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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels.</p> <p>However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>.</p> <p>Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes.</p> <p>Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?</p> <h2>Osteoarthritis and obesity</h2> <p>Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis.</p> <p>Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation.</p> <p>For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>.</p> <p>Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help.</p> <p>But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.</p> <p>Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.</p> <h2>Semaglutide for osteoarthritis?</h2> <p>The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.</p> <p>They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.</p> <p>As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.</p> <p>The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.</p> <p>This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.</p> <p>The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>.</p> <p>Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.</p> <h2>How could semaglutide reduce knee pain?</h2> <p>It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.</p> <p>But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>.</p> <p>While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.</p> <p>The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.</p> <p>It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue.</p> <p>There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this.</p> <p>Further, it can be difficult to access.</p> <h2>I have knee osteoarthritis, what should I do?</h2> <p>Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstocl</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.</em></p> </div>

Body

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Aussie rocker hits back at John Farnham's drugging claims

<p>A legendary Australian rockstar has hit back at John Farnham's claims that he was <a href="https://oversixty.com.au/health/caring/so-ashamed-john-farnham-opens-up-about-years-of-abuse" target="_blank" rel="noopener">drugged</a> by a former manager. </p> <p>Peter Tilbrook, who was the guitarist for iconic Aussie rock band The Masters Apprentices in the 1960s, has taken to social media to share his own stories about Darryl Sambell, after Farnham wrote in his memoir that Samuel drugged him in the early days of his career. </p> <p>As Farnham wrote in <em>The Voice Inside</em>, he recalled that Sambell “drugged me for years and I had no f**king idea,” until he found a half-dissolved pill at the bottom of a cup of coffee. </p> <p>Asked what it was, Sambell told Farnham: “That’s just something to keep you awake.”</p> <p>However, Tilbrook took aim at the comments saying he also worked with Sambell and only had good experiences.</p> <p>"Sambell was a brilliant and skilful manager to us, and from what we saw and heard, definitely to Farnham as well," Tilbrook said online.</p> <p>"I find it very hard to believe that any another manager at the time could have done any more to further Johnny's incredible career."</p> <p>Sambell, who managed Farnham's early career from 1967 to 1976, also managed The Masters around the same time, and Tilbrook asserted his experience with the late manager was nothing like Farnham's.</p> <p>"He was an amazing, caring and resourceful manager," Tilbrook said. </p> <p><em>Image credits: petertilbrookentertainment.com/news.com.au</em></p> <p> </p>

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Aussie Vietnam vet reunited with lost war medals just in time

<p>A Vietnam veteran has been reunited with his lost war medals that were missing for a year, just in time for Remembrance Day. </p> <p>When attending a Remembrance Day event in New Zealand last year, Townsville veteran Malcolm Edmiston lost his medals somewhere along the journey to Christchurch from Brisbane. </p> <p>The medals were left sitting unclaimed in Brisbane Airport's lost and found after being found in an airport terminal, before airport staff launched a social media campaign to find their owner. </p> <p>After seeing a post on Facebook, Edmiston was finally reunited with his precious medals just in time for this year's Remembrance Day events. </p> <p>"It's very good to have them back, great to have them back, I thought they were gone and gone for good," Malcolm told <em><a href="https://9now.nine.com.au/today/lost-war-medals-returned-to-vietnam-veteran-in-time-for-remembrance-day/b03bf4df-0d3c-440b-9783-1e6c7ac73a11" target="_blank" rel="noopener">Today</a></em>.</p> <p>"The zip was opened on my case and somehow they fell out, so it's a good reminder for us to take extra care when we pack."</p> <p>Malcolm was not the only one in his family to serve the country, sharing how his father served in the Royal Navy, he had uncles in the Royal Australian Air Force and and the Royal Air Force and a brother who served in Naval Reserve.</p> <p>His son also served in the Navy and with so many of his fellow Vietnam veteran soldiers no longer alive, having his medals back today is something special.</p> <p>"Remembrance Day is a very important day for me," he said.</p> <p>Brisbane Airport's media manager Peter Doherty added that he was thrilled to see the medals return to their rightful owner. </p> <p>He said, "For Malcolm's lifetime of service, the least we could do was the door-to-door service to get the medals back to him."</p> <p><em>Image credits: Today </em></p>

Retirement Life

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Disgraced Olympian sentenced over failed drug plot

<p>An Olympic silver medallist and his younger brother, who tried to smuggle hundreds of kilograms of cocaine worth about $200 million into Australia, have been sentenced a second time. </p> <p>Nathan Baggaley, 48, a former champion kayaker and his brother Dru Baggaley, 42, faced Brisbane supreme court on Monday after pleading guilty to attempting to import a commercial quantity of drugs.</p> <p>Dru and another man were intercepted by the navy in July 2017, after he was found using a seven-metre inflatable boat to pick up 650 kilograms of cocaine from a ship near Australia's east coast. </p> <p>The inflatable boat, which was launched from Brunswick Heads on the NSW north coast, had been bought by Nathan and was registered in his name. </p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">The brothers were previously found guilty of </span>attempting to import cocaine by a Brisbane Supreme Court jury in April 2021. </p> <p>Nathan was sentenced to 25 years' imprisonment and his brother 28 years, but they later won appeals against their convictions and were ordered to face the retrial that was supposed to start on October 28, but instead pleaded guilty to the same charge.</p> <p>On Monday, Justice Declan Kelly sentenced Nathan to 13 years in jail and his brother 15 years. </p> <p>With time already served, they are now eligible for parole. </p> <p>During their sentencing hearing, Justice Kelly said there was insufficient evidence to prove Dru knew he was importing cocaine, after the court was told he thought he was collecting tobacco. </p> <p>“Dru was reckless that there was a substantial quantity of a border-controlled drug but there is insufficient evidence that he knew the precise quantity,” Justice Kelly said.</p> <p>He said that Nathan didn't initially know that it was an attempt to import a border-controlled drug until July 30 2018. </p> <p>"From that point in time he was aware of the attempt to import a substantial quantity of a border-controlled drug but was reckless as to the identity of that drug," Justice Kelly said.</p> <p>“It cannot be shown that Nathan knew the drug was cocaine or the precise amount of the drug.”</p> <p>Kelly accepted a defence barrister's submission the facts were profoundly different” compared to their 2021 sentencing, but said that regardless, the importation size was a "“very relevant factor” in his sentencing.</p> <p><em>Image: Erik S Lesser/EPA/ Shutterstock Editorial</em></p>

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Freddy Krueger at 40 – the ultimate horror movie monster (and Halloween costume)

