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      PCOS Diets Are Unlikely to Ease Symptoms

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      Patients were told for years that cutting calories would ease the symptoms of polycystic ovary syndrome. But research suggests dieting may not help at all.For years, people who had polycystic ovary syndrome and were also overweight were told that their symptoms would improve if they lost weight via a restrictive diet. In 2018, a leading group of PCOS experts recommended that overweight or obese women with the hormonal disorder consider reducing their caloric intake by up to 750 calories a day. That guidance helped to spawn questionable diet programs on social media, and reinforced an impression among people with PCOS that if only they could successfully alter their diets, they would feel better.But the recommendations were not based on robust PCOS studies, and researchers now say that there is no solid evidence to suggest that a restrictive diet in the long-term has any significant impact on PCOS symptoms. Dieting rarely leads to sustained weight loss for anyone, and for people with PCOS, losing weight is particularly difficult. Beyond that, the link between sustained weight loss and improved symptoms is not very clear or well-established, said Julie Duffy Dillon, a registered dietitian specializing in PCOS care.In 2023, the same group, called the International PCOS Network, revised its guidance based on a new analysis of the research and dropped all references to caloric restriction. The group now recommends that people with PCOS maintain an “overall balanced and healthy dietary composition” similar to the Mediterranean diet, which is associated with a reduced risk of the health issues that are linked to the disorder, like cardiovascular disease and diabetes. It’s not known whether eating this way might improve symptoms of PCOS. The changes in the guidelines reflect “the PCOS literature and the lived experience of people with the condition,” said Dr. Helena Teede, an endocrinologist at Monash Health in Australia and lead author of the 2023 guidelines. “It’s no longer about blaming people or stigmatizing them, or suggesting that it’s their personal behavioral failure that they have higher weight.”What is PCOS?PCOS is a hormonal disorder that affects as many as five million women in the United States. It’s characterized by irregular periods, infertility, excessive facial hair growth, acne and scalp hair loss — symptoms that are common with other health conditions, too, making diagnosis tricky. People with PCOS usually ovulate less than once a month and often also have higher levels of androgens (male sex hormones) or multiple underdeveloped follicles on their ovaries (not, as the name suggests, cysts) or both.Typically, when a woman is experiencing symptoms, a doctor will either scan the ovaries to look for those follicles or draw blood to test hormone levels. There is no cure for PCOS; the first line of treatment is often some form of birth control to help regulate the menstrual cycle.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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      6 Reasons That It’s Hard to Get Your Wegovy and Other Weight-Loss Prescriptions

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      An array of obstacles make it difficult for patients to obtain Wegovy or Zepbound. Finding Wegovy is “like winning the lottery,” one nurse practitioner said.Talk to people who have tried to get one of the wildly popular weight-loss drugs, like Wegovy, and they’ll probably have a story about the hoops they had to jump through to get their medication — if they could get it at all.Emily Weaver, a nurse practitioner in Cary, N.C., said she told her patients that finding Wegovy was “like winning the lottery.”Here are six reasons why.1. Demand is very high.Fueled in part by TikTok videos and celebrity testimonials, people are increasingly seeking prescriptions for appetite-suppressing medications. The drugs in this class have long been used to treat diabetes but more recently have been recognized for their extraordinary ability to help patients lose weight. The medications are injected weekly and have sticker prices as high as $16,000 a year.About 3.8 million people in the United States — four times the number two years ago — are now taking the most popular weight-loss drugs, according to the IQVIA Institute for Human Data Science, an industry data provider. Some of these prescriptions are for diabetes. The medicines are Novo Nordisk’s Ozempic and Wegovy (the same drug sold under different brand names), and Eli Lilly’s Mounjaro and Zepbound (also the same drug).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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      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

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      College Athletes and Ideals for Women’s Body Image

