We talk about habits often in our classes. We all have habits, good and bad, especially when it comes to our diet and lifestyle. Why is a bad habit so difficult to change? It is common to struggle to replace those bad habits with good habits. Change is difficult because we don't have the right tools. And... we don't like change.
Our Emotional Eating and Forming & Maintaining Optimal Habits classes help us to look at our state of mind and emotional state. Habits are reward based, and resistance is subconscious. We place our own obstacles in our way without even knowing it. We resist change because we are focusing on what we are giving up instead of what we have to gain.
"For example, we all get a dopamine hit when we eat. That is a survival mechanism. Signals to the brain encourage us to eat. But sometimes eating bad foods makes us feel better and we repeat this behavior because we want that "reward" of feeling better and relieve our anxiety, because what gets rewarded gets repeated. So now a good habit (eating for survival and energy) turns into a habit that is self-destructive." This is the process that produces discouragement. We know what to do but we can't do it.
So how do we start? First, examine what your goals are, keeping in mind that reaching that goal is never a straight line from A to B. Make a decision to change one thing at a time, have a vision, write down what you want to accomplish, examine that goal honestly, formulate a plan (that's where attending classes comes in). Start new. "Starting new is not starting over. Starting over implies returning to where you were. Starting new means stepping into something that has never existed before.: (Graham Cooke) Most importantly, be consistent. James Clear says that "consistency enlarges ability." Imagine that every day that you are consistent in your goal towards a healthier lifestyle, the greater your ability will be to accomplish it. And THIS is what makes you resilient. The definition of resilience is "the ability of a system (or person) to respond to or recover readily from a crisis, disruptive process, etc."
Pam Popper from Wellness Forum Health says it best "If you really want to change your life and your health, the best comparator to use is “optimal.” How do your diet and lifestyle habits compare to habits that are optimal? Two important clarifications are needed here; one is that “optimal” does not mean “perfect” and the other is that optimal habits are defined as those that lead to high quality of life and longevity."
Practicing mental resilience in order to live "optimal" healthy diet and lifestyle is a way to show compassion towards yourself. You will start to learn when your body is saying no to the things that do not serve it in a healthy way. You will start to discover what frustrates and exhausts you and walk away from those things. You will know that you do not need to go beyond your ability. You will start to dig deeper in being intentional on creating the vision of what you want to accomplish.
Liz Fattore
Nurture Your Health
Licensed Food Over Medicine Professional
Wellness Forum Health
For a very long time, doctors have mistakenly told patients that higher HDL cholesterol levels are a marker for better health, and that the ratio of HDL to LDL was an important metric to monitor. Many doctors have furthermore insisted that lower HDL levels are markers of poor health. None of this is true. Lower LDL AND HDL cholesterol levels should be the goal, and higher HDL levels are not only not protective, but are a risk factor for coronary artery disease and other health issues.
Some Basics
A primary role of HDL cholesterol is reverse transport, the mechanism by which the body takes excess cholesterol from the peripheral tissues and bloodstream and delivers it to the liver for removal by the gall bladder. Generally, HDL levels can be expected to rise in response to higher plasma LDL levels. With few exceptions, higher plasma LDL levels result from consuming a diet high in saturated fat and cholesterol, both of which are concentrated in animal foods. The more LDL and saturated fat consumed, the more cholesterol produced by the liver. Another way of looking at this is that there would be no need for higher HDL levels if a person were not consuming so much food containing LDL cholesterol and saturated fat.
Quality is Better Than Quantity
The measurement of plasma cholesterol that is most related to the prevention of atherosclerosis and coronary events is HDL efflux capacity – the ability of HDL to remove bad, or LDL cholesterol from macrophages.[1] Macrophages are immune cells that become pro-inflammatory foam cells when they engulf LDL cholesterol. This explains why some people with high plasma HDL cholesterol develop coronary artery disease, while others with lower plasma HDL do not.
To illustrate this point, HDL efflux capacity was measured in almost 1000 subjects;
442 of them had been diagnosed with coronary artery disease, 351 had not been diagnosed coronary artery disease, and 203 healthy volunteers.