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-daniel-301018">Adam Daniel</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>Movie monsters have captivated audiences since the days of early cinema. They evoke fascination and terror, allowing audiences to confront their fears from the safety of the movie theatre or living room.</p> <p>Arguably one of the most enduring and captivating of these monsters is Freddy Krueger, the villain of the <a href="https://www.imdb.com/title/tt0087800/">A Nightmare on Elm Street</a> series who celebrates his 40th screen birthday this November.</p> <p>Memorably played by Robert Englund, Freddy quickly became a cultural icon of the 1980s and 1990s. Beyond his burned face and iconic bladed glove, Freddy’s dark humour and acidic personality set him apart from other silent, faceless killers of the era, such as Michael Myers in <a href="https://www.imdb.com/title/tt0077651/?ref_=nv_sr_srsg_2_tt_6_nm_0_in_0_q_halloween">Halloween</a> or Jason Vorhees in <a href="https://www.imdb.com/title/tt0080761/?ref_=fn_al_tt_1">Friday the 13th</a>.</p> <p>Written and directed by horror maven <a href="https://theconversation.com/wes-craven-the-scream-of-our-times-46915">Wes Craven</a>, 1984’s A Nightmare on Elm Street garnered positive reviews for its innovative concept: Freddy stalked and attacked his victims in their dreams, making him inescapable and allowing him to tap into their deepest fears. The series (seven films plus a 2010 remake and <a href="https://www.imdb.com/title/tt0329101/?ref_=fn_al_tt_1">Freddy vs. Jason</a> spin offs) blended supernatural horror and surrealism with a dark and twisted sense of humour.</p> <h2>Scary … but funny</h2> <p>Humour was key to Freddy’s “popularity”. Both sinister and strangely charismatic, Freddy’s psychological torture of his adolescent victims often oscillated between terrifying and amusing.</p> <p>A famous kill scene from 1987’s <a href="https://www.imdb.com/title/tt0093629/?ref_=fn_al_tt_1">A Nightmare on Elm Street 3: Dream Warriors</a> demonstrates this paradox.</p> <p>Aspiring actress Jennifer drifts off to sleep while watching a talk show on TV. In her dream, the host of the talk show suddenly transforms into Freddy, who attacks his guest before the TV blinks out. When Jennifer timidly approaches the TV set, Freddy’s head and clawed hands emerge from the device, snatching her while delivering an iconic one-liner: “This is it, Jennifer – your big break in TV!”</p> <p>Freddy turns his victims’ fears or aspirations – their dreams – against them.</p> <figure><iframe src="https://www.youtube.com/embed/dCVh4lBfW-c?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">‘Whatever you do, don’t fall asleep.’</span></figcaption></figure> <h2>Creating a monster</h2> <p>Craven has shared how the character of Krueger came to life in <a href="https://www.imdb.com/title/tt1510985/?ref_=fn_al_tt_1">Never Sleep Again: The Elm Street Legacy</a>, an oral history of the series.</p> <p>He described a childhood experience of seeing a strange mumbling man walking past his childhood home. The man stopped, he said, and looked directly at him “with a sick sense of malice”. This deeply unsettling experience helped shape Freddy’s menacing presence.</p> <p>The character’s creation also emerged from the filmmaker’s interest in <a href="https://www.iflscience.com/nightmare-on-elm-street-was-inspired-by-a-real-life-medical-mystery-60527">numerous reports of Southeast Asian refugees dying in their sleep</a> after experiencing vivid nightmares.</p> <p>In the film, Krueger’s origin story reveals him as a child murderer who was apprehended but released due to a technicality in his arrest. Seeking justice, the parents of his victims take matters into their own hands, and form a vigilante mob. They corner him in his boiler room and burn him alive. But Freddy’s spirit survives to haunt and kill the children of his executioners.</p> <h2>Cultural repression, expressed on film</h2> <p>Film critic and essayist <a href="https://www.cineaste.com/summer2019/robin-wood-on-horror-film-collected-essays-and-reviews#:%7E:text=Freudian%20theory%2C%20a%20crucial%20theoretical,the%20horror%20film%20perpetually%20enacts.">Robin Wood argued</a> horror films often bring to the surface elements society has repressed. These fears, desires, or cultural taboos are not openly acknowledged.</p> <p>But movie monsters act as manifestations of what society suppresses, such as sexuality, violence or deviant behaviour. American academic <a href="https://www.tandfonline.com/doi/abs/10.1080/01956051.1995.9943696">Gary Heba</a> argues Freddy is:</p> <blockquote> <p>an example of America’s political unconscious violently unleashed upon itself, manifesting everything that is unspeakable and repressed in the master narrative (perversion, child abuse and murder, vigilantism, the breakdown of rationality, order, and the family, among others), but still always present in the collective unconscious of the dominant culture.</p> </blockquote> <figure><iframe src="https://www.youtube.com/embed/UBrl4H0Uzng?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Actor Robert Englund calls Freddy Krueger ‘the gift that keeps on giving’.</span></figcaption></figure> <h2>The monster decades</h2> <p>The 1970s and 1980s marked a golden era for the creation of horror film nasties like Krueger, Myers, <a href="https://www.imdb.com/title/tt0072271/?ref_=fn_al_tt_3">The Texas Chainsaw Massacre</a>’s Leatherface and <a href="https://www.imdb.com/title/tt0094862/?ref_=fn_al_tt_19">killer doll Chucky</a>.</p> <p>Since then, the landscape of horror has shifted, with fewer singular monsters emerging. The diversification of horror sub-genres (zombie virus horror, anyone?), the rise of psychological horror (<a href="https://www.imdb.com/title/tt7784604/?ref_=nv_sr_srsg_2_tt_4_nm_2_in_0_q_heredi">Hereditary</a>), and an emphasis on human-driven terror (<a href="https://www.imdb.com/title/tt0416315/?ref_=nv_sr_srsg_1_tt_7_nm_0_in_0_q_wolf%2520creek">Wolf Creek</a>) or supernatural forces all contribute to this shift.</p> <p>While modern horror continues to thrive, few characters have achieved the same iconic status as Freddy – although some would argue Art the Clown from the recent <a href="https://www.imdb.com/title/tt4281724/">Terrifier</a> franchise and the reinvigorated Pennywise from <a href="https://www.imdb.com/title/tt1396484/?ref_=nv_sr_srsg_1_tt_6_nm_1_in_0_q_it">IT</a> could join this exclusive group.</p> <figure><iframe src="https://www.youtube.com/embed/ZuYoEtEI_go?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">‘Five, six, grab your crucifix.’ A 2010 Nightmare on Elm St reboot failed to fire.</span></figcaption></figure> <h2>Happy Halloween!</h2> <p>Despite a <a href="https://www.imdb.com/title/tt1179056/">failed reboot in 2010</a>, the legacy of A Nightmare on Elm Street is strong, having influenced numerous filmmakers with its skilful mix of surrealism and slasher horror.</p> <p>However, it’s the orchestrator of the titular nightmares whose legacy is perhaps the strongest.</p> <p>With each Halloween, new fans choose Freddy for their costume. All it takes is a tattered striped sweater, a brown fedora hat, and a glove with sharp, finger-lengthening blades. Don’t forget makeup to re-create Krueger’s grisly facial burns. Sweet dreams!<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/240905/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/adam-daniel-301018"><em>Adam Daniel</em></a><em>, Associate Lecturer in Communications, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: New Line Cinema - IMDB</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/freddy-krueger-at-40-the-ultimate-horror-movie-monster-and-halloween-costume-240905">original article</a>.</em></p> </div>

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Tearful Jackie O reveals past drug addiction

<p>Jackie O Henderson has revealed her private battle with drug addiction that resulted in a stint in rehab. </p> <p>On her KIIS FM radio show with Kyle Sandilands, Jackie O read an excerpt from her autobiography <em>The Whole Truth</em>, that is set to his shelves on October 29th, detailing her struggles with addiction two years ago.</p> <p>Henderson said she was “badly addicted” to painkillers, sleeping pills and consuming alcohol for three years, before checking herself in for a month-long stay at the Betty Ford Centre in Palm Springs, California, in November 2022. </p> <p>The radio host said she was feeling “so nervous” to read out the excerpt, as it was “something I haven’t been very forthcoming about or very truthful about”, recalling how she was feeling “diminished, untethered and alone”.</p> <p>“By that point, I had no self-esteem, so I was insecure, vulnerable, and heartbroken,” she read.</p> <p>“It was a recipe for disaster, and I took the coward’s way out to escape those feelings.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/DBfJRIoSaRz/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/DBfJRIoSaRz/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Kyle and Jackie O (@kyleandjackieo)</a></p> </div> </blockquote> <p>Jackie admitted that it was only a small circle of friends who knew about her addiction, with Sandilands saying he was oblivious to his co-host's struggles. </p> <p>“I just didn’t want anyone to know until I had at least gotten a year or more of sobriety under my belt,” Henderson said.</p> <p>“I can only speak to my experience because my addiction is so different to anyone else’s."</p> <p>“But people can ask me anything they want, and I’m OK with that. I brought this up, I put it out there myself, so I’m well and truly OK talking about it. I’m excited that I can be more authentic than I’ve ever been.”</p> <p>She went on to recall how before she flew to America for rehab, she told her audience that she was taking time off for the end of the year. </p> <p>“But I know I won’t make it that far, I’m hanging on by a thread,” she read from her book.</p> <p>“There’s only one thing to do today, get on a plane for Los Angeles. My best friend and manager Gemma O’Neill is with me … she tells me I won’t need any fancy dresses where I’m going.”</p> <p>Henderson recalled grabbing lunch with O’Neill the day of their flight and being “teary”, adding, "Not because I don’t want to go on this journey but because I don’t have the faintest idea what it will be like and that scares me.”</p> <p>At the Betty Ford Centre, she was enrolled in a 28-day, 12-step program to “treat the substance dependence and drug addiction I’ve been able to keep secret for three long and painful years”.</p> <p>The 49-year-old said there were “lots of different reasons” for her addiction, but did not go into any on-air.</p> <p>Henderson said she went back and forth about whether to share her story but decided to make it public, “to use my story to help people”.</p> <p>She ended the emotional segment by sharing her gratitude that the story had never previously emerged and she was soon to celebrate her two-year sobriety milestone.</p> <p>“My life has changed for the better and I’m really, really thankful that I did it,” she said.</p> <p><em>Image credits: Instagram </em></p>

