Pat Hartman | Childhood Obesity News

Almost Half a Ton, Continued

Pat Hartman October 31, 2024 No Comments

Katie Peterson realized she needed help, but was trapped in the old catch-22 known as needing help too much. She had to lose 200 pounds before any medical institution would even consider her case; and was turned away by several facilities, which did not even want to make an appointment to talk it over until those 200 pounds were gone.

The general guidelines to qualify for bariatric surgery would frustrate a saint. As journalist Kati Blocker explained in a meticulously detailed piece for UCHealth.org,

You must have a BMI of 40 or more; or a BMI of 35 or more, plus a serious obesity-related health problem, such as type 2 diabetes, high blood pressure, or sleep apnea.

But at the same time, with all that going on, the patient must be deemed healthy enough to undergo surgery. Also, the doctors require the patient not to be a smoker — which Peterson was. The hopeful patient must have tried other weight-loss methods, like diet and exercise. There is a mandatory psychological exam.

Blocker writes,

Most importantly, you have to be committed to the long-term process of weight loss. By following the post-surgery recommendations, you give yourself the best possible chance to begin successfully.

In 2016, the family encountered both interpersonal and financial difficulties. Katie’s son got in some trouble serious enough to be arrested for. At this point, her lifelong habit of stress eating extended to consuming a bottle of pills all at once. She was hospitalized until a judge had pretty much no choice other than to let her go home, because no mental health facility would take her. She was still too big. Despite periodic talks with a therapist, she reverted to type:

I again stress ate. I was eating this whole time. From when I woke up to when I went to bed, I was eating something.

Although outside pressures eased a bit, Katie was up to 700 pounds and facing even more determined rejection from medical institutions. The math was simple. No 200-pound loss equals no surgery. Her depression did not lift, and the non-stop stress eating continued. But when her son graduated from high school, she felt inspired to look for help again and found an intriguing article online. After filling out a form, she was invited to meet with Dr. Robert Quaid of UCHealth.

The three-hour trip to Colorado involved being loaded into a minivan by half a dozen firefighters, and at Poudre Valley Hospital she weighed in at 890 pounds. This was the occasion of the quotation borrowed for our title:

I was flabbergasted. I couldn’t believe I’d let my life go that far where I was almost half a ton.

Dr. Quaid, the bariatric surgeon, made a treatment plan that would include attempted removal of the lap band, then a sleeve gastrectomy, to be followed around 18 months later by a single anastomosis duodenal switch, and then at some future point the removal of around 100 pounds of “excess tissue and skin.”

To help her attain mental and physical readiness, Peterson was paired up with nurse navigator Michelle Carpenter for ten months of preparatory life changes. In May of 2022, it finally happened. After the very complicated first surgery, she spend five days in the hospital before returning to Wyoming where therapy continued, along with virtual support group attendance and communication with Carpenter. The three-month follow-up visit was good, and by the six-month check-up Peterson had lost 242 pounds since surgery. She was down to 648.

Almost exactly one year ago, journalist Kati Blocker published another follow-up story about Katie Peterson, who had already lost 330 pounds at that point, a considerable improvement from her days of weighing “almost half a ton.” In the meantime, she had been cheered by messages from many strangers who reached out to encourage her and also to express how much she had encouraged them. These include a young man (almost 700 pounds) about whom Kati Blocker also wrote a very recent article.

Your responses and feedback are welcome!

Source: “900 pounds and hopeless:” Katie’s weight-loss story, UCHealth.org, 01/17/23
Source: “From 900 pounds to independence,” UCHealth.org, 11/07/23
Source: “Once nearly 700 pounds, this young man is on the road to better health,” UCHealth.org, 09/19/24
Image by Ian Britton/Attribution-NonCommercial 2.0 Generic

Almost Half a Ton

Pat Hartman October 29, 2024 No Comments

Is it exploitative to pass along the story of an extremely obese person? How could it be, if the subject voluntarily signs a contract and is appropriately compensated? On the other hand, there have been some TV programs, for instance, that did not really need to be made; some shows centering on obesity which the world could have happily gotten along without.

Before even thinking about spreading some types of news, this is what publishers, editors, and journalists would do well to pause and consider: Does the public really need to be told this story, and if so, why? Are we just going for cheap sensationalism here, or what?

In many cases, however, the motive is obviously sincere. For instance, not long ago journalist Kati Blocker wrote for UCHealth.org a very comprehensive biographical piece about one Katie Peterson, who at age 44 weighed nearly 900 pounds. Raised in a tiny midwestern town, Katie felt chronically stressed by negative emotions caused by traumatic life events. Despite having been adopted as a baby, she was aware of at least some of her genetic medical history, including proneness to obesity and heart disease.

