GLP-1 drugs have ushered in a new era in weight loss.

In just a few years, medications such as semaglutide and tirzepatide, known by the brand names Ozempic, Wegovy, Mounjaro and Zepbound, have gone from niche diabetes treatments to household names, reshaping how America thinks about weight loss.

A November 2025 Kaiser Family Foundation poll found that 1 in 8 U.S. adults have tried a GLP-1 medication for weight loss, diabetes or another condition. And we expect that number to rise now that one of these drugs, Wegovy, has become available in pill form, increasing its accessibility for many people.

These drugs’ ability to help patients lose anywhere from 15% to 20% of body weight has made them one of the most powerful nonsurgical obesity treatments ever seen.

GLP-1, short for glucagon-like peptide-1, is a hormone your gut normally makes that helps control blood sugar and appetite after eating. It signals the pancreas to release insulin when blood sugar rises and slows how quickly food leaves the stomach, which helps people feel full sooner.

Modern GLP-1 medications are designed to amplify these effects, leading to better blood sugar control and substantial weight loss for many patients.

But success brings a new question that millions of people are confronting: What happens after the weight comes off? And just as importantly, what should patients do when their progress suddenly stalls, even while still on the medication?

As an obesity medicine physician, I’ve seen firsthand how life-changing GLP-1 drug therapy can be for my patients. But I also remind each of them that no medication – GLP-1s included – replaces the foundational importance of nutrition, physical activity, sleep and mental health. These lifestyle pillars are essential for maintaining muscle and bone health, preventing significant weight regain and supporting long-term cardiovascular and metabolic health.

The key is simple but critical: Every weight-loss or health plan must be tailored to each person.

How the body responds to weight loss

In 2023, the Centers for Disease Control and Prevention reported that more than 40% of American adults live with obesity. For most people, the real challenge isn’t losing weight – it’s keeping it off.

Researchers have known this for decades. As early as the mid-20th century, studies of commercial diet programs showed that while short-term weight loss was common, regaining weight long term was the norm.

This is because when people lose weight, the body’s natural inclination is to return to its previous weight – a phenomenon called metabolic adaptation. As a result, the brain releases more of the hunger hormone ghrelin and dials down leptin, one of the hormones that signals fullness and energy sufficiency.

The net effect is simple: After weight loss, people are hungrier, feel less satisfied after eating and burn fewer calories than expected. The body interprets weight loss as a threat to survival and responds by slamming the brakes on metabolism through sophisticated energy-conserving mechanisms. Put plainly, when there’s less body weight to maintain, the body does less work – but it also becomes extra efficient, burning fewer calories than predicted and nudging weight back up.

Add to that an environment filled with ultraprocessed foods, oversized portions, high stress and limited time for movement, and it’s no surprise that so many people’s weight ends up yo-yoing despite their best efforts.

Putting GLP-1 drugs to the test

Clinical trials on GLP-1 medications also follow these well-established patterns. A pivotal 2021 clinical study of more than 1,900 adults, known as the STEP 1 trial, laid the groundwork for the use of these drugs as a treatment for weight loss.

But a follow-up 2021 study, known as STEP 4, showed that within 48 weeks of no longer taking semaglutide, participants regained approximately two-thirds of their prior weight loss, while those who remained on GLP-1 drug therapy continued to lose weight.

This is not because people lack discipline, but rather because their biology fights hard to return to its old set point.

Obesity, Chronic diseases, Weight loss, Dieting, Ozempic, Wegovy, Mounjaro, Weight loss drugs, GLP-1,  Zepbound, GLP-1 drugs
Oral Wegovy pills were approved by the Food and Drug Administration in December 2025 and became available for purchase in the U.S. in January 2026. UCG/Universal Images Group via Getty Images

Lower-cost, longer-term maintenance

Although obesity is now widely recognized as a chronic disease, clinical guidance has not kept pace with this new generation of highly effective medications.

For most patients, the most effective long‑term strategy after achieving a target weight is to continue GLP‑1 treatment. Clinicians aim for the lowest dose that still helps regulate appetite and stabilize weight.

