a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Cats kept indoors can <a href="https://safeandhappycats.com.au/">live a good life</a> when they get access to a variety of positive experiences. Examples include performing natural behaviours, feeling safe at home and using their full sensory capabilities, including their sense of smell. Plants such as catnip, cat thyme and silver vine are potent smelly stimulants that can affect cat minds and moods. Ever wondered if these mind-altering substances are safe gifts for our feline friends? And importantly, is it OK to provide these, or is offering catnip to a cat like offering alcohol to a child? <h2>Catnip, cat thyme and silver vine, oh my!</h2> Owners who are concerned about their cats feeling bored and frustrated might offer them fresh or dried catnip (Nepeta cataria), silver vine (Actinidia polygama), cat thyme (Teucrium marum) or other plant materials such as valerian (Valeriana officinalis) and Tatarian honeysuckle (Lonicera tatarica). These last couple <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">could offer an alternative</a> if your cat doesn’t respond to catnip. Toys filled with the leaves or extracts of these plants can cause apparently euphoric behaviour in domestic cats (as well as big cats like leopards and jaguars). Not all cats respond this way to these smells, which is <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">believed to have a genetic basis</a>. <h2>Are these treats safe for cats?</h2> Cats have a highly developed sense of smell. Some plants release chemical compounds to deter insects or to attract predators of insects that might otherwise destroy them. This includes <a href="https://www.science.org/doi/10.1126/sciadv.aba0721">nepetalactone</a>, an ingredient isolated from catnip and silver vine. Indeed, <a href="https://www.science.org/content/article/why-cats-are-crazy-catnip">it has been argued </a> that exposure to nepetalactone leads to an increase in feel-good hormones in cats. It may also act as a <a href="https://www.science.org/doi/10.1126/sciadv.abd9135">natural mosquito repellent</a> (note that it does not repel all mosquitoes and is not effective for flea or tick control). This may be why sniffing catnip, silver vine and some other plants causes cats to roll on their backs and rub their chins, cheeks and bodies on the plants. Other <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">observed behaviours</a> include: licking, shaking their head while carrying plant material in their mouth, drooling, kicking the plant material with their hind feet, and a “wavelike” motion of the skin over their backs as muscles contract and relax. These responses <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">generally don’t last long</a>, usually seconds to minutes, before cats relax or resume their normal behaviour. Rather than becoming addicted to these substances, cats are more likely to become habituated and desensitised, with the plants having less effect over time. When sniffed, these plants <a href="https://www.cell.com/iscience/fulltext/S2589-0042(23)01925-9">appear</a> to have <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">no adverse effects</a> on cats. <figure><iframe src="https://www.youtube.com/embed/yNUz4zQTA1E?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Cats (and a dog!) react to the active compound in catnip and silver vine, nepetalactone.</figcaption></figure> <h2>Is it ethical to alter the minds of our cats?</h2> When considering how to improve the lives of animals we care for, we tend to focus on whether the benefits outweigh the potential harms. Despite some marketing claims that these plants activates the brain’s opioid system, delivering a “natural high” for cats, there is no evidence these substances actually alter the minds of cats in the same way as alcohol or other drugs alter the minds of humans. The marketing of these cat treats as “kitty crack” or “<a href="https://www.meowijuana.com/">meowijuana</a>” and silver vine sticks as “<a href="https://www.nekopiapets.com.au/product-page/joycat-cat-cigarettes-silvervine-stick">kitty cigarettes</a>” is likely to deter some people from offering their cats <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">this kind of olfactory stimulation</a>. Unlike offering alcohol to a child, though, the evidence suggests our cats are OK when given access to these treats. These items won’t induce psychosis and won’t lead to addiction or withdrawal symptoms. And we don’t need to worry about our cats operating heavy machinery or making important decisions under the influence of mind-altering substances! Provided they can walk away at any time, it seems reasonable to let them opt in to a fun time. In fact, we harness the power of cats’ sense of smell in other ways by using <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435919/">synthetic feline facial pheromones</a>. This can help reduce fear, anxiety and distress in cats. These substances can come in useful in settings such as multi-cat households or when moving house. <h2>How to make sure your cat has the purr-fect time</h2> Offering a range of smells (olfactory stimulation) is just one way to ensure your cat has a varied and interesting life. Here are some tips: <ul> <li> offer cats choices to interact with treats and toys – don’t force them </li> <li> rotate the toys and experiences on offer, so every day offers something fresh </li> <li> offer items that cats can scratch – scratching posts and corrugated cardboard are popular items </li> <li> if you are concerned your cat has swallowed part of a toy or seems unwell, check in with your vet. </li> </ul> Given the short-lived effects of these plant-based olfactory stimulants on cats, it is important that we <a href="https://www.sciencedirect.com/science/article/abs/pii/S0168159119301054">optimise their environment, lifestyle and interactions</a> with humans to improve their welfare. We can’t just rely on catnip or silver vine to give our cats a good life indoors – it’s really up to us!<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/214947/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, Senior Lecturer, Sydney School of Veterinary Science, <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/are-catnip-and-treats-like-it-safe-for-cats-heres-how-they-affect-their-minds-and-moods-214947">original article</a>.

