Volunteers knit bra inserts for breast cancer survivors to dress well, regain confidence
Minister for Digital Development and Information Josephine Teo launching Knitted Knockers@NHG, where volunteers can knit and distribute the bra inserts, on June 6. ST PHOTO: TARYN NG
SINGAPORE - In her quest to find the right filling for her bra after undergoing mastectomy, breast cancer survivor Lyn Ee, 74, discovered Knitted Knockers, soft breast prostheses made from cotton yarn.
'They not only provide a gentler, softer alternative to the traditional breast prosthetics that can be hot and heavy, they also give back to breast cancer survivors their looks, confidence and peace of mind,' Ms Ee said.
Today, 10 years after her discovery , the soft mounds of cotton yarn are being distributed free at all restructured hospitals in Singapore to women who have had mastectomy.
Wanting to share her discovery of the prostheses with others here, Ms Ee in 2015 founded Knitted Knockers Singapore, t he local chapter of the American non-profit that has expanded internationally, gathering a group of volunteers to knit the bra inserts to give to breast cancer patients.
Knitted Knockers@NHG (National Healthcare Group), where volunteers can knit and distribute the bra inserts, was launched on June 6 by Minister for Digital Development and Information Josephine Teo.
Speaking at an event marking the 15th anniversary of the Tan Tock Seng Hospital (TTSH) Breast Clinic, Mrs Teo cited the initiative as an example of the good work the clinic has done.
'You want to provide the best clinical care and are equally keen to support the emotional well-being of your patients . The fact that you have put as priority helping patients regain a sense of normalcy and confidence – particularly for women who have had to go through mastectomies – is admirable ,' she said at the event.
Minister for Digital Development and Information Josephine Teo (right) greeting breast cancer survivor Lyn Ee.
ST PHOTO: TARYN NG
Mrs Teo also shared the story of Ms Carmelita Calesagsag, her family's foreign domestic helper of 27 years who is a breast cancer survivor.
The 61-year-old Filipina , fondly called Carmen by the Teos, has been working for the family for 27 years.
Mrs Teo said: 'I remember vividly the day she was diagnosed. After she had reported a lump, Carmen had been sent by our family doctor to be properly tested. Parliament was in session when I received Carmen's phone call. I guessed it was bad news, because she would otherwise have waited till I got home .
'Over the next few weeks, I saw her struggle with fear and despair. Against the advice of some, we decided she should be treated in Singapore instead of being sent home. Now, 17 years later, we are glad we made that choice. Carmen is fully recovered. She watched all three of our children become working adults and remains very much a part of our family.'
Ms Carmelita Calesagsag (right) has been working for Mrs Teo's family for 27 years.
PHOTO: COURTESY OF JOSEPHINE TEO
Breast cancer is the most prevalent cancer among women in Singapore, making up nearly 30 per cent of all cancers diagnosed among women here.
The incidence here has more than tripled over the past 50 years, to 74 cases per 100,000 women now – one of the highest in Asia.
The Breast Clinic has performed more than 6,100 breast cancer surgical operations since 2010 and over 450 in 2024 alone, the largest number within the NHG cluster last year .
One of the clinic's latest innovations is endoscopic breast surgery that combines keyhole mastectomy with immediate breast reconstruction.
The minimally invasive procedure is performed in the same setting by both a specially trained breast surgeon and a plastic surgeon. Cancerous tissue is removed from the affected breast, which is immediately reconstructed by the plastic surgeon using the patient's own skin, fat, and blood vessels.
Since its introduction at the clinic in November 2024, three of its patients have undergone this advanced dual procedure.
The first patient to undergo the procedure was polytechnic lecturer Kwa Sai Geok, 62, who was diagnosed with Stage 1 breast cancer during a routine mammogram in 2024.
Polytechnic lecturer Kwa Sai Geok was the first patient to undergo endoscopic breast surgery at the Tan Tock Seng Hospital Breast Clinic.
PHOTO: COURTESY OF KWA SAI GEOK
Describing herself as 'a forward-looking person and always trying my best to shorten the time to pull myself back up', Madam Kwa said she opted for the keyhole mastectomy and reconstructive breast surgery to future-proof her health.
'I did not feel any pain during the four-day stay in hospital... and life was back to normal about four months after my right hand fully recovered with the help of the TTSH physiotherapist,' she said.
Dr Ang Wei-Wen, a consultant from Breast Surgery Service at TTSH, said that not everyone is suitable for the minimal-scar endoscopic mastectomy and reconstructive surgery.
'This is due to various factors, such as the stage and type of cancer, the patient's overall health, and the location and size of the tumour,' he said.
Dr Ang said the next step would be to use robotics for the procedure.
'It is the future of breast surgery and already a trend in South Korea. It has more dexterity than a human surgeon, leading to smaller incisions, reduced pain, and faster recovery,' he added.