Another option patients may pursue is to slowly taper off the drugs over about three to six months and to focus on reinforcing lifestyle choices that support goals for overall health and weight maintenance.

When your weight plateaus on a GLP‑1 drug

Plateaus in weight loss are normal, even on GLP‑1 drug therapy.

In clinical trials, weight loss with GLP-1 medications tends to follow a predictable curve: rapid early losses during drug initiation and dose increases, a gradual slowing and eventual plateau. A plateau, typically defined as little or no weight change for eight to 12 weeks, is not a sign of failure but rather the body adapting to a lower weight.

But before assuming that a GLP-1 medication has stopped working, clinicians will typically consider how the patient is using the drug, such as whether it’s being taken properly, with little to no missed doses, and whether it is being stored properly.

Clinicians will also evaluate a patient for medical conditions that might make weight loss more challenging, such as perimenopause or hypothyroidism, which is underactive thyroid.

They will also take into consideration whether the patient is on other drugs that might be obesogenic, meaning causing weight gain, or if they are using an FDA-approved GLP-1 drug versus a compounded medication, which can have variable quality and unknown efficacy.

Obesity, Chronic diseases, Weight loss, Dieting, Ozempic, Wegovy, Mounjaro, Weight loss drugs, GLP-1,  Zepbound, GLP-1 drugs
Despite the effectiveness of GLP-1 drugs for weight loss, there is still no replacement for healthy lifestyle patterns, including regular exercise. MoMo Productions/DigitalVision via Getty Images

Balancing weight loss with bone health

Helpful strategies to prevent weight regain related to diet include building meals around lean protein and noticing where calories might be creeping in, such as snacks, sugary drinks and alcohol.

With GLP-1 drugs, the goal for nutrition has shifted from calorie restriction to calorie quality. Aim for a healthy balance of vegetables, lean proteins and whole grains. And make sure your water intake is sufficient, especially since GLP-1 medications not only reduce hunger but can also reduce feeling thirsty.

When it comes to movement and exercise, people can add resistance training, increase their exercise intensity or both.

With any weight loss, no matter the method, people lose not only fat but also some muscle and bone. In clinical trials of GLP-1 medications, fat loss far outweighs losses of lean mass. However, any loss of lean mass matters because it can affect physical function, fracture risk and how well the body maintains weight and metabolic health over time.

Weight loss reduces the mechanical load on bones, which can lead to lower bone density and, in some people – such as those who are postmenopausal, as well as people over age 65 – an increased risk of fracture. Because bones adapt to the weight they carry, losing weight means less stress on the skeleton, and over time this can lead to small decreases in bone strength. This underscores the importance of resistance exercise for strength training, adequate protein intake during GLP-1 therapy and close monitoring for patients who are at higher risk of fracture.

Next-generation therapies, which include combinations of GLP-1 drugs and other peptides, are being studied for their potential to better preserve muscle and bone compared with GLP-1 drugs alone.

Patients on GLP-1 drugs who are experiencing a plateau may also want to talk with their doctor about considering a dose adjustment, medication switch or adding an additional drug.

If GLP-1 medication doses cannot be increased due to side effects, doctors will consider all options for other medications and for optimizing lifestyle, such as nutrition, exercise and sleep, to support the patient’s goals.

This article originally appeared on The Conversation. You can read it here.

  • Woman says her husband keeps ‘ruining’ romance novels by acting them out before she reads them
    Photo credit: CanvaA nightly seduction.
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    Woman says her husband keeps ‘ruining’ romance novels by acting them out before she reads them

    “I genuinely don’t deserve him and also he is ruining my books.”

    Sometimes people reveal the climactic scene in a great book we’re reading before we even get there. It may be annoying, but most of the time, the ruined moment happens by accident.

    One woman shared this challenge in her Reddit thread, My husband is spoiling the spicy scenes in my romance books by acting them out before I get to them. Is it all a weird coincidence, or is their real genius hidden behind one man’s romantic gesture?

