Tatyana Meshcheryakova | Childhood Obesity News

Obesity Guidelines Differ Between Adults and Children

Tatyana Meshcheryakova June 18, 2025 No Comments

Obesity is a growing health concern that often begins in childhood and continues into later life. Half of children with obesity stay obese into their teen years, and about 80% of those teens carry it into adulthood.

Despite the long-term nature of obesity, current clinical guidelines are usually split into rigid age categories. A recent review in Obesity Reviews analyzed existing obesity guidelines and found both overlaps and notable differences between recommendations for adults and children. The review looked at 39 guidelines issued between 2017 and 2023, containing a total of 1,248 specific recommendations.

The researchers found a lack of robust, adolescent-specific recommendations. This age group, caught between childhood and adulthood, often falls through the cracks.

Guideline differences

One major difference lies in how BMI is evaluated. Children’s BMI is measured using percentile curves that change with age and development, while adults use fixed BMI thresholds. For exercise, adults are advised to do both aerobic and strength training, while adolescents are typically only guided toward aerobic activity. Likewise, adults are given dietary options like low-calorie and low-carb diets or meal replacements, but these are largely absent — or even discouraged — for adolescents.

One reason for the limited dietary recommendations for teens is concern about how restrictive diets might impact growth. Still, a 2019 meta-analysis suggests such diets can work for adolescents, though more long-term research is needed.

When it comes to setting goals, pediatric guidelines recommend a slow and steady decrease in BMI, whereas adult guidelines often aim for a 5-10% reduction in body weight within six months. For children and teens, family involvement plays a big role in success, while adult patients are encouraged to focus on personal responsibility and education around health.

The report also highlighted a gap in guidance around metabolic and bariatric surgery (MBS) for teens. While surgery is suggested for teens with a BMI over 50, adults qualify at a BMI of 40. Few adolescent-specific recommendations exist due to a lack of research, though the authors expect more data to emerge in the coming years as obesity rates among teens rise.

The common ground

Despite these gaps, the review did identify some common ground. Both age groups are advised to have annual BMI screenings, undergo assessments for eating disorders and other obesity-linked conditions, and consider cognitive behavioral therapy. When surgery is being considered, both sets of guidelines support a team-based, multidisciplinary approach.

Your responses and feedback are welcome!

Source: “Obesity Guidelines Differ for Adult, Pediatric Patients,” AJMC, 6/13/25
Source: “Discrepancies Between Recommendations in Evidence-Based Guidelines for the Management of Obesity in Adolescents and Adults: An Evidence Map,” Obesity Reviews, 5/27/25
Image by Moe Magners/Pexels

Maximizing GLP-1 Treatment Success

Tatyana Meshcheryakova June 11, 2025 No Comments

A new joint advisory from four major clinical organizations provides a much-needed roadmap to help patients get the most out of GLP-1 medications for obesity. While GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound) have gained popularity for their powerful effects on weight loss, this new guidance stresses that medical therapy alone isn’t enough. Nutrition and lifestyle changes are key to long-term success.

The Obesity Society, American College of Lifestyle Medicine, American Society for Nutrition, and Obesity Medicine Association came together to publish a unified advisory titled “Nutritional Priorities to Support GLP-1 Therapy for Obesity.” Drawing on a broad base of clinical and research expertise, the team reviewed current evidence and developed eight core strategies to help clinicians support patients receiving GLP-1 medications:

(1) Patient-centered initiation of therapy; (2) careful baseline nutritional assessment; (3) management of GI side effects, (4) personalized, nutrient-dense, minimally processed diets; (5) prevention of micronutrient deficiencies; (6) adequate protein intake and strength training to preserve lean mass; (7) leveraging a good diet to maximize weight reduction; and (8) promoting other lifestyle changes around activity, sleep, mental stress, substance use, and social connections to maximize long-term success.

The clinical advisory, led by Advisory Chair Dariush Mozaffarian, M.D., DrPH, of Tufts University, Boston, was published simultaneously in Obesity, American Journal of Lifestyle Medicine, The American Journal of Clinical Nutrition, and Obesity Pillars.