The researchers reported that:
· Subjects with high HDL efflux capacity had lower levels of atherosclerosis and obstructive coronary artery disease, while those with low HDL efflux capacity had higher levels of atherosclerosis and obstructive coronary artery disease.· Statins were not effective for raising HDL efflux capacity.· There was no relationship between blood levels of HDL and efflux capacity.· Habits influenced efflux capacity: smokers had low HDL efflux capacity even if they had higher plasma HDL levels, for example.· There was a significant relationship between HDL efflux capacity and carotid artery thickening (a marker for atherosclerosis), and this relationship persisted regardless of plasma levels. In other words, higher plasma cholesterol was not protective, while lower plasma levels with higher efflux capacity was.· The proportion of patients with coronary artery disease decreased consistently with increases in HDL efflux capacity.[2]
The bottom line:
Measuring plasma levels of HDL to determine health status is futile. Additionally, attempts to increase HDL levels using drugs and supplements has been shown to increase the risk of cardiovascular events and death.[3] [4]
Furthermore, higher HDL levels are indicators for risk of macular degeneration,[5] fractures,[6] and dementia. Data from a longitudinal study that included 18,668 healthy participants showed that those with HDL levels of 80 mg/dLor higher had a 27% higher risk of dementia than subjects with HDL levels of lower of 60 mg/dL.[7] The diet that protects the cardiovascular system also protects the brain.
Conclusions:
A plant-centered diet that is low in saturated fat and cholesterol is the best diet for humans. The incidence of coronary artery disease is very low in cultures that consistently consume a plant-based diet. These include the Tarahumara Indians[8], The Papua New Guinea highlanders[9], and rural Chinese.[10] In some rural areas of China, hundreds of thousands of people go for years without a single myocardial infarction.
[1] Khera AV, Cuchel M, de la Llera-Moya M et al. “Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis.” NEJM 2011 Jan;364(2):127-135
[2] IBID
[3] Keene D, Price C, Shun-Shin MJ, Francis DP. "Effect on cardiovascular risk of high-density lipoprotein targeted treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomized, controlled trials including 117 411 patients." BMJ 2014; 349:g4379
[4] Michael O'Riordon "No Clinical Benefit to Raising HDL With Existing Therapies, Meta-Analysis Shows" July 23, 2014 www.heartwire.com
[5] Colijm JAM, den Hollander AI, Demirkan A et al. “Increased High-Density Lipoprotein Levels Associated with Age-Related Macular Degeneration: Evidence from the EYE_RISK and European Eye Epidemiology Consortia.” Ophthalmology 2019 Mar;126(3):393-406
[6] Hussain SM, Ebeling PR, Barker A, Neilin LJ, Tonkin AM, McNeil JJ. “Association of Plasma High-Density Lipoprotein Cholesterol Level With Risk of Fractures in Healthy Older Adults.” JAMA Cardiol 2023 Mar;8(3):268-272
[7] Hussain SM, Robb C, Tonkin AM et al. “Association of plasma high-density lipoprotein cholesterol level with risk of incident dementia: a cohort study of healthy older adults.” Lancet Regional Health 2023 Nov: https://doi.org/10.1016/j.lanwpc.2023.100963
[8] Connor WE, Cerqueira MT, Connor RW, et al. “The plasma lipids, lipoproteins, and diet of the Tarahumara Indians of Mexico.” Am J Clin Nutr 1978 Jul;31(7):1131-42
[9] Sinnett PF, Whyte HM. “Epidemiological studies in a total highland population, Tukisenta, New Guinea. Cardiovascular disease and relevant clinical, electrocardiographic, radiological and biochemical findings.” J Chron Diseases 1973 May; 26(5):265-290
[10] Campbell TC, Parpia B, Chen J. “Diet, lifestyle, and the etiology of coronary artery disease: The Cornell China Study.” Am J Card 1998 Nov;82(10B):18T-21T.
Dr. Pam Popper, President, Wellness Forum Health
Your Wellness Lifestyle Starts Here
Some of the worst dietary advice is given to athletes of all ages. The misinformation starts in middle and high school, when well-meaning but misinformed coaches often instruct student athletes to eat more protein, use sports drinks for hydration, and consume dairy products for strong bones. Supplements are almost always recommended by trainers for body builders and other adult athletes with the promise that they contribute to more rapid muscle development and better performance. Diet and supplement recommendations are delivered with the implication that results are virtually assured and usually without any explanation of the potential risks. Furthermore, other dietary patterns, such as more plant-based diets are almost never discussed, except to dismiss them as not adequate for helping athletes to train and perform.
Supplements, in particular, are a concern, and the results of a new study should encourage even more people to avoid them. This study included 356 men between the ages of 18 and 55 who had had testicular cancer and 513 controls. Researchers looked at many factors, including exercise, smoking, drinking, family history, and the use of supplements for building muscle. The researchers concluded that muscle-building supplements, particularly those that contained both creatine (which is a hot topic right now) and protein, and those with testosterone-boosting androstenedione, significantly increased the risk of testicular germ cell cancer. Lead researcher Tongzhang Zheng said, “The observed relationship was strong. If you used them at an earlier age, you had a higher risk. If you used them longer, you had a higher risk. If you used multiple types, you had a higher risk.”