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The Wegovy effect: A weight-loss drug reshapes the lives of US teens battling obesity
(Clockwise from left) Austin Smith and his mother, Katie Duncan and Stephanie Serrano are among young people using Wegovy for weight loss. PHOTOS: REUTERS High-school freshman Austin Smith sank into depression from the merciless teasing and bullying he endured from his classmates over his weight. By age 15, Katie Duncan felt unhealthy and self-conscious from the excessive weight she carried, but couldn't tame the incessant food cravings caused by a tumor that had damaged part of her brain. Ms Stephanie Serrano, diagnosed with type 2 diabetes and liver disease related to her obesity, stopped attending high school in person and became a virtual shut-in after years of failed dieting. For these teens, obesity had become a painful physical and emotional burden, the persistent social stigma of their condition isolating them from their peers, and they were frustrated by their inability to lose weight. That's why, with support from their parents, they joined a small but fast-growing cohort of American teens who have chosen to take Novo Nordisk's weight-loss drug Wegovy, placing them at the forefront of a monumental shift in the treatment of childhood obesity. As childhood obesity rates soared in recent decades to epidemic levels, pediatricians could offer children and their families little beyond the conventional – and often ineffective – counsel of healthier diets and more exercise. That changed in December 2022, when US regulators approved Wegovy, which has become a multibillion-dollar seller for treating obesity in adults, for children 12 and older. Since then, teenagers have been starting on Wegovy at quickly rising rates, as Reuters recently reported. Still, based on those rates, the overall numbers remain small – fewer than 100,000 – next to the roughly 8 million, or one in five, American teens living with obesity. Those who have embraced the treatment, including the American Academy of Pediatrics, say Wegovy gives adolescents a chance at a healthier future by reducing their risk of developing type 2 diabetes, liver disease and other debilitating, and costly, chronic illnesses. They say weight loss can also ease the harm of the teasing and social isolation teens with obesity often endure. Some doctors, though, are hesitant to prescribe the drug, citing the lack of long-term safety data, concerns that children won't get adequate nutrition while taking it, and the possibility that it could cause eating disorders. Their caution is echoed in statements by US Health Secretary Robert F. Kennedy Jr., who has criticised the 'overmedicalisation of our kids' and emphasises the role of healthier food in combating chronic disease. That split leaves families to consider for themselves the potential benefits and risks of Wegovy when deciding on a course of treatment for a child with obesity. For this article, Reuters reporters found children who had taken Wegovy or a similar weight-loss drug to speak with them about their experiences. The reporters spent more than a year closely following four teens and their families to examine in detail the impact of treatment. Here are their stories: 'I can't wait' GLADSTONE, Missouri – 'Why do you want to lose weight?' When Ms Elizabeth Smith asked her son Austin that question, he didn't hesitate. 'To be healthier and so people will stop bullying me,' he said. Elizabeth wrote his answer on the form she was filling out as they waited in the doctor's office. Austin was near the end of a miserable freshman year. At almost 300 pounds, he struggled each morning to squeeze down the aisle of the school bus. Other students teased him relentlessly. He looked pregnant, they said, and he was gross. At school, the insults continued. He found solace in woodworking class, where he could focus on his projects and tune out the taunts – until the day a classmate cornered him, jammed a power drill into his long, curly hair and turned it on, leaving the tool dangling from a messy tangle. Ms Elizabeth Smith tousles the hair of her son, Austin Smith, who uses Wegovy for weight loss. PHOTO: REUTERS Even before his parents learned about that incident, they knew something was wrong. Austin, who has a mild form of autism, had grown increasingly withdrawn and rarely left his bedroom, where his mother found him sobbing after school several times. 'I can't make any friends,' Austin told her. They feared he might contemplate suicide. They decided to seek medical help. A psychiatrist put Austin on an anti-depressant. Ms Elizabeth thought the obesity specialist who had been treating her could help, too. Five weeks earlier, Dr Matt Lindquist at University Health in Kansas City, Missouri, near their home in suburban Gladstone, had started her on Wegovy, and she had already dropped 20 pounds, to around 220. That's how Austin and Ms Elizabeth found themselves filling out forms in Dr Lindquist's office in April 2023. Four months earlier, US regulators had approved Wegovy for teens with obesity, defined as a body mass index at or above the 95th percentile for children of the same age and sex. The doctor judged Austin, then 15 years old, to be in good overall health and a good candidate for Wegovy. The drug would tame the constant hunger Austin described. Dr Lindquist told Austin that after starting on Wegovy, he should cut his meal portions in half and eat more healthy proteins and vegetables. Even then, the doctor said, Austin might experience the common side effects of nausea and vomiting. Out of pocket, the more than US$1,000 ($1,286)-a-month cost of Wegovy would have been unaffordable. The Smiths live paycheck to paycheck on Ms Elizabeth's pay as a hospital billing clerk at University Health and what her husband, Jeremy, earns building courtroom exhibits. But Ms Elizabeth's employer-sponsored health insurance covered Wegovy. About a month after the visit with Dr Lindquist, the first box of Austin's Wegovy injections arrived. Ms Elizabeth, fearing Austin would get sick in class, asked him to wait to start the drug until after the school year ended in a week. 