As we celebrate Healthy Aging Month, it serves as a reminder that it’s never too late to take charge of your health and well-being. At RWWC, we are committed to supporting individuals in their journey towards healthy aging by offering a range of preventative services designed to enhance overall quality of life.

One of the key pillars of our approach is providing comprehensive annual check-ups that include thorough blood work analysis. By proactively monitoring your health markers, we can identify potential issues early on and implement interventions to prevent the onset of diseases.

We emphasize the importance of annual gynecological check-ups to promote reproductive health and overall well-being. Our specialized team is dedicated to providing personalized care and empowering women to prioritize their health at every stage of life.

Nutrition counseling is another essential component of our preventative services. We believe that a balanced diet is fundamental to healthy aging, and our nutrition experts are here to guide you in making sustainable dietary choices that support your long-term health goals.

In addition to physical health, we recognize the significance of mental well-being in the aging process. Our psychology counseling services offer a supportive environment for addressing mental health concerns, managing stress, and enhancing overall emotional resilience.

As a part of our aesthetic approach to healthy aging, we also offer medical spa treatments designed to rejuvenate your skin, boost your confidence, and enhance your natural beauty.

Lastly, our weight loss programs are tailored to individual needs, providing personalized strategies to help you achieve and maintain a healthy weight, improve metabolic health, and enhance overall vitality.

This Healthy Aging Month, take a proactive step towards prioritizing your health and well-being. Let us be your partner in aging gracefully and living your best life. Contact us today to learn more about how our preventative services can support you on your journey to healthy aging.

Semaglutide, the active ingredient in drugs like Wegovy and Ozempic, can help people lose weight — and a new study says it may also help people quit smoking.

In the study, published in the Annals of Internal Medicine on Monday, researchers found semaglutide was associated with lower risks for tobacco use disorder-related health care measures, including reduced smoking cessation medication prescriptions and counseling.

The study compared 222,942 new users of anti-diabetes medications, including including semaglutide and seven others. Participants had both Type 2 diabetes and tobacco use disorder and, according to the findings, mostly showed differences within 30 days of starting the prescription when comparing the groups.

While it’s too early to suggest prescribing the drugs for smoking cessation, the findings suggest the need for more research to evaluate semaglutide’s potential for tobacco use disorder treatment.

This isn’t the first time an association has been noted between drugs like Wegovy or Ozempic for weight loss and reduced cravings for things like smoking. Some doctors and patients have seen diminished cravings for nicotine, alcohol and even opioids as a unexpected side effect.

Why are researchers and patients seeing this? It has to do with how drugs like Ozempic work with the reward centers in the brain, Dr. Tamika Henry, founder of the California-based Unlimited Health Institute, previously told CBS News.

“When we think about the reward centers, it releases dopamine, which is our feel-good hormone. So what happens is, when you do a certain activity, dopamine surges – and you’re like, ‘Oh, I want to keep doing that,’ whether that’s indulging in alcohol, nicotine or even gambling,” she said. “How Ozempic works is, it decreases the surge of dopamine, and therefore the desire for that particular activity is decreased.”

However, the risk of negative side effects is also a factor to consider with these drugs, including for uses beyond weight loss.

“As you’re thinking about decreasing an addiction, yes, you want to do that, but is there also going to be some association with nausea? Are you also going to have problems with heartburn, fatigue?” Henry said. “The other thing is taking a medication is just part of it. You need to start to do the other things that help you along the way. Because if the medication is removed, then what happens?”

BioTE Medical has established the “gold standard” regarding pellet preparation. The BioTE method of hormone replacement is a time tested method of hormone optimization that was created from hundreds of studies performed on hundreds of thousands of patients worldwide to successfully optimize hormone levels of women as they meander through phases of perimenopause and menopause.

“After monitoring outcomes for tens of thousands of men and women who have benefitted from this therapy, we have found results have been better than expected with more than 96% of patients satisfied.” States Dr. Gray Donovitz, founder of Biote.

“Hormone replacement therapy by pellet implantation has been used with great success in the United States, Europe and Australia since 1938” Donovitz states. Pellets deliver consistent physiologic levels of hormones and avoid fluctuations of hormone levels.

Testosterone and estradiol may improve lipid profiles by reducing cholesterol, reducing triglycerides, and increasing HDL cholesterol. This has positive benefits on the cardiovascular system. The pellets not only prevent bone loss and increase bone density. Response to testosterone remains optimal (i.e., relief of depression, increase in bone density, relief from insomnia, relief from aches and pains, lessened anxiety, improved memory, concentration and increased energy.