The researchers also noted that many supplements contain unknown ingredients that can increase the risk of cancer, citing a study that showed that 15% of supplements that did not include hormones on the labels contained anabolic androgenic steroids which have been associated with testicular cancer in animal studies.
The incidence of testicular germ cell cancer is rising in both the U.S. and Europe, and is the most common malignancy in men between the ages of 15-39 years of age. While many other factors are most certainly contributors, including poor diet, supplements to boost sports performance increase the risk even more, and should be avoided.
Athletes should be informed that optimal performance can be achieved without high-protein diets and supplements; in fact more and more athletes are finding that sports performance is enhanced by eating a more plant-based diet. Athletes do not need to choose between optimal performance or optimal diet. In fact optimal diet leads to optimal performance.
Li N, Hauser R, Holford T et al. “Muscle-building supplement use and increased risk of testicular germ cell cancer in men from Connecticut and Massachusetts.” British J Cancer March 31 2015;112:1247-1250
Niamh Michall “Muscle-building supplements linked to testicular cancer risk.”
Nutraingredients-usa.com April 14 2015
Wellness Forum Health
Stress Paralyzes Immune Cells
A research team in Australia led by immunologist Scott Mueller injected a stress hormone, norepinephrine, into the bloodstreams of mice. The purpose was to see how immune cells responded to stress hormones. Within just a few minutes, T-cells stopped moving. To make sure it was the stress hormone and the injection itself, the researchers performed the same experiment using dopamine, which had no effect on immune function.
To further research the issue, researchers infected the mice with herpes simplex virus (HSV). After two days the mice were treated with a molecule called Iso that mimics the action of adrenaline, a stress hormone. This also stopped the action of T-cells and dendritic cells for over two hours. When another substance called salmeterol, which acts on the same receptors, was injected two times per day for three days, there were fewer virus-specific T-cells at the sites of infection. Additional experiments with mice injected with melanoma cells or malaria parasites showed the same result – stress hormones and substances that mimic them suppress immune function.
There are other mechanisms at work too:
- In response to intense fear or stress, messages from the brain are sent to the endocrine system
- The adrenal glands release adrenaline and noradrenaline
- The body gets ready for fight or flight
- The heart beats faster, and blood pressure rises to send more blood to the arms and legs
- Extra glucose and fat are released for energy
This cascade of events works well for short-term situations in which people must act quickly to survive but does not work well when lower-level stress and anxiety becomes a chronic condition.
Stress also activates responses like inflammation, which helps to repair damaged or infected tissues. Inflammation causes white blood cells to flood an area where an injury has occurred, and release cytokines and recruit macrophages to clean out debris and dead cells. Inflammation is helpful for healing injury; not so much when stuck in the “on” position due to being in a continuous state of fight or flight.
Remaining constantly stressed about viruses makes you more likely to get sick from viruses. Here are some recommendations to reduce your stress:
- choose sources of information that do not result in increased stress
- carefully choose the people you hang around with – some have become toxic sources of stress and panic
- focus on strategies like eating well, exercising, getting out in the sunlight, drinking water – you will feel less stressed about health if you are healthy
- practice gratitude – thinking about what is good in life shifts the focus from the things that are not as good.
Devi S, Alexandre YO, Loi JK et al. “Adrenergic regulation of the vasculature impairs leukocyte interstitial migration and suppresses immune responses.” Immunity 2021 Jun;54(6):1219-1250
Building a Muscular Body for Health and Longevity
Did you know that as we age, we "disintegrate"? Nursing homes are full of folks who did not age well.
Building muscle strength is protective for our health. Frailty is destructive to our health.
Muscle is a functional metabolic organ and poor muscle strength is an independent predictor of poor health outcomes for the elderly who do not engage in proper strength training.
Skeletal muscle is the largest organ in the body by mass-30% to 50% of total body mass-depending on fitness level. Muscle is considered an endocrine organ contributing to metabolic function, hormone regulation and disease prevention. Muscle plays a part in preventing Type 2 diabetes because it plays a role in glucose metabolism. Muscle controls glucose and lipid levels, which results in reduced risk of diabetes. Muscle loss results in reduced glucose clearance, which then increases the risk of Type 2 diabetes. Energy expenditure, or calorie burn, is related to how muscular you are as well, with exercise playing a more minor role.
Most people in westernized countries lose muscle as they age. This is referred to as sarcopenia. The average muscle mass of a young healthy person ranges from 77 to 110 lbs. Contrast that to an elderly woman that has not engaged in strength training with only around 29 lbs. of muscle mass.
Muscle burns more calories than fat. A young person loses around 0.5% muscle mass per year. By the time we are in our 50s-60s, it accelerates to 3% per year. It is an imperceptible change which leads to that moment in life when we wake up one day and say, "how did I get so overweight and out of shape?!" Sarcopenia has been happening!