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‘Dark tourism’ is attracting visitors to war zones and sites of atrocities in Israel and Ukraine. Why?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/juliet-rogers-333488">Juliet Rogers</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>There is a disturbing trend of people travelling to the sadder places of the world: sites of military attacks, war zones and disasters. Dark tourism is now a phenomenon, with <a href="https://dark-tourism.com/">its own website</a> and dedicated tour guides. People visit these places to mourn, or to remember and honour the dead. But sometimes they just want to look, and sometimes they want to delight in the pain of others.</p> <p>Of course, people have long visited places like the <a href="https://www.auschwitz.org/en/visiting/guided-tours-for-individual-visitors/">Auschwitz-Birkenau</a> Memorial, <a href="https://www.911memorial.org/911-faqs">the site of the Twin Towers</a> destroyed in the 9/11 attacks, <a href="https://www.robben-island.org.za/tour-types/">Robben Island Prison</a>, where Nelson Mandela and others spent many years, and more recently, <a href="https://chernobyl-tour.com/english/">the Chernobyl nuclear power plant</a>. But there are more recent destinations, connected to active wars and aggression.</p> <p>Since the <a href="https://www.newsweek.com/2024/10/11/one-year-hamas-oct-attack-israel-northern-border-1961816.html">Hamas military attacks</a> of October 7 2023, in which around 1,200 people were killed and more than 250 taken hostage, celebrities and tourists have visited the related sites of the Nova music festival and the Nir Oz Kibbutz in Palestine/Israel.</p> <p>The kibbutz tours, guided by former residents, allow people to view and be guided through houses of the dead, to be shown photographs and bullet holes. Sderot, the biggest city targeted by Hamas, is offering <a href="https://apnews.com/article/israel-gaza-hamas-oct-7-tourism-sderot-8b21f590c37fa6780bf9190d6bfb62b7">what it describes as “resilience tours”</a>, connecting tourists with October 7 survivors.</p> <p>Similar places are visited <a href="https://wartours.in.ua/2023/02/25/dark-tourism-in-ukraine/">in Ukraine</a>. The “popular” Donbas war tour, for instance, takes visitors to the front lines of the conflict and offers “a firsthand look at the impact of the war on the local population”, introducing them to displaced locals, soldiers and volunteer fighters. There’s also <a href="https://wartours.in.ua/en/">a Kyiv tour</a>, which takes in destroyed military equipment and what remains of missile strikes.</p> <h2>Solidarity tours</h2> <p>These tours have various names, but <a href="https://touringisrael.com/tour/october-7-solidarity-tour/">one Israeli company</a> calls them “solidarity tours”. The idea of solidarity lessens the presumption of voyeurism, or the accusation of ghoulish enjoyment of pain or suffering. It suggests an affinity with those who have died or those who have lost loved ones.</p> <p>But solidarity is a political affiliation too. These tours are not only therapeutic. They are not only about “bearing witness”, as many guides and visitors attest. They are also about solidarity with the struggle.</p> <p>What is this struggle? Genocide scholar Dirk Moses <a href="https://www.bostonreview.net/articles/more-than-genocide/">has written thoughtfully</a> on this after October 7. Colonial states seek not just security, but “permanent security”. This makes them hyper-defensive of their borders. Israel was created as a nation <a href="https://www.pbs.org/wgbh/americanexperience/features/truman-israel/">by the newly formed United Nations</a> in 1947, two years after the end of World War II and in the shadow of the Holocaust: it was an inevitable product of the <a href="https://theconversation.com/a-century-on-the-balfour-declaration-still-shapes-palestinians-everyday-lives-86662">Balfour Declaration</a> (1917) that carved up the Middle East.</p> <p>The creation of the Israeli state turned relationships between Palestinians and Jewish people into borders to navigate and police, producing a line of security to defend.</p> <p>These borders have long been sites of humiliation and denigration toward Palestinians, whose homelands have been now occupied for many generations. Israeli Defense Force soldiers themselves <a href="https://www.breakingthesilence.org.il/testimonies/videos/29690">have spoken passionately</a> about the brutal and arbitrary violence that occurs there, <a href="https://link.springer.com/article/10.1007/s10978-016-9195-y">including “creative punishments”</a>. These were the borders that protected the sites targeted by Hamas. The Nova music festival was five kilometres from one of these borders.</p> <p>For many Israelis, any breach of those borders, any sense of loss of control, courts the terrors of the past. It raises the spectre of the Holocaust: the destruction of European Jewry, the loss of sovereignty over family, home, and over life, the loss of millions of lives, again. For Israel, as for any colonial state, security is a permanent aspiration, in Moses’s terms. The stakes are high.</p> <p>Dark tourism, seen in this light, is not only solidarity with those who have lost loved ones on October 7. It is solidarity with the border, with those who have lost that security. And that loss is profound, traumatic and, at least psychologically, can provoke violent reactions in an effort to have the borders – geographical and psychological – reasserted.</p> <h2>‘I stand with you’</h2> <p>Transitional justice mechanisms such as the truth commissions in <a href="https://www.justice.gov.za/trc/">South Africa</a>, <a href="https://www.usip.org/publications/2002/02/truth-commission-timor-leste-east-timor">Timor Leste</a> and <a href="https://www.usip.org/publications/1983/12/truth-commission-argentina">Argentina</a> apply legal frameworks to heal nations from the trauma of crimes against humanity. These mechanisms are one choice after experiences of mass violence. Ironically, their catchphrase is <em>Nunca Mas</em> (never again), which was the title of the 1984 report by Argentina’s <a href="https://www.usip.org/publications/1983/12/truth-commission-argentina">National Commission on the Dissappeared</a>.</p> <p>Permanent security of the kind Israel is seeking is another choice – and its catchphrase might well be the same. Never again will Israel’s borders be breached, never again will Jewish life be subjected to mass destruction with impunity.</p> <p>This is what solidarity can mean: not only grieving alongside those who have suffered, but attachment to an identity and borders, which are reinforced through participation. “I stand with you” is perhaps what the visits are for. I stand with you on this land, at this time, and perhaps for all time.</p> <p>But stand beside you in what now? In grief, yes. But also in rage, in pain, in vengeance and, for some, in making Israel great again.</p> <p>The hashtag #standwithus accompanies some calls for visits to the October 7 sites, for this form of tourism. It means stand with us at Israel’s border. From there, you can hear the sound of bombs falling: <a href="https://inews.co.uk/news/world/israel-7-october-massacre-sites-dark-draw-tourists-3101715">in Gaza</a>, a place where no solidarity tour will go. Yet.</p> <h2>Memorials, grief and understanding</h2> <p>Dark tourism is not always for those associated with the events. Some people visit sites of disaster and loss because they want to understand the greater sadnesses of the world and its formidable brutalities. Some want to show their respect to others. It’s not dissimilar to visiting memorials.</p> <p>Memorials collate the disparate parts of grief and reflect it as public memory. They offer fragments of historical pain that can be borne in more than one mind, to create a shared reality.</p> <p>In Pretoria, South Africa, a memorial called <a href="https://www.freedompark.co.za/">Freedom Park</a> depicts the names of every person who died in every war fought in South Africa, as well as those South Africans who died in the world wars. The names are written on a wall that circles the park. It is impossibly long and circular, and you cannot measure it with your own stride. It is disorientating and interminable, like grief.</p> <p>In this memorial-metaphor, you are unable to comprehend – and at the same time are awash with – a history of loss, represented by the names. The walls contain you, and then they cannot. Grief and even solidarity is not always about comprehension or containment. Sometimes it is about proximity. Sometimes, it is about sitting with not knowing. Sometimes, it is about solidarity with something that cannot be made sense of.</p> <p>Trauma, psychoanalysis tells us, is an experience of what we cannot assimilate. If you sit in proximity to people and places where traumatic events have happened, you can learn something. If you see the bullet holes at a site of loss, you can comprehend something. But not everything. Bullet holes in a wall are the very definition of a partial story.</p> <p>People visit memorials and sites of loss to learn and to unlearn. Dark tourism has this quality.</p> <h2>Obscenity of understanding</h2> <p>In my field, criminology and trauma studies, we try to understand why people do the violent things they do. Holocaust filmmaker and commentator <a href="https://www.jstor.org/stable/26303924">Claude Lanzmann has said</a> we must not indulge in what he calls the “obscenity of the project of understanding” in relation to Nazi perpetrators of the Holocaust.</p> <p>He regards curiosity about the minds of perpetrators and the rationale for violence as a violence in itself. Of the Holocaust, he says you cannot ask “Why were the Jews killed?”. It is the result that matters. But it is also the reaction that matters. The state of Israel itself – permanent security and its attendant horrors – is part of that reaction.</p> <p>But understanding can influence the reaction to violence, and contribute something to the promise of Never Again. Understanding allows us to hold more than one story in mind. It allows us to do more than <a href="https://www.ochaopt.org/">count the more than 1,200 killed</a> in Israel, or the 41,689 (plus) Palestinians killed in Gaza. Bodies are always more than numbers. But explanation is one thing, justification another. Justification is best left to the courts, international or otherwise, after the violence has ceased.</p> <p>It is hard to hear about dark tourism in Israel/Palestine and in Ukraine and try to understand it. It is hard not to condemn the tourists. But we are quick to condemn at this time – and even quicker to demand others do the same. Perhaps we should not be so righteous, and we should resist the urge to easily condemn, from our homes in what <a href="https://www.mup.com.au/books/after-mabo-paperback-softback">Tim Rowse has called</a> the “ongoing colonial encounter sometimes called ‘Australia’”.</p> <p>Indigenous people here speak of the lack of memorials on this land. But every bordered property is a site for dark tourism in Australia. Dark tourism is the effort to seek out destinations of violence and devastation, but it is not hard to see genocide from our front door in this country.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/240119/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/juliet-rogers-333488"><em>Juliet Rogers</em></a><em>, Associate Professor Criminology, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dark-tourism-is-attracting-visitors-to-war-zones-and-sites-of-atrocities-in-israel-and-ukraine-why-240119">original article</a>.</em></p> </div>

