People receiving weight-loss drug Wegovy sustained weight loss for up to four years, shedding an average of 10% of their body weight in that time, as per a new study. Wegrovy is a brand that markets semaglutide injections, that have gained widespread attention for their weight-loss effects. The study also found that Semaglutide injections boost an individual's heart health, even when weight loss doesn't take place.

The study, called SELECT, was published in journal Nature Medicine. "At four years, we see ongoing benefits of semaglutide," said Cheng-Han Chen, MD, interventional cardiologist from Cardiologist, who was not involved in the research. Besides the weight loss, it also lead to a loss in cardiovascular outcomes.

The research was conducted on 17000 adults, who had obesity but did not have diabetes. Overall, people who received once-weekly injections of semaglutide lost on average 10.2% of their body weight over the course of four years. All of the study participants continued to lose weight for about 65 weeks, a year and three months, and then their weight remained at a stable level.

Were There Any Side Effects?

What Did The Results Say?

Of the people on the highest dose of Wegovy, 68% lost at least 5% of their body weight. This compared to 21% of people on the placebo. Additionally, of the total people on Wegovy about 23% lost at least 15% of their body weight. For those in the placebo group, only 1.7% lost that much body weight.

Semaglutide Shows Heart Benefits Beyond Weight Loss

Researchers found that even individuals who did not experience significant weight reduction while on the drug saw a reduced risk of major heart events. Recent analysis of the SELECT trial data revealed that semaglutide significantly lowers the risk of heart attack, stroke, and cardiovascular-related deaths in adults with obesity or those who are overweight. Notably, the results of this study lead the US FDA to approve Novo Nordisk's Wegovy for reducing heart-related risks in this group.

What Is Semaglutide?

Are Their Any Side Effects Of Semaglutide?

Semaglutide, marketed under the brand name Wegovy, is primarily an antidiabetic medication used to treat Type 2 diabetes. It is also an anti-obesity drug used for long-term weight management. While it can be taken as a subcutaneous injection or orally, it has significant side effects. It primarily impacts your gastrointestinal tract and its side effects include constipation, nausea, abdominal pain, diarrhoea, and fatigue amongst others.

Menopause brings several changes to a woman’s body, and the breasts are no exception. As levels of oestrogen and other hormones decline, the glandular tissue in the breasts gradually decreases and is replaced by fatty tissue. This can change how the breasts look and feel.

For many women, breasts may become softer, less firm or change slightly in size and shape after menopause. Loss of skin elasticity with age can also contribute to changes in breast shape.

These changes can be a normal part of aging. But not every breast change after menopause should be attributed to hormones.

What breast changes can happen after menopause?

The hormonal changes associated with menopause can alter the composition of breast tissue. Some women may notice that their breasts feel softer or less dense than they did before menopause. Changes in skin elasticity can also lead to sagging or a gradual change in breast shape.

These changes, by themselves, are generally not a cause for alarm.

The concern arises when a new, unusual or persistent change appears, particularly if it is different from what a woman has experienced before.

Also read: Could A Daily Pill Help Prevent Breast Cancer Recurrence? Roche's Promising Experimental Drug Awaits FDA Approval

Which breast changes should not be ignored?

After menopause, women should speak to a doctor if they notice:

• A new change in the size or shape of one breast
• A new lump or area of thickening in the breast
• Persistent swelling in the breast
• Dimpling, puckering or thickening of the breast skin
• A newly inverted or retracted nipple
• Unusual nipple discharge, particularly if it contains blood
• A change in the appearance of the nipple or areola
• A new lump or swelling in the armpit or near the collarbone

These signs do not necessarily mean that cancer is present. Several benign breast conditions can cause similar changes. However, they should not be self-diagnosed or automatically dismissed as a consequence of menopause.

What about breast pain?

Breast pain is commonly caused by benign conditions and, before menopause, may also be associated with hormonal fluctuations. After menopause, persistent or unexplained breast pain should nevertheless be discussed with a doctor, particularly if it occurs alongside another breast change.

It is also important to remember that the absence of pain does not rule out breast cancer. Many breast cancers do not cause pain, and some may not produce a lump that can be felt.

This is one reason women should not wait for pain or a clearly palpable lump before seeking medical advice when they notice something unusual.

Is breast cancer screening necessary after menopause?

