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• Sarah Ferguson, the Duchess of York, announced she has been diagnosed with malignant melanoma. 
• Ferguson’s melanoma diagnosis is the second time the former royal family member has been diagnosed with cancer in the past year. 
• Last summer, she underwent a mastectomy after receiving a breast cancer diagnosis.
• Breast cancer may also increase a person’s risk for melanoma.
• As with many forms of cancer, melanoma is often treatable when detected early.

Sarah Ferguson, the Duchess of York and ex-wife of Prince Andrew, shared on Monday that she has melanoma, a serious and aggressive form of skin cancer.

In an announcement on Instagram, the 64-year-old former royal family member said she’d been taking some time to herself since being diagnosed with malignant melanoma.

Ferguson, widely known as “Fergie,” said the diagnosis came as a “shock” since it is the second cancer diagnosis she’d received in the past year. 

Ferguson underwent a mastectomy and reconstructive surgery last summer after being diagnosed with breast cancer during a routine mammogram screening. A breast cancer diagnosis may also increase a person’s risk of melanoma.

A spokesperson for Ferguson told CNN the malignant melanoma was discovered during reconstructive surgery following a mastectomy. Several moles were removed, one of which was identified as cancerous. Ferguson promptly received treatment and is at home recovering and “in good spirits,” she shared in the post.

As with many forms of cancer, early detection of melanoma is key to increasing a person’s chance of survival.

“It was thanks to the great vigilance of my dermatologist that the melanoma was detected when it was,” Ferguson wrote.

“I believe my experience underlines the importance of checking the size, shape, colour and texture and emergence of new moles that can be a sign of melanoma and urge anyone who is reading this to be diligent,” Ferguson shared.

Ferguson’s melanoma announcement is the latest in a recent wave of royal family health news. Last week, Kate Middleton, the Princess of Wales, had a scheduled abdominal surgery, and King Charles III is being treated for an enlarged prostate. 

What causes melanoma

Melanoma is an aggressive form of skin cancer that can spread quickly to other parts of the body and can be deadly. Melanoma develops in the skin cells responsible for giving the skin its color or pigmentation, also known as melanin.

Melanoma may develop from an existing mole or manifest as a new growth resembling a mole.

In most cases, melanoma is caused by UV exposure from sunlight. Fair-skinned people are often more susceptible to melanoma, but melanoma can also affect people with darker skin tones. Sun protection, regardless of skin tone, is key to prevention.

Dr. Trevan Fischer, surgical oncologist and assistant professor of surgical oncology for Saint’s John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA, told Healthline that in rare cases, genetic factors may increase a person’s melanoma risk. These include:

• P16 genetic mutation 
• dysplastic nevus syndrome (multiple atypical moles) 

“While most melanoma is due to sun damage, there are some congenital or genetic markers that can predispose you to having melanoma,” he explained. 

Who is most at risk for developing melanoma and why?

The biggest risk factor for developing melanoma is skin tone and UV damage from the sun.

Fischer explained that people who have lighter skin tones and tend to burn and have had chronic sun exposure are at the highest risk of developing melanoma. Hair and eye color may also factor into a person’s risk for developing melanoma.

Melanoma most frequently presents on the face, arms and other extremities, but Fischer explained the disease may appear anywhere on the body, including areas that do not get exposed to sunlight.

What’s the link between melanoma and breast cancer?

Breast cancer may increase a person’s risk of developing melanoma, which may have been possible in Ferguson’s case, though a direct link has not yet been established. 

Fischer explained that people who have a BRCA mutation, a known genetic mutation that increases breast and ovarian cancer risk, may have an increased risk for developing melanoma. 

He said other schools of thought believe that undergoing treatment for breast cancer may weaken the body’s immune system and make cells more susceptible to melanoma. 

Is melanoma treatable when detected early? 

Early detection, as with most cancers, is key to successful treatment. In most cases, early-stage melanoma may only require surgery at the site and follow-up appointments with your doctor.

When melanoma is detected early it is unlikely the cancer has spread to the lymph nodes. When melanoma spreads to the lymph nodes it may require treatment including immune therapy and other medications.

In severe cases of late-stage melanoma, radiation may be required. 

Early detection also reduces the risk of melanoma recurrence. Fischer said it’s more likely a person who’s had melanoma could have a new case of melanoma rather than a recurrence of the original melanoma that was treated.

People at high risk for melanoma, such as those with lighter skin tones, should be screened at least once yearly by a dermatologist, who will conduct a full body scan.

At this time, there are no official recommendations for skin cancer screening, Fischer explained, but experts say most adults should begin annual screenings in their 30s and 40s, though this recommendation may vary depending on an individual’s circumstances. 

“I always see my patients twice a year,” Fischer said. “And then I had them see the dermatologist twice a year for the first several years after [a skin cancer] diagnosis because we’re looking to catch something even at an earlier stage.”

Takeaway

Sarah Ferguson, the Duchess of York and former royal family member, shared on Instagram that she had been diagnosed with melanoma, an aggressive form of skin cancer. 

Ferguson’s melanoma diagnosis is the second time she’s been diagnosed with cancer in the past year. Ferguson’s doctors discovered a cancerous mole while she was undergoing reconstructive surgery following a mastectomy for breast cancer. 

A breast cancer diagnosis may increase a person’s risk for skin cancer. As with any form of cancer, early detection of melanoma is key to successful treatment.

• A new systematic review and meta-analysis found a link between drinking 100% fruit juice and weight gain among children and adults.
• One of the reasons fruit juice contributes to weight gain is that it does not make us feel full, which leads to consuming more calories.
• The healthiest beverage swap for both children and adults is water. And if you do drink fruit juice, cut it with water or seltzer.

High in sugar and calories, health experts are finding more evidence that 100% fruit juice may cause weight gain.

In a recent systematic review and meta-analysis, researchers looked at 42 studies, which included 17 that focused on children and 25 on adults.

They discovered a link between consumption of 100% fruit juice and weight gain in children. For adults, they also found a positive association.

“This comprehensive review is the first to evaluate 100% fruit juice consumption and body weight in children and adults using both prospective cohort studies (which follow large groups of people over time to assess relationships between exposures such as diet and lifestyle with health outcomes) and RCTs (which assign groups of people to an intervention or control and examine differences in outcomes between the group),” Michelle Nguyen, lead author of the study, PhD Candidate at the Department of Nutritional Sciences Faculty of Medicine at the University of Toronto, told Healthline. “The use of both these study designs are critical to evaluate the totality of evidence.”

