Not all obesity treatments are equally effective, a new study finds.

Obesity affects more than 40% of adults and 19% of children in the United States.

National Institute of Diabetes and Digestive and Kidney Diseases. Obesity. Treatment options for obesity have changed and expanded rapidly—to the point where it can be confusing to keep up with what options are available.

These treatment options include popular prescription medications like Ozempic (semaglutide), Wegovy (semaglutide), and Mounjaro (tirzepatide).

A new analysis published last month in JAMA pared down the best obesity treatments currently on the market.

“It’s been really surprising—over the past four, five years—how many medications are coming out,” Melanie Jay, MD, one of the report’s authors, told Health.

“The purpose of this review was to summarize the data in an accessible place, to synthesize the things we know,” she said.

To determine which treatments work best, Jay and her team reviewed more than 100 studies, randomized control trials (RCTs), and other articles.

Given the toll obesity takes on the U.S., advanced research on the condition is important.

Obesity has been linked to higher rates of heart disease—the leading cause of death in the U.S.—type 2 diabetes, hypertension, osteoarthritis, and premature death.

The new study also underscores the fact that obesity is a medical condition and should be studied as such.

“All this knowledge about obesity highlights how obesity really is a disease—it’s not about willpower; it’s not a moral failing,” said Jay, who is also an associate professor in the Department of Medicine and Department of Population Health at NYU Grossman School of Medicine.

Here’s how obesity treatments compare, as well as what other aspects of obesity still need to be studied.

Recent research identifies behavioral changes, medications, and surgery as the most effective treatments for obesity.

For the new review, Jay and her team analyzed 126 articles to gather data on available obesity treatments.

“There were tens of thousands of articles on obesity,” she explained.

The authors of the report wrote that they chose only the highest-quality papers to include in their review. Among these articles were:

• 26 randomized control trials (RCTs)
• 29 meta-analyses and systematic reviews
• 14 longitudinal/population-based studies
• 15 clinical practice guidelines
• Four policy guidelines
• Two cross-sectional studies
• Two study/intervention descriptions
• 34 narrative reviews

The researchers found that the most effective obesity treatments are: bariatric surgery, behavioral interventions, and the use of certain medications—glucagon-like peptide receptor 1 (GLP-1) agonists and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists.

GLP-1 agonists include medications with active ingredients semaglutide, (like Ozempic and Wegovy), and liraglutide. Tirzepatide is a glucose-dependent insulinotropic polypeptide/GLP-1 agonist, found in medications like Mounjaro and Zepbound.

The authors of the review found the effective treatments differed in how much weight they helped people with obesity lose:

• Bariatric surgery: 25% to 30% weight loss
• GLP-1 agonists and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists: eight to 21% weight loss
• Behavioral interventions: five to 10% weight loss

Among the medications analyzed for the review, tirzepatide (Mounjaro and Zepbound) had the “greatest effect,” with an average weight loss of 21% after 72 weeks of use.¹

The new review provides an accurate analysis of the field of obesity treatment right now, Benjamin O’Donnell, MD, an endocrinologist and weight management expert at The Ohio State University Wexner Medical Center, told Health.

“Having read this report, what the authors describe aligns very well with my own experience and practice in treating obesity,” he said. “There’s nothing very surprising here.”

It’s worth noting, O’Donnell added, that what works for one person with obesity may not work for the next.

“Each person should be provided [an] individualized treatment plan with a focus on lifestyle changes and finding a long-term approach,” he explained.

Obesity Treatments Aim to Impact Hunger Levels

O’Donnell notes that the effectiveness of various treatments varies based on their impact on an individual’s feelings of fullness or hunger.

Bariatric surgery, typically recommended for individuals with a body mass index (BMI) of at least 35 or those with a BMI of 30 to 34.9 with concurrent metabolic disease, comes in multiple types. These procedures generally restrict food intake and may also modify nutrient absorption and food digestion. Bariatric surgery becomes a consideration when lifestyle interventions, such as diet and exercise, prove ineffective.