'I can't wait,' Austin said. She gave him his first injection that night. The effect was almost immediate. He used to come home from school and devour dozens of chicken nuggets while playing video games. Now, he felt full far sooner. Many nights, he stayed in his room at dinnertime. 'I felt a little bad because I couldn't eat my parents' cooking,' Austin said. The only side effect he experienced was a little stomach upset. Elizabeth began keeping a log of Austin's weight. At the start of his sophomore year, two months after starting Wegovy, Austin had lost 23 pounds. That's when he first noticed the difference: On the school bus that morning, he didn't bump into the seats while walking down the aisle. 'I was so happy to go home and tell my parents about it,' he said. In early September 2023, Dr Lindquist increased Austin's weekly dose of Wegovy to the maximum, 2.4 milligrams, as recommended on the label. Austin started vomiting after eating. Dr Lindquist cut the dose back to the previous 1.7 milligrams. The vomiting subsided. Austin reveled in his altered appearance, and his mood lightened. He told Ms Elizabeth the bullying had stopped. He liked to stand in his now billowing marching band uniform and pull the waistband outward to reveal gaping spaces. He was back to tending his oregano, thyme and other herbs growing in pots outside the front door. He played in the backyard with his puggle, Lucy, or one of his family's other two dogs. He spent weekends hanging out with his best friend, an elderly man in the neighborhood, gardening, walking their dogs and watching movies. In October 2023, five months into treatment, Austin was down to 232 pounds. Ms Elizabeth wrote Dr Lindquist to ask about his target weight for Austin. The doctor responded that he didn't set weight goals, preferring to focus on a patient's overall health, and was encouraged by Austin's progress. 'I would say he likely needs meds lifelong to support a healthy weight,' the doctor wrote. Ms Elizabeth's heart sank. 'I wouldn't want him to be on this for a lifetime,' she said. Austin didn't share those qualms. 'Before, I would look in the mirror and hate myself and wish I could be an entirely different person,' he said. 'Now I feel like I can accept myself a bit more.' He had dropped to 222 pounds by early December 2023. One Saturday, he came into the kitchen and lifted his shirt to show his family his now-visible ribs. For Christmas, Ms Elizabeth bought him extra-large pants and shirts to replace his 2XL clothes. 'He's like a whole new person,' his pediatrician told Ms Elizabeth, echoing many family friends and relatives. Austin's father was cheered by his son's physical and emotional transformation. Jeremy had lost about 30 pounds while taking Ozempic, Novo's medication for type 2 diabetes that has the same active ingredient as Wegovy. At a January 2024 appointment, Dr Lindquist chided Austin when he admitted to skipping meals. 'You need to put gas in your tank to make it go,' the doctor told him. He referred the teen to a nutritionist. Ms Elizabeth scheduled an appointment, but had to cancel because of a work conflict and hasn't booked a new visit. The following April, Austin was at 200 pounds. He celebrated the end of his sophomore year by taking a trip in June to Belize with other students. He snorkeled and went on eight different zip-lines through the rainforest. The weight limit for riding the zip-lines was 280 pounds. Back home, Ms Elizabeth wept when she watched the video Austin shared of him gliding through the trees. 'He couldn't have done this before,' she said. Soon after his return, he was hit hard by the death of his elderly friend. His psychiatrist prescribed a more powerful anti-depressant. Austin then panicked when, after Dr Lindquist stretched out Austin's dosages, he started eating more and putting on pounds. That stopped when he went back to regular weekly injections. The family got another shock in January, when Ms Elizabeth's insurance through University Health quit covering Wegovy and other so-called GLP-1 drugs for weight loss. Wegovy had been free, after insurance and Novo-provided coupons. Now, the health system would be providing Wegovy at US$250 for a three-month supply through its own pharmacy. Insurance coverage for Wegovy has steadily expanded since the drug's 2021 launch, and Novo has offered ways to bring down out-of-pocket costs. But employers and government agencies often impose restrictions to hold down costs associated with the drug's high price and the large number of patients eligible to take it. In 2024, 64 per cent of US employers with 20,000 or more workers covered GLP-1 drugs for obesity, up from 56 per cent in 2023, according to Mercer, a benefits consulting firm. Medicare and most state Medicaid programs don't cover the drugs solely for weight loss. Ms Elizabeth has been able to scrape together enough to cover the cost. She also had to find Austin another doctor at University Health after Dr Lindquist left to set up his own practice and the hospital stopped covering Wegovy for doctors outside of its network. Austin is just relieved that his parents can afford to keep his prescription going. His weight has leveled off at about 200 pounds – a 30 per cent loss in two years. He doesn't want to contemplate life without Wegovy. 'I feel I would be bigger,' he said. 'I don't want to go back.' 