The guidelines in more detail

Clinical trials show that GLP-1s can reduce body weight by 5% to 18%, with multiple benefits such as improved blood sugar levels and cardiovascular risk reduction. However, real-world results tend to be more modest, and several challenges can stand in the way of long-term success. These include side effects like nausea and vomiting, nutritional deficiencies due to reduced food intake, and loss of lean muscle and bone mass. Additionally, many patients struggle with adherence over time, often regaining lost weight once treatment stops.

To address these issues, the expert panel emphasized the importance of a patient-centered approach starting from the initiation of therapy. A thorough nutritional assessment should be done at the beginning of treatment to identify any pre-existing deficiencies or health risks. Managing gastrointestinal side effects early on is essential for helping patients stick with the medication.

When it comes to diet, the group recommends moving away from restrictive eating patterns and instead focusing on nutrient-dense, minimally processed foods tailored to each patient’s preferences and needs. Ensuring adequate intake of vitamins, minerals, and protein is especially important for preserving muscle and bone health during weight loss. In addition to proper nutrition, strength training and physical activity should be prioritized to support lean mass retention.

The advisory also encourages clinicians to look beyond diet and exercise. Sleep quality, mental health, substance use, and social support all play a role in achieving and maintaining healthy weight loss. By taking a holistic view, healthcare providers can create a more sustainable and supportive plan for patients on GLP-1 therapy.

Dr. Marc-Andre Cornier, President of The Obesity Society, said:

This guidance lays a nutrition roadmap to help providers support their patients on sustainable and lasting weight reduction journeys… It underscores the importance of nutrition on quality of life and is an important contribution to the literature about incorporating lifestyle interventions into obesity care.

For patients and providers alike, the message is clear: GLP-1 medications are a powerful tool, but their true potential is only realized when paired with smart, personalized lifestyle support.

Your responses and feedback are welcome!

Source: “Advisory: Nutrition Priorities for GLP-1 Use in Obesity,” Medscape, 6/4/25
Source: “Nutritional priorities to support GLP-1 therapy for obesity…,” PubMed, 5/30/25
Image by Pavel Danilyuk/Pexels

The MAHA Report’s Shortcomings and Mistakes

Tatyana Meshcheryakova June 4, 2025 No Comments

In a bold and sweeping move, the Trump administration released the “MAHA Report: Make Our Children Healthy Again,” a 72-page document outlining the rise of chronic illnesses among America’s youth. Spearheaded by Health Secretary Robert F. Kennedy, Jr., the report zeroes in on an urgent public health crisis — one that includes high rates of obesity, asthma, behavioral health disorders, and autoimmune conditions. Among these concerns, childhood obesity stands out as both emblematic of broader systemic issues and as a pressing problem that demands real solutions.

While the report identifies compelling drivers such as poor diet, environmental toxins, lack of physical activity, and chronic stress, experts argue that its proposed solutions fall short. The diagnosis is clear. The treatment? Frustratingly vague.

A real and rising epidemic

The numbers are hard to ignore. According to the Centers for Disease Control and Prevention (CDC), roughly one in five children in the U.S. is obese. Obesity in childhood is not just about weight; it significantly increases the risk of developing type 2 diabetes, cardiovascular disease, and mental health challenges later in life.

The MAHA report acknowledges this epidemic, pointing to dietary patterns dominated by ultra-processed foods, lack of exercise, and toxic environmental exposures as major contributors. And many experts agree. Dr. William Dietz of George Washington University noted that targeting ultra-processed foods is an important step, though it needs nuance and depth, not just broad condemnation.

Yet, while the report shines a spotlight on known issues, it seems to sidestep a critical aspect of the obesity conversation: socioeconomic inequality.

Poverty, processed foods, and missed opportunities

One of the most glaring oversights in the MAHA report is its limited engagement with poverty as a root cause. Processed foods are cheaper and more accessible than fresh, nutrient-rich alternatives, especially in underserved communities where food deserts persist. Families grappling with low incomes may rely on inexpensive, calorie-dense foods simply to feed their children.

Rather than addressing this systemic problem through programs like expanded school meal funding or subsidies for fresh produce, the report offers proposals that critics describe as “splashy,” such as removing food dyes or funding small-scale research trials — steps that may look good in headlines but lack the structural force needed to shift real-world outcomes.

