United News of Bangladesh

Weight-loss drugs are not the quick fix solution that many people believe, especially if you hope to keep the pounds off in the long-term. Sarah Le Brocq has direct experience of the transformative effects of weight-loss drugs. She has lived with obesity for most of her adult life and tried numerous diets. "Anything that came out, I thought, 'I'll try that because that might work for me'." Unfortunately, the weight always came back, she told the BBC's Inside Health. After taking weight-loss drugs for more than two years, she has lost almost eight stone (51kg/112lb). "All of a sudden I wasn't thinking about food anymore," she says. "I've just got more energy, I'm doing things I couldn't do before… it's kind of given me a new freedom in life again." Millions of people like Sarah are now accessing medications like semaglutide and tirzepatide, better known by their popular brand names Ozempic and Mounjaro. The numbers of people on weight-loss medication is only likely to increase as new drugs appear on the market too, including pills rather than the current jabs. It's clear that these drugs are opening up a new era in the treatment of obesity. The condition, is now a "mitigatable" issue, David Cummings, professor of medicine at the University of Washington tells me. "They are the closest thing I've seen to miracle drugs". Other academics, however, warn that we risk losing sight of the need for behavioural change, especially as weight tends to be regained quickly when people stop taking the drugs. So what should anyone planning to use weight-loss medication consider before they start? How they work Weight-loss drugs work by suppressing an individual's appetite by mimicking hormones that tell our body when it is full. The most common are known as glucagon-like peptide 1, or GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP. The drugs bind to specialised molecules on the surface of our cells known as GLP-1 and GIP receptors, which play a key role in telling our body when it has had enough food. Typically someone taking these drugs will begin to lose weight within the first few weeks. Although the drugs are only approved for weight loss in people with obesity, there is a rapidly growing private market for those not considered clinically obese. Their popularity has been rising because they are extremely effective, with weight loss of between 14-20% in 72 weeks. But about 10-15% of people lose very little weight, so called "non-responders". GLP-1s are like "a chemical shield" that protects individuals against our "modern obesogenic environment, filled with cheap, calorie-dense foods", says Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow and leads the UK Government's Obesity Healthcare Goals programme. He has also consulted on medical trials with several companies who produce weight-loss drugs but does not own any shares. "There's food everywhere," he says – and within half an hour anyone "can pick up the phone and order 10,000 calories of food". If you stop, you'll gain weight If someone living with obesity starts to take weight-loss drugs, they need to consider that they may be on the drug long-term, says Cummings, who runs a weight management programme for individuals with obesity who have BMIs of 50 and above. A common question he is asked by his patients before they start taking a weight-loss drug is how long they will be on it. Typically, they stop taking the drugs after about a year, he says. One analysis of scientific studies involving more than 9,000 patients indicated the average treatment duration was 39 weeks. People believe they can continue to lose weight using their willpower, he says, but the evidence suggests that is not the case. People stop for various reasons, either due to the expense of treatment, their insurers stopping coverage or individuals not wishing to be on drugs for a prolonged period of time, Cummings has found. And when people do stop the drugs, their weight tends to rebound. A recent study found that weight regain happens up to four times more quickly after stopping weight-loss drugs compared to someone ending a weight-loss programme that focuses on changing their behaviour. Another study found that those on weight-loss drugs gained 1.5kg (3.3lbs) eight weeks after they stopped the medication, with their weight continuing to climb with the more time that passed. The same study also found that other health concerns, such as high blood pressure, also returns. New research has also found that people who stop taking weight-loss drugs gain back around 60% of the weight they lost a year later. It returns quickly because of something researchers call "food noise", which consists of persistent and intrusive thought around food, says Sattar. Hormones play a role too. When an individual