Early signs include not being able to climb stairs like we used to, not being able to lift something heavy that never gave us trouble in the past, and falls, to name a few. This all leads to a loss of independence.
Life spans are shorter for people who are not muscular and recovery from diseases can take longer due to complications that develop in older and frail people. During illness, the body depends on nutrients stored in muscle to promote better immune response and tissue repair. People with limited muscle reserves therefore have a harder time recovering from illness, including cancer.
The only solution to this is strength training. Eating a high protein diet does not help. Muscle mass also contributes to lower levels of inflammation and muscle releases myokines like interleukin 6 that lowers inflammation. Inflammation is a major influence in promoting all of the diseases that we don't want to get, like cardiovascular disease, arthritis, cancer.
Aerobic exercise helps, but strength training helps more! Another benefit of strength training is that it directly stimulates mitochondrial biogenesis and improves mitochondrial function, which impacts energy production and improves the function leading to increased endurance and lower risk of disease and lower risk of early death.
Strength training is key to preventing osteoporosis and improving bone mass if you have already lost some bone mass.
Just walking is not enough because strength training impacts bones that walking does not, like hips and spine. 10,000 steps a day does not build strength, or even aerobic capacity. You are just "marking time".
Be willing to do what needs to be done for your long-term health. It's fun to be a strong person.
Did you know that you can rebuild your brain with exercise?
In a previous blog, I wrote about the brain's capacity to rewire itself based on repeated thoughts and experiences. This is called "neuroplasticity". If you are a scripture reader, the apostle Paul points to neuroplasticity when he says, "be transformed by the renewing of your mind." (Romans 12:2) The more you do or think something, the more neural pathways you create. Our goal should be to create strong pathways by setting our minds and actions on positive thoughts and habits, reinforcing them daily. Whatever "rut" you think you are stuck in, well, you are not if you don't want to be. We have the ability to change, to transform.
When we exercise, we are also creating new neural pathways. People who exercise have physically different brains.
- The hippocampus, which is key for memory, is stimulated by exercise that increases heart rate. Out of shape people grew new blood vessels in the hippocampus after just 12 weeks of exercise. Aerobic exercise that is good for the heart is good for the brain. Higher levels of aerobic fitness is associated with increased hippocampus volume.
- Exercise has been shown to reverse age-related shrinkage of the brain. Klotho, which is a hormone associated with longevity and protection against cognitive decline, show increased levels after only 20 minutes of intensive aerobic exercise.
Alzheimer's is almost always a diet and lifestyle induced disease, and exercise plays a key role in prevention as well as a diet rich in fruit and vegetables, high in fiber and low in fat. Physical activity
affects the brain’s immune cells, which results in lowered inflammation in the brain.
Microglia are immune cells in the brain which clear away debris and dying cells that result from injury or infection. Microglia also stimulate production of new neurons, which communicate with other cells, a process called neurogenesis that is involved in learning and memory. Microglia shift from a resting state to an activated state in order to do their jobs. When signals from pathogens or damaged cells activate the microglia, they produce pro-inflammatory molecules which are needed to repair damage to resolve infection or injury. The bottom line is that if we eat well for our health, we will be eating well for our brain!
Are you ready to transform your mind? Is it still in a rut? Are you believing the negative spin that you tell yourself? Once you buy into the lies you tell yourself, you risk that it will certainly play itself out.
We remain committed to making learning about health interesting and fun. You CAN take control of your health and make better and more informed decisions about what you eat, how you exercise, and other optimal lifestyle changes.
Liz Fattore
Certified Food Over Medicine Instructor
Diet & Lifestyle Intervention
How often do you hear that someone is "addicted to food"? Did you know that there is no such condition and that there is a downside to calling abnormal eating a "food addiction"?
Humans are hard-wired to experience pleasurable feelings from eating and sex to ensure both personal survival and survival of our species. Food is different from other "addictive substances" – we can give up alcohol and cigarettes without endangering our survival, but we must eat to survive. It’s fair to say that we are all addicted to food for this reason. When we eat, dopamine is released, and we feel good, which is nature’s way of making sure we eat again.
If "addiction" is not driving overeating, what is? Overeating and binge eating are compulsive behaviors that involve food. An important purpose for compulsive behavior is to relieve stress and discomfort. The person who regularly overeats or binges uses food much in the way that some people use alcohol or drugs. But there is a very important difference. A person can abstain from alcohol and drugs for an entire lifetime, but cannot abstain from food.
Research shows that the particular substance that a person uses to reduce pain and discomfort is less important than the reason for use. This is why not all people who use drugs become addicted. During the early 1970s it was common for U.S. soldiers to use heroin while stationed in Vietnam. They often had to be admitted to detox centers to withdraw after returning home. After detox, over 90% of soldiers stopped using heroin and never used it again.