Katie was a chubby baby and a heavy child. She was raised to believe that “it was something you were doing wrong. Obesity was your fault. It wasn’t hereditary. You ate too much.” She told Blocker,

I’ll be the first to say I have a food addiction. But at (a young) age, you don’t want to hear that. I started at age 12 seeing a therapist, my parents telling me there must be some tragic thing that happened for me to eat the way I ate.

In 2001, Katie married her first husband and gave birth to a son. She kept on gaining weight and was up to 646 pounds when she became pregnant again. For that high-risk delivery, she traveled to a neighboring state. A few years later, she traveled to yet another state for lap band surgery. She was able to lose 250 pounds in a year, but still could never get below 400.

Still, she felt pretty good, relative to how things had been. But life happened. There was a divorce, an attempt at college that failed, and another marriage. She met her biological father and began to build a relationship, but he died soon after. Other life reversals and family disasters followed, some of which caused her to feel guilt.

Following the classic tropes of eating the feelings or stuffing them deep inside, her consumption only increased. She says,

I dove into food like it wouldn’t be there anymore. I kept eating large amounts of things. It was horrible.

Blocker described Katie’s very circumscribed life, moving “with help from her then fiancé and her 17-year-old daughter” from the bed to the living room sofa, then back to bed at night. She wrote of her subject,

Like many people with a food addiction, eating made Peterson forget about life, so she’d have half of a pizza rather than a few slices. Chips and dip, cookies, candy — she didn’t care what it was.

Is it universally accepted that an addict just doesn’t care? Is it an immutable truism that a hooked person will ingest or inject anything, led on by even the faintest hope that it will put their head where they want it to be? Just throw any old substance in there, and hope for the best? Is this why so many die from fentanyl?

At any rate, the agony of existence was not purely mental. Carrying around all those pounds caused Peterson constant pain in the back, hips, and legs.

(To be continued…)

Your responses and feedback are welcome!

Source: “900 pounds and hopeless: Katie’s weight-loss story,” UCHealth.org, 01/17/23
Image by Pete Markham/Attribution-ShareAlike 2.0 Generic

A Very Unusual Case

Pat Hartman October 24, 2024 No Comments

Ed Cara of Gizmodo.com recently reported on a medical situation in Ecuador involving a 24-year-old woman who sought help because of severe stomach pain along with frequent vomiting. Barely able to eat or drink, she had lost a considerable amount of weight.

Upon examination of her midsection, a hard mass could be felt from the outside. During a 45-minute procedure, surgeons removed from the patient’s stomach a compacted two-pound lump of hair whose 16-inch length included an incursion into the small intestine. (Yes, there is a photo). Her doctors estimated that the accumulated hair had been eaten over a period of at least two years.

Hair-pulling disorder, or trichotillomania, is classified as a body-focused repetitive behavior (a topic which Dr. Pretlow has addressed) and also as a mental health condition. Although the head is most often involved, a sufferer might pluck hair from any part of the body. There may be a ritualistic element, like choosing a certain hair that feels just right. Victims describe the urge to pluck hairs as irresistible, and they are often impelled to bite, chew, or even swallow the extirpated hair.

Hair-pulling may relieve negative feelings or even generate positive ones. An internal conflict or other psychological, or emotional issue is always presumed to be involved. The habit usually shows up between the ages of nine and 13, and some people coexist with it throughout their lives. It is unlikely to just go away, and an ignored, untreated hairball that causes intestinal blockage can be fatal.

The childhood obesity connection

Trichotillomania is often classified as a co-occurring disorder, which means that it typically develops along with another illness; chiefly anorexia, bulimia, or binge eating. Consequently, the two disorders must both be treated at the same time:

[O]ptions for treating both of these conditions include psychosocial methods, such as the use of cognitive-behavioral methods, as well as the utilization of medications. Ideally, all implemented strategies for addressing these issues should be under the guidance of a comprehensive treatment team of eating disorder specialists.

Along with psychological and behavioral therapy, SSRI drugs may help, though no specific drug to knock out trichotillomania has been discovered or developed. This condition has been seen often enough that the compacted mass of hair removed from the Ecuadorian woman and similar patients has a name: It is a bezoar.

