Ozempic (Drug)

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    Compounded Semaglutide: What to Know About Overdose Risks of Ozempic Alternative

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    Some patients say it’s easy to get the do-it-yourself doses of compounded semaglutide wrong.Three hours after Becky Cheairs injected herself with the first dose of compounded semaglutide, she started to vomit. Crouched over the toilet, reeling from nausea, she thought there was no way she would make it on the R.V. trip from Arkansas to San Antonio she had planned that weekend.She was right: She spent the next day throwing up at least once an hour.Like many others, Ms. Cheairs, 66, had taken the drug to lose weight. But she hadn’t taken the brand-name products Ozempic or Wegovy, which come in pens pre-filled with a specific dose. Instead, the medication she was prescribed through a telehealth service came with a vial and a bag of syringes to draw the drug out herself.Ms. Cheairs’ husband asked how much she had taken, then read the instructions. He was shocked: Ms. Cheairs had accidentally given herself five times the amount she was supposed to take.Accidents like this are becoming more common. There have been 159 calls to national poison control centers so far this year involving compounded GLP-1s, the class of medications that includes semaglutide. In 2023, there were only 32.The vast majority of these calls are from people who took too much medication, said Kait Brown, the clinical managing director at America’s Poison Centers. The problem has become so concerning that the Food and Drug Administration issued a warning last month about people overdosing on compounded semaglutide. Some patients have been hospitalized, developed pancreatitis or gallstones, or have fainted or become dehydrated. Some patients had taken 10 or even 20 times more than the intended dose.The demand for Ozempic and similar drugs has pushed compounded medications, once a somewhat niche corner of health care, into the mainstream. There isn’t solid data on how many people take compounded GLP-1s. But some estimates have suggested millions of Americans may be seeking them out, often, because they are looking for a cheaper option or can’t find the brand-name drug in stock.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Fake Ozempic Is Putting Patients at Risk. Here’s How to Spot It.

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      Fake versions of popular drugs used for weight loss are putting people at risk.Experts have grown increasingly concerned about fake versions of Ozempic and popular weight loss drugs. These copycats can look deceptively real, and may contain dangerous substances or entirely different drugs altogether.In June, the World Health Organization warned that fake batches of Ozempic were found in the United States, the United Kingdom and Brazil. Also in June, Eli Lilly issued a letter expressing concern that counterfeit versions of its own drugs, Mounjaro and Zepbound, were being sold online, through social media and at medical spas. Those who study the counterfeit drug market say these findings are alarming, but not all that surprising. The drugs are expensive, often hard to find and highly sought-after.“Such high demand and short supply and such a desperate population — that’s a recipe for disaster,” said George Karavetsos, a former director of the Food and Drug Administration’s Office of Criminal Investigations.As a result, a counterfeit market has emerged, with phony drugs sold online at low prices without a prescription or any contact with a doctor. Some websites have storefronts to sell what they claim is semaglutide, the substance in Ozempic, which customers can add straight into an online shopping cart. The National Association of Boards of Pharmacy said it had identified thousands of websites illegally selling drugs like Ozempic, including fake versions. Patients often have no way to verify what’s in these products.Shabbir Imber Safdar, the executive director of the Partnership for Safe Medicines, said he worried about both the rise of fake drugs and also the popularity of compounded semaglutide and tirzepatide, the substance in Mounjaro. These customized versions of drugs are made at compounding pharmacies and under best practices, contain ingredients that come from facilities registered with the F.D.A. But regulators have warned about adverse events linked to compounded semaglutide, and stressed that compounded medications are subject to less oversight than traditionally approved medications.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Some States Say They Can’t Afford Ozempic and Other Weight Loss Drugs

