A New Generation of Weight Loss Drugs Makes Bold Promises, But Who Really Wins

In the months after having her second child, Sarah found herself fed up. The 40-year-old Seattle resident was cutting carbs and sugar, and exercising regularly, but couldn’t seem to shed the pounds she had put on during pregnancy. So when an email newsletter mentioned a new weight-loss drug called Wegovy, Sarah decided to give it a try. Eight months later, she is out more than $10,000—and down more than 60 lbs.

“Wegovy made losing weight almost effortless,” Sarah, whose name has been changed to protect her identity, told Quartz. “I’m not hungry often anymore and it doesn’t take any willpower to eat less. I simply don’t have any desire to overeat.”

Sarah is one of 125,000 US-based patients now taking Wegovy (whose generic name is semaglutide), a member of a new class of weight-loss drugs. These drugs work differently than the appetite suppressants popular among previous generations of dieters. They are also hitting the market at a different moment: one in which people are more eager than ever for realistic, science-based methods for addressing excess weight, even as a growing faction of activists and doctors voice skepticism of weight as an accurate measure of health.

A new class of weight-loss drug

In the mid-1990s, experiments on Gila monster venom found it contained hormones that could help lower blood sugar. That led to the diabetes drug Ozempic, which ultimately went on the market in 2018. People on that drug discovered a funny side effect: They lost weight.

In 2021, that same compound was approved by the US Food and Drug Administration (FDA) under the name Wegovy for the express purpose of weight loss. Drugs like Wegovy work in more complex ways than simply suppressing appetite, and promise fewer (though not zero) side effects.

Like Wegovy, many of these drugs were originally approved for other conditions; liraglutide (brand name Saxenda for weight loss) was also originally approved as a diabetes drug (Victoza). In fact, semaglutide and liraglutide work similarly in the body: They’re known as GLP-1 receptor agonists because they activate receptors for the glucagon-like peptide-1 (GLP-1) hormone, reducing appetite by slowing digestion and the rate at which the body takes up glucose.

Perhaps most important, the new drug promise significant weight loss. “The previous weight loss drugs were just modestly effective,” says John Buse, an endocrinologist at the University of North Carolina School of Medicine. The average patient would lose 5% of their body weight, in some cases up to 8%. But with semaglutide, he says, “we’ve gotten the kind of weight loss that makes people pay attention: 10-15% of body weight. That’s the average weight loss—half of people are losing more than that. It’s a gamechanger in the conversation…now that we have medicines for which a substantial proportion of patients can expect to lose 30 to 50 lbs.”

In one 68-week pre-approval clinical trial, patients on Wegovy did indeed lose 14.9% of their body weight on average, compared with 2.4% for people on a placebo. (Although, as several writers and scholars have pointed out, the study was funded by Novo Nordisk, which makes Wegovy.) Given the average weight of trial participants—100 kg, or 220 lbs.—that meant weight loss of about 15 kg, or 33 lbs. Other drugs in development have had similar results. In a recent trial for one called tirzepatide from Eli Lilly, more than half of patients lost at least 20% of their body weight—50 lbs. in many cases.

What it takes to lose weight

This new class of drugs is entering a market that at first glance seems ripe for breakthrough. According to the US Centers for Disease Control and Prevention (CDC), 42% of Americans—70 million people—meet the criteria for obesity (having a BMI of 30 or more). At one point or another, most of those people will try a diet and exercise regimen to lose weight.

But a growing body of research shows that diets are not an effective way to lose weight and keep it off. “Obesity is a complex disease… ​for most people, lifestyle modifications, diet, and exercise are just not enough,” says Katherine Saunders, a doctor at the Comprehensive Weight Control Center at Weill Cornell Medicine and co-founder of Intellihealth, an app-based platform that brings evidence-based obesity treatment to patients.

In part because of that complexity, bariatric surgery has since 2009 been considered the standard of care for patients looking to lose a substantial amount of weight. But these procedures can be invasive and expensive, and can come with significant and long-lasting complications.

The dearth of other options leaves some patients and doctors excited about this new generation of drugs. “Right now, the field is really looking for more efficacy, number one. People will do almost anything to lose weight,” says Buse. “We have more than just surgery now for promoting substantial weight loss. The most exciting thing is that obesity is on the ropes.”

A complicated picture

While hopes are high, the realities of taking these drugs can be more complicated for patients. There are often side effects—the most common for semaglutide and liraglutide are diarrhea, vomiting, and nausea. On Wegovy, Sarah says she’s experienced diarrhea so severe that a few times she had to delay her next dose.

