Eating every two hours is a modern-day diet. It is considered an ideal diet to promote weight loss while eating anything you want. The rapid weight loss can come at a cost, and well get to that in a moment.

The idea behind eating every two hours is to boost metabolism. Youll hear those advocating for the two-hour diet speaking about eating sweets safely as eating every two hours helps to keep your blood sugar stable. The reason for this is that your blood sugar rises when you eat something sweet, and just as its starting to spiral down, you eat something again. You dont really feel hungry as you are always eating a little food every two hours.

All of this does sound quite ideal. So, what could be wrong with this diet?

To consider this, lets explore this from two different perspectives. The first is Ayurveda and the second is functional medicine. Lets go back to ancient wisdom. Eating every two hours is not a time-tested practice. It is not a part of local Indian mannerisms of food and eating. This is where the problem lies.

1.Ayurveda is Indias ancient natural system of healing. It does not focus on symptoms or disease but is a holistic practice. The approach is that all life must be kept in balance, and that good health is the harmonious functioning of the entire individual. One of the four pillars of Ayurveda is Ahar. Ahar refers to nutrition, and for a functional diet, we require strong Agni, easy digestion, and proper elimination. We are not going into this in detail, but we need to look at Agni to provide context for understanding the two hourly diet.

2.Any food we eat is only useful to us if Agni is strong. If it is not strong, we end up with Ajeerna, or indigestion. That leads to accumulation of Ama, or toxic waste, and then we trigger disease.

3.Agni is the key to healthy living. Agni creates digestive enzymes, helps us assimilate nutrients, gives us glowing skin, improves mental clarity, supports enthusiasm, helps us assimilate nutrients for body tissues, regulates body temperature, produces Ojas or vitality, balances appetite, regulates our weight, ensures good sleep, and so much more. It is the fire element that is responsible for digestion. Without balanced agni, anything that we eat can lead to indigestion, accumulation of toxicity, and disease.

4.In ancient Ayurvedic texts, recommendations to keep Agni balanced include sitting down and eating mindfully, chewing food until its liquid, having warm food, staying relaxed, and eating only three meals a day at a maximum, with no snacks. This is the key point we must consider. One of the major causes of disruption to Agni is eating frequently with a gap that is less than 4-5 hours in between two meals.

We cannot refute ancient texts that are rich in knowledge and time-tested wisdom. If we consider the benefit of rapid weight loss with eating every two hours, we must also consider all the negative effects of following such a diet. Healthy Agni is linked to keeping the whole constitution balanced.

To understand the science, we need to look at something in our body called the migrating motor complex.

However, there can be long term challenges which are often ignored.

2.The migrating motor complex is a pattern of electromagnetic activity observed within your gastrointestinal tract during gaps between meals. Think of it as waves of cleansing peristalsis that occurs every hour and a half to almost four hours. It is your intestines way of deep level cleansing, and it can only occur if there is a gap between meals. It is required for deep cleansing of your gastrointestinal tract. It is required to maintain healthy function of the gastrointestinal system. Healthy functioning of the MMC is required for gut motility. Your migrating motor complex sweeps through and cleanses the small intestine so that there is no residual food.

3.When you eat every two hours, you prevent optimal functioning of the migrating motor complex and this can increase your risk for gut infections like Small Intestine Bacterial Overgrowth or SIBO, which will show up as diagnosis of IBS. SIBO cases have been found to have disrupted functioning of the migrating motor complex. Disrupted MMC function. Can cause nerve damage. Disruption of the MMC also leads to bacterial buildup.

4.More and more research shows that you need a gap of 4-5 hours between meals. Ayurveda has always brought attention to avoiding too many snacks. Therefore, this is not a long-term dietary approach. It can be therapeutic as an approach to stabilise adrenal function.

Like anything else, we must consider that we are all unique. However, here is what I could suggest as a broad framework. If you are just beginning with your health journey, and struggling with blood sugar issues and adrenal issues, it can be helpful to eat more frequently.

However, working with someone who can help you to improve blood sugar balance and your own physiology is important.

(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.)

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The pros and cons of two-hour diet plan, as per Ayurveda - YourStory

Hemp seeds are a plant-based source of complete protein that provides a range of nutrients. It is an excellent option for individuals who want to add more protein to their diet while avoiding animal products.