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      Public employees in West Virginia who took the drugs lost weight and were healthier, and some are despondent that the state is canceling a program to help pay for them.Joanna Bailey, a family physician and obesity specialist, doesn’t want to tell her patients that they can’t take Wegovy, but she has gotten used to it.Around a quarter of the people she sees in her small clinic in Wyoming County would benefit from the weight-loss medications known as GLP-1s, which also include Ozempic, Zepbound and Mounjaro, she says. The drugs have helped some of them lose 15 to 20 percent of their weight. But most people in the area she serves don’t have insurance that covers the cost, and virtually no one can afford sticker prices of $1,000 to $1,400 a month.“Even my richest patients can’t afford it,” Dr. Bailey said. She then mentioned something that many doctors in West Virginia — among the poorest states in the country, with the highest prevalence of obesity, at 41 percent — say: “We’ve separated between the haves and the have-nots.”Such disparities sharpened in March when West Virginia’s Public Employees Insurance Agency, which pays most of the cost of prescription drugs for more than 75,000 teachers, municipal workers and other public employees and their families, canceled a pilot program to cover weight-loss drugs.Some private insurers help pay for medications to treat obesity, but most Medicaid programs do so only to manage diabetes, and Medicare covers Wegovy and Zepbound only when they are prescribed for heart problems.Over the past year, states have been trying, amid rising demand, to determine how far to extend coverage for public employees. Connecticut is on track to spend more than $35 million this year through a limited weight-loss coverage initiative. In January, North Carolina announced that it would stop paying for weight-loss medications after forking out $100 million for them in 2023 — 10 percent of its spending on prescription drugs.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How Ozempic Is Changing Diabetes Treatment

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      Millions of patients rely on insulin. But with new drugs, some have been able to lower their doses or stop taking it altogether.For over 20 years, Betsy Chadwell carried her insulin pens everywhere. Day in and day out, she carefully calibrated the doses needed to keep her Type 2 diabetes in check. “Every meal, and every morning and every night — it controls your life,” she said.In late 2021, she started on the diabetes drug Ozempic. Within months, she was able to stop taking the short-acting insulin she typically took before each meal altogether, and she has substantially reduced the dose of long-acting insulin she uses daily. Scaling back on insulin has given her a sense of freedom, she said. She still uses a continuous glucose monitor to track her blood sugar, meticulously watching for slumps and spikes — but even as she took less insulin, she said, Ozempic has helped keep her glucose levels more under control.Millions of Americans rely on some form of insulin, a lifesaving drug that has long been a mainstay of diabetes treatment. But it can also be a burden to patients like Ms. Chadwell, who must juggle different formulations and doses, and often must have insulin on hand at all times. “I really feel for those patients, because you can never stop having it in the back of your mind,” said Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who studies obesity. But in recent years, Ozempic and a similar drug, Mounjaro — both weekly shots that can lower blood sugar, in part by mimicking a hormone that stimulates insulin production — have offered patients an enticing new option to try managing their Type 2 diabetes without relying as heavily on insulin.And drugmakers are examining other ways these drugs might work alongside insulin: Novo Nordisk, the company that makes Ozempic, is studying a new drug called IcoSema, a weekly shot that combines insulin icodec (an ultra long-acting version of insulin) and semaglutide, the compound in Ozempic.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Ozempic and Wegovy Have Health Benefits Beyond Weight Loss

