This Nurse Practitioner Lost 100 lbs Taking the Weight Loss Drug Contrave

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2 months ago

December 16, 2024

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Share on Pinterest Nurse practitioner Tim Nicaise tried everything to lose weight without success. Then his doctor prescribed the drug Contrave and his life changed. Image Provided by Tim NicaiseNurse practitioner Tim Nicaise reached 300 pounds before turning to anti-obesity medication.After years of trying to lose weight and improve his health, his doctor recommended Contrave.A year after stopping the medication, Nicaise has maintained an 85-pound weight loss.

Tim Nicaise grew up competing in gymnastics, which helped him maintain a weight of about 140 pounds for most of his life.

However, in his late 20s, he began socializing and eating out more, and in his early 30s, after becoming a dad, life stressors began to push him toward an unhealthy relationship with food. As a nurse practitioner, the pressure of caring for people also played a part, especially during the pandemic.

Once the pandemic hitmy job really pivoted to crisis mode where I was seeing patients who were dying that shouldnt be dying, so patients who one week or two weeks prior were walking and healthy, Nicaise told Healthline.

My mental health was just depleted at that time, and food became even more of a comfort for me. you had to do whatever you could do to feel better at that point and get yourself through the day.

In 2023, Nicaise reached 300 pounds, was prediabetic, and had sleep apnea. He was also taking three blood pressure medications.

I didnt even look like the same person. I hated looking in the mirror. I hated everything about myself at that point, he said.

For the previous six years, he tried to get healthy by reading wellness books and following different diets like Weight Watchers and Keto. However, nothing worked.

I had really damaged and altered my body so much that I needed a complete overhaul of who I was; not just diet, but exercise, mental health, setting boundaries with family, said Nicaise. Turning to medication

In January 2023, Nicaises doctor suggested he consider taking an anti-obesity medication because he was on the brink of needing a fourth blood pressure medication. At first, he was apprehensive about taking an anti-obesity medication due to stigma.

It almost seemed like it was an easy way out, and I had failed. I am a medical professional and am not a person [who goes to] a pill for every ill situation, he said.

Due to insurance coverage issues, Nicaise was not eligible to take a GLP-1 drug like Zepbound or Wegovy. However, he did get preauthorization from his insurance to cover Contrave, an oral combination of bupropion and naltrexone.

Bupropion, famous by trade-name Wellbutrin for depression, is a dopamine/norepinephrine reuptake inhibitor, which increases those brain hormones in the areas of the hypothalamus which send signals to reduce appetite, Karl Nadolsky, DO, a clinical endocrinologist and obesity specialist at Holland Hospital and clinical assistant professor of medicine at Michigan State University, told Healthline.

Naltrexone is an opioid antagonist approved for alcohol misuse disorder. Nadolsky said it blocks the negative endorphin feedback, and this blocking helps to amplify the benefits of bupropion.

Contrave also works on the mesolimbic areas of the brain and seems to have more benefits in those who describe cravings or food addiction, Nadolsky said. Differences between Contrave and GLP-1 drugs like Ozempic

There are several differences between Contrave and GLP-1 receptor agonist medications like Ozempic, Wegovy, and Zepbound.

First, the two medicines in Contrave target the pathways known to regulate mood, energy expenditure, cravings, and pleasure sensation in the brain, said Allison Rhodes, MD, dual-certified obesity medicine and internal medicine physician at The Ohio State University Wexner Medical Center.

GLP-1 receptor agonists are incretin mimetics, a.k.a. similar copies of our own gut hormones. GLP-1 slows gastric emptying, increases release of insulin when sugar (glucose) is present, suppresses glucagon secretion and therefore liver glucose output, stimulates glucose uptake into cells, and increases proliferation of the cells in the pancreas that make insulin, Rhodes told Healthline.

GLP-1s also increase glucose uptake and storage in muscles and decrease hunger through multiple pathways in the brain.