Mixed messages on prevention and research

The MAHA report calls for a shift toward preventive medicine, urging NIH and FDA to support more research into the health effects of diet and chemicals. On paper, this looks promising. However, in practice, the Trump administration has simultaneously enacted cuts that directly undermine these goals.

Thousands of federal employees have been laid off, and budget cuts have hit agencies such as the CDC and NIH — organizations tasked with the very research and data collection the report claims to champion. Dr. Dietz warns that such cuts may erode our ability to monitor obesity trends, making it harder to assess progress over time.

This contradiction raises the question: Can we fight an epidemic without the tools to measure and understand it?

Overmedicalization and lifestyle solutions

Another area of focus in the report is “overmedicalization”— the idea that the healthcare system is too focused on treating disease rather than preventing it. On this point, there’s widespread agreement. Childhood obesity cannot be solved with a prescription pad alone.

Instead, a comprehensive prevention model would include:

Parent-infant training in emotional regulation
Robust nutrition education in schools
Community-based fitness initiatives
Subsidized access to whole, unprocessed foods
Improved urban planning to ensure walkable neighborhoods and safe parks
Policies addressing environmental pollutants

And while the report mentions lifestyle medicine and surveillance of pediatric drugs, it doesn’t go far enough in proposing how such a shift would be funded or implemented at scale.

What else is missing?

Ultimately, the MAHA report highlights an urgent problem but falls short of a strategy to fix it. Childhood obesity isn’t just a matter of bad personal choices or isolated environmental exposures. It’s the result of systemic forces: poverty, inequality, food industry lobbying, and crumbling public health infrastructure.

Lauren Wisk from UCLA points out that real progress will come from social policies that address root causes, not just from banning food dyes or launching a few more studies. For instance, universal school meal programs, expanded SNAP (food stamp) benefits, and tighter regulations on junk food marketing to kids could move the needle far more than flashy headlines.

If the administration is serious about “making our children healthy again,” it must follow up this report with policies that put science, equity, and prevention at the forefront. Otherwise, this report may end up as just another diagnosis without a cure.

AI only makes it worse

In a follow-up development, the Trump administration has issued corrections to the report after journalists discovered several flawed and nonexistent citations, casting doubt on the report’s scientific integrity. Investigations by a nonprofit NOTUS and NBC News revealed that at least four referenced studies do not exist, including one falsely attributed to epidemiologist Katherine Keyes.

Dr. Keyes commented:

I can confirm that I, and my co-authors, did not write that paper… I was surprised to see what seems to be an error in the citation of my work in the report, and it does make me concerned given that citation practices are an important part of conducting and reporting rigorous science.

The report’s credibility has come under further scrutiny due to its anonymous authorship, limited medical representation among commission members, and questionable interpretation of cited research. Out of 522 total references, seven could not be verified, and some included URLs containing “oaicite,” suggesting that generative AI may have played a role in compiling sources.

Additionally, researchers like Mariana Figueiro, a professor at the Icahn School of Medicine at Mount Sinai, have stated that their studies were misrepresented. Her work on melatonin suppression in college students was incorrectly cited as evidence about children’s sleep and screen time. She said:

The conclusions in the MAHA report are incorrect and misrepresented our finding… We looked at melatonin suppression, not sleep onset. We also used college students, not children as subjects. Finally, the journal name was incorrect.

Unsurprisingly, these errors have sparked criticism over the report’s scientific validity and its use in shaping national health policy.

Your responses and feedback are welcome!

Source: “MAHA Commission report paints a dark picture of U.S. children’s health,” NPR, 5/22/25
Source: “Trump admin corrects RFK Jr.’s MAHA report after citation errors,” NBC News, 5/30/25
Source: “The MAHA Report Cites Studies That Don’t Exist,” NOTUS.org, 5/29/25
Image by Markus Winkler/Pexels

New Study Links Childhood Weight Patterns Before Age 9 to Obesity Risk

Tatyana Meshcheryakova June 2, 2025 No Comments

Children don’t all grow the same way. A recent study from the NIH-funded Environmental Influences on Child Health Outcomes (ECHO) Program, reported in JAMA Network Open, sheds light on how early weight trends can signal future health concerns. Researchers tracked nearly 9,500 children’s body mass index (BMI) from infancy through age 9 and identified two distinct growth patterns.