Physicians can sometimes gloss over or downplay those effects. But a visit to dedicated Reddit pages for these drugs shows whole communities of patients struggling to adhere to the regimen when they’re feeling sick, and seeking support from a community to understand whether what seems like a severe reaction is normal. (Novo Nordisk did not respond to a request for comment.)

How well a patient can tolerate a drug “is something we think about quite a lot,” Saunders says. “We always start with lower doses and increase gradually as tolerated. Everyone is different. We keep in close touch with the patient and monitor them closely.”

And while these new drugs are relatively well-studied, there are still unknowns. They seem to help patients keep weight off more reliably than diet and exercise alone, but those benefits fade after people stop taking the drugs, and patients do often regain weight. There are also questions about long-term effects. In 1997, weight loss drug fenfluramine/phentermine (fen-phen) was pulled off the market after it was found to cause heart problems. More recently, Belviq (lorcaserin), which the FDA approved for weight loss in 2012, was pulled from the US market in 2020 because long-term use was found to increase the incidence of various types of cancers.

Even if a patient does want to go on one of these drugs, she might not be able to. Many patients keen to try Wegovy can’t access it at the moment, due to a supply chain issue that its manufacturer doesn’t expect to resolve until later this year. Even then, most US health insurers, including Medicare, do not cover drugs like Wegovy, and paying out of pocket can cost thousands of dollars per month. After Sarah’s doctor told her she doesn’t prescribe Wegovy, Sarah secured a prescription through an online health provider; she pays for it out of pocket.

The lack of insurance coverage is in spite of the fact that the American Medical Association declared obesity to be a disease in 2013. “The conversation around insurance coverage needs to be had with insurance companies, but also with employers,” says Kimberly Gudzune, the medical director for the American Board of Obesity Medicine. “It needs to be seen as an investment in your workforce.” The Treat and Reduce Obesity Act, which would expand Medicare to include obesity treatments, has been introduced to US Congress every year since 2012, but has never passed.

America’s love/hate relationship with weight

Though excess body fat was once considered a sign of wealth or fertility, over the past century a stigma has developed against larger bodies. Today doctors associate excess weight with medical conditions like heart disease, cancer, type 2 diabetes, sleep apnea, osteoarthritis, and depression. Studies also show that life is harder when you move through the world in a larger body. Fat people are less likely to be hired for a job, are paid less, are less likely to get married, and are less likely to be happy (though not if they’re living around other fat people). One 2006 study found that 46% of respondents would rather give up one year of life than be obese; 5% said they’d rather lose a limb.

The current state of research makes it impossible to unravel the full complexity of weight and health, but the conversation is starting to accommodate more nuance. Ubiquitous metrics such as body mass index are increasingly understood to be unreliable indicators (though doctors often still use them), and even the language around larger bodies is under review. Many physicians use “obese” to describe people who have excess weight or a BMI over 30, but activists are shying away from the word. “The reason…we are reluctant to use the words ‘overweight’ and ‘obesity’ is that they are made up, they can change,” says Tigress Osborn, a fat activist and chair of the National Association to Advance Fat Acceptance.

In fact, some research suggests that fat may have a protective effect on the body. “The body’s weight-regulating mechanism is about survival. It’s a system with more moving parts than we understand,” says Marilyn Wann, a fat activist and author of the book Fat!So? “Trying to remove weight from an individual or from the population is like trying to take a sledgehammer to the weather—we don’t know the unintended negative consequences we’re going to create.”

There are signs that in the future physicians may be more accepting of bodies of different sizes. But as weight loss drugs get more effective and more available, those cultural gains for body positivity (or body neutrality, or fat acceptance) may also be called into question.

A new relationship between doctors and patients

Overweight patients who come to see Shelly Crane might have an experience they’ve never had before. “I don’t initiate a weight-loss conversation with a patient,” says Crane, a family physician at Advocate Aurora Health in Milwaukee, Wisconsin. Most weight-loss programs come with more risk of harm than good, she says, and there’s not enough evidence that people who do lose weight are healthier in the end.

Crane doesn’t regularly prescribe new drugs for weight loss, though she says more patients are coming in and asking for them lately. Instead, she prefers to keep conversations focused on goals of care. “Patients say, ‘I know I need to lose weight,’ and I say, ‘Why do you think you need to lose weight? What would change in your life if your weight was lower?’” That gives her an opening to talk about health more broadly—how is the patient’s sleep? Their diet? Their mobility? “I try to stay in my sphere of what I’m able to do as a family doctor and really address the root of the health issue as much as I can.”