    My husband is acting differently in the bedroom

    A woman writing under the Reddit tag u/Embarrassed-Friend-8 shared she loves romance novels. Enough to consume four to five a month. Recently, her husband of 11 years started acting differently in the bedroom with what she describes as “themed” nights. She explains, “I’ll think ‘okay, that was fun and a little random’ and move on.” But then the real unexpected twist occurs. She continues, “A few days later I’ll be reading my book, hit a spicy scene and actually have to put my Kindle down bc it’s the same scene. Like, the same vibe, the same moves, occasionally almost the same setup.”

    She thinks he might be reading ahead and playing a fun little prank. But then the story beneath the story begins to reveal itself.

    “I read on my Kindle. He’d have to get into my account, figure out where I am in each book, read ahead, and then coordinate. He’s a big tech/numbers guy, so if he’s doing this I guarantee there’s a spreadsheet involved somewhere.   I’m honestly not even mad. Genuinely if this is what’s happening it might be the most unhinged romantic gesture anyone has ever done for me. But he is technically spoiling the books??”

    husband, wife, reddit post, role-play, dinner date
    A sexy dinner date.
    Photo credit Canva

    People love a good role-play story

    As this story started to gain traction, the comments section filled up fast with amused, confused, and thoroughly invested people. It’s hard to resist a great story that begins with, “11 years and he’s still out here finding new ways to be surprising. I genuinely don’t deserve him and also he is ruining my books.” These are some of the Redditors’ thoughts:

    “Made the mistake of reading this post to my husband and I think I actually saw a light bulb turn on above his head — gonna start locking my Kindle…”

    “Book mark your favorite scenes…give him a selection so there’s still an element of surprise.”

    “You made me laugh so hard this morning!”

    “Yes, but ruining them in the BEST possible way!”

    “Absolute legend behavior, but you’re right, he needs to drop some DLC that isn’t in the source material for the real surprises.”

    “This is adorable and also sweet and romantic!”

    “I mean, the husband is looking at this as ‘ok, challenge accepted!’”

    “Girl, start reading some spicier stuff!”

    mystery, Kindle, spreadsheets, fun surprise
    A woman looks through a spyglass.
    Photo credit Canva

    The mystery is uncovered in a Reddit update

    In an update to the original post, the woman shared that she was very appreciative of the comments and support from readers of her posting. “Turns out you all were right. He had access to my shared Kindle library and got this idea for a prank, but once he did it a few times he really got ‘invested.’” She continues, “He’s going to stop spoiling my books but we did come up with another arrangement, also thanks to the comments here. I’m going to give him a list of pre-approved spicy scenes and he’ll choose (in no specific order) which he wants to surprise me with.”

    This husband was willing to go the extra mile to keep their relationship moving in a healthy direction. And yet, there was one more little update she had to add in, “YES there was a spreadsheet. Chili pepper emojis for spice levels. A column for notes (needs wine, links to Spotify playlists, etc). Color coding. Multiple tabs. More organization than even I was expecting. It will be ongoing and is now shared so I can drop in my own chili peppers and notes.”

    sunsets, sexy moments, healthy intimacy, romance readers
    A romantic couple as the sun sets.
    Photo credit Canva

    Romance novels are not just for the ladies

    Romance novels aren’t simply a niche. It’s one of the most widely read genres worldwide. It’s not just casual reading either. Romance readers are voraciously digesting an average of five novels per month. A 2021 study in Humanities & Social Sciences Communications found that most readers are in relationships and looking for little escape and relaxation. Writing that is exciting, easy, and fun to read matters more than the sexual content.

    What might be surprising is that romantic literature appeals to male readers more than you might think. In a 2025 survey conducted with fans of romance books by Talker Research, 63% of the men considered themselves die-hard fans. Also, men spend 364 hours annually reading romance compared to women, who spend 312 hours.

    couples, dates, relationships, passion, fun
    A couple eats watermelon together.
    Photo credit Canva

    A little bit of romance matters

    Research shows that doing something new together can reignite connection. A 2024 study in Science Direct found that passion and intimacy are directly related to overall relationship satisfaction. And it’s not the big swings at romance that matter most. It’s the small, attentive actions that bring more intimacy.

