The Guardian has reported this morning that:
A weight loss injection could reduce the risk of heart attacks and benefit the cardiovascular health of millions of adults across the UK, in what could be the largest medical breakthrough since statins, according to a study.
It found that participants taking the medication semaglutide, the active ingredient in brands including Wegovy and Ozempic, had a 20% lower risk of heart attack, stroke, or death due to cardiovascular disease.
I am not doubting the report. Nor am I denying that this might be a powerful discovery. But I also sense a number of other things.
One is the sense of glee there must be in the pharmaceutical company responsible for this. There is nothing more profitable than a preventive medicine that will be prescribed to large numbers of people 'just in case'. They will be laughing all the way to the bank.
Then there will be those asking 'how do we pay for this?' I do, of course, have answers. However, my fear is that essential services to those who are really ill will suffer to meet the needs of those currently being mistreated by the medico-pharma-big sugar industrial complex.
What I mean by that is that however good this drug might be, nothing could reduce the risk of heart attacks more than reducing the amount of sugar in diets, the amount of ultra-processed food we eat, and people doing more regular exercise without the need to go to anything like a gym - a good walk at a reasonable pace done quite often would do just as well. These facts are not being mentioned because that would reduce big business profits, which would never do.
The risk of heart attacks could, in other words, be much better solved by people learning to have much better lifestyles, which would often be more enjoyable than those they already have. But this is not on the NHS agenda of either the Tories - whose Health Secretary is married to the boss of British Sugar in a coincidence that is almost staggering in its absurdity - or of Wes Streeting for Labour. Why is that, I wonder?
I did take medical advice on the drafting of this post.
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There are a lot of interacting factors here:-
1) The intention is that those with a BMI of over 27 will benefit from this drug. (from news reports this morning), so those already with an issue.
2) The 70%+ of supermarket food purchases in the UK that are classed as ultra-processed with high levels of fats/sugars contribute hugely to the continuing obesity problem. The highest profit margins are from these ultra-processed foods.
3) The poorest 20% of the population are the least well nourished, as fruit and veg are much more expensive than doughnuts and so suffer from the highest rates of obesity, as well as rising malnutrition.
4) The levels of youth obesity are high and increasing, often attributed to being due to children being less physically active in the digital age, but also because there is increasing child poverty and hence these children have poorer dietary standards.
Tony, your response reads like,
1. Yeah but
2. Yeah but
3. Yeah but
4. Yeah but
Yes, people need help, also, people need to not give in and accept their lot, which a lot of, yeah buts, imply.
Also, if people took the time to shop locally and buy healthy fruit and especially veg, they’d find as I have done, that it’s cheaper.
Overall, a vegetarian diet is cheaper, without a doubt.
We are largely vegetarian.
Of course it is highly qualified. The entire issue is extremely complex.
The notion that obesity has a simple cause and thus a simple remedy can apply is glib, at best.
The research evidence is incontrovertible regarding the links between poverty and vulnerability to obesity.
The entire food retailing system militates against a balanced diet for large sectors of the population, but especially those less well off.
In the UK the big 6 supermarkets control 85%+ of all food sales.
The same is true in the States, which has even higher levels of obesity.
Food choices and diets are therefore highly manipulated by the retail sector.
Add to that a very large fast and takeaway food sector (now with added home deliveries) mostly selling industrially processed products, which are often unbalanced nutritionally.
It’s all very well commenting that local fruit and veg shops offer cheap alternatives, but these are few and far between, as are independent butchers, and actually our local greengrocer is more expensive than the supermarkets.
Neal
You make a huge assumption about other peoples’ lives here: “Also, if people took the time to shop locally and buy healthy fruit and especially veg, they’d find as I have done, that it’s cheaper. ”
If I shop locally I can buy poor quality, expensive fruit and veg from the Co-op. If I spend an hour on the bus I can buy poor quality, slightly less expensive fruit and veg from an indoor market. Then spend anothe hour on the bus getting home. My best option is to have it delivered from Tesco! I very much doubt that my situation is unique.
I admit my local Coop has really quite good veg, less than 1/2 mile away. But maybe I am lucky. And I can be picky when it comes to veg.
I would advise people to look at the writings of Professor Kate Manne, who has written about these drugs in the wider context of fatphobia. While in the short term they may offer change, they come with many potential side effects, also most people will eventually plateau and discontinue use of the drug and then the weight will more often than not return.