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New study finds epilepsy drug could reduce sleep apnoea symptoms

<p>New research has found that a drug used for epilepsy could be used to reduce the symptoms of sleep apnoea. </p> <p>Obstructive sleep apnoea, which affects about one in 20 people, according to the National Institute for Health and Care Excellence in England, includes symptoms like snoring and it causes a person's breathing to start and stop during the night, with many requiring an aid to help keep their airways open. </p> <p>An international study has identified that taking sulthiame, a drug sold under the brand name Ospolot in Europe, may help prevent patients' breathing from temporarily stopping. </p> <p>This provides an additional option for those unable to use mechanical breathing aids like the Cpap machines. </p> <p>“The standard treatment for obstructive sleep apnoea is sleeping with a machine that blows air through a face mask to keep the airways open. Unfortunately, many people find these machines hard to use over the long term, so there is a need to find alternative treatments,” Prof Jan Hedner from Sahlgrenska university hospital and the University of Gothenburg in Sweden said. </p> <p>Researchers conducted a randomised controlled trial of almost 300 obstructive sleep apnoea patients across Europe, who did not use Cpap machines. </p> <p>They were divided into four groups and given either a placebo or different strengths of sulthiame. </p> <p>The study measured patients’ breathing, oxygen levels, heart rhythm, eye movements, as well as brain and muscle activity while asleep. </p> <p>It found after 12 weeks, those taking sulthiame had up to 50% fewer occasions where their breathing stopped, and higher levels of oxygen in their blood. However, a bigger study needs to be done to confirm the beneficial effects on a larger group. </p> <p>The findings, were presented at the European Respiratory Society Congress in Vienna, Austria. </p> <p>Erika Radford, the head of health advice at Asthma + Lung UK said the findings were a positive step forward in moving away from having to rely on mechanical breathing equipment.</p> <p>“This potential alternative to the current main treatment would make it easier for people to manage their condition,” she said. </p> <p><em>Image: Shutterstock</em></p>

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Common drug shows potential in reversing ageing

<p>A common medication has been found to have anti-ageing qualities, with scientists finding that the drug can de-age monkeys. </p> <p>Metformin, a cheap and common diabetes drug that has been used since the 1950s, could be an anti-ageing elixir, with scientists from the Chinese Academy of Sciences and Beijing Institute of Genomics using the pill to "markedly" slow down ageing in the animals.</p> <p>According to the experts, the medication reduced deterioration of the brain and boosted cognitive abilities in the primates while also slowing down bone loss and aiding in the "rejuvenation" of several tissues and organs. </p> <p>The most significant improvements were seen in the liver and frontal lobe, the part of the brain responsible for language, reasoning, problem solving, memory, movement and personality. </p> <p>Researchers said all of the findings led to the conclusion that "metformin can reduce biological age indicators" up to six years, with the medication paving the way for ageing reversal in humans.</p> <p>The drug was previously tested on mice, but since testing the medication on Cynomolgus monkeys - that are both physiologically and functionally similar to humans - the tests have shown more promise for potential human trials. </p> <p>The researchers said of the 40-month study, "Our research pioneers the systemic reduction of multi-dimensional biological age in primates through metformin, paving the way for advancing pharmaceutical strategies against human ageing."</p> <p>The scientists added, "[The study] represents an important advance in the quest to delay human ageing, with geriatric medicine research gradually shifting its focus from treating individual chronic diseases to systemic intervention against ageing."</p> <p><em>Image credits: Shutterstock </em></p>

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"Lucky to be alive": Concerning Andrew O'Keefe update

<p>Andrew O'Keefe will remain in jail after his bail was revoked, just days after being arrested on drug charges. </p> <p>The former TV host was arrested on Monday and charged with drug possession after police searched a nearby car and allegedly found methamphetamine.</p> <p>His arrest came just hours after the 52-year-old was discharged from the <a href="https://oversixty.com.au/health/caring/andrew-o-keefe-rushed-to-hospital" target="_blank" rel="noopener">hospital</a>, after he was revived by paramedics in the early hours on Sunday morning after an alleged drug overdose. </p> <p>In Waverley Local Court on Tuesday, Magistrate Jacqueline Milledge said O’Keefe was “lucky to be alive” as she read a police statement of facts on an application to detain the former TV host rather than let him out on bail again. </p> <p>O'Keefe was out on bail at the time of the alleged overdose, after allegedly breaching a court order, trespassing and intimidating a man in Sydney’s eastern suburbs in July.</p> <p>O’Keefe’s lawyer did not argue against the application and the magistrate revoked his bail, meaning he will remain custody before his return to court in October.</p> <p>“If he wants to stay alive that’s the best thing to do,” Milledge said.</p> <p>O’Keefe’s lawyer suggested a possible application for release on the next occasion for O’Keefe to receive treatment but Milledge said “a “highly persuasive” argument would be required.</p> <p>O’Keefe’s frequent appearances in court are “absolutely tragic” and “very, very sad,” the magistrate said.</p> <p>“He’s a frequent flyer, he’s just so used to it,” she said.</p> <p>“The mental health applications, the rehab, all been tried, and tested, and failed.</p> <p>“I just don’t see the same thing over and over again is going to be working for him and, god help him, it’s a shame that he doesn’t have an epiphany.”</p> <p><em>Image credits: Seven News </em></p>

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Andrew O'Keefe rushed to hospital

<p>Andrew O'Keefe has been rushed to hospital after being revived by paramedics at a party in Sydney's Eastern Suburbs over the weekend. </p> <p>The disgraced TV host was partying at a home in Vaucluse at 3:30am on Saturday when emergency services were called after allegedly suffering a drug overdose. </p> <p>Paramedics revived O'Keefe at the scene before transporting him to the nearby St Vincent's Hospital for treatment. </p> <p><em>The Daily Telegraph</em> reported that he has since been released from hospital. </p> <p>In a statement, NSW Police said of the incident, "Officers attached to Eastern Suburbs Police Area Command were called to a home unit on Old South Head Road at Vaucluse about 3.40am, responding to concerns for the welfare of a 52-year-old man."</p> <p>"NSW Ambulance paramedics rendered assistance to the man before taking him to St Vincent's Hospital where he was reported to be in a stable condition. Inquiries into the incident are continuing."</p> <p>O'Keefe's health incident comes just days after a court upheld his convictions for domestic violence assault, as District Court Judge John Pickering rejected his lawyers' arguments that a woman had inflicted scratch marks on her own arm and later blamed O'Keefe.</p> <p>The troubled former TV star was convicted in January of three counts of domestic violence-related assault, twice contravening an AVO against him, and two charges for possessing a prohibited drug.</p> <p>He was ordered to serve 18 months on a community corrections order, which involves supervision and reporting requirements, and fined $800 for the drug offences.</p> <p><em>Image credits: JOEL CARRETT/EPA-EFE/Shutterstock Editorial</em></p> <p> </p>