Family & Pets

"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

Travel Trouble

"I just don't like old skin": Jane Fonda's bizarre confession

Jane Fonda has made an unusual confession about her dating life, explaining why she would only date people of a certain age. The Hollywood legend, 85, has been married three times throughout her life: first to director Roger Vadim from 1965 to 1973, then to activist Tom Hayden from 1973 to 1990, and finally to CNN founder Ted Turner from 1991 to 2001. Fonda is currently single, but doesn't plan on staying that way. Despite being open to finding love, the actress has a very specific criteria for potential suitors to meet before agreeing to a date. On the Absolutely Not podcast, the Oscar winner initially suggested she was done with men for good, saying, “I’m done, I’m over, I’m [almost] 86 years old, even in the dark I wouldn’t want to be naked in front of anybody.” But she then went on to confess that there’s still a chance she could fall for a man, but they would just have to be substantially younger. “And here’s another thing, I’m ashamed to say this, if I were to take a lover, he’d have to be 20. Because I don’t like old skin,” said Fonda. She continued, “And consequently, I don’t want to foist that on anybody else. I assume other people are like me, I just don’t like old skin.” “I disapprove of 86-year-old men with 20-year-old women, so I’m not going to repeat it. I can ogle them, and I can’t pretend that I don’t get turned on if I see a certain kind of a person, but no, no, no, I don’t want to force that on anybody.” Her confession has been criticised on social media, with some suggesting the star would be “cancelled” if it was a man that had said the same about young women. “This is seriously weird,” tweeted one fan, while another said: “But an 85 year old man wanting to date a 20 year old woman is disgusting? Am I right?” Image credits: Getty Images