For individuals with a BMI of 30 or higher, or a BMI of at least 27 with obesity-related comorbidities like hypertension, type 2 diabetes, cardiovascular disease, or sleep apnea, medications like Semaglutide, Liraglutide, and Tirzepatide are recommended. These medications work by suppressing appetite and delaying gastric emptying, leading to extended periods of food retention in the stomach.

Behavioral interventions are suggested for individuals dealing with obesity or being overweight. These interventions encompass dietary changes, exercise, stress management techniques, and guidance for those experiencing insufficient sleep.

The Future of Obesity Treatment in the US

While the report acknowledges the effectiveness of multiple treatments currently available, Jay highlights several challenges in the field of obesity treatment.

A significant concern is the shortage of obesity specialists in the U.S., especially considering the anticipated rise in the number of people affected by obesity. Despite the benefits of new medications, they introduce fresh challenges, particularly in terms of accessibility.

Jay emphasizes the existing access issues, stating that the supply is not meeting the demand. The critical question of who can access these medications also remains unanswered, raising concerns about potential widening health disparities if better treatments are not made universally accessible.

The introduction of new medications prompts the need for more studies to address questions about eligibility criteria and insurance coverage. Despite the comprehensive overview provided by the new review on current obesity treatments, continuous studies are essential to stay abreast of the evolving market.

According to Jay, the review may become slightly outdated within a year due to the constant emergence of new medications.

A recent study suggests that by incorporating more kiwis into your diet, the need for vitamin C supplementation could be reduced or eliminated. Published last month in Foods, the research revealed that consuming two SunGold kiwifruits daily for six weeks led to a significant increase in daily ascorbic acid (vitamin C) intake by 150 mg. The findings indicate that meeting this level of vitamin C through kiwi consumption may offer health benefits and eliminate the need for additional supplementation. Dr. Laura Purdy, a board-certified family medicine physician, emphasized the immune-boosting properties of kiwifruit, highlighting its significance in strengthening the immune system during cold and flu seasons.

What Is a SunGold Kiwi?

Unlike green kiwis which have fuzzy brown skin, an oval shape, and green fruit, gold kiwifruits have smooth, hairless skin and yellow fruit. Gold kiwis also contain more than 290% of the vitamin C you need daily.²

While this study on the effects of eating kiwifruit daily was small in size—consisting of only 24 healthy males between the ages of 25 and 60 without a history of type 1 or 2 diabetes or glucose intolerance—the results were promising.

Not only did the participants increase their vitamin C levels, but their fiber intake also increased, and their inflammatory and metabolic biomarkers were not negatively impacted.

This means it is safe to consume kiwifruit daily without any adverse reactions to your metabolism—unless you’re allergic to it. Purdy explained that, interestingly, it is not uncommon to be allergic to kiwifruit.

“If you notice any symptoms of an allergy, then it’s important to consult with your doctor,” she said. “This includes an itchy throat, vomiting, swollen tongue, trouble swallowing, breaking out of hives, and difficulty breathing.”

Here’s how daily kiwi consumption can boost vitamin C levels and make a positive impact on overall well-being.

SunGold Kiwis Are Full of Vitamin C

Kiwis stand out as vitamin C powerhouses.

While many people associate vitamin C with increased orange consumption or supplements, Jacqueline Wyman, MS, RDN, CDN, a registered dietitian nutritionist and owner of Jacqueline Wyman Nutrition LLC in Westchester, New York, highlights that SunGold kiwis—specifically used in the study—provide the highest vitamin C content per gram.

Adding one or two SunGold kiwis to your daily routine ensures that you meet the recommended vitamin C intake, according to Wyman. Beyond their rich vitamin C percentage, choosing kiwis as a snack over less nutrient-dense options can contribute to overall improved nutrition and well-being.

Wyman explains that an 80g piece of SunGold kiwi contains 130 mg of vitamin C, while the green variety, albeit slightly smaller, contains 70 mg. If you enjoy kiwifruit, Wyman recommends considering them as an excellent source to fulfill your daily vitamin C requirement.

Kiwifruit’s Impact on Cold and Flu

There is limited research on whether or not kiwifruit will prevent you from getting a cold or flu—even with its large quantities of vitamin C.

The idea of taking large doses of vitamin C to prevent the common cold originated in the 1970s when scientist and researcher Linus Pauling speculated that a daily vitamin C intake of 1,000 mg could reduce the incidence of colds by about 45%.

