Culture

GLP-1 – Compounded or Brand-Name?

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Caroline Apovian, MD, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, Boston.

“Doctors who are obesity medicine specialists like myself in academic centers do not prescribe compounded semaglutide or tirzepatide,” she said.

Many of the compounded prescriptions, she said, come from telehealth virtual–only companies interested in profits.

GLP-1 Prescribing Decisions: Compounded or Brand-Name? – Medscape – November 14, 2024 – https://www.medscape.com/viewarticle/glp-1-prescribing-decisions-compounded-or-brand-name-2024a1000krd?

To be clear, all of my GLP-1 posts are not anti-pharma. If you can afford these medications and they work for you on your weight loss journey that’s great. Just be aware of the possible side effects and the fact these medications are for life. You will regain all that you’ve lost if you stop taking the drug.

Here’s the link to Complications? What Complications? (just another GLP-1 receptor agonist post)

Scary Charts 09.23.24 (another generational gap)

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54 percent of Gen Z participants polled for Statista’s Consumer Insights survey in the U.S. between July 2023 and June 2024 claim that owning a car is important to them, compared to 69 percent of baby boomers. This suggests that the perceived necessity of car ownership is not only influenced by the availability and quality of public transit but also by generation. Owning a Car Is Less Important To Younger Generations https://www.statista.com/chart/33097/importance-of-owning-a-car-for-us-residents-by-generation/

Let me think about this. Digital from birth, Covid-19 pandemic global shutdown, social media, shared ride businesses, grocery shopping done and delivered, prepared meal delivery, inflation, cost of cars both new and used, shit jobs that don’t pay much, cost of car insurance and maintenance, cost of gasoline, going Green, fear of accidents, fear of violence, self-fulfilling prophecy, coddled since birth, never learned to drive, never wanted to drive…

Did I miss anything?

Cannabis Use and Psychosis Risk (Aussie Version)

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Professor Emmerson says Queensland’s Metro North Health — Australia’s largest public health service, based in north Brisbane and the surrounding region — is seeing increased presentations of psychosis due to medicinal cannabis.”The Metro North early psychosis service reports 10 per cent of their new presentations — so these are kids aged 16 to 21 — are people who’ve ended up on medicinal cannabis and are becoming psychotic,” the Brisbane-based psychiatrist says.

Doctors warn of significant increase in people hospitalized with psychosis after being prescribed medicinal cannabis — https://www.abc.net.au/news/2024-07-21/medicinal-cannabis-psychosis-harm-risk-prescription-marijuana/104116952

Cannabis Use and Psychosis Risk

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The investigators found that cannabis use was significantly associated with psychotic disorders during adolescence (adjusted hazard ratio [aHR], 11.2; 95% CI, 4.6 to 27.3), but not during young adulthood (aHR, 1.3; 95% CI, 0.6 to 2.6). Adolescents who used cannabis also had a substantially higher risk for hospitalizations and emergency department visits (aHR, 26.7; 95% CI, 7.7 to 92.8), while there was no substantial risk observed in young adulthood (aHR, 1.8; 95% CI, 0.6 to 5.4). Growing Evidence Supports the Link Between Cannabis Use and Psychosis Risk — https://www.psychiatryadvisor.com/news/cannabis-use-and-psychosis-risk/

Have you read the book The Dangerous Truth About Today’s Marijuana by Laura Stack? https://johnnysambassadors.org/book/

If you have small children I highly recommend this book.

More Random Thoughts on Retirement – Memorial Day 2024

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JP Morgan data showing expectations vs. reality on the timing of retirement:

Source: When Life Forces Your Hand – https://awealthofcommonsense.com/2024/05/when-life-forces-your-hand/

Memorial Day 2024

The Boss once again is outside in the yard doing her thing. I’m inside doing my thing, drinking coffee, reading, writing. One of my addictions is staying current with the news and this post popped up in my RSS feed. At my age it doesn’t take much prompting for me to reflect on retirement. The Road to 70 is nearly complete. Soon I’ll be writing the next chapter of life The Road to 75. Dear Reader, if this sounds “old”, it is.

Critical thinking and understanding risk are the cornerstones of what I do. So when I have an opportunity to validate or repudiate the key assumptions in my plans I am in my Happy Place. When I decided not to retire several years ago my personal mantra focused on the following two critical variables in my retirement planning:

Stay healthy.

Find a willing employer.

Number One. I just had my annual wellness checkup. Bloodwork normal. Tendency towards obesity curtailed. Blood pressure elevated on two readings. Per Doctor’s orders I bought a BP machine and started keeping a log. All of my readings at home have been normal. A little white coat effect and the excitement of seeing my physician (Redhead Effect)…all good.

Number Two. Don’t underestimate how essential having or finding an employer who will pay you to work as you get older. Too many of us know the feeling of being cast out to the street for becoming too “old”.

As I prepare to write the next chapter it’s time to revisit and revise the two most important goals that got me to where I am. After some considerable time and effort here are my revised goals for the next five years.

Stay healthy.

Keep working for my current willing employer.

Happy Memorial Day.