Relationships

Why we feel like Christmas comes around more quickly each year

<a href="https://theconversation.com/profiles/ruth-ogden-1182467">Ruth Ogden</a>, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores University</a> Think back to your childhood. December was the longest of months. It might have been filled with rehearsing school nativity performances, writing up your wishlist and savouring the morning’s advent calendar chocolate. But at times it felt like Santa would never arrive. As an adult it’s a different experience. One minute it’s summer holidays, barbecues and sunburn and then, in the blink of an eye, it’s mince pies, tinsel and turkey. Is it just me, or is Christmas coming around faster? If you cannot believe the festive season is upon us already, you’re not alone. My colleagues and recently conducted a survey of 918 adults in the UK (full results still to be published) and found 77% of respondents agreed Christmas seems to arrive more rapidly each year. One reason may be the way we experience the <a href="https://brill.com/view/journals/time/9/3/article-p275_275.xml">passage of time changes as we age</a>, often resulting in the feeling that <a href="https://journals.sagepub.com/doi/abs/10.1177/0961463x13478052">time speeds up as we get older</a>. For a seven-year- old, the 12 months between Christmases are a huge proportion of their life. For a 45-year-old, those same 12 months are a small portion of their experience. This <a href="https://journals.sagepub.com/doi/10.2466/pms.1975.41.1.235">difference in ratio</a> compresses the relative time between Christmases each year. Our experience of time also changes because we rely on memory to estimate duration. When we judge how long something lasted for, we base our estimate on <a href="https://psycnet.apa.org/record/2004-18721-003">how many memories we made during the period of interest</a>. Whether we are trying to remember the length of a film, car journey or relationship, the number of memories we encoded during it will serve as an indicator of its length. Periods of time in which fewer new memories are made, either because there was a lack of stimulating tasks, novel activities or heightened emotions, are interpreted by <a href="https://philpapers.org/rec/BLORAP">our brains as short</a>. <h2>Where has the year gone</h2> As we age, memory becomes more fallible and we recall less from our day to day lives. We’re also less likely to try new things than when we were younger. Together these factors may contribute to the sensation that less time has passed since last Christmas than we were expecting. Because what we do has such a strong influence on how we experience time, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235871">changes to our routine distort the passage of time</a>. A predictable day helps time to flow steadily. This was illustrated on a global scale during the pandemic. One minute we were all going about our daily lives. Then all of a sudden, our routines were scrambled. People from <a href="https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0266261">Buenos Aries</a> to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266877">Bagdad</a> reported an overwhelming sense time did not pass as normal during the pandemic. While Christmas does not cause the same level of disruption as a global pandemic, it disrupts our habits. <h2>Can’t wait ‘til it’s Christmas?</h2> Another factor which may make us feel like Christmas is here too fast is the amount of energy we put into anticipating it. For many children, Christmas is arguably the most eagerly awaited event of the year. Advent calendars count down the days until Father Christmas arrives. All this excitement means children pay a lot of attention to the passage of time in the run up to Christmas. Unfortunately for them, focusing on the passage of time <a href="https://digitalcommons.usm.maine.edu/facbooks/472/">typically makes it drag</a>. For most adults, Christmas is less thrilling. So adults probably think less about the countdown. Paying less attention to time <a href="https://pubmed.ncbi.nlm.nih.gov/35902608/">makes it pass more quickly</a>. The effect may have been particularly pronounced this year because, in the post-pandemic normality, life is busier than ever and we have even less time to think about Christmas. Technological change also affects our perception of time. Advances in technology enable us to accomplish more tasks, more quickly, than ever before. This acceleration in the <a href="https://journals.sagepub.com/doi/10.2466/pms.1975.41.1.235">pace of life</a> over the past 20 years may also contribute to the sensation that Christmas now comes around too soon. <h2>Running out of time</h2> Despite paying less attention to time, adults experience significantly more demands on their schedules than children in the run up to Christmas. For children, Christmas happens by magic. For adults however the festive mystique is replaced by large amounts of planning, shopping, wrapping and cooking. The added time pressure created by Christmas may contribute to time passing more quickly. The lack of control children have over Christmas likely increases their level of <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053810015300465">temporal uncertainty</a>. Not knowing when, or indeed if, something will happen can also slow the passage of time. However, maybe we feel like Christmas comes around faster each year because it really does. In years gone by Christmas advertising wasn’t seen until the start of Advent. Nowadays it is normal to see chocolate Santas on the supermarket shelves in early October. This literal <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165176505002284">shifting of the Christmas timeline</a> undoubtedly adds to the psychological sense of Christmas coming earlier. However, retailers’ attempts to increase profits by starting the festive period earlier each year come at a price. When retailer Very.com launched it’s Christmas <a href="https://metro.co.uk/2022/10/10/christmas-advert-in-october-from-very-outrages-viewers-17534895/">advertising campaign on October 7</a> in 2021 there was public outrage. We don’t want to actually see Christmas coming around more quickly. Very didn’t repeat their mistake this year.<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/194575/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ruth-ogden-1182467">Ruth Ogden</a>, Reader in Experimental Psychology, <a href="https://theconversation.com/institutions/liverpool-john-moores-university-1319">Liverpool John Moores 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/why-we-feel-like-christmas-comes-around-more-quickly-each-year-194575">original article</a>.