Hemp protein comes from the hemp plant, which is the same species as the cannabis plant. However, unlike cannabis, hemp contains only traces of tetrahydrocannabinol (THC). THC is the intoxicating compound that creates a high.

Hemp is the source of cannabidiol or CBD oil, but its seeds are also a rich source of plant-based protein. Manufacturers make hemp powder by grinding hemp seeds into a fine, earthy tasting powder.

This article looks at hemp protein, its nutrition, and its health benefits. It also compares hemp protein to other protein powders and looks at alternative plant protein sources.

Learn all about the hemp plant here.

Hemp protein is a complete protein, meaning it contains all nine essential amino acids that the human body needs but cannot produce. Therefore, an individual must include these amino acids in their diet.

Some experts claim that hemp seed is one of the most nutritionally complete food sources. People can consume hemp seeds either whole or without the hull or in various hempseed products, such as oil, flour, and protein powder.

Studies have found that the nutritional value of hemp seed varies considerably according to the environment it grew in and what specific plant type it is. However, typically, its nutritional profile contains:

The most abundant protein in hemp seed is edestin, making up around 82% of total hemp protein content. Albumin makes up around 13% of the total protein, while -conglycinin constitutes up to 5% of the total.

Together, these proteins contain the nine essential amino acids. The most abundant is glutamic acid, followed by arginine. Hemp protein has more sulfur-containing amino acids, such as methionine, cysteine, and homocysteine, than soy protein and milk protein casein.

Hemp protein also contains higher levels of amino acids than soy protein, except for aspartic acid, glutamic acid, and lysine. Lysine is the primary shortfall in hemp proteins.

According to the U.S. Department of Agriculture National Nutrient Database, a 31 gram (g) serving of hemp protein powder contains 12 g of protein and 120 calories.

Learn more about essential amino acids here.

Hemp protein has various health benefits, including:

Although humans typically digest animal protein more easily than plant protein, research indicates that individuals can readily digest hemp protein.

This may be because hemp protein is high in edistin and albumin, which the body can digest easily. The body breaks down these foods and uses a large proportion of the amino acids in various processes, such as tissue repair and cell maintenance.

When hemp protein undergoes heat treatment, it becomes even more digestible.

Learn about the differences between plant and animal protein here.

Eating enough dietary fiber supports digestive health and reduces the risk of heart disease, obesity, type 2 diabetes, and certain cancers.

Consumption recommendations range from 1938g a day, depending on someones gender and age. However, around 95% of people in the United States do not consume anywhere near this amount of fiber.

Individuals might consider adding hemp protein to their diets to improve their fiber intake, as a 31 g serving contains around 11 g of fiber.

Learn more about the importance of dietary fiber in the diet here.

Hemp protein contains unsaturated fats. A 31g serving contains around 2g of fat, most of which is healthy polyunsaturated fatty acids (PUFAs).

The polyunsaturated fatty acids in hemp protein include linoleic acid (omega-6) and alpha-linolenic acid (omega-3). The body cannot synthesize these fatty acids, so they must come from a diet resource.

Omega fatty acids are essential for health as they help maintain cell membranes, contribute to heart health, and regulate inflammation and metabolic processes.

Learn about dietary sources of omega-3 fatty acids here.

Protein powders are either plant-based or animal-based. Besides hemp protein, other popular choices include whey protein and soy protein.

The protein and calorie content in 100 g of these proteins are:

Although whey protein is high in protein, it is also an allergen. Therefore, people who are sensitive or allergic to dairy products may need to avoid this source of protein. Likewise, soy allergies are relatively common. However, typically, experts do not consider hemp an allergen, and some suggest it is suitable as an ingredient for hypoallergenic food.

Additionally, whey protein is not vegan and cannot supplement vegan diets. However, hemp and soy products are suitable for vegetarians and vegans.

Hemp and soy proteins derive from plants and are complete protein sources. However, people may prefer to opt for hemp as it is less processed, unlikely to trigger allergies, and is easily digested.

Learn more about suitable proteins for vegans here.

If individuals do not enjoy the taste of hemp protein, there are other ways to consume hemp seeds and benefit from its health-supporting properties, including:

Learn about some of the best plant-based protein sources.