Crane was drawn to this approach by listening to her patients talk about experiencing size discrimination, and by following the work of fat activists such as Ragen Chastain and Aubrey Gordon. Though she’s been trained in a more integrative style of medicine, her approach toward body acceptance was also shaped by her discovery of intuitive eating during medical school. Since then, she’s been working on deprogramming herself and her colleagues from anti-fat bias.

Crane is part of a burgeoning movement among doctors to improve the treatment of larger patients. For some, that means skipping the dreaded weigh-in, a practice that is somewhat controversial within medicine. Medical organizations like the Association of American Medical Colleges also offer guidelines to reduce anti-fat bias among clinicians.

For doctors, the updated approach at least engenders trust, which can in turn get patients to seek medical care more frequently and improve their overall health. At most, it broadens the definition of what “healthy” means, and looks like.

Some fat activists see this shift as an important step. “The thing we hear most often from the public is, ‘I thought I had this thing, but all the doctor wanted to talk to me about is weight loss, and now the thing is worse,’” Osborn says. “It’s progress to have people in the medical establishment recognizing that there are other healthcare concerns besides weight, if weight is a healthcare concern.”

The hope is that this evolution continues. Activists want more people, in the medical profession and outside of it, to respect their autonomy. That becomes even more pressing in a possible future filled with weight-loss drugs—a future where a person can simply take a drug and stop being fat. “The ease with which I could become smaller—why should I? That should be up to me. Just like, if you believe it’s a medical disorder, the treatment I choose should be up to me,” Osborn says. “Like with anything else, if you believe fat is a disorder, we should let people decide whether people will get treated or not.”

“Fatness isn’t a problem to be solved in and of itself. It is not the root cause of all ills, as much as [medicine] would like to think it is,” Crane says. “We can help people live full, rich lives when we focus on goals of care and not on weight.”

By Alexandra Ossola

Source: A new generation of weight loss drugs makes bold promises, but who really wins? — Quartz

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Restricting Calories Leads To Weight Loss, Not Necessarily The Window of Time You Eat Them In

1

Results of a new weight loss study were published this week, leading to headlines proclaiming intermittent fasting “isn’t a magic diet trick after all”.The researchers aimed to test whether adding a restriction on what time of day you were allowed to eat (or not) to the usual low calorie (or kilojoule) diet led to greater weight loss compared to just following a low calorie diet. They recruited 139 adults whose average weight was 88 kilograms and age 32 years.

The participants were randomised to follow either the low calorie diet that had reduced their usual daily energy intake by 25%, or the same low calorie diet with the addition of a time period during which they were allowed to eat in an eight-hour window between 8am and 4pm each day.This approach is called “time-restricted eating” or a “16-hour intermittent fast”. Both groups received support from health coaches to follow their diets for 12 months.

Results showed that after one year, people in both groups lost 7-10% of their baseline body weight. While the low calorie group lost an average of 6.3 kilograms, the low calorie plus time restricted eating group lost 8 kilograms. Although there was a 1.8 kilogram difference between the groups, it was not a statistically significant difference.

Participants in both groups also had better blood sugar and blood fat levels and improved insulin sensitivity, but again there was no significant differences between groups.

1. It wasn’t based in the US

Most intermittent fasting studies have been conducted in the United States. This trial was done in China and recruited people in Guangzhou, so it provides important data using a culturally sensitive, prescribed calorie restriction over 12 months.

2. It showed small extra time restrictions on eating don’t make much difference

In their normal lives, the participants in Guangzhou had a usual window for daily eating of about 10.5 hours. Studies in other populations, particularly the US, show about 90% of adults have an eating window of 12 hours, with only 10% of adults having an overnight fasting period greater than 12 hours.

For more than 50% of people in countries like the US, the overnight fast is less than nine hours, meaning they eat over a 15 hour time period each day. So in the current study, the time restriction on eating was only minor – at about two hours less per day than what’s usual for people in China. This would not have been too big a difference from usual.

The researchers also reported that in China, the biggest meal is usually eaten in the middle of the day, so that was not influenced by the time restriction. In countries where the evening meal is the biggest or people snack all evening, then time restriction may still be a beneficial way to reduce intake.

A 2020 review of 19 studies that used time-restricted intermittent fasting found it was an effective treatment for adults with obesity, leading to greater loss of body weight and body fat, with significantly lower systolic blood pressure and blood glucose.

3. It showed support is imperative

Both groups in this trial were given a lot of support to adhere to the kilojoule-restricted diet. They were provided with one meal replacement shake per day for the first six months, to make it easier to follow the kilojoule restriction and help improve adherence to the diet.