tries to lose weight, it triggers a powerful hormonal response that tells your body to regain the weight you lost. Cummings explains that because of this, the brain interprets a calorie drop as an energy deficiency, so after stopping weight-loss drugs, hormones that stimulate appetite increase while the rate at which you burn energy – the metabolic rate – decreases. "If these biological defences are strong enough, they can blunt the drug's effectiveness," he says. Lifestyle change Sattar has observed that for a small proportion of people who make lifestyle changes, it may be possible to reduce the dose or use the drug intermittently instead. Some really do make "fundamental changes in their diet", he says. "Others might need it at a lower dose than they would when they started. But the majority will probably still need some dose of the drug because the [food] environment is still the same." There's also increasing concern that individuals are taking weight-loss medication as a substitute for making life-style changes – even though evidence shows that modifying lifestyle in combination with weight-loss drugs is what will lead to greater weight loss. Experts have recently cautioned in a scientific review of the evidence that when there's a lack of behavioural and lifestyle support for those on weight-loss drugs, it can leave individuals vulnerable to nutritional deficiencies. "We need to make sure people are getting enough protein and are getting all the vitamins and minerals they need," says Marie Spreckley a nutrition and behavioural scientist at Cambridge University and lead author of the report. "You don't want to have longer-term unintended consequences, like frailty and muscle loss. We don't want to replace one health concern with another." Because these medications cause a dramatic appetite reduction, patients tend to eat less overall, she and her colleagues note. This can lead to a "missed opportunity" if patients are not supported long-term and their food choices remain poor. No quick fix The World Health Organization has therefore stated that medication alone won't "reverse the obesity challenge". Early interventions, screening and creating healthier environments are also needed, the organisation has stated in its guidelines on using GLP-1 drugs. This is easier when people are still taking the drugs, Sattar says. "You have more mental space to think about your diet." But behavioural change is extremely challenging, says Amanda Daley, a professor of behavioural medicine at Loughborough University in the UK. She says there needs to be better communication with patients about how quickly they can regain weight once they stop taking GLP-1 medication. Obesity is a chronic, relapsing condition, she says, which means it cannot be "cured" with a drug alone. That's why additional support and "wraparound care" is key to ensure patients make dietary changes as well as increasing their physical activity. It's unclear whether private providers are providing this crucial additional support, she says, which she finds concerning since so many people access the drugs privately and it is hard to monitor continuation of care. Micro-nudges help change behaviour To overcome some of this – researchers at Stanford have looked at how they can help support and encourage lifestyle changes. In one recent study, researchers tested whether small nudges – or "microsteps" – could help encourage healthy behavioural change for those taking GLP-1 medications. The tiny changes focused on nutrition, physical activity, sleep and stress management. Crucially, the microsteps were small and manageable, such as swapping sugary drinks for water, no longer drinking coffee after lunch, taking a deep breath when stressed or popping outside for five minutes. They found these helped improve behavioural expectations. It's this "expectation" that's a first necessary step for behavioural change, says Maya Adam, a clinical associate professor of paediatrics at Stanford School of Medicine, who was involved in the study. "Achieving your best health involves a lot more than pharmacotherapy alone," she says. "We found that giving people these little nudges may be very effective." She calls these steps "too small to fail" because even small daily changes and habits make a real difference over time. Side-effects These kind of interventions are crucial to help give people the tools they need to enact change, Daley says, especially considering the known side effects. These include gastrointestinal issues. There has also been an observed increase in pancreatitis and gallstones. Muscle loss is another concern, especially among individuals who are not exercising. Recently a study found links to bone and joint conditions too. While we now have several years of data on the effectiveness of GLP-1 drugs, we don't yet know what the long-term outlook will be or whether the results will wear off over time. There is also a lack of data on how these drugs affect pregnancy outcomes or future generations, as the advice is not to take weight-loss drugs during pregnancy.  