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Ian Thorpe opens up on darkest moment of his career

<p>Ian Thorpe has recalled the moment an irregular drug test almost upended his life and destroyed his reputation. </p> <p>The Aussie swimming legend opened up about a few key moments in his personal life that coincided with the height of his swimming career in a tell-all new book. </p> <p>The 41-year-old athlete singled out the drug test chapter as one of the darkest moments of his career in a new book Profiles In Hope, written by former NSW Liberal leader John Brogden.</p> <p>In 2006, Thorpe underwent a routine drug test that returned an irregular result, with French newspaper <em>L’Equipe</em> reporting that he had returned an unusual level of testosterone.</p> <p>However, results also showed a hormone called leutenising hormone, another naturally occurring substance.</p> <p>The news of the test gained international attraction, and resulted in Thorpe launching a lawsuit against the newspaper.</p> <p>“An irregular test isn’t uncommon. They happen. So firstly, no one should know that information to begin with,” Thorpe says in the book, according to the <em><a title="www.dailymail.co.uk" href="https://www.dailymail.co.uk/sport/olympics/article-13845887/Ian-Thorpe-goes-public-never-heard-devastating-admission.html">Daily Mail</a></em>.</p> <p>“An irregular test means nothing. An irregular test gets thrown out."</p> <p>He said at the time the speculation that he was a cheat was “so upsetting” and the way the information was leaked to French journalist made him feel “deeply alarmed”.</p> <p>He also admitted that during the media storm around the testing, he did not want to leave his home and says now he had thoughts about taking his own life and staging it as an accident.</p> <p>The “Thorpedo” now has the tools in place for his mental health to look back and think he could have handled it better. </p> <p>“In that kind of state, you’re entirely irrational, your logic is warped,” he tells Brogden.</p> <p>“It’s only in the periods when you have clarity of mind, when your mental health is good, that you can actually reflect on things and say, ‘Well, I could have done this’. </p> <p>“I realised what I was doing wasn’t working, and that I needed help. So I got that help, and even though I was still in a long-term depressive state, I got better. I wasn’t at the point of suicide.”</p> <p><em><strong>Need to talk to someone? Don't go it alone. Call Lifeline on 13 11 14 or <a href="http://lifeline.org.au/" target="_blank" rel="noopener noreferrer" data-stringify-link="http://lifeline.org.au" data-sk="tooltip_parent">lifeline.org.au</a></strong></em></p> <p><em>Image credits: Shutterstock </em></p>

Caring

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Tragic flaw sees man use voluntary assisted dying drugs prescribed for his wife

<p><strong><em>Warning: This article contains discussions of suicide and depression that some readers may find upsetting</em></strong></p> <p>A Queensland coroner has criticised the state's voluntary assisted dying laws, after an elderly man took his own life using drugs prescribed for his wife.</p> <p>The Coroner's Court in Brisbane held an inquest into the May 2023 death of a man in his 80s, referred to by the pseudonym ABC.</p> <p>The man's partner, who had a terminal illness, was found eligible for the voluntary assisted dying [VAD] program in March 2023. </p> <p>Under that law a person can self-administer a VAD substance in a private location but they must nominate a "contact person" who will be legally required to return any unused or leftover portion within 14 days.</p> <p>The self-administered drug was delivered to the couple's home a month later, and the man was the "contact person" responsible for the substance. </p> <p>On the same day the drug arrived, his wife was admitted to hospital with Covid, where they decided to take an intravenous VAD drug. She died in hospital on May 8, 2023.</p> <p>The man was told to return the drug within two days of his partner's death, but he failed to do so, using it to take his own life eight days later. </p> <p>He did not return the drug as he was unable to leave his home, and there was no arrangement made for a health professional to collect it. </p> <p>ABC’s adult daughter recalled the moment she found her lifeless father after returning from running errands. </p> <p>“I thought he was asleep in the chair. I put my arms around him. He was cold,” she told the inquest. </p> <p>The woman became emotional and said that she found an empty box in the kitchen and “knew immediately it was the VAD”.</p> <p>In his findings, coroner David O’Connell said he was not judging the merits of VAD, but it had led to a "tragedy" only 107 days after it was legalised. </p> <p>“Persons should not be placed in a position where they can be led into unwise decisions,” the coroner said in his findings handed down on Wednesday.</p> <p>O'Connell said that the laws had failed to find a balance between a patient's autonomy and lethal medication safety. </p> <p>“The VAD law has (the substance) provided to persons with no medical training, no regulatory oversight, and in a period of great personal and emotional turmoil,” he said.</p> <p>The inquest heard ABC had previously been diagnosed with, and received medication for depression, which should've been considered before approving someone as a contact person. </p> <p>"The fact that ABC had been medically diagnosed with depression and took medication was not something the VAD authorities considered, or even enquired on, when approving them to be a Contact Person. Indeed, there are simply no checks or enquiries of the Contact Person's suitability," he said. </p> <p>He added that while there was no breach of protocol or legislative processes by QVAD personnel, it was "not a well-considered law".</p> <p>O'Connell recommended the Queensland government implement an earlier draft of VAD laws that required oversight by a medical professional at all times.</p> <p>Queensland Health Minister Shannon Fentiman said the government would consider the coroner’s recommendations. </p> <p>“Following that case, we are working on a review of that legislation coming up to three years that will start next year, and that will obviously be one of the things that we look at,” she said.</p> <p><em>Image: Shutterstock</em></p>

Caring

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Five people arrested over Matthew Perry's death

<p>Five people have been arrested in connection with the death of <em>Friends</em> actor Matthew Perry, who died of a drug overdose in October 2023. </p> <p>Matthew Perry’s assistant Kenneth Iwamasa, two doctors, and two alleged drug dealers, including Jasveen Sangha, the so-called “Ketamine Queen of Los Angeles”, have been arrested over the star's death.</p> <p>All five suspectes are facing charges including “conspiracy to distribute ketamine” over allegations they supplied the 54-year-old with the illegal drugs in the final weeks of his life.</p> <p>In the last four days of his life, Mr Perry paid $100,000 AUD for 70 vials of ketamine.</p> <p>Three of the five people charged have pleaded guilty to several drug-related offences, while a licensed doctor and an alleged drug dealer arrested in California on Thursday are the lead defendants in a “broad, underground criminal network” to distribute ketamine to Mr Perry and others.</p> <p>“These defendants took advantage of Mr Perry’s addiction issues to enrich themselves. They knew what they were doing was wrong. They knew what they were doing was risking great danger to Mr Perry, but they did it anyway,” said US Attorney Martin Estrada.</p> <p>Following the arrests, Matthew Perry's stepfather has shared a message of gratitude to law enforcement and hoped justice would be served. </p> <p>Keith Morrison, a Canadian journalist, and other loved ones of the <em>Friends</em> star in a statement issued to NBC News say they are finding some solace in the legal system nine months on from his death.</p> <p>"We were and still are heartbroken by Matthew's death, but it has helped to know law enforcement has taken his case very seriously," they said. "We look forward to justice taking its course."</p> <p><em>Image credits: Matt Baron/BEI/Shutterstock Editorial </em></p>

Legal

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Aussie Olympian arrested in Paris after trying to buy drugs