They also received dietary counselling from trained health coaches for the 12 months of the trial. They received dietary information booklets that included advice on portion size and sample menus. They were encouraged to weigh foods to improve their accuracy in reporting kilojoule intakes and were required to keep a daily log with photographs of foods eaten and the time, using the study app.

They also received follow-up calls or app messages twice a week and met with the health coach individually every two weeks for the first six months. In the second six months, they continued to fill out their dietary records for three days per week and received weekly follow-up telephone calls and app messages and met with a health coach monthly. They also attended monthly health-education sessions.

This was a lot of support and is very important. Receiving long-term support to achieve health behaviour changes typically achieves a weight loss of 3–5% of body weight, which significantly lowers risk of weight-related health conditions, including a 50% lower risk of developing type 2 diabetes over eight years.

4. Even with good adherence, individual weight loss varies

Individual weight loss responses were very variable, even though adherence was high in this trial.

About 84% of participants adhered to the prescribed daily calorie targets and time restricted eating period. Weight loss at 12 months varied from 7.8 to 4.7 kilograms in the low calorie only group, and 9.6 to 6.4 kilograms in the low calorie plus time-restricted eating group.

As we have seen many times previously, this study confirms there is no one best diet for weight loss. It also shows small decreases in the window of time you’re eating probably won’t make a difference to weight loss.

By:

Laureate Professor in Nutrition and Dietetics, University of Newcastle

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Weight Loss: Why We Should Stop Complimenting It

(CNN)If your friend has recently lost weight, you might want to tell her how great she looks. Maybe you also say that you wish you had her body or self-control or you ask her how she did it. Perhaps you’ve been on the receiving end of such a “compliment” in the past. Such comments are well meaning but can have unintended negative consequences.

“In that case, we are unintentionally exacerbating or affirming the thin ideal that our society tends to emphasize and idolize,” said Alvin Tran, an assistant professor of public health at the University of New Haven in Connecticut, who does research on eating disorders and body image. “We need to be very cautious when we do approach conversations around someone’s physical appearance, especially their weight.”

This is especially important when talking to people with eating disorders or serious body image issues, since such remarks can worsen their situation. Compliments about someone’s weight loss or thinner body perpetuate society’s deep-seated diet culture, Tran said, and the idea that thinness is inherently good.

“We do tend to operate (as if) we can somehow look at people and, based on body size, determine whether they’re healthy,” said Tamara Pryor, a senior fellow and director of research at ED Care, an eating disorder treatment center based in Denver.

“We have people in large bodies that are in a state of malnourishment as well as people in extremely low size that are malnourished, and people that are standard size but still very severely compromised by an eating disorder. People can’t look at them and tell that.”

But if you’re pleased or wowed by how someone looks, should you not compliment them at all? What is and isn’t OK to say? CNN asked for advice from Pryor and Joann Hendelman, the clinical director of the National Alliance for Eating Disorders.

The following conversation has been lightly edited for length and clarity

CNN: Why else is complimenting someone’s weight loss or thinness problematic?

Tamara Pryor: It’s intrusive. Whose business is it for us to be passing judgment, particularly expressing it verbally? We might look at people and make judgment calls, but we need to keep it to ourselves. I come from the second wave of the feminist movement, where it was “my body, my business.” That still stands to be the case.

CNN: How might people on the receiving end feel?

Pryor: If somebody said to me, “Oh my gosh, you look great. You’ve lost some weight,” I would find myself thinking, “What did you think of me beforehand? Was I not acceptable?” I could imagine the pressure the receiver would then feel to maintain the lower weight or lose more weight to receive more praise or be accepted.

They might think, “What about me and the essence of who I am as a human being?” There are both physical consequences and significant psychological consequences that get perpetuated.

Joann Hendelman: If you don’t get that compliment, then it becomes, “There’s something wrong with me. I’m not good enough.”

CNN: What should people consider when they want to praise someone’s thinner appearance?

Pryor: Any questions regarding appearance tend to be triggering, and they’re more triggering for people with eating disorders, because they have such a heightened sensitivity about how they’re being judged based on body shape and size.

My patient and her mother went to a clothing store. She’s extremely low weight and anorexic, and had just started treatment. As she’s in the dressing room, her mom gasps, because when she saw her daughter trying on clothes, she realized how extreme the weight loss was. In comes the clerk, who hears the mom say, “Oh, honey, I’m so sorry. I had no idea that your weight had gotten so low. I’m so grateful that you’re in treatment now.”

