Maggie's Farm

Jabra hearing aids get excellent reviews. And their hearing test is online.

One aspect of hearing loss is that others notice before the listener does. 

Why do people with any fat stores ever feel hungry, or eat anything at all, considering they may have 1-5 month's worth of energy stored as fat?  (We term the hunger experienced by overweight people "False Hunger," because it is.)  Except in the truly malnourished or extremely fit, low body-fat athletes, hunger is rarely a signal of an energy deficit or of any nutritional need.

Think about it. Even normal-weight (neither overweight nor underweight) people carry 8-10 weeks of energy stored in fat if they can only access it. 

You can consider appetite in the pudgy or overweight, not to mention the obese, to be a design flaw based on the hunting and gathering, and, earlier, just plain gathering condition of human existence, same as the other great apes who only become overweight in captivity. Agriculture and food abundance, along with sedentary life, exposed the design flaw for people who overnourish themselves.  Of course, physical inadequacy is another side effect.

Here are a few issues (below) - 

I have seen people treated for cancer until the day they died with the poisons still dripping into their veins. I disapprove, although I am not an oncologist. There is a time to be born, and a time to die. Hospice care is a blessing with opioid meds as needed.

 Oncology therapy at the end-of-life: Have we missed the mark?

Unless elderly ("Have a good BM today?"), people don't talk much about poop. However, most people do it.

 It Was Once Someone’s Job to Chat With the King of England While He Used the Toilet, “Groom of the Stool” could be a crappy role, but it came with great benefits.

 How Often Should You Poop? What’s Normal and What’s Not?

Statistics say that 73% of Americans are overweight. Everybody knows the health and functional consequences of being overweight, however defined. Most people do not care. It's a free country, so I don't care if you do not.

If you care about fitness and functionality, staying trim and strong is a good idea. Staying strong is easy: Go to the gym or something daily with weights and cardio and calisthenics. It is rewarding if not exactly fun. Exercise will not keep many people trim.

It's an American thing. I don't know why because many parts of the world are full of cheap, tasty fast foods.

Without wanting to seem obnoxious to any overweight readers,  I have to offer the best article I've seen about nutrition and weight. It's a bit of a long read, but entirely reasonable: Behavioral Nutrition.

The authors are correct. For many people, willpower doesn't work. Habits do. A quote:

 Modern weight-loss approaches thus constitute an incomplete approach to long-term weight-control and one that must be complimented by a much more comprehensive appreciation of dietary habits, thought patterns and behaviors, and individual differences in consumption, food preferences, and control, as outlined below in a new approach to weight-loss [21]. Indeed, the selection and consumption of food in the modern era of abundance may have little to with nutritional analysis, appropriate macronutrient levels, or sustenance, as educational programs over the past decades have ensured that most the population is aware of what constitutes a healthy diet. Instead it could be argued that food consumption (and thus long-term weight control) is driven by a host of forces including personality, cognitive processes, food history, personal habits, ingrained behaviors, genetics, responses to environmental cues, neurochemistry and biological drivers, and mood states. In such circumstances, the current model of weight loss, with its emphasis on education, caloric restriction, moderation (moderate food intake) and will power, is ill equipped to promote sustainable weight-control and instead may have resulted in high rates of failure. One must question where the scientific evidence for this longstanding and continued approach to weight management lies, or perhaps by focusing on the most obvious factor, calories, and the field has overlooked the most critical, the person consuming those calories... 

 Virtually every major medical organization—from the American Medical Association (AMA) and the American Association of Medical Colleges (AAMC) to the American Association of Pediatrics—has embraced the idea that medicine is an inequity-producing enterprise. The AMA’s 2021 Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity is virtually indistinguishable from a black studies department’s mission statement. The plan’s anonymous authors seem aware of how radically its rhetoric differs from medicine’s traditional concerns. The preamble notes that “just as the general parlance of a business document varies from that of a physics document, so too is the case for an equity document.” (Such shaky command of usage and grammar characterizes the entire 86-page tome, making the preamble’s boast that “the field of equity has developed a parlance which conveys both [sic] authenticity, precision, and meaning” particularly ironic.)

While this link is an advertisement directed towards physicians, it makes clear what is going on in medical practices today: THE DEATH AND LIFE OF THE “PRIVATE PRACTICE PHYSICIAN”

While many physicians might like the idea of independence, for most specialties the need for a large back-office staff requires being part of a group practice. Then, sooner or later, somebody buys the group. The buyer could be a hospital, a giant medical business, or even a venture capital fund. 

Things have changed. In many ways, sharing some income and being a part of a larger business makes it easier than being an old-fashioned independent physician. It's not the same thing, though.

People have been talking about this article: If you can’t balance on one leg for at least 10 seconds, you may be in trouble.

I think it's a silly article. Obviously, if you are older and in bad shape, you are more likely to be sick and die. But go ahead and try it. For a better test, do it with eyes closed.