But given the negative health outcomes for those living with obesity, the side effects pale in comparison, both Sattar and Cummings say. This is particularly the case for individuals with multiple weight-related conditions. Heart disease, cancer and stroke are the leading causes of death worldwide – and all are linked to obesity. A changing landscape What is clear is that the landscape for weight-loss medication is rapidly evolving. There are other health benefits too beyond weight loss. In one major study involving two million people, the drugs were linked to better heart health, fewer infections, lower risk of drug abuse and lower incidences of dementia. It's also been shown to improve sleep apnoea, arthritis and substance abuse. A new drug called retatrutide has also shown promise in recent trials. It mimics three hunger-regulating hormones, and early evidence indicates weight loss of nearly 29%, after 68 weeks according to manufacturer Eli Lilly. The drugs are but one tool for obesity care, Daley says. More important is the need to make it easier for people to make healthier changes that last beyond medication. And because of the abundance of people eating calorie-dense ultra-processed foods, obesity will continue to be a growing health concern, experts warn. Our ultimate goal, Daley adds, should be to change the food environment to offer better choices and influence government policy so that the next generation won't need these drugs at all.   Source: BBC

As the world observes Autism Awareness Day on Thursday, experts are highlighting an important but often overlooked issue: many women and girls on the autism spectrum are diagnosed later in life than their male counterparts. Autism spectrum disorder (ASD) affects people of all genders, but long-standing diagnostic frameworks and social expectations have historically made it harder to identify in females, reports GulfNews. Experts note that the delay in diagnosis is not due to autism being less common in women, but because autism often presents differently in females, and women may develop coping strategies to adapt to social expectations, a phenomenon known as masking. These differences often lead to misdiagnoses, such as depression or anxiety, and can mean that women are only identified later in life. For some women, autism is only identified later in life, often during periods of burnout, when the effort of constantly adapting becomes unsustainable. Others may recognize it when parenting, noticing patterns in themselves that mirror behaviors in their children. Harris emphasizes that being on the spectrum is not a limitation: “A neurodiverse mind is a brilliant one, capable of many extraordinary things.” Signs to Look Out For While every autistic person is unique, certain patterns may indicate autism in women: Intense focus on specific interests or hobbies Social exhaustion or difficulty maintaining long social interactions Sensory sensitivities Repetitive motor movements (stimming): These can include hand-flapping, rocking, spinning, etc. These signs can easily be misinterpreted, which is why awareness and understanding are crucial. Supporting women and people with Autism Harris emphasizes that support starts with acceptance and understanding. “Recognizing that autism reflects a different way of experiencing the world, rather than something to be changed, is key,” she explains. Practical ways to support someone include: Listening to and believing their experiences Avoiding repeated criticism for behaviors that may be challenging to others Allowing for differences in communication, social interaction, and behavior without expecting conformity Respecting autonomy and working collaboratively rather than making assumptions “Feeling understood and accepted can significantly reduce the pressure many autistic people experience,” Harris notes. This supportive environment can make a big difference, helping reduce the need for masking and promoting mental well-being. Moving towards awareness Autism awareness is evolving. Increasingly, clinicians, educators, and families are recognizing that autism does not always look the same in everyone. By learning to identify signs earlier, society can reduce misdiagnosis, provide timely support, and celebrate the unique strengths that neurodiverse people bring to their communities. For Autism Awareness Day, experts like Harris encourage everyone to go beyond stereotypes, listen closely to women’s experiences, and foster environments where differences are accepted and valued.

