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Ultra-Processed Food — the Scoop Goes On

Pat Hartman May 15, 2025 No Comments

About half a year back, a new study made the case that probably far too much of the average child‘s diet is composed of ultra-processed food, familiarly known as UPF. Measuring consumption in terms of calorie intake, researchers reckon that for 7-year-olds, processed foods comprise 59% (well over half) of their diets. But just wait until you hear about the younger ones:

Researchers found processed foods made up 47% of toddlers’ calories… The nutritional culprits may not be what you expect. The biggest offenders weren’t ice cream, fries or candy. They were products like high fiber cereals, flavored yogurt, and breads — foods that are often marketed as “healthy.”

Toddlers are commonly understood to be children whose walking skills are not yet fully developed; from one to three or even four years old, depending on whom you ask. Also, to be fair, some babies start to toddle at nine months, so of course they must be included in the classification.

It will come as no surprise, that kids who are set on the UPF path by heedless adults, will probably continue upon it. Most people like to stick with what they already know, so hyper processed it is. But even if they don’t cling to the familiar, that curious adventure-seeking tendency will send them eagerly in pursuit of more exciting junk food. Yet, at the same time, these early adapters to ultra processing are rarely adventurous about exploring ultra-nutritious alternatives to balance out their diets.

Regrettably hooked minors

The consumption of excessively processed foods (and food-adjacent substances) is believed to correlate with an overall higher mortality rate. For instance, research published by the American Journal of Preventive Medicine showed that chowing down on a lot of UPF “increased the risk of premature death from all causes,” and the authors cited numbers:

A new study has found that for each 10% increase in calories from these foods, the risk for premature death increases by almost 3%.

According to a very recent piece published by BBC.com, a study that covered eight countries, including the United States and the United Kingdom (which are the worst two in terms of junk food’s effects on their citizens), suggests a connection between UPF and early death.

One factor that makes it so difficult to keep track is that the typical hyper-processed food tends to contain five or even more ingredients with shady reputations. Sacrificing safety to favor aesthetics, these additives, sweeteners, and other chemicals are tossed in to improve the texture, flavor, eye appeal, or some other aspect of the product. Also, human life is complicated, so the individual’s general dietary preferences, exercise, sleep, medications, and many other factors can affect the equation.

Regrettable limits

This fact is hard to accept, but we have no other choice: To perform really undeniable research in this area would require keeping humans in conditions matching those of experimental laboratory animals, for decades. Because otherwise, there are just too many variables, and too many opportunities for accidental mistakes in reportage, or even deliberate sabotage.

But when people are just living their ordinary human lives, any attempt at strict accounting is vulnerable to colossal amounts of randomness, which is not compatible with good science. The uncontrollable quality of life holds less true with infants and very young, who can sometimes be satisfactorily managed. There is no excuse for not exercising some amount of conscious deliberation in feeding them.

A moment’s consideration will reveal that children whose ambulation is still uncertain, even at the advanced age of four, are probably not able to hike to the convenience store on their own. Also, few of them drive, and even if they did, they might not be able to reach up to the counter to pay for their junk food.

The hard truth is that no child gets hold of UPF unless some nominally responsible adult supplies it to them. Grownups, there is no point in trying to squirm out of responsibility. This is a “you problem.” Please don’t feed those kids junk, or let other people do it either.

Your responses and feedback are welcome!

Source: “Study finds how much ultra-processed foods children are eating,” WBay.com, 11/11/24
Source: “Every Bite of Ultra-Processed Foods May Increase Risk of Early Death, Study Says,” VeryWellHealth.com, 05/05/25
Source: “Ultra-processed foods may be linked to early death,” BBC.com, 04/28/25
Image by angelicavaihel/Pixabay

New Research on GLP-1 Receptor Agonists vs. Pediatric Obesity

Tatyana Meshcheryakova May 14, 2025 No Comments

There’s been much debate whether GLP-1 receptor agonists should be given to children to treat obesity, and whether it is even safe to do so. New findings presented at the European Congress on Obesity (ECO 2025) that is happening this week suggest that children with severe obesity are more likely to see a significant reduction in their BMI when GLP-1 receptor agonists are included in their treatment.

What the study showed

To explore the effectiveness of these medications, Dr. Annika Janson, researcher at the National Childhood Obesity Centre, Karolinska University Hospital, Stockholm, Sweden, and a team of researchers studied their impact when added to an existing intensive treatment program for pediatric obesity.

The study analyzed data from 1,126 children (ages 0-16, about 52% boys) with severe obesity, classified using criteria from the International Obesity Task Force, who were enrolled in the National Childhood Obesity Centre in Stockholm. All participants were undergoing intensive health behavior and lifestyle treatment (IHBLT), a comprehensive program that works with families, schools, and other support systems to improve various health-related behaviors, including nutrition, physical activity, screen time, and mental health. A multidisciplinary team typically provides this care.

Starting in 2023, GLP-1 medications — first liraglutide, then semaglutide — were incorporated into treatment for some patients. Approximately 25% of the children in the study were prescribed one of these GLP-1 drugs.

The caveats

The study authors did establish that GLP-1 medications can be given to kids from the age of 12 as “clinical trials have shown children lose 5-16% of their body weight after a year of treatment.” This comes with warnings and call for safety precautions — as it should.