Mind

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

<a href="https://theconversation.com/profiles/sophie-scott-1462197">Sophie Scott</a>, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> It’s getting towards the time of the year when you might feel more overwhelmed than usual. There are work projects to finish and perhaps exams in the family. Not to mention the pressures of organising holidays or gifts. Burnout is a real possibility. Burnout is defined by the <a href="https://www.who.int/standards/classifications/frequently-asked-questions/burn-out-an-occupational-phenomenon#:%7E:text=Burn%2Dout%20is%20defined%20in,has%20not%20been%20successfully%20managed.">World Health Organization</a> (WHO) as having three main symptoms – exhaustion, loss of empathy and reduced performance at work. Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> argues for a broader model, particularly as the WHO’s third symptom may simply be a consequence of the first two. So what is burnout really? And how can you avoid it before the holidays hit? <h2>More than being really tired</h2> The Australian research model endorsed exhaustion as the primary burnout symptom but emphasised burnout should not be simply equated with exhaustion. The second symptom is loss of empathy (or “compassion fatigue”), which can also be experienced as uncharacteristic cynicism or a general loss of feeling. Nothing much provides pleasure and joie de vivre is only a memory. The third symptom (cognitive impairment) means sufferers find it <a href="https://www.abc.net.au/news/2023-02-13/gordon-parker-says-the-burnout-definition-needs-to-broaden/101920366">difficult to focus</a> and retain information when reading. They tend to scan material – with some women reporting it as akin to “baby brain”. Research <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">suggests</a> a fourth symptom: insularity. When someone is burnt out, they tend to keep to themselves, not only socialising less but also obtaining little pleasure from interactions. A potential fifth key feature is an unsettled mood. And despite feeling exhausted, most individuals report insomnia when they’re burnt out. In severe cases, immune functioning can be compromised (so that the person may report an increase in infections), blood pressure may drop and it may be difficult or impossible to get out of bed. Predictably, such features (especially exhaustion and cognitive impairment) do lead to compromised work performance. Defining burnout is important, as rates have <a href="https://dspace.library.uu.nl/bitstream/handle/1874/420608/Burnout_Fatigue_Exhaustion.pdf?sequence=1&isAllowed=y">increased</a> in the last few decades. <h2>‘Tis the season</h2> For many, the demands of the holidays cause exhaustion and risk burnout. People might feel compelled to shop, cook, entertain and socialise more than at other times of year. While burnout was initially defined in those in formal employment, we now recognise the same pattern can be experienced by those meeting the needs of children and/or elderly parents – with such needs typically increasing over Christmas. Burnout is generally viewed according to a simple stress-response model. Excessive demands lead to burnout, without the individual bringing anything of themselves to its onset and development. But the Australian <a href="https://pubmed.ncbi.nlm.nih.gov/34052460/">research</a> has identified a richer model and emphasised how much personality contributes. Formal carers, be they health workers, teachers, veterinarians and clergy or parents – are <a href="https://www.taylorfrancis.com/books/mono/10.4324/9781003333722/burnout-gordon-parker-gabriela-tavella-kerrie-eyers">more likely</a> to experience burnout. But some other professional groups – such as lawyers – are also at high risk. In essence, “good” people - who are dutiful, diligent, reliable, conscientious and perfectionistic (either by nature or work nurture) – are at the <a href="https://journals.lww.com/jonmd/Abstract/2020/06000/A_Qualitative_Reexamination_of_the_Key_Features_of.4.aspx">greatest risk</a> of burnout. <h2>6 tips for avoiding seasonal burnout</h2> You may not be able to change your personality, but you can change the way you allow it to “shape” activities. Prioritising, avoiding procrastination, decluttering and focusing on the “big picture” are all good things to keep in mind. Managing your time helps you regain a sense of control, enhances your efficiency, and reduces the likelihood of feeling overwhelmed by responsibilities. 1. Prioritise tasks Rank tasks based on urgency and importance. The Eisenhower Matrix, <a href="https://www.amazon.com.au/7-Habits-Highly-Effective-People/dp/0743269519">popularised</a> by author Stephen R Covey, puts jobs into one of four categories: <ul> <li> urgent and important </li> <li> important but not urgent </li> <li> urgent but not important </li> <li> neither urgent nor important. </li> </ul> This helps you see what needs to be top priority and helps overcome the illusion that everything is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159458/">urgent</a>. 2. Set realistic goals Break down large goals into smaller, manageable tasks to be achieved each day, week, or month – to prevent feeling overwhelmed. This could mean writing a gift list in a day or shopping for a festive meal over a week. Use tools such as calendars, planners or digital apps to schedule tasks, deadlines and appointments. 3. Manage distractions Minimise <a href="https://psycnet.apa.org/record/2023-66900-001">distractions</a> that hinder productivity and time management. <a href="https://www.journals.uchicago.edu/doi/full/10.1086/691462">Research</a> finds people complete cognitive tasks better with their phones in another room rather than in their pockets. People with phones on their desks performed the worst. Setting specific work hours and website blockers can limit distractions. 4. Chunk your time Group similar tasks together and allocate specific time blocks to focus on them. For example, respond to all outstanding emails in one stint, rather than writing one, then task-switching to making a phone call. This approach <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075496/">increases efficiency</a> and reduces the time spent transitioning between different activities. 5. Take breaks A <a href="https://psycnet.apa.org/record/2022-90592-001">2022 systematic review</a> of workplace breaks found taking breaks throughout the day improves focus, wellbeing and helps get more work done. 6. Delegate Whether at home or work, you don’t have to do it all! Identify tasks that can be effectively delegated to others or automated. To finish the year feeling good, try putting one or more of these techniques into practice and prepare for a restful break.<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/216175/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sophie-scott-1462197">Sophie Scott</a>, Associate Professor (Adjunct), Science Communication, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> and <a href="https://theconversation.com/profiles/gordon-parker-94386">Gordon Parker</a>, Scientia Professor, <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/its-beginning-to-look-a-lot-like-burnout-how-to-take-care-of-yourself-before-the-holidays-start-216175">original article</a>.