At the same time, heroin use was increasing in the U.S., but the situation concerning discontinuation was quite different. Addicts found it much more difficult to quit, and many were admitted to rehab centers multiple times and never stopped using drugs. What made this situation even more confusing was that the soldiers in Vietnam were using much stronger heroin than the heroin used by drug addicts in the U.S. American soldiers should have had a much more difficult time withdrawing, but they did not. The reason: Why people use heroin is more important than the physical action of the drug.
Soldiers were using heroin to deal with the horrors of war. When they returned home, the threat was gone, so the need for heroin was gone for most of them too. On the other hand, the reasons why many American addicts continued to use heroin remained unresolved, which is one of the reasons they returned to the drug time and time again.[1]
Conventional treatment for "food addiction" usually involves some form of abstinence from certain foods such as sugar, white flour, desserts, or bread. The rationale is that person can’t have any of these foods because eating them will "trigger" a return to abnormal eating patterns.
There are several problems with this strategy. The first is that abstention from particular foods rarely works. Sooner or later the person eats bread or cake or a cookie.
Another is that this strategy relies on perfectionism and all-or-nothing thinking, two of the most common cognitive distortions that drive people to seek therapy. Perhaps most important is that the success rate for abstinence programs overall is very low, even with substances for which there is more clear evidence of harm and addiction like drugs and alcohol. And abstention does not address the psychology of use. If it did, there would be no need for abstention.
The reality is that poor habits and carrying excess weight are indications of a bigger problem – life! Most chronically overweight, serial dieters, in addition to an abnormal relationship with food, have other issues and thinking patterns that interfere with success, such as, unrealistic goals and an inability to set boundaries.
The goal should be to help the overweight person change his or her thinking and behavior patterns AND to learn how to have a normal relationship with food. ALL people who want to have a normal relationship with food CAN have a normal relationship with food IF they are willing to change their minds and adopt new thought patterns and behaviors.
Humans are hard-wired to experience pleasurable feelings from eating and sex to ensure both personal survival and survival of our species. Food is different from other "addictive substances" – we can give up alcohol and cigarettes without endangering our survival, but we must eat to survive. It’s fair to say that we are all addicted to food for this reason. When we eat, dopamine is released, and we feel good, which is nature’s way of making sure we eat again.
If "addiction" is not driving overeating, what is? Overeating and binge eating are compulsive behaviors that involve food. An important purpose for compulsive behavior is to relieve stress and discomfort. The person who regularly overeats or binges uses food much in the way that some people use alcohol or drugs. But there is a very important difference. A person can abstain from alcohol and drugs for an entire lifetime, but cannot abstain from food.
Research shows that the particular substance that a person uses to reduce pain and discomfort is less important than the reason for use. This is why not all people who use drugs become addicted. During the early 1970s it was common for U.S. soldiers to use heroin while stationed in Vietnam. They often had to be admitted to detox centers to withdraw after returning home. After detox, over 90% of soldiers stopped using heroin and never used it again.
At the same time, heroin use was increasing in the U.S., but the situation concerning discontinuation was quite different. Addicts found it much more difficult to quit, and many were admitted to rehab centers multiple times and never stopped using drugs. What made this situation even more confusing was that the soldiers in Vietnam were using much stronger heroin than the heroin used by drug addicts in the U.S. American soldiers should have had a much more difficult time withdrawing, but they did not. The reason: Why people use heroin is more important than the physical action of the drug.
Soldiers were using heroin to deal with the horrors of war. When they returned home, the threat was gone, so the need for heroin was gone for most of them too. On the other hand, the reasons why many American addicts continued to use heroin remained unresolved, which is one of the reasons they returned to the drug time and time again.[1]
Conventional treatment for "food addiction" usually involves some form of abstinence from certain foods such as sugar, white flour, desserts, or bread. The rationale is that person can’t have any of these foods because eating them will "trigger" a return to abnormal eating patterns.
There are several problems with this strategy. The first is that abstention from particular foods rarely works. Sooner or later the person eats bread or cake or a cookie.
Another is that this strategy relies on perfectionism and all-or-nothing thinking, two of the most common cognitive distortions that drive people to seek therapy. Perhaps most important is that the success rate for abstinence programs overall is very low, even with substances for which there is more clear evidence of harm and addiction like drugs and alcohol. And abstention does not address the psychology of use. If it did, there would be no need for abstention.
The reality is that poor habits and carrying excess weight are indications of a bigger problem – life! Most chronically overweight, serial dieters, in addition to an abnormal relationship with food, have other issues and thinking patterns that interfere with success, such as, unrealistic goals and an inability to set boundaries.