According to Dr. Janson,

[…] treating children in real-life situations has challenges that don’t come up in research studies. Children have varying degrees of obesity, co-morbidities and complications and may have faced problems in supply of the drug, financing it or taking it. As a consequence, it is difficult to isolate the effect of adding GLP-1 drugs to the plethora of treatments that are already available.

This echoes the opinions of another group of researchers that looked into treating pediatric obesity using liraglutide. The study authors said:

This meta-analysis suggests that liraglutide could be a useful therapeutic option in pediatric obesity, especially in patients who have not achieved significant weight reduction with conventional interventions… However, its implementation should be individualized, considering the potential adverse effects, and rigorous monitoring should be carried out to ensure safety.

An added benefit

Dr. Janson’s study also suggests that weight loss injections like liraglutide may also reduce family conflicts around food and mealtime stress. Families reported less tension and fewer arguments around food, with children experiencing less constant hunger and being more open to other lifestyle changes.

Dr. Janson said:

For some children, not always feeling hungry is a completely new experience… While not a solution for every case, GLP-1 medications offer real benefits for many children with severe obesity, and more should have access to them.

Your responses and feedback are welcome!

Source: “GLP-1 drugs linked to significant BMI reduction in children with severe obesity,” News Medical, 5/12/25
Source: “Systematic Review and Meta-Analysis of Liraglutide Treatment in Children Who Are Overweight or Obese: A Therapeutic Paradigm Shift?,” Cureus, 5/8/25
Source: “Weight loss jabs in obese children can help avoid mealtime rows, study says,” The Guardian, 5/12/25
Image by Guduru Ajay bhargav/Pexels

The Scoop on Ultra-Processed Foods, Continued

Pat Hartman May 13, 2025 No Comments

We discussed the NOVA classification system, where the designated fourth group, ultra-processed food, is the villain of the day. A lot of humans feel very strongly that meat-eating is not only okay, but beneficial to the system. And yet, even if meat is available and philosophically acceptable, it might still be problematic.

A slab of beefsteak is one thing, but a tampered-with burger is something else. Sausage, hot dogs, bacon, and deli meats are under suspicion, because they are likely to be spiffed up with nitrates or miscellaneous preservatives. Meat that has been salted, cured, smoked, and otherwise processed is a whole different animal. (Incidentally, for protein, experts recommend such alternatives as tuna, grilled chicken, and boiled eggs.)

Likewise, frozen meals that only need to be heated up in a microwave or standard oven are likely to have been ultra-processed, and replete with plenty of sodium and an inordinate amount of fat, and garnished with flavor enhancers, emulsifiers, and preservatives.

What’s inside those crunchy, irresistible chips and crackers? Emulsifiers, saturated fat, preservatives, artificial flavors, and lots and lots of sodium. Salty chips go great with chilled, intensely sweetened beverages, whose coldness and fizziness block the mouth’s ability to perceive the overdose of sugar they deliver. Speaking of which… how about those cookies and cakes? You got your heaping helping of sugar, your refined flour, your preservatives, your fake colors and flavorings — what more could a person ask?

Morgan Pearson, M.S., R.D., goes on to say that aside from those major players, it is also a good idea to check the credentials of some more innocent-looking items. Supermarket bread, instant soups and noodles, fruit yogurts and drinks, and even baby formula can all conceal unwelcome surprises.

“But the customers like it,” and other weak excuses

The sad fact is, plenty of players (mainly the manufacturers and purveyors, including advertisers, of NOVA Group 4 products) will defend the stuff with their last breath. We will not hazard a guess about the exact percentage of miscreants in the field. But for most of them, it’s all about profit, and more specifically, about how much of the profit finds its way into their own personal pockets.

Then there are folks who work for the food industry and in related fields, who are not necessarily people with bad intent. It’s just that, for them, the evidence does not add up in the same way it does for more cautious medical specialists.

Prof. Kevin McConway, emeritus professor of applied statistics, The Open University (a distance-learning university based in U.K.), said of a particular study that it “makes lots of mathematical assumptions which make him cautious about what the findings mean,” and he is not the only one with reservations. Is all ultra-processed food unequivocally bad for all people? Would it be possible to pinpoint certain recipes that could be improved, and still produce the same results of customer satisfaction and loyalty?

Many executives and other defenders point out that it is “impossible for any one study to be sure whether differences in mortality between people who consume different UPF amounts are actually caused by differences in their UPF consumption.” University of Oxford diet and obesity expert Dr. Nerys Astbury agrees that the research so far has its limitations.

It is no secret that diets high in fat and sugar can increase disease risk, and ultra-processing does tend to hang out with bad company like sugar and fat. Of course the industry calls that sort of food “energy dense,” a description which has a more respectable ring to it.

Your responses and feedback are welcome!

Source: “Ultra-Processed Foods to Avoid If You Want to Lose Weight,” VeryWellHealth.com, 04/09/25
Image by Create4fun/Pixabay

The Scoop on Ultra-Processed Foods

Pat Hartman May 8, 2025 No Comments

Ultra-processed (aka hyper-processed) edible products are a blight on public wellness and society at large. VeryWellHealth.com prefers “ultra-processed,” and it was possible to glean copious information on this food genre from three of the website’s recent articles (authors: Stephanie Brown and Kathleen Ferraro), all listed at the bottom of the post.