Overall, these collective effects reduce food intake, increase satiety, and improve glucose metabolism, which can lead to robust weight loss, said Rhodes.

While Contrave has no direct benefits for diabetes, Nadolsky said GLP-1s can improve pancreatic insulin secretion and glucagon inhibition of the liver.

Side effects from each may vary too, said Caroline Messer, MD, an endocrinologist at Northwell Lenox Hill Hospital.

Contrave may cause some fatigue, anxiety, agitation, and increased risk of seizures. The side effects from GLP1s are almost exclusively gastrointestinal in nature, she told Healthline.

However, more serious side effects have also been reported.

Contrave is typically much cheaper, and there are coupons that can make the medication affordable, Messer noted.

The way the medications are taken also varies. While Contrave is a pill that is taken twice daily, the most common forms of GLP-1s used for weight loss are subcutaneous injections given once a week.

Naltrexone has a half-life of 5 hours, and extended-release bupropion has a half-life of 21 hours, whereas weekly dosed GLP-1 receptor agonist medications have a half-life of 7 days, Rhodes said. Weight loss differences between Contrave and GLP-1s like Ozempic

The average weight loss with Contrave is more modest than semaglutide or tirzepatide.

But for those who respond early, as assessed by 5% weight loss in the first few months, average around 11% weight loss, which is very clinically meaningful, said Nadolsky.

After six months of taking Contrave, Nicaise lost 100 pounds. In addition to taking the medication, he ate a low-carb diet and practiced intermittent fasting. He also walked every day, ensuring he reached either 20,000 steps or 10 miles.

He also continued to see a therapist he had been going to for years for additional support in his weight loss journey.

[She helped me on how] I can mentally get myself in a better place to lose the weight and become physically more well, along with mentally more well, said Nicaise.

He said the process of losing weight was largely connected to his mental well-being and that Contrave provided a psychological benefit.

I would say it calmed my desire to comfort myself with food. I used to think about food all the time and snacking was a huge thing for me and it dampens that desire to reach out to food and it allowed me to find other avenues like exercise and meditation.I was replacing times that I didnt need to eat with other activities, he said.

Nicaise has been off Contrave for a year and has gained back 15 pounds. He has lower cholesterol, blood sugar, and blood pressure and no longer has sleep apnea. He continues to follow the same diet, and his daily walks have turned into daily runs. He also continues to see his therapist regularly.

He now takes naltrexone alone for its mental health benefits.

My weight loss journey has changed my life like a complete 180, he said. Im happier. Im not as irritableI feel better, and the most unexpected of the weight loss journey is honestly getting my self-esteem back and self-confidence. Encouraging others to begin their weight loss journey

For others who want to improve their health through weight loss, Nicaises biggest advice is to reject being embarrassed about how they reached their current weight and instead look forward.

Dont be embarrassed to talk to your doctor about it. If your doctor doesnt want to talk to you about it, find a new doctor, he said. Your weight plays such a role in so many aspects of your health and once you can get that thing under control, the changes you notice in your day-to-day life are just extraordinary.

Because every person has unique risk factors that contribute to the development of overweight and obesity, your doctor ca determine which type of medication is best for you.

Obesity is a chronic, multifactorial disease that requires a multifaceted, individualized approach to create a sustainable, adaptive plan that manages nutrition, physical activity, behavior, and selection of pharmacotherapy to optimize healthy weight loss, said Rhodes.

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Pope Francis has ‘initial, mild’ kidney problem and still in critical condition, says Vatican

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2 hours ago

February 23, 2025

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Pope Francis has 'initial, mild' kidney problem and still in critical condition, says Vatican

The Pope remains in a critical condition and is now showing an “initial, mild” kidney problem – but is “vigilant” and took part in Mass in hospital with those caring for him.

The Vatican statement said Francis hadn’t had any more “respiratory crises” since Saturday evening.

However, a problem with his kidneys has emerged, with blood tests showing “an initial, mild, renal insufficiency, which is currently under control”, according to the update.

