Ozempic and Wegovy have received a lot of publicity as revolutionizing treatment options for obesity. Both medications form a class of GLP-1 receptor agonists, which mimic a hormone in the body called glucagon-like peptide-1 and are involved in the regulation of appetite and blood sugar. Indeed, in initial clinical studies, the majority of those on the drugs lost 15% to 22% of body weight, hence much optimism. For most patients, these medications are underwhelming for about 20% of patients due to minimal weight loss or other challenges.

Take a closer look at why the weight loss drugs may not work for everyone, together with what options exist when they don't deliver the expected outcomes.

Why Weight Loss Drugs May Not Work

While GLP-1 receptor agonists have produced phenomenal responses in a majority of patients, it remains a reality that these drugs work differently for different people. Here's why:

1. Genetic and Hormonal Variability

Weight loss medications interact with complex systems in the body that differ from person to person. Genetics, hormones, and individual brain responses to energy regulation play significant roles in determining how a person responds to drugs like Ozempic and Wegovy.

2. Underlying Medical Conditions

Other conditions, such as sleep apnea, may be prevalent and prevent or delay the achievement of weight loss goals. Prescription drugs like antidepressants, steroids, or contraceptives are other medications that can nullify weight loss medication benefits.

3. Unrealistic Expectations

Often, they come to these medications with enormous hopes; expecting the promised rapid and dramatic weight loss. Progress creates disappointment if it has not stalled. In patients who rigidly follow recommended lifestyle modifications, frustration and disappointment are most common.

Why it is Important to Identify Non-responders

For most patients, the effectiveness of GLP-1 receptor agonists is evident within a few weeks of treatment. Weight loss typically begins within a few weeks of initiating therapy and tends to increase with dosage. However, some patients respond very little, if at all, despite strict adherence to their regimen.

For nonresponders, this can feel like a dead end. However, understanding the unique complexities of obesity is essential. This condition stems from brain dysfunction, and the pathways that contribute to weight regulation differ among individuals.

Alternative Treatment Options

When Ozempic or Wegovy doesn’t yield desired results, there are still many paths to explore:

1. Switching to Another GLP-1 Drug

For example, some patients who don't respond well to one GLP-1 receptor agonist might find success with another drug in the same class. Newer medications, such as Zepbound, target other hormone pathways and seem promising even for those not responsive to earlier drugs.

2. Use of Older Medications

While there is much to say about newer drugs, older treatments can still be useful and work for some patients. One can also seek the help of a medical provider specializing in obesity treatments in order to identify the best alternatives.

3. Lifestyle Changes

Diet, exercise, sleep, and stress management continue to be integral components of any weight loss program. New changes may be small but can make an enormous difference in one's health and success.

4. Medical Management of Obesity

It is a complex disorder, and most patients should receive a multidisciplinary treatment. Collaboration with an obesity-aware doctor may mean access to tailored treatment plans, ranging from psychological support all the way to metabolic testing, and many others.

Why Side Effects of Weight Loss Drug Ozempic May Be a Barrier

For others, side effects like nausea, vomiting, or diarrhea hinder them from continuing with these drugs. These symptoms often reduce as the body becomes accustomed, but for some, they might be severe enough to stop treatment altogether. In those instances, alternative drugs or procedures become vital to find.

Long-term effects of Ozempic or Wegovy on the Brain

Another largely unexplored area relates to GLP-1 drugs' long-term effects on the brain's regulation of hunger and satiety. Although GLP-1 drugs suppress appetite and can lead to effective weight loss, emerging research suggests that they may also affect brain reward mechanisms, changing the way patients experience foods.

This aspect could prove of paramount significance in the future treatment of obesity. Perhaps GLP-1 receptor agonists do indeed affect and rewire the brain's reward pathways and will thus provide sustained benefits beyond discontinuation. However, more research is required to understand this phenomenon fully.

While for many, Ozempic and Wegovy have revolutionized obesity treatment, these are certainly not a one size fits all. Nonresponders need not lose hope- alternative strategies and medications abound. A consultation with an obesity expert healthcare provider is essential to put together a comprehensive, tailored treatment plan.

The route toward effective weight loss may be challenging, but with the evolution of obesity medicine and a better understanding of individual needs, there is a path forward for everyone.

Recently the news of Norovirus outbreak in an AIDA cruise that has infected more than 100 guests and crew on board made news. This is the 21st outbreak, as confirmed by the Centers for Disease Control and Prevention (CDC). This case has brought back memories from the Royal Caribbean Cruise outbreak, where 94 out of 1,874 and 4 crew members also were infected by Norovirus.

This virus is also known as the 'rib-cracking' winter virus, which sets it apart from rest of the winter viruses. People who have been sickened by this contagious virus are vomiting explosively, which may make the sufferers to experience a cracking in their ribs, which is where it gets its name 'rib-cracking' winter virus.