    A 2023 review in the National Library of Medicine found that in the psychology of a romantic relationship, responsiveness, emotional attunement, and mutual investment build a stronger, lasting connection.

    Romance might seem like something we’re all supposed to instinctively know how to do. This husband is willing to invest time and creativity into his marriage, even if his first attempts didn’t land perfectly. What she thought was a small frustration slowly turned into a stronger connection. All of this good started by simply trying and reading a little ahead.

  • It’s never too late to learn a language – adults and kids bring different strengths to the task
    Photo credit: Bulat Silvia/iStock/Getty Images PlusAdult language learners have an understanding of grammar that can help them learn a new language. But they are also likely to feel more self-conscious as they do so.

    There’s a common assumption that if someone starts learning a language when they are very young, they will quickly become fluent.

    Many people also assume that it will become much harder to learn a language if they start later in life.

    Research into language learning shows that how old someone is when they learn a language does matter, but there is no point at which the ability to learn a language switches off.

    While a young language learner can more easily acquire a native accent, adults retain the ability to learn new languages well into later life. Anyone can continue to learn and refine their vocabulary and grammar. Other factors, like motivation, can also play a role for learners of all ages.

    I am a linguist and the author of a forthcoming book, “Beyond Words: How We Learn, Use, and Lose Language,” which looks at how language is learned, used and lost across a lifespan — and why age alone does not set hard limits on our linguistic abilities.

    Instead, the strategies learners use, the outcomes they achieve most easily, and how others judge their progress can all change over time.

    How age shapes language learning

    Someone’s age can influence their language learning ability in a variety of ways.

    Scientists sometimes talk about sensitive periods, or an early development window in which the brain is especially receptive to certain kinds of input.

    When it comes to language, babies and children are particularly sensitive to the sound patterns of speech. They can also pick up on subtle phonetic distinctions that adults struggle to perceive or reproduce.

    This helps explain why children who grow up bilingual often sound native in both languages. Accents, more than vocabulary or grammar, are where age-related differences are most pronounced.

    Sensitive periods are found in other animals, too, especially birds, which have an early sensitive period for learning their species-specific song from an adult tutor.

    After this window closes, learning a new language is still very much possible. But it usually takes more conscious effort and practice.

    Studies also show that children exposed to a second language early, roughly before puberty, are more likely to develop nativelike pronunciation and intonation.

    Brain imaging research shows that people who learn two languages early in life tend to process both languages in the same parts of the brain. Those who learn a second language later often use slightly different brain areas for each language.

    In practical terms, early bilinguals are more likely to switch between languages effortlessly. Later learners may have to more consciously work through their second language, especially at first.

    Two boys sit next to each other at a desk in a classroom filled with other children at desks.
    Second grade students do classwork during a Spanish-only, dual immersion class in University Hill Elementary School in Boulder, Colo., in 2022. Glenn Asakawa/The Denver Post via Getty Images

    Benefits to learning a language as an adult

    Pronunciation is only one part of language proficiency. Adults bring their own strengths to the task.

    Unlike young children, adult learners already have a fully developed first language. They also have skills in reasoning and pattern recognition, as well as an awareness of how language works.

    This allows adults to learn in a more deliberate way, as they study grammar rules and consciously compare languages. Adults are also more likely to rely on deliberate strategies, such as memorization, to learn a language.

    In classroom settings, adults often outperform children in early stages of learning, particularly in reading and writing.

    Language learning never truly stops. Even in adulthood, people continue to develop and refine their first language, shaped by their education, work and social environment, and how they use it day to day.

    While it may be harder for adults to acquire a nativelike accent later in life, the good news is that grammar, vocabulary and fluency remain well within reach for most adult learners.

    Benefits of learning a language as a kid

    Children, meanwhile, tend to learn languages implicitly, through immersion and interaction, often without conscious attention to rules.

    Social and emotional factors also play a major role in successfully learning a language.