'What I'm doing isn't working' WILMINGTON, Delaware – At 15, Katie Duncan, 6-foot-1 and 270 pounds, was growing increasingly anxious and depressed about her weight. Some of her clothes no longer fit, she was easily winded while walking, and her back ached. Classmates occasionally lobbed mean comments about her size. Blood tests showed she had high triglyceride levels, which can increase the risk of stroke and heart disease. But Katie's hunger never let up. She often ate four or five meals a day. She would devour an entire pizza and hide snacks in her bedroom to satisfy cravings. She had tried an older weight-loss drug that did nothing. 'We need to change something,' she told her father, Randy, in the summer of 2023. 'What I'm doing isn't working.' Ms Katie Duncan uses Wegovy for weight loss. PHOTO: REUTERS Randy scheduled an appointment at the Healthy Weight and Wellness Clinic at the nearby Nemours Children's Hospital. The Duncans knew the hospital well: Katie had been treated there after she was diagnosed at age seven with a brain tumor. Doctors had given her a 20 per cent chance of surviving the cancer. Katie took an experimental drug and underwent months of chemotherapy and radiation. She was tiny at the time, only 42 pounds. The cancer went into remission within a year. However, the tumor had damaged her hypothalamus, the portion of the brain that controls hunger, and the nearby pituitary gland, which releases hormones that regulate growth and metabolism, among other key functions. Her doctors put her on a lifelong regimen of synthetic hormones and a low-dose steroid to replace what she lost. The brush with death forged a fierce bond between father, divorced since Katie was 3, and daughter, the youngest of five siblings and the only one still living at home. Randy, a paramedic and volunteer firefighter, took off from work to go to every doctor's appointment and physical therapy session with her. Katie treasured a locket with her father's photo inside and refused to go to school without it. He accompanied her on every school field trip. Katie tried a sleepaway camp hosted by the hospital and called her dad to pick her up after the first night. 'I don't like being away from my family,' she said. But by the time Katie was 9, Randy, now remarried, noticed something was wrong. Katie was constantly hungry, and the two clashed repeatedly over it. During a trip to SeaWorld in Florida, they shouted at each other when Katie complained that she was starving, even after a big breakfast at their hotel. Katie steadily put on weight during her middle-school years. She avoided running and other sports due to painful neuropathy in her feet, likely caused by her cancer and chemotherapy. She couldn't keep pace with classmates in physical education. At her appointment in 2023, Katie saw Dr Thao-Ly Phan, medical director of the Nemours weight clinic. After examining Katie and reviewing her medical history, Dr Phan determined that Katie probably has 'hypothalamic obesity' from her brain injury, for which the replacement hormones don't fully compensate. 'Her body isn't helping her out,' Dr Phan said. While brain cancer isn't common, Dr Phan said, teens can have other, more common underlying conditions or treatments that lead to obesity and complicate their care. For example, polycystic ovary syndrome can cause hormonal imbalances and weight gain, especially around the belly, in young women. Antidepressants, mood stabilisers and other psychiatric medications can lead to weight gain, too. After prescribing Wegovy, Dr Phan had Katie see the clinic's psychologist and nutritionist, a routine step the doctor requires of her patients. 'We don't want kids to lose so much weight that they develop eating disorders,' she said. 'We want to make sure that they're still getting the nutrition they need to grow and to thrive.' Katie got her first dose of Wegovy in November 2023. She lost about 20 pounds in the first couple months, with only mild side effects. At times, Katie had no interest in eating and skipped meals, despite Dr Phan's warnings not to. Poor nutrition and eating habits during adolescence can have long-term consequences, from impairing cognitive development to increasing the risk of osteoporosis and bone fractures, research shows. About six months after Katie started treatment, the family's insurer cut off coverage of her Wegovy. Randy's appeal of that decision failed, and he switched Katie's prescription to her secondary insurance with the state Medicaid program, which had been in place since her cancer treatment. Delaware is one of 14 states with Medicaid coverage for the newer GLP-1 weight-loss drugs. Katie missed only one weekly dose. At an appointment with Dr Phan in March, Katie weighed 209 pounds, down 60, or 22 per cent of her body weight, in about 18 months. Her triglycerides were no longer elevated. The weight loss has brought welcome changes. Katie said she used to lack motivation to do much at all and would lounge for hours in bed. 'I used to always feel yucky before,' she said. 'The weight loss has actually helped a lot with my energy.' The 17-year-old now enjoys regular visits to the Planet Fitness gym with her father and stepmother, Denise, and spends more time on her painting and crafts. She has more stamina to cook two hours straight in her high-school culinary class. She also doesn't get winded chasing after her two-year-old niece at family gatherings. While she used to hide herself in baggy clothes, she now feels comfortable wearing sundresses. Randy is pleased with Katie's progress. He worries that Delaware may stop covering GLP-1 weight-loss drugs through Medicaid due to budget shortfalls or proposed cuts in federal funding. California and North Carolina are seeking to rescind Medicaid coverage of the drugs to save millions of dollars. 