The term, referring to any indigestible mass found in an animal’s gastrointestinal system, has ancient connotations. Historically, a bezoar was valued for its alleged curative power, for instance as an antidote to the poison that an enemy had dropped into one’s goblet. A bezoar could typically be worth several times its weight in gold, and might be embellished with precious metals and jewels. But a person unable to afford their own could rent an unadorned bezoar (or a fake one, made of polished stone) from the local alchemist.

Your responses and feedback are welcome!

Source: “Doctors Pulled a 2-Pound Hairball From a Woman’s Stomach,” Gizmodo.com, /07/19/24
Source: “Trichotillomania (hair-pulling disorder),” MayoClinic.org, undated
Source: “Trichotillomania and Eating Disorders,” EatingDisorderHope.com, 06/12/12
Images by Dr. Alexey Yakovlev and Gee Hair/Attribution-ShareAlike 2.0 Generic

Teal-o-Ween Catches On

Pat Hartman October 22, 2024 No Comments

It appears that pumpkin aficionados will be spotting more teal pumpkins this year. The color does not simply mean “no candy,” although that concept in itself is quite valid — but there is a lot more to it.

A few years back, in a relatively quiet American state, a revolutionary movement began with the Food Allergy Community of East Tennessee (in particular, Becky Basalone.) The Teal Pumpkin Project has spread because this broad issue touches children in every state. In the USA alone, around six million children (roughly one out of 13) suffer from food allergies, and nearly half of those affected have experienced at least one serious allergic reaction.

Commercially available candy, and this goes double for the specialized Halloween variety, is very likely to include in its recipe one or more common allergens. These include milk, eggs, wheat, soy, peanuts, tree nuts, and sesame. Also, as has been widely publicized over the past few years, any type of candy is likely to contain unhealthful amounts of sweeteners with serious downsides.

A worldwide sensation

FARE, the organization concerned with Food Allergy Research and Education, says that…

Kids with food allergy are not the only ones who benefit from non-food treats. Many other medical conditions make candy off-limits, such as food intolerances, eosinophilic esophagitis (EoE), celiac disease, food protein-induced enterocolitis syndrome (FPIES), diabetes, and having a feeding tube.

Now in its 10th year, the Teal Pumpkin Project has been catching on in other countries, too. Even more significant, its core principle has encompassed other groups, such as kids with autism spectrum disorder, who encounter their own set of difficulties. This area is a bit controversial, however.

While allergic children can collect treats in any receptacle of their choosing, autistic children are encouraged to carry a blue hollow plastic pumpkin or some other blue container, as a signal that they may be unable to make the traditional “Trick or Treat!” request. The notion is problematic from the start, because in the minds of many observers, teal is blue, and vice-versa. And this goes double after dark.

On the psychological level, this self-labeling can easily be interpreted as different from the other kind, and among children, adults, neighbors, and medical professionals, the response to the concept is mixed. Other controversies exist too, of course, and some grouches enjoy telling the parents of differently abled children that “Your kid’s problem is your problem. Not mine.”

FARE’s website is a place to download signs to print out at home or at school or wherever, that part does not matter as long as people are inspired to use them. “Non-food treats available here” is a friendly, neighborly, inclusive message. As for what those treats might be, this page offers a very comprehensive list, compiled by Maria Chamberlain, of possible alternatives to sweets. (A few more suitable items not included on that list are key rings, mini notebooks, mini puzzles, and fidget toys.) The page also offers the official posters available for download and print.

To be a good Teal host…

— Please register ahead of time with the Teal Pumpkin Project Map, if your community offers this amenity. If it does not, find out how to promote the movement locally. In the Age of Social Media, there is very little we can escape knowing about, so jumping on board with this trend should be easy.

— Parents can also pass out flyers at school events, well ahead of time, to alert others to the possibilities. Workplaces can educate their employees about the idea, and you know that retail stores will jump right on it and promote it if they sell anything relevant, from teal paint to little non-food prizes.

— For everyone’s convenience, have the non-food treats in a separate container from the food treats, this just goes without saying.

— Display a Teal Pumpkin Project sign from a window, porch step, or in some other visible area.

— A person doesn’t even need to have a house from which to operate, but, depending on the environment, can get together with one or two like-minded adults, set up a “Trunk-or-Treat” car, and distribute treats from any available space. If the weather or the neighborhood’s ambiance is likely to be too harsh, get together with other parents and responsible adults to plan an indoor event.

— Have big fun.

Your responses and feedback are welcome!