<p>An Aussie Olympian has been arrested after he was caught on the streets of Paris trying to buy a gram of cocaine. </p> <p>Hockey superstar Tom Craig tried to outrun police when he was caught, before realising he couldn't evade the authorities and surrendered. </p> <p>He and teammates had been at a family and friends celebration at the Hotel Maison in Montmartre in the 9th arrondissement after both his team and the Hockeyroos team of girlfriend Alice Arnott lost in the quarter finals.</p> <p>The 28-year-old had spent nearly 18 hours in custody after being arrested at midnight on Tuesday before being released with “a probationary criminal warning for drug use”.</p> <p>As a result of his indiscretion, the Kookaburras veteran has had his Olympic rights stripped from him, been banned from the athletes village and told he does not have the right to march in the closing ceremony.</p> <p>Craig, who is a qualified solicitor, fronted the media in central Paris hours before an AOC press conference, in which he apologised for his behaviour.</p> <p>“I would firstly like to apologise for what has occurred over the last 24 hours,” the Tokyo silver medallist said. “I made a terrible mistake and I take full responsibility for my actions."</p> <p>“My actions are my own and by no way reflect the values of my family, my teammates, my friends, the sport and the Australian Olympic team. I have embarrassed you all and I’m truly sorry.” </p> <p>In the AOC press conference, Australian Olympic chef de mission Anna Meares said she was adamant Kookaburras star Tom Craig was acting alone when trying to purchase the drugs. </p> <p>“We do feel very confident that this is an isolated incident,” Meares said.</p> <p>“I would rather be here talking about the three gold medals that we have won today. But here we are first."</p> <p>“I cannot condone what Tom has done. He is a good person who made a bad decision. But there are consequences that come with decisions like this."</p> <p>“Our team has been exemplary at these Games and his actions do not reflect the values of this team, nor do they diminish this team’s performances. He has apologised, shown remorse and he has owned up to his mistake and we will support him if he needs help."</p> <p><em>Image credits: X (Twitter)/DAVE HUNT/EPA-EFE/Shutterstock Editorial </em></p>

Legal

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Doctors at war

<p><em>In the annals of military history, the valour and sacrifices of doctors who served alongside soldiers in combat zones often go unrecognised. Yet their stories, as retired colonel Robert Likeman poignantly illustrates in his Australian Doctors at War series, reveal a legacy of courage and commitment that is integral to understanding the full scope of wartime heroism.</em></p> <p>---</p> <p>Winston Churchill, in his <em>Sketches on Service During the Indian Frontier Campaign of 1897</em>, wrote, “The spectacle of a doctor in action among soldiers, in equal danger and with equal courage, saving life where others are taking it, allaying pain where all others are causing it, is one which must always seem glorious, whether to God or man”.</p> <p>It is certainly true that doctors in a combat zone share the risks of shot and shell equally with the fighting soldier, but they also experience the added stress of taking responsibility for those wounded and dying on the battlefield, and in situations where the best of treatment cannot be readily given.</p> <p>Glorious or otherwise, the stories of our Australian Army doctors at war remain relatively unrecognised. Doctors have always been among the first to volunteer – in all 1,242 doctors served with the first Australian Imperial Force, careless for their own safety, and 55 of them failed to return. These men represented a significant proportion of the medical workforce in Australia, which by 1937 only reached 5,000. In World War 2, with the introduction of compulsory military service, the number of serving doctors exceeded 2,500. Hardly any of them are still with us today, but their children and grandchildren are our fellow citizens, and in many cases our local doctor may be one of these. It is a legacy not to be dismissed lightly. </p> <p>Those who have served in the Army know that treating the ailments of soldiers and preserving their health occupies much more time than dressing their wounds. In World War 1, fought over the agricultural lands of Europe, infectious diseases such as gas gangrene, tetanus and trench fever were common. In the deserts of World War 2, these were replaced by hepatitis, sandfly fever and eye infections. New Guinea presented a wholly different spectrum of disease, dominated by malaria, scrub typhus and amoebic dysentery. The maintenance of “fighting fitness” was a daily struggle for the doctors. </p> <p>The 2021 Interim Report of the Royal Commission into Defence and Veteran Suicide did not identify medical officers as being particularly at risk of psychological injury as a result of their service in a war zone. But in view of their exposure to mass trauma and death, they might be assumed to have a significant risk of Post Traumatic Stress Disorder, both from the chances of being wounded or killed, and from the guilt associated with the failure to preserve life. Two of the medical officers who served at Gallipoli shot themselves on their return to Egypt, perhaps because they had seen men die who might have been saved with better medical attention. Fourteen other doctors from the 1st Australian Imperial Force are known to have committed suicide after their return to Australia. </p> <p>Close to 3,000 Australian nurses served overseas with the Australian Army Nursing Service in World War 1, but female doctors were not permitted to enlist. A significant number of them however, at least 19, served in the British Army or in voluntary hospitals in Europe. One of them, Phoebe Chapple, was awarded the Military Medal for Bravery. In World War 2, 22 women doctors were commissioned in total – moreso due to the shortage of manpower than from egalitarian principles – though none of them were posted overseas. In recent overseas deployments, women doctors in the Army have quite properly taken their rightful place.</p> <p>The military service and civilian practice of all the Australian doctors who served in both World Wars has been meticulously documented in my six-volume series, <em>Australian Doctors at War</em>, published by Halstead Press. Your relatives may be among them.</p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/06/Robert_Likeman_01.jpg" alt="" width="1280" height="720" /></p> <p><em>The Inevitable Hour</em> is the sixth and final volume of my <em>Australian Doctors at War</em> series, covering the period from January 1943 to the disbanding of the Second Australian Imperial Force in April 1947. Even after the Japanese had been driven from Papua and New Guinea, they still retained most of the archipelago. The threat to Australia was great, and despite being a then small nation, the country mobilised quickly to disrupt Japanese holdings in Madang, Wewak and Wau. Overcoming the constant influx of wounded men needing treatment, suffering themselves from afflictions such as hepatitis, dysentery and depression, aggravated by extreme and tropical climates, Australia’s medical officers were under considerable pressure, during the war and in the monumental demobilisation of the 2nd AIF that followed Japanese defeat.</p> <p><em><strong>ABOUT THE AUTHOR</strong></em><br />Robert Likeman is a graduate of Oxford University, where he studied Classics, Oriental Languages and Medicine. He is a specialist in obstetrics and gynaecology, in tropical medicine, and in rural and remote medicine. After service in the British Army he migrated to Australia in 1972. He is the author of seven books of military history and two biographies, and co-author of a textbook of obstetrics and gynaecology for doctors practising in developing countries.</p> <p><em>Images courtesy of Robert Likeman.</em></p>

Books

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Boomers vs millennials? Free yourself from the phoney generation wars