Also these drugs were developed for the treatment of diabetes and the weight loss was a side effect that, as you point out Richard, was seen as worth marketing to the public by the pharmaceutical companies, which in turn reduces the supply for people who need it for life-saving purposes.
Ultimately I agree that systemic change is needed and just trying to shame people for being bad parents/people because they are time poor due to having to work several jobs thereby encouraging the use of quick fix meal options to feed themselves and their families does not and will not ameliorate the situation.
https://www.penguinrandomhouse.com/books/722318/unshrinking-by-kate-manne/
http://www.katemanne.net/opinions.html
As usual the health industry treats the symptoms and not the cause, because it can make more money. Did anyone hear the government explain how we can boost our immune system during the pandemic?
I remember someone I knew – who ironically died young from alcohol related issues commenting on the number of ‘active old’ we knew and that none of them had ever owned a car.
Says it all really
Might this article be relevant to the U. K.?
https://www.counterpunch.org/2024/05/14/weight-loss-drugs-go-hand-in-hand-with-junk-food-industry/
Probably
This article absolutely nails it.
Indeed. The cynic in me says one of the companies raking in enormous profits from semaglutide is using some of those to have a PR offensive.
It has long been known that type 2 diabetes is a risk factor for heart attacks, and that dealing with the type 2 diabetes (which in most cases can be done through improved diet and exercise) reduces that risk. It is interesting though that the new study shows that even in a group without diagnosed type 2 diabetes (though they were overweight which is often associated with it) a pharmacological treatment for diabetes has a favourable effect on heart attack risk.
The comparison with statins is optimistic. Statins have been widely used for so long that their side-effect profile is well established (and small), and of course they are cheap and easily taken drugs. And as you say for the sort of cases in the study – non-diabetic with known cardiovascular risk – improving diet and exercise is also cheap and with few side effects. However diet and exercise aren’t as easy to do as taking a pill, and the companies are obviously hoping that people who prefer not to put the effort in will nevertheless put up with the inconvenience of self-injection and that someone else will pick up the cost.
Unfortunately, few members of the public realize that obesity is a form of malnutrition as defined by WHO. “Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. The double burden of malnutrition consists of both undernutrition and overweight and obesity, as well as diet-related noncommunicable diseases.” You are dead right to describe how big Pharma will be rejoicing all the way to the bank; another great money spinner like Statins. The ‘Number Needed to Treat’ data on Statins is not convincing, especially in certain cohorts of patients who are routinely prescribed the drug. I have no doubt that drug companies will pursue a similar strategy of promoting mass inclusion of potential beneficiaries for life-long medication with these drugs.
I believe that rather than implementing a controversial ‘Sugar Tax’, a responsible government should consider introducing a tax that specifically targets the combination of sugar or other sweeteners in combination with salt in the same food product, as this would be incredibly beneficial. Why? Firstly it would not provoke outrage from parents claiming that the working poor could no longer afford treats for their children. However, the wholly unjustified toxic combination of sugar and salt in the same foods is frequently overlooked by consumers as one component masks the other despite both being included at toxic levels. This tax would compel manufacturers to reduce or eliminate this combination from their formulations in products to the benefit of the public. There is no legitimate reason why any product should include both sugar and salt. Try to find mustard, mayonnaise or many other savory products that unnecessarily include sugar: this could change.
Salt is not the enemy though, by and large. That is now more widely understood, I think.
Although too much salt really is a problem, particularly with high blood pressure, it is the masking effect of salt that creates a major problem in processed foods. The unnecessarily high quantities of sugar and salt in tandem fool the consumer into thinking they are not consuming too much of either additive. Sugar also has a whole plethora of names, often with two or ever three different sugars added to a product.
I was also horrified to learn, from a recent presentation at the Royal Society of Medicine, that the vegetables currently available to us now no longer have the high quantity of valuable nutrients they used to contain. This was a lecture where Professor Nolan explained how targeted nutritional supplementation of the eye and brain offers a safe and effective management option for AMD and Alzheimer’s disease. In one slide, the picture of a bowl of spinach leaves compared with over twenty such bowls required to obtain the same nutritional value really shocked me. We were told that most modern Vegetables are nutritionally depleted. Perhaps it would be better to grow our own, but who has the time? I am considering starting a few cut-and-come-again varieties in Kratky Jars.