Caring

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>.

Body

Taste depends on nature and nurture. Here are 7 ways you can learn to enjoy foods you don’t like

<a href="https://theconversation.com/profiles/nicholas-archer-181464">Nicholas Archer</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/astrid-poelman-1481227">Astrid Poelman</a>, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> You’re out for dinner with a bunch of friends, one of whom orders pizza with anchovies and olives to share, but you hate olives and anchovies! Do you pipe up with your preferred choice – Hawaiian – or stay quiet? This scene plays out every day around the world. Some people ferociously defend their personal tastes. But many would rather expand their palate, and not have to rock the boat the next time someone in their friend group orders pizza. Is it possible to train your tastebuds to enjoy foods you previously didn’t, like training a muscle at the gym? <h2>What determines ‘taste’?</h2> Taste is a complex system we evolved to help us navigate the environment. It helps us select foods with nutritional value and reject anything potentially harmful. Foods are made up of different compounds, including nutrients (such as proteins, sugars and fats) and <a href="https://www.youtube.com/watch?v=2P_0HGRWgXw">aromas</a> that are detected by sensors in the mouth and nose. These sensors create the <a href="https://www.youtube.com/watch?v=MZn2PMUWO-Y">flavour of food</a>. While taste is what the tastebuds on your tongue pick up, flavour is the combination of how something smells and tastes. Together with texture, appearance and sound, these senses collectively influence your food preferences. <figure><iframe src="https://www.youtube.com/embed/MZn2PMUWO-Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Flavour is the overall impression you get when eating.</figcaption></figure> Many factors influence food preferences, including age, genetics and environment. We each live in our own sensory world and no two people will have the same <a href="https://theconversation.com/curious-kids-why-do-some-people-find-some-foods-yummy-but-others-find-the-same-foods-yucky-77671">experience while eating</a>. Food preferences also change with age. Research has found young children have a <a href="https://pubmed.ncbi.nlm.nih.gov/24452237/">natural preference</a> for sweet and salty tastes and a dislike of bitter tastes. As they grow older their ability to like bitter foods grows. Emerging evidence shows bacteria in saliva can also produce enzymes that influence the taste of foods. For instance, saliva has been shown to cause the release of sulphur aromas in cauliflower. The <a href="https://www.acs.org/pressroom/presspacs/2021/acs-presspac-september-22-2021/childrens-dislike-of-cauliflower-broccoli-could-be-written-in-their-microbiome.html">more sulphur that is produced</a>, the less likely a kid is to enjoy the taste of cauliflower. <h2>Nature versus nurture</h2> Both genetics and the environment play a crucial role in determining food preferences. Twin studies estimate genetics have a moderate influence on food preferences (between 32% and 54%, depending on the food type) in <a href="https://www.sciencedirect.com/science/article/pii/S000291652305027X?via%3Dihub">children</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/27385609/">adolescents</a> and <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/dietary-patterns-and-heritability-of-food-choice-in-a-uk-female-twin-cohort/8507AAF01330C599BAC62BCC0EF4CF06">adults</a>. However, since our cultural environment and the foods we’re exposed to also shape our preferences, these <a href="https://pubmed.ncbi.nlm.nih.gov/24452237/">preferences are learned</a> to a large degree. A lot of this learning takes place during childhood, at home and other places we eat. This isn’t textbook learning. <a href="https://www.cabidigitallibrary.org/doi/10.1079/9780851990323.0093">It’s learning</a> by