'I hope to God they keep Wegovy around for kids,' Randy said. Katie wants to stay on the drug and trusts that her dad and her doctor wouldn't let her take anything harmful. 'Wegovy doesn't scare me,' she said. 'I've had so many needles in my life.' 'I'll do whatever it takes' DODGE COUNTY, Wisconsin – Early in 2024, after eight months on Wegovy, Leo had a choice to make. He could stop taking the drug, end the side effects that were wreaking havoc on his life and risk regaining some of the more than 25 pounds he had lost. Or he could stay on it, keep losing weight and hope the severe stomach aches, nausea and diarrhea would abate. For this article, Leo and his mother, Jamie, asked Reuters to withhold details such as their precise location and Leo's surname, and Leo declined to be photographed. They said they feared the exposure would lead to more teasing from Leo's peers about his appearance and his decision to take a weight-loss drug. Leo had been a strong candidate for Wegovy when he first saw an obesity specialist, Dr Leslie Golden, in mid-2023. He was a compulsive eater from an early age, due in part to his attention-deficit/hyperactivity disorder, for which he takes medication. He was diagnosed with obesity at 11 years old. Three years later, he was carrying 181 pounds on his 5-foot-4 frame. Jamie tried to stock the kitchen with healthier foods. But Leo's older sister and two older stepbrothers wanted ultra-processed snacks and sugary drinks around. Leo would gulp down five cans of Coke in a day. He sneaked snacks and sodas into his bedroom at night, leaving empty wrappers and cans for his mother to find strewn about the next morning. One of his stepbrothers was severely underweight, complicating Jamie's food choices for the family. The teasing and bullying started in middle school. When he walked the halls between classes, other students hurled jeers and jokes at him. 'It was always directed at my weight,' he said. 'The comments just got to me.' Leo knew he had a problem but felt powerless to do anything about it. 'I was eating way too much,' he said. 'I was worried I was going to get way too overweight.' Jamie, a pharmacist, thought Wegovy might help. Frustrated with her own efforts to lose weight, she had started taking the drug in January 2022. She, like Leo after her, suffered severe gastrointestinal side effects, but they faded, and after a year, she had lost 50 pounds. Leo, having learned what Wegovy did for his mother, was open to trying it. In June 2023, Leo had his first appointment with Dr Golden, at her obesity clinic in a town near where he and his family live about an hour outside Milwaukee, Wisconsin. He already bore troubling signs of the effects of his obesity. His blood pressure was high. His elevated blood sugar level put him at increased risk for type 2 diabetes. The doctor worried that Leo could develop liver and heart disease if he didn't lose weight. She prescribed Wegovy. Dr Golden doesn't require families to undergo counseling on lifestyle changes as a prerequisite for prescribing the drug for children. She said most families have already tried other ways to lose weight before they reach her office, and imposing a months-long delay before drug therapy 'is really just another form of bias and stigma'. She does ask for monthly visits so she can monitor a child's progress. Her patients pick three goals for the coming month – for nutrition, movement and behavior. For Leo, at one point, that meant eating more carrots and cauliflower, playing basketball in the driveway and downing fewer sugary drinks. Soon, Leo was eating a lot less, though what he ate didn't change so much. At restaurants, he could stomach only three bites of the double cheeseburgers he usually ordered. He was happy with the weight he was losing. The bullying was easing up, and some classmates even complimented him on looking thinner. He grew comfortable raising his hand in class. 'It feels pretty good to get myself out there,' he said. But as his doses steadily increased – the standard of care for GLP-1 medicines is to up the dose every four weeks – the side effects started taking a toll. He took medicines to quell the nausea and diarrhea. He dropped off anti-diarrhea pills with the school nurse. Some days, his stomach upset was so bad that Jamie had to pick him up at lunchtime. Leo was experiencing by far the most common side effects of Wegovy. In the largest clinical trial of the medicine on teens, 62 per cent of patients experienced nausea, vomiting and diarrhea. Most reported mild to moderate side effects that lasted two to three days. Since their launch, Wegovy and other GLP-1 drugs have also been associated with much rarer incidents of gastric paralysis, pancreatitis, depression and blindness. As his absences piled up, Leo's grades suffered, and he grew moodier. At a parent-teacher conference in October 2023, teachers told Jamie that Leo had become more withdrawn in class. At a checkup with his regular pediatrician later that month, his answers on a questionnaire indicated depression. The doctor prescribed an antidepressant. That didn't lessen the side effects, though, and Leo's school absences persisted. In February 2024, the high school notified his mother that he had missed 10 days, the maximum allowed for the year. Soon after that is when Dr Golden presented Leo with the choice about continuing with Wegovy. Jamie favored sticking with the drug. The doctor wanted the choice to be Leo's. 'Jamie is a very involved parent who wants to protect and do what's best for him,' Dr Golden later told Reuters. 'I had to really zone in on Leo: Do you want to keep taking this?' Despite the physical pain and discomfort, the problems at school, the depression, Leo was adamant. 'I'll do whatever it takes,' Leo told Dr Golden. 