I had an allotment in my 30s for a couple of years
It was hard work and I have never tried again
Kim; and that’s when veggies can get here at all https://www.theguardian.com/business/article/2024/may/15/brexit-border-it-outages-delay-import-of-perishable-items-to-uk-by-up-to-20-hours
I’m not sure whether taxing the combination of salt and sugar would work out well, but I do see what you’re trying to do with this idea. A sugar tax only on drinks has led to substitution with artificial sweeteners, which have their own problems: they cause allergic reactions for some people, and ruin the taste of some drinks (in some opinions). Some sugar as a treat is OK. It is high levels of sugar in savoury foods that is bad. However, there might well be more unintended consequences from taxing a salt/sugar combination. I doubt tax is the best tool to fix this problem.
The biggest thing that can be done to tackling poor diets is tackling poverty. Higher benefits, higher wages, abolish NRPF, allow refugees both to work and to access the same benefits as other people, and actually allow them to have their claims for asylum assessed fairly (or they will “disappear” from the system, and are almost certain to end up highly exploited and in extreme poverty).
If you have to work every hour of the day, you don’t have time to cook. If you don’t have stable housing, you may not have access to a (reasonably equipped) kitchen. These kinds of considerations come before whether people know how to cook.
Some people’s capacity to cook is limited by disabilities, so what kinds of support they need to eat more healthily is another question. Austerity has targetted people with disabilities more than any other group, through cuts to both benefits and public services.
“Try to find mustard, mayonnaise or many other savory products that unnecessarily include sugar:” Try to find the same without seed oils, in particular, rapeseed. There’s your metabolic imbalance right there, caused by the substitution of cheap harmful substances for expensive healthy ones. Outlawing that situation and reversing it would raise the cost of food substantially but it has to be done nevertheless if more and more money isn’t to be unnecessarily thrown away on healthcare issues which should have been prevented at source. Once again, benefits and wages will have to be adjusted to accommodate these changes or maybe, blue-skying here, govt could encourage the production of healthy food through subsidy. We know it has the money…
The weight lost will be significantly more muscle than fat unless diet’s amended accordingly (more protein, which realistically means more meat) and weightlifting to ameliorate the effects of that muscle loss is taken up. I note that while we’re told of the beneficial effects regarding cardiovascular issues etc we aren’t told how many suffered deleterious effects as a consequence of sarcopenia. Why would that be, I wonder?
BBC apparently colluding with a PR campaign on these drugs, based on ay non-published non- peer reviewed study funded by the drug company itself.
The very dubious Sir John Bell – Oxford ‘academic’ – of Astrazenica covid fame- is being platformed on radio 4 World at One – as though he was detached and independent despite his opaque and controversial financial interests in big pharma companies.
Surprise surprise he thought the drugs could help promote a sea change in population health -( although helpfully prompted to say there is no such thing as a magic bullet).
I find myself wondering how much the risk of heart disease could be reduced if the Government focused on reducing the stress in people’s lives. But of course that would require a Government which did sensible things instead of always just looking for dog-whistle policies.
People live in fear
Of course they want dopamine hits and then have heart attacks
Stress is a high factor for obesity. Not just because of its physical fight or flight effects upon the body but also because of the high proportion of those suffering from it being put on anti depressants in both the US and UK. With women more likely to be prescribed SSRis then men by a factor of 2 to 1. One rarely discussed side affect of most anti depressants is the compromising of the balance of the thyroid gland and consequent uncontrollable obesity. So yes, our state created poverty first fattens, then exploits its victims for profiteers.
All topics here close to my heart. But what about education ? Gone are the days of cooking skills taught in schools. Nobody is shown how to prepare 30 minute cheap tasty dishes, a la Nigel Slater or jack Munro etc. The terrible Food Deserts amidst impoverished communities. And what about the terrible loss of nutrients and lack of micronutrients in even modern fruit and veg? What about Industrial Agriculture and the impoverished soil, (and the enormous benefits to be had in our food and climate system if Regenerative Farming practices were adopted).
But it’s all back to Big Capital…. none want to see such ideas implemented as it would be wipeout for the “Bigs” Ag, Pharma, Oil, Supermarket, etc.
I was never taught to cook.
My boys school thought woodwork much more useful.
My mother thought that, like my father, I would never need to do so.
When I moved to London in 79 my father asked me who was looking after me and was baffled when I said I cooked for myself.