Most kids (about 89%) followed a typical growth curve where BMI naturally dropped between ages 1 and 6, then gradually increased again. However, about 11% showed a different trend — their BMI remained stable from ages 1 to 3.5, then climbed sharply through age 9. Children in this group were significantly more likely to have obesity by age 9, with BMI measurements above the 99th percentile.

The study also found that certain early-life factors may raise the risk of obesity later on. These include being born with a high birthweight, maternal smoking during pregnancy, having a mother with a high BMI before pregnancy, and excessive weight gain during pregnancy.

Childhood obesity, defined as a BMI at or above the 95th percentile for a child’s age and sex, often results from excess body fat and can lead to serious health problems like heart disease and type 2 diabetes later in life. Without intervention, kids who follow these higher-risk growth patterns may continue to struggle with weight into adolescence and adulthood.

To better understand these trends, researchers used data from medical records, parent-reported measurements, and both in-person and at-home evaluations. Their goal was to track how BMI changed over time and uncover any links to early childhood experiences.

Lead researcher Chang Liu, an assistant professor of psychology at Washington State University, said in a news release:

The fact that we can identify unusual BMI patterns as early as age 3.5 shows how critical early childhood is for preventing obesity… Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain.

Your responses and feedback are welcome!

Source: “Early childhood weight patterns linked to future obesity risk,” News Medical, 5/22/25
Source: “Preschool BMI Can Predict Childhood Obesity Risk,” HealthDay News, 5/28/25
Image by Nataliya Vaitkevich/Pexels

A Drug-Free Approach to Weight Loss

Tatyana Meshcheryakova May 21, 2025 No Comments

While semaglutide-based drugs like Ozempic and Wegovy have become popular tools for weight loss, many people still prefer to lose weight without relying on medication. For those looking for a natural approach, research shows that certain nutrients and eating habits can stimulate the same biological pathways that these drugs target.

Specifically, eating more fiber and healthy fats — like those found in olive oil and avocados — as well as paying attention to meal timing, food order, eating speed, and chewing thoroughly, can naturally boost the body’s production of GLP-1, a hormone that plays a key role in appetite control and digestion.

Mary J. Scourboutakos, Adjunct Lecturer in Family and Community Medicine, University of Toronto, who has a Ph.D. in nutrition, doled out advice and looked at some studies supporting it. According to Dr. Scourboutakos,

A strategic approach to weight loss rooted in the latest science is not only superior to antiquated calorie counting, but also capitalizes on the same biological mechanisms responsible for the success of popular weight-loss drugs.

Semaglutide medications work by increasing levels of GLP-1 (glucagon-like peptide 1), a hormone that signals fullness and slows digestion. They also block DPP-4, an enzyme that normally breaks down GLP-1 quickly. This dual action allows the hormone to remain active in the body for much longer (sometimes up to a week), helping people feel full for extended periods and eat less as a result.

But medication isn’t the only way to elevate GLP-1, as we’ve explored in some of our previous posts. There are some less expensive regimens that could serve as alternatives to taking weight loss drugs.

What you eat matters

Fiber, especially from beans, vegetables, whole grains, nuts, and seeds, is a powerful GLP-1 booster. When gut bacteria ferment fiber, they produce short-chain fatty acids that trigger GLP-1 release. This may help explain why higher fiber intake is consistently linked to weight loss, even without cutting calories.

Monounsaturated fats, like those in olive oil and avocados, can also increase GLP-1. Nuts like pistachios, which are rich in both fiber and healthy fats, have also been shown to boost GLP-1.

How you eat is just as important

Beyond food choices, how you eat can also influence GLP-1. Meal sequence makes a difference: eating protein before carbs, or vegetables before carbs, leads to greater GLP-1 release than the reverse order.

Timing matters too

Like other hormones, GLP-1 follows a daily rhythm. Eating a meal in the morning, such as at 8 a.m., triggers a stronger GLP-1 response than eating the same meal in the evening. This helps explain the wisdom behind the saying, “Eat breakfast like a king, lunch like a prince, and dinner like a pauper.”