Novo Nordisk, the manufacturer of Ozempic® (semaglutide injection), is alerting consumers that a counterfeit version of Ozempic, which reportedly contained insulin glargine instead of semaglutide, was purchased in a retail pharmacy in the United States.

Ozempic is a diabetes treatment that has gained widespread popularity as a weight loss drug, spurring a black market for the medication. In June 2023, United Kingdom reporters found Ozempic for sale on Facebook, and Nigerian authorities found fake Ozempic pens containing insulin in nine countries.

Novo Nordisk advises retail pharmacies to always purchase semaglutide medications “through authorized distributors of Novo Nordisk and reliable sources” and shared a list of tips to help health care providers and patients recognize signs that a medication may be counterfeit when purchasing Ozempic or other semaglutide injection products. Report from the NABP (National Association of Boards of Pharmacy)

• Oprah Winfrey hosted a new TV special highlighting the use of GLP-1 weight loss drugs and the obesity epidemic.
• On the special, Winfrey invited medical professionals to discuss how the drugs worked and why obesity is a disease, not a character flaw.
• Experts are hopeful Winfrey’s use of her platform will help change the conversation around obesity and how it’s treated.

“For 25 years, making fun of my weight was national sport,” Oprah Winfrey said during the opening monologue for An Oprah Special: Shame, Blame and the Weight Loss Revolution, which aired Monday on ABC and is now available to stream on Hulu.

Though out of the spotlight, millions of people living with obesity have been the subject of similar comments throughout their lives.

According to the World Health Organization, 1 in 8 adults worldwide have obesity. Additionally, more than 160 million children and adolescents worldwide have obesity.

“I come to this conversation with the hope that we can start releasing the stigma and the shame and the judgment, to stop shaming other people for being overweight or how they choose to lose – or not lose – weight and, most importantly, to stop shaming ourselves,” said Winfrey, who in late 2023 revealed she was taking anti-obesity medicine and received both support backlash.

Experts who treat people with obesity say Winfrey’s efforts to reduce the shame and stigma around obesity are important.

“When celebrities speak about weight loss medications, and even weight loss in general, people definitely pay more attention, and it brings more interest in options available for weight loss,” says Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center.

In particular, Winfrey’s special called attention to five key takeaways about how we speak about obesity and the new range of drugs used to treat it, such as Wegovy and Zepbound.

Obesity is a disease 

The American Medical Association designated obesity as a disease in 2013. However, even people with obesity may not know that.

Scott Butsch, MD, noted on Oprah’s special that people have an “uneducated belief” that obesity is a matter of willpower and a “self-inflicted” issue.

“It’s not a matter of willpower,” said Butsch, the Director of Obesity Medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute and a consultant for one of the pharmaceutical companies behind anti-obesity medications.

Winfrey compared obesity to substance use, another condition once thought of as a lack of willpower. She added that not everyone who drinks too much has substance use issues, but some do.

“Obesity is a complex, multifactorial disease with genetic and environmental underpinnings,” says Christopher McGowan, MD, a gastroenterologist, obesity medicine specialist, and founder of True You Weight Loss. “For those individuals prone to obesity, their drive to eat may be more significant, their propensity to increase weight may be higher, and their ability to preserve weight is stronger. These factors cannot be overcome by willpower alone, nor are they the result of a lack of willpower.”

Butsch likened it to being underwater. Eventually, a person will need to come up for a breath. Similarly, someone with obesity will eventually regain weight (without assistance).

Drugs like Ozempic and Wegovy quiet “food noise,” keeping people fuller longer and reducing the drive to eat.

“It’s not a matter of willpower,” Butsch said on the special. “People who perhaps are thin might never think about food the way people who have obesity [do].”

The CDC also lists genetics, socioeconomic factors, and medications as potential causes of obesity, which it defines as a “complex disease that occurs when an individual’s weight is higher than what is considered healthy for his or her height.”

It’s why advice to “just diet and exercise” can fall short for people with obesity — they’ve likely tried, and it was not effective or sustainable on their own.

“There is still so much misinformation in our society that many patients and even healthcare providers still believe that obesity can be permanently reversed with enough willpower and counting your calories in versus out,” says Michael Glickman, MD, the founder and CEO at Revolution Medicine.