Source: “Bring Magic to Halloween With the Teal Pumpkin Project,” FoodAllergy.org, 10/15/24
Source: “Here’s what the Teal Pumpkin Project is and why it matters,” NBCNewYork.com, 10/18/24
Image by Jen Reeves/Attribution 2.0 Generic

How to Survive Halloween

Pat Hartman October 17, 2024 No Comments

Some very ambitious activists envision the possibility of a society-wide adjustment in the theory and practice of Halloween. It is almost as if adding on pounds has become the national sport, and they are determined to resist this trend. In recent years, to the point where politics often become involved, the holiday has increasingly attracted the notice of people who would like to see (and help) the entire landscape improve.

Former First Lady Michelle Obama poured a lot of energy into trying to end childhood obesity, or at least to make a dent in it. But what happened in Washington? “White House M&Ms” were the presidential treat, inviting snide comments from some members of the press. Today, one shudders to imagine the photo-worthy costumes that might hit the streets, which celebrating the holiday so close to Election Day will no doubt inspire.

Why the concern? As the first of a series of occasions where food is the signifier of love, togetherness, hospitality, generosity, and, in too many cases, regret, Halloween kicks off the eating season. As first in line, this quaint holiday can be a horror for an overweight kid. It’s all about doing the exact thing she or he is not supposed to do — acquire and consume a bunch of sweets.

Here’s a thought: Let’s figure out how to reduce the amount of junk the kids collect, how much they hold onto, and how much of it they ultimately consume. The goal is to minimize the acquisition, retention, and consumption of candy. Mainly, the first. The method is to offer, and even create, alternatives that are more desirable.

So much angst

Critics say those industrial-size packages of candy appear on supermarket shelves earlier every year. (Maybe. Is Easter too early?) Worse yet, some wary folks suspect that most of it is left over from last year. Can you tell the difference between a fresh bag of candy corn and a superannuated one?

Even people who don’t want to abolish the holiday altogether would like to radically change its nature. Plenty of parents are nervous about the whole trick-or-treat concept. All year, kids are told “Never take candy from a stranger” and suddenly, the rule is ignored. Every autumn, rumors circulate about shady neighbors who are said to tuck razor blades or various substances into the treats they distribute.

As the wisecrack goes, “That’s crazy. Nobody gives away perfectly good drugs.” Above that is a layer of cosmic humor. The candy, stuffed with not only sugar but high fructose corn syrup, food dyes, and all sorts of additives, is capable of doing more damage than some drugs. Childhood obesity, as many news items remind us, is growing by leaps and bounds.

Look to the future

Why? Because it might make a big difference in the outcome — that outcome being your child’s or children’s health for the rest of their lives. Okay, so maybe you missed the boat this time. Maybe you already bought the jumbo bags of sweet treats, weeks ago on the way home from a day at the outdoor swimming pool, on the theory that the price would rise as Halloween approached. Maybe some hungry family member has already depleted the stock. It might be a good idea to check, as there is still time to get more.

None of this needs to happen

Look to the future, parents, but first think back to previous Halloweens, especially last year. Did you make any notes to yourself about doing things differently? Maybe it is not too late. And there is always next year.

Meanwhile, set aside some time in the months that lead to Halloween 2025, to have a look at a little story of how things could be. For further inspiration, check out one or several previous Childhood Obesity News posts on the subject.

Things don’t have to stay the way they are! The future is ours to create.

Your responses and feedback are welcome!

Image by Da Puglet/Attribution-ShareAlike 2.0 Generic

A Halloween Retrospective

Pat Hartman October 15, 2024 No Comments

The trick-or-treat ritual boils down to three elements: First, prepare a costume in which to collect candy. Next, collect candy. Finally, decide what to do with the candy. Send it to our troops overseas? Donate it to dentists who offer something useful or philanthropic in return? Take it downtown and give it to the first person whose worldly goods are in a shopping cart?

Most likely, kids are going to opt for eating all of it. Otherwise, why did they go to the trouble? Often, the only choice parents have — if any — is to decree that their offspring should ration the goodies over a period of days. Good luck with that, by the way.

Through the years, Childhood Obesity News had offered numerous suggestions to help bring some sanity into the proceedings. “The Most Fun with the Least Sugar” is our motto, or would have been if we had thought of it sooner.

But seriously, this blog has touched upon many topics with the potential to bring on more smiles while minimizing the tummy aches, not to mention the calories. The holiday is a danger zone for kids who are in good shape. For those who are conscious of being overweight or obese, or at risk, it can be an ordeal.