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      Last year was called the year of Ozempic, though it was also a year of Ozempic backlash and Ozempic shortages, which could persist for years. Even so, we appear very far from a peak for GLP-1 drugs, like Ozempic and Wegovy, which are powered by a molecule called semaglutide, and Mounjaro, which uses its cousin tirzepatide. It seems possible to imagine a future in which almost everyone is taking some variety of GLP-1 drug, and with a pretty good reason to do so.Probably, you have heard about the game-changing impact of such drugs on obesity, a condition that affects 40 percent of Americans and increases the risk of heart disease, stroke and hundreds of other comorbidities. Patients on Ozempic and Wegovy can lose 15 to 20 percent or more of their weight in a little over a year, and if they stay on the drugs, the weight tends to stay off. That may not sound like a monumental effect, but consider that on average, an obese 210-pound man who loses 20 percent of his body mass generally passes quickly through the overweight stage all the way to a normal weight.If anything, though, we’ve probably talked too much about cosmetic weight loss and Hollywood vanity — and certainly made too many comparisons to fen-phen, Botox and Viagra. The GLP-1 drugs have been shown to cut risk of heart attacks, strokes and death from coronary disease by 20 percent among overweight and obese patients, presumably through the salubrious effect of weight loss, though the researchers can’t yet say for sure. Semaglutide has been shown to eliminate or reduce the need for insulin among those with recent-onset Type 1 diabetes. In a clinical trial of people with Type 2 diabetes and moderate to severe kidney disease, the drug reduced the risk of kidney disease progression and cut the death rate from cardiovascular and kidney-related causes by 24 percent — such a clear result that the trial was ended early. Semaglutide has reduced fatty liver deposits in patients with H.I.V. and nonalcoholic steatotic liver disease. It has normalized the menstrual cycles of those with polycystic ovary syndrome. (It has also, somewhat mysteriously, seemed to produce a wave of unintended pregnancies among women taking birth control, at least if TikTok videos are to be trusted.)Studies have shown promise in treating Alzheimer’s and Parkinson’s with GLP-1 drugs, perhaps by regulating insulin levels and reducing inflammation, and the drugs may yet prove useful in treating many other conditions made worse by chronic inflammation. Some studies have found large decreases in the risk of depression and anxiety; others found smaller but still positive effects. There are potential applications for schizophrenia and neurological dysfunction, thanks to the role that insulinlike hormones like GLP-1 play in the development of the central nervous system and the way semaglutide reshapes the brain’s chemical reward system. It seems to bend the curve on alcoholism and drug addiction and curb other addictive behaviors, as well — compulsive shopping and sex addiction, gambling and nail biting, smoking and skin picking. A compulsive nation has stumbled into what looks like a treatment for compulsion and one that happens to protect against some of the country’s biggest killers and curb some of its most pervasive pathologies and inner demons.Americans love to dream of miracle drugs, but hardly anything ever seems to fill the bill. True, semaglutide has arrived with real questions trailing like bunting: Much of the weight loss is from lean muscle mass, which isn’t ideal, and there are reasons to worry over the possibility of thyroid problems, loss of bone density and sarcopenia, a weakness disorder associated with aging. There are potentially other serious long-term side effects, though millions of Americans have been taking Ozempic for Type 2 diabetes for years without serious issues. (Some of them do report more familiar side effects, like nausea.) The GLP-1 drugs aren’t a permanent fix in a single shot — whether the thing being addressed is body mass index or cardiac risk or the progression of Alzheimer’s — but a permanent disease-management program. They also haven’t exactly cured cancer, although more than a dozen cancers are linked to obesity, and in at least one case, colorectal cancer, there is reason to believe GLP-1 drugs may directly cut the chances of developing the disease.All that means that semaglutide isn’t exactly a cure-all, in the vernacular sense. But it seems to be about as close as we’ve gotten, even in a time of racing biomedical progress, to that old science-fiction proposition — one pill for almost everything and almost everyone forever.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Are You Starting Ozempic or Another GLP-1? We Want to Hear From You.

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      The New York Times is looking to speak with people who are about to start GLP-1 medications such as Ozempic and are open to allowing us to chronicle their experiences.Have you tried numerous avenues to help your chronic illness, obesity or mental health and turned to Ozempic, Wegovy or another GLP-1 drug to address these issues? The New York Times wants to chronicle the journeys of people who are about to start taking one of these medications or who are losing access to them. We’re especially interested in hearing from groups of people, such as friends or families, that are taking these drugs as a group.We will keep all responses confidential and will reach out to respondents whose stories we’d like to learn more about. We will only use your contact information to follow up with you and will not share it outside the Times newsroom. More

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      Israel’s Destructive Bombs, and DeSantis’s Costly Ground Game

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      The New York Times Audio app is home to journalism and storytelling, and provides news, depth and serendipity. If you haven’t already, download it here — available to Times news subscribers on iOS — and sign up for our weekly newsletter.The Headlines brings you the biggest stories of the day from the Times journalists who are covering them, all in about five minutes.A Times visual investigation reveals that one of Israel’s largest bombs was regularly used in areas designated safe for civilians.The New York Times, Source: Planet LabsOn Today’s Episode:A Times Investigation Tracked Israel’s Use of One of Its Most Destructive Bombs in South Gaza, by Robin Stein, Haley Willis, Ishaan Jhaveri, Danielle Miller, Aaron Byrd and Natalie ReneauAt Least 15 Dead in Czech Republic After Shooting at Prague University, by Andrew Higgins, Jenny Gross and Aric TolerHow DeSantis’s Ambitious, Costly Ground Game Has Sputtered, by Rebecca Davis O’Brien, Nicholas Nehamas and Kellen BrowningCan Ozempic and Weight-Loss Drugs Treat Other Diseases?, by Dani BlumMiniature Livestock Are a Hot-Ticket Item This Holiday Season, by Madison Malone KircherJessica Metzger and More