The goal should be to help the overweight person change his or her thinking and behavior patterns AND to learn how to have a normal relationship with food. ALL people who want to have a normal relationship with food CAN have a normal relationship with food IF they are willing to change their minds and adopt new thought patterns and behaviors.
References:
[1] Lance Dodes MD, Zachary Dodes. The Sober Truth: Debunking the Ba Science Behind 12-Step Programs and the Rehab Industry. Beacon Press.
Pam Popper, Wellness Forum Health President
Americans have become the unhealthiest people in the world. They are taking more drugs than ever before, more are obese, and lifespans are shortening. In 1900, the average life expectancy for Americans was 47 years, and by 2019 it reached 79 years. But in 2020, U.S. life expectancy dropped to 77 years and in 2021, further dropped to 76.4 years, according to the CDC. (Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States) In fact, life expectancy in countries like Columbia is higher than in the U.S. (Lauren Irwin. US trailed dozens of developed nations for average life expectancy: research. The Hill November 7 2023 https://thehill.com/policy/healthcare/4298072-us-trails-developed-nations-average-life-expectancy/#:~:text=The%20U.S.%20ranked%20in%20the,around%20the%20world%20fell%20by%20 )
One of the major contributors to this downhill trend is the abandonment of personal responsibility for health, and the search for quick fixes like drugs and supplements and diets that lead to fast weight loss. Here’s what the quick fixes have in common: They don’t work, and they often make things worse. Take GLP-1 inhibitors for weight loss, for example. Wellness Forum Health has advised against these drugs since they were first approved in 2014, stating that they would lead to worsened health and even increased obesity in the long term. They were right. Recent evidence shows that while short-term weight loss is significant, changes in body composition while taking the drugs lowers metabolism and leads to other concerning health issues.
You might have seen Sharon Osborne in the news lately, sharing about her health situation due to taking this drug for weight loss. She knew nothing, nor was informed of, the terrible risks and side effects. Ozempic is a Type 2 diabetes drug, not to be used for weight loss.
According to trial results published in the New England Journal of Medicine, about 40% of the weight lost while taking GLP-1 inhibitors is muscle mass. Muscle burns more calories than fat – 14 calories per pound per day vs 3 calories per pound respectively. (Zurlo F, Larson K, Bogardus C, Ravussin E. "Skeletal muscle metabolism is a major determinant of resting energy expenditure." J Clin Invest 1990 Nov;86(5):1423-1427)
Loss of muscle mass can lead to physical instability and weakness, which can lead to disability and an inability to live independently. Frailty is one of the most common reasons for ending up in nursing homes. No one aspires to spend their final years in one of these places, but if you are not physically capable of living on your own, this is where you will end up.
When patients stop taking GLP-1 inhibitors, either due to economic factors, side effects or both – the rebound weight gain is fast and significant, and the person is even worse off than before taking the drug.
Maintaining a lean body is advantageous for health for several reasons, including:
People who have muscular bodies have a higher basal metabolic rate, which results in higher calorie burn, as mentioned before.
Muscles use glucose for energy, which helps with glucose control, which is particularly important since most obese people are diabetic or on their way to becoming diabetic.
Skeletal muscle serves as an endocrine organ, regulating hormones including those that enhance energy expenditure.
When patients stop taking GLP-1 inhibitors, either due to economic factors, side effects or both – the rebound weight gain is fast and significant, and the person is even worse off than before taking the drug.
Maintaining a lean body is advantageous for health for several reasons, including:
People who have muscular bodies have a higher basal metabolic rate, which results in higher calorie burn, as mentioned before.
Muscles use glucose for energy, which helps with glucose control, which is particularly important since most obese people are diabetic or on their way to becoming diabetic.
Skeletal muscle serves as an endocrine organ, regulating hormones including those that enhance energy expenditure.
The bottom line is that we can expect that the new weight loss drugs are going to create to a bigger problem than the mess created by opiates. Millions of people are taking them, and their weight loss is temporary at best. At some point, both the cost and the side effects will result in discontinuation for many, if not most. Companies with self-funded health plans are already starting to exclude coverage for them due to the expense. And multiple lawsuits have already been filed for injuries and deaths related to the drugs. In the future, doctors and medical centers may refuse to prescribe them due to liability concerns. What will happen to people who opted for this quick fix? They won’t just be back to where they started from, but worse off – because it will be even harder for them to lose the excess weight they’ve carried for a very long time.
The quick fix is never a real fix. It just postpones doing the things that have been proven to improve health – changing thinking patterns, adopting new diet and lifestyle habits, and taking responsibility for self. (Pam Popper, Wellness Forum Health)
According to a systematic review and meta-analysis that included 42 studies and almost 47,000 patients, cancer patients with high levels of muscle strength and cardiorespiratory fitness (CRF) had a lower risk from death from any cause. This relationship held true even for patients with advanced-stage cancers. All-cause mortality decreased by as much as 46% for patients who were fit, when compared with patients who were weaker and had lower CRF.