Something else to focus on

Not surprisingly, a lot of anti-Halloween sentiment centers around the health aspect. The whole point and purpose of these suggestions for fun is to turn the spotlight away from the sugar treats and shift the emphasis to creativity and participation. Figuring this out could be an opportunity for family togetherness so memorable that even sweets are forgotten. At least temporarily.

For instance, if you plan to distribute trick-or-treat goodies from the front porch, there are very good reasons to switch over to non-food items. Of course, your kids will be expert consultants on this decision. Go out and get some exercise walking around in a store, or shop online for inexpensive but desirable objects to distribute. Pencils with miniature jack-o-lanterns on top, or even some non-Halloween-related gadgets that can be bought in bulk.

Parents, this is a secret worth remembering. What your kids really want is your attention, and generally the younger they are, the more true this is. Entertaining activities can go a long way toward persuading little ones to do what you want, which is to forget about candy for a while. Make up a game that could become a treasured tradition. Incidentally, check out this little tale depicting what could so easily become a normal way of doing things.

Is there an infant in the house?

An ever-popular Halloween sub-category is costumes for babies. A very young minor child is granted no say in the matter, and might turn up disguised as a taco, a banana, a chili pepper, a hamburger, a slice of pizza, a lobster, a hot dog, a roast turkey, a packet of ketchup, a candy bar, or a gingerbread man. (That last choice is economical, as it can be recycled for Christmas.)

In a dystopian vision, it is possible that some far-sighted disreputable second cousin might smell future profit and encourage the silliest costumes and snap plenty of photos, with an eye toward growing a nice passive income stream by blackmailing those former babies when they reach an embarrassment-prone age.

Just kidding. But seriously, this might be the year to adopt a new paradigm. Take a look at one or all of the previous posts on this topic. Try substituting attention for treats, and encourage activity rather than consumption. If the results are not what you hoped for, we have the whole year to construct and refine a plan for next year. Refuse to accept discouragement, and remember, because individuals and families vary greatly, nothing works for everybody. It is equally certain that nothing works if we don’t try it.

Your responses and feedback are welcome!

Image by Theo Crazzolara/Attribution 2.0 Generic

It’s That Scary Time Again

Pat Hartman October 10, 2024 No Comments

Well, almost. We still have a couple of weeks to plan and stock up for Halloween. In many segments of American society, this occasion represents the starting gun, the opening act, the ground zero, the kickoff, the onset, of the anticipated and dreaded Winter Holidays. Pretty soon, edible and drinkable treats will be coming at us from many directions. Sharing festival food is one of humanity’s most ancient, honored, widespread, and deeply ingrained cultural characteristics.

In these times, how we “do” Halloween tends to set the tone for the rest of the holidays that cluster around the end of any year and the beginning of the next. If we can get through this one with relatively little damage, maybe we can survive the rest of the ordeal-by-temptation and emerge in February with heads held high, and without extra inches around the waistlines.

Non-food fun

Parents and others who are called upon to do something constructive with children are often eager to pursue the greatest possible entertainment value with the least possible caloric intake, and Childhood Obesity News has just discovered a treasure trove. The Reader’s Digest website publishes several lavishly illustrated Halloween fact collections, each one of which could provide an evening of family amusement.

Journalist Melissa Mills quotes Halloween expert Lesley Bannatyne:

The celebration of Halloween often illustrates what’s going on in our culture. Halloween feeds on zeitgeist in a way that other holidays can’t. It’s expressive of who we are and what we value, what we’re thinking about or are afraid of or love…

Take, for instance, “The Most Popular Halloween Costume the Year You Were Born.” This particular collection begins with 1950, so it’s a great opportunity for children to see what their nearest ancestors were up to in the spooky season, back in the day. What a great opportunity to spend some time sitting around and just talking with the kids — rather than eating.

To learn that Grandma’s first celebrity crush was a guy in a fur hat (Fess Parker as Davy Crockett) could be an anthropological treat. To see what Mom or Dad wore (or refused to wear, or were thwarted from wearing) for trick-or-treat at age 10 might be quite illuminating, and possibly even form new bonds between the generations.

At least a few of the entries are bound to stir up curiosity, and lead to personal reminiscences as well as interesting and possibly useful exchanges of information about pop culture figures of the past, both real and fictitious. That particular collection ends with 2005, but never fear, the most popular costumes in each American state are spotlighted by a similar article, which in turn could spark family-oriented conversation about relatives in those states, or to a phone call or two, or to some historically informed speculations about why people in different parts of the country tend to enjoy certain costumes.