    Children are generally less self-conscious than adults and more willing to take risks when speaking.

    Adults, by contrast, are often acutely aware of mistakes and may hesitate to speak for fear of sounding foolish or being judged.

    Research consistently shows that being willing to communicate is a strong predictor of success in learning a new language. Anxiety, inhibition and negative feedback from others can significantly slow progress, regardless of age.

    Accent, bias and social pressure

    Other factors, like social pressure and discrimination, matter as someone tries to learn a new language.

    Research into language and identity shows that listeners frequently associate accented speech with lower intelligence or competence, despite there being no connection between accent and cognitive ability.

    Non-native speakers often experience stigmatization, discrimination and prejudice from native speakers.

    This bias can discourage adult learners and reinforce the false belief that successful language learning means sounding native.

    Motivation and aptitude matter, too

    Motivation is another key factor that affects learners of all ages.

    People learn new languages for many reasons: a new country, work, school, relationships or interest in another culture.

    Research distinguishes between the different reasons people learn a language. Some are practical, like advancing a career or passing a test. Others are personal, such as wanting to connect with a community, culture or family.

    Learners who feel a strong personal or emotional connection to the language are more likely to keep going even when it gets difficult, and they often reach higher levels of fluency than those without this connection.

    Other people have a natural aptitude for learning a language and can pick it up easily. Perhaps they quickly notice sound patterns, or they can remember new vocabulary after hearing it once or twice.

    Language aptitude is different from intelligence and varies from person to person. Aptitude makes success in learning a language more likely, but it doesn’t guarantee it.

    Learners with average aptitude can still become very proficient in new languages as adults if they have consistent exposure, practice and motivation.

    Different ages, different strengths

    So is it better to learn a second language as a child or as an adult? Research suggests the more useful question is which aspects of language learning, such as pronunciation, fluency or long-term mastery, matter most.

    Learning a new language early makes it easier to sound like a native speaker and to use the language smoothly, without having to think about the rules.

    Learning that language later in life draws on adult strengths, such as planning, problem-solving and focused practice.

    Ultimately, some people pick up languages quickly while others struggle, regardless of how old they are.

    Beliefs about language learning shape education policy, parenting choices and how multilingual speakers are treated in everyday life.

    When adults are told they’ve missed their chance to learn a language, many never bother to try. When foreign accents are treated as flaws, capable speakers can be unfairly discriminated against.

    In fact, research shows that learning a language is possible at any age – it’s a lifelong, achievable journey, rather than a race against the clock.

    This article originally appeared on The Conversation. You can read it here.

  • What does the appendix do? Biologists explain the complicated evolution of this inconvenient organ
    Photo credit: Sebastian Kaulitzki/Science Photo Library via Getty ImagesMost people get acquainted with their appendix when it’s inflamed and about to rupture.
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    What does the appendix do? Biologists explain the complicated evolution of this inconvenient organ

    It may be inconvenient, but the appendix is no evolutionary mistake.

    Most people know only two things about the appendix: You don’t need it – and if it bursts, you need surgery fast.

    That basic story traces back at least to Charles Darwin, the English naturalist who developed the theory of natural selection. In “The Descent of Man,” he described the appendix as a vestige: a leftover from plant-eating ancestors with larger digestive organs. For more than a century, that interpretation shaped both textbook and casual medical wisdom.

    But the evolutionary story of the appendix turns out to be much more complicated.

    Along with our colleague Helene M. Hartman, a student preparing for a career in health care, we combined our expertise in behavioral ecologybiology and history to review the scientific literature on the appendix, expecting a simple answer.

    Instead, we found an organ that evolution kept reinventing, more interesting than most people imagine.

    How did the appendix evolve?

    The appendix is a small pouch branching off the first section of the large intestine. Its shape and structure vary widely across species – a clue that evolution may have tinkered with it more than once.

    Some species, including certain primates such as humans and great apes, have a long, cylindrical appendix. In others, including several marsupials such as wombats and koalas, the appendix appears shorter or more funnel-shaped. Still others, including some rodents and rabbits, have differently proportioned or branching structures. This structural diversity suggests that evolution has modified the organ under different ecological conditions.