The authors wrote: "Assessing physical fitness, particularly muscle strength and CRF, is crucial for predicting mortality in cancer patients. Implementing tailored exercise prescriptions to enhance these physical fitness components throughout the cancer continuum may contribute to reducing cancer-related mortality."[1]
An even larger systematic review and meta-analysis included 12 studies with 1.3 million cancer patients and examined the relationship between muscle strength, CRF and cancer mortality. This review showed that muscle strengthening activities were associated with a 13% lower risk of mortality, and that mortality was even lower - 28% - when aerobic activity was included.
The authors wrote that this was likely based on several mechanisms:
Changes in body composition which lowered body fat. Excessive body fat is a risk factor for cancer.
Higher body fat also contributes to insulin resistance, which in turn leads to higher levels of insulin-like growth factor (IGF-1). Insulin and IGF-1 can increase cell proliferation and reduce cellular apoptosis.
Weight loss: obesity is correlated with negative changes to the intestinal microbiome, which results in increased production of pro-inflammatory molecules and hormones including estrogen.
Strength training increases muscle mass, which improves glucose control and improves immune function.
Physical activity improves circulation which reduces hypoxic environments in which tumors can thrive.[2]
A large body of evidence from many sources supports exercise as an integral part of a strategy for surviving cancer. Kelly Turner is the author of Radical Remission : Surviving Cancer Against All Odds. The book resulted from her interviews with almost one thousand patients with advanced cancer who survived. While they collectively used dozens of strategies, they all used nine, which were described in detail in the book. She subsequently started the Radical Remission Project to train coaches, conduct research, and gather even more survival stories. After she and her team worked with cancer patients for a few years, she added exercise and movement as the tenth important strategy that increases survival.
Many cancer patients are unhealthy and lack fitness at the time of diagnosis. Instead of encouraging them to improve their health and become fit, oncologists often insist that diet has nothing to do with cancer risk or survival, and many discourage physical activity, instead advising patients to rest. Friends and family often agree.
This was the case for Ruth Heidrich, one of the reality patients who appeared in the hit film Forks Over Knives. Ruth was diagnosed with metastasized breast cancer in her 40s. She not only survived, but thrived thanks to adopting a plant-based diet as recommended by Dr. John McDougall, and vigorous exercise. She said in the film that her friends were telling her, "Ruth, you’re a cancer patient, you should be resting." She responded, "I just knew that if I built a strong body, I could beat this." And she did, going on to compete in triathlons and run marathons well into her 80s.
Pam Popper, President
Wellness Forum Health
[1] Bettariga F, Galvao D, Taaffe D et al. "Association of muscle strength and cardiorespiratory fitness with all-cause and cancer-specific mortality in patients diagnosed with cancer: a systematic review and meta-analysis." Br J Sports Med 2025 Jan; published online ahead of print
[2] Nascimento W, Ferrari G, Martins CB et al. "Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies." Int J Behav Nutr Phys Act 2021 May;18:69
An article posted on Medscape compared the results of plant-based eating, bariatric surgery, and drugs like GLP-1 inhibitors for weight loss to determine which option led to the most long-lasting results. The clear winner: plant-based eating.[1] The article included data from several studies to support this conclusion. A systematic review and meta-analysis showed that 49% of patients who underwent bariatric surgery regained at least some of the weight they lost, and many patients regained a significant amount of weight. Those who were the worst off had Roux-en-Y bypass surgery, with 64% of those patients regaining weight.[2] I’ve written before about the dismal results for GLP-1 inhibitors, and the author of the Medscape article shares my concerns. One trial showed that patients taking the drugs lost weight, but one year after discontinuation, participants regained 2/3 of their weight back.[3] This is not surprising. Permanent weight loss can only take place when people commit to changing their habits, when they learn to make time for self-maintenance, and when they develop a normal relationship with food. Obviously, drugs cannot and do not result in these types of changes. Additionally, the side effects are heinous. Side effects include low blood sugar, nausea, heartburn, vomiting, stomach pain, diarrhea, constipation, sore throat, symptoms of stomach flu, dizziness, thoughts about self-harm, signs of thyroid tumor-like swelling or lump in the neck or trouble swallowing, symptoms of pancreatitis, gall bladder disease, kidney disease, and stomach paralysis.[4] The meds increase the risk for vision loss, which is not usually regained after discontinuation.