Some experts say that these abominations constitute over 70% of the total USA food supply, which if true is pitiful. Others say they make up 50% or even close to 60% of the average American’s diet. All those sources could be correct. Still, large amounts of research on this matter have taken place not only in the U.S., but in Australia, Brazil, Canada, Chile, Colombia, Mexico, and the United Kingdom.

Back in 2009, a research team led by Carlos A. Monteiro (M.D., Ph.D.) defined ultra-processed foods as the most extreme of four possible categories, according to the NOVA classification system. This system has been refined somewhat over time, and its creators have put together an online research tool, TrueFood, which extracts data from systems run by the Food and Drug Administration and the U.S. Department of Agriculture.

The website uses machine learning whose algorithm assigns ultra-rating numbers to more than 50,000 food products, based on how much they have been messed with. In theory, the number indicates the hazard level of the different foods, in terms of their degree of processing. (That web address is not included here because your computer’s security system may issue a danger warning — probably because the site uses Artificial Intelligence to rate the thousands of items, and the results include “margins of error” anyway.)

So, get on with it

Group 1 includes unprocessed or minimally processed foods; Group 2 signifies processed culinary ingredients. In the third group, “processing” is a benign word that does not indicate danger, but just means that the edible item has been washed, chopped, peeled, steamed, or something else that an old-fashioned cook might do — in other words, any basic prep level at all.

With Group 4, however, we are now in ultra-processed land, where the problems dwell. Dr. Monteiro suggested that “[…] the end products of food ultra-processing are products that perhaps we shouldn’t call foods…” His official definition deemed them to be…

[…] industrial formulations made mostly or entirely with substances extracted from foods, often chemically modified, and from additives, with little if any whole food added.

These agglomerations of predominantly harmful (or at best, useless) stuff are likely to contain plenty of fat, sugar, salt, and weird additives. Apparently, if the product is made with any additive, or with even one NOVA Group 4 ingredient, it can be considered ultra-processed.

What these alleged groceries will likely not contain are whole foods or even identifiable elements of food, like fiber, vitamins or minerals. The allegedly edible substances may have been subjected to chemical modification and recombination. Here is a fact with a sinister ring to it:

Sequences of processes are and must be used to obtain, alter, and combine the ingredients and to formulate the final products.

As a definition, that sentence encompasses so much it actually turns out to be meaningless. Because multiple various factors are involved, and because studying the actual habits of people is problematic unless they can be kept in environments equivalent to lab cages, some experts are not convinced of the potential harm.

(To be continued…)

Your responses and feedback are welcome!

Source: “What Does ‘Ultra-Processed Food’ Actually Mean?,” VeryWellHealth.com, 07/06/22
Source: “Every Bite of Ultra-Processed Foods May Increase Risk of Early Death, Study Says,”
VeryWellHealth.com, 05/05/25
Source: “What Happens to Your Body When You Eat Fewer Ultra-Processed Foods,” VeryWellHealth.com, 04/11/25
Image by jodiandbrett/Pixabay

Jamie Oliver Continues His Quest to Improve School Lunch, Now in the U.S.

Tatyana Meshcheryakova May 7, 2025 No Comments

Renowned chef and children’s health champion Jamie Oliver has brought his Ministry of Food’s 10 Skills Food Education program to the U.S. for the first time on May 1, 2025. He is now making promo rounds, including news and talk shows like Good Morning America and Live With Kelly & Mark.

After seeing major success in the U.K., this free and forward-thinking initiative aims to teach middle and high school students the core cooking skills they need to make healthier choices that last a lifetime. With an ambitious target of reaching one million students worldwide by 2030, the program provides teachers and community groups with hands-on lessons, videos, recipes, and tools designed to help young people build confidence in the kitchen.

Again, it’s free, but schools need to sign up. And in case you were wondering, The “Ministry of Food” part comes from Oliver’s 2008 book, “Jamie’s Ministry of Food: Anyone Can Learn to Cook in 24 Hours” (you can find some of the recipes here).

A long, tough uphill battle dating way back

Recently, Jamie Oliver opened up about the toughest battle of his career — transforming school lunches in the U.K. From public backlash to political breakthroughs, one chef’s mission to feed kids better sparked a national movement and lasting change. Thanks to our head writer Pat Hartman, this blog also followed Oliver’s difficult yet determined journey through the years, like this 2016 post on the Oliver vs. sugar debate and the 2012 post about his crusade against childhood obesity in the U.S.

In a candid interview featured in a new episode of Netflix’s “Chef’s Table: Legends,” Oliver revisits the stormy days of his school food campaign, calling it the “most miserable” period of his life. His mission was simple: get healthier, more nutritious meals into British schools. But what seemed like common sense to him — feeding kids better — quickly turned into a national controversy. Oliver’s efforts famously signaled the end of unhealthy cafeteria staples like the Turkey Twizzler, sparking fierce pushback from some parents who went as far as delivering junk food through school gates.