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      The Republican Alternatives to Trump

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      More from our inbox:Whatever Happened to Civil Presidential Debates?Questions for HamasQuestions for IsraelAdvice for These Fraught TimesAntipsychotic Drugs and Weight GainThe presidential hopefuls seemed content to aim for second place behind former President Donald J. Trump and deliver digs at President Biden.Maansi Srivastava/The New York TimesTo the Editor:Re “If You’re Going to Win the Nomination, Here’s Step 1,” by Kristen Soltis Anderson (Opinion guest essay, Nov. 8):Ms. Anderson says that many Republicans are open to opponents of Donald Trump who can articulate a new direction for the party, but that those candidates are running out of time to make their case.Ms. Anderson mentions the former South Carolina governor Nikki Haley as a viable alternative to Mr. Trump. But in terms of good fiscal governance and foreign policy, I believe that Ms. Haley is even more misguided than Mr. Trump.For example, she has recommended ending the federal gas tax, enacting a new middle-class tax cut and extending the 2017 Trump administration tax cut. While such policies might attract some voters to Ms. Haley, they would greatly diminish the revenue needed to pay for essential services, not to mention blowing up the national debt.As for international affairs, she has recommended sending special forces to “take out the cartels” in Mexico. Imagine how Mexico and other countries might react to such an invasion.Serious Republicans don’t need to look far to find a better presidential candidate than Ms. Haley.Eric MurchisonVienna, Va.To the Editor:Ron DeSantis, Nikki Haley and the other G.O.P. candidates must know that the most likely path to a nomination for them is if Donald Trump is convicted or forced to drop out of the race. In that scenario, many Republican voters are likely to be very angry, and they will rally behind the candidate who can most compellingly channel their indignation. Anyone who has been seen as significantly anti-Trump will be out of the running.It is strategically savvy of them not to level any direct harsh criticism at Mr. Trump. If the time comes that Mr. Trump is forced out of the race, the last thing his competitors will do in that situation is suggest that the charges against him are anything other than politically motivated.William ShermanHuntington, N.Y.To the Editor:This guest essay suggested that the candidates explain why they are running against Donald Trump, which in fact was one of the questions asked during Wednesday’s debate. Perhaps the reason they have not yet done so convincingly is that they are not running “against” Mr. Trump.Several of them are likely running for vice president, and that would preclude discussing their differences.Carolyn BrossBloomingdale, N.J.Whatever Happened to Civil Presidential Debates? To the Editor:Re “From Substance to Shouting: The Demise of Political Debate in America” (Opinion video, nytimes.com, Nov. 7):Our view of politics has shifted dramatically from the days when presidential debates were respectful discussions of platforms and ideologies. I am a high school junior, and my classmates and I are worried about the future of the American presidency.Presidential debates, once characterized by thoughtful discussions, have transformed into heated contests where candidates pick one another apart in hopes of winning a few more percentage points. Genuine discourse is rare, and recap videos showcase the biggest insults or the funniest moments.How does it affect our country’s future when presidential candidates can’t engage in respectful discussion? What does it mean for American society when our ideology divides us