Whether 100% fruit juice is a healthy beverage is a question of great interest from clinicians, the general public, parents and caregivers, and policy makers.

The evidence on 100% fruit juice and weight gain has yielded mixed findings from both observational studies (prospective cohort studies) and clinical trials, Nguyen explained. 

Study findings indicate that 100% fruit juice consumption was associated with weight gain in children, especially among younger children. Among prospective cohort studies in adults, they found that 100% fruit juice was associated with weight gain among studies that did not account for intake of calories in their statistical analyses (unadjusted for calories), suggesting that excess calories play a role in this association. 

“Ultimately, these findings support public health guidance to limit the consumption of 100% fruit juice, especially in young children – to consume whole fruit rather than fruit juices. Our findings are in support of the AAP guidelines on 100% fruit juice consumption in children.  We hope these findings will inform clinical practice guidelines and public health strategies to reduce overweight and obesity,” Nguyen stated.

How does 100% fruit juice contribute to weight gain?

The reason for weight gain is mainly due to the high sugar content.

“I find that most people have an easy time understanding how soda can lead to weight gain. But sometimes we forget how similar soda and fruit juice are,” Dr. Nate Wood, physician at the Yale School of Medicine and culinary school graduate, stated. “Although fruit juice originally comes from a whole fruit (and we know whole fruits are healthy), soda is made in a factory. Otherwise, the two drinks are largely the same: they are both very sugary water.”

Wood continued: “Although sugary water is high in calories, drinking it does not make us feel full. For this reason, the calories in sugary beverages like fruit juice are sometimes called ’empty calories.’ Drinking these calories frequently is one common way that we end up consuming more energy than our bodies need. This extra energy is then converted to body fat, which leads to weight gain.”

However, it is important to note there are other factors that need to be taken into consideration to know what’s causing the increase in BMI.

“The authors of this study looked at studies that compared fruit juice to a non-caloric beverage, so it makes sense that the drink that has calories will be linked with a higher BMI,” said Natalie Rizzo, MS, RD, author of Planted Performance. “And correlation doesn’t equal causation. This means that just because kids who drink fruit juice tend to gain BMI, it’s impossible to know if it’s from the fruit juice alone.”

In addition, the consumption of liquid calories has been shown to result in greater weight gain compared to the consumption of solid calories, Nguyen explained.

Furthermore, “the lack of dietary fiber in fruit juice compared to its whole fruit form can result in decreased satiety and overconsumption of these beverages. In children specifically, studies have indicated that early introduction of fruit juice may lead to increased risk of overweight and obesity due to increased preference for sweet food,” said Nguyen. “Thus, delaying the introduction of 100% fruit juice in young children, moderating serving sizes, and choosing whole fruit rather than fruit juice is recommended.”

This raises the question: “is it advisable to have the actual fruit and skip on the juice?” 

“The answer is nuanced because some kids refuse fruit, but they will accept 100% fruit juice. And 100% fruit juice is made from fruit and has no added sugar, so a kid who drinks it is still getting plenty of vitamins and minerals from drinking the juice,” Rizzo explained. “As a matter of fact, older research states that kids who drink 100% fruit juice have higher intake and adequacy of dietary fiber, vitamin C, magnesium, and potassium. But, if a kid is willing to eat fruit instead of drinking juice, then it’s a good idea to have them do so.”

Nutritional guidelines for children and adults regarding fruit juice 

Children under 12 months of age should not be given any fruit juice, Wood explained. For children and adults above 12 months of age, it’s reasonable to occasionally consume fruit juice as a sweet treat. 

“The key way to look at fruit juice is a sweet treat, not a health food,” said Wood. “It’s not the same as eating a serving of whole fruit. Fruit juice is not essential for children in the same way that it’s not essential for adults. We’re certainly better off opting for whole fruit.”

Limiting fruit juice consumption is advised.

“Kids tend to be more selective in what they will and will not eat,” said Rizzo. “Because of that, they will refuse other healthy options and over consume certain beverages, like juice. So for kids, I would recommend limiting juice intake if they are neglecting other things, like milk or water.” 

Adults have more knowledge of nutrition and are able to make more informed choices, so they can limit themselves to a serving of juice, rather than over consume. Both children and adults don’t need to fully avoid juice, but they should limit the serving size, Rizzo added.

Healthy beverage replacements

“Water is always the best choice for kids and adults,” Rizzo stated. “And milk is important for kids to get calcium and Vitamin D. If a kid wants fruit juice, makes sure it’s 100% juice and limit the serving to 4 ounces per day.”

Unsweetened, fortified soy milk is another option rich in calcium and vitamin D for children who can’t have dairy or whose families prefer plant-based options.

The most important thing when selecting juice is to opt for 100% juice, Wood stated. There are many products out there that look like juice but are actually a juice cocktail made with extra sugar. It’s also important to note that some fruit juices are higher in sugar than others.

 For instance, grape juice can have 36 grams of sugar in a single cup, whereas orange juice has about 21 grams of sugar per cup. 

“I often tell folks to cut their juice with a little still or sparkling water,” said Wood. “For instance, you could add 4 ounces of grape juice to a lime seltzer. It’s fizzy and fun, slightly sweet, has a zip from the lime, and contains much less sugar than a glass of pure grape juice would.”

He added: “Another option would be to take whole fruit, muddle it in the bottom of your glass, and then add some water or seltzer. This works particularly well with berries or slices of citrus — lemon, grapefruit, and lime.”

Takeaway

According to a new systematic review and meta-analysis, there is a positive association between drinking 100% fruit juice and weight gain among children and adults.

Fruit juice is a contributing factor to weight gain because it is high in sugar and calories. It also doesn’t make us feel full, which leads to drinking too much.

Health experts suggest switching to water for both children and adults.

• Cases of measles have been detected in multiple states in the U.S. as well as the U.K. in recent months.
• Measles is one of the most contagious diseases known to exist.
• Nine out of 10 people who have not been immunized against the measles virus will become infected after exposure.

Recent measles outbreaks in several northeastern states in the U.S., as well as across the U.K., have caused some alarm among health officials and renewed controversy over the level of vaccination rates.

Cases of measles have been reported in Delaware, Pennsylvania, and New Jersey, with other reports of infected individuals in Washington state; another person with measles reportedly traveled through Dulles International Airport and Ronald Reagan Washington National Airport on Jan. 3 and 4.

The Centers for Disease Control and Prevention has explained that more than 61 million doses of the measles vaccine (MMR) were postponed or missed between 2020 and 2022 as a result of supply delays during the first two years of the COVID-19 pandemic. “This increases the risk of bigger outbreaks around the world, including the United States,” a CDC statement says.