Oliver recalls:

I just wanted to fix it all… I was like the enemy… The bins at the end of lunch were full of my food…

Despite the discouragement, Oliver remained determined. He later realized the resistance wasn’t about the food itself but familiarity. “Those kids were probably the fourth generation that hadn’t learned to cook at home or at school,” he explained. It wasn’t just a change in menu but a cultural shift.

Oliver says:

I was told a child needs to try something 14 times before accepting it. They need love and encouragement, just like your own child.

Getting policymakers on board proved equally frustrating. Oliver recalled the challenge of getting government officials to move past budget concerns. But the tide finally turned with the release of his Channel 4 documentary “Jamie’s School Dinners.” The series captured public attention and coalesced political will. Within weeks, Oliver had a meeting with then-Prime Minister Tony Blair, who agreed to fund sweeping reforms in school food standards.

Blair himself appears in the “Chef’s Table” episode, praising Oliver’s enduring influence:

Jamie’s much more than a chef. He made cooking cool and linked food to health and nutrition long before it was mainstream.

A few words about “Chef’s Table: Legends”

If you are not familiar with “Chef’s Table,” it’s an acclaimed docuseries in its second decade that spotlights some of the world’s most visionary and captivating chefs. The latest installment, currently playing on Netflix, features legendary chefs Jamie Oliver, José Andrés, Thomas Keller, and Alice Waters. Not only are they culinary icons but they’re also compassionate advocates for a better world, feeding those in crisis, and creating healthier lifestyles for us all.

A glimpse at Oliver’s worldview

In a recent roundtable interview, Oliver spoke about how he got into cooking (“And when I say cooking saved me, I don’t think I’m exaggerating”), and the one ingredient that he absolutely could not live without:

Olive oil. We grew up using butter and lard and ghee. But olive oil is the connector. It’s the thing that allows you to transmit flavor and spice and herbs. And of course, it’s the healthiest oil on the planet, full of polyphenols.

We will leave you with one more quote, which was Oliver’s response to the question about the one thing he wished people understood about food:

I think, now more than ever, cooking is freedom. Cooking is the amazing ability to nourish yourself and your family and the people that you love with deliciousness and truth. And it’s a real superpower.

If I had one wish in the world, it would be that every 16-year-old kid would leave high school knowing 10 recipes to save their life, the basics of nutrition, where food comes from, and how it affects their body.

It is not a luxury; it’s a necessity. It’s a life skill. Every time you’re trying to fix a problem, you’re looking at the most vulnerable within the problem.

And in the U.K., we have free-school-lunch kids, and the parents of those kids have to be earning a very small amount of money to get that free school lunch. Filling that child’s tummy and that child’s mind is really exciting.

For me, that just gives you a template for true hope. And to truly be fair, to truly be a democracy, you have to have hope — that no matter where you come from, as long as you apply yourself, as long as you turn up, as long as you’re kind, the sky’s the limit.

Your responses and feedback are welcome!

Source: “Culinary Legends Gather Around the Chef’s Table For Its 10th Anniversary,” Netflix, 4/25/25
Source: “Jamie Oliver shares cooking lessons,” Good Morning America, 4/29/25
Source: “Episode Guide,” Live With Kelly & Mark, 5/1/25
Source: “Jamie Oliver admits controversial school dinners campaign was ‘most miserable’ time of his life,” Tyla.com, 4/28/25
Image: Screenshot of Jamie Oliver’s Ministry of Food’s Ten Skills Food Education Program homepage, used under Fair Use: Commentary

Eggs on our Minds

Pat Hartman May 6, 2025 No Comments

To mention that eggs have been in the news lately would be a laughable understatement. For approximately the past three months they have been on everybody’s mind, and even that is far from being the whole picture. For EatThis.com, Sarah Garone and Olivia Tarantino wrote:

If there’s any food fraught with a tug-of-war over its healthfulness, it’s eggs. Over the years, eggs have been viewed as everything from an example of the perfect whole food to a dreaded harbinger of heart disease.

Too many eggs can bring on an undesirable effect: too much cholesterol. The authors note that nutritional guidelines no longer mention a specific cholesterol limit, but recommend that consumption of it be “as low as possible.” On the other hand, a spectacularly large study (half a million adult Chinese subjects) revealed that “up to one egg per day actually decreased the chances of developing cardiovascular disease.”

But with more, the benefits drop off precipitously. The people of China are known for their per-capita egg consumption, and collectively they account for around 400 billion eggs per year.

A recent article from ScienceDirect.com delved into the effect on obesity of the various nutrients found in eggs. Some of them actually play a role in regulating lipid metabolism in ways that prevent obesity. Apparently, it is not even certain that the consumption of egg cholesterol increases human blood cholesterol. When it comes to diabetes risk, the jury is still out.

As for weight gain, eggs seem to suffer from a certain amount of guilt by association. People like to eat them with bacon, sausage, hash-brown potatoes, and other unwise choices. Some helpful suggestions in this area include studying up on heart-healthy cooking fats, and combining eggs with vegetables.

What is going on, anyway?

A review published at around the same time in the journal Poultry Science looked at a meta-study that had reviewed two decades of nutritional literature and found that most of the nutrients in eggs are not obesogenic but surprisingly appear to “reduce the probability of obesity via lipid metabolism regulation.”