If a person wants to increase their protein intake while reducing their use of animal products, they can find a range of alternative plant protein sources. Options include:

Although an individual can add protein powders to their daily routine to boost their intake, they should not use them in place of a nutritionally balanced diet.

People should also consider that over-consuming dietary protein can have adversely affect metabolism and gut health.

It is also worth noting that protein powders may contain various added ingredients, such as sugar or sodium, to improve their taste. People should carefully read nutritional labels if they want to avoid these additives.

Learn about the dangers of consuming too much sugar here.

Hemp protein comes from the seeds of the hemp plant. It is a rich source of fiber and polyunsaturated fatty acids that the human body finds easy to digest.

A 31 g serving of hemp protein contains around 12 g of protein and 11 g of fat, depending on the source of the hemp plant and the environmental conditions it grew in.

If people prefer not to consume hemp protein, they can add hemp seeds to baked goods, soups, salads, or make hemp milk and add to drinks.

Hemp protein contains less protein than whey and soy protein. However, it is suitable for vegans, people with soy or milk allergies, and those who prefer to avoid highly processed foods.

Originally posted here:
Hemp protein: Nutrition, health benefits, and more - Medical News Today

Welcome toIn Season,our series celebrating the juiciest fruit and crispest veggies in Texas. This winter, we asked local chefs to share stories about their favorite items of seasonal produceand create original recipes that make the most of winter bounty.

Chris Williams loves squash. Growing up, the chef and owner of Lucilles in Houston was introduced to the winter produce in a way many Southerners first meet it: smothered in brown sugar in a casserole. Since then, Williams has come to appreciate squash for its subtle yet pleasing qualities. I like it on its own now, Williams says. I like any type of squash. You can grill it, salt it, and then serve it.

Williamss recipe for roasted acorn squash stuffed with collard greens and quinoa showcases the fruit (yes, squash is a fruit!) without drenching it in butter and dusting it with sugar.

This dish in particular was born out of my fathers heart issues, he says. He had to go on an all-vegan diet. Im used to my father being a staple in my restauranthes always there. And then when he went on this diet, he wasnt there.

This change in his dads dietary needs inspired Williams to adjust his thinking about the way he cooks.

When my dad was put on this diet, I started coming up with ways to get him back into the restaurant safely and responsibly, Williams says. Lucilles touts Southern staples like steak smothered in gravy and fried catfish with grits. I was thinking about flavors that he likes and things that he was eating and trying to figure out a way to put it all together in a way that was refined and delicious. Thats what the dish was born out of. He embraced the challenge of finding new and delicious things to eat that make him happy, and this hit all the marks for him.

Williams says this recipe is the third iteration of the original version he made for his dad. The dish is vibrant and deliciousa perfect addition to your table during cooler months in Texas.

Serves 4

2 acorn squashes, halved and seeded2 tablespoons honey2 teaspoons curry powder teaspoon cayenne pepper cup lemon juice cup canola oil1 teaspoon salt

1 teaspoon olive oil1 garlic clove, minced1 bunch collard greens, cleaned and roughly chopped2 Anjou pears, peeled and small diced (hold in water with lemon after dicing)2 cups cooked red quinoa (hold chilled after cooking) cup cooked chickpeas1 tablespoon kuchela, a hot Trinidadian relish (or more, to taste)1 teaspoon sherry vinegar cup pomegranate seeds

4 garlic cloves1 cup red bell peppers, roasted, peeled, and chopped2 ounces almonds, roasted cup curly parsley, chopped2 teaspoons cumin2 tablespoons smoked paprika2 tablespoons sherry vinegar cup olive oil

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Recipe: Roasted Acorn Squash Stuffed With Collards and Quinoa - Texas Monthly

If a person has diabetes, it is important that they get enough exercise. Physical activity can help control blood sugar levels and lower an individuals risk of developing complications from their diabetes, such as heart disease and nerve damage.

Regular exercise is essential for overall health. According to the Centers for Disease Control and Prevention (CDC), people should aim for at least 150 minutes of moderate-intensity physical activity each week.

This remains true for individuals with type 1 diabetes, a condition that hinders the bodys ability to produce the hormone insulin. This can lead to high blood glucose levels, which people need to manage with a combination of medications and lifestyle, including diet and physical activity. Unlike type 2 diabetes, type 1 diabetes is irreversible and requires lifelong management.

