DR. MICHAEL MOSLEY: Why the new vaccine for weight loss works better in women than in men

A few years ago, my wife, Clare, was shocked when a patient walked into her GP’s office and lightly said, “My husband hits me.”

Fortunately, this was not domestic violence: the patient was actually complaining that she and her husband had been on the 5:2 diet at the same time and he was losing more weight than she was.

Clare pointed out that while men typically lose more weight when dieting, women experience similar health benefits, especially when it comes to important measures like blood sugar control, even if they don’t lose as much weight.

But surprisingly, new research shows that women appear to do better than men when given new weight-loss drugs like Semaglutide (brand names Wegovy or Ozempic).

This is important as Rishi Sunak announced earlier this week a £40million pilot scheme designed to allow GPs to prescribe them.

DR. MICHAEL MOSLEY: A few years ago, my wife, Clare, was startled when a patient walked into her GP’s office and lightly said, “My husband is hitting me.”

Why do men lose more weight when they diet? That’s probably because we tend to be more muscular and have a higher metabolic rate, which means we burn more calories while sitting and even while sleeping.

Higher testosterone levels also help: Studies have shown that hormonal boosting leads to significant weight loss in men with low testosterone levels.

Curiously, however, recent research has shown that the situation is reversed with the new weight loss drugs, with women losing a higher percentage of their body weight than men.

Medications like Semaglutide work by mimicking the action of the GLP-1 hormone, which is released in your gut in response to food. It causes your body to produce more insulin, which lowers blood sugar levels. For this reason, it was originally developed for people with type 2 diabetes.

But these drugs also work on your brain and suppress appetite. People who have tried them say that one of the biggest changes is that the drugs stop cravings. The result is impressive weight loss. However, as soon as you stop taking the drug, there is often a significant increase in weight.

One of the first major studies looking at semaglutide found that the men and women given the drug lost an impressive 2.6 pounds (15.3 kg) over a period of 66 weeks.

Less positive, however, was a follow-up study published in the journal Diabetes, Obesity and Metabolism in April this year, which found they had regained two-thirds of their weight within a year of stopping the drug — whether that means people are losing the Should medication ever be taken, it will clearly be a problem.

Also notable was that the women in the study lost a higher percentage of their original weight than the men, about 18 percent versus 13 percent, according to a reanalysis of the data by Dr. Alyssa Susanto, a researcher in the Faculty of Medicine and Health at the University of Sydney.

dr Susanto, who recently presented her findings at the International Congress on Obesity in Melbourne, did not speculate as to why that might be. However, I suspect that it could be because these new drugs act so powerfully on the brain and reduce food cravings — and research suggests that women are more prone to food cravings than men.

For example, a 2005 study titled “Eating and Dieting Differences in Men and Women” (published in the Journal of Men’s Health & Gender) concluded that men tend to overeat because they are “pleasure-oriented.” (while the desire for something is more intense and stronger). dominates your thoughts).

Men also tend to diet for health reasons, often at the suggestion of a doctor or partner. Women, on the other hand, tend to struggle with cravings for high-calorie, tempting treats.

dr Susanto suggested that studying the differences between men and women in weight loss could lead to better, more individualized treatments.

While these gender differences are interesting, this study really shows how important it is to first identify and deal with the causes of overeating.

That’s what researchers at the Mayo Clinic in the US did: They identified four different types of overeaters based on various tests, including how many calories people ate at a buffet meal and how long it took them to get their bowels empty .

The four types are:

• Hungry brains: These people need to eat above average to feel full because the hunger center in their brain stays “switched on” longer than average.
• Hungry Guts: This describes those who feel hungry shortly after eating and feel the need for frequent snacking. This appears to be because food moves through the stomach faster than average.
• Emotional Eaters: As the name suggests, they eat when they are stressed.
• Slow Burners: They have a slower than average metabolic rate.

In a recent clinical study of 165 overweight volunteers, Mayo researchers compared the different types of overeaters to a specific weight-loss approach.

Those with “hungry brains” were given a time-limited diet high in fiber to keep them full. It was believed that encouraging people to eat their food within a limited amount of time would “turn off” their brain hunger center.

Those with “hungry guts” were given protein supplements with meals to help keep them full longer. Here the belief was that eating more protein would delay gastric emptying and lead to an earlier release of gut hormones, which tell you when you’re full.

DR. MICHAEL MOSLEY: Those with “hungry brains” were put on a time-limited, high-fiber diet to keep them full. It was thought that encouraging people to eat their food within a limited amount of time would “turn off” their brain hunger center (file image)

The emotional eaters received emotional support and were encouraged to practice mindfulness, while the slowburners, like the hungry guts group, consumed protein supplements but also completed a HIIT (high-intensity interval training) program, as this has been shown to help with overspeeding boost metabolism.

The results were interesting. Compared to a control group who followed a standard calorie program, those who followed a tailored diet lost more than twice the weight in 12 weeks.

They also lost more inches from their waists, experienced greater improvements in mood, and decreased blood lipid levels.

Larger, longer-term studies are needed, but this research shows that when it comes to weight loss, there is no one-size-fits-all solution.

Hidden risk in the water

At this time of year I like nothing better than an evening swim in the nearby Thames. I haven’t done that yet, mostly because of the stories of raw sewage being pumped into our rivers.

But there’s another, more insidious threat: so-called “forever chemicals” or PFAS (per- and polyfluoroalkyl substances), which have been used to make food containers and non-stick cookware for decades.

Unfortunately, once released into the environment, they linger for a very long time, which is bad news since some PFAS, even in small amounts, can lead to problems like infertility and cancer.

In the UK, the official limit for PFAS in tap water is 100 nanograms (ng) per liter, but in the US it is as low as 25ng for some PFAS. The European Union is now planning to ban almost all PFAS within ten years.

In the meantime, filter your water and avoid microwaving food in the plastic containers at your takeout. I’ll probably just swim in the sea too.

Don’t let the Junior Physician title fool you

My son Jack is returning to the UK next week after spending a number of years as a resident in Melbourne where he was looking to broaden his medical horizons and recharge after a long stay in a Covid ward.

Despite the name, most “junior doctors” are highly qualified professionals. It can take ten years or more to become an NHS adviser, meaning after medical school you’ll be classified as a resident well into your 30s or even 40s.

DR MICHAEL MOSLEY: My son Jack is returning to the UK next week after spending a number of years as a resident in Melbourne where he was looking to broaden his medical horizons and re-energize after a long stay in a Covid ward

So I wasn’t surprised to learn that “one of the most debated motions” at the recent Junior Doctors Conference was the term “junior doctor,” the BMJ says — it was “misleading to the public… and underestimated the incredibly valuable.” Work that doctors do.” of all grades do it.

While they search for a more appropriate name, their strike actions continue.

I have great sympathy for patients whose lives are being impacted by these strikes, but my sympathy also goes out to the young doctors who have seen real pay cuts over the last decade.

If the problem is not solved, there is a risk that young doctors will migrate to countries like Australia, where they have better pay and working conditions.

We urgently need to train more doctors, but also value the ones we have.

I just hope that the lure of friends and family is enough to deter Jack and others from booking a flight to work where they will be more valued.