But I have found cooking a pleasure – even in the years when my wife was very ill and I fed two teenage boys monstrous piles of food that they seemed to need. They knew the routine. I stopped work at 6 and by 6.30 there was a meal on the communal table, almost always from basic ingredients, and with a minimum number of pans. I found it de-stressing. My advantage was not commuting most days, I suspect. But we can easily forget the fact that cooking can be pleasurable. I have always found it so. I don’t claim to be great at it. But there’s a lot of pleasure to be had in feeding people a good meal you’ve prepared.
My husband is a much better cook than I am, for this I am eternally grateful.
From the very well-informed Dr. Zoë Harcombe “People are so desperate to lose weight that they do unwise and often dangerous things. Semaglutide strikes me as more unwise and more dangerous than most other options. An up to 1 in 10 chance of retinopathy and eye problems… An approximate 1 in 100 chance of acute pancreatitis… An unknown risk of thyroid cancer… And a virtual guarantee of weight regain – and possibly more – unless weekly stomach injections are continued for life.”
https://www.zoeharcombe.com/2023/02/a-story-about-weight-loss/
So semaglutide is a wonder drug for weight loss, diabetes, coronary artery disease, stroke, cancer and even might just do its bit for dementia. What with the wonder profits and all that public health nonsense you don’t have to worry about- snake oil comes to mind!
After a sustained bout of illness in the second half of last year – including my fifth COVID infection (I work in a school) – I had raised blood pressure (marginal hypertension) and am pre-diabetic. I was put on a blood pressure drug, but refused anything else. I was able to restart my running and resistance exercise. My BP is now down in the normal range, my blood sugar is also.
However, when I saw the practice pharmacist, there was an insistence on increasing both dosage and range of drugs. I had to display my GP standard BP monitor and the series of readings and repeat my progress in reducing weight, BP and blood sugar, to get them to back down. Anyone less obstinate would’ve left with a bagful of drugs.
My daughter is a Health Visitor and ex paediatric nurse. She looks at my blood tests etc, and her only comments were I was right, and that the tentacles of big pharma are deep into GP practices.
I know you are not alone with this…..
I am considering starting the 5:2 fasting program as advocated by Dr Michael Mosley. This is not just in the vain hope of losing a little excess weight. The program has significant other benefits caused by stressing your body to cope as we used to when we were hunter gatherers. Humans have not always enjoyed constant grazing and I was convinced, after watching Dr Mosley’s presentation on fasting, that this is not challenging our bodies in a way that makes us stronger. Any two days in a week, not necessarily consecutive days and not zero consumption, just reduction to 500-600 Calories on the two fast days; that is a doable goal.
I know people who have done this
But, be careful: calorie control means you eat muscle and that makes no sense at all
Serious exercisers (not me, I admit, but I live with someone who is) lose body mass and gain wait by doing exercise that adds muscle whilst burning fat.
The 5/2 Diet has moderated to become Fast 800; 800 Calories two days a week. I was attracted to it because of the research that has gone into this that does not indicate muscle loss. However, it does require a careful choice of foods on those 800 Calorie days and the other five days shouldn’t include a junk food free-for-all! Mosley does also recommend ‘HIT’, High Intensity Exercise, that I am no longer capable of. However, I was convinced after watching a BBC program where Dr Mosley looked into the benefits of fasting and concluded that fasting has a significant impact in several areas, not just weight loss. It’s the other benefits that fueled my interest, especially 2, 4 and 6.
Benefits of a 5:2 diet:
1. It improves your insulin response, reducing your risk of type 2 diabetes
2. It activates autophagy for cell regeneration
3. It improves metabolism efficiency
4. It may reduce the risk of various cancers, including breast cancer
5. It can be more effective for weight loss than continuous calorie restriction, particularly for visceral fat loss
6. It may delay neurological disorders such as dementia, Parkinson’s and strokes
7. It may reduce risk of cardiovascular disease
I will still have my egg for breakfast and rely on ‘Huel Hot and Savory’ for 400 Calories of nutritionally well balanced food including 25grams of plant protein. I used these freeze dried meals to help me cope during the worst days of my cancer treatment and I recommend them to other cancer patients who struggle to make meals and eat. I have yet to find a single person who enjoys subsisting on Ensure or Complan! Huel Hot and Savory are real meals and I think they would significantly help the elderly to maintain all their basic nutritional needs. Your Doctor wife might consider looking into this product; the meals are really tasty.
I am told that almost all the research on the ebenfits of this diet was (as is typcial) done on younger men. There are dounbts it can work for older women. I pass that on. I cannot comment. My wife needs 2,000 or more calories a day to keep up with her exercise regime or she would lose too much weight.