Exercise can impact a persons blood sugar levels and cause people with diabetes to experience very low blood sugar. Several studies suggest that this is why many individuals with the condition may not want to participate in as much physical activity as experts recommend.

Not getting enough exercise can lead to several health concerns. Despite the potential effects of exercise on blood sugar levels, it is possible for people with diabetes to safely manage blood sugar levels while still maintaining an active lifestyle.

Read on to learn how to exercise safely with type 1 diabetes, which exercises to choose, and how to manage blood sugar levels.

People with type 1 diabetes need to exercise regularly to help manage their condition. The benefits of frequent exercise apply to everyone, including those with diabetes, and they include:

Anyone with type 1 diabetes who is new to exercise or who has not regularly exercised for some time should get medical clearance from their doctor first, according to American College of Sports Medicine guidelines.

It may help to speak with healthcare professionals so that they can help devise an appropriate physical activity plan.

The Centers for Disease Control and Prevention (CDC) recommend types of activity that meet the criteria for moderate-intensity physical activity, including:

These kinds of exercise are suitable for most people, including those with type 1 diabetes.

Individuals who have not been active recently or have never been active should start slowly and gradually build up the intensity and duration of their workouts over time.

Anyone who has not regularly exercised for some time should take rest days between workouts if necessary, depending on the intensity and duration of the physical activity.

According to the CDC, people with diabetes should be particularly mindful of certain factors, such as:

If a person has high blood sugar before they exercise, they should check their blood or urine for ketones.

If ketones are present, the American Diabetes Association (ADA) recommends avoiding vigorous activity.

If people exercise when they have high ketone levels, they risk developing ketoacidosis, a life threatening complication of diabetes that requires immediate medical attention.

Depending on the type and duration of workouts, a person may notice that their blood glucose levels rise (hyperglycemia) or drop (hypoglycemia).

Exercise lowers blood sugar, both acutely and over time, in two distinct yet equally important ways: by increasing insulin sensitivity and by allowing glucose to enter cells without insulin.

According to the ADA, this means that a persons muscles can use available insulin to take up glucose both during and after a workout.

Additionally, physical activity helps cells burn glucose for energy as the muscles contract. Being active allows glucose to leave the bloodstream and enter cells that require energy, resulting in a drop in blood glucose, regardless of whether insulin is available.

High-intensity exercise can increase the levels of hormones, such as epinephrine and glucagon, in the body, which can then increase blood glucose levels, according to an older study from 2009. Doctors call high blood glucose hyperglycemia.

To prevent this, if a person has high blood sugar before they exercise, they should measure their levels more often during exercise. Adequate hydration can prevent the concentration of sugar in the blood from becoming too high.

If individuals have high blood sugar after exercise, they should measure their ketone levels. If these ketone levels are high, they should speak with their doctor. It is crucial to avoid physical activity when ketone levels are high to prevent life threatening ketoacidosis.

Doctors call low blood sugar hypoglycemia, which some may experience after working out. It is important to ensure that people always have a source of carbohydrates on hand, so they are ready to treat hypoglycemia immediately.

Blood glucose levels can drop for up to 24 hours after a person has completed their workout, so people should take care to monitor their levels.

If individuals have recurring issues with low blood sugar after working out, they should speak with a doctor. They may need to adjust their insulin intake to prevent them from developing low blood sugar levels.

If a person notices they are becoming hypoglycemic, either while working out or afterward, they should immediately consume a carbohydrate-rich snack.

Experts define hypoglycemia as a reading of under 70 milligrams per deciliter (mg/dl). The CDC recommends people raise their blood sugar levels with the 1515 rule by eating 15 grams (g) of carbs and checking blood sugar levels after 15 minutes. They should then repeat these two steps until the blood sugar levels return to their usual range.

Fast-acting carbohydrates suitable for treating low blood sugar include:

People should always read the labels of foods they consume when treating hypoglycemia. They need to check the grams of carbohydrates per serving and make sure they do not contain high levels of other macronutrients such as fiber, fat, and protein. These can slow the absorption and effect of carbohydrates on blood sugar levels.