However, there seems to be an exception among “high responders,” or individuals who are particularly prone to significant changes in their cholesterol levels because they metabolize it either more or less effectively. The body of course needs the stuff, but normally our own livers produce enough of it. There seems to be a feeling that more research in this area would be welcome.

Leaving that aside, “[E]ggs are one of the healthiest sources of protein, essential amino acids, and micronutrients beneficial to human health.” Not surprisingly, the cooking method makes a noticeable difference, with soft-boiled eggs being the safest bet.

In “9 Steps to Perfect Health,” Chris Kesser has noted that nutrients in animal products like fish, meat, poultry, dairy, and eggs are highly bioavailable, meaning that we can absorb them easily. Pasture-raised animals are known for their nutrient-dense meat, while pasture-raised hens make eggs that contain as much as 10 times more omega-3 than factory hen eggs, as well as being noticeably higher in B12, folate, vitamin A, protein, and fat-soluble antioxidants like vitamin E.

Can we agree to disagree?

The consensus seems to be that eggs are great for just about everyone, except people troubled by diabetes or cardiovascular disease. But even for folks who do not have to deal with those conditions, there is still such a thing as too many. Agreement seems to have settled on the notion that an average of one egg per day is reasonable, although they can be distributed throughout the week as multiple eggs on some days, and none on others.

Some authorities are even okay with healthy folks eating 10 eggs per week, although cholesterol-sensitive individuals need to tone it down. For those who forego the yolks, two egg whites count as the equivalent of one whole egg.

Your responses and feedback are welcome!

Source: “ 5 Dangerous Side Effects of Eating Too Many Eggs, According to Science,” EatThis.com, 09/01/24
Source: “Association between egg consumption and risk of obesity: A comprehensive review: Egg Consumption and Obesity,” ScienceDirect.com, February 2025
Source: “Eggs are back on the menu: Study finds no link to obesity with moderate intake,” News-Medical.net, 12/19/24
Source: “9 Steps to Perfect Health,” Chris Kresser, undated
Image by stevepb/Pixabay

Do I Have to Take a GLP-1 Medication Forever?

Tatyana Meshcheryakova April 30, 2025 No Comments

This is the question many patients who take GLP-1 drugs ask their doctors (and themselves). The internet has been increasingly churning out articles based both on recent research and personal experiences discussing what happens when you stop taking them (ever heard of “Ozempic rebound”?), and expert advice on how to maintain your weight loss when you stop taking the meds. There sure seems to be a lot of interest in quitting but preferably without gaining the weight back.

Over the past few years, GLP-1 medications have dramatically transformed how doctors approach obesity treatment and, more importantly, how people manage their health. These drugs, including semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro), have helped countless patients lose weight and improve their overall well-being.

But as effective as they are, many people are now asking a very important question: “Do I have to take a GLP-1 forever?” Let’s dive into what we know and what you can do if you’re thinking about stopping a GLP-1 — based on several sources.

Why GLP-1s are a big deal

A recent article by Chief Medicine Officer at Noom, Dr. Linda Anegawa, points out that roughly three out of four Americans live with excess weight, putting them at higher risk for conditions like heart disease, diabetes, and more. It’s no wonder that an estimated 160 million adults in the U.S. are actively trying to lose weight.

Enter GLP-1s — a game-changing class of medications that mimic natural hormones to regulate appetite, improve blood sugar levels, and support weight loss. For many, they’ve been a lifeline, helping some patients lose up to 15% of their body weight. So it’s easy to see why GLP-1 meds are a big deal.

So, how long do you have to take a GLP-1?

Here’s the truth: GLP-1s are relatively new in the world of obesity treatment. Originally developed for managing type 2 diabetes, these medications are now widely used for weight loss, but long-term data is still catching up. Some people will take them long-term, possibly for life. Others may choose to stop because they’ve hit their goal, are experiencing side effects, can’t afford them, or simply want to try a different approach. What matters most, Dr. Anegawa notes, is having a safe, supported transition off the medication — if that’s your choice.

What happens if you stop taking a GLP-1 medication?

According to Dr. Anegawa,

[…] medications quickly can have consequences for some people. If needed, a clinician can create a tapering schedule you can follow to minimize any concerns.

As you taper off, you might experience changes in your blood sugar and an increase in appetite. Increased appetite, if unchecked and not managed carefully, can lead to weight regain.

How to maintain your progress

Apparently, many people have successfully maintained weight loss long-term without medications. The National Weight Control Registry (NWCR) has been tracking thousands of former users who’ve done just that.

Their success stories reveal some important habits, which Dr. Anegawa transformed into tangible advice. While it won’t reveal any surprises, it’s still good to adjust expectations, come with a realistic plan, and remind yourself that there’s work to be done on a daily basis.

First, it’s essential to have medical support from someone who understands obesity as a complex, chronic condition. There are often multiple factors at play, and your doctor can help identify other treatment options and strategies that work for you.

Next, remember that weight loss medications aren’t a replacement for healthy eating but rather a tool. So, build and maintain strong nutrition habits like sticking to protein-rich meals that feature plenty of vegetables.