The clerk said, “Are you kidding? I would die to be that thin. How did you do it?” So, then the patient has this mixed and conflicted response: She can feel her mother’s very real concern, but on the other hand, she’s getting complimented.

Hendelman: I have known and worked with people who had cancer or another reason why their bodies were small. For them, compliments are very uncomfortable because they know they have this horrible illness, and yet people are complimenting them on this weight loss that they would give everything not to have.

CNN: What can people say instead?

Pryor: Find ways to engage that don’t include commentary on their bodies.

Eating disorder resources

US: National Eating Disorder Association

The NEDA has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text “NEDA” to 741-741.

The NEDA also has a list of recommended websites and free or low-cost resources.

US: National Association of Anorexia Nervosa and Associated Disorders

ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers.

Australia: National Eating Disorders Collaboration

A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays.

UK: Beat Eating Disorders

Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year.If someone needed to lose weight for health reasons, complimenting them on their tenacity in achieving that goal isn’t best. Because then it’s like, “Oh, boy, what if I fail or gain some weight back?” That feels like a lot of pressure. Instead, if someone brings up recent weight loss, ask how they feel about the weight they’ve lost or what made them do it, rather than making a judgment yourself.

Hendelman: Compliment them on what they’re wearing, or say something like, “Your eyes are so bright today” — those kinds of things. If a friend is still so tied to being skinny in order to get compliments, and I say how fantastic that is, I am supporting their focus on their body size and doing them a disservice.

CNN: How can people stop perceiving weight loss or thinness as ideal and inherently good?

Pryor: Think about what being healthy means and what your body can do for you — such as taking in the nutrients you need or gaining strength.

Hendelman: If we could all accept that our bodies get us from this position to the next position, and that it’s not about the way our bodies look, but what’s inside — it’s amazing how much our bodies can give us back.

It’s important to accept who we are and our uniqueness. We have to accept our genetics. The more we can accept our bodies, the healthier we are likely to be. Believe that our bodies know best.

Source: Weight loss: Why we should stop complimenting it – CNN

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You Can’t Outrun Your Fork But That Doesn’t Mean Exercise Can’t Help You Lose Weight

1Every January, millions of individuals make New Year’s resolutions to lose weight or eat healthier, if not both. To achieve this goal, many individuals will begin strenuous exercise programs that incorporate too much exercise too soon, leading to fitness burnout or injury. Overtraining can actually prevent you from losing weight.

As a health neuroscientist, I have been studying the brain and cognitive mechanisms underlying dietary behaviours and the role exercise plays in helping people improve their diets for over 10 years.

Energy and exercise

The truth is that you simply cannot exercise away a poor diet and expect to lose weight (if that is your goal). Humans are very good at conserving energy and will account for any calories burned through exercise by consuming more calories later in the day or by being less physically active throughout the rest of the day.

That being said, you can — and should — use exercise to help you lose weight and maintain your weight loss. But not to offset calories consumed.

If you are looking to lose weight, the only way to do it is by controlling your calorie intake. The best and most effective way of doing that is limiting the consumption of ultra-processed foods — typical “junk foods” and fast-food meals. Even if you are not trying to lose weight, reducing ultra-processed food consumption is good for mental and physical health.

Regular exercise makes it easier to do this by improving the brain and cognitive processes that help us regulate junk food consumption, and by reducing stress. And the best part is, as little as 20 minutes of brisk walking is all you need to get the beneficial effects.

Why we over-consume junk foods

We know that we shouldn’t overeat candy, cookies, cake and chips, or drink sugary sodas. Diets that are high in these ultra-processed foods cause us to gain weight. But they are just so hard to resist.

Ultra-processed junk foods have been designed to be as tasty and rewarding as possible. When we are exposed to media advertisements, or actual food items (for example, chocolate bars in the checkout lane at grocery stores), brain activity in regions associated with reward processing increases. This reward-related brain activity results in increased food cravings and the drive to eat, even when we are not hungry.

A brain region known as the dorsolateral prefrontal cortex (dlPFC) helps us limit the consumption of ultra-processed foods by both decreasing activity in these reward regions to reduce food cravings and by initiating the cognitive processes needed to exert conscious control over food choices.

When using functional brain imaging to examine brain responses, neuroscientists have shown that increased activity in the dlPFC helps us control food cravings and select healthier food items by decreasing activity in the reward regions of the brain. Conversely, when activity in the dlPFC is decreased, we have a harder time resisting the temptation of appealing junk foods and will consume more snack food.