OK Boomer

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The workplace is evolving, too, with businesses increasingly seeking the experience and wisdom of senior talent. Currently, 19% of adults 65 and older are employed, compared to 11% in 1987, according to Pew Research. Moreover, individuals aged 65 and older constitute the most rapidly expanding group within the labor force. By 2032, it’s expected that one in every four U.S. workers will be 55 or older, with nearly one in 10 being 65 or older, showcasing the growing presence of seniors in the workplace.

Boomers are defying age norms and you are losing out – https://www.fastcompany.com/91116274/boomers-are-defying-age-norms-and-you-are-losing-out

I am finally on the cutting edge of something.

Flamethrower + Robot Dog = (fill in the blank)

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Thermonator, the first “flamethrower-wielding robot dog,” is legal in 48 US states.

At first I thought this wasn’t real after reading this article but it is.

You can now buy a flame-throwing robot dog for under $10,000 — https://arstechnica.com/gadgets/2024/04/you-can-now-buy-a-flame-throwing-robot-dog-for-under-10000/

I had to watch the video. I suggest sound off if you don’t want to poop in your pants.

YIKES

Enough

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In the pursuit of “fine” to “great,” we chase products. Through no fault of our own, we fall prey to messaging from social media users, algorithms, and expert marketers, urging us that this shampoo or this rug will shift the scales toward enoughness. “This is how the marketplace continues to work,” says Brooke Erin Duffy, an associate professor of communication at Cornell University, “which is by amplifying our inadequacies and insecurities.”

Baked into these social platforms is a natural ecosystem for comparison. In the past, people weighed themselves against celebrities in the media and those within their immediate social circles, Duffy says. Now, we can compare ourselves to the idealized version of millions of strangers online — who may be perpetuating an aesthetic trend inspiring us to buy in order to participate.

How to be enough
Our obsession with self-improvement is making us miserable. https://www.vox.com/the-highlight/24091379/how-to-be-enough-habituation-hedonic-treadmill-comparison

How to be enough.

How to have enough.

Know when enough is enough.

You’re welcome.

Trends in Behavioral Health Medications

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Nurse Practitioners and Behavioral Health Medications Prescriptions

Nurse practitioners had the largest increases in prescribing incident prescriptions across the 5 drug classes. This is consistent with a study that found that behavioral health visits among Medicare beneficiaries conducted by psychiatric behavioral health nurse practitioners increased by 162%, whereas those by psychiatrists decreased by 6% from 2011 to 2019.35 Our study, based on incident prescription data, suggests an increasing contribution of nurse practitioners initiating medication treatment of behavioral health conditions compared with other health care practitioners.

Chai G, Xu J, Goyal S, et al. Trends in Incident Prescriptions for Behavioral Health Medications in the US, 2018-2022. JAMA Psychiatry. Published online January 10, 2024. doi:10.1001/jamapsychiatry.2023.5045 — https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2813980

Welcome to our new world of self-diagnosed ADHD, online pill mills, and “shortages” of prescription medications.

The past couple of decades have seen a continuous increase in attention deficit hyperactivity disorder (ADHD) diagnoses. National population surveys reflect an increase in the prevalence from 6.1% to 10.2% in the 20-year period from 1997 to 2016 and experts continue to debate and disagree on the causes for this trend.1

ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct; 119(5): 467–473.– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/

Too Old To Grow Up?

Percentage change in the leading health conditions affecting millennials in the United States from 2014 to 2018 — https://www.statista.com/statistics/1276447/percentage-change-of-the-leading-conditions-affecting-millennials

I was doing my usual Saturday morning routine, catching up on whatever was catching my attention and I came across this Scary Chart looking for ADHD incidence in Millennials. Whoa…check out the early CAD percentage increase.

The Best Retirement Letter Ever

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That’s it!

My favorite excerpt from the letter:

Let’s be honest, some people in academia are horrible, arrogant, selfish and narcissistic. And no matter how much the people at the top say they deal with bad behaviour, the nasty folk do have an annoying habit of getting promoted. The way in which academia selects and rewards particular skill sets produces an over-concentration of people who are low on empathy. I’ve met a lot of those ‘special’ colleagues over the years (no names mentioned obviously). I will not miss them one jot. They create a toxic working environment , dominate the discourse, ride roughshod over the rules, and cause a great deal of harm to others and get away scot-free. They’ve done me significant mental damage, but I can now happily forget them and move on with life.

My recommendation to anyone starting out in academia is stand your ground, challenge these energy vampires and politely make it clear that you don’t want to play their stupid toxic games. They really don’t have the power that they want you to believe they have, even though the system tends to promote them to roles that are beyond their emotional competence to fulfill. Pity them for the lack of other things to do with their lives. And, remember that 98% of what we do as academics is of no importance at all out there in the real world, so when a self-entitled colleague insists that their work on their favourite gene is earth-shattering; more important than anything you could ever do; and a good reason for their career to be advanced faster than yours; just smile and ignore them. Do your own thing, at your own pace. Have a life outside the university and remember that it’s just a job.

https://journalofhumannutritionanddieteticseditor.wordpress.com/2023/11/27/thats-it/