To treat hypoglycemia, people should look for foods that contain only carbohydrates in their simplest form, which is sugar. However, this advice only applies when consuming food to treat hypoglycemia and is inappropriate nutrition advice for regular eating.

Without treatment, hypoglycemia can become more serious.

Severely low blood sugar levels are untreatable using the 1515 rule, and injectable glucagon is the best way to address severe hypoglycemia.

Additionally, glucagon emergency kits are available on prescription, and a person may wish to teach others they exercise with on using them in emergencies. This is because when someone is severely hypoglycemic, they may lose consciousness and be unable to administer the kit themselves.

People with type 1 diabetes should always check their blood glucose levels before working out.

If a persons blood sugar is lower than 100 mg/dl before exercising, they should eat a small snack, which should be rich in carbohydrates and contain around 15 g of carbs.

The following snacks contain around 15 g of carbs per serving size:

If a person exercises over an extended period, their blood sugar levels will likely drop during their workout.

With this in mind, people should regularly check their blood glucose levels and take snack breaks if necessary.

Experts recommend consuming additional carbohydrates after every 3060 minutes of exercise.

Exercising with type 1 diabetes does not have to be difficult.

With some extra precautions, people with the condition can maintain an active lifestyle, leading to a lower risk of complications and health conditions.

However, it is important that individuals with type 1 diabetes monitor their blood sugar levels during and after workouts to ensure they stay at safe levels.

Read more here:
What to know about exercising with type 1 diabetes - Medical News Today

The NHS outlines a number of other lifestyle changes you may be able to make to lower your cholesterol.

A key one is to cut down on alcohol. You should try to avoid drinking more than 14 units of alcohol a week, and avoid binge drinking. You can ask your GP for help if you are struggling to cut down.

There are two main types of fat: saturated and unsaturated. Eating too many foods high in saturated fat can raise the level of cholesterol in your blood. The NHS says most people in the UK eat too much saturated fat.

The American Heart Association says that in general, red meats (such as beef, pork and lamb) have more saturated fat than skinless chicken, fish and plant protein, and can raise your blood cholesterol and increase your risk of heart disease.

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How to live longer: The spice which may ward off cancer and heart disease - study findings - Daily Express

When it comes to weight loss or maintenance, of course, what you eat is crucial, and some research suggests when you eat is important, too. But a new study in Scientific Reports suggests another big component of your eating habits can help: chewing food more slowly.

To determine the potential effects of slow chewing, researchers asked 11 healthy, normal-weight men to go through three trials: drinking liquid food normally every 30 seconds, drinking liquid food but keeping it in their mouths for 30 seconds before swallowing, and chewing food for 30 seconds before swallowing.

All three approaches resulted in the same level of fullness, but it was the slow chewing that turned out to be unique, because it increased what's called diet-induced thermogenesis, or DIT. This refers to how much heat is generated in the body after eating and how it affects your metabolic rate. A low level of DIT tends to promote weight gain, while a high level has the opposite effect.

Even though it might seem like a minor action, increased chewing among participants elevated their DIT and the researchers noted that the difference per meal or snack might be small, but the cumulative effect done every time you eat could be substantial.

Related: The #1 Best Juice to Drink Every Day, Says Science

Although the study has limitations based on its small sample size, it's not the first to make the connection between slow eating and weight loss or maintenance. For example, a clinical trial published in the Journal of the Academy of Nutrition and Dieteticsfound that increasing the number of chews before swallowing reduced meal sizes in part because people ate for longer, and that led to eating less.

Another study in Frontiers in Psychology suggests there may be a mental component as well. In that research, participants who paid more attention to chewing showed a change in their brain's reward circuits, which led to less impulsive eating behaviors.

Another benefit to slow eating is becoming more mindful about what you're eating, and simply enjoying the taste more, says New York-based dietitian Vanessa Rissetto, R.D., co-founder of Culina Health. She says it can feel overwhelming to try to eat every single bite with mindful attention, but like a meditation exercise, start with a modest attempt.

For example, try being mindful of your next three bites of food. As you work the strategy into your eating more often, you're more likely to get to that other big question around food, which can help you improve your eating habits in order to achieve your weight loss goals.