How contagious is measles?

Measles is an airborne virus that can stay in the air for two hours and can be acquired by touching contaminated surfaces or inhaling the virus in the air. According to the CDC, nine out of 10 people who have not been immunized against the measles virus will become infected after exposure. The symptoms of measles include:

• Cold or flu-like symptoms
• Red eyes
• Fever
• Red or reddish-brown rash across the entire body
• Spots inside the mouth

“Measles is extremely contagious and there has been an increase in measles cases around the world (with a million more measles cases reported in 2022 than 2021 by the WHO) due to setbacks in measles vaccination rates during the COVID-19 pandemic,” Dr. Monica Gandhi, MPH, a professor of medicine at the University of California San Francisco’s Division of HIV, Infectious Diseases, and Global Medicine, told Healthline. “Members of the public are at risk if they have not been vaccinated (which usually happens in childhood) so the larger population need not be concerned if vaccinations are kept up to date.”

In the last half of 2023, there were more than 20,000 cases of measles in Yemen, the country with the leading outbreak. This is an indicator that without widespread immunity or vaccination, the virus can spread widely, Dr. Tina Tan, an attending physician at Division of Infectious Diseases at the Ann & Robert H. Lurie Children’s Hospital of Chicago, told Healthline.

“There are multiple countries around the world where measles is endemic and circulates widely in the community,” Tan said. “With international travel on the increase, unimmunized individuals are getting exposed to measles in the foreign countries that they are visiting, they are getting sick and exposing unimmunized, under immunized and persons that are too young to be immunized or who are unable to be immunized for medical reasons to measles. This has been reported on a number of occasions where exposure is occurring on airplanes, in airports or in the unimmunized person’s community.”

What’s causing these new outbreaks?

The combination of reduced vaccine rates from the early pandemic years and a backlash against vaccines in general by some parents are likely contributors to this uptick in measles, which had been essentially eliminated from the general U.S. population for years. In Mississippi, for example, nearly 99% of kindergartners received both MMR in 2021-22 — the highest rate in the nation. But a U.S. District Court judge in 2023 allowed parents there to file for religious exemptions to state-mandated vaccines, and it appears that similar trends have occurred in other states.

“There are reduced rates of childhood vaccination in the US, with a record number of applications by parents for exemptions to mandatory vaccination at school (reported by the CDC in November 2023),” Gandhi said. “Therefore, young children who have not yet been vaccinated (vaccination starts at 12-15 months) or whose parents decline to get them vaccinated are most at risk of measles infections.”

Unlike the recent increases in respiratory infections around the U.S., these measles outbreaks are not a result of any type of seasonal patterns, Tan said.

“The surges that we are seeing are due to a decline in MMR immunization rates, so that there are more people that are unimmunized and do not protective immunity,” Tan said. “Measles is one of the most highly contagious infectious diseases with the attack rate in a susceptible individual exposed to measles being 90% in close contact setting. Population immunity needs to be 95% or greater in order to stop ongoing transmission in the community.”

What precautions can I take to avoid infection?

Vaccination against measles is extremely effective and safe. The World Health Organization estimates that between 2000 and 2021, 56 million deaths were prevented because of the vaccine. Children typically don’t receive the first dose of vaccine until they are a year old, with a second dose typically between the ages of 4 and 6. For adults who have not been vaccinated, getting the shot is ultimately the strongest defense.

“There is no evidence that face masks have any effectiveness against the small measles virus; ventilation is likely to minimize the risk of any pathogen spread by a respiratory route. The measles vaccine is a live, attenuated vaccine (developed in 1965) given in conjunction with live vaccines for mumps and rubella (e.g. MMR vaccine),” Gandhi said. “Natural infection confers lifelong immunity and the strength of protection from two vaccine doses (which confers 97% protection) is long, although adults should receive a booster MMR vaccine during an outbreak.”

“For those persons who are unimmunized who have been exposed to measles including those that for medical reasons are unable to be vaccinated, they should be quarantined at home and not attend school, daycare or be in a healthcare setting for at least 21 days after the onset of rash in the last case of measles reported in the setting where they were exposed,” Tan added.

Given that these surges are not seasonal, and how infectious the virus that causes measles can be, widespread vaccination is the most effective tool any population has to return to a status the U.S. had in 2000, when the WHO declared measles “eliminated” in the country.

“The level of immunity to measles in the general population in the U.S. is quite high given high vaccination rates (given in childhood since the 1960s) with high natural infection rates prior to the 1960s,” Gandhi said. “However, population immunity will decline if these childhood vaccination rates in the U.S. to measles do not improve. Young children should receive two doses and adults may require booster vaccination prior to international travel, prior to college, prior to pregnancy or during outbreaks.”

Takeaway

An increase in measles infections in several U.S. states is an indicator that immunity and vaccination rates have dropped.

The best defense against measles, doctors and health officials say, is getting vaccinated against the virus.

Children under the age of 1 cannot usually be vaccinated, but after that it’s recommended that they get both doses of the vaccine.

• A study of a half-million people found substantial increased risk of death in individuals who sit most of the day at work. The risk was even greater for cardiovascular disease.
• Individuals who were active at work or intermittently sitting did not have an increased risk.
• Experts say that more must be done to counteract prolonged occupational sitting to avoid these health risks.

People who sit for long periods of time at work are at higher risk of death, especially from cardiovascular disease, compared with those who are more active throughout the day, suggests a new study of nearly a half-million people.

But there’s good news too: moving intermittently even for as little as 15 minutes throughout the day appears to mitigate the risk, as does regular exercise.

Those findings come from a large retrospective study in Taiwan, published today in the journal JAMA Network Open.

Researchers used data from a biannual health checkup program between 1996-2017 that included both men and women who were twenty years old or older. The average age of participants was thirty-nine.

More sitting linked to 16% increased mortality risk

Participants were asked to respond to questions about their lifestyle, activity level, and how much sitting they did per day at work. Researchers then categorized the participants into three categories based on their “occupational sitting volume,” essentially, how much time at their job was spent sitting: “mostly sitting,” the highest volume of sitting per day, “alternating sitting and nonsitting,” intermittent sitting throughout the day, and “mostly nonsitting,” the most active category.

After controlling for things like BMI, smoking, drinking, sex, and age, the study found that individuals in the “mostly sitting” category had a 16% increased risk of death and a 34% increased risk of death from cardiovascular disease than those in the “mostly nonsitting” group.