experiencing (eating), which typically leads to increased liking of the food – or by watching what others do (modelling), which can lead to both positive or negative associations. <a href="https://www.sciencedirect.com/science/article/pii/S000291652305027X?via%3Dihub">Research</a> has shown how environmental influences on food preferences change between childhood and adulthood. For children, the main factor is the home environment, which makes sense as kids are more likely to be influenced by foods prepared and eaten at home. Environmental factors influencing adults and adolescents are more varied. <h2>The process of ‘acquiring’ taste</h2> Coffee and beer are good examples of bitter foods people “acquire” a taste for as they grow up. The ability to overcome the dislike of these is largely due to: <ul> <li> the social context in which they’re consumed. For example, in many countries they may be associated with passage into adulthood. </li> <li> the physiological effects of the compounds they contain – caffeine in coffee and alcohol in beer. Many people find these effects desirable. </li> </ul> But what about acquiring a taste for foods that don’t provide such desirable feelings, but which are good for you, such as kale or fatty fish? Is it possible to gain an acceptance for these? Here are some strategies that can help you learn to enjoy foods you currently don’t: <ol> <li> eat, and keep eating. Only a small portion is needed to build a liking for a specific taste over time. It may take 10–15 attempts or more before you can say you “like” the food. </li> <li> <a href="https://www.sciencedirect.com/science/article/pii/S0950329302001106">mask bitterness</a> by eating it with other foods or ingredients that contain salt or sugar. For instance, you can pair bitter rocket with a sweet salad dressing. </li> <li> eat it repeatedly in a positive context. That could mean eating it after playing your favourite sport or with people you like. Alternatively, you could eat it with foods you already enjoy; if it’s a specific vegetable, try pairing it with your favourite protein. </li> <li> eat it when you’re hungry. In a hungry state you’ll be more willing to accept a taste you might not appreciate on a full stomach. </li> <li> remind yourself why you want to enjoy this food. You may be changing your diet for health reasons, or because you’ve moved countries and are struggling with the local cuisine. Your reason will help motivate you. </li> <li> start young (if possible). It’s easier for children to learn to like new foods as their tastes are less established. </li> <li> remember: the more foods you like, the easier it’ll become to learn to like others. </li> </ol> A balanced and varied diet is essential for good health. <a href="https://www.sciencedirect.com/science/article/pii/S0195666315003438?ref=pdf_download&fr=RR-2&rr=82a5fd5069821f63">Picky eating</a> can become a problem if it leads to vitamin and mineral deficiencies – especially if you’re avoiding entire food groups, such as vegetables. At the same time, eating too many tasty but energy-dense foods can increase your risk of chronic disease, including obesity. Understanding how your food preferences have formed, and how they can evolve, is a first step to getting on the path of healthier eating.<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/215999/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicholas-archer-181464">Nicholas Archer</a>, Research Scientist, Sensory, Flavour and Consumer Sciences, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a> and <a href="https://theconversation.com/profiles/astrid-poelman-1481227">Astrid Poelman</a>, Principal Researcher, Public Health & Wellbeing Group, <a href="https://theconversation.com/institutions/csiro-1035">CSIRO</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/taste-depends-on-nature-and-nurture-here-are-7-ways-you-can-learn-to-enjoy-foods-you-dont-like-215999">original article</a>.