"Are you eating because you're actually hungry, or it because you're bored, stressed, or tired?" says Rissetto. "Are you feeding into that habit loop where a sugary item makes you feel good, so you just grab one because you're on autopilot? Understanding why you're eating makes a big difference."

With that much awareness, it can lead to healthier eating habits without feeling deprived along the way, she adds.

For more, check out The Best Dinner Combinations for Faster Weight Loss.

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This Secret Trick Can Help You Start Losing Weight Immediately, Says New Study Eat This Not That - Eat This, Not That

Time is money and health is wealth. Since two of our most important assets, health and time are directly related to ones wealth, what does one prioritize? Considering the kind of lifestyles that we are all a part of, it is difficult to find time for anything including ones health. Sedentary and fast paced lifestyles have left us with weight issues, related problems and little time to keep fit. Being overweight is not just an issue in itself, but is the root of several other health conditions that can complicate health.

Bloating, though, is remotely connected to the weight gets as much attention as weight gain. A bloated stomach does not always mean you are over weight, but it can give out an impression of being so. Also, bloating makes you uncomfortable all the time. Hence, it is essential to control bloating so that your belly remains in the normal shape and does not make you uncomfortable.

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Weight loss: Try this concoction to battle bloating and get a flat belly - Times of India

Though they were inspired to lose weight for different reasons, Todd and Julie Chrisley have enjoyed losing weight together. For Julie, losing weight has been a long process that began after she went through early menopause as a result of her breast cancer treatment. "I'm a breast cancer survivor and because of that I also went through menopause early," Julie told People in an interview published on Wednesday. "I felt like the chips were stacked against me and I was gaining weight."

Julie had previously lost 20 pounds with Nutrisystem, but since teaming up with Todd to become an ambassador for Nutrisystem's Partner Plan, has lost an additional 10 pounds. After seeing Julie's success with Nutrisystem, Todd, who had noticed that he had packed on a few pounds during the COVID-19 pandemic, began his own weight loss journey with Nutrisystem. "I am proud to say I've always maintained the same weight I was in high school," Todd told People. "But after having COVID back in March 2020, it was like my metabolism just came to a screeching halt." Since embarking upon his weight loss journey with his wife, Todd has lost 18 pounds.

Their shared weight loss journey has made the couple even closer. "It has made us closer because it's something that we talk about," Julie told theDaily Mail. "And it's kind of like a competition. ... I think Todd and I consider ourselves partners in everything we do. So to be able to incorporate Nutrisystem and be one other thing that we're partners with, I think is amazing."

Link:
The Truth About Julie And Todd Chrisley's Weight Loss - The List

Weight loss can prevent, delay, or reverse type 2 diabetes, but it can be very hard to achieve and maintain. Thats why the approval of semaglutide to treat obesity is causing such excitement.

The diabetes medication semaglutide was recently approved to treat obesity, and other potentially effective obesity medications are in the pipeline. Susan Z. Yanovski, MD, discusses the critical need for effective ways to treat and manage weight for people with diabetes. She also describes semaglutide and other new medications that could make weight loss more feasible for more people with type 2 diabetesif barriers to their use can be overcome.

Q: How are overweight and obesity linked to type 2 diabetes?

A: Overweight and obesityare strong risk factors for type 2 diabetes. About 80% of adults with type 2 diabetes also have overweight or obesity. Greater levels of obesity confer higher risk for the disease.

In type 2 diabetes, both insulin resistance and reduced pancreatic beta cell function lead to elevated blood glucose. Insulin resistance is very common in people with obesity, who frequently develop impaired glucose tolerance and prediabetes before the diabetes developssometimes years beforehand. In fact, almost 35% of U.S. adults have prediabetes. Eventually their beta cells cant keep up with the increased demand to maintain healthy blood glucose levels in the target range, and they develop diabetes.

Q: Can weight loss prevent or delay the onset of type 2 diabetes?

A: Yes. Even a relatively modest amount of weight loss can prevent or delay diabetes. We know this from the National Diabetes Prevention Program. We also know from studies that the use of anti-obesity medications can also reduce the risk of prediabetes progressing to diabetes. With larger amounts of weight loss, for example from bariatric surgery, remission of type 2 diabetes can occur with a return to healthy blood glucose levels in some patients.

Q: What is the history of medications to manage weight?