What Is Norovirus? What Makes It So Unique?

The virus typically spikes after the holidays, when families gather indoors. However, new data from the Centers for CDC shows this year’s surge has arrived weeks ahead of schedule, and experts say there’s no obvious explanation yet.

According to the CDC, 12.5 percent of norovirus tests came back positive during the week of November 22, nearly identical to the 13 percent positivity rate the week before. Compared to two weeks earlier, infections have jumped by about 25 percent. But the real number of cases is likely far higher, as most people with norovirus never get tested.

Between August 1 and November 13, health officials recorded 153 norovirus outbreaks, more than double last year’s 69 during the same period, and far above the 65 reported in 2023.

The CDC estimates the U.S. sees around 2,500 outbreaks every year. An outbreak is recorded when two or more people fall ill from a suspected or confirmed shared source.

On cruise ships, which are closely monitored by federal agencies, outbreaks have also been climbing. The AIDAdiva, a German vessel currently on a long global route, recently reported a spike in cases. In a statement to USA TODAY, AIDA Cruises said it has increased hygiene measures on board and that infections are already declining.

“Seasonal illness peaks between November and April, and the AIDAdiva report reflects what we’re seeing on land,” the cruise line said.

Why Norovirus Hits So Hard

Norovirus infects roughly 21 million Americans every year and sends about 2 million to hospitals or clinics. It spreads easily through contaminated food, surfaces, shared utensils, or direct contact with an infected person. Even a tiny amount of virus can trigger illness.

Symptoms usually appear within 12 to 48 hours and include nausea, vomiting, diarrhea, stomach cramps, and sometimes fever and chills. The biggest danger is dehydration, which can set in quickly. Severe fluid loss can lead to low blood pressure, reduced organ perfusion, electrolyte imbalances, and in extreme cases, seizures or fainting.

The virus contributes to about 900 deaths in the U.S. annually, mostly among older adults.

Doctors emphasize that hand sanitizers don’t reliably kill norovirus. Frequent handwashing with soap and water is the best protection.

The season’s lowest positivity rate was recorded in early August at 6.5 percent. But with holiday travel and gatherings underway, health officials warn infections are likely to rise.

What Are The Symptoms Of Norovirus And How Long Do They Last?

• Nausea
• Vomiting
• Stomach pain or cramps
• Watery or loose diarrhea
• Feeling ill
• Low-grade fever
• Muscle pain

The symptoms usually begin 12 to 48 hours after your first exposure to the virus and could last from 1 to 3 days. You can, however, continue to shed virus in your stool for several week after your recovery. The shedding could go up for months if you have another medical condition.

Delhi woke up again to a thick layer of smog, with Delhi's AQI hovering over 300 on the Air Quality Index on Thursday morning under "very poor" category. After a long nine-day wait, city's AQI had slipped under "poor" category on Tuesday, but it is again back on the "very poor" category, while on Wednesday, there were strong winds that dispersed the pollutants. Yet the condition of the air quality remains bad.

As a result of this many people are leaving the city, or have at least considered leaving the city.

"I Felt Breathless And Constantly Fatigued"

Nikita Singh, 31, who runs a remote PR boutique agency was living in Delhi on and off for two years because it was two years back when she struggled to breathe during Delhi winters. "The pollution levels were so extreme that I felt breathless and constantly fatigued. That was the first time I seriously questioned whether I could continue living here long-term," she says.

For the first two years, she kept "oscillating". "I would stay in Delhi for work during peak months, then leave when pollution became unbearable, especially from November to January. Every return felt heavier. I had my eyes burning, headaches, chest tightness and a general feeling of 'I cannot do this forever'."

She has now permanent moved away from Delhi to Jodhpur, in Rajasthan, where she works remotely. However, it has not been easy on her. "Emotionally, it was tough because Delhi had become familiar, and my life and work circle were mostly based there," she says. However, thanks to her fully remote work and that fact that she had decided to prioritize her health, she was able to make the move.

She says that Jodhpur offers the cleaner air which she "never felt in Delhi". Her decision to move also came with her family uprooting from Delhi. "My family and I shifted together. AQI was a major trigger. We realized we could not keep exposing ourselves to those levels of pollution year after year," she reveals.

Migration And Pollution: More Delhiites Are Considering To Move Out Of The City

She is not alone, Vikash Makkar, a freelance linguist specialist and a journalist, who had been living in Delhi from the last 12 years, moved back to his hometown in Jamshedpur. "Since October with an unplanned journey, I moved to my hometown and have been living there. It is quite relaxed here as compared to Delhi's ongoing pollution crisis that I had faced," he shares.