Exercise can help regulate food consumption

Exercise boosts brain plasticity, which is the brain’s ability to adapt its functions based on new input. Boosting brain plasticity makes it easier to change our habits and lifestyle. More and more evidence has shown that regular physical activity can increase prefrontal brain function and improve cognition.

These exercise-induced increases in prefrontal brain function and cognition makes it easier to regulate or limit our consumption of junk foods. And we can see the effects with as little as 20 minutes of moderate intensity exercise.

I have shown that people consume less ultra-processed food such as chips or milk chocolate after 20 minutes of moderate-intensity exercise (in our study, this was a brisk walk at 5.6-6.1 kilometres per hour on a treadmill with a slight incline). Research has also shown that both a single session of high-intensity interval training and a 12-week high-intensity aerobic exercise program can reduce preferences or appetite for high-calorie junk foods. Similar effects are seen when people engage in moderate aerobic exercise or strength training.

The key takeaway here is that regular exercise can reduce how much people want junk foods and improve their ability to resist the temptation of these appealing foods by improving brain function and cognition. This makes it easier to limit the consumption of these foods to achieve healthier eating and weight loss goals.

Exercise also helps reduce stress

When people are stressed, the body releases a hormone called cortisol, which activates what is known as the fight-or-flight response. When cortisol levels are high, the brain thinks it needs more fuel, resulting in increased cravings for sugary or salty ultra-processed foods.

Participation in regular exercise or a single bout of exercise reduces perceived stress levels and cortisol levels. Exercise also helps reduce unhealthy drink and food consumption when people are stressed.

Stress can also impact how the brain functions. Research has shown that stress can result in decreased activity in the prefrontal cortex and increased activity in reward regions of the brain when looking at pictures of food. This makes it harder to resist the temptation of appealing junk foods.

By offsetting the impact of stress on prefrontal brain function, exercise makes it easier to maintain your goals of healthier eating or reducing junk food consumption. Twenty minutes of brisk walking can help the prefrontal cortex recover from temporary changes in activity, like the ones seen when people are stressed.

Next time you are feeling stressed, try going for a brisk 20-minute walk. It could prevent you from stress-eating.

What exercise is best?

Researchers often get asked what is the best exercise and how much exercise to do.

At the end of the day, the best exercise is one you enjoy and can sustain over time. High-intensity interval training (HIIT), aerobic exercise, meditation and mindfulness, yoga and strength training are all effective in helping improve diet by targeting prefrontal brain function and reducing stress.

If you are beginning a new exercise routine this new year, ease into it, be kind to yourself, listen to your body and remember that a little goes a long way.

By: Cassandra J. Lowe

I am a CIHR and Canada First Research Excellence Fund (CFREF; BrainsCAN) funded Postdoctoral Fellow at Western University. My research examines the cognitive and neural factors that increase the likelihood individuals will over consume appealing “junk foods” (e.g., chips, chocolate, candy, fast-food meals)….

Source: You can’t outrun your fork. But that doesn’t mean exercise can’t help you lose weight or change your diet.

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4 Japanese Dieting Tricks I Used To Lose 20 Pounds

For someone who played sports throughout the majority of her life, I admit I was never good at portion control or exercising for weight loss. My teammates were extremely lean while I looked — as my brother would say — chonky.

I didn’t have the best relationship with my body so I wanted to slim down and feel better about it, but I couldn’t find anything in the U.S that I felt like I could realistically accomplish. To be honest, the fitness culture in this country scares me. I knew I didn’t want to drink Kombucha every day or attend expensive SoulCycle classes for the rest of my life.

When I lived in Japan for a couple of years, I was shocked by the not-so-intense fitness culture. None of my peers went to the gym, drank protein smoothies, or ate granola bars for meals. Throughout my time learning about their culture, I realized that the health culture in Japan gravitates towards prevention rather than cure, which is different from the US philosophy.

Rather than overworking the body to compensate for the overconsumption of high-calorie food, Japanese people eat balanced meals and walk miles for commute every day. Not many people go to the gym or buy expensive products to sustain their because their daily routine is already healthy.

I’m going to introduce 4 Japanese dieting tricks I’ve picked up while living with my family in Japan for a few years. These were all so easy to implement in my day-to-day routine, and they’ve helped me lose 20 pounds in a year without doing anything rigorous that my peers in the U.S were doing. I also believe these tricks will be helpful for those who can’t exercise due to physical injuries or those who find themselves constantly thinking: “I never have time in my day to do something more.”

1. Relax in a half-body bath every other day

A half-body bath may sound silly, but it’s essentially taking a bath while immersing only half of our bodies. The key is to take a relatively longer and warmer bath, which helps speed up our metabolism. The recommended bath time is typically 20~30 minutes — anything longer than that can burden your body and have counter effects.