Many people experience a puzzling phenomenon: going to bed very hungry but waking up the next morning with little or no appetite. A recent Quora post asked why this happens, prompting experts to explain the science behind it. Dr Mohnish Kataria, Senior Consultant in Gastroenterology at Paras Health Panchkula, says this is a common occurrence. “During sleep, the body adjusts energy use and hormone levels. Appetite-regulating hormones like ghrelin (hunger hormone) and leptin (satiety hormone) fluctuate overnight, which in some people can suppress morning hunger,” he told media. Additionally, the body’s energy requirements drop significantly during sleep. Since the body isn’t actively burning calories, there’s no urgent need to eat immediately upon waking, leading to a temporary lack of hunger. For many, appetite builds gradually as the day goes on, so skipping breakfast occasionally is not a concern. Several factors influence this phenomenon: Sleep patterns: Poor or irregular sleep can disrupt hunger hormones and reduce appetite. Metabolism: A lower metabolic rate at night and early morning weakens hunger signals. Eating habits: Going to bed hungry or late meals can temporarily alter energy needs. Circadian rhythm: The body’s internal clock may delay hunger until later in the day. Experts note that morning hunger is not necessarily strong for everyone and usually increases as the day progresses. When to seek medical adviceIf lack of morning hunger becomes persistent and is accompanied by other symptoms, it may indicate an underlying issue. Dr Kataria recommends consulting a doctor if you notice: Continued loss of appetite throughout the day Continued loss of appetite throughout the day Unexplained weight loss Fatigue or weakness Nausea, bloating, or digestive discomfort These signs could point to gastrointestinal or metabolic conditions that require professional attention. #From Indian Express

Experts say simply counting calories is not enough to maintain a healthy weight, as factors like meal timing, eating speed, and food type also play a crucial role. Research shows that consuming most calories earlier in the day, slowing down while eating, and focusing on minimally processed foods can help the body manage energy more efficiently. The way food is chewed and metabolized, as well as differences in gut microbiomes, further influence calorie absorption. Sarah Berry, professor of nutrition at King’s College London, said individual responses to food can vary widely, highlighting the importance of “eating smarter” rather than relying solely on calorie counting. Experts advise a balanced diet rich in fiber, fruits and vegetables, and low in processed sugar, salt and fat, combined with mindful eating habits, to support long-term health.   With inputs from BBC

A new wave of allergy treatments is giving hope to millions suffering from hay fever, with immunotherapy showing promise not just in relieving symptoms but in potentially “training” the body to resist seasonal allergies. Allergic rhinitis, commonly known as hay fever, affects over 400 million people worldwide and can lead to chronic respiratory issues, ear infections, and even asthma. Experts say the condition is often underestimated, with many patients only receiving temporary symptom relief rather than preventative care. Allergen immunotherapy (AIT), delivered through sublingual tablets or injections, gradually desensitises the immune system to specific allergens such as grass, ragweed, or dust mites. Daily sublingual tablets started 8–16 weeks before allergy season and continued for three years can significantly reduce symptoms and may prevent the development of asthma in children. Clinical trials show long-term benefits lasting years after treatment ends. For patients who cannot undergo immunotherapy or have severe asthma, biologics offer an alternative, targeting the immune system to reduce inflammation, though they are costly and do not provide lasting remission. Other strategies to manage hay fever include using nasal sprays with both antihistamine and corticosteroid, taking second-generation oral antihistamines, and reducing exposure to pollen through measures such as keeping windows closed, using air purifiers, wearing masks outdoors, and showering before sleep. Experts emphasise that hay fever should not be trivialised. Effective, safe, and increasingly accessible treatments are available, and early intervention can greatly improve patients’ quality of life.   With inputs from BBC

Most Americans will "spring forward" for daylight saving time this Sunday, losing an hour of sleep a change that can leave people tired, irritable, and even impact their health. The shift in daylight darker mornings and longer evenings can disrupt the body’s internal clock, potentially causing sleep problems for days or weeks. Research shows a slight increase in heart attacks and strokes immediately after the March time change. Daylight saving time begins at 2 a.m. Sunday, and clocks will “fall back” on Nov. 1. Hawaii, most of Arizona, Puerto Rico, American Samoa, Guam, and the U.S. Virgin Islands do not observe the spring switch. Globally, many countries also follow daylight saving time, though start and end dates vary. Experts recommend getting morning sunlight to help reset the circadian rhythm, which regulates sleep and alertness. The extra evening light from daylight saving time delays melatonin release, making it harder to fall asleep. Sleep deprivation can affect heart health, metabolism, stress levels, and cognitive functions. The change also temporarily increases risks on the road, with more fatal crashes reported in the days after the shift, particularly in the morning. Heart attacks and strokes also see a small rise, possibly due to disrupted circadian rhythms combined with existing risk factors. To adjust, sleep specialists suggest morning sunlight, shifting daily routines like meals and exercise earlier, avoiding late naps and caffeine, and reducing evening exposure to screens. Although there have been repeated calls to end the time change including former President Donald Trump’s promise  health experts recommend sticking with standard time year-round, which better matches human biology and supports more consistent sleep.