However, other clinical studies since then have failed to demonstrate its efficacy.

That said, researchers in a 2012 study did find that eating kiwifruit could potentially shorten the duration of a cold.

Scientists found that people who ate four gold kiwis a day reported less severe congestion and sore throat pain than the control group. The participants who ate kiwis each day also noted that their cold symptoms resolved faster than those in the control group.

There also are other benefits to eating kiwifruit.

Research has found that regularly eating kiwis can increase HDL cholesterol (“good” cholesterol), reduce triglycerides, and lower blood pressure. And, gold kiwis, in particular, may help people with anemia boost their iron levels when eaten alongside iron-rich meals.

“Incorporating kiwi into your daily routine this winter is a practical way of taking in vitamin C because smaller doses are more readily absorbed than one large dose, such as a supplement,” says Wyman.

She recommends that people plan to have a kiwi as part of a midday snack or dessert, along with other fruits and vegetables that contain higher levels of vitamin C.

Boosting Your Vitamin C This Winter

According to Wyman, obtaining vitamin C from a variety of fruits and vegetables is preferred to supplements because they offer many other benefits as opposed to one single vitamin.

“It is interesting to note that in studies of vitamin C and prevention or treatment of disease, [researchers] state that it is difficult to separate the benefits of vitamin C with the synergistic effect of all the components in fruit and vegetables, for example, fiber, folate, magnesium, and potassium,” she said.

If you are looking to boost your vitamin C but do not like kiwi or are allergic to it, you can find vitamin C in several other foods, too.

Aside from oranges, bell peppers in all colors have generous amounts of vitamin C, with orange bell peppers having the most, explained Wyman.

“You can also get a comparable amount of vitamin C in kale, broccoli, Brussels sprouts, cabbage, strawberries, and pineapple,” she said.

Are you in the habit of washing chicken before cooking? Is it a necessary step?

Across TikTok, Reddit, and X, there are advocates for rinsing chicken under water, claiming that it helps eliminate potentially harmful bacteria on the meat.

Contrary to this popular belief, health agencies contend that this practice is ineffective.

According to the Centers for Disease Control and Prevention (CDC), washing chicken serves no purpose.

Not only is washing chicken unnecessary, but it might also do more harm than good, as Darin Detwiler, PhD, an author, consultant, and professor of food policy at the Northeastern University College of Professional Studies, pointed out to Health.

“Cleaning a bird? All you’re doing is cross-contaminating the rest of your kitchen with pathogens,” he explained. “You’re not actually doing anything that adds food safety value.”

Cooking Raw Chicken Is the Safest Way to Avoid Foodborne Illness

Just because there’s no need to wash your chicken doesn’t mean you should overlook food safety precautions.

According to the CDC, approximately a million Americans fall ill each year due to contaminated poultry, with Salmonella being the primary concern in these cases.

The CDC estimates that around 1 in 25 packages of chicken is tainted with Salmonella.

While not all these illnesses can be directly linked to chicken, Salmonella alone causes approximately 1.35 million infections, 26,500 hospitalizations, and 420 deaths annually in the U.S.—surpassing the impact of any other bacteria.

Salmonella infection typically manifests as four to seven days of diarrhea, fever, and stomach pain. In rare instances, the bacteria can spread to other body parts, such as the blood, joints, or brain, leading to severe disease.

While it’s understandable that people may want to take precautionary measures, such as washing chicken, to avoid Salmonella poisoning, it’s crucial to note that rinsing off chicken won’t eliminate pathogens, as emphasized by Detwiler.

“People often believe they can wash off bacteria, but the safer approach is to cook it thoroughly,” explained Ciara Lundy, RDN, an inpatient clinical dietitian at Mayo Clinic in Arizona, in a statement to Health. “If they cook their chicken to 165 degrees, that should eliminate all bacteria.”

Rinsing Chicken Actually Increases Your Risk of Food Poisoning

Researchers have shown that washing chicken “spreads pathogens all over your sink and around the faucet and the handle and the sides,” Detwiler explained.