A: Unfortunately, anti-obesity medications have had a history of safety problems, which led to several medications being withdrawn from the market. In addition, the amount of weight loss with anti-obesity medications that were approved prior to 2021 has been modest, ranging from an additional 3 to 9 percent loss of initial weight compared with placebo. Thats less than most patients and clinicians would consider acceptable. The greater the weight loss, the greater the reduction in most obesity-related comorbid conditions.

According to the Government Accountability Office, only about 660,000 of more than 70 million Americans with obesity used prescription weight-loss medications from 2012 through 2016. And only about 3% of U.S. adults who are trying to lose weight reported taking those medications between 2013 and 2016.

Q: Semaglutide was approved for weight management by the FDA in June 2021; it had previously been approved as a diabetes medication. What is this medication?

A: Semaglutide belongs to the glucagon-like peptide (GLP-1) receptor agonist class of medications. These are incretin hormones that improve glycemic control by stimulating insulin secretion in response to food intake and hyperglycemia. This lowers both post-meal and fasting blood glucose. Semaglutide is one of several GLP-1 receptor agonists approved to treat diabetes, as second-line agents after metformin.

At the dosage approved for diabetes, GLP-1 receptor agonists not only lower blood glucose, but also reduce weight by about 3-5% of initial weight. Scientists believe this occurs because the medications reduce appetite and they slow down gastric emptying, which can increase a sense of fullness and decrease hunger. In addition, semaglutide and another medication in this class, liraglutide, reduce risk of major adverse cardiovascular events with diabetes.

The weight-loss results in patients prescribed GLP-1 receptor agonists to treat diabetes inspired research to see whether higher dosages would produce even more weight loss. Following this research, liraglutide was approved in 2014 and semaglutide in 2021 to treat obesity, both at higher dosage than that used to treat diabetes. Liraglutide is administered as a daily subcutaneous injection, while semaglutide is injected once weekly.

Q: Why is the health care community particularly excited about semaglutide?

A: The excitement about semaglutide is due to its efficacy for weight loss in people with obesity. At the full dosage of 2.4 milligrams, you see an average weight loss of about 15% of initial body weight, compared to most obesity drugs where you find a 5-10% weight loss. The other reason for excitement is because of the percentage of people who lost really large amounts of weight, with about a third of people losing at least 20% of their initial weight, an amount approaching that seen with some types of bariatric surgery.

These findings came out of the STEP research trials; STEP stands for Semaglutide Treatment Effect in People with Obesity. In the research trials, people with diabetes who received semaglutide with behavioral treatment had somewhat less weight loss than people without diabetes. However, they did lose an average of almost 10% of their initial weight after one year on the medication, which was about 6% more than those who received a placebo.

The STEP trials also looked at what happens when people continue with or discontinue semaglutide after 1 year. They found that when people were switched to a placebo, they regained much of their lost weight, whereas those who stayed on semaglutide continued to lose weight and stabilized their weight loss at about 15% of their initial weight. Results from a follow-up study of semaglutide versus placebo showed that this weight loss can be sustained for at least two years. This reinforces the idea that you really need to treat obesity as you would any other chronic disease.

Q: What do health care professionals need to consider when prescribing semaglutide as a medication to manage weight for patients with diabetes?

A: Clinicians need to consider the patients other medications and medical conditions. For example, they shouldnt be prescribing semaglutide if the patient is taking another GLP-1 receptor agonist or a dipeptidyl peptidase 4 (DPP-4) inhibitor. The patient also shouldnt use any GLP-1 receptor agonist if they have a personal or family medical history of medullary thyroid cancer or recurrent pancreatitis. Any of the contraindications for GLP-1 receptor agonists when prescribing to treat diabetes will apply when prescribing to treat obesity.

Also, if the patient is on another anti-diabetes medication that can cause hypoglycemia, such as insulin or a sulfonylurea, they will need to be carefully monitored. Its likely that the dose will need to be adjusted when adding semaglutide, to reduce the risk of hypoglycemia.

Q: What is the cost of semaglutide, and will this be a barrier to uptake?

A: Cost is a major concern for use of all prescription medications to treat overweight and obesity. Theyre often excluded from reimbursement by insurers, including Medicare, some state Medicaid programs, and many private insurers. Most people taking anti-obesity medications pay for them out of pocket, and they can be very expensive.

