ASK DR ZOE
Can I take Ozempic if I’m not overweight or obese? I just want to slim down before Christmas
Plus, Dr Zoe helps out another reader whose is still suffering from hot flushes at 74
FLU season may feel a little far off, but preparation starts now.
If you haven’t booked in your vaccine, this is your sign to do so!
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Flu jabs are free on the NHS if you’re over 65, pregnant, have certain health conditions or if you’re a healthcare worker, carer or live with someone who is immunocompromised.
Two and three-year-olds can get the flu nasal spray vaccine.
Booking takes just minutes.
Use the NHS app, call your GP, or 119 free, or go online to .
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Technically, flu season starts in December but infection rates start to rise this month.
Why bother getting a jab?
Well, flu is not just a bad cold, it causes a more severe illness.
While most people will recover after a week or two, for those identified as “at risk” it can be worse, fatal in some cases.
Most read in Health
In the past two winters, there were 18,000 deaths associated with flu even though they were mild seasons.
If you are not eligible for a free flu vaccine, one at a pharmacy costs from £12.
GP gives their verdict on cheap cold and flu home remedies
Here’s a selection of what readers have asked this week . . .
HOT FLUSHES 16 YEARS AFTER LAST PERIOD
Q) I HAD my last period at age 58 and at almost 74, I’m still having hot flushes.
I had been on HRT for four years previously when I was perimenopausal.
One GP told me it could go on until I’m 100 and another told me to “just live with it”.
But they’re really difficult to live with. I recently went away for a few days and the weather was lovely and warm but I was uncomfortable, to say the least.
Can you recommend what, if anything, I can do?
A) It sounds like you’re having a hard time at the moment and I’m sorry to hear that.
It’s always important to ensure that hot flushes aren’t just put down to and assumed to be the menopause.
Other things must be ruled out, especially if at the age of 74 they are new or getting worse.
There are plenty of other conditions which can cause hot flushes such as thyroid disorders, some infections and certain types of cancer as well.
So please make sure your GP investigates if necessary.
If you’re wondering about starting HRT again then there are a few things to think about.
Whatever your age, it is important to understand and be able to assess the risks versus benefit of treatment.
That equation does change as we get older, making the risks of taking HRT more significant as we age.
That’s not to say you absolutely can’t take it, but it is not commonly started in women above the age of 60, or if they are more than ten years past menopause.
It would be worth asking if there is a GP or nurse at the practice who has a special interest in menopause and if not, you may need to be referred to a menopause specialist if you do want to explore HRT further.
Of course there are non-hormonal treatments that can treat hot flushes too, including some antidepressant medications, gabapentin and, just last year, a new drug called fezolinetant was licensed in the UK for moderate to severe vasomotor symptoms – however, it is currently licensed for those up to age 65.
IS OZEMPIC SAFE FOR EVERYONE?
Q) IS it safe for people who are not overweight to use Ozempic?
A) Ozempic is not licensed as a treatment for obesity or weight loss in the UK and should only be prescribed for diabetes.
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Wegovy, which contains the same drug, semaglutide, is licensed for weight loss.
Mounjaro is a slightly newer, similar drug which is also licensed for treating obesity.
These types of injectable medications work to help people lose weight, predominantly by suppressing appetite.
The causes of obesity are complex, with genetics being one of the major factors.
Our genes partly determine how much we need to eat before we feel full and play a part in how our brain responds to food cues, so a highly responsive person will feel the urge to eat more often on any given day.
With the changes to the world over the past few decades, with bigger portion sizes, calorie-dense foods and food cues everywhere we turn, it’s easy to see why some people, due to their genetics, find it difficult to remain a healthy weight more than others.
So one way to look at these drugs is that they level the playing field.
For people who are genetically predisposed to being more hungry, the medication makes their urge to eat more aligned to that of a person who finds it easy to stay slim.
In terms of safety, no medication is without any risk and the balance against benefits is different for each individual, but are more likely to lean towards being beneficial for people who have severe obesity, especially if they have related health issues.
For people of a healthy weight, or who carry excess weight but remain metabolically healthy, it’s much more likely that the risks outweigh any benefit.
Common side effects include nausea, vomiting, abdominal discomfort, gallstones and diarrhoea.
Less common, but more severe side effects include acute pancreatitis.