29-year-old Riya Baibhawi also uprooted from the city. She had been living in Delhi from last 5 years. She is currently living in Ludhiana, Punjab, and her decision to leave city is also affected by the pollution. Though, it was not easy for her. "It was very tough because it was very difficult to find career opportunities with competitive salaries outside Delhi-NCR. It also required a cut down of my social life, which adversely affected my mental health," she says. She shares that one of her friends, who had been living in Noida for the last 20 years had also moved out as pollution exacerbated her asthma.

Another family, who have been living in Delhi's Karol Bagh for more than two decades now are considering moving out of Delhi. "They are looking for properties outside Delhi where air is cleaner," shares their 26-year-old daughter who now lives in her marital home in Noida.

As per a survey by a consumer insights platform Smytten PulseAI, about 34.6% of the residents surveyed in Delhi NCR have considered to move out of the city due to worsening air. A 2023 study published in the International Journal of Environmental Research and Public Health shows that if the level of PM2.5 increases by 10µg/m3, migrants coming into the city will be reduced by 21.2%. While migration in the city has been ongoing, pollution does show some strains of people moving out of the city.

As per the Air Quality Life Index released by the Energy Policy Institute at the University of Chicago (EPIC), the fine particulate matter or PM2.5 in air will shorten an average Indian's life expectancy by 5.3 years, and in Delhi, it could shorten a person's life span by 11.9 years. However, the Union government has said in the parliament that there is "no conclusive national data to establish a direct correlation between deaths or diseases occurring exclusively due to air pollution". This statement comes at a time when doctors themselves noted a surge in cases due to pollution and have urged people to leave the cities.

The internet is obsessing with the idea that Japan has a fat law, it fines people for being "fat". Talk about sensational headlines, mistranslations, and social media exaggerations. But what does Japan's so-called 'fat law' actually say? Does it really change anything?

Health and Me did a closer fact check on Japan's Fat Law, and here is what we found.

Japan's Metabo Law: What It Really Means?

In 2008, the Japanese Ministry of Health, Labour and Welfare introduced the Metabolic Syndrome Countermeasures Promotion Law, which was popularly nicknamed the 'Metabo Law'. the word 'metabo' comes from metabolic syndrome, a cluster of high-risk conditions that include elevated blood pressure, high blood sugar, abnormal cholesterol, and excess fat around the waist. If left untreated, this could increase the risk of heart attacks, stroke and diabetes.

The law's main focus is on identifying these risks as early as possible. As part of Japan's long-standing annual health check tradition, about 50 to 56 million adults aged 40 to 74 undergo this mandatory waist measurements every year. The waistline thresholds are:

• 85cm for men
• 90cm for women

While the numbers are not arbitrary, they match the International Diabetes Federation's guidelines used to screen metabolic risks.

Is It Illegal To Be Overweight In Japan?

The Times-Union fact check confirms: "Japanese citizens cannot be fined or imprisoned for being overweight". RosePlus Japan also reports that the term "fat tax is a mistranslation and that "it is not illegal to be fat in Japan".

The law does not:

• Fine individuals for their weight
• Send people to jail for being overweight
• Deport or deny visas based on size
• Ban obese people

How Does The Law Actually Work?

The law basically shifts the responsibility away from individuals to governments and employers.

Annual measurement: Employers and local authorities measure the waistlines of eligible adults.

If someone exceeds the limit:

• They are offered counseling, health guidance, and follow-ups.
• After three months, progress is reviewed.
• After six months, they may receive additional health education.

No individual penalties: There is no fine for not losing weight.

Employer penalties:

• If a company fails to reduce the percentage of employees at risk, it may face increased contributions to national healthcare funds.
• Companies like NEC previously estimated potential fines of up to $19 million for not meeting targets

This structure makes the Metabo Law more of a workplace wellness mandate than a personal weight regulation.

Lost In Translation

Much of the misunderstanding comes from how Japanese concepts were translated in English. With the word "law" being reported internationally, it implied a strict legal prohibition.

"Metabo" was incorrectly equated was being "fat", losing its medical meaning.

Was The Law Successful?

• Japan already had one of the lowest obesity rates in the world, around 3.5 percent in 2009, compared to over 30 percent in many Western countries.
• Life expectancy in Japan has remained among the highest globally.
• However, obesity rates among men (based on BMI 25+) reportedly continued rising, reaching 31.7 percent in 2022 according to The Japan Times, as cited in the HR Digest analysis

However, there have been things that changed since 2008. This includes companies offering nutrition workshops, physical activity support, health check programs for employees and their families. The annual health checks are now more structured. People flagged for metabolic syndrome were connected with counselling and monitoring, which can reduce long-term medical costs. The conversation has now also shifted towards body autonomy, public health and role of employers in personal wellness.