A long bath of 20~30 minutes is a similar concept to a spa, which is also a large part of Eastern culture. A longer bath usually makes me start sweating after 5~10 minutes into the process, and similar to a spa, it can start to feel uncomfortable. To make this easier, I take my phone or a book to read to the bathtub so the 30 minutes don’t feel too distressing. Taking a half-body bath has become my favorite part of the day when I get to relax and spend time alone.

Americans tend to prefer showering over bathing, but the opposite is true in Japan. I used to shower every day, but I switched to bathing a few times a week and showering the other days. The trick is to take a bath in 100~106 degrees Fahrenheit water as opposed to the 92-degree bath that is recommended in the U.S.

I immerse half of my body until the water level sits right below my chest. A full-body bath in hot water feels constricting on my lungs and heart, but a half-body bath is comfortable enough to take for half an hour, if not less.

If the temperature goes down during the duration of the bath, I like to add some more hot water to bring the temperature back up to the stated range. Japanese bathtubs typically come with a thermometer that allows me to easily set the water temperature. In the U.S where this isn’t the case, I fill up the bath then add hot or cold water to adjust the temperature.

You may ask, why is this a common dieting technique in Japan? Well, taking a half-body bath makes it easier to stay in the bath longer while the hot temperature of the water heats up the body and accelerates the calorie-burning process. The total calories burned per bath are not high enough to be effective for weight loss on their own, but doing it consistently (like every other day of the week) will speed up the metabolism, improve the skin, and get rid of bloatedness. I’ve found it a great way to detox my body and experienced gradual weight loss after a couple of weeks of consistently trying out this method.

When I first started taking half-body baths, all the sweating made me feel uncomfortable and dehydrated. Drinking lots of water before doing this is important to stay hydrated and avoid passing out in the bathtub!

2. Replace rice or spaghetti with konjac

I learned this trick from my Japanese mom who highly encouraged me to eat konjac, also called yam cake. She herself lost over 15 pounds from integrating konjac in two of her meals per day, which she started doing as she could not exercise due to her asthma. This diet has boosted her confidence as she started to feel self-conscious of her stomach that came with age. To this day, my 52-year-old mom is often mistaken to be in her early 40’s, and she attributes it entirely to her konjac diet.

Konjac tastes pretty much like nothing or just a little bit salty, so it’s easy to cook konjac with pretty much anything as a substitute for rice or wheat noodles and it’ll take on the flavor of whatever you cook with.

When I cook rice, I mix the rice grains with konjac and cook it together in a rice cooker. This has helped me easily integrate konjac into my daily diet. Another option would be to buy konjac rice, which is konjac noodles in the form of rice. Konjac rice is made of , bringing down my daily carb consumption.

Konjac is also a great alternative to wheat noodles, which are high in carbohydrates and eventually get converted to sugar in the body. My personal favorite is containing very low carbs and are rich in glucomannan fiber. Glucomannan is recognized as an solution for patients with diabetes or high cholesterol.

Konjac is widely used in the Eastern world for weight loss and cholesterol management. The reason is that it is rich in water-soluble fiber that helps . Konjac also tends to expand in the stomach, slow down the speed at which the digestive system empties, and keep me fuller for longer. This is similar to the feeling of eating vegetables as they also tend to help us gain the satisfaction of feeling full while also not increasing sugar and calorie intake. Konjac is inexpensive too ($1.69 for 255 grams), which means I can skip out on all the expensive Sweetgreen meals.

3. Chew your food more, almost excessively

This trick is most effective for people who tend to binge eat or struggle with portion control. Chewing a lot helps the feeling of “full” last longer.

Chewing food promotes digestion in a timely manner. If we swallow our food without chewing it properly, there are two side effects: 1) The stomach has a difficult time digesting food, and 2) The saliva cannot break down the food. Saliva has amylase and lipase that help break down food and, on top of that, has an antibacterial effect. Chewing food almost excessively lets our saliva do its job, which can be extremely powerful.

In addition, chewing alone releases histamine to the brain that tricks it into thinking that we’re full. It’s a simple mind trick, but I found myself eating smaller portions when I remind myself to keep chewing. The trick is to chew at least 30 times for each bite of food, alternating between chewing on the right and left sides of your mouth. We tend to have a “favorite” side to chew on, but chewing with only one side is tougher on your jaw and is said to cause an imbalanced body.