“As in the alcohol analogy, you would not tell a patient struggling with alcoholism that they should just willpower their way out of it. Alcoholism requires comprehensive multidisciplinary treatment, just as obesity should. The brain ultimately controls our body and our actions, and it should be the primary focus of our treatment approaches,” he added.

A 2019 scoping review of research from 2000 to 2017 suggested that individuals reported feeling patronized and disrespected, that all of their health issues were attributed to weight, and that they had low trust in their providers. They also mentioned avoiding the doctor.

Amy Kane, a mother who appeared on the special, noted that she dreaded going to the doctor before losing weight. Now, she looks forward to it.

Despite the notion that all health issues can be fixed by losing weight — through diet and movement — McGowan has seen many patients with obesity exercising more and putting a greater emphasis on dietary choices than normal-weight peers.

“The difference is that the battle is steeply uphill. A person with obesity has a differently wired brain, leading to greater caloric intake,” he says. “Is this an addiction akin to alcoholism? Not precisely, but the concept is similar. There is an innate, genetically driven drive to consume more, which is hardwired and challenging to overcome.”

Many people living with obesity feel shame

Guests like Kane tearfully recounted their feelings after a lifetime of living with obesity. Kane first felt shame in fifth grade when a peer called her “fat.”

“The bias against obesity is deeply ingrained in our culture,” McGowan says.

Winfrey called fat-shaming one of the last acceptable biases, and McGowan agrees, saying it has “devastating implications.” Again, the misinformation about why someone is living with obesity comes into play.

“Obesity has long been — erroneously — equated with laziness and a lack of willpower,” McGowan says. “Naturally, individuals affected by obesity may internalize this sentiment and direct the blame inward.”

Winfrey and Kane discussed the finger-pointing notion that living with obesity was a personal choice and the shame and confusion they felt when first-line treatments like diet and exercise weren’t enough.

“This is absolutely heartbreaking, and it’s tough to live in a world that is constantly making assumptions about you — solely because of your appearance — and not treating you nicely,” says Dr. Rachel Goldman, PhD a clinical psychologist and Ro advisor.

Now that Kane is no longer living with obesity, she says she’s treated differently, especially in clothing stores. Even her children are treated differently, she told Winfrey.

Overcoming shame associated with taking anti-obesity drugs

It’s almost as if people with obesity can’t win. They’re shamed for their weight. Then, they’re shamed for the way they lose it if they take a medication — like they’ve used a cheat code.

Kane waved off the criticism, chalking it up to misinformation. Experts say the idea is harmful.

“Belittling people for using these tools is extremely detrimental,” Ali says. “If people start thinking of obesity as a chronic disease, like high blood pressure or diabetes, then there may be less stigma associated with using the tools available.”

McGowan echoed these sentiments, saying it’s rooted in the idea that people can will their way out of obesity. He constantly hears patients tell him, “I don’t want to use a shortcut,” when discussing anti-obesity medications.

“If you need insulin for diabetes, it’s a life-saving treatment,” McGowan says. “But anti-obesity medications, or even bariatric surgery, are viewed as the easy way out.”

Hopefully, greater awareness of obesity as a disease will help curb this misinformation. However, Goldman says it would benefit people if we discussed the drugs differently.

“We need to shift the conversation away from weight loss drugs,” Goldman says. “If the focus is on weight, we are never going to get away from this shaming and the criticism that this is the easy way out. If we talk about this in terms of health and seeking treatment for a disease, the conversation will change — it will be less judgmental and more about emotion and empathy. It all starts with the words that we use.”

Anti-obesity medications are available for people under 18

Maggie Ervie’s mother, Erika, discussed Maggie’s journey — which included constantly feeling hungry as a child and her mother custom-making a Halloween costume so she could be a Disney Princess for Halloween.

Maggie tried sports, camps, and attending an obesity clinic. Maggie was 300 lbs. by the time she turned 11. Doctors feared she’d die young.

Maggie, now 15, had bariatric surgery and began taking Victoza at 13. Victoza isn’t as known as Ozempic or Wegovy.

Wegovy became available to people ages 12 and up in December 2022 after Maggie had already begun Victoza.

“Victoza and Wegovy are both GLP-1 agonist medications, but Victoza is taken daily, and Wegovy is taken weekly,” Glickman says. “Wegovy has also been shown in studies to be more effective for weight loss. Due to the convenience of weekly dosing and better efficacy, Wegovy is much more commonly used today than Victoza.”