'No matter how sick I get, I don't want to stop.' Several weeks later, the side effects began to ease. By last summer, Leo had dropped under 150 pounds. His waist had shrunk by five inches. Based on his body mass index, he no longer had obesity. 'I am happy that I don't get called names anymore,' Leo said. Then last autumn, he started to put on weight. Dr Golden had reminded Leo that some additional weight was expected as he grew three inches taller over the span of a year, eventually reaching 5 foot 7. But Leo's mother found food wrappers and soda cans in his bedroom. In November 2024, Leo wept when he stepped on the scale at home and saw that he had gained 14 pounds, up to 164. 'I'm getting fat again,' he told his mother. At an appointment with Dr Golden the following month, the doctor put Leo on the highest weekly dose of Wegovy to help counter his cravings. That worked, without the side effects he had experienced earlier. At a checkup in April, Leo weighed 154 pounds, down nearly 30 pounds in the past two years. Leo took a cooking class during his sophomore year and hopes to attend culinary school one day. He also took a part-time job stocking shelves at the local hardware store. Leo's pediatrician was pleased with his improved self-esteem and energy level. She asked Jamie: 'What is the end game? When is Dr Golden going to stop it?' That's an open question. Dr Golden has repeatedly advised Leo that he will probably have to take Wegovy for the rest of his life to maintain a healthy weight. Leo and his mother are OK with that. 'There is no end game,' Jamie told the pediatrician. Afraid of gaining it back FREDERICK, Maryland – Ms Stephanie Serrano didn't want to take a weight-loss drug. She didn't think it would work, and even if it did, she didn't like injections, especially if she had to get them for the rest of her life. But Ms Stephanie was desperate. At 320 pounds, she had already been diagnosed with type 2 diabetes and liver disease. She was tired of being the biggest kid in class and had become a virtual shut-in after years of failed dieting. 'Every doctor that I had ever seen would just tell me to eat healthier, like it was that simple,' Ms Stephanie said. In 2022, her family doctor referred the then-16-year-old to the obesity clinic at Children's National Hospital in Washington, DC. There, initial tests revealed that she had polycystic ovary syndrome, a common cause of weight gain in young women. 'That diagnosis changed everything,' she said. 'I wasn't lazy or not trying hard enough. My body was actually working against me.' In October that year, Ms Stephanie's doctor at Children's National, Dr Susma Vaidya, prescribed Ozempic, Novo's drug for type 2 diabetes with the same active ingredient as Wegovy, which hadn't yet been approved for teens. Ozempic has been widely used off-label for weight loss, both prior to Wegovy's launch and after due to shortages and spotty insurance coverage of the latter. By the time she saw Dr Vaidya, Ms Stephanie had her heart set on weight-loss surgery, swayed by TikTok videos of young adults showing their dramatic before-and-after transformations. 'Seeing how much they changed, it's incredible,' she said. 'So that's kind of what I wanted for my life. I wanted a permanent change.' Ms Stephanie Serrano lost weight by using Ozempic and undergoing bariatric surgery. PHOTO: REUTERS Dr Vaidya, medical director of the obesity clinic at Children's National, persuaded Ms Stephanie to accept a compromise: Ms Stephanie would give Ozempic a try while undergoing a six-month evaluation, including sessions with a dietician and a psychologist, to determine whether she was a good candidate for surgery, based on factors like adequate family support and eating regular, well-balanced meals. Ms Stephanie started taking the lowest recommended dose of Ozempic. The side effects were mild, though she occasionally experienced nausea and stomach pain after a big meal. She lost nine pounds in the first month. After four months, in February 2023, she was surprised – and pleased – that she had lost about 30 pounds. 'I had never seen the number on the scale go down,' she said. At that point, Dr Vaidya told Ms Stephanie she could continue taking the drug, or she could undergo surgery. Ms Stephanie's father, Jose, who was taking Ozempic for his type 2 diabetes, preferred that she stick with the drug. He worried about her risk of complications from a major operation. Ms Stephanie held firm. Despite her weight loss on Ozempic, she felt that surgery was the only way to end the isolation she had endured for years. Since the start of the Covid-19 pandemic, Ms Stephanie had retreated from school and friends. In 2021, during her sophomore year, her high school gave students the option to return or continue with online classes. She never went back to the classroom. Through the lens of social media, she watched classmates gloat about their beauty 'glow ups' and post photos of themselves with new makeup routines and outfits. MS Stephanie quit the school's Junior Reserve Officers' Training Corps, a leadership program sponsored by the US military, to avoid being around other people. 'I hid myself for those years,' she said. 'I no longer wanted to be a prisoner.' In April 2023, Ms Stephanie, at about 285 pounds, had gastric-sleeve surgery, which involved removing a large portion of her stomach to reduce food intake. She came through the surgery and recovery without complications. Today, the 19-year-old college freshman is down to about 175 pounds. She eats small meals and exercises regularly. Her diabetes is in remission, and her liver function is normal. She takes a full load of classes at a nearby community college and plans to transfer to a four-year university soon. She aspires to be a sports psychologist. As Ms Stephanie lost weight, she became more outgoing at school and in church and found she could make friends. She opened up to the possibility of a relationship and flirted with a young man at church. That didn't go anywhere, but she had surprised herself with her willingness to even try. 