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/bobby-duffy-98570">Bobby Duffy</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a></em></p> <p>Generational thinking is a big idea that’s been horribly corrupted and devalued by endless myths and stereotypes. These clichés have fuelled fake battles between “snowflake” millennials and “selfish” baby boomers, with younger generations facing a “war on woke” and older generations accused of “stealing” the future from the young.</p> <p>As I argue in my book, <a href="https://atlantic-books.co.uk/book/generations/">Generations</a>, this is a real shame. A more careful understanding of what’s really different between generations is one of the best tools we have to understand change – and predict the future.</p> <p>Some of the great names in sociology and philosophy saw understanding generational change as central to understanding society overall. <a href="http://dhspriory.org/kenny/PhilTexts/Comte/Philosophy2.pdf">Auguste Comte</a>, for example, identified the generation as a key factor in “the basic speed of human development”.</p> <p>He argued that “we should not hide the fact that our social progress rests essentially upon death; which is to say that the successive steps of humanity necessarily require a continuous renovation … from one generation to the next”. We humans get set in our ways once we’re past our formative years, and we need the constant injection of new participants to keep society moving forward.</p> <p>Understanding whether, and how, generations are different is vital to understanding society. The balance between generations is constantly shifting, as older cohorts die out and are replaced by new entrants. If younger generations truly do have different attitudes or behaviours to older generations, this will reshape society, and we can, to some extent, predict how it will develop if we can identify those differences.</p> <p>But in place of this big thinking, today we get clickbait headlines and bad research on millennials “<a href="https://www.businessinsider.com/millennials-hate-napkins-2016-3?r=US&amp;IR=T">killing the napkin industry</a>” or on how baby boomers have “<a href="https://www.theatlantic.com/ideas/archive/2019/06/boomers-are-blame-aging-america/592336/">ruined everything</a>”. We’ve fallen a long way.</p> <h2>Myth busting</h2> <p>To see the true value of generational thinking, we need to identify and discard the many myths. For example, as I outline in the book, gen Z and millennials are not lazy at work or disloyal to their employers. They’re also no more materialistic than previous generations of young: a focus on being rich is something we tend to grow out of.</p> <p>Old people are not uncaring or unwilling to act on climate change: in fact, they are more likely than young people to boycott products for social purpose reasons.</p> <p>And our current generation of young are not a particularly unusual group of “culture warriors”. Young people are always at the leading edge of change in cultural norms, around race, immigration, sexuality and gender equality. The issues have changed, but the gap between young and old is not greater now than in the past.</p> <p>Meanwhile, there are real, and vitally important, generational differences hidden in this mess. To see them, we need to separate the three effects that explain all change in societies. Some patterns are simple “lifecycle effects”, where attitudes and behaviours are to do with our age, not which generation we are born into. Some are “period effects” – where everyone is affected, such as in a war, economic crisis or a pandemic.</p> <p>And finally, there are “cohort effects”, which is where a new generation is different from others at the same age, and they stay different. It’s impossible to entirely separate these distinct forces, but we can often get some way towards it – and when we do, we can predict the future in a much more meaningful way.</p> <p>There are many real generational differences, in vitally important areas of life. For example, the probability of you owning your own home is hugely affected by when you were born. Millennials are around half as likely to be a homeowner than generations born only a couple of decades earlier.</p> <p>There is also a real cohort effect in experience of mental health disorders, particularly among recent generations of young women. Our relationship with alcohol and likelihood of smoking is also tied to our cohort, with huge generational declines in very regular drinking and smoking. Each of these point to different futures, from increased strain on mental health services to declining alcohol sales.</p> <p>But lifecycle and period effects are vitally important too. For example, there is truth in the idea that we grow more conservative as we age. One analysis suggests that this ageing effect is worth around <a href="https://www.sciencedirect.com/science/article/abs/pii/S0261379413000875">0.35% to the Conservatives each year</a>, which may not sound like a lot, but is very valuable over the course of a political lifetime.</p> <p>And, of course, the pandemic provides a very powerful example of how period effects can dramatically change things for us all.</p> <h2>Reaching beyond the avocado</h2> <p>When there is such richness in the realities, why are there so many myths? It’s partly down to bad marketing and workplace research – that is, people jumping on the generation bandwagon to get media coverage for their products or to sell consultancy to businesses on how to engage young employees.</p> <p>This has become its own mini-industry. In 2015, US companies spent up to US$70 million (£51 million) on this sort of “advice” <a href="https://www.wsj.com/articles/helping-bosses-decode-millennialsfor-20-000-an-hour-1463505666">according to the Wall Street Journal</a>, with some experts making as much as US$20,000 an hour. Over 400 LinkedIn users now describe themselves solely as a “millennial expert” or “millennial consultant”.</p> <p>Campaigners and politicians also play to these imagined differences. Our increasing focus on “<a href="https://www.kcl.ac.uk/policy-institute/assets/culture-wars-in-the-uk.pdf">culture wars</a>” often involves picking out particular incidents in universities, such as the <a href="https://www.bbc.co.uk/news/uk-england-manchester-45717841">banning of clapping</a> at events or the <a href="https://www.bbc.co.uk/news/uk-england-oxfordshire-57409743">removal of a portrait of the Queen</a> to exaggerate how culturally different young people today are.</p> <p>Maybe less obviously, politicians such as former US President Barack Obama repeatedly lionise coming generations as more focused on equality, when the evidence shows they’re often not that different. These assertions are not only wrong, but create false expectations and divides.</p> <p>Some have had enough, calling on the Pew Research Center in the US, which has been a champion of generational groups, to <a href="https://www.washingtonpost.com/opinions/2021/07/07/generation-labels-mean-nothing-retire-them/&amp;data=04%257C01%257C">stop conducting this type of analysis</a>. I think that misses the point: it’s how it’s applied rather than the idea of generations that’s wrong.</p> <p>We should defend the big idea and call out the myths, not abandon the field to the “millennial consultants”.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/167138/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/bobby-duffy-98570">Bobby Duffy</a>, Professor of Public Policy and Director of the Policy Institute, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/boomers-vs-millennials-free-yourself-from-the-phoney-generation-wars-167138">original article</a>.</em></p> </div>

Mind

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To tackle gendered violence, we also need to look at drugs, trauma and mental health

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged <a href="https://ministers.pmc.gov.au/gallagher/2024/helping-women-leave-violent-partner-payment">more than A$925 million</a> over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.</p> <p>However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.</p> <h2>Why is this crucial?</h2> <p>The World Health Organization estimates <a href="https://iris.who.int/bitstream/handle/10665/341604/WHO-SRH-21.6-eng.pdf?sequence=1">30% of women</a> globally have experienced intimate partner violence, gender-based violence or both. In Australia, <a href="https://www.abs.gov.au/statistics/people/crime-and-justice/partner-violence/latest-release#key-statistics">27% of women</a> have experienced intimate partner violence by a co-habiting partner; <a href="https://pubmed.ncbi.nlm.nih.gov/37004184/">almost 40%</a> of Australian children are exposed to domestic violence.</p> <p>By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.</p> <p>These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.</p> <h2>What’s the link with mental health, trauma and drugs?</h2> <p>The relationships between mental illness, drug use, traumatic experiences and violence are complex.</p> <p>When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there <a href="https://theconversation.com/bondi-attacker-had-mental-health-issues-but-most-people-with-mental-illness-arent-violent-227868">is evidence</a> people with serious mental illness can be more likely to become violent.</p> <p>The use of alcohol and other drugs also <a href="https://theconversation.com/alcohol-and-drug-use-exacerbate-family-violence-and-can-be-dealt-with-69986">increases the risk</a> of domestic violence, including intimate partner violence.</p> <p>About <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/understanding-fdsv/factors-associated-with-fdsv">one in three</a> intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/">using alcohol or other drugs</a>.</p> <p>It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00075-0/fulltext">high rates</a> of trauma among people who become violent.</p> <p>For example, experiences of childhood trauma (such as witnessing physical abuse) <a href="https://www.sciencedirect.com/science/article/pii/S1359178915000828?via%3Dihub">can increase the risk</a> of perpetrating domestic violence as an adult.</p> <p>Early traumatic experiences can affect the brain and body’s <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0895-4">stress response</a>, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.</p> <p>This response to stress increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675346/">alcohol and drug problems</a>, developing <a href="https://pubmed.ncbi.nlm.nih.gov/30798897/">PTSD</a> (post-traumatic stress disorder), and <a href="https://psycnet.apa.org/record/2015-17349-001">increases the risk</a> of perpetrating intimate partner violence.</p> <h2>How can we address these overlapping issues?</h2> <p>We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.</p> <p>The early intervention and treatment of <a href="https://doi.org/10.1186/s12905-019-0728-z">mental illness</a>, <a href="https://doi.org/10.1177/1541204020939645">trauma</a> (including PTSD), and <a href="https://doi.org/10.1016/j.avb.2015.06.001">alcohol and other drug use</a>, could help reduce violence. So extra investment for these are needed. We also need more investment to <a href="https://www.sciencedirect.com/science/article/pii/S2212657023000508">prevent mental health issues</a>, and preventing alcohol and drug use disorders from developing in the first place.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S074937972200023X?via%3Dihub">Preventing trauma</a> from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. <a href="https://journals.sagepub.com/doi/10.1177/070674371105600505">Safe and supportive</a> environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.</p> <p>We also need to acknowledge the widespread <a href="https://store.samhsa.gov/product/practical-guide-implementing-trauma-informed-approach/pep23-06-05-005">impact of trauma</a> and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.</p> <h2>How about programs for perpetrators?</h2> <p>Most existing standard intervention programs for perpetrators <a href="https://journals.sagepub.com/doi/10.1177/1524838018791268">do not consider</a> the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have <a href="https://psycnet.apa.org/doi/10.1037/a0012718">little</a> or <a href="https://doi.org/10.1016/j.cpr.2021.101974">mixed effects</a> on the behaviour of perpetrators.</p> <p>But we could improve these programs with a <a href="http://rcfv.archive.royalcommission.vic.gov.au/MediaLibraries/RCFamilyViolence/Reports/RCFV_Full_Report_Interactive.pdf">coordinated approach</a> including treating mental illness, drug use and trauma at the same time.</p> <p>Such “<a href="https://www.sciencedirect.com/science/article/pii/S014976341930449X?via%3Dihub">multicomponent</a>” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.</p> <h2>What needs to happen next?</h2> <p>Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.</p> <p>We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.</p> <p>We also need to look more widely at preventing intimate partner violence and gendered violence.</p> <p>We need developmentally appropriate <a href="https://theconversation.com/4-things-our-schools-should-do-now-to-help-prevent-gender-based-violence-228993">education and skills-based programs</a> for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.</p> <p>We also need to address the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278040/">social determinants of health</a> that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.</p> <p>All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.</p> <hr /> <p><em>The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229182/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/to-tackle-gendered-violence-we-also-need-to-look-at-drugs-trauma-and-mental-health-229182">original article</a>.</em></p> </div>