completely? A president’s priority should be to represent the people and work toward the betterment of our nation. We cannot afford to lower this standard.As the future generation of voters and leaders, it falls on us young people to advocate a return to civil and meaningful discussion in our political debates. The strength of our democracy depends on it, and young voices need to be part of the solution.Maia DietzSan Jose, Calif.Questions for Hamas Ronen Bergman/The New York TimesTo the Editor:Re “Hamas’s Goal for Oct. 7: A Permanent State of War; Group’s Leaders Say Carnage Was Needed to Restore Focus on Palestinians” (front page, Nov. 9):After reading your interviews with Hamas leaders, one wonders:1. Are the Palestinian citizens of Gaza OK with a permanent state of war?2. Where is that permanent state of war supposed to lead?3. What cause was “slipping away”? Certainly not peace or a two-state solution; so what is left?4. If the cause and the policy of permanent war mean the destruction of Israel, are all those chanting “Free Palestine” or “From the river to the sea” supportive of that?Scott BenardeWest Palm Beach, Fla.Questions for IsraelTo the Editor:Israel’s stated war objective, repeated often by Prime Minister Benjamin Netanyahu, is to “destroy Hamas.” Hamas is a movement, a political-military organization with the backing of Iran and other entities.Might one ask what exactly does “destroy Hamas” look like? Is it every member of Hamas surrendering, or is it the death of the leadership, much of which does not even live in Gaza? How does one measure success when the stated aim is impossible to measure, let alone manage?I think that if we are paying for the arming of Israel — and make no mistake, we are — we are entitled to a straight answer.Geoffrey D. BatrouneyRye Brook, N.Y.Advice for These Fraught Times Photo illustration by The New York TimesTo the Editor:Re “How to Stay Sane in Brutalizing Times,” by David Brooks (column, Nov. 5):What amazing advice from Mr. Brooks on how people can stay sane in these perilous times. His emphasis on humility, prudence and caution is inspiring. I would add just one thing: self-compassion. Today public leaders need to be kind to themselves for the nearly impossible jobs they are often called on to do.Jerome T. MurphyCambridge, Mass.The writer is a retired Harvard professor and dean who taught courses on leadership.To the Editor:David Brooks reaches back thousands of years, integrating diverse cultures and quoting appropriate phrases from several authors, to emphasize the vast depth of his subject matter. Yet after all that, he does not cite the one that summarizes the entire concept: “Love one another. As I have loved you, so you must love one another.”Mary Ann McGinleyWilmette, Ill.Antipsychotic Drugs and Weight Gain Derek AbellaTo the Editor:Re “Psychiatric Drugs Add Pounds. Some See Solution in Ozempic” (front page, Nov. 6):Like other clinical psychiatrists, I use a simple, low-tech solution for my patients who gain weight on their antipsychotic drugs. In consultation with our patients, we find another antipsychotic, one that doesn’t cause weight gain. There are many to choose from.Together with our patients, we look for the most effective drug with the least side effects, at the lowest possible dose. To be on the safe side, we weigh our patients at each visit to guard against weight gain.Of course, this requires continuing follow-up visits with our patients, to form a trusting relationship and a common goal of healing. But with a new patient it’s essential to provide such close attention.Some might object that such frequent office visits for follow-up care are too expensive. But compared with the monthly cost of Ozempic, good care is a bargain.Alice FellerBerkeley, Calif. More