“This increased risk was observed across various subgroups, including men, women, younger and older individuals, smokers, and non-smokers. These findings emphasize the need to reduce prolonged sitting in the workplace and increase daily physical activity to mitigate the elevated risks of mortality associated with sitting,” Dr. Wayne Gao, PhD, an Associate Professor at the School of Public Health, Taipei Medical University, Taiwan, and first author of the research, told Healthline.

Reduce risk by cutting sit time

The middle group, the intermittent sitters, on the other hand, did not demonstrate an increased risk of death when compared to the most active group.

Dr. Scott Lear, PhD, a Professor of Health Sciences and Chair in Cardiovascular Prevention Research at Simon Fraser University, is most interested in this middle group

“That middle group, that the intermittent sitting group, was really no different from those who did the least amount of sitting. So it was mainly the ‘mostly sitting’ group that  had increased risks for cardiovascular disease  and early death,” Lear said.

Researchers also found that exercise could offset the risks posed by extended periods of sitting during the day. While there’s no clear formula for how much exercise someone has to do to offset sedentary behavior, the study does offer some insight.

According to Gao, engaging in 15-30 minutes per day of exercise, what they refer to in the study as “leisure time physical activity” (LTPA), is enough to offset the health risks of the “mostly sitting” group. 

The researchers also used another physical activity metric known was Personal Activity Intelligence (PAI) to assess daily exercise. Individuals who scored greater than one-hundred per week using the PAI scale, also mitigated the risks associated with prolonged sitting.

Sitting too much linked to heart disease, type 2 diabetes and cancer

It’s no secret that Americans spend a lot of time sitting down, and that can lead to a host of health problems. According to the CDC, about one-in-four Americans sit for more than 8 hours per day, and the average US adult sits between 6.5-8 hours per day.

Sitting too much and other sedentary behavior has been linked to increased risk of early death, cardiovascular disease, type 2 diabetes, and cancer. Your mental health and brain can be affected too. Multiple studies have looked back on the increase in sedentary behavior during the Covid-19 pandemic and found a strong association between sitting time and mental health issues like depression and anxiety. 

This year, the National Institute on Aging published a study showing a strong association between sedentary behavior and dementia risk. They found the risk was particularly great for adults who were sedentary for 10 or more hours a day. 

“It has been reported that modern lifestyles have become increasingly sedentary, resulting in prolonged sitting as a regular part of daily life. Scientific literature also agrees on the harmful effects of prolonged sitting,” said Gao.

In 2020, the World Health Organization for the first time included recommendations on sedentary behavior in its physical activity guidelines. They don’t provide specific guidance about sedentary behavior, of which sitting is a major part, other than to recommend that “Adults should limit the amount of time spent being sedentary.” They also recommend including exercise and replacing sedentary activities with physical activity.

Sitting too much? Here’s what to do to improve your health

The study authors advocate for cultural and occupational changes to “denormalize” prolonged occupational sitting, similar to how public health initiatives have worked on smoking.

“Some recommendations include incorporating regular breaks, introducing standing desks, providing designated workplace areas for physical activity, and offering gym membership benefits. These changes can help shift the culture and perception surrounding prolonged occupational sitting,” said Gao

A few simple ways to be more active and sit less at work, Gao recommends:

• Taking regular breaks to get up and move around. Use an alarm if you need to.
• During set break periods, take a walk or engage in light physical activity.
• Find opportunities to be more active, like using stairs or riding a bike to work.
• Exercise or take part in physical activity during your free time.
• Join a company-sponsored sports team.

Lear also supports initiatives to get people more active, but admits: “We’re not going to get away from sitting.”

Although companies could use money to pay for things like standing desks or treadmills in the office, he believes those are probably inefficient ways to spend money and reduce sedentary behavior. Instead, he agrees that individuals should be more aware of how much time they spend sitting during the day and actively make time to stand up and move around, even if that means setting an alarm every thirty minutes.

“If we can encourage people to get up every 20 or 30 minutes, do something other than sitting, like moving around, that’s an easier message to get across and easier, more feasible for people than to say, ‘Oh, don’t sit anymore,’” he said.

The bottom line

Extended periods of sitting at work are linked to increased risk of death in a new study of a half-million people.

Prolonged sitting and sedentary behavior have become much more common and are associated with numerous serious health problems, like cardiovascular disease.

Exercise can help to offset the risks posed by prolonged sitting.

Finding ways to sit less while at work, like taking active breaks, are an important part of reducing the risks caused by sedentary behavior.

• A new study finds that taking a daily multivitamin may help your cognition and memory.
• Researchers found individuals who were given multivitamin had a modest benefit in their memory and cognitive function over two years.
• The vitamin may help with cognitive aging.

New research finds that a multivitamin may help you maintain both your cognition and memory.

The new study published online on January 18, 2024, in The American Journal of Clinical Nutrition, reports that daily multivitamin supplementation was beneficial for both global cognition and episodic memory.

Global cognition refers to the overall status of our cognition while episodic memory deals with our recollection of past events and experiences.

The study is the third in a series of studies that are part of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).

The purpose of COSMOS is to determine whether cocoa flavanols or multivitamins have the ability to reduce the risk for certain health conditions including cognitive decline, heart disease, stroke, and cancer.

Multivitamins linked to better memory and cognition

In the two previous COSMOS studies, the researchers assessed people’s cognition via telephone and the Internet. For the present study, COSMOS-Clinic, they gave a subset of 573 people in-clinic cognitive assessments.

After analyzing their data, the team saw a “modest” benefit from the multivitamin in these individuals over a period of two years. They also saw a significant improvement in the participants’ episodic memory.

When the data from all three studies was combined, it was found that there was strong evidence that both global cognition and episodic memory had improved.

The study authors estimated that daily supplementation had delayed cognitive aging by about two years in comparison to those who had received a placebo rather than a multivitamin.

Why these findings matter

These findings are important, according to Kelsey Costa, MS, RDN, a registered dietitian and nutrition consultant for the National Coalition on Healthcare because “[m]ild cognitive impairment (MCI) and Alzheimer’s disease (AD) pose significant health challenges in the US, especially in the aging population.”

Costa noted that those who have MCI are about three to five times more likely to develop some form of dementia.

Additionally, the prevalence of AD is expected to reach over 14 million by 2060. This especially affects Hispanics, African Americans, and people over the age of 85. It is also expected to be more prevalent among women.

“Given the increasing prevalence rates of MCI and AD, particularly in older adults and specific groups, finding safe and effective preventative measures is crucial,” said Costa. “The study suggests that daily multivitamin supplementation could serve as a key part of the solution.”