Dr. Anewaga writes,

To lose weight, you want to also make sure you’re taking in less calories than you’re burning (i.e. be in a caloric deficit). To maintain your weight, you should determine your maintenance calories — i.e. the number of calories you should be eating per day to maintain your current weight.

Also, aim for at least 150 minutes of moderate-intensity activity per week, plus two strength-training sessions. You don’t need to overhaul your life overnight — even walking more each day can make a difference. In fact, NWCR participants actually increased their steps after coming off weight loss meds.

Staying hydrated is another must for appetite control, streamlined physical performance, and maintaining optimal energy levels. Noom recommends 91 ounces daily for women and 125 ounces daily for men, reminding us that fruit-infused water or water-rich foods like cucumbers and melons count too.

Another piece of advice is to know your triggers. Work-related stress, holidays, and even travel can set you back. Finally, Dr. Anegawa wants us to know that leaning on your support system (family, friends and community) can be a powerful way to stay ahead. (For example, this study showed that people with strong support are more successful in maintaining weight loss over time.)

Let’s add a personal narrative into the mix

That would be one of Dr. Mara Gordon’s, who is a family physician in Camden, N.J., and a contributor to NPR. Dr. Gordon’s personal journey is absolutely worth exploring because she brings her perspective as both “a size-inclusive physician who doesn’t push my patients to lose weight” and a former Ozempic user.

Dr. Gordon doesn’t mince words, diving right into it:

Ozempic made me nauseated, gave me heartburn, disrupted my sleep. It wasn’t worth it. I was not alone, it turns out, in finding it difficult to stick with the Ozempic and similar drugs. New research shows the vast majority of people who try GLP-1 agonists for weight loss end up stopping them…

But at the time, I hadn’t yet fully embraced a weight-neutral approach to caring for my patients — and caring for myself. After all, I had spent years of medical training absorbing the message that the only way to be healthy was to get down to a body mass index of 25 or below.

But my experience with Ozempic made me realize I had confused two distinct issues: Being healthy is not always the same thing as being thin.

The research Dr. Gordon refers to is a study that “found that nearly 65% of study subjects who were taking the medications explicitly for weight loss, rather than diabetes control, ended up going off them within a year.” Again, common reasons included suffering from significant side effects, having to absorb a high price of the medications because the insurance didn’t cover them, or simply because a person has lost a significant amount of weight and just wanted to stop.

In Dr. Gordon’s case, she explained, she just felt healthier when she wasn’t taking Ozempic. She writes that…

[A] narrow focus on weight — which, so often, our medical training still teaches — misses the point that there’s more to being well than a number on the scale. For me, I felt healthier at a higher weight because stopping Ozempic helped me exercise regularly, sleep better, and feel less pain.

As I try to help my patients navigate decisions about these medications, I keep returning to the core value of bodily autonomy. Health is multidimensional and deeply personal. My patients decide what it means to be well — with or without a GLP-1 drug.

Back to the question…

For some, yes. For others, no. But no matter where you are on your journey, you have options, and you’re not alone.

And let’s finish strong with the words of wisdom from Dr. Pretlow (and a topic definitely worth exploring going forward):

GLP-1 meds are only a band-aid and do not treat the underlying problem, which we feel is the displacement mechanism going off the rails.

Your responses and feedback are welcome!

Source: “Are GLP-1s forever? How to get off them.,” Noom, 3/24/25
Source: “I quit Ozempic and embraced feeling healthy over striving for thinness,” NPR, 4/24/25
Source: “Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity,” JAMA Network, 1/31/25
Image by Ketut Subiyanto/Pexels

The 7th of the 9 Truths

Pat Hartman April 29, 2025 No Comments

This is Truth #7 in a series that encompasses all nine of them, as proposed several years ago by the Academy for Eating Disorders. By this point, a reader might begin to suspect that not much more is known today, than was back when “Nine Truths about Eating Disorders” first appeared.

Many of the conclusions demonstrate unchanging precepts — like the fact that two things can be true at the same time. In the words of #7’s subtitle, both genes and environment “play important roles in the development of eating disorders.”

Anorexia nervosa, bulimia nervosa, and binge eating disorder all run in families. Which exact genes are responsible, is still a mystery. One current source says, “There is a known phenotypic link between AN, growth, and sexual maturation, yet the genetic overlap between these phenotypes remains enigmatic.” So, there we have it.

On the other hand, generalizations apply, and there is one thing we do know. Science did not need to wait for the telescope or the microscope to discover that eating disorders run in families, or to notice that the cultural environment has a lot to do with how individuals (and nations) feel about human bodies and food customs. Still, psychological pressure does not seem to cause as much distress as it would, if not affected by other factors.

Can we ever know anything?

It is interesting that most people who, according to the signs, “should” develop eating disorders, do not. To discover the reasons behind this and so many other mysteries, the authors warned, would require scientists to inspect “very large sample sizes (in the tens of thousands).” But of course, volume is only one facet of discovery. Life, as always, is multifactorial. As the 2017 authors phrased it,

Eating disorders are “complex traits,” meaning that multiple genetic and environmental factors — each of small to moderate effect — act together to increase risk. Genetic and environmental factors may not only act in an additive manner, but may co-act in other ways.

