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The dose makes the medicine—and for many critical prescription drugs, the dose depends on a patient's body weight. Usually, this is not a problem; weight changes large enough to significantly affect dosages often occur gradually, over periods long enough for doctors to notice and adjust prescriptions. But, in the era of new weight loss drugs, that may no longer be the case.

In a cautionary tale published Monday in JAMA Internal Medicine, researchers at the University of Colorado reported the case of a man who lost nearly 30 percent of his body weight in a six-month period using a new weight loss drug. Then, he showed up at an emergency department with heart palpitations, excessive sweating, confusion, fever, and hand tremors. Tests indicated the man had atrial fibrillation, an irregular heart rhythm that can lead to heart failure and stroke without treatment.

The 62-year-old had no history of atrial fibrillation, but he had previously been diagnosed with obesity, Type 1 diabetes, and hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone). For his hypothyroidism, he took levothyroxine, a synthetic thyroid hormone that is dosed by weight.

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Buying counterfeit weight loss drugs from illegal online pharmacies that don't require prescriptions is, in fact, a very bad idea, according to a study published Friday in JAMA Network Open.

The counterfeit drugs are sold as equivalents to the blockbuster semaglutide drugs, Ozempic and Wegovy, which are prescription only. When researchers got their hands on three illegal versions, they found that the counterfeit drugs had low-purity semaglutide, had dosages that exceeded the labeled amount, and one had signs of bacterial contamination.

The three substandard drugs tested came from three different illegal online pharmacies, which sold them as generic semaglutide drugs for weight loss, appetite suppression, diabetes, and cardiovascular health. However, the researchers, led by scientists at the University of California, San Diego, and the University of Pécs in Hungary, had initially tried purchasing counterfeit drugs from six such sellers.

Enlarge / Lars Fruergaard Jorgensen, chief executive officer Novo Nordisk A/S, during an interview at the company's headquarters in Bagsvaerd, Denmark, on Monday, June 12, 2023. (credit: Getty | Carsten Snejbjerg)

After some persuasion from Sen. Bernie Sanders (I-Vt.), the CEO of Novo Nordisk will testify before lawmakers later this year on the "outrageously high cost" of the company's diabetes and weight-loss drugs—Ozempic and Wegovy—in the US.

CEO Lars Jørgensen will appear before the Senate Committee on Health, Education, Labor, and Pensions (HELP), which is chaired by Sanders, in early September. The agreement came after a conversation with Sanders in which the CEO reportedly "reconsidered his position" and agreed to testify voluntarily. As such, Sanders has canceled a vote scheduled for June 18 on whether to subpoena Novo Nordisk to discuss its US prices, which are considerably higher than those of other countries.

The independent lawmaker has been working for months to pressure Novo Nordisk into lowering its prices and appearing before the committee. In April, Sanders sent Jørgensen a letter announcing an investigation into the prices and included a lengthy set of information requests. In May, the committee's investigation released a report suggesting that Novo Nordisk's current pricing threatens to "bankrupt our entire health care system."

Enlarge / Children checking their weight. (credit: Getty | BSIP)

Kids and teens with a high body mass index (BMI) were 29 times more likely to have a high fat mass index compared with youths who had lower BMIs, making the controversial metric a "very good screening tool," according to a study published Monday in the journal Pediatrics.

The study adds to the long-standing debate about the use of BMI, which has always been an imperfect proxy for assessing a person's body fat, aka adiposity. Last year, the American Medical Association adopted a strongly worded policy calling out the calculation's "significant limitations" and "historical harms," including "racist exclusion," because its use is largely based on white populations. But other experts have pushed back, arguing that the maligned metric is still a quick low-cost tool for assessing the health and risks of patients.

BMI, calculated by dividing a person's weight in kilograms by their height in meters squared, has long been used as a shorthand way of assessing a person's adiposity. In children, high BMIs are associated with cardiovascular disease risks later in life. But, the metric can also be misleading. Because it is based solely on weight and height, it does not distinguish between fat and lean mass. As such, athletes with relatively large amounts of lean muscle mass can easily have BMIs that put them in the overweight or obesity categories, while those with little lean mass but high fat mass can still have BMIs in a normal range. BMI also does not tell clinicians anything about body fat distribution, which can be important for health risks. And research has found that the relationship between BMI and adiposity can differ by race and ethnicity. For instance, at the same BMI, Black children tend to have less adiposity than white children.

Enlarge / Panty liners, hygienic tampons, and sanitary pads. (credit: Getty | LOU BENOIST)

People in the US are starting their menstrual cycles earlier and experiencing more irregularities, both of which raise the risk of a host of health problems later in life, according to an Apple women’s health study looking at data from over 70,000 menstruating iPhone users born between 1950 and 2005.

The mean age of people's first period fell from 12.5 years in participants born between 1950 and 1969 to 11.9 years in participants born between 2000 and 2005, with a steady decline in between, the study found. There were also notable changes in the extremes—between 1950 and 2005, the percentage of people who started their periods before age 11 rose from 8.6 percent to 15.5 percent. And the percentage of people who started their periods late (at age 16 or above) dropped from 5.5 percent to 1.7 percent.

In addition to periods shifting to earlier starting ages, menstrual cycles also appeared to become more irregular. For this, researchers looked at how quickly people settled into a regular cycle after the start of their period. Between 1950 and 2005, the percentage of people obtaining regularity within two years fell from 76.3 percent to 56 percent.