'Having a crush on anyone seemed so silly before. I could never imagine someone loving me,' she said. 'I was always ashamed of myself.' Amid all this progress, another problem emerged: Ms Stephanie was consumed with fear of gaining the weight back. She started skipping meals and guzzling energy drinks. After eating a small meal, she would run a mile to burn off the calories. Her legs and back began to ache, and she sometimes lost her balance – signs of possible muscle loss. Dr Vaidya told her, 'This is your body asking for protein.' Dr Vaidya diagnosed Ms Stephanie with an eating disorder in April 2024 and referred her to a hospital psychologist. Dr Vaidya also prescribed bupropion, an anti-depressant sometimes used to manage binge eating. The possibility that weight-loss drugs may put teens at risk of disordered eating is why some doctors urge rigorous screening of patients and continuous monitoring during treatment. Research on any association between weight-loss drugs or bariatric surgery and eating disorders is limited. Some small studies found that the use of GLP-1 drugs may decrease binge eating episodes among those who already had the disorder. But the studies only tracked patients for three to six months, leaving longer-term effects unknown. Ms Stephanie's psychologist urged her to stop counting calories and poring over the nutrition labels on packaged foods. She's making progress, but it's a 'constant battle,' she said. Stephanie still gives in sometimes to count calories, and when she exceeds her target, 'I completely shut down.' At home, Ms Stephanie does much of the cooking for her parents and older sister, Lily. She rarely eats what she cooks. At a recent dinner, her family enjoyed the carne asada, beans and pico de gallo she had prepared while she picked at a small bowl of rice and a homemade tortilla. She didn't finish either. Later, Ms Stephanie, her mother, Ms Vanessa Serrano, and Lily visited a local mall – a place she used to avoid because it was hard to find clothes her size there. At the American Eagle store, she tried on a pair of black jeans. She emerged hesitantly from the dressing room to have a look in a mirror. After Lily told her she looked incredible and snapped photos, Ms Stephanie checked herself out from several angles. She bought the jeans and wore them to church the next day. REUTERS Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
3 days ago
- Straits Times
‘I'll never try again': For some Palestinians in Gaza, seeking aid is just too risky
More than 50 Palestinians were killed waiting for aid in Khan Younis on June 17, according to the Gaza Ministry of Health, which blamed Israel for the deaths. PHOTO: AFP 'I'll never try again': For some Palestinians in Gaza, seeking aid is just too risky Saleem Abdul Kareem walked for hours just to get a food handout June 17 morning at a traffic circle in the southern Gaza Strip city of Khan Younis. When he arrived, he came upon a scene of carnage. 'I saw so many dead and injured; all I could think about was running,' Mr Kareem, 32, told The New York Times in a telephone interview. 'This was my second attempt to get aid. I got nothing either time, and after what I saw, I'll never try again.' More than 50 Palestinians were killed waiting for aid in Khan Younis on June 17, according to the Gaza Ministry of Health, which blamed Israel for the deaths. The Israeli military said that a crowd had gathered near a stranded aid truck in the city and that it was aware of reports that people had been wounded by Israeli fire when they approached the truck. On June 16, the Health Ministry said, at least 20 Palestinians were killed by Israeli forces and more than 200 wounded when a crowd gathered early near an aid distribution site in southern Gaza. Israel said it was still looking into those reports. Nearly every day, large crowds of desperate and hungry Palestinians flock to the few aid distribution points left in Gaza, waiting for hours and jostling for a place in the line to get food handouts before they run out. People carrying sacks of flour walk along al-Rashid street in western Jabalia, on June 17. PHOTO: AFP Some of the aid sites began operating a few weeks ago under a controversial new Israeli-backed system run by an American-led company, the Gaza Humanitarian Foundation, which largely replaces a system overseen by the United Nations. Israel says the aim of the new system is to provide food to civilians without it falling into the hands of Hamas militants. And the UN and other aid groups are also still sending some limited aid into Gaza. International relief organisations, including the UN, have said the amount of aid getting through is woefully inadequate, a shortage that is only increasing desperation in the enclave. They have also condemned the new system for forcing civilians to pass Israeli soldiers on the perimeter of the sites to reach the food, putting them in greater danger. In recent weeks, Israeli forces have repeatedly used deadly force to control crowds on the approaches to the new aid sites, forcing many Gaza residents to choose between letting their families go hungry or risking getting shot. 'The danger is too high for me to go to these centers,' Awni Abu Hassira, 38, from Gaza City, said in a phone interview. 