I saw an article this week that detailed the sad story of a woman who took Ozempic for weight loss. Initially, things went great, and she lost a great deal of weight. However, when her price for the drug went higher, she had to quit taking it and gained all the weight back plus an additional 15 lbs.

Because we sell nutritional supplements, you probably expect me to get on an anti-pharmacy soapbox and say “I told you so.”

I am not going to do that.

I have not seen evidence that drugs like Ozempic are overly harmful in themselves. In fact, they are usually just appetite suppressants. Appetite suppressants help lower calorie intake, and that is a good thing. We sell appetite suppressants here too.

As an aside, I want to point you to this video I recorded a few months ago. It discusses the different categories of weight loss products and how they work. While it is fairly lengthy at 25 minutes, it may help you if you are in weight loss mode and considering supplements or drugs.

Back to Ozempic, here is my general thought: Ozempic does what it is supposed to do, but it cannot rewire the mind, and it cannot create the habits and discipline needed to change eating behavior once the drug usage is stopped.

In short, Ozempic is designed to only work when you are taking it. I am not saying that in a derogatory way; the same is true of our appetite suppressants too. It is pretty much true of every category of weight loss products.

This is why, while I talk a lot about weight loss here, I don’t talk much about the weight loss products we sell. I see weight loss products as a small part of the equation. Essentially, they can help you lose weight faster to get to your target weight faster. That is a positive thing; use appetite suppressants with my blessing, whether pharmaceuticals or supplements.

However, you should not depend on these kinds of products to maintain weight loss long term. Long-term weight maintenance does not require any expensive drugs or supplements. For most of us, it just requires a few wiring changes between the ears. Focus on that; that is what is going to make or break your weight management success.

I have friends who have exited businesses for large amounts of money, resulting in an instant retirement with no financial care in the world. Suddenly, they have tons of free time and can do anything they want to do.

That might sound enviable, but be careful what you wish for. In transparent moments, those friends will often admit that their new life has been challenging. They talk about loss of purpose, loss of identity, restlessness, and boredom.

Here’s why: Humans are designed to be busy, and we are happiest when we are busy and have tension in our lives. When we get bored, for better or worse, we tend to find a way to generate some excitement. In fact, if you stop and think about it, that is the role that sports plays in society. Sports provide humans with busyness and tension.

I bring this up because many of us are retired or thinking about retiring, and others are in jobs that are either not fulfilling or demanding. Some of us are now empty-nesters without the time demands of parenting. As a result, a lot of us probably face (or will soon face) the same restlessness and boredom that my wealthy friends face.

If you find the idea of doing nothing unappetizing, that is normal. There is simply not much fun or meaning in “killing time.”

If you are dealing with what I am talking about, I want to encourage you to be intentional about finding solutions. And, while hobbies are often denigrated in society as non-important, they are one of those solutions.

Hobbies are beneficial in many ways, including emotional and physical health, especially when aging. Here are just a few of the proven ways that hobbies improve your life during aging.

• Increased brain function
• Increased creativity
• Decreased stress
• Increased happiness
• Better relationships and more social connections
• Increased self-esteem
• Increased physical health

The benefits of hobbies have been widely studied, as discussed here in this article from Harvard. In fact, you can find enormous amounts of data about this topic on health websites across the web.

I get that there is a perception about hobbies as being unimportant. I get it: building furniture in the garage may not be as important as the work you used to do. But, don’t underestimate the importance of having that hobby, not just for yourself but for the people around you. Hobbies make the world a better place for all of us.

Give yourself permission to find some.

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A clinical study that I found interesting was released about a week ago. The study compared two diets: a vegetarian diet and a diet containing about 6 oz of lean, unprocessed beef daily. It found that those on the vegetarian diet had improvements in glucose/insulin and cholesterol (total and LDL).

I want to mention the group that funded the study was the National Cattlemen’s Beef Association. If this sounds strange, just know that it is normal for interested parties to fund these kinds of studies. That does not mean that bias must be present, but it is a warning sign. In this case, I think it is significant that the results were different than the organization probably hoped for.

As far as the study goes, there are some factors I think that should be considered before drawing many conclusions:

• Few people who eat meat limit their red meat intake to 6 oz, and the meat they eat is often not lean and unprocessed. For example, many burgers today have a whopping 8 oz of hamburger in them with a high-fat content 🙂
• For the vegetarian group, the improvements in cholesterol and glucose/insulin were statistically insignificant. It is not like there was a substantial ground-shaking improvement.
• There were many other health factors (such as muscle mass) that were not considered by the study. In other words, the benefits of a vegetarian diet in one area might be counteracted by increased risks in other areas.