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      More from our inbox:Elizabeth Warren’s Election Analysis: We DisagreeEric Adams and the MidtermsSue Republican LiarsA Matter of SpaceAudra Koopman, who ran track and field at Penn State, said she felt pressured to avoid sweets and to trim down. But even as she did, she didn’t feel like she performed better.Rachel Woolf for The New York TimesTo the Editor:Re “Women in College Sports Feel Pressure to Be Lean at Any Cost” (Sports, Nov. 14):Thank you for raising awareness about the risks of scrutinizing body composition in college athletes. I am a clinical psychologist specializing in eating disorders, and the highlighted profiles echo stories I have heard many times over.No evidence suggests that participating in a sport causes eating disorders, but rates of these illnesses among athletes are higher than the national average. Athletes who participate in endurance, weight-class or aesthetic-based sports are at heightened risk.A focus on metrics like body fat percentage and body weight may breed an unhelpful hypervigilance on restrictive eating, body size and burning calories. College-age men and women are often still maturing physically, and by taking drastic measures to change their bodies risk their physical and psychological well-being.They also risk missing out on the greatest pleasures of sports: being a good teammate and finding joy in competition even while competing at a high personal level.Deborah R. GlasoferNew YorkThe writer is an associate professor of clinical medical psychology, Columbia Center for Eating Disorders, New York State Psychiatric Institute.To the Editor:Women in college sports are simply the tip of the spear when it comes to our affluent culture’s widely promoted ideal of thinness for women. I lived in Nigeria for many years, and there plumpness in a woman is seen as a desirable signifier of affluence. So this ideal for women’s bodies is anything but universal or timeless.Athletes and dancers perform in public, and the moves that make up their routines are easier when there is less body fat to contend with.This fact extends into other areas of daily life. But though men perform these activities too, and can also have eating disorders, the fact that women are the focal point of this discussion, as they were when I was a professor of women’s studies at Rutgers, says something about the larger issue of gender ideals in our culture.Katherine EllisNew YorkElizabeth Warren’s Election Analysis: We Disagree Kenny Holston for The New York TimesTo the Editor:In “Democrats, Let’s Seize This Moment” (Opinion guest essay, Nov. 14), Senator Elizabeth Warren claims, “The so-called experts who called Democrats’ messaging incoherent were just plain wrong — and candidates who ignored their advice won.”I beg to differ. Surveys show that a large majority of Americans favor most Democratic policies — legal access to abortion, a fair and progressive tax structure, strong environmental regulations and worker protection, a reasonable minimum wage, not cutting Social Security or Medicare, and the Affordable Care Act. Yet many Democratic candidates barely squeaked by, and the Democrats lost control of the House of Representatives.It’s easy to know what Republicans stand for — even if it’s based on lies. It’s all over the media. I’m not sure that most Americans can say what Democrats stand for, although a large minority of Americans seem to think that we steal elections, and want to curtail the police, open the borders and hand out large sums of money to people who refuse to work. Why? Because the Republican message (often lies) is getting through.Democratic politicians may have great ideas, but they’re terrible at communicating them. Otherwise they’d have a much bigger majority in government.Shaun BreidbartPelham, N.Y.To the Editor:Democrats squeaking by in the midterms is not an overwhelming endorsement of President Biden’s spending and other policies. In many cases it’s voting for the least worst candidate.Has Elizabeth Warren not seen the polls about dissatisfaction with both former President Donald Trump and President Biden? If “none of the above” were a choice, it would likely have won on many ballots.As a centrist, I want elected officials to stop talking and writing about how great they are and how bad their opposition is. Rather, focus on what you will accomplish, bipartisan cooperation and problem solving.Many of my moderate Democratic friends would vote for Liz Cheney if she were a presidential candidate. Sure, she is more conservative, but she has demonstrated integrity, bipartisanship and intelligence. That would be a refreshing change.Gail MacLeodLexington, Va.Eric Adams and the MidtermsMayor Eric Adams views the Democrats’ poor performance in New York as validation of his messaging about crime and his brand of moderate politics.Sarah Blesener for The New York TimesTo the Editor:Re “Democrats See Adams at Root of State Losses” (front page, Nov. 18):Mayor Eric Adams did not lose four New York congressional seats. Asserting that he is to blame says, in essence, that