Why multivitamins might help with memory and cognition

Melanie Murphy Richter, MS, RDN, a Registered Dietitian Nutritionist and instructor of Nutrition Physiology at the University of California, Irvine, explained that the vitamins and minerals that are found in multivitamins play an important role as catalysts in a variety of brain functions.

“For instance, we need certain vitamins like B6 and B12 to produce the neurotransmitters serotonin and dopamine for the brain,” she stated.

Richter went on to say that neurotransmitters are involved in sending signals to other parts of the body.

“If they are underproduced, our signaling pathways will be slowed or even ineffective. Not to mention, serotonin dictates our sleep cycles. Underproduction of serotonin can lead to impaired sleep which is known to accelerate whole-body aging, including of the brain,” she explained.

Yet other micronutrients found in multivitamins — such as vitamins C and E and minerals like selenium and zinc — can protect against the oxidative damage that is associated with age-related cognitive decline, per Richter.

Richter added that micronutrients are also important in breaking down macronutrients like carbohydrates, fats, and proteins. Micronutrient deficiencies can leave us unable to break down our food for energy which can also deprive the brain of energy.

“This can lead to brain fog, poor memory recall and eventually more serious decline over time,” she explained.

Finally, Richter pointed to minerals like magnesium, zinc, and copper which play a big role in maintaining the brain’s electrical charge.

“Inadequate supply of these micronutrients … can lead to malfunctioning communications between brain cells and degradation of our overall brain functioning,” she remarked.

Should you be taking a multivitamin supplement?

Claire Sexton, DPhil, Alzheimer’s Association senior director of scientific programs and outreach said that although these results are encouraging, the organization is not ready to recommend widespread multivitamin use in order to prevent cognitive decline.

“Independent confirmatory studies are needed in larger, more diverse and representative study populations,” she stated.

“It is critical that future treatments and preventions are effective in all populations,” Sexton added. “COSMOS-Clinic, for example, had less than 2% non-White in the multivitamin group and 5% non-White in the placebo group.”

She noted, however, that multivitamins are easy to obtain and relatively affordable. “With confirmation, these promising findings have the potential to significantly impact public health — improving brain health, lowering health care costs, reducing caregiver burden — especially among older adults.”

Sexton further advised that people speak with their healthcare providers about the benefits and risks of any dietary supplements they are taking, including multivitamins, noting that, although it’s preferable to obtain nutrients through a balanced diet, this is not always possible for people.

Takeaway

Researchers have found that a daily multivitamin supplement was linked with slowed cognitive aging and improved memory.

This is important because of the growing prevalence of dementia.

The improvements in memory and cognition could be because vitamins and minerals play important roles in brain health.

It’s too soon, however, to say whether people should be taking a multivitamin as a strategy to prevent cognitive decline as they age. You should speak with your doctor if you have questions about whether a multivitamin supplement is right for you.

• People with cardiovascular disease who took an erectile dysfunction (ED) drug and a medication for angina, or chest pain, had a higher risk of early death.
• The ED drugs examined in the study are phosphodiesterase type 5 inhibitors (PDE5i), sold under the brand names Viagra, Levitra, Cialis and others.
• People taking both of these types of medications should talk to their doctor about stopping one or both of the medications, or possible alternative treatments.

A new study finds that Viagra, Cialis, and other similar types of medication are linked to a higher risk of cardiac issues for people who also take medication for chest pain.

Phosphodiesterase type 5 inhibitors (PDE5i) — sold under the brand names Viagra, Levitra, Cialis and others — are a common treatment for erectile dysfunction (ED) in people with cardiovascular disease.

However, people prescribed both a PDE5i for ED and a nitrate for angina (chest pain) had a higher risk of heart failure, early death, and other negative health outcomes, a new study shows.

“Physicians are seeing an increase of requests for erectile dysfunction drugs from men with cardiovascular diseases,” said senior study author Dr. Daniel P. Andersson, associate professor at Karolinska Institutet in Stockholm, Sweden, in a news release.

“While there is a positive association of ED medication for men with cardiovascular disease, patients taking nitrates may experience an increased risk of negative health outcomes,” he said.

The study was published Jan. 15 in the Journal of the American College of Cardiology.

Why using both Viagra and nitrates are not recommended

The use of PDE5i treatment in people with cardiovascular disease and ED has been controversial, the authors of the new paper write. These drugs can affect blood flow, disrupt the lining of the blood vessels, and cause oxidative stress.

In addition, use of a PDE5i and nitrate together is not recommended, because both types of drugs can cause drops in blood pressure, but through different mechanisms. In spite of this, some research has found that the number of people prescribed both types of drugs is growing.

In the new study, researchers examined whether men with cardiovascular disease who were prescribed both drugs had a higher risk of certain cardiovascular outcomes.

The study included 61,487 men who had a history of a myocardial infarction (heart attack) or percutaneous intervention (treatment to open a blocked artery, also known as revascularization) from 2005 to 2013. The data came from the Swedish Patient Registry.

In addition, participants filled at least two prescriptions for nitrates — sublingual nitroglycerin or oral nitrates — during that time. Some participants also filled at least two prescriptions for a PDE5i —sildenafil, vardenafil, tadalafil or a combination of those.

Among these men, 55,777 were treated with nitrates alone, and 5,710 were treated with nitrates and a PDE5i. Researchers followed nitrate-only users for an average of 5.7 years, and PDE5i and nitrate users for an average of 3.4 years.

The average age of the nitrate-only users was 70 years, and the average age of men treated with a PDE5i and nitrate was 61 years.

Researchers examined medical data to see how many men died early from any cause, or from a cardiovascular or other cause; or had a heart attack, heart failure, or any major cardiovascular event; or needed cardiac revascularization.

People taking both a PDE5i and nitrate had a higher risk of all of those health outcomes, compared to those taking a nitrate alone, the study showed.

However, few of these negative health events occurred 28 days after participants filled the prescription for a PDE5i, “indicating a low immediate risk for any event,” the researchers wrote.

Dr. Cheng-Han Chen, interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, Calif., wasn’t surprised by the study’s findings.

Chen was not involved in the study.

“We have known for a long time that using a PDE5i along with nitrates can result in an unsafe drop in blood pressure,” he told Healthline. “This study clearly confirms that this combination can result in increased risk of cardiovascular events and even mortality.”

What to know about heart health and erectile dysfunction

One of the limitations of the study is that researchers did not know if patients took the medications that they were prescribed, or how often — only that they filled the prescription.

The study also included people who had already had a heart attack or underwent revascularization, which makes them high-risk. As a result, the findings may not apply to other groups of people.

