Latest / Morning Medical with Dr. Chow / Obesity Redefined, Flu Outbreaks, and Circadian Rhythms in Dementia

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Obesity Redefined, Flu Outbreaks, and Circadian Rhythms in Dementia · Morning Medical with Dr. Chow

• 0:00
  Hello and welcome to another episode of Morning Medical with Dr.
• 0:04
  Chow.
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  I am your host, Dr.
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  Chi-Ming Chow, here to bring you the latest in medical and health news from around the globe.
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  Today, we're diving into a very intriguing study that suggests the way we define obesity
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  could be changing, potentially classifying more Americans as obese.
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  Let's get into it.
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  Researchers at Massachusetts General Brigham have proposed an update to how we define
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  obesity, and the impact of this change could be significant.
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  According to their study published in JAMA Network Open, this new definition could
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  classify nearly seventy percent of United States adults as obese.
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  That's a substantial increase from the current estimate of forty-two point nine percent.
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  So, what exactly is changing with this new definition?
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  Traditionally, obesity has been defined primarily by the Body Mass Index, or BMI, which
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  considers a person's weight in relation to their height.
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  However, the new criteria introduce waist and body fat measurements into the equation.
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  This approach aims to reveal where body fat is distributed, which can be a critical factor in
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  assessing health risks.
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  The study examined three hundred thousand people and found that the obesity rate could
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  jump to nearly seventy percent under these new criteria.
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  This new definition captures individuals who might have been considered healthy based on BMI
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  alone but actually have a higher risk of conditions like heart disease and diabetes due
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  to their body fat distribution.
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  Dr.
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  Lindsay Fourman, one of the study's co-authors and an endocrinologist at Massachusetts General
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  Brigham, noted that while we've been aware of an obesity epidemic, these findings are quite
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  astounding.
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  With nearly seventy percent of the adult population now considered to have excess fat,
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  it is crucial to understand which treatment approaches should be prioritized.
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  The study emphasizes the limitations of relying solely on BMI.
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  It does not take into account how fat is stored throughout the body, a factor that can
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  significantly impact overall health.
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  For instance, visceral fat, which is stored deep within the abdominal organs, is known to
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  be metabolically harmful and is linked to conditions such as diabetes, hypertension, and
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  cardiovascular disease.
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  Dr.
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  Philip Rabito, a specialist in endocrinology and weight loss in New York City, highlighted
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  that redefining obesity to include individuals with high-risk fat distribution could help
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  direct more clinical attention and resources to this vulnerable group.
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  More patients might become eligible for GLP-1-based therapies, which could
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  significantly reduce their future cardiovascular risk.
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  Dr.
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  Mary Claire Haver, a board-certified OB-GYN, also commented on the findings, noting that she
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  has observed this trend in her own clinic for years.
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  She emphasized that while BMI is a blunt tool, fat distribution matters far more from a
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  physiologic and metabolic standpoint.
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  Visceral fat is the primary driver of insulin resistance and cardiovascular disease, among
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  other risks.
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  Dr.
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  Haver pointed out that focusing solely on weight can obscure who is truly at risk and
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  contribute to stigma.
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  She advocates for tools that assess body composition, waist circumference, and markers
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  of insulin resistance to give a more accurate picture of health than a scale can provide.
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  She believes that shifting the conversation from weight alone to body composition and fat
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  distribution is essential for more personalized and effective care.
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  In Windsor-Essex, health officials are raising alarms as flu cases have surged nearly sixfold
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  compared to last year.
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  The dramatic spike is attributed to the H3N2 strain of Influenza A, which is particularly
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  severe this season, adding significant pressure to local hospitals.
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  Between December 21st and December 27th, 2025, there were 208 positive tests for Influenza A
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  in Windsor-Essex, compared to just 32 cases during the same period in 2024.
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  This surge aligns with warnings from health officials that this flu season could be
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  especially severe, particularly in Ontario, where Influenza A is dominating.
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  Dr.
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  Mehdi Aloosh, the Medical Officer of Health for the Windsor-Essex County Health Unit, noted
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  that they anticipated a more severe flu season this year, and the current situation is meeting
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  those expectations.
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  He expressed gratitude to residents who stayed home while sick over the holidays, helping to
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  limit the spread, but emphasized that the risk remains high as children return to school.
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  The health unit continues to urge residents to stay home when sick, practice good hand
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  hygiene, and get vaccinated.
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  They stress that it is not too late to receive a flu shot, which remains available through
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  pharmacies and healthcare providers.
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  Additionally, they recommend that individuals at higher risk of severe illness use masks if
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  they must leave home while symptomatic for medical care.
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  Pharmacist Tim Brady from Windsor shared insights into the current situation, mentioning
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  an increase in people seeking flu medication.
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  He observed that many are experiencing more severe symptoms, resulting in several days of
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  missed work, which contrasts with the typical shorter duration of the flu.
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  Brady also pointed out that some people may have become lax in their hygiene practices
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  compared to the height of the COVID-19 pandemic.
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  Hospitals in the region, including Windsor Regional Hospital and Erie Shores HealthCare,
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  are experiencing increased pressure due to the spike in flu cases.
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  Kristin Kennedy, the Chief Executive Officer of Erie Shores HealthCare, reported a significant
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  increase in respiratory illness cases, with a spike of about 153 percent compared to the last
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  three years.
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  Hospitals are urging residents to seek emergency care only when necessary and to
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  consider alternatives such as primary care providers, walk-in clinics, or virtual
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  appointments for non-emergency concerns.
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  Jonathan Foster, Vice-President of Emergency Services at Windsor Regional Hospital,
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  emphasized that emergency departments prioritize the most serious cases and that
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  anyone experiencing severe symptoms, such as chest pain or difficulty breathing, should seek
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  emergency care immediately.