In a U.S. Department of Agriculture observational study, participants were asked to prepare raw poultry and a garden salad. Researchers found that 60% of those who decided to wash their chicken had bacteria in their sinks. And 26% of those who washed their poultry ended up causing cross contamination: Bacteria from the poultry found its way onto their lettuce.

“It causes more problems than it solves,” said Detwiler.

The idea of washing chicken seems to stem from cooking methods that people learned from parents or grandparents, Detwiler explained.

A small 2021 survey found this to be true—participants said their “chicken preparation methods were primarily influenced by family.”

Detwiler explained that generations ago, it was necessary to wash chicken before it was prepared, since people were more frequently slaughtering or plucking their own chickens.

However, in our modern day, this has become largely obsolete.

“We’re buying birds that have been, if you will, manufactured and packaged,” said Detwiler. “In terms of the bird that we buy for cooking, it is prepared and packaged for us to be able to literally remove it from the bag and put it into the oven.”

Another possibility is people simply do it out of habit, Lundy explained, lumping raw poultry in with other grocery store ingredients that are usually washed.

“With produce and things like that, you want to wash those so that they’re clean. I think maybe [chicken] just kind of fell into the same category,” she said. “[With fruit or vegetables] you’re definitely going to wash that, because you can wash off dirt and grime and things like that. But no, you can’t wash the bacteria off.”

Other Tips to Stay Safe When Cooking Chicken

Apart from refraining from rinsing chicken, there are additional measures individuals can adopt to reduce the risk of poultry-related food poisoning.

After purchasing raw chicken, it’s advisable to decide whether it will be cooked within the next couple of days (suitable for refrigeration) or if it will be consumed later in the week, in which case freezing is recommended, as explained by Lundy.

When thawing chicken, avoid leaving it on the counter for extended periods, and refrain from cooking it while still frozen, Detwiler advises.

During the thawing process, running frozen chicken under cold water to expedite the process should be avoided, according to Lundy. To prevent pathogen growth within the danger zone (40 degrees through 140 degrees), gradual defrosting in the refrigerator over multiple days is preferable.

For grocery shopping, the CDC recommends bagging chicken to prevent juices from leaking onto other foods. Additionally, ensure that chicken is securely stored in a container, preferably at the bottom of the refrigerator.

Throughout the cooking process, maintain the separation of raw chicken on a dedicated cutting board to prevent contact with other foods. Clean any kitchenware that comes in contact with raw chicken with soap and hot water, as advised by the CDC.

After cooking, chicken or other poultry is safe for consumption in the refrigerator for three to four days, according to Detweiler. If planning to eat it beyond that timeframe, freezing is recommended.

For those who prefer washing their chicken, the CDC suggests doing so cautiously. This involves gently running water over the chicken to minimize splashing, promptly cleaning the sink and surrounding areas afterward, and practicing thorough handwashing.

While these precautions may require additional effort, they play a crucial role in ensuring food safety. As Detwiler emphasizes, consumers need to contribute to maintaining the safety of their food.

A recent study suggests that ibuprofen might not be the optimal choice for treating migraines.

Despite the popularity of certain over-the-counter pain medications, their effectiveness can vary. According to new research published in Neurology last month, migraine-specific drugs were found to be up to five times more effective than commonly used medications like ibuprofen.

The study also highlighted that non-steroidal anti-inflammatory drugs (NSAIDs) other than ibuprofen demonstrated greater efficacy.

Chia-Chun Chiang, MD, the lead author of the study and an assistant professor of neurology and headache specialist at the Mayo Clinic in Rochester, Minnesota, emphasized the importance of consulting a doctor when individuals consistently resort to over-the-counter medications for headache relief. Dr. Chiang stated, “We have many migraine-specific medications that we can try.”

Discover which migraine medications may offer a higher likelihood of alleviating symptoms.

The most effective treatments for migraines include Triptans, Ergots, and Antiemetic Medications.

Chiang and her team conducted an assessment of 25 different types of migraine medications, utilizing a smartphone app for data collection.

Through the app, participants contributed over 4.7 million records detailing the medications used for migraines and their effectiveness. The research team discerned the most effective classes of drugs for migraine treatment and identified specific medications within those classes that proved highly potent against migraine attacks.