In addition, the study is observational, so it cannot show direct cause and effect. 

It could be that the increased risk of negative health outcomes is due to both types of medications causing dilation of the blood vessels, said Dr. Yu-Ming Ni, cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif. 

However, there could be other reasons for the increased rates of early death in people taking both drugs, he told Healthline. For example, the need for a PDE5i may be a sign of more severe cardiovascular disease overall.

“Having erectile dysfunction can be related to poor blood flow in the penis,” said Ni. However, “we know that having blood vessel disease in arteries in one part of the body suggests you’re going to have blood vessel disease in arteries in other parts of the body.”

More research is needed to understand the link between the use of these drugs and the negative health outcomes seen in this study.

In general, people should not be on both medications at the same time, Ni said, something backed up by the new study’s findings.

However, “many men [taking a nitrate] also happen to be on erectile dysfunction medications at the same time, and [your physician] may not be aware of it, for various reasons,” he said. “So it’s really important to bring this to the attention of your physician, if you’re taking both.”

Chen recommends that if you are taking both types of medications, you should talk to your primary care provider or cardiologist about stopping one or both drugs.

In addition, “patients with both ED and angina should know that there are alternatives to nitrates — such as calcium-channel blockers and ranolazine — that can be more safely used if they are taking a PDE5i,” he said.

Takeaway

Researchers examined medical data on men with cardiovascular disease who were prescribed a nitrate for angina, or chest pain. Some were also prescribed a phosphodiesterase type 5 inhibitors (PDE5i) for erectile dysfunction.

Men who were prescribed both types of drugs had a higher risk of dying early, heart attack, and other cardiovascular outcomes, compared to those who were prescribed only a nitrate.

Experts say that, in general, these two types of medications should not be used together. If you are taking both drugs, talk to your doctor about stopping one or both meds, or finding an alternative medication.

• Pharmaceutical company Eli Lilly is urging people not to use its tirzepatide medications Mounjaro and Zepbound for cosmetic weight loss.
• They said the drugs are designed for serious diseases and can pose potentially serious health risks to people using them for other purposes.
• Experts say the benefits of these drugs outweigh the risks for people with obesity, but that balance may not be true for someone trying to lose a minimal amount of weight.

Officials at Eli Lilly have posted an open letter regarding the use of its FDA-approved tirzepatide medications, Mounjaro and Zepbound, for cosmetic weight loss.

The company stated that it was aware of the practice of these drugs being prescribed or used outside of the parameters of the Food and Drug Administration as well as the use of tirzepatide by compounding pharmacies that mix customized medicines.

“Mounjaro and Zepbound are indicated for the treatment of serious diseases; they are not approved for – and should not be used for – cosmetic weight loss,” the statement reads.

“Products claiming to contain tirzepatide, Mounjaro, or Zepbound that are made and/or distributed by compounding pharmacies have not been reviewed by the FDA or global regulatory agencies for safety, quality, or efficacy; are not FDA-approved or approved by global regulatory agencies like Mounjaro and Zepbound; and may expose patients to potentially serious health risks,” the officials added.

Are Mounjaro and Zepbound safe to take for weight loss?

Mounjaro is available in injectable single-dose pens or vials.

It is recommended for adults with type 2 diabetes to improve blood sugar, but it is meant to be combined with dietary and exercise changes.

There is an FDA warning on Mounjaro about a potential increased risk for thyroid cancer.

Other side effects include:

• Pancreatitis
• Hypoglycemia
• Allergic reactions such as rash or swelling
• Kidney failure
• Diarrhea
• Nausea
• Vomiting
• Vision changes
• Gallbladder pain
• Jaundice
• constipation

Zepbound is also injectable and is meant for adults who are overweight or have obesity.

The company’s recommendation is that it be used with a reduced-calorie diet and an increase in physical activity.

Zepbound also has an FDA warning about potential thyroid cancer risk.

Other side effects include:

• depression
• hair loss
• heartburn
• hypoglycemia
• allergic reactions such as rash or swelling
• pancreatitis
• jaundice

In referring to drugs containing tirzepatide, Dr. Dan Azagury, FACS, the chief bariatric surgeon and medical director of Stanford University School of Medicine’s Lifestyle and Weight Management Clinic in California, said using the medications for cosmetic purposes is not recommendable.

Aside from the side effects, he said the drugs can create longer-term problems for people who are trying to lose weight quickly rather than applying dietary and exercise regimens over time for overall health.

“We tell our patients that if they start the drug they should do so being comfortable with the idea of staying on it forever,” Azagury told Healthline. “Because often when you stop there is a rebound effect. In particular, if you stop abruptly. Patients who take this just to lose 5 to 10 pounds and stop will then likely regain 10 to 15 pounds, leading to worse long-term outcomes and a yo-yo effect that is unfavorable. I think educating patients in that way would be beneficial.”

Are Mounjaro and Zepbound different than Ozempic?

Ozempic, along with drugs such as Wegovy, are commonly called GLP-1 drugs, or glucagon-like peptide1 receptor agonists. Tirzepatide drugs are part of the GLP-1 class.

Ozempic is meant to be prescribed to adults with type 2 diabetes to help lower risks of heart disease and manage blood sugar levels, but it is also prescribed off-label — where a drug that’s approved for certain conditions is prescribed for another purpose — for weight loss or weight management.

Wegovy is recommended with exercise and a low calorie diet for long-term weight loss in:

• adults with a body mass index (BMI) of 30 or higher (obesity)
• adults with a BMI of 27 or higher (which is considered overweight) and a health condition that’s related to weight
• children 12 years and older whose BMI is in the 95th percentile or higher (which is considered obesity)

All GLP-1 drugs have been found to be linked to serious gastrointestinal side effects, some of which can require hospitalization.

Research published in October 2023 reported strong associations with intestinal blockage and pancreatitis in users of GLP-1 drugs.

Risks vs benefits in using tirzepatide drugs

Azagury said that the use of these type of drugs for purposes other than those approved by the FDA can change the risk factors for people.

“Every drug has side effects and potential risks. When the FDA approves a drug, they weight the benefits vs the risks,” Azagury said. “They issue an indication for use based on that equation. If you’re doing it for cosmetic purposes with no health benefit, then that equation is different and the side effects or risks might outweigh the benefits.”

Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California, said the statement by Eli Lilly will likely make no difference on how people look for cosmetic weight loss treatments.