If by chance the family anticipates a new member, another article offers “27 Best Pregnant Halloween Costume Ideas to Show Off Your Baby Bump.” The kangaroo is very tempting. It is easy to follow links to the other related collections, such as 38 ideas for the whole family to all dress in related outfits; 45 funny costumes; 55 scary ones; and a whopping 83 inspirations for large groups. Needless to say, any or all of these journalistic efforts can provide something Halloweeny for kids and parents to do together, other than eat.

Actually, for the ambitiously crafty family, there is still time to make some simple costumes, either imitating those seen in any of these collections, or totally different ones inspired by all the creativity on display. Any activity that diverts attention from the collecting and consuming of a ton of sugar and additives, is a win.

Your responses and feedback are welcome!

Source: “The Most Popular Halloween Costume the Year You Were Born,” RD.com, 10/04/24
Source: “Here Are the Most Popular Halloween Costumes in Every State,” RD.com, 10/24/22
Source: “27 Best Pregnant Halloween Costume Ideas to Show Off Your Baby Bump,” RD.com, 01/20/24
Image by City of Greeley/Public Domain

Ethics, Public Opinion, and Lived Experience

Pat Hartman October 8, 2024 No Comments

A certain school of thought holds that actual legitimate science exists only in a lab with a lot of fancy equipment, and that “anecdotal evidence” is trash, unworthy of even a glance. But there are times when anecdotal is the only type of evidence on offer. This is because of the ethics, or rather the lack of ethics, that would be involved in knowingly testing unproven drugs on pregnant women.

As an example of the type of problem that can arise, polycystic ovary syndrome (PCOS) makes a woman particularly vulnerable to unexpected pregnancy when inner conditions change, like when taking weight-loss drugs — which indirectly attests to the usefulness of social media. A troubling connection between drugs, pregnancy or lack thereof, and PCOS, is just the kind of detail that can be usefully shared in an online forum.

Social media to the rescue

Utilizing available platforms, women have taken it upon themselves to communicate with each other, sharing good news and bad news, fears, regrets, and fluctuating emotions. For instance, after two C-sections, someone had been assured that she was now infertile, except she wasn’t.

After being on Ozempic for four months, this woman turned up pregnant — not a circumstance to be taken lightly. Even a healthy unplanned child can seriously affect a family’s well-being, let alone an unexpected baby with a birth defect — the possibility of which has not yet been ruled out.

For the foreseeable future, the majority of available data might continue to be of the anecdotal variety. If there is one thing the World Wide Web excels at, that function is providing a way for all sorts of like-minded people to connect with each other. Women seem eager to share their stories and opinions with others who have been through the experience of GLP-1 plus pregnancy, or who might be likely to accidentally or purposely embark on it.

For instance, in March of this year, a Healthline article reported that TikTok was abuzz with reports of surprise pregnancies associated with Ozempic, to the point where such conceptions are called “Ozempic babies” regardless of which pharmaceutical product or brand is in use.

There are reports from women who tried for years to start a family, then lost (even just a relatively small amount of) weight due to a GLP-1 preparation, and had what some call miracle babies. As for what problems might come along with such a “miracle,” that story will take many years to unfold.

Of course, part of this trend must be attributed to weight loss alone, because it was happening even before these particular GLP-1 drugs hit the market. Texas endocrinologist Dr. Neha Lalani notes that weight loss alone can lead to improvement in the patient’s metabolic health to the point where ovarian function might be spontaneously restored:

[I]ncreased fertility and surprise pregnancy has been well-reported in previously infertile patients, even with modest weight loss (approximately 5%) with lifestyle modification as well as other weight loss medications.

For The Washington Post, journalist Amy Klein looked into the anecdotal reports which have appeared on TikTok, Reddit, and in a Facebook group called “I got pregnant on Ozempic” that boasts over 500 members. A typical history is offered by a woman who had been taking semaglutide for diabetes and incidentally lost around 80 pounds. She initially thought her nausea was drug-induced, but it was morning sickness.

Another, because of polycystic ovary syndrome, had been unable to conceive for 10 years. In her words, “My little Mounjaro baby is almost 6 months old.” PCOS is often found concurrent with obesity, and the profession has already learned that losing as little as 5% of body weight can improve the odds of successful conception.

PCOS, with its insulin resistance, weight gain and infertility, is a risk factor that can portend the development of type 2 diabetes, so GLP-1 receptor agonists are often prescribed. For Pharmacy Times, doctoral candidate Alejandra C. Nogueira explained in more depth:

[A] recent metanalysis highlighted that even significant weight loss did not improve clinical pregnancy or live birth rates. Therefore, increased unplanned pregnancies with concurrent semaglutide use in women who are not receiving fertility treatments could be indirectly tied to the drug’s ability to promote weight loss rather than a direct effect on fertility.