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      An Anti-Obesity Drug and Cultural Stigmas

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      More from our inbox:Seeking More Insight Into Republican VotersScandal at Liberty UniversityFree Analysis? Alice Rosati/Trunk ArchiveTo the Editor:Re “Ozempic Can’t Fix What Our Culture Has Broken,” by Tressie McMillan Cottom (column, Oct. 15):By “broken” in the headline, the column implies that we still perpetuate a cultural bias against obese people.Yes, we do stigmatize fat people. I’m fat. What’s also broken, though, is our habit of blaming society for failing to accept us, and medical institutions for failing to fix us, before we take an honest look at our own choices contributing to becoming unhealthy in the first place.Clearly obesity is an epidemic with complex environmental, economic and genetic factors. But for most, physical activity and healthy eating are still nature’s best prevention and remedy. Unlike Ozempic, they’re not a sexy quick fix. They’re work.Maybe healthy eating and activity are just too simple. But viewing ourselves first as victims of unfair systems is also not the answer.Society will always judge. Institutions will always be profit-driven. Blaming is easy. Honest self-assessment and changing habits are hard.Leslie DunnCarmel, Calif.To the Editor:Tressie McMillan Cottom’s fine column covers almost all the issues that I, as a slightly overweight but not obese woman, have with the new weight-loss drugs.But one issue needs to be addressed: What will we think about and how will we treat people (women) who choose not to take this drug, for whatever reason? Maybe it’s because it’s too expensive; maybe because it’s a commitment to a lifetime of taking the drug; maybe it’s just, amazingly, because they are comfortable in their rounded, plush bodies, and don’t desire to change them. Will they face even more opprobrium for that choice than they already do?I’ve spent the last 66 years (and counting) being told that my body isn’t “right,” by doctors, family and society. I’ve just finally come to terms with the fact that I’m stuck in it, and I’m lucky to be able to wake up every morning and get out of bed. Isn’t that enough?Naomi Weisberg SiegelPittsburghTo the Editor:While I agree with the author on many points, one point she didn’t address effectively is that Ozempic and other weight-loss drugs help cover up a main culprit that is causing our obesity: the U.S. food industry and “ultraprocessed foods.”Up until about the 1980s the U.S. didn’t have such a serious obesity problem. Then sugar began being added to everything, along with other things not found in any garden or kitchen.Dr. McMillan Cottom points out that people can be obese and be healthy, but that is not true of most obese people. Ozempic was created because of rampant diabetes in the U.S., the risk of which is increased by eating ultraprocessed foods.Our food industry is killing us with slow deaths from chronic diseases.Deborah JerardMontpelier, Vt.The writer is a pediatrician.Seeking More Insight Into Republican VotersWhy These 11 Republican Voters Like Trump But Might Bail on HimThe group discusses what it would take for a candidate other than Trump to win their vote.To the Editor:Re “Could These Republican Voters Abandon Trump?” (“America in Focus” series, Opinion, Oct. 22):This piece was disturbing but unenlightening about why voters support Donald Trump.Focus groups are supposed to probe for deeper understanding of participants’ views, yet your moderator accepted answers without delving into how participants reached those views.For example, when Cristian said about Donald Trump that “he does get things done,” the moderator could have asked for specifics. It would have been an interesting answer because Mr. Trump actually got very little done.The most glaring omission was Mr. Trump’s false claims of a stolen 2020 election. Do participants agree with Mr. Trump? Where do they get their news? Does this issue even matter to them?We have known for months that Mr. Trump maintains strong voter support. We might have gotten some insight into why had the moderators asked more clarifying questions.Ann LaubachAustin, TexasTo the Editor:First, I will applaud both Kristen Soltis Anderson for her skilled questions and moderation, as well as Patrick Healy and the Times Opinion team for sticking with your amazing series, most recently “Could These Republican Voters Abandon Trump?” Fascinating stuff.But just like the infamous CNN town hall with Donald Trump, it leaves an urgent set of questions. Mainly these:1. What about the criminal cases against Mr. Trump?2. What about climate change and the green agenda?Without understanding in depth these 11 Republicans on these topics, I just don’t see how I can evaluate. Of course, I recognize that these individuals have most likely completely dismissed these entire areas of thought. Nonetheless, to understand the situation in my country, I need to see what rationales they are using to do that.George OdellNewburyport, Mass.Scandal at Liberty University Julia Rendleman for The New York TimesTo the Editor:Re “The Worst Scandal in American Higher Education,” by David French (column, Oct. 23):Thank you to Mr. French for bringing the truly appalling behavior of Liberty “University” officials to our attention. Yet while he reports that the $37.5 million fine Liberty might face would be “unprecedented,” I can’t help but wonder why the Department of Education wouldn’t strip Liberty of its accreditation altogether, making it ineligible to receive federal money.Such a move is long overdue, and not just because Liberty has lied about campus crime and pressured victims of sexual assault to stay quiet. Liberty, and a host of other Christian institutions, are not colleges in the critical sense. These are places where answers precede questions, where intellectual exploration is hemmed in by theological dogma, and where basic tenets of academic freedom are treated as optional.Why should taxpayers be funding education at such places at all?Steven ConnYellow Springs, OhioThe writer is a professor of history at Miami University.Free Analysis?James AlbonTo the Editor:“How Do You Charge a Friend for a Professional Favor?” (Business, nytimes.com, Oct. 21): Another favor-asking situation that commonly occurs is asking physicians, be they friends or a recent acquaintance at a social event, for free medical opinions or even advice. The many ways of handling those situations would warrant an entire New York Times article.There is another common experience that occurs when one is introduced to someone as a psychiatrist, psychoanalyst or therapist in nonprofessional settings.Such introductions often evoke the question, “Are you analyzing me?” To which I almost always respond, “Not if you’re not paying me.” And we move on.Jack DrescherNew YorkThe writer, a psychiatrist and psychoanalyst, is past president of the Group for Advancement of Psychiatry. More