Thats why the most prescribed obesity medication is phentermine, which is a generic medication thats only approved for short-term use and has not been tested in long-term studies. A medication like semaglutide, with the cost of about $1,300 a month, is going to be prohibitive for many patients who could benefit. Cost may also even be a barrier for patients with insurance that covers the medication, because of copays.

However, reimbursement is better for semaglutide when prescribed at the lower dose levels to treat diabetes. Were fortunate that we now have medications in two classes, sodium-glucose co-transporter-2 (SGLT2) inhibitors and GLP-1 receptor agonists, that have been shown to reduce major adverse cardiovascular events and have a favorable impact on weight when used by patients with type 2 diabetes. When clinicians are adding medications to metformin to improve glycemic control in patients with overweight or obesity and type 2 diabetes, they may want to consider either an SGLT2 inhibitor or a GLP-1 receptor agonist.

Q: What other weight-loss medications are in the research pipeline?

A: Its an exciting time for the development of new obesity treatments. Just this past year, setmelanotide was approved for adults and children with some rare forms of genetic obesity. This drug isnt appropriate for most people because obesity usually has multiple causes, not just alterations in single genes. However, it demonstrates the promise of targeting anti-obesity therapy to specific underlying mechanisms, which is a step towards precision obesity treatment.

There are also new incretin medications being developed that target more than one receptor, both to treat diabetes and obesity, including one called tirzepatide. The results of Phase 3 studies were presented at the American Diabetes Association meeting in summer 2021, and it showed very high efficacy for both glycemic control and weight loss. Were still waiting for more data from studies of these other medications; they are not yet approved for diabetes or obesity treatment.

Watch the JAMA Network video featuring Dr. Yanovski, Pharmacotherapy for Obesity.

How do you discuss medications to manage weight with your patients with diabetes?

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What's New in Medications for Weight Management for People with Diabetes | NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases...

Eating carbs as leftovers rather than hot and freshly cooked might help with weight loss , registered nutritionist Rhiannon Lambert told Insider.

When we eat carbohydrates, they are broken down in the gut and absorbed as sugar, which raises blood glucose levels.

However, when cooked carbs like pasta, potatoes, and rice are cooled, a type of fiber called resistant starch increases in the food, Lambert said.

"Resistant starch is the starch that resists digestion. It doesn't get digested in the small intestine and then goes on to ferment," she said.

Having a lot of resistant starch in the diet is good because it doesn't quickly convert into sugar, she said.

The resistant starch stays increased even if leftovers are reheated before being eaten, and it means that the carbs' fiber content is higher, which in turn causes fewer blood sugar spikes.

Dr. Chris van Tulleken, a researcher who has studied resistant starch, previously told the BBC that the temperature of food could help make meals more fiber friendly.

"We can convert a carb-loaded meal into a more healthy fiber-loaded one instead without changing a single ingredient, just the temperature. In other words our leftovers could be healthier for us than the original meal," he said.

Stable blood sugar levels aid weight management and decrease cravings caused by low energy, registered dietitian Alexandra Rowles wrote for Healthline.

And there is evidence that suggests reheated carbs can prevent blood sugar spikes.

A small 2014 study, authored by Dr. Denise Robertson from the University of Surrey and Van Tulleken, found that eating cooked, chilled, and reheated pasta caused the smallest spike in blood sugar, compared to pasta that was freshly cooked, or cooked then eaten cold.

Another small 2015 study by the University of Indonesia on white rice drew the same conclusion.

Be careful when reheating rice though in her book "The Science of Nutrition," Lambert recommends cooling and refrigerating within an hour of cooking, reheating thoroughly, and eating within a day to prevent bacterial spores from forming.

Eating more resistant starch could also increase feelings of fullness and satiety, according to a 2015 study.

To boost the resistant starch in bread, Lambert recommends freezing slices and toasting straight from frozen.

"If people are on a body fat loss mission and they're looking at leveling their blood sugar levels, or if they're looking at their productivity and avoiding afternoon slumps, it could be beneficial to try and consume more resistant starch," she said.

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Eating leftover, reheated carbs can aid weight loss: nutritionist - Insider