A structured morning routine can play a significant role in improving mental health, focus and overall well-being, according to US psychiatrist Daniel Gregory Amen. Experts say the first few minutes of the day often influence energy levels, mood and productivity, making simple morning habits an important factor in maintaining emotional balance. In a recent Instagram post shared on Feb 22, Dr Amen outlined several morning practices that he believes can help strengthen mental clarity and boost mood. The psychiatrist first emphasised the importance of starting the day with a positive mindset. He suggested people begin their mornings by reminding themselves that the day ahead can be productive and meaningful, noting that mental preparation works best when combined with simple physical routines. Dr Amen also recommended stepping outside early in the morning to get natural sunlight and taking a short walk. According to him, exposure to sunlight and light physical movement can help stimulate metabolism and activate the brain. Hydration is another key part of his routine. He advised drinking a large glass of water in the morning, preferably with half a lemon added, saying it can help refresh the body. Diet also plays an important role in maintaining steady energy levels throughout the day. Dr Amen said he usually starts his morning with foods rich in protein and healthy fats. As part of his own routine, he often eats eggs and later has a protein shake. He also supports intermittent fasting, suggesting that leaving a gap of 12 to 16 hours between meals can be beneficial, meaning a later breakfast may work well for some people. Another habit he recommends is making mindful choices during the day by regularly asking whether a particular action or food is beneficial for brain health. According to Dr Amen, adopting small and consistent habits such as sunlight exposure, hydration, balanced nutrition and intentional decision-making can help people begin their day with greater mental clarity and stability.

With summer around the corner, many are looking to shed extra fat and get in shape. Fitness coach Dan Go, drawing on over 20 years of experience, has shared a 16-point plan that he says could help people lose up to 14 kg (around 30 pounds) in three months through simple diet and lifestyle changes. Key recommendations include stopping food intake three to five hours before bed to improve sleep and control hunger, and setting a fixed daily calorie intake by multiplying body weight by 12. Protein intake is also important, with a daily requirement calculated as body weight multiplied by seven. Dan Go suggests including foods such as Greek yoghurt, lean meats, fatty fish, eggs, leafy greens, potatoes, beans, berries, and other high-fibre fruits and vegetables. Meal frequency should be limited to two to three times a day, with a structured schedule: the first meal 1–2 hours after waking, the second meal in between, and the last meal several hours before bedtime. Hydration, strength training three times a week, walking 8,000–10,000 steps daily, and prioritising quality sleep are also highlighted. He advises following a consistent sleep routine, tracking progress through weight, waistline, workouts, and nutrition, keeping a transformation journal, and avoiding alcohol during this period. “Losing 30 pounds by summer is achievable, but the real win is feeling energetic, confident, and healthy,” Dan Go said. He stressed that this plan offers general guidance and is not a substitute for professional medical advice. With inputs from NDTV    

Many people feel tired all the time even after getting enough sleep, and experts say the reasons go far beyond how many hours we spend in bed. Studies show that constant fatigue is common worldwide. A 2023 global analysis found that one in five adults experienced ongoing fatigue for up to six months without any clear medical illness. In the United States, a 2019 survey by the National Sleep Foundation found that 44 percent of adults felt sleepy several days each week. In the UK, a 2022 poll by YouGov showed that one in eight adults felt tired all the time. Women reported fatigue more often than men. Doctors say tiredness is one of the most common complaints they hear. In the UK, the National Health Service even uses the term TATT, meaning tired all the time. However, experts say fatigue is not the same as sleepiness. Sleepiness means feeling likely to fall asleep, while fatigue is broader and can affect the body, mind and emotions. Specialists explain that fatigue can be