In Japan, it’s a common understanding that there are two types of bodies: 1) a healthy body that can lose weight, and 2) an imbalanced body that is more resistant to weight loss. The first step to weight loss is building a body that can easily lose weight. To do this, Japanese people speed up their metabolism by taking half-body baths and chewing at least 30 times.

4. Eat vegetables first

This is ingrained in Japanese culture, in which your favorite aunties will insist that you eat your vegetables before consuming other foods. Japanese meals traditionally come in a healthy balance of grains, protein, and vegetables, and Japanese people always start tackling their vegetables before indulging in the protein and grains.

This trick is partially psychological, as eating vegetables first makes us feel fuller before eating other foods. Again, this helped me a lot with portion control. Vegetables also have a lot of fiber, which is known to help with digestion.

That’s not why Japanese people eat vegetables first, though. They actually eat vegetables first because they say there is a strong correlation between insulin and weight loss. My Japanese mom explained it to me like this:

When the body absorbs sugar from the food that we eat, the sugar level spikes up. Then the sugar that we consume gets converted into energy, helping us get tasks done and go about our day-to-day. Then our pancreas releases insulin into our bodies.

Insulin plays a role in bringing down sugar levels and turning the sugar that hasn’t been converted to energy, into fat. In other words, if the sugar level spikes too quickly and too much insulin is released, it becomes easier for our bodies to build up fat. That’s why when we eat rice, bread, or snacks when we’re on an empty stomach, our sugar levels rise up too quickly and an abundance of insulin is pushed out into our bodies.

This trick works because eating vegetables on an empty stomach, before eating other foods, prevents the sugar level from spiking up and insulin from being mass released. Japanese people say that eating vegetables first helps create a body that is more resistant to weight gain.

Some find it easier to lose weight while others find it more difficult. This was an interesting argument to me because I never thought about how people have different body types. While there are multiple explanations for this, Japanese people say that our habits dictate whether we have a body that is “easy to lose weight” versus the opposite.

Doing yoga, having a good posture, and walking often— these Eastern health habits all play a part in building a body that can lose weight.

What really surprised me the most was that these habits were common sense to people living in Japan. None of my friends or colleagues went to the gym — in fact, none of them carved out a time in their day to become skinny. They all ate healthily, walked a few miles per day, and remembered these simple tricks to maintain their health and wellness.

I didn’t see drastic results in the short term because I wasn’t forcing my body to go through drastic changes. But I trusted the process, focused on consistency, and I feel like I have a much better relationship with my body now.

I think of food and exercise as a way to treat and show love to my body. Eating protein-rich food and drinking lots of water make my body happy. If I start out with a mile and gradually work my way up to 5 miles, my body feels great after the run. I don’t want to make my body go through drastic changes and stress it out too much because it’s the one and only vessel for our soul. So let’s start small and make long-lasting effects through these 4 tricks:

  1. Take a half-body bath a few times a week to speed up metabolism.
  2. Replace carbs with konjac to lower sugar intake.
  3. Chew every bite at least 30 times to make sure the saliva is doing its work.
  4. Eat vegetables first to become resistant to weight gain.

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Source: 4 Japanese Dieting Tricks I Used to Lose 20 Pounds | by Project HBE | May, 2021 | Ascent Publication

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Japanese cuisine encompasses the regional and traditional foods of Japan, which have developed through centuries of political, economic, and social changes. The traditional cuisine of Japan (Japanese: washoku) is based on rice with miso soup and other dishes; there is an emphasis on seasonal ingredients. Side dishes often consist of fish, pickled vegetables, and vegetables cooked in broth.

Seafood is common, often grilled, but also served raw as sashimi or in sushi. Seafood and vegetables are also deep-fried in a light batter, as tempura. Apart from rice, a staple includes noodles, such as soba and udon. Japan also has many simmered dishes such as fish products in broth called oden, or beef in sukiyaki and nikujaga.

Historically influenced by Chinese cuisine, Japanese cuisine has also opened up to influence from Western cuisines in the modern era. Dishes inspired by foreign food—in particular Chinese food—like ramen and gyōza, as well as foods like spaghetti, curry, and hamburgers, have been adapted to Japanese tastes and ingredients.

Traditionally, the Japanese shunned meat because of Buddhism, but with the modernization of Japan in the 1880s, meat-based dishes such as tonkatsu and yakiniku have become common. Japanese cuisine, particularly sushi and ramen, has become popular throughout the world.

In 2011, Japan overtook France to become the country with the most 3-starred Michelin restaurants; as of 2018, the capital Tokyo has maintained the title of the city with the most 3-starred restaurants in the world. In 2013, Japanese cuisine was added to the Unesco intangible heritage list.

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