Maggie's Farm

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.”

How a ‘fatally, tragically flawed’ paradigm has derailed the science of obesity

Yes, it is about carbs and not so much about calories.

Is Obesity A Lack Of Will, A Poor Lifestyle Choice, Or A Disease?

I term being overweight (aka fat) simply as a physical condition regardless of how it came to be. Many people seem to be quite content with being heavy even though it is not fashionable or entirely functional.

When people I see want to lose weight, I offer simple nutritional advice. Once in a while, they take it. 

How What Was Good Became Ugly and Then Bad

In history, being fat was a sign of prosperity. In this world of food abundance, it is the opposite: "You can't be too rich or too thin."

Money is great but it can't buy happiness, and you can be too thin but that is another issue. 

Immune system “clock” predicts illness and mortality

Part 1 is here 

Now to the related topic of Satiety. 

It was not long ago that being pudgy or having a bit of a gut signaled prosperity, and leanness signaled lower class. Now it's the opposite. With incredible food abundance, and with obesity always in the news, funding for nutrition-related studies has grown.  So now we know a lot more about how insulin works and about how the three food categories (fats and oils, carbs, and protein) are handled by the body. We are also learning about how hunger and satiety work. It's quite interesting but complicated.

These are "First World issues."  In our world of nutritional abundance, recreational, social, and emotional eating, and the constant temptation of food porn, "hunger" often does not denote a need for nutrition except for the skinny, and satiety is often over-ridden by habit, speed-eating, stomach-stretching, delicious foods, sugar-and-carb dosing, and insulin-resistance.  That is what it means when overweight people, who have no pressing energy needs at all other than water, vitamins, and minerals, eat hungrily two or three times a day. We term that appetite "false hunger" not because the appetite is not subjectively experienced but because appetite has, for them, disconnected from nutritional need and satiety signals (which are very slow to go into effect). That luxury used to be only for the wealthy.

It's like the flip side of anorexia. Anorexia nervosa is famously difficult to ameliorate, but it is not too difficult for most pudgy or fat people to re-set their bio-psycho-social food-o-stat if they want to. For starters, that entails small portions, plenty of protein to satisfy the hormones, and very slow eating so as not to short-circuit the awareness of the moment at which "That's enough to sustain me, because I don't feel hunger anymore." That way, the "Eat 'til I'm filled or stuffed...now I'm stuffed" effect never has to happen.

In the Western world, "sufficient" can be the stopping point, not "filled." Except Thanksgiving, when feeling ill from getting stuffed with stuffing is expected.

Being too scrawny, with underdeveloped muscle and bone, is life-limiting and unhealthy, but not as life-limiting as carrying excess fat around with its lengthy list of associated ailments. There's no need to carry it on your body, because there's a pizza joint on every corner to prevent sudden death from starvation.  Most people, fortunately, make themselves sensitive to satiety signals most of the time so most active adults are neither significantly under- or over-weight. 

Obviously, little of this applies to most children and adolescents. 

Where did the cultural habit of three square meals per day come from?

 It's quite recent, actually, and really a European cultural concept. More specifically, a British aristocratic concept because even today an Italian breakfast (except for the tourists) is an espresso or latte and a biscotti, and a typical French breakfast is a cafe au lait and a croissant. Typical Italian supper?  Soup and bread, or cheese and leftovers.

"Eating between meals"? I suspect people might feel better with 5 mini-meals - balanced snacks, really, because stuffed and lazy after supper is not an effective life plan. Stuffed and lazy after any meal is not a good plan except on Thanksgiving. Serious exercisers and athletes tend to discipline themselves to a 5 meal program to keep the nutrients flowing. They have to eat when they aren't hungry to maintain their level of fitness and power, and to keep their weight up.

A mini-meal for many can be something like a couple of slices of chicken and a handful of olives, or an apple and some cheese slices, maybe a slice of pizza or a cup of yoghurt or oatmeal with berries. Volume and details depending, of course, on total muscle mass, body frame, daily physical demands, physical goals, etc.  Body-builders need 4-5 full meals daily to put on muscle mass, while the old-fashioned three squares/day will make most adults flabby if not obese.

To understand what your body needs, look at it nude in the mirror. One look will tell you what it needs in fitness and nutrition in terms of muscular development, leanness or fatness, posture, etc. When it comes to food, we can't listen to our body too much. It's a liar because it was programmed for scarcity a long time ago, before agriculture. Humans seem to have the instinctive inclinations (eat, nap, fight, play, sex, and repeat until dark when the predators come out) of monkeys, chimps, and gorillas but we have some added higher capacities, or so the scientists claim.

A brief history of the origin of three meals/day.

Part 2 tomorrow will deal with hunger, appetite, and satiety. 

I quit them years ago when they were hijacked by lefty functionaries. 

This new AMA position paper is crazy, illiterate, and only comprehensible in tone: AMA Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity.

It sounds like the Babylon Bee. 

More evidence is emerging

Ozempic (semaglutide) had been approved by the FDA for Type 2 diabetes, but now it has also been approved for treatment of overweight and obesity provided you have 1 weight-related problem (which could include arthritis, etc.).

It comes as a (tiny) weekly injection, done at home. 

It is mainly an appetite-suppressant, and a highly-effective one according to a couple of patients. It can have some GI side-effects, but is usually tolerated.

It is something to consider for those who have too much trouble with food. As we have often said, it's impossible to burn off dangerous deep fat with exercise.