It has been understandably feared that the GLP-1 drugs might harm fetuses. A recent study of 168 women who, unsuspecting of pregnancy, took such drugs in their first trimester, found pregnancy outcomes no worse than those of women with diabetes or obesity. Nevertheless, many authorities point out that a developing fetus needs sufficient nutrition, so anything that impairs an expectant mother’s appetite is probably not a good idea.

Ozempic and Wegovy, prescribed for type 2 diabetes and obesity respectively, are both made by Novo Nordisk. Whenever a member of the press asks, company representatives specify that any drug trials have specifically excluded women who were either pregnant or trying to be, so “not enough human data is available to establish whether semaglutide is associated with major birth defects, miscarriage, or adverse outcomes for either the mother or the baby.”

The company does not recommend its products to be used during breastfeeding, either. In lab rats, semaglutide shows up in the mama rats’ milk, and the implications of this regarding humans are not known. And now that these drugs are accepted for teens and even children, there is no way of knowing what effect this will have on their future ability to bear healthy babies.

Importantly, the consensus seems to be that if there is any possibility of pregnancy when a woman is using these medications, contraception not connected with the gastrointestinal tract should definitely be chosen. Plenty of alternatives exist, including good old-fashioned condoms.

Your responses and feedback are welcome!

Source: “’Ozempic Babies’: How Weight Loss Drugs Can Interfere with Birth Control and Boost Fertility,” Healthline.com, 03/26/24
Source: “An Ozempic baby boom? Some GLP-1 users report unexpected pregnancies,” WashingtonPost.com, 04/05/24
Source: “So-Called “Ozempic Babies” Raise Questions About Unintended Effects of GLP-1 Agonists,” PharmacyTimes.com, 10/03/24
Image by Pat Hartman

GLP-1 Drugs and Babies, Part 2

Pat Hartman October 3, 2024 No Comments

Any factor with the potential to affect a baby throughout its entire lifetime is not a thing to be taken lightly. A number of authorities have something to say about the subject of GLP-1 drugs in conjunction with pregnancy.

Many media articles mention Ozempic, a drug which, because of its early and widespread popularity, seems to stand in for and take the fall for the whole group of similar meds. But that one preparation does not represent the entire range of risk. Another brand’s packaging, for instance, warns of increased risk to the fetus, of cleft lip and cleft palate.

The Food and Drug Administration states that no one should take GLP-1 drugs if they are trying to become pregnant. For those who are planning on motherhood and are on a GLP-1, the FDA recommends stopping the medication at least two months before trying to conceive.

Jamie Winn, Pharm.D., told journalist Cathy Cassata,

While no studies have been conducted on pregnant people taking GLP-1 drugs, studies in animals such as rats, rabbits, and monkeys showed that these animals experienced high rates of miscarriages when they were given an injectable GLP-1 medication. The babies the animals gave birth to were smaller in size than usual and with more birth defects.

Just to complicate matters, pregestational diabetes has long been known to “increase the risk for potential pregnancy, including birth defects, miscarriage, fetal growth restriction, premature labor, and preeclampsia.” Some professionals believe that so far, weight-loss drugs offer no greater risk than insulin, which pregnant women with diabetes have needed to take.

Still, clinical endocrinologist Dr. Sethu Reddy has said that no GLP-1 receptor agonist is “indicated for improving fertility” and that “risk can not be ruled out.” On the other hand, GLP-1 receptor agonists seem to perform no worse than insulin, and patient acceptability and adherence are great advantages.

But this only applies to the small percentage of potential mothers who must receive extra protection because of their diabetes. Dr. Sonia Hernández-Díaz is quoted as saying,

[T]he safety of these agents in pregnancy is largely unknown, as pregnant women are typically excluded from clinical trials; hence, treatment guidelines do not recommend these agents in pregnancy.

Around the same time, a Swedish study provided reassurance about the prenatal exposure experienced by fetuses when the mothers are treated for obesity with semaglutide. Only a month later, it was announced that a study of 50,000 pregnancies in six countries, followed up for the first year after birth, provided “reassuring” answers regarding the GLP-1 drugs. Still, even though they apparently post no greater risk than insulin, one year of follow-up cannot tell the whole story.

A researcher who wants to know everything about the effects these drugs have on mothers and their babies cannot simply round up a group of suitable female subjects and keep them on the premises, while hourly monitoring every body function. Nor can they even pay women who have used or are using the substances to turn themselves and their fetuses into lab specimens.