Additionally, little as was known about AN at the time, even less was known about BN and BED. Moving on to Truth #8, we will not even go into why eating disorders do not follow Mendelian transmission patterns. And besides, in many cases, a family with an afflicted child will be at a loss to identify any relative who suffered from one of the conditions. Of course, war, adoption, and other socially unstabilizing vicissitudes can break connections which might have aided logical causation assumptions.

Too much togetherness presents another research problem, called confounding. In a family, there are a lot of shared genes and a lot of shared environmental factors, and how are scientific observers supposed to separate the effects of each influence? For this and many related reasons, “Rigorous studies of gene-environment interaction in eating disorders are sparse.” But basically, Truth #8 goes like this: “Genes alone do not predict who will develop eating disorders”:

[H]undreds (or perhaps thousands) of genes act in concert and are influenced by environmental factors. An individual’s risk is a composite of the cumulative number of genetic and environmental risk and protective factors to which they are exposed.

And then, there is the whole field of epigenetics, with DNA methylation, and the modification of things we never imagined could be modified, and the need to differentiate between epigenetic changes seen in the blood and what might happen in the brain; and how to figure out prevention, which is so much preferable to spending years and billions on cures.

One more, for the road

Truth #9 is short and sweet: “Full recovery from an eating disorder is possible. Early detection and intervention are important.” The authors define physical recovery as “the resumption and maintenance of a healthy body weight and a normalization of all physical parameters affected by the eating disorder”:

[B]ehavioral recovery means the absence of eating-disorder related behaviors such as food restriction, binge eating, and purging. Psychological recovery, including the attainment of normal attitudes toward food and the body, is important yet often overlooked.

Then, it gets complicated again due, for starters, to a “lack of consensus on the exact definition”:

It has been proposed that full recovery is achieved only when patients are indistinguishable from healthy controls on all eating disorder related measures, including psychological aspects.

Your responses and feedback are welcome!

Source: “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders,” NIH.gov, October 2017
Source: “An evolutionary perspective on the genetics of anorexia nervosa,” Nature.com, 02/19/25
Image by Prawny/Pixabay

The Nine Truths and Mortality

Pat Hartman April 24, 2025 No Comments

Again, the document of interest here is a very inspiring piece of scientific journalism titled “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders”, which predicted the directions in which research proceeded after its publication. Among the foundations of this branch of the science, we have reached Truth #6 — and this is major: Eating disorders come along with increased risk for medical complications, as well as suicide, making premature death the most significant outcome in which an eating disorder may result.

A seemingly inexplicable link

Over 20 years ago, researchers who dove more deeply into this found that for females between the ages of 15 and 26 afflicted with anorexia nervosa (AN), “the mortality rate is 12 times higher than the death rate of all other causes of death.” Overall, amid the multitude of psychiatric illnesses, the self-starvation route notoriously claims one of the highest death tolls. Even that statistic is equivocal because “one in five deaths in AN is attributable to suicide.”

In fairness, it would seem that, if any of them are deemed to be suicide, they all should be. It’s just that hanging or shooting oneself takes a lot longer than pure, classic starvation. At any rate, here is a shocker:

A large clinical study found that 35.6% of eating disorder patients had attempted suicide at least once, and patients with binge eating and/or purging behaviors were associated with an elevated risk for suicide attempts compared with patients without such behaviors.

Back then, scientists suspected a genetic basis for the “co-occurrence of eating disorders and suicide,” which is intriguing enough to break off from reviewing the past, to look up some more recent news, and indeed it is very current.

About two months ago, Cambridge University Press published a paper with a remarkably long Conclusions section. Here is an excerpt:

On a phenotypic level, we identified a common latent factor contributing to susceptibility to eating disorders and suicidal ideation, both of which also presented substantial proportions of independent variance. These findings suggest a moderate degree of shared genetic architecture, supporting the hypothesis that these conditions are partially influenced by overlapping genetic factors.

By combining observations from the genetic, neurobiological, and psychological perspectives, researchers identified in patients markers of the shared risk for eating disorders and suicidal ideation. Like never before, it became possible to begin understanding shared neurocognitive deficits. In addition, both eating disorders and suicidal ideation are influenced by environmental factors.

Among many other questions, the exploratory teams wanted to discover if eating disorders lead to suicidal ideation, or vice-versa. If there is nothing resembling a causal relationship either way, that strengthens the possibility that they “emerge concurrently from shared vulnerabilities.”

The interested scientists hoped to find numbers of individuals with “elevated genetic predisposition for the general susceptibility factor” and conduct longitudinal studies which ultimately reveal protective factors that could be used to reduce the risk of both eating disorders and suicidal ideation. This type of knowledge is expected to have powerful ethical, social, and clinical ramifications.

As if that were not enough

The following month (last month, as of this writing) saw the publication of “Genetic links between eating disorder symptoms and suicidal ideation” by Bryony Doughty, which summarizes the latest news on the heritability of eating disorders, in conjunction with suicidal ideation and behavior. Not surprisingly, the newest reports are hardly more informative than the ones a decade old or more. The whole subject has turned out to be an incredibly tough nut to crack. As an action plan, it is suggested…

[…] that mental health professionals should routinely screen for suicidality in patients with any disordered eating symptoms, even if they aren’t showing symptoms of mood disorders… For individuals struggling with an eating disorder, understanding that suicidality may have a genetic root can be validating.