Food & Wine

Why Gladys likely won't be the new Optus CEO

Rumours are swirling that former NSW premier Gladys Berejiklian could be taking the top job at Optus after former chief executive Kelly Bayer Rosmarin resigned on Monday. According to NCA NewsWire, the former premier has flagged her interest in the role as Optus launched its global search for the chief's replacement. Berejiklian was responsible for managing the company’s business customers in early 2022, but there's one massive roadblock that might stop her from becoming the next Optus CEO. Any decision to promote Berejiklian could be seen as risky after she was found to have engaged in serious corrupt conduct with former Wagga Wagga MP and partner Daryl Maguire, by the NSW Independent Commission Against Corruption (ICAC). Despite appealing the findings, it is highly unlikely that Berejiklian would get the job after the ICAC ruling. Although the decision itself would ultimately fall with the Optus board, Greens senator Sarah Hanson-Young said that she wanted someone who “understands that we need better regulation and work with the government, not against them”. “I think Gladys will have to get some other things off her desk before she steps forward," she said. “What I want to see is somebody who puts the public interest first, is honest and has integrity.” Berejiklian has stayed silent on the matter, with Optus chief financial officer Michael Venter currently taking on the role of interim chief executive as the telecom company continues to lookout for a replacement. Image: Mark Kolbe/Getty Images

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Why Gladys likely won't be the new Optus CEO

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

Eye infections might seem like a minor complaint – but in some cases they can cause blindness and even death

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

"Finally felt like the right time": John Farnham's huge announcement

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

"There's no place like home": Marcia Hines and her amazing cat share sweet message

What will aged care look like for the next generation?

Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

How to navigate a parent’s cancer diagnosis – like Princes William and Harry will now have to do

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

I have COVID. How likely am I to get long COVID?

Are catnip and treats like it safe for cats? Here’s how they affect their minds and moods

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

"I just don't like old skin": Jane Fonda's bizarre confession

Why we feel like Christmas comes around more quickly each year

It’s beginning to look a lot like burnout. How to take care of yourself before the holidays start

Drug resistance may make common infections like thrush untreatable

Taste depends on nature and nurture. Here are 7 ways you can learn to enjoy foods you don’t like

Why Gladys likely won't be the new Optus CEO

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