“Patients seeking these medications for weight loss will try to obtain them regardless of any warnings,” Ali told Healthline. “These medicines are in short supply because the demand is so high. Many patients who do not meet the manufacturers’ guidelines are seeking these medications for weight loss. These medicines are more effective than diet and exercise alone, so people who do not have significant weight view them as a more convenient solution.”

That type of demand, Azagury said, is also creating problems or people for whom tirzepatide drugs would be beneficial for long-term health.

“It’s unfortunate because this is an expensive drug that is extremely beneficial to patients with obesity and they have difficulty accessing it,” he said. “Its use for cosmetic by people who can afford it is increasing disparities and reducing access for patients who would truly benefit.”

• A new study shows women with perinatal depression are associated with a greater risk of dying by suicide, particularly during the first year of their diagnosis.
• Many factors affect perinatal depression onset, including hormone changes during and after pregnancy, personal or family history of depression, major life stressors, and marital conflict.
• To treat this type of depression, experts recommend psychotherapy and antidepressants in serious cases.

A new study shows that women with clinically diagnosed perinatal depression face an increased risk of death as a result of suicide, especially during the first year after receiving a diagnosis. The results were published January 10 in the BMJ.

Researchers examined data from the Swedish national registry between 2001 and 2018 and found 86,551 women with a first-time diagnosis of perinatal depression and 865,510 women without perinatal depression who gave birth around the same age and during the same year.

They also looked at data for 24,473 of the women who had perinatal depression with 246,113 full sisters who were unaffected by this illness and gave birth to at least one baby throughout the study duration.

The findings demonstrate that women with perinatal depression are more than twice as likely to die compared to women who do not have perinatal depression. The risk appears highest during the first year after being diagnosed.

While suicide is rare for people with perinatal depression, the increase in suicide was nearly six fold compared to people without this mental illness. Those with perinatal depression were also three times as likely to die from an accident, the researchers report.

“This study uses a large dataset from Swedish registries and demonstrates a significant association between peripartum depression and risk of suicidal behavior,” Dr. Khatiya Moon, a psychiatrist at Northwell Health, told Healthline. Moon was not involved in the research.

“A strength of the study is that the investigators tried to control for factors like upbringing and previous history of depression or other psychiatric disorders, which could otherwise confound the results,” she added.

Perinatal depression linked to increased suicide risk

In the study, researchers discovered that women with perinatal depression had a greater risk of mortality.

The findings were consistent regardless of any pre-existing psychiatric conditions, particularly among people who died by suicide and during the first year after being diagnosed. 

“Becoming a parent is a major life transition,” Moon said. “Not only are there massive hormonal shifts that affect the brain and body of the postpartum person, the psychological transition to parenthood is among the most dramatic changes most people ever go through.” 

“The parenthood transition also changes how a person relates to others and what supports they may need. Without the right support, the postpartum period can be fraught with challenges. This study is another reason to take perinatal depression seriously as a contributor to maternal mortality,” Moon added.

The study also highlights the risks associated with major depression, a recurrent mental illness.

“Major depression is a serious illness associated with high risk for other medical illness and mortality, including suicide,” Dr. Adele Viguera, associate director of the Perinatal and Reproductive Psychiatry Program at Cleveland Clinic, told Healthline. Viguera was not involved in the new research.

“These findings underscore the serious morbidity and elevated mortality associated with major depression, whether postpartum or not. If a person has had one episode of major depression, their risk for developing a subsequent episode is around 50%,” Viguera noted.

“If an individual has experienced at least two episodes, their risk for having another episode increases to 80%. Postpartum depression is no different with respect to these serious consequences, including elevated risk for subsequent recurrences both postpartum and outside of the postpartum period,” Viguera continued.

Michele Goldman, a psychologist with the Hope for Depression Research Foundation, told Healthline while the study highlights the importance of monitoring and intervening in higher-risk populations, “there was a lack of clarity in the study that brings up additional questions about the findings.”

“The study defines depression as people having received a diagnosis by a professional after receiving specialized care or because someone was dispensed an antidepressant medication,” Goldman explained.

“Being on an antidepressant medication does not constitute a diagnosis of depression; further, there are people on antidepressant medications to treat other conditions (not depression). Therefore, their main criteria to categorize women as having depression is not necessarily a sound measure,” Goldman noted.

What causes perinatal depression?

Many factors contribute to perinatal depression, the period before and after the birth of a child.

Moon said the exact causes of perinatal depression are not fully understood but noted the causes may vary from person to person.

“Previous studies looking at this question have suggested that some women with PND may have differences in how their body treats GABA, an important neurotransmitter that is involved in regulating mood,” Moon said.

“This was part of the rationale in the development of zuranolone and brexanolone, which are both FDA approved for [the] treatment of postpartum depression and both involved in GABA modulation,” he added.

The postpartum period also brings a rapid shift in hormones such as estrogen, progesterone, and allopregnanolone. Postpartum depression affects around 1 in 8 pregnancies, according to the Centers for Disease Control and Prevention (CDC).

“As these hormones influence mood-regulating neurotransmitters, it is thought they may play a role in postpartum depression,” Viguera said.

“However, studies find no consistent link between hormone levels and mood issues after birth. Still, some think certain women are extra sensitive to postpartum hormonal shifts, making them vulnerable to postpartum depression and related mood problems during menstruation and menopause,” she added.

Beyond hormones, other factors also seem to be at play. 

“Consistently, women who report marital dissatisfaction, insufficient social support, and stressful events during or after pregnancy have higher rates of postpartum depression,” Viguera said.

“The condition likely indicates an underlying susceptibility to depressive disorders. Women with histories of depression or bipolar disorder are at greater risk, and women who develop postpartum depression often have recurring depressive episodes unrelated to reproduction.”

While hormones may contribute to perinatal and postpartum depression onset, psychological and social factors also affect risk a person’s risk.

All new birthing parents are at risk for developing postpartum depression regardless of age, relationship status, education, or income level. However, certain risk factors may increase a person’s likelihood of developing this debilitating mental health condition. According to Viguera, these include:

• previous postpartum depression
• depression during pregnancy
• personal or family history of depression 
• recent major stressors
• inadequate social support system 
• marital conflict

How is perinatal depression treated?

Perinatal and postpartum depression is treatable, especially when diagnosed early.

“It is imperative to evaluate and diagnose postpartum mood disturbances,” Viguera said.

“Often, a first step is screening, followed by referral to an expert in this area. The approach to treatment is multi-prolonged and can include a variety of treatment modalities, usually in combination such as with talk therapy, medications, involving family members to provide support at home and community support services.”

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed for treating perinatal and postpartum depression.

“These can help manage symptoms and regulate mood,” said Viguera. 