[5] All of this sounds dismal, but there is a much better way to lose weight – plant-based eating, as the Medscape author concludes. A five-year study led by Dean Ornish, and published in 1998 compared a group of patients who consumed a plant-based diet, engaged in aerobic exercise, received training in stress management, and who had group support with a usual-care control group. The plant-based group lost almost 24 pounds at the end of one year and kept over half of it off 5 years after the intervention. The control group experienced worsening health with continued progression of coronary atherosclerosis.[6] Another study compared outcomes for patients who were obese or overweight with at least one comorbidity. One group consumed a low-fat whole food plant-based diet while the other received standard care. At 6 months, BMI reduction for the plant-based group was 4.4 vs 0.4 for the standard care group.[7] Other studies have shown similar results,[8] [9] and many report not only weight loss, but lower plasma cholesterol, lower blood pressure, reduced fasting glucose levels and other improvements in markers of health. These studies are over 20 years old, and none of them included portion control, which people do not like and almost never maintain. We don’t need more research; rather we just need to pay more attention to the existing body of evidence for guidance on how to help patients lose weight and improve their health. A major impediment is that there is so much less money to be made teaching people how to eat plants than there is in making, distributing and prescribing drugs. This can be changed, however, by forcing medical institutions and health professionals to follow informed consent laws. There are two ways to accomplish this; one is to teach patients to demand objective information from their providers BEFORE making any health-related decisions in non-emergency situations. We teach our members to do this on their own since real INFORMED discussions rarely take place in medical offices. The other option is lawsuits against health professionals and institutions that do not do this. If failure to make informed consent an integral part of medical care becomes expensive enough, providers and institutions likely will change. In the meantime, here is what a doctor SHOULD tell an overweight or obese patient about his/her situation and choices. "I’m concerned about your weight, because it places you at significantly higher risk of coronary artery disease, cancer, diabetes, musculoskeletal disorders, and premature death. I strongly encourage you to do something about this before it gets worse. There are three options. I’ll tell you about each and then send you home with some written material to study. #1: Bariatric surgery. There are significant side effects, and you will likely gain back some or all of the weight you lose. You will suffer from severe nutritional deficiencies that cannot be resolved with supplements. You will eat tiny amounts of food for the rest of your life and if you revert to eating larger portions you will feel sick for a while, stretch out the stomach again, and end up back where you started from. #2 Weight loss drugs, like GLP-1 inhibitors. Side effects include low blood sugar, nausea, heartburn, vomiting, stomach pain, diarrhea, constipation, sore throat, symptoms of stomach flu, dizziness, thoughts about self-harm, signs of thyroid tumor-like swelling or lump in the neck or trouble swallowing, symptoms of pancreatitis, gall bladder disease, kidney disease, and stomach paralysis. If you stop taking the drugs, you’ll likely regain most if not all of the weight you lost, and the side effects may not go away. #3 I can teach you how to eat delicious, low-fat plant food 3-6 times per day – as much as you want of it. You’ll need to invest some time in learning how to do it right, and how to shop and cook. You’ll have to change your mindset about food, and perhaps address psychological issues that cause you to overeat. But if you do this and stick with it, you’ll achieve normal weight, and if you are taking drugs for conditions like blood pressure and type 2 diabetes, you will probably be able to discontinue them. Which would you like to do?" I think most people would choose option three. From Pam Popper, President Wellness Forum Health [1] Betya Swift Yasgur. Nutrition, Drugs, or Bariatric Surgery: What’s the Best Approach for Sustained Weight Loss? Medscape Jan 10 2025 https://www.medscape.com/ [2] Reis MG, Guimaraes LF, Moreira G et al. "Weight regain after bariatric surgery: A systematic review and meta-analysis of observational studies." Obesity Med 2024 Jan;45:100528 [3] Wilding JPH, Batterham RL, Davies M et al. "Weight regain and cardiometabolic effects after withdrawal of semaglutude." Diab, Obes, Metab 2022 Apr;24(8):1553-1564 [4] https://www.drugs.com/ozempic. [5] Hathaway JT, Shah MP, Hathaway DB. Et al. "Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglitude." JAMA Ophthalmol 2024 Jul;142(8):732-739 [6] Ornish D, Scherwitz LW, Billings JH et al. "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease." JAMA 1998;280(23):2001-2007 [7] Wright N, Wilson L, Smith M, Duncan B, McHugh P. "The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes." Nutr Diabetes 2017 Mar;7(3):e256 [8] Barnard N, Scialli A, Turner-McGrievy G, Lanou A, Glass J. "The effects of a low-fat, plant-based dietary intervention on body weight, metabolism and insulin sensitivity." Am J Med Sept 2005;118(9):991-997 [9] Barnard N, Scialli A, Turner-McGrievy G, Lanou A, Glass J. "The effects of a low-fat, plant-based dietary intervention on body weight, metabolism and insulin sensitivity." Am J Med Sept 2005;118(9):991-997 |