Maggie was the subject of an article in The Cut, and the family has received criticism for putting her on medication at a young age. Erika implored people to “walk a mile in our shoes” before judging.

“This is a sensitive topic,” McGowan says. “The treatment of obesity in adolescents has additional layers of complexity, including the patient’s evolving maturity, family dynamics, psychiatric complexities, and social factors. But early treatment of obesity can delay or prevent future health problems, including diabetes, heart disease, and premature death.”

Glickman mentioned Erika’s line was one of his favorites of the night and encouraged parents and adolescents to weigh risks and benefits with healthcare providers.

Anti-obesity medications are not an easy fix

Winfrey said she combined medications with hiking, running, resistance training, and consuming a “healthy diet.”

Even in clinical trials, like those for Zepbound, participants combine medication with lifestyle interventions like diet and exercise.

“Anti-obesity medications are not designed to be used in isolation and must be paired with a diet and lifestyle program,” McGowan says. “This is how they were studied in clinical trials, and we know that lifestyle modification remains the foundation of any chronic weight treatment.”

McGowan suggests working with a registered dietitian and personal trainer.

“You can only expect to lose weight effectively with help, support, and accountability,” McGowan says. “A comprehensive weight management program that offers medical supervision, nutrition counseling, and behavioral support is the optimal framework for success.”

Can you tell the difference between flu vs. strep vs. COVID-19? Cold and flu season is in full swing, and COVID-19 cases are rising once again. Knowing what symptoms to look for when you first start feeling sick can help. Read on to learn the key factors to consider when determining which illness you have and what to do.

Strep vs. COVID-19 and Other Illnesses

Strep

Strep throat is a bacterial infection that can cause severe throat pain, swollen lymph nodes, fever and white patches on the tonsils. Strep will not typically include other cold and flu like symptoms, like a runny nose or cough. Strep throat can be specifically tested for and is easily treated with antibiotics. Antibiotics will help prevent a serious but rare problem called rheumatic fever and reduce the time you are contagious. About 10% of sore throats in adults are caused by strep.

COVID-19

COVID-19 is a viral illness caused by the novel coronavirus that produces many symptoms including Sore throat, runny nose, nasal congestion, persistent cough, and headache. If you are experiencing these symptoms – you can start with a home test. If this is negative, repeat the test 24 to 48 hours later. If your test is positive and you have risk factors for severe COVID, please contact us right away to schedule an appointment to discuss Paxlovid. Paxlovid must be started within 5 days of symptom onset.

Flu

The flu is another viral illness that is similar to the common cold but much more severe symptoms. Sometimes it can be hard to tell the difference because the flu affects your nose, throat, and lungs and has many of the same symptoms as a cold. The flu is commonly diagnosed with a rapid antigen or diagnostic test. Antivirals are available but they must be given within 2 days of symptom onset and only shorten symptoms by about 12-24 hours.

Sinus Infection

Many of the symptoms of a sinus infection are the same you’d experience with a bad cold. They include: postnasal drip (that thick mucus in the back of your throat), discolored nasal discharge (green, yellow or brownish mucous coming out of your nose), stuffy nose or nasal congestion and tenderness or pain in the face – usually under the eyes or around the nose. You can also have headaches, tooth pain, coughing from the post nasal drip, fever, fatigue, a bad smell in your nose or a bad taste in your mouth and bad breath. Most sinus infections are viral, however if your symptoms are lasting more than a week, please make an appointment as antibiotics may be necessary.

Pneumonia

Pneumonia is a secondary infection in the lungs that can cause high fever, chest pain, difficulty breathing, shortness of breath and cough. It’s usually caused by bacteria, fungi, or viruses like COVID-19. Pneumonia is usually diagnosed with a chest X-ray to look for inflammation in the lungs and is commonly treated with antibiotics.

How Can I Avoid Getting Sick?

You can help prevent illnesses by:

• Wearing a mask in public.
• Stay up to date with vaccinations
• Practicing good hygiene, using hand sanitizer with 60 percent alcohol, and disinfecting surfaces.
• Ensuring you’re taking good care of yourself and addressing any underlying conditions.
• Not touching your face, eyes, or mouth.
• Steering clear of anyone who is sick, whether it’s strep vs. COVID-19.