Screening remains an important part of breast health after menopause, but the appropriate approach depends on factors such as age, family history, personal medical history and individual risk.

Women should discuss screening with their healthcare provider and follow recommendations appropriate to their age and risk profile. Every woman should also learn how to perform a self-breast examination and become familiar with the normal look and feel of her breasts. Regular self-examination can help women notice new or unusual changes early and seek medical advice promptly.

Self-breast examination should complement, rather than replace, recommended screening and clinical evaluation. If a woman notices a new lump, skin change, nipple change or any other unusual finding, she should consult a doctor even if her routine screening is due later.

Those with a strong family history of breast or ovarian cancer, or a known genetic predisposition to breast cancer, may require a different or more intensive screening strategy.

Importantly, screening is intended for women who do not have symptoms. If a woman notices a new breast change, she should not simply wait for her next routine screening appointment; she should discuss the change with a doctor.

Also read: Breast Cancer: Are Women in India Being Diagnosed Too Late?

Don't blame every change on menopause

Menopause is a natural stage of life, but it should not become an explanation for every new symptom.

Most breast changes are not cancerous. However, the only way to determine the cause of a persistent or suspicious change is through appropriate medical evaluation.

Women should become familiar with how their breasts normally look and feel and pay attention to changes that are new or unusual for them.

Breast health does not become less important after menopause. In fact, continuing to pay attention to changes, practising regular self-breast examination and staying up to date with appropriate screening can help detect problems early.

The message is not to fear every change, but to avoid ignoring one simply because menopause has begun. When something feels or looks different, getting it checked is always better than assuming it is “just menopause.”

By Dr. Tapti Sen, Sr. Consultant ,Breast Surgery, RG Stone Urology & Laparoscopy Hospital, Kolkata

Many women notice changes in their breasts, such as localised tenderness, an itchy nipple or a slight pulling of the skin. These changes are often caused by benign conditions, including hormonal changes, irritation or infection.

Breast cancer does not always present as a painless lump, however. It can sometimes appear in less typical ways, and recognising persistent or unexplained changes can help people seek timely assessment.

India’s breast cancer burden

GLOBOCAN 2022 estimates recorded 192,020 new breast cancer cases and 98,337 deaths in India in 2022. These estimates placed India third globally for the number of new cases and first for the absolute number of deaths. These are estimates for 2022, not current annual counts.

Changes in skin, shape and nipple

A tumour can involve the breast’s supporting fibrous structures and surrounding tissues, causing skin tethering, dimpling or a new change in breast shape or symmetry. Any new, unexplained change deserves clinical assessment.

Changes in the nipple also deserve attention. A nipple that newly flattens, turns inward or deviates to one side should be assessed. Spontaneous discharge from one nipple—particularly bloody or clear discharge—can be a warning sign, although it is not always caused by cancer. Persistent itching, burning, flaking or eczema-like crusting of the nipple may be associated with Paget’s disease of the breast, a rare malignancy involving the nipple–areola complex that is often associated with an underlying breast carcinoma.

Unexplained swelling or persistent lumps in the armpit or above the collarbone can sometimes be an early sign of breast cancer. These findings also have non-cancerous causes and need assessment rather than self-diagnosis.

Also read: Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US & Europe

Pain, redness and swelling

Breast cancer can be painful, even though pain alone is not a reliable way to tell whether a change is cancerous. A painful lump should not be ignored, and a painless lump should not be assumed to be harmless.

Inflammatory breast cancer can be particularly difficult to recognise. It may cause rapid breast enlargement, heaviness, redness, warmth and swelling, sometimes without a distinct lump. The skin may develop a pitted appearance resembling orange peel. Because these symptoms can resemble mastitis or other skin conditions, infection may initially be suspected. However, persistent or worsening redness and swelling, especially when symptoms do not improve as expected with treatment, require prompt reassessment and investigation for an underlying malignancy.

How the diagnosis is confirmed

Any persistent or suspicious breast change warrants clinical assessment. Depending on the person’s age and symptoms, evaluation may include diagnostic mammography and targeted ultrasound. Further imaging or biopsy may be needed when indicated. A suspicious finding should not be dismissed solely because initial imaging is reassuring.

Persistent or suspicious nipple and skin changes require timely specialist assessment. If Paget’s disease or another malignancy is suspected, biopsy may be necessary without a trial of topical treatment. Suspected inflammatory breast cancer requires prompt imaging and tissue diagnosis; a skin punch biopsy may also be indicated.