'I don't want to face death this way.' People ride atop and hang onto a firetruck transporting them as others walk around them carrying sacks of flour along al-Rashid street in western Jabalia, on June 17. PHOTO: AFP In June 17's episode, the Israeli military said that 'a gathering was identified adjacent to an aid distribution truck that got stuck in the area of Khan Younis' near Israeli forces conducting operations. It was not immediately clear which aid group the truck was linked to. Videos shared on social media and verified by the Times showed the aftermath of the violence June 17 in Khan Younis, where crowds of people had gathered around the Tahlia traffic circle to wait for aid early in the day. In one video by a local photographer, at least 20 bodies are visible on darkened ground where blood is pooling. Two of the bodies are severely mangled, and two other people have bleeding head wounds. Other footage circulating on social media and reviewed by the Times shows people screaming and yelling as crowds run through the area. Asked about the deadly incidents June 16 and 17, the Gaza Humanitarian Foundation said in a statement that its distribution sites were not involved. Other aid organisations, the statement said, 'struggle to deliver aid safely' and are at risk of looting. The Israeli statement, using the abbreviation for the Israel Defense Forces, said it was 'aware of reports regarding a number of injured individuals from IDF fire following the crowd's approach'. It said the military 'regrets any harm to uninvolved individuals'. Israel also said that two of its soldiers had been killed in combat in southern Gaza in recent days. On both June 16 and 17, some victims were taken to a hospital in Khan Younis. On June 16, Naseem Hassan, a medic at a hospital in Khan Younis, described the difficulty of aiding people who were shot as they tried to collect food from a nearby aid distribution point. He said scores of Palestinian victims had been rushed to his hospital. 'People who are injured have to crawl or be carried for over a kilometre to reach us,' said Mr Hassan, who works at Nasser Hospital. 'We couldn't reach the aid centers; ambulances can't get there,' he said. Israel says the aim of the new system is to provide food to civilians without it falling into the hands of Hamas militants. PHOTO: AFP The United Nations has warned that Gaza's population is on the brink of famine, with thousands of children already severely malnourished. 'The facts speak for themselves,' said Volker Türk, the UN human rights chief. Speaking in Geneva on June 16, he called Israel's military campaign in Gaza a source of 'horrifying, unconscionable suffering'. 'All those with influence must exert maximum pressure on Israel and Hamas to put an end to this unbearable suffering,' he said. NYTIMES Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
4 days ago
- Straits Times
White House health efforts need farm industry input, over 250 agriculture groups say
FILE PHOTO: U.S. President Donald Trump, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., Secretary of Agriculture Brooke Rollins attend a Make America Healthy Again (MAHA) Commission event, in the East Room of the White House in Washington, D.C., U.S., May 22, 2025. REUTERS/Evelyn Hockstein/File Photo/File Photo WASHINGTON - More than 250 groups representing farmers, ranchers, and agrochemical companies urged the Trump administration on Tuesday to seek their input on future activities of the Make America Healthy Again commission, after the body's first report pointed to pesticides as a possible health risk. The farm sector has been pushing for more involvement in the work of the commission, established by President Donald Trump in February and named for the social movement aligned with Health Secretary Robert F. Kennedy Jr. The commission is tasked with identifying the root causes of chronic disease, and Kennedy has pointed to highly processed food and chemicals such as food dyes as contributing to poor health outcomes. The MAHA report released in May was produced without adequate input from the farm sector and as a result, "contained numerous errors and distortions that have created unfounded fears about the safety of our food supply," said the letter sent on Tuesday morning to Kennedy, Agriculture Secretary Brooke Rollins and Environmental Protection Agency Administrator Lee Zeldin. "The MAHA Commission would benefit from inviting public comment and formally including representatives from food and agriculture in any future reports," said the letter. Its signatories included the American Farm Bureau Federation and trade groups for corn, soy, livestock, and other farm products. A spokesperson for the Department of Health and Human Services said the agency welcomes farmers' input. "Their perspective is essential to the mission of the MAHA commission, and we look forward to continued dialogue to ensure our work will Make America Healthy Again," the spokesperson said. A spokesperson for the Department of Agriculture said Rollins would ensure farmers were part of the conversation about finding solutions to the problems identified in the MAHA report. The EPA did not respond to a request for comment. Before the release of the MAHA report, the farm industry had pressed the administration not to mention pesticides, which industry groups say are critical tools for maintaining a competitive American farm sector. The report, which contained errors including the citation of nonexistent studies, pointed to crop protection tools like pesticides and insecticides as possible contributors to negative health outcomes, but noted that agrochemicals are subject to robust EPA review. Trump directed the MAHA commission to produce a second report in August that contains a strategy for tackling childhood chronic disease. Rollins and Kennedy have been working together to advance other MAHA priorities, including urging states to bar junk food and sodas from the nation's largest food aid program and revising the dietary guidelines that make recommendations on what Americans should eat. REUTERS Join ST's Telegram channel and get the latest breaking news delivered to you.