I have said this over and over: I believe in clinical studies. In fact, I look to them as the primary and best way to actually know the effectiveness of various health remedies. But, this particular study is woefully weak in giving much in the way of real answers. It simply is too limiting in the questions it is designed to answer.

So, regarding meat, until I see something better, I will stick with my mantra about moderation. I am skeptical of extreme diets, and while some may disagree, I consider vegetarian diets to be a bit extreme when viewed historically. People have always consumed meat. Very likely, they consumed far less than what many consume today, but eating meat has always been part of the human condition. I see no big reason for that to change, and in fact, I think there are big benefits to eating meat.

So, this is one of those studies where the takeaways are modest. If you are a vegetarian, carry on. If you are a meat-lover, make sure you are not overdoing it, but carry on too.

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Because we have been in Greece and eating Greek food exclusively for the past week, I thought it might be timely to talk about the Mediterranean diet a bit.

While there is no official diet “rules” to follow, the Mediterranean diet generally looks like this:

• High intake of extra virgin olive oil, leafy green vegetables, fruits, whole grains, nuts, and legumes.
• Moderate intake of fish and other lean meat, dairy products, and red wine.
• Low intake of saturated fat, eggs, sweets, and red meat.

The diet is generally considered to be a “plant-based diet” and contains high levels of several nutrients including polyphenols, fiber, and mono- and polyunsaturated fatty acids. However, it is important to note that the diet varies from many diets considered healthy in the US because it unapologetically includes meats, vegetable oils, and wine.

So, is the diet a fad or are there real benefits to following it? As it turns out, there are real benefits.

The most important benefits of the diet revolve around cardiovascular health. In particular, the Mediterranean diet reduces blood pressure and improves endothelial function; high adherence to the diet is associated with a lower risk for cardiovascular disease risk and longer telomere length (a recognized biomarker of aging).

Evidence from randomized controlled clinical studies and observational studies also supports the benefits of the Mediterranean diet for glycemic control and diabetes risk, cancer incidence, cognitive decline, and overall lifespan/longevity.

And yes, there are weight loss benefits as well.

I want to emphasize that these benefits are not just my opinions or the opinions of the people who live in that part of the world. These are proven benefits based on clinical data. Here are a few important caveats:

• The benefits of the diet have been observed to be greater in Mediterranean regions than in non-Mediterranean. What this suggests is unclear, but it could mean that there are other factors at play other than diet that help accentuate the benefits of the diet.
• It is somewhat hard to quantify exactly what foods belong in the diet. As an example, I am writing this from Naxos, an island that is famous for potatoes. Potatoes are not part of the diet, but I can promise you that every restaurant in Naxos serves locally-grown fried potatoes and they are spectacular. Perhaps the locals don’t touch them, but I find that unlikely.
• The use of wine in the diet is debatable. For sure, most people in the region drink wine but very importantly, they do so with meals. If you follow the diet and drink wine, remember to limit wine consumption to meal times as much as possible.

Remember that you don’t have to go all-in on any diet. The Mediterranean diet actually looks an awful lot like many other diets that are considered healthy. There is a pattern here. Rather than forcing yourself into a rigid diet plan, most of us should just resolve to eat healthier: more vegetables, less meat, and less processed food.

And, according to the Greeks, consume more olive oil. Contrary to what many in the West believe, a daily intake of olive oil will not kill you.

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About a decade ago, I had a major back surgery.

My back injury happened in a water skiing accident. Over the next year, the pain came and went but never got better. Eventually, I found myself at a chiropractor who did somewhat extreme adjustments and I ended up numb below the waist. I brought this up to him and he claimed it was temporary and no big deal.

By the time I figured out that the chiropractor had no idea what he was doing and got an MRI done, I was in real danger of ending up with a lot of permanent damage. Fortunately, I found a skilled surgeon who fixed my spine.

After the surgery, I figured out quickly that I was not out of the woods yet. I was in extreme pain and started doing therapy, which could be excruciating at times. And, I started walking, which in itself was painful.

It took about a year of work to get through that pain. However, after that, except for one incident a year ago when I injured my knee and ended up with a few weeks of back spasms, my back has been completely pain free. Today, I do anything I want to do, including lifting weights.

I tell that story because many of you have back pain. I would never suggest that your back pain is the same as mine was and what worked for me will definitely work for you. Back injuries are very unique because they involve very complex nerve networks where a millimeter of a disc being out of place makes a big difference on the pressure that is put on nerves. I get that.