Also read: Breast Cancer in Young Women: What You Should Know

Common causes of delay

People may delay seeking help because they expect a symptom to become painful, hope it will go away, or assume that redness or itching is due to irritation. Breast symptoms other than a lump can also be associated with longer diagnostic journeys. The length of delay varies between individuals and healthcare settings, so precise comparisons should be interpreted in the context of the study and the interval it measures.

Repeatedly treating persistent skin redness or nipple crusting with antibiotics, moisturisers or steroid ointments without reassessment can delay appropriate investigation. Treatment may be reasonable when infection or a skin condition is suspected, but symptoms that persist, recur or worsen need further evaluation.

When to seek medical advice

A new breast lump, unexplained skin dimpling, new nipple inversion, spontaneous bloody discharge, or persistent redness and swelling warrants prompt medical assessment. Unexplained fullness or swelling in the armpit or above the collarbone should also be checked. Most breast changes are benign, but symptoms should not be ignored or self-treated indefinitely. A healthcare professional can decide whether imaging, biopsy or other investigations are needed.

Early assessment can improve the chance of diagnosing breast cancer at a treatable stage. In general, breast cancer diagnosed while localised has a better prognosis than disease that has spread to distant parts of the body, although outcomes also depend on tumour biology, treatment, and other clinical factors.

By Dr. Arun Kumar Sharma, Consultant, Surgical Oncology, Fortis Hospital Jalandhar

Fertility health is influenced by metabolic health, but body weight or waist size alone cannot show the complete picture.

When people think about metabolic health, weight and waist size are often the first things that come to mind. However, these numbers do not always tell the full story.

A person can have a normal body weight and still have problems such as insulin resistance, high blood sugar, abnormal cholesterol or high blood pressure. These factors can influence hormonal and reproductive health and may affect fertility in some people.

Understanding metabolic health is therefore important not only for preventing diabetes and heart disease, but also as part of overall reproductive health.

Why Metabolic Health Matters For Fertility?

The body's metabolism and reproductive system are closely connected. Problems with blood sugar regulation and insulin sensitivity can affect hormone function and, in some women, may contribute to irregular ovulation or menstrual cycles. Metabolic health can also be relevant to male fertility.

Obesity, diabetes and poor metabolic health may be associated with changes in sperm quality and reproductive function. This means fertility care should consider the health of both partners rather than focusing only on reproductive organs.

Also read: Egg Freezing Is Rising, But Are We Freezing Fertility or Buying Time?

Your Waistline Does Not Tell The Whole Story

Waist circumference and body mass index (BMI) can provide useful information, but they are only part of a health assessment.

Two people with the same weight or waist measurement can have very different blood sugar, cholesterol, blood pressure and fitness levels. Someone who appears slim can still have insulin resistance or other metabolic concerns. This is why health should not be judged only by appearance or a weighing scale.

What Should You Monitor?

Depending on individual risk factors, doctors may recommend checking blood pressure, blood sugar, cholesterol and other metabolic markers. Family history, age, physical activity, diet and existing medical conditions can also influence risk.

Women with irregular periods or difficulty with ovulation may benefit from discussing metabolic health with their doctor. Men with fertility concerns should also consider their overall health and lifestyle.

How Can You Support Metabolic and Fertility Health?

A balanced diet, regular physical activity, adequate sleep and stress management can support both metabolic and reproductive health. Meals should include vegetables, fruits, whole grains, protein sources and healthy fats.

Regular exercise does not have to mean intense workouts. Walking, strength training, cycling or other activities that can be maintained consistently can be beneficial.

Tips for better metabolic health:

• Do not judge health only by weight or waist size.

• Get blood sugar, blood pressure and cholesterol checked when advised.

• Eat a balanced, nutrient-rich diet.

• Stay physically active.

• Get adequate and regular sleep.

• Avoid smoking and tobacco.

• Manage stress.

• Discuss irregular periods or fertility concerns with a doctor.

The connection between metabolic and reproductive health is often overlooked. A healthy-looking waistline does not always mean that metabolism is healthy.

Looking at blood sugar, blood pressure, cholesterol, lifestyle and other individual factors provides a more complete picture. Taking care of metabolic health can therefore be an important part of taking care of fertility health too.