The pace of eating and chewing also affects GLP-1 levels

One study found that slowly eating ice cream over 30 minutes led to higher GLP-1 levels than eating it quickly in five minutes. However, when vegetables are eaten first, the speed of eating seems to matter less in terms of blood sugar response.

Even how well you chew your food can play a role. Chewing cabbage, for example, increased GLP-1 levels more than drinking it as a purée.

Food vs. medication

While these dietary strategies can raise GLP-1 levels, the effects are still modest compared to medications, Dr. Scourboutakos points out. For example, a Mediterranean diet was shown to raise GLP-1 to around 59 picograms per milliliter, while even the lowest dose of Ozempic can push levels to 65 nanograms per milliliter, which is over 1,000 times higher.

Still, when it comes to long-term health outcomes, food may have the edge. Dr. Scourboutakos writes that…

[…] when you compare long-term risk for diseases like heart attacks, the Mediterranean diet lowers risk of cardiac events by 30 per cent, outperforming GLP-1 medications that lower risk by 20 per cent. While weight loss will always be faster with medications, for overall health, dietary approaches are superior to medications.

Dr. Scourboutakos’ advice for a drug-free weight loss approach includes:

Eating a substantial breakfast, or frontloading your calorie intake earlier in the day
Including a fiber-rich food at every meal
Making olive oil a regular part of your diet
Eating protein and vegetables before carbohydrates
Snacking on fiber- and fat-rich nuts like pistachios
Chewing your food thoroughly
Eating slowly and mindfully

What else can you do to lose weight without the meds?

A recent article on the Medical News Today website also dug deep into some proven, drug-free strategies to lose weight and keep it off. Besides of the ones mentioned above and a few other, most obvious ones like recommending regular physical activity. The three we’d like to mention are intermittent fasting, tracking your progress, and getting enough sleep.

Intermittent fasting

Intermittent fasting involves cycling between periods of eating and fasting, typically within a set window of time each day. It encourages weight loss primarily by helping people consume fewer calories overall. A 2022 meta-analysis found that intermittent fasting, when practiced for up to 26 weeks, can be just as effective for losing weight as a traditional low-calorie diet. Of course, fasting isn’t for everyone, even adults, so it’s best to consult your doctor.

Common forms of intermittent fasting include:

Alternate-day fasting: This method involves fasting every other day, while eating normally on non-fasting days. A modified version allows 20–30% of daily caloric needs on fasting days.
The 5:2 diet: Fast (or drastically reduce calorie intake) for two days each week and eat normally on the other five.
The 16:8 method: This plan limits eating to an eight-hour window each day (e.g., noon to 8 p.m.) and involves fasting for the remaining 16 hours. It’s often referred to as time-restricted eating.

Tracking your weight-loss progress

Keeping a record of daily food intake, physical activity, and weight progress can significantly support weight loss goals. Using journals, apps or online trackers helps people become more aware of their habits and encourages healthier choices.

A 2020 review found that this kind of self-monitoring can drive behavior change and increase motivation. A 2021 study also linked consistent food and weight tracking with more successful weight loss, particularly among users who logged their meals diligently. Additionally, a 2022 review suggests that wearable fitness trackers can improve activity levels, fitness, and body composition.

Getting enough sleep

Finally, this article took a comprehensive look at childhood obesity causes and treatment. We’ve covered plenty of that over the years on this blog, but the article reminds us that…

Studies show children who sleep less are more likely to be overweight or obese, and the risk increases with shorter sleep duration. A review of 17 studies found that children of all ages who slept less than the recommended amount had a 58% increased risk of being overweight or obese.

(Here’s a link to the study.)

So, just how much sleep do children need? The American Academy of Sleep Medicine recommends (and the American Academy of Pediatrics endorses) the following amounts of sleep by age group:

Ages 4-12 months: 12-16 hours (including naps)

Ages 1-2 years: 11-14 hours (including naps)

Ages 3-5 years: 10-13 hours (including naps)

Age 6-12 years: 9-12 hours

Age 13-18 years: 8-10 hours

Even though these natural strategies may seem obvious and may not match the potency of medications, they offer a sustainable, side-effect-free way to manage weight and improve overall health.

Your responses and feedback are welcome!