So in a nutshell, the simple answer to your question is no.
Tip of the week
SEASONAL affective disorder is when shorter days – and as a result, less daylight – can lead people to suffer from mood changes, fatigue, and depression.
If you have had a persistently low mood and are struggling to cope, please see your GP who can help.
Q) MY son is 17 and has got some spots on his back and shoulders and I’m not sure what it could be.
A) Thank you for the picture, below, which shows the classic signs of acne, a common skin condition.
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Both blackheads and whiteheads can occur with acne and it can range from a few spots on the face, neck, back and chest, to something more problematic, with solid painful lumps under the skin which may cause scarring.
Acne usually starts during puberty but can come at any point and most of us will experience it at some point.
It’s caused by lots of different factors – sebaceous (oil-producing) glands are found near the surface of the skin and they’re affected by our hormones.
In acne, the glands are sensitive and can produce too much oil.
At the same time, dead skin cells build up and block the pores, leading to blackheads and whiteheads.
Fortunately, there are lots of treatments – your son could try going to your local pharmacist first and requesting some over-the-counter medications that don’t require a prescription such as benzoyl peroxide or azelaic acid.
Could you help him with applying this to the skin?
It could be several months before changes are seen so it’s worth persevering with whatever treatment you start with.
Often people stop using treatments after the first few days because they can cause some mild increase in redness, dryness and irritation at first.
But as long as the symptoms are mild you should continue, or use on intermittent days until the skin gets used to it.
Alongside any treatment it’s important to follow some simple lifestyle rules too – don’t wash more than twice a day or use strong soaps as this can strip the natural oils from the skin and make the sebaceous glands work even harder to produce more.
Moisturise using a fragrance-free water-based emollient and try to avoid picking spots.
If over-the-counter medications don’t work, your GP can prescribe something.
Options include antibiotic or retinoid topical treatments applied directly to the skin, oral antibiotics, or oral contraceptive pills in females.
Dermatologists can prescribe isotretinoin capsules (Roaccutane) which is highly effective but it’s important to understand the potential side effects on mental and sexual health.
OBESITY LEVELS TRIPLE
WE are wolfing down giant portions of food without even realising, experts have warned.
More than a third of us never think about how the size of a serving can affect the waistline, and regularly eat way too much pasta, rice, cheese and cereal to be healthy, research by MyFitnessPal found.
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Obesity levels here have more than tripled since 1994, with an estimated 26 per cent of people now in the category, according to the British Obesity Society.
But 77 per cent say they feel uncomfortably full after meals and two-thirds are going back for seconds.
One in five eat so quickly that they don’t realise they are full, with four in ten eating in front of the TV.
Only half of those surveyed checked packets for serving size suggestions.
It all means half of us are eating double the NHS-recommended portion of pasta (75g, one handful) and rice (75g, one and a half handfuls).
Half of us fill a cereal bowl to the top at breakfast time, instead of adhering to the recommended 40g.
A third of the survey participants said they have no grasp on what the recommended portion size for a meal should be.
MyFitnessPal head of nutrition Melissa Jaeger said: “By paying more attention to portion sizes and using a nutrition tracking app, we can make more informed choices that better support our health goals.”
QUALITY OF LIFE ISSUES
THOUGH modern medicine continues to evolve rapidly, increases in life expectancy have stalled, a study suggests.
Average life expectancy almost doubled over the course of the 19th and 20th centuries, but the rate of increase has dramatically slowed in the past 30 years, according to Chicago-based research.
Life expectancy at birth in the world’s longest-living populations has increased by only an average of six and a half years since 1990, according to the analysis of the longest-living countries in the world, reported in the journal Nature Aging.
The researchers say ageing and its complications are now the main obstacle to a longer life.
But aiming to extend life by reducing age-related disease could be harmful, if those additional years aren’t healthy, they maintain.
Lead author Professor Jay Olshansky said: “Most people alive today at older ages are living on time that was manufactured by medicine.
“But these medical Band-Aids are producing fewer extra years of life even though they’re occurring at an accelerated pace, implying that the period of rapid increases in life expectancy is now over.
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“We should now shift our focus to efforts that slow ageing and extend ‘healthspan’.”
Some scientists had predicted that life expectancy would continue to improve over the 21st century thanks to advances in medicine and public health.
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