“An exciting development in the treatment of postpartum depression is the recent release of the first-ever FDA-approved antidepressant indicated for postpartum depression called zuranolone (Zurzuvae), the first rapid-acting oral short-course treatment specifically for moderate to severe [postpartum depression] PPD. Onset of action is seen as early as day 3 in clinical trials,” she noted.

Various psychotherapies can also be very helpful in treating postpartum depression. 

“For example, cognitive behavioral therapy helps identify and change negative thought patterns, or interpersonal therapy focuses on improving communication and relationships,” Viguera said, noting that group therapy connects pregnant and postpartum people around similar difficulties.

In many cases, the combination of talk therapy and medication provides a better outcome for recovery than either modality alone. Other helpful interventions for perinatal depression may include:

• getting adequate sleep
• following a balanced diet
• exercising regularly
• joining support groups

“Having a strong support system is also crucial,” Viguera said. “Partners, family, and friends can provide emotional support and practical help with child care to alleviate stress. In general, treatment is tailored to each woman’s needs and symptoms with the goal of restoring mood and daily functioning.”

Moon added that pre- and post-natal care appointments “go a long way” for most people.

“Pregnancy and parenthood also provide the opportunity to connect with people in one’s community in a new way, and it can be helpful to build networks of other parents through childbirth and parenting classes, support groups, and mother-infant classes,” Moon said.

If you’re experiencing symptoms of peripartum anxiety and depression, it’s important to seek treatment and bring up concerns to your healthcare team, such as an OB-GYN.

Takeaway

A new Swedish study shows an increased risk of death, particularly death by suicide, among people diagnosed with perinatal depression.

The findings highlight the mortality risks associated with perinatal, postpartum, and major depression, which are debilitating mental health disorders when untreated.

“It is well known that people with mental disorders experience excess mortality compared with the general population,” Viguera said. “Postpartum depression is no different with respect to these serious consequences.”

With the emergence at the end of last year of COVID-19 variant JN.1, there are questions about how it compares to the many other variants that have been identified. JN.1 descends from variant BA.2.86 and has an additional mutation in …

• Pharmaceutical company Eli Lilly will begin offering an “end-to-end” healthcare experience called LillyDirect.
• The service will help patients get access to doctors and to the company’s medicines, including weight loss drug Zepbound.
• Obesity doctors welcomed the announcement, saying it will help expand access for many Americans.

American pharmaceutical company Eli Lilly will begin offering a suite of healthcare services, including access to independent telehealth providers and free shipping on medication.

The company announced the launch of LillyDirect on January 4, 2024, and bills it as an “end-to-end digital healthcare experience.” The program is targeted at individuals with obesity, migraine, and diabetes.

It will offer pharmacy and healthcare services, including convenient access to medications like insulin and the recently approved obesity medication Zepbound.

“With LillyDirect, our goal is to relieve some of those burdens by simplifying the patient experience to help improve outcomes. LillyDirect offers more choices in how and where people access healthcare, including a convenient home delivery option to fill Lilly medicines they have been prescribed,” David A. Ricks, Eli Lilly’s chair and CEO said in a press release.

Services offered by LillyDirect include:

• Access to an online pharmacy for the company’s medicines with free shipping.
• Educational information about disease management.
• Tools to find independent healthcare providers via both telehealth and in-person settings.
• Manufacturer savings on medicines

Eli Lilly has partnered with telehealth company Form Health for telehealth options and Healthgrades for in-person doctors. They also make it clear that all healthcare providers are independent of Eli Lilly.

“The LillyDirect listing is not an endorsement or recommendation of the independent clinician networks or telehealth clinicians. The telehealth service providers and healthcare professionals listed through the “find in-person care” feature on LillyDirect are independent and separate from Lilly. Treatment decisions and prescribing practices are made at the discretion of the provider’s care team,” a representative for Eli Lilly told Healthline in an emailed statement.

A welcome addition to obesity care

Dr. Caroline Apovian, MD, a Professor of Medicine at Harvard Medical School and the co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, welcomed the announcement.

“I think this is a great move. Lilly is really helping patients by getting them to a telemedicine program run by doctors who can get them access,” she told Healthline.

Those sentiments were echoed by other experts contacted for this story.

“From my perspective, anything that helps patients have access to care, and in particular to specialized high quality care and drugs is positive,” said Dr. Dan Azagury, MD, section chief of Minimally Invasive and Bariatric Surgery and medical director for the Bariatric and Metabolic Interdisciplinary clinic at Stanford University.

Both Apovian and Azagury disclosed that they are medical consultants to Form Health.

Lowering barriers to access

Telehealth services that sprang to life during the pandemic are now important to obesity care. Both Azagury and Apovian say that telehealth is now essential to help them keep up with the demand for care.

“I would say, in general, obesity care lends itself very well to telehealth. I’ll tell you that my practice has switched to telehealth because of COVID, but we’ve never switched back,” said Azagury.

“There are many people out there who want our services. We are hiring more physician assistants and nurse practitioners to help the MDs and hiring more MDs because clearly with 42% of Americans who need obesity treatment, we don’t have enough obesity medicine specialists to do it,” said Apovian.

Apovian told Healthline that telehealth services also give her greater freedom to see patients who require more complex care and have serious comorbidities.

“My slots in my center to see in-person patients can be reserved for patients with congestive heart failure and obesity or kidney failure with obesity,” she said.

Ongoing obesity drug shortages

LillyDirect could also help play a role in ensuring that patients who need medication can reliably get it.

Novel diabetes and obesity medications known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), have proven to be exceptionally effective for weight loss. They have simultaneously grown in popularity and burst into pop culture and headlines across the United States.

However, the popularity of the drugs has been a blessing and a curse. Novo Nordisk, the Danish pharmaceutical company behind Ozempic and Wegovy has faced numerous shortages and supply chain issues while attempting to keep up with demand.

The conundrum has, in some instances, left patients unable to get access to their medication. 

Just this week, Ricks said that Zepbound had reached 25,000 new prescriptions per week and that the company’s current output might not meet demand. While the company is investing in more manufacturing infrastructure, how much of the drug they can actually produce is unclear.

The bottom line

American pharmaceutical company Eli Lilly will begin offering healthcare services through their new program LillyDirect.

LillyDirect services include an online pharmacy, tools for finding in-person and telehealth doctors, and some financial incentives like free shipping and manufacturer savings on medication.

Obesity experts contacted by Healthline were supportive of the initiative, saying that it would help expand access and help meet surging demand for obesity drugs, including Zepbound.