Source: “Nature’s Ozempic: What and how you eat can increase levels of GLP-1 without drugs,” The Conversation, 5/15/25
Source: “How to naturally lose weight fast,” Medical News Today, 5/14/25
Source: “Childhood Obesity Causes and Treatments,” Very Well Health, 5/13/25
Image by Vanessa Loring/Pexels

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

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

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

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

New Canadian Guideline Promotes Patient-Centered Care for Childhood Obesity

Tatyana Meshcheryakova April 16, 2025 No Comments

A newly released guideline for managing obesity in children and teens encourages a patient-centered approach that prioritizes behavioral and psychological support — with a focus on outcomes that matter most to young patients and their families.

Published in the Canadian Medical Association Journal, the guideline is based on the latest research and was developed by Obesity Canada after a four-year collaborative effort. The process involved adolescents, caregivers with lived experience, health professionals, researchers, and more than 50 experts from various fields. It couldn’t come soon enough, too, since the last guideline was published in 2007.

Dr. Bradley Johnston, co-chair of the guideline committee and associate professor of nutrition and health research methods, explained that the goal was to support shared, informed decision-making by providing clear summaries of scientific evidence. The team prioritized outcomes such as mental health, quality of life, cardiovascular risk factors, and avoiding harm.

Pediatric obesity is recognized as a complex, chronic, and often stigmatized condition that can lead to more than 200 related health issues. In Canada, nearly one in four children under 12 and one in three teens between 12 and 17 have a body mass index (BMI) considered overweight or obese. Globally, severe obesity in youth is on the rise.

Dr. Sanjeev Sockalingam, scientific director at Obesity Canada, emphasized that long-term success depends on accessible, family-focused care that helps children build and maintain healthy behaviors. When appropriate and available, this may include medications or surgery.

The guideline outlines 10 core recommendations, covering nutrition, physical activity, psychological therapies, technology-based tools, medications, and surgery. It also includes nine good practice statements, with an overall recommendation to combine at least two intervention types for the best outcomes.

Lisa Schaffer, executive director of Obesity Canada, stressed the urgency of early intervention. She said:

Delaying care until adulthood increases the risk of complications and deepens the effects of living with a stigmatized chronic condition.

To support implementation, Obesity Canada has created educational tools such as infographics and videos to guide healthcare providers and families in choosing the most effective treatment paths for children struggling with obesity.

This is where GLP-1 receptor agonists also come in

Simply telling kids to “eat less and move more” doesn’t work on its own, says Dr. Sockalingam. He says obesity should be treated like any other complex chronic disease — with a range of tools.

Among those tools are medications like GLP-1 receptor agonists — including Ozempic, Mounjaro, and Wegovy — which mimic a natural hormone to help manage appetite and blood sugar. While only some of these are approved in Canada for obesity, the guidelines suggest they could be considered in specific cases, along with bariatric surgery, especially when serious health complications are involved.

Dr. Jill Hamilton, who co-authored the new guidelines and leads endocrinology at the Hospital for Sick Children, acknowledges more research is needed — particularly around the safety of medications like GLP-1s for younger patients. Ultimately, treatment decisions must respect the values and preferences of families.

Your responses and feedback are welcome!

Source: “Treat childhood obesity by reducing stigma, adding options, say new Canadian guidelines,” CBC News, 4/14/25
Source: “Health Matters: Child obesity treatment guide updated,” Global News, 4/14/25
Source: “A patient-centered approach for managing obesity in children and adolescents,” Medical XPress, 4/14/25
Image by Наталия Игоревна/Pexels

Guideline differences

The common ground

The guidelines in more detail

A real and rising epidemic

Poverty, processed foods, and missed opportunities

Mixed messages on prevention and research

Overmedicalization and lifestyle solutions

What else is missing?

AI only makes it worse

What you eat matters

How you eat is just as important

Timing matters too

The pace of eating and chewing also affects GLP-1 levels

Food vs. medication

What else can you do to lose weight without the meds?

Intermittent fasting

Tracking your weight-loss progress

Getting enough sleep

What the study showed

The caveats

An added benefit

A long, tough uphill battle dating way back

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

A glimpse at Oliver’s worldview

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…

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

This is where GLP-1 receptor agonists also come in

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

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