Tirzepatide.

As they say, ask your doctor whether this seems right to try. 

Second Booster for COVID-19 Vaccination: Early Results

Effects of Intermittent Fasting on Health, Aging, and Disease

The news these days are preoccupied with the topic. I have never had a single, clear view on it and still do not. Moral, religious, freedom, politics, etc.

As I have noted in the past, I refused to participate in an abortion in medical school and nobody cared. I was not alone. It was not on any clearly-defined moral or religious grounds really, just more like a disgust for the whole idea. Other people did them as comfortably as doing a tummy-tuck. OK for them. Maybe I was weak. It was an inner conflict. I would never have been willing to do a tranny surgery either, but they were not routine then. 

I confess that I came from a good, solid family which stayed together and produced a large litter of good, solid citizens. Protestant, not Roman Catholic.

Regardless of the above, it is all about sex. Sex is a strong drive in us animals. We do not always use our brains despite every form of birth control.

Do you supinate, pronate, or neither? Sometimes you can tell by the wear on your shoe soles, but when it is more pronounced you can feel it when you walk or run.

When these things are severe, they can affect your joints and lower back. This is why God made Podiatrists. 

It is well-known that vigorous exercise does not "work up an appetite." On the contrary, it tends to reduce hunger and appetite.

That might not apply to 8 hours on the Appalachian Trail or a day job as a lumberjack, but it is certainly true for me with my 1-hr daily exercises. The more consistently I exercise, the less interest I have in food and the smaller the portions I can handle. This effect is most pronounced with demanding cardio and calisthenic exercise, not much with strength exercise or with sports. There is a theory that the effect has something to do with Peptide YY.

Nobody wants to eat anything after a hour of tough cardio exercise and that suppressive effect tends to last 24 hrs. 

Maybe it makes some genetic sense. If you need to move yourself vigorously and frequently, the less fat you have on you the better you can avoid becoming part of a Tiger Dinner Party. Hunger is an interesting instinct and only recently has it been studied biochemically. One thing we know for certain is that subjective hunger or attraction to food is not a signal for a need for nourishment for most adults in a food-rich environment.

Overweight people seem to have the strongest subjective hunger, and sedentary people tend to have stronger appetites. Cause or effect? Chicken or egg?

Two books about dealing with dementia:

The 36-hour Day

Creating Moments of Joy along the Alzheimer's Journey 

Could Viagra reduce Alzheimer’s risk?

Correlation or causation, or just one of the 50+ percent of medical studies which turn out to be wrong? 

Regardless of the above, Cialis and Viagra are good for guys who can use it. You are not dead yet. By coincidence, some might recall that Bob Dole did some of the first TV ads for Viagra. Good for him. 

Re my post about semaglutide and weight loss, I was not entirely up-to-date. As of this summer, it IS now FDA-approved for weight loss in non-diabetics.

It is termed "a game-changer" for overweight problems.

"Diet and exercise" are typical suggestions for the sedentary or over-eaters. However, strict nutritional plans rarely work for overweight people in the long run, and exercise has minimal effect on fat loss (but is essential for general fitness). Nutritional self-control is difficult for most people. Most, not all. 70% of Americans are overweight by some measure.

Metformin is a typical medicine for overweight, pre-diabetes, etc.  In my experience, it is not very effective and has many side effects.

In my view, semaglutide  might be the current gold standard. It's a tiny weekly injection, done easily at home. Like everything, it has some side effects but not much. It can be labeled as Wegovy or as Ozempic. You have to qualify as meaningfully overweight to get a prescription. It definitely reduces appetite, but has other beneficial physiological effects especially on the insulin system. Can it permanently re-jigger your food compulsions after months of use? It is not clear. 

Semaglutide is on-label for Type 2 diabetes, or pre-diabetes, and off-label for weight loss alone. 

If you have overweight issues, discuss it with your doctor as an option.  It could save your joints, your heart, maybe your life (for a while). I would try it, if eating were one of my hobbies.

Fruits are designed as attractions for critters to spread their seeds. Thus they contain sugar (fructose, not glucose) and a bit of fiber to hold it together.

Fruit is a fun snack, especially with pears. Pears are perfect with cheese.

If you want to lose weight, fruit is something to avoid. Fructose goes directly to fat storage.  

In exclusive interviews, two prominent providers sound off on puberty blockers, 'affirmative' care, the inhibition of sexual pleasure, and the suppression of dissent in their field.

As readers know, I view these "treatments" as malpractice, quackery, or something in that direction. 

About semaglutide and related topics: The Future of Weight Loss:

 Semaglutide, and the drugs that will follow it, may soon replace most bariatric surgeries. “Slowly, slowly, slowly, we outcompete the surgeons,” predicts Macklin, who is already referring many fewer patients for surgery. “They know we’re coming.”