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What happens when I stop taking a drug like Ozempic or Mounjaro?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Drugs like Ozempic are very <a href="https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.12932">effective</a> at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.</p> <p>But does weight come back when you stop using it?</p> <p>The short answer is yes. Stopping <a href="https://jamanetwork.com/journals/jama/fullarticle/2812936">tirzepatide</a> and <a href="https://doi.org/10.1111/dom.14725">semaglutide</a> will result in weight regain in most people.</p> <p>So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.</p> <h2>It’s a long-term treatment, not a short course</h2> <p>If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.</p> <p>For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.</p> <p>Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)</p> <p>Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.</p> <h2>Why do people stop?</h2> <p>Research trials show anywhere from <a href="https://asean-endocrinejournal.org/index.php/JAFES/article/view/1771">6%</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/35015037/">13.5%</a> of participants stop taking these drugs, primarily because of <a href="https://www.health.harvard.edu/staying-healthy/glp-1-diabetes-and-weight-loss-drug-side-effects-ozempic-face-and-more">side effects</a>.</p> <p>But these studies don’t account for those forced to stop because of cost or <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">widespread supply issues</a>. We don’t know how many people have needed to stop this medication over the past few years for these reasons.</p> <p>Understanding what stopping does to the body is therefore important.</p> <h2>So what happens when you stop?</h2> <p>When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to <a href="https://pubmed.ncbi.nlm.nih.gov/30565096/">move out of your system</a>. As it does, a number of things happen:</p> <ul> <li>you start feeling hungry again, because both <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/">your brain and your gut</a> no longer have the medication working to make you feel full</li> </ul> <ul> <li> <p>blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index">low glycemic index</a> to stabilise your blood sugars</p> </li> <li> <p>over the longer term, most people experience a return to their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092593/">previous blood pressure and cholesterol levels</a>, as the weight comes back</p> </li> <li> <p>weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.</p> </li> </ul> <p>While you were on the medication, you will have lost <a href="https://academic.oup.com/jes/article/5/Supplement_1/A16/6240360">proportionally less skeletal muscle than fat</a>, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.</p> <h2>Is stopping and starting the medications a problem?</h2> <p>People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of <a href="https://pubmed.ncbi.nlm.nih.gov/21829159/">yo-yo dieting</a>.</p> <p>When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to <a href="https://www.jomes.org/journal/view.html?doi=10.7570/jomes.2017.26.4.237">deal with</a> spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can <a href="https://cardiab.biomedcentral.com/articles/10.1186/s12933-022-01735-x">stress</a> your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.</p> <p>Interestingly, the risk to the body from weight fluctuations is greater for people who are <a href="https://jech.bmj.com/content/74/8/662">not obese</a>. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.</p> <h2>How can you avoid gaining weight when you stop?</h2> <p>Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:</p> <ul> <li> <p>getting quality <a href="https://www.hindawi.com/journals/ije/2010/270832/">sleep</a></p> </li> <li> <p>exercising in a way that builds and maintains muscle. While on the medication, you will <a href="https://pubmed.ncbi.nlm.nih.gov/32628589/">likely have lost muscle</a> as well as fat, although this is not inevitable, especially if you <a href="https://www.europeanreview.org/article/34169">exercise regularly</a> while taking it</p> </li> </ul> <ul> <li> <p>addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2009.159491">fat-phobic and discriminates</a> against people in larger bodies</p> </li> <li> <p>eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.</p> </li> </ul> <p>Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224972/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/natasha-yates-1213624">Natasha Yates</a>, General Practitioner, PhD Candidate, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-when-i-stop-taking-a-drug-like-ozempic-or-mounjaro-224972">original article</a>.</em></p> </div>

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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’

<p><em><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">lowering the risk</a> of a having a heart attack or stroke, while also silencing “<a href="https://theconversation.com/some-ozempic-users-say-it-silences-food-noise-but-there-are-drug-free-ways-to-stop-thinking-about-food-so-much-208467">food noise</a>”.</p> <p>As demand for semaglutide increases, so are <a href="https://www.smh.com.au/lifestyle/health-and-wellness/in-a-fat-phobic-world-ozempic-is-hardly-the-easy-way-out-20240401-p5fgjd.html">claims</a> that taking it is “cheating” at weight loss or the “easy way out”.</p> <p>We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.</p> <p>Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.</p> <h2>How does it work?</h2> <p>Semaglutide is a <a href="https://en.wikipedia.org/wiki/GLP-1_receptor_agonist">glucagon-like peptide-1</a> receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called <a href="https://en.wikipedia.org/wiki/Glucagon-like_peptide-1">GLP-1</a> for short, work better.</p> <p>GLP-1 gets secreted by cells in your gut when it <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">detects increased nutrient levels</a> after eating. This stimulates insulin production, which lowers blood sugars.</p> <p>GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.</p> <p><iframe id="tc-infographic-1031" class="tc-infographic" style="border: none;" src="https://cdn.theconversation.com/infographics/1031/c11b606581d4bc58a71f066492d7f740b52c04e1/site/index.html" width="100%" height="400px" frameborder="0"></iframe></p> <p>GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.</p> <p>Some studies have found less GLP-1 gets released after meals in <a href="https://pubmed.ncbi.nlm.nih.gov/38218319/">adults with obesity or type 2 diabetes mellitus</a> compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.</p> <p>GLP-1 has a very short half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/28443255/">two minutes</a>. So GLP-1RA medications were designed to have a very long half-life of about <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">seven days</a>. That’s why semaglutide is given as a weekly injection.</p> <h2>What can users expect? What does the research say?</h2> <p>Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).</p> <p>A large group of <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">randomised controlled trials</a>, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.</p> <p>Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">led to 6–12% greater weight loss</a> compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.</p> <p>Weight reduction due to semaglutide also leads to a <a href="https://pubmed.ncbi.nlm.nih.gov/36769420/">reduction in systolic and diastolic blood pressure</a> of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/triglycerides">triglyceride levels</a> (a type of blood fat) and <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">improved physical function</a>.</p> <p>Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a <a href="https://pubmed.ncbi.nlm.nih.gov/37952131/">20% lower risk</a> of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.</p> <h2>Who is eligible for semaglutide?</h2> <p>Australia’s regulator, the Therapeutic Goods Administration (TGA), has <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">approved</a> semaglutide, sold as Ozempic, for treating type 2 diabetes.</p> <p>However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.</p> <p>The TGA has <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy to treat obesity</a> but it’s not currently available in Australia.</p> <p>When it’s available, doctors will be able to prescribe <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">semaglutide to treat obesity</a> in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.</p> <h2>What else do you need to do during Ozempic treatment?</h2> <p>Checking details of the <a href="https://pubmed.ncbi.nlm.nih.gov/36691309/">STEP trial intervention components</a>, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.</p> <p>Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of <a href="https://www.healthdirect.gov.au/tips-for-getting-active">moderate-to-vigorous physical activity</a>, like brisk walking, dancing and gardening each week.</p> <p>STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">review of obesity medication trials</a> found people reported they needed less <a href="https://pubmed.ncbi.nlm.nih.gov/28652832/">cognitive behaviour training</a> to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and <a href="https://theconversation.com/9-ways-wont-power-is-better-than-willpower-for-resisting-temptation-and-helping-you-eat-better-71267">avoiding things that trigger eating</a>.</p> <h2>But what are the side effects?</h2> <p>Semaglutide’s side-effects <a href="https://pubmed.ncbi.nlm.nih.gov/38041774/">include</a> nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.</p> <p>In one study these <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">led to</a> discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.</p> <p>More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.</p> <p>To reduce risk or severity of side-effects, <a href="https://pubmed.ncbi.nlm.nih.gov/36934408/">medication doses are increased very slowly</a> over months. Once the full dose and response are achieved, research indicates you need to take it long term.</p> <p>Given this long-term commitment, and associated <a href="https://www.health.gov.au/topics/private-health-insurance/what-private-health-insurance-covers/out-of-pocket-costs#:%7E:text=An%20out%20of%20pocket%20cost,called%20gap%20or%20patient%20payments">high out-of-pocket cost of medication</a>, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219116/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/clare-collins-7316"><em>Clare Collins</em></a><em>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image credits: </em><em>Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-taking-drugs-like-ozempic-isnt-cheating-at-weight-loss-or-the-easy-way-out-219116">original article</a>.</em></p>

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