(To be continued…)

Your responses and feedback are welcome!

Source: “Ozempic’s Effects on Pregnancy and Fertility: Experts Answer 4 Common Questions,” Healthline.com, 08/14/24
Source: “Are Weight Loss Drugs Like Ozempic Safe While Trying to Get Pregnant?,” Healthline.com, 04/25/23
Source: “Are GLP-1 receptor agonist drugs safe to use in pregnancy?,” MedicalNewsToday.com, 12/16/23
Source: “Prenatal exposure to GLP-1 receptor agonists and other second-line antidiabetics may not pose greater risk to infants than insulin,” Harvard.edu, 12/11/23
Source: “First Large Study of GLP-1 Receptor Agonists During Pregnancy,” JAMANetwork.com, 01/02/24
Image by Vladimir Pustovit/Attribution 2.0 Generic

GLP-1 Drugs and Babies

Pat Hartman October 1, 2024 No Comments

It seems to be taking a long time for science to sort out exactly what is going on with the relationship between the GLP-1 genre of weight-loss medications and the creation of new humans. This is partly because deliberate experimentation would be unethical. Researchers can’t take a bunch of women who are pregnant or hope to be, and deliberately administer potentially harmful substances to them.

Scientists who want the knowledge are required to wait patiently for the statistics to become apparent among women who have accidentally found themselves in this situation, or who have knowingly and purposely conceived despite being cautioned against it.

An earlier post looked at the two main situations that provided information in earlier years. In some cases, weight loss alone can facilitate conception, and that includes women being treated with Ozempic or similar drugs. But just because this effect was noticed did not imply that the combination of pregnancy and these meds could be recommended. At the same time, unintentional pregnancies were occurring because the drugs might indirectly cause a patient’s birth control pills to be diluted or expelled.

The GLP-i meds purposely delay stomach emptying, so the user does not experience hunger to the same degree as previously, or as soon. Anything consumed stays in the stomach longer than before, which is not particularly desirable for other reasons.

Additionally, the meds commonly cause vomiting, which could also lead to something quite significant, like an unplanned pregnancy because the birth control pills are vomited up too. One way or another, the absorption factor is affected.

Dr. Phillip Kadaj, for example, has said,

If the hormones in birth control pills aren’t being fully absorbed because of the delayed emptying from semaglutide, there’s a chance that the pill may not be quite as effective.

This is quite an understatement when the possible outcome might result in setting up an online “want list” for baby shower gifts and planning a gender-reveal party. It is not a decision to be lightly made. Meanwhile, animal studies have indicated the possibility of unfavorable outcomes like miscarriage and birth defects. Furthermore, the risk incurred by breastfeeding with these drugs present is still a mystery.

One or all?

Currently, it seems that only tirzepatide might, in and of itself, hinder the effectiveness of oral contraception. But all drugs of this class can potentially cause vomiting, and thus the expulsion of birth control pills. And while this type of medication could increase the potential for an unplanned pregnancy, it could also threaten that pregnancy with as-yet-unknown damage. For one thing, maternal weight loss is not usually recommended when a baby is trying to develop inside, needing resources whose availability, or lack thereof, will affect its entire subsequent life.

As is so often the case, there is not enough research yet to really nail down the answer. The sticking point is that among the hormonal and non-hormonal birth control methods, no other current method is influenced by changes in the digestive system. Some doctors don’t say enough about this whole area of risk, while others take a conservative stand and advise patients to start using condoms several weeks before starting a course of weight-loss drugs.

(To be continued…)

Your responses and feedback are welcome!

Source: “Is There a Connection Between Semaglutide (Ozempic) and Birth Control?,” Healthline.com, 09/01/23
Source: “What to Know Before Taking Obesity Drugs While on Birth Control,” Health.com, 10/24/23
Image by Alick Sung/Attribution 2.0 Generic

Almost Half a Ton, Continued

Almost Half a Ton

A Very Unusual Case

The childhood obesity connection

Teal-o-Ween Catches On

A worldwide sensation

How to Survive Halloween

So much angst

Look to the future

None of this needs to happen

A Halloween Retrospective

Something else to focus on

Is there an infant in the house?

It’s That Scary Time Again

Non-food fun

Ethics, Public Opinion, and Lived Experience

Social media to the rescue

GLP-1 Drugs and Babies, Part 2

GLP-1 Drugs and Babies

One or all?

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

Food & Health Resources