physical, such as muscle tiredness after exercise, but it can also be mental and emotional. This type of fatigue can cause brain fog, low motivation, poor focus and irritability. Scientists say they are only beginning to understand how fatigue affects the brain, thanks to new imaging and lab techniques. Fatigue can be linked to serious illnesses such as cancer, depression, long Covid and multiple sclerosis. But doctors stress that many people feel tired without having a major disease. That is why doctors first try to rule out medical causes using blood tests. Tests can help detect thyroid problems, hormone imbalances or shortages of nutrients such as iron, vitamin B12, vitamin D and magnesium. Experts say nutrient deficiencies can reduce energy because these nutrients are vital for normal body functions. However, doctors say test results are normal in most patients who complain of fatigue. In such cases, lifestyle factors are often the cause. These include poor sleep habits, stress, diet, mental health and lack of rest due to work or family responsibilities. Experts say sleep quality is often more important than sleep length. Interrupted or poor quality sleep can leave people feeling unrefreshed even after many hours in bed. During deep sleep, the brain clears waste products through a system known as the glymphatic system. Disrupted sleep reduces this process and may increase tiredness. Timing of sleep also matters. Sleep that does not match the body’s natural daily rhythm is less effective. This is why shift workers often face health problems. Experts say sleeping at irregular hours can reduce REM sleep, a key stage needed for emotional balance, memory and brain health. Stress is another major cause of fatigue. When people are stressed, the body releases cortisol, a hormone that raises heart rate and body temperature. High cortisol levels make it harder to fall asleep and stay asleep, leading to the feeling of being tired but unable to rest. Sleep disorders are also common hidden causes. Loud snoring and breathing problems during sleep may signal sleep apnoea, a condition that disrupts sleep throughout the night. People may still sleep for seven to nine hours but wake up feeling exhausted. Dehydration, excessive caffeine and alcohol use can also worsen fatigue. Experts say caffeine can stay in the body for hours and affect sleep, while alcohol may help people fall asleep faster but disrupts sleep later in the night. Health experts say improving energy usually requires basic but consistent steps. These include balanced nutrition, regular sleep routines, stress management, physical activity, enough water and good sleep habits. While these changes may sound simple, doctors say they are often the hardest to maintain in daily life. Experts stress that anyone with long lasting or worsening fatigue should seek medical advice to rule out serious conditions and get proper guidance.   With inputs from BBC

Hundreds of patients have reported that certain medications for movement disorders, including GSK’s Ropinirole, triggered compulsive behaviours such as gambling, overspending, and hypersexuality, according to a BBC investigation. Emma, a patient who developed Restless Legs Syndrome during pregnancy, lost tens of thousands of pounds to gambling after taking Ropinirole. She only discovered the link between her medication and compulsive behaviour after reading media reports. Many others contacted the BBC, including healthcare professionals and banking executives, describing similar experiences. The drugs, part of a family of dopamine agonists, boost dopamine levels in the brain, which regulates movement, motivation, and reward. Experts warn that overstimulation can lead to harmful behaviours, including sex addiction, binge shopping, and criminal acts. Despite these risks, doctors in the UK are reportedly still not fully warning patients about potential side effects. Past incidents show the severity of the issue. In 2000, GSK identified a case of paedophilia linked to Ropinirole, but warnings on sexual urges only appeared years later. Legal cases are emerging internationally, including in Belgium and France, where patients claim these medications have caused financial and personal devastation. Health authorities and charities advise patients to discuss any concerns with their doctors. The Medicines and Healthcare products Regulatory Agency (MHRA) said that warnings took time to issue because all evidence must be reviewed, and leaflets cannot list every possible individual reaction.   With inputs from BBC