    Diagram of a segment of the small intestine with fingers of the appendix oriented in various degrees
    The appendix can be oriented in the body in multiple ways. Mikael Häggström, M.D./Wikimedia Commons

    That suspicion is supported by evolutionary analyses. Comparative studies show that an appendix-like structure evolved independently in at least three distinct lineages of mammals – marsupials, primates and glires, a group that includes rodents and rabbits. A broader evolutionary survey found that the appendix evolved separately at least 32 times across 361 mammalian species.

    When a trait evolves repeatedly and independently, biologists call this convergent evolution. Convergence does not mean a structure is indispensable. But it does suggest that, under certain environmental conditions, having that structure provided a consistent enough advantage for evolution to favor it again and again.

    In other words, the appendix is unlikely to be a useless evolutionary accident.

    What does the appendix do?

    The appendix supports the immune system. It contains gut-associated lymphoid tissue – immune cells embedded in the intestinal wall that help monitor microbial activity in the gut. In early life, this tissue exposes developing immune cells to intestinal microbes, helping the body learn to distinguish between harmless symbionts and harmful pathogens.

    The appendix is particularly rich in structures called lymphoid follicles during childhood and adolescence, when the immune system is still maturing. These immune components participate in mucosal immunity, which helps regulate microbial populations along the intestinal lining and other mucosal surfaces. Lymphoid follicles produce antibodies, such as immunoglobulin A, to neutralize pathogens.

    Researchers have also proposed that the appendix acts as a microbial refuge. Some have suggested that biofilms – thin, structured communities of bacteria – line the appendix. During severe gastrointestinal infections that flush much of the gut microbiome from the colon, beneficial bacteria sheltered within these biofilms may survive and help repopulate the intestine afterward. Those beneficial microbes assist with digestioncompete with pathogens and interact with the immune system in ways that reduce inflammation and promote recovery.

    These hypotheses motivated a question our team explored: If the appendix helps preserve microbial stability, could removing it subtly affect reproductive fitness?

    Older clinical concerns suggested that appendicitis or appendectomy might impair fertility by causing inflammation and scarring – known as tubal adhesions – in the fallopian tubes. Such scarring could physically obstruct the egg’s passage to the uterus. But several large studies have since found no decrease in fertility after appendectomy – in some cases, researchers found a small increase in pregnancy rates.

    The appendix appears to have multiple functions, including immune and microbial ones. Affecting fertility, however, does not seem to be one of them.

    Evolutionary importance and modern life

    While the appendix has an interesting past, with evolution continually reinventing it, its modern importance is modest at best. Darwin underestimated the organ’s history, but his instinct wasn’t far off in the medical present: Some parts of human biology mattered more in the environments people evolved in than in the lives they lead today.

    Early humans lived in environments with little sanitation and strong social contact – perfect conditions for outbreaks of pathogens that cause diarrhea. An appendix that quickly restored the microbiome after infection could significantly improve survival. But over the past century, clean water, improved sanitation and antibiotics have sharply reduced deaths from diarrheal diseases in high-income countries.

    As a result, the evolutionary pressures that once favored the appendix have largely disappeared. Meanwhile, the medical risks of keeping the appendix – most notably appendicitis – remain. Modern surgery typically treats an infected appendix by removing it. A structure that was once a global evolutionary advantage is now more of a medical liability.

    This mismatch between past adaptations and present environments illustrates a core principle in evolutionary medicine: Evolution optimizes for survival and reproduction in ancestral environments, not for health, comfort or longevity in modern ones.

    Evolution operates at the level of populations over generations, favoring traits that increase average reproductive success, even if those traits sometimes harm individuals. Medicine works the other way around – helping individuals thrive in the present world rather than survive the past one.

    The appendix is not an IKEA spare part included “just in case,” but neither is it essential today. Human biology has many traits that were once beneficial, now marginal – and understanding them allows medicine to make better modern decisions.

    This article originally appeared on The Conversation. You can read it here.

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