Your responses and feedback are welcome!

Source: “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders,” NIH.gov, October 2017
Source: “Genomic links between symptoms of eating disorders and suicidal ideation,” Cambridge.org, 02/19/25
Source: “Genetic links between eating disorder symptoms and suicidal ideation,” MQMentalHealth.org, 03/17/25
Image by morganharpernichols/Pixabay

Motion Sickness and Metabolism: Surprising Brain Circuit Discovery

Tatyana Meshcheryakova April 23, 2025 No Comments

Motion sickness is an all-too-familiar nuisance for many travelers — affecting roughly one in three people — but what if the queasiness you feel on a bumpy ride could hold clues for something far more impactful, like obesity treatments? That’s exactly what a team of researchers from Baylor College of Medicine and their collaborators have begun to uncover.

In a new study published in Nature Metabolism, scientists have identified a previously unknown brain circuit that links the sensation of motion sickness with how the body regulates its temperature and metabolism. This unexpected connection could open the door to entirely new strategies for tackling obesity.

A personal curiosity turns into groundbreaking research

The research was sparked by a simple, personal question. Dr. Longlong Tu, a postdoctoral fellow highly susceptible to motion sickness himself, proposed studying the brain circuits behind it. His mentor, Dr. Yong Xu, professor of pediatrics and associate director for basic sciences at the USDA/ARS Children’s Nutrition Research Center at Baylor, initially wasn’t sold on the idea. Dr. Xu says,

[…] I was not very excited about the idea because it’s not one of the main interests of my lab… However, I became more interested and supported Tu’s idea when he explained the emerging evidence suggesting a link between motion sickness and metabolic balance, which is one of my research interests.

Building a mouse model for motion sickness (without the vomiting)

Studying motion sickness in mice presented a challenge: Mice can’t vomit. But the researchers found a clever workaround. Both humans and mice exhibit a drop in body temperature — hypothermia — when subjected to motion stimuli, such as back-and-forth horizontal movement. Using this as a measurable response, they developed a mouse model that could simulate motion sickness through temperature, activity, and brain monitoring.

The team discovered that motion-activated specific neurons — glutamatergic neurons — in a brain region called the medial vestibular nucleus parvocellular part (MVePCGlu). These neurons are responsible for initiating the body’s thermal response to motion, and when they were activated, body temperature dropped. What’s more, the anti-nausea drug scopolamine blocked this temperature drop, validating that their model accurately mimicked motion sickness responses.

A new frontier: The brain’s role in metabolic health

The study took an exciting turn when researchers started manipulating these neurons beyond motion stimuli. When they inhibited MVePCGlu neurons in stationary mice, the animals’ body temperatures and physical activity levels rose. Even more compelling: These mice ate more food but gained less weight and showed improved glucose tolerance and insulin sensitivity — key indicators of better metabolic health. In other words, targeting this brain circuit could potentially boost energy expenditure and protect against obesity, even in the context of increased food intake.

Rethinking the role of the vestibular system

Traditionally, the vestibular system — the part of the inner ear and brain that helps control balance and eye movements — hasn’t been a focus in metabolic research. But this study changes that narrative. “These results highlight the underappreciated function of the brain’s vestibular system in metabolic balance,” said Dr. Xu. It suggests a fascinating new angle for obesity research: treating metabolic disorders by targeting the same brain regions that trigger motion sickness.

Looking ahead

For Dr. Tu, the study is more than a scientific breakthrough — it’s personal. He hopes that better understanding of the neural basis for motion sickness could lead to improved treatments for his own condition. But now, his personal quest has the potential to impact millions of people facing challenges with obesity and metabolic diseases.

This study is a powerful reminder that sometimes the most unexpected questions lead to the most profound discoveries. And in this case, a queasy stomach might just hold the key to a healthier future.

Your responses and feedback are welcome!

Source: “Unexpected New Clues to Fighting Obesity: Scientists Identify Brain Circuit That May Help Burn Fat,” SciTechDaily.com, 4/19/25
Source: “Motion sickness brain circuit may provide new options for treating obesity,” Baylor College of Medicine, 3/24/25
Source: “Vestibular neurons link motion sickness, behavioural thermoregulation and metabolic balance in mice,” Nature Metabolism, 3/21/25
Image by Anna Shvets/Pexels

Regrettably hooked minors

Regrettable limits

What the study showed

The caveats

An added benefit

“But the customers like it,” and other weak excuses

So, get on with it

A long, tough uphill battle dating way back

A few words about “Chef’s Table: Legends”

A glimpse at Oliver’s worldview

What is going on, anyway?

Can we agree to disagree?

Why GLP-1s are a big deal

So, how long do you have to take a GLP-1?

What happens if you stop taking a GLP-1 medication?

How to maintain your progress

Let’s add a personal narrative into the mix

Back to the question…

Can we ever know anything?

One more, for the road

A seemingly inexplicable link

As if that were not enough

A personal curiosity turns into groundbreaking research

Building a mouse model for motion sickness (without the vomiting)

A new frontier: The brain’s role in metabolic health

Rethinking the role of the vestibular system

Looking ahead

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