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  Let's delve into an intriguing study that suggests your sleep and activity patterns might
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  reveal hidden risks to your brain health.
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  Published in the journal Neurology, this study explores the connection between circadian
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  rhythms and dementia risk among older adults.
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  Circadian rhythms are essentially our body's internal clock, governing our sleep-wake cycles
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  and other vital bodily functions.
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  While most people's circadian rhythms are automatically regulated, factors like changes
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  in light levels or irregular schedules can throw them off balance.
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  Researchers monitored over two thousand people, with an average age of seventy-nine, for about
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  twelve days to track their rest and activity patterns.
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  None of the participants had dementia at the start of the study, allowing researchers to
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  focus on the potential development of cognitive issues over time.
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  What they found was that individuals with weaker daily activity rhythms were more likely
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  to develop dementia.
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  Specifically, the study revealed that those with the weakest circadian rhythms had nearly
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  two point five times the risk of developing dementia compared to those with the strongest
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  rhythms.
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  The study also highlighted a possible "U-shaped" association between the stability of
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  the sleep-wake cycle and dementia risk.
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  It suggested that people with consistently low activity levels might have less stable
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  circadian rhythms, which could in turn increase their risk of cognitive decline.
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  Interestingly, the timing of peak activity also played a role.
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  Participants whose activity peaked at two fifteen in the afternoon or later had a
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  forty-five percent higher risk of developing dementia compared to those whose activity
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  peaked earlier in the day.
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  It's important to note that while this study found an association between circadian rhythms
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  and dementia risk, it does not establish a direct cause-and-effect relationship.
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  However, it does emphasize the potential importance of maintaining a strong circadian
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  rhythm that aligns well with the natural twenty-four-hour day.
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  Dr.
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  Wendy Wang, the lead author of the study from the Peter O’Donnell Junior School of Public
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  Health at the University of Texas Southwestern Medical Center, recommends that people aim to
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  keep regular sleep and activity times to support a robust circadian rhythm.
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  While more research is needed to fully understand the link between circadian rhythms
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  and dementia, this study adds to the growing body of evidence suggesting that our sleep and
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  activity patterns could have a significant impact on our brain health as we age.
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  In a significant development for weight management, Novo Nordisk has introduced a new
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  option for those seeking to lose weight – Wegovy is now available as a daily pill.
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  This is a notable shift from the weekly injection that many are familiar with.
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  Patients with a prescription can now obtain the starter one point five milligram dose of the
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  tablet, with higher doses expected to be available by the end of the week.
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  The introduction of Wegovy as a pill is a big step forward in addressing obesity with GLP-1
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  medications.
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  Eli Lilly is also expected to receive United States Food and Drug Administration approval
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  for its oral medication, currently known as orforglipron, by the summer.
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  Where can you find the Wegovy pill?
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  It is available at various pharmacies, including CVS and Costco, as well as telehealth
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  providers such as Ro and LifeMD, and through Weight Watchers, NovoCare Pharmacy, GoodRx,
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  among others.
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  Despite initial shortages of the GLP-1 injections, Novo Nordisk is confident it can
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  meet the demand for the Wegovy tablet, thanks to investments in their manufacturing
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  capabilities over several years.
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  Let us talk about the cost.
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  The one point five milligram starter dose of the pill costs one hundred forty-nine dollars a
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  month for cash-paying patients.
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  The four milligram dose will remain at this price until April fifteenth, after which it
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  will increase to one hundred ninety-nine dollars.
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  The nine milligram and twenty-five milligram doses are priced at two hundred ninety-nine
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  dollars a month.
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  In comparison, the injectable version costs three hundred forty-nine dollars monthly for
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  self-pay consumers, although new patients can receive two months of the lowest two doses for
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  one hundred ninety-nine dollars each until March.
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  For those whose insurance plans cover the drug for obesity, the cost could be as low as
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  twenty-five dollars a month for the pill or injection under a savings program offered by
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  Novo Nordisk.
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  The active ingredient in both the pill and injection is semaglutide, approved by the
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  United States Food and Drug Administration for people with obesity or overweight along with a
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  weight-related health issue.
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  A key difference between the pill and the injection is the method of administration.
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  The pill is taken daily on an empty stomach with a small amount of water, and no other
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  food, drink, or medicines for at least thirty minutes.
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  This allows time for absorption.
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  The pill and injection resulted in similar weight loss in clinical trials, with the pill
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  showing an average weight loss of fourteen percent over sixty-four weeks.
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  Both forms of Wegovy are associated with side effects such as nausea, vomiting, constipation,
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  and diarrhea.
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  The decision to switch from the injection to the pill depends on personal preferences and
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  circumstances.
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  Some may prefer the daily pill if they find it difficult to tolerate the injection or have
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  trouble increasing the dose.
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  Dr.
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  Jorge Moreno from Yale Medicine suggests that those who experience tolerability issues with
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  the injection might consider the pill.
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  Dr.
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  Judith Korner from Columbia University highlights that the weekly injections might
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  have longer-lasting effects, with any side effects potentially persisting longer than with
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  the daily pill.
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  If a patient does not like how they feel on the pill, they can choose not to take it the next
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  day.
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  Cost is a significant factor in deciding between the pill and injection.
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  Insurance coverage remains unpredictable, but there is hope that the lower cost of the Wegovy
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  pill will encourage more insurance plans to cover it.
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  As always, discussing options with a healthcare provider is essential for making the best
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  choice for your health needs.
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  And that wraps up today's episode of Morning Medical with Dr.
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  Chow.
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  Thanks for tuning in to stay informed about the latest medical and health news.
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  Remember to take care of your health, and I will be back tomorrow with more updates.
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  Have a great day!