The study revealed that three classes of drugs—triptans, ergots, and antiemetic medications—outperformed ibuprofen significantly. Triptans, which bind to serotonin receptors in the brain, including medications like Migranow (sumatriptan), Zomig (zolmitriptan), Frova (frovatriptan), and Relpax (eletriptan), were found to be five times more effective than ibuprofen.

Ergots, comprising ergotamine or dihydroergotamine, sometimes combined with caffeine in drugs like Ergomar (ergotamine), Migranal (dihydroergotamine), and Trudhesa (dihydroergotamine), proved three times more effective than ibuprofen.

Antiemetic medications, addressing nausea and including Reglan (metoclopramide), Compazine (prochlorperazine), and chlorpromazine, were nearly three times more effective than ibuprofen.

Among the individual medications studied, eletriptan, zolmitriptan, and sumatriptan—all triptans—emerged as the most effective.

While ibuprofen exhibited a success rate of approximately 42%, migraine-specific medications, especially triptans, demonstrated efficacy ranging between 72% and 78%. Other NSAIDs, such as ketorolac, indomethacin, and diclofenac, as well as prescription drugs, also surpassed ibuprofen in effectiveness.

Acetaminophen, the active ingredient in Tylenol, was found to be 17% less effective than ibuprofen. Chiang emphasized that the study, utilizing real-world patient-generated data, provides a comprehensive comparison of 25 medications, reinforcing findings from randomized clinical trials.

Migraine Is an Under-Treated Condition

While the recent study provides valuable insights, there are certain gaps in its findings.

The research team gathered data over a six-year period, concluding in 2020. Notably, the Food and Drug Administration (FDA) has since approved several new migraine drugs, including two distinct types: gepants, categorized as calcitonin gene-related peptide (CGRP) inhibitors, and ditans, functioning similarly to triptans.4

An essential consideration is that the study did not account for the dosage of medications, and it excluded the use of any recently approved migraine treatments. This includes the aforementioned gepants and ditans. Dr. Hope O’Brien, founder and medical director of Headache Center of Hope in Cincinnati, Ohio, highlighted this omission, emphasizing the importance of recognizing the absence of specific dosage information and the exclusion of newer migraine treatments.

The study also revealed a significant issue known to headache specialists—migraine is often undertreated. Nearly half of the participants reported inadequate pain relief, with 33% stating the need for multiple medications to manage migraine pain. Dr. O’Brien, a fellow of the American Academy of Neurology and the American Headache Society, emphasized the gravity of this problem.

Furthermore, the study did not differentiate how the medications were administered—whether as a pill, injection, or nasal spray. Dr. Chia-Chun Chiang, the lead author, acknowledged the need for further research to confirm the impact of different dosages and formulations of medications, underscoring the importance of incorporating newer migraine medications in future studies.

Despite these limitations, Dr. Chiang highlighted the groundbreaking aspect of the study, as it departs from traditional data sources by utilizing information on migraine medications directly generated by patients through an online electronic diary. This novel approach offers a unique perspective on understanding the effectiveness of migraine treatments.

Diagnosing Migraine Disorders

Doctors may use migraine diagnostic criteria published by the American Headache Society to diagnose a person with a headache condition.

Migraines are headaches that last between 4 and 72 hours. They also have at least two of these four criteria: unilateral pain, meaning pain on one side of the head, pulsating or throbbing pain, moderate-severe intensity, and pain that’s aggravated by routine physical activity, such as walking around the house.

A migraine also causes at least one of the following: nausea, vomiting, and/or sensitivity to sound and light.

According to the American Headache Society, to have a migraine disorder, people must have at least five attacks in a lifetime.

In the 2021 consensus statement, the American Headache Society recommended a step-up approach to migraine management, meaning patients should start with either a single medication, lower doses, or over-the-counter treatments before building upon that base to pin down an individualized approach that works for them.

“Most patients have already tried over-the-counter medications, so patients who have been identified with migraine should be treated with a migraine-specific medication,” O’Brien said. “The goal is that they use one medication to stop a migraine and they are back to normal within 1–2 hours.”

Some people may require a second medication as a backup.

“But the goal is not to use multiple medications,” O’Brien said.