Unless a doctor tells you differently, I do want to encourage you though to move and work, and work some more. Generally speaking, back problems are helped when you strengthen the muscles that support the back and make them more flexible. Do core work.

A study released last week suggests that just stretching your hamstring helps with lower back pain. This is rather obvious when you think about it: tight hamstrings put pressure on the back muscles, which in turn tightens them. Tight back muscles lead to back pain.

Here are some simple hamstring stretches. These were the kinds of things I did in therapy after my back injury. Many of them can be done without even getting out of bed.

When you are ready to start strengthening your core, there are many possibilities at your disposal. Marla likes yoga; I do more extreme things like weight lifting and planks.

Above all, stay positive and don’t give up on trying to eliminate back pain from your life. It is not a necessary part of aging. For most of us, the secret is simply in hard work and movement.

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A study released last week suggests that the mineral selenium can help with headache pain (both frequency and severity). Selenium is found in many meats as well as nuts, and is available in many supplement forms as well.

While on the subject, here are some other interesting clinical study results about headaches (according to Examine.com).

Watermelon can trigger migraines. (Don’t hate on me for telling you.)
Natural health remedies with at least some evidence of effectiveness for helping with headaches include peppermint, creatine, fish oil, kefir, and umckaloabo.

Many people (including my own mother) believe that using white willow bark can alleviate headache pain. However, at present, there are no studies that either support or undermine that belief.

This, by the way, highlights probably the biggest weakness of using clinical studies for supplement efficacy: there are simply too many things to test and many, many tests have never been done. I was speaking to our ND on staff (Dr. Shannyn) this week and she brought up that point. Sometimes, though imperfect, the only clinical data we have is real life.

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In order to keep some semblance of sanity, the only social media platform I still visit is Twitter/X (which in itself is a cesspool unless you find a way to filter out political crazies). Recently, I saw this tweet:

I know Dave. He is a great guy, and I did not challenge him for a few reasons. One of those reasons? I have to admit that he has a point.

Many times in this newsletter, I have written about the way health supplements are marketed. Dave is right when he says that supplements are often (mostly?) sold with narrative (a flashy/compelling story) or anecdotal evidence (either historical precedent or testimonials).

There is a real weakness in either of those marketing tactics. Just because a herb was used by a tribe in South America 600 years ago does not mean it actually worked for them. And, just because an aunt recovered from an illness while taking an herb does not mean the herb was responsible for the recovery.

This is why, over and over, I talk about science here. The main way we know if a supplement actually works is with science.

Curiously, those who are skeptical of supplements often do not extend that same skepticism to pharmaceuticals. If you ask them why, they will tell you it is because of the science, and in particular, clinical studies.

They trust the clinical studies done on drugs, but do not seem to understand that the exact same kinds of clinical studies are done on herbs and supplements.

In fact, there are thousands of clinical studies being done at any given time on the kinds of products we sell. They are being released constantly. That is why I push Examine.com so much here. Examine.com has no industry ties; they simply keep track of clinical studies and evaluate supplements based on the data that comes out of those studies.

Using tools like Examine.com, I can say very confidently that there are countless studies that substantiate the value of specific supplements for specific health conditions. I have talked about this exact topic in the video here.

Now, I do want to say that just because I go to science for answers does not mean that science is the only place to go for answers. Science can be wrong, but even when not wrong, we may simply not have enough knowledge about the science yet. There are many studies that still need to be done.

That is why there is at least some value in searching for answers in other places. Historical precedent does sometimes give clues about health. Your aunt’s testimonial about a supplement may be useful as well. We all naturally look for this kind of validation when searching for answers about any topic, from health to buying a new refrigerator. There is a reason for that.

This is a complicated epistemological conundrum, but here is my point: Dave is right that supplements are often sold using dubious proof, but he is flat-out wrong to suggest that there is “never real proof” to support supplement use. Among other things, science provides the proof. If you are taking supplements, science is on your side.

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In perhaps the best news you will hear this week, a new study suggests that eating chocolate can have the following benefits:

• Reduced abdominal circumference (waist size)
• Reduced total cholesterol and LDL
• Reduced triglycerides
• Reduced fasting glucose
• Reduced systolic and diastolic blood pressure

What kind of chocolate was studied? The answer may surprise you: cocoa capsules, cocoa extracts, cocoa beverages, cocoa/dark chocolate bars, and cocoa snacks. In other words, mostly normal chocolate.

Don’t get too excited. The benefits were fairly moderate in scope. Eating a pound of chocolate a day is not likely to solve all your health issues. But on the other hand, this study backs up a contrarian opinion that chocolate has more health benefits than you might think.

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