the majority of voters who elected Republicans in swing districts chose poorly and that if voters had not been told crime was a problem, the Democratic candidates in those districts would have won.Mr. Adams has identified crime as a priority for his administration. By virtue of winning election, he is entitled to set his agenda. Whether the current increase in crime is a surge or a blip can be debated, certainly, but the idea that he should soft-pedal concerns about public safety to help other Democratic candidates is inappropriate.On the other hand, the fact that Republicans exploited perceptions about crime for electoral gain may be deplorable, but it is well within the rules of the game.The Democrats’ loss of New York congressional seats resulted from hubris around redistricting and willful ignorance about public perception of issues like bail reform. Eric Adams had nothing to do with either.Rob AbbotCroton-on-Hudson, N.Y.Sue Republican LiarsTo the Editor:Re “Misinformation on Pelosi Attack Spread by G.O.P.” (front page, Nov. 6):The notion seems firmly rooted among Democratic political leaders that since politics is rough and tumble, they should rise above it when the G.O.P.’s fabrication machine spews ominous conspiracy theories and baseless slurs to obscure reality.But since Republican politicians aren’t restrained by shame, common decency or respect for the truth, tolerating their falsehoods only encourages the right wing to wallow in fact-free filth. Instead, the victims of right-wing slanders owe it to themselves — and to us — to seek money damages for defamation from reckless Republican liars.First Amendment law protects scorching invective. But there’s a limit. Under the constitutional principles that govern defamation law, a political speaker is not free to knowingly utter falsehoods or to speak with reckless indifference to truth or falsity.That principle plainly applies to unfounded Republican claims about Paul Pelosi. It likewise applies to Newt Gingrich’s assertion that John Fetterman has “ties to the crips gang,” and to Donald Trump’s lies about a voting machine maker.Multimillion-dollar damage awards might deter Republicans from fouling the political landscape with lies designed to conceal their lack of answers to America’s problems.Mitchell ZimmermanPalo Alto, Calif.The writer is an attorney.A Matter of Space Hiroko Masuike/The New York TimesTo the Editor:Re “Dimming Hope Office Buildings Will Ever Refill” (front page, Nov. 18):Not enough housing? Too much office space? Go figure.Deborah BayerRichmond, Calif. More

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      Should Biden Announce That He Won’t Run Again?

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      More from our inbox:Solving New York City’s Housing ShortageSolace at the Beach Pool photo by Evan VucciTo the Editor:Re “Hey, Joe, Don’t Give It a Go,” by Maureen Dowd (column, Aug. 7):I can’t agree with Ms. Dowd that President Biden should declare himself a lame duck to protect his legacy. I can’t think of anything more out of his character than that. He doesn’t do things for himself. The nation’s well-being, not his legacy, is his central concern.Ms. Dowd begins by speaking of Ruth Bader Ginsburg, who “missed the moment to leave the stage,” and suggests that Mr. Biden’s time has come to leave. Good lord, he hasn’t even completed two full years in office yet. He has things to do and a nation to serve and protect. Just imagine how luckless he would be if he tried to do that as a lame duck.There’s time for him to leave, but this isn’t it. Maybe in the primaries, but maybe not.Roger CarlstromYakima, Wash.To the Editor:The Biden interregnum will be well remembered for bringing decency and sanity back to the Oval Office. He has come to be that “calming force for a country desperately in need of calming.” However, running for a second term at age 81 ignores the infirmities of age.If he should choose not to run again he would not become irrelevant; he would become a revered elder statesman who lived out his last hurrah on his own terms with renewed dedication and admirable resilience as manifested in his long career of public service. I am reminded of a quote from Orson Welles, who once said, “If you want a happy ending, that depends, of course, on where you stop the story.”Precision timing turns on recognizing the arc of one’s story and heeding the foreshadowed warnings with grace and knowing acceptance.Barbara Allen KenneyPaso Robles, Calif.To the Editor:The insistent chants for President Biden to announce that he will not run for a second term because he will be too old in 2024 is ageism pure and simple.If the “old dude in the aviators has shown he can get things done, often with bipartisan support,” as Maureen Dowd states, why not let him continue trying?Even if Mr. Biden is having second thoughts about re-election, why should he declare himself a lame duck president before it is necessary to do so? Does Ms. Dowd seriously believe that if he takes himself out of the running that “over the next two years he could get more of what he wants and then step aside?” Why don’t we ask the Republicans if they will cooperate?Mr. Biden has shown patience and perseverance. It comes with age and experience. Let us not sideline an old man just yet just because the cry is for “new blood.”Let Mr. Biden decide if and when to declare his candidacy.Eleanor M. ImperatoManhasset, N.Y.To the Editor:Thank you, Maureen Dowd, for saying what needs to be said. President Biden, I have been a longtime supporter and fan. What better opportunity for you to prove you’re not driven by ego but by principle? There is much still for you to accomplish. Make the most of this time. Show the American people a president who, untainted by political aspirations, is making decisions solely based on what’s best for the country.Diane LoveNew YorkTo the Editor:OK, let’s just say for the sake of argument that Maureen Dowd is right and Joe Biden shouldn’t run again. Then who do the Democrats have? We need somebody not just competent and visionary, but electable. That was my reasoning for voting for Mr. Biden in 2020.The Republicans obviously have Donald Trump and Ron DeSantis champing at the bit. I don’t think either of them would have a problem energizing the base.So if not Joe, who do we have?Dylan TaylorPhiladelphiaTo the Editor:Maureen Dowd has written what had to be said. Joe Biden must not run again, and he now has the perfect excuse to make his exit.Ruth Bader Ginsburg was a great example of overstaying one’s welcome. If only she’d retired when she had the best excuse in the world — her failing health — we might not today be living with this dystopian Supreme Court. Dear, dear President Biden: Please remember this and think of the scary consequences of your losing in 2024.It’s time for a younger candidate to take the reins of the Democratic Party. But he or she will need a couple of years to get his message out, and that means that Mr. Biden must announce now that he plans to be a one-term president.I love you, Joe, but you’ve given your all for the party, and it’s time to go.Clare ChristiansenOak Harbor, Wash.Solving New York City’s Housing ShortageTaylor Sicko moved out of New York City during the pandemic after she lost her job and was unable to afford rent. She has a new, remote job — based in New York — but she doesn’t want to move back.Rachel Woolf for The New York TimesTo the Editor:Re “Rising Rents, and No Cure on Horizon” (Business, Aug. 2):Your excellent story rightly diagnoses a major crisis facing the city — a decades-long failure to build enough housing to meet demand — but understates the responsibility that some local elected officials and anti-development activists bear for allowing it to spiral out of control.As noted, the city has committed a record $22 billion for housing — far more than any other city in the country. But all the money in the world won’t build the number of homes we need if local elected officials continue to block zoning changes that add additional density in their districts and NIMBY groups file frivolous lawsuits that delay new construction year after year.The City Council should work with the mayor to implement common-sense zoning changes and embrace opportunities to build new housing in their neighborhoods. Survey after survey has shown that the vast majority of New Yorkers are desperate for more affordable housing that will allow them and their children to stay in the city, and to assure we can retain the talented, diverse work force that makes the city the greatest in the world. It is time we made their wish a reality.Carl WeisbrodNew YorkThe writer is former chairman of the New York City Planning Commission.To the Editor:While elected officials are fighting tooth and nail to rezone neighborhoods, thousands of unoccupied rent-stabilized units sit vacant in New York City. Once a rent-stabilized unit becomes vacant, landlords are not required to rent out unoccupied rent-stabilized units to new tenants. Landlords are often incentivized to warehouse vacant rent-stabilized units, decreasing the availability of affordable housing in New York City.In the current housing market, applicants are entering rental bidding wars for market-rate units while vacant rent-stabilized units sprinkled across the five boroughs collect dust.Dena RosmanNew YorkSolace at the Beach To the Editor:Re “The Joys of Swimming While Fat,” by Phoebe Wahl (Op-Art, Aug. 13):Thank you so much for publishing a graphic depiction of a fat mommy who “risks” showing her body, her “redness and chafing and sweat” at the beach. She finds solace and peace swimming where she feels totally herself. Her struggles with internalized shame float away. No small feat!I can’t wait to share this with my life issues group for women who binge eat as a survival skill. Well put, Ms. Wahl. As women we need to stand up to “the burdens of patriarchy and society’s judgments” all the time!Arden Greenspan GoldbergNew YorkThe writer, a licensed clinical social worker, is a certified eating disorder specialist. More