Uterine Cancer is the most common gynecologic cancer in the United States. About 65,950 new cases of uterine cancer are diagnosed in the United States each year. The incidence and  the mortality rate have been increasing since 2007. This rise in uterine cancer rates is attributed to the rise of obesity. Obesity is the leading risk factor for uterine cancer. It is most commonly diagnosed between the ages of 55 and 64.There are 2 main categories of uterine cancer. 97percent are endometrial cancers ( a cancer that forms in the lining, also called the endometrium ,of the uterus) and 3 percent are sarcomas. This article concentrates on  the more common endometrial cancer.

Risk factors for the development of uterine cancer are influenced by hormones. Starting menstruation before the age of 12, never having a pregnancy or giving birth  for the first time after the age of 30, and late menopause all expose the body to estrogen for a longer period of time and raise the risk for uterine cancer development. Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC) is an inherited disorder that can be passed from parent to child and is associated with  a genetic predisposition to different cancer types including uterine cancer.  Women who are positive for BRCA1 gene mutation  are at a higher risk for uterine cancer.The use of Tamoxifen for breast cancer patient treatment has about a 1 in 500 risk , obesity (a BMI >30) and increasing age are all risks. Diabetes, chronic anovulation  ( having four or less menstrual periods in a year before starting perimenopause), PCOS, and estrogen replacement therapy after menopause given without adequate progesterone,and diets such as a high glycemic index diet, high saturated fat intake, proinflammatory diets and high meat consumption are all risks for uterine cancer formation. A family history of uterine cancer increases the risk in 1st degree relatives.

Alcohol intake has no known risk for uterine cancer. Postmenopausal women who smoke cigarettes have a decreased risk of developing uterine cancer (although cigarettes contribute to formation of other cancers).The use of aspirin has been shown to decrease the risk of uterine cancer particularly in obese women.  Pregnancy is protective, as is the use of contraceptives like progesterone containing IUDs and the use of oral contraceptive pills ( the longer you take the pill in your lifetime the greater the benefit with 4 years of pill taking cutting the risk of uterine cancer in half) . Tubal sterilization decreases the risk as well as maintaining a healthy weight and being physically active.

Common symptoms of uterine cancer are postmenopausal bleeding, bleeding between menstrual periods, and pelvic pain or pelvic pressure. There is no screening test for uterine cancer. Consult a gynecologist if you are experiencing any of these symptoms.

The diagnosis of uterine cancer occurs with a physical exam, pelvic ultrasound and a biopsy of the uterus ( endometrial biopsy).

Uterine cancer is treated in a number of different ways including surgery, chemotherapy, and radiation.

Everyone has heard of the “Morning-After Pill,” but there are actually a few options to prevent an unplanned pregnancy following unprotected intercourse or a contraception failure.

• PlanB One-Step is the most widely used pill. It delays ovulation which prevents sperm from coming into contact with an egg. It is not an abortion pill and will not affect an established pregnancy. It can be taken up to 5 days after intercourse, but should be taken as soon as possible. PlanB, if taken within 5 days, is 95% effective in preventing pregnancy. Plan B works best in women under 165 pounds. It can be purchased over-the-counter without a prescription but some insurance plans do cover it. We can send a prescription to your pharmacy without an appointment. Send a message through the Patient Portal if you require a prescription. You may experience some unexpected bleeding after taking PlanB, but that is normal.
• Ella (ulipristal) is also an emergency contraception pill that can be taken up to 5 days after unprotected intercourse and has the added benefit of making it more difficult for an egg to attach to the uterine wall. It is more effective than Plan B if you have to take it days 3-5 after unprotected intercourse and works better in women over 165 pounds. It is only available by prescription, which we can write without an appointment. Send a message through the Patient Portal if you require a prescription. You may experience some unexpected bleeding after taking Ella, but that is normal.
• The most effective form of emergency contraception is to insert the copper IUD (Paragard) within 5 days of unprotected intercourse. This has the added benefit of providing birth control for up to 10 years. The Paragard IUD requires approval from your insurance so contact them right away if this is the emergency contraception you desire.

All of these methods are safe and have been approved by the FDA. None of the emergency contraception options affect future fertility or the ability to carry a healthy pregnancy in the future.

*PlanB and Ella are less effective in women taking Tegretol and Topamax. Contact our office right away to discuss the Paragard should you need emergency contraception and are taking these medications.