The 88-year-old Pope is still having “high-flow oxygen therapy” into his nose, while his hemoglobin value has increased after being given blood transfusions on Saturday.

The Pope has been at Rome’s Gemelli hospital since 14 February and is being treated for double pneumonia and chronic bronchitis.

Sunday evening’s statement said he was “vigilant and well oriented”, but due to the complexity of his case the prognosis is “reserved”.

“During the morning, in the apartment set up on the 10th floor, he participated in the Holy Mass, together with those who are taking care of him during these days of hospitalization,” the update added.

On Sunday morning, the Vatican said the Pope had a “tranquil” night and confirmed he would not lead prayers for the second week running.

Instead, Francis, who has been Pope since 2013, prepared words to be read on his behalf at the recitation of the Angelus.

‘I ask you to pray for me’

The Pope’s message said: “I am confidently continuing my hospitalisation at the Gemelli Hospital, carrying on with the necessary treatment; and rest is also part of the therapy!

“I sincerely thank the doctors and health workers of this hospital for the attention they are showing me and the dedication with which they carry out their service among the sick.

“In recent days I have received many messages of affection, and I have been particularly struck by the letters and drawings from children.

“Thank you for this closeness, and for the prayers of comfort I have received from all over the world! I entrust you all to the intercession of Mary, and I ask you to pray for me.”

The message is understood to have been written in the last few days.

On Saturday night, the Vatican said the Pope was in a critical condition after a “prolonged respiratory crisis” that required a high flow of oxygen.

It said he’d had blood transfusions after tests revealed thrombocytopenia, which is associated with anaemia.

Millions around the world have been concerned about his increasingly frail health – and his condition has given rise to speculation over a possible resignation.

Faith is never lost but it feels optimism is fading

By Lisa Holland, Sky correspondent in Vatican City

It’s hard to imagine a Sunday in the Vatican City without the Pope. Every week – unless he’s travelling – he is a constant, appearing at the same Vatican windows to deliver his message.

Instead, his written words were distributed by Vatican officials. In his message, the Pope thanked his doctors and people around the world for their good wishes.

But it seems the upbeat message was written before the dramatic downturn in the Pope’s health, which has left him in a critical condition. The business and the events of the Church are continuing in his absence.

Faith is never lost but it feels like optimism is fading and we are living through the last days of Pope Francis.

In St Peter’s Square the sun shone – and a gentle light fell on the ancient stone of the basilica.
The beauty and pageantry of columns of deacons and visitors filing in for a special mass as part of the Catholic Church’s jubilee year sat awkwardly with the prognosis of the Pope’s ailing health.

The visitors and deacons who’d come from around the world to take part, and hoped to see the Pope, were left disappointed. Though they said they felt his presence. “It is what it is,” said one.

They know the Pope is an 88-year-old man who has spent the last few years assisted by a wheelchair and walking stick. Throughout his life he has been dogged by lung issues.

It leaves an almost philosophical mood ahead of what the coming days may bring.

Doctors said on Friday that he was “not out of danger” and was expected to remain in hospital for at least another week.

They also warned that while he did not have sepsis, there was always a risk the infection could spread in his body.

Sepsis is a complication of an infection that can lead to organ failure and death.

Pope Francis has a history of respiratory illness, having lost part of one of his lungs to pleurisy as a young man. He also had an acute case of pneumonia in 2023.

Environment

Volvo Penta set to show off its new BESS subsystem at bauma 2025

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4 hours ago

February 23, 2025

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Volvo Penta set to show off its new BESS subsystem at bauma 2025

Volvo Penta BESS subsystem to be Bauma highlight

Volvo Penta will debut its latest modular and scalable battery energy storage system (BESS) platform for the off-grid construction and mining industries at the bauma equipment show – here’s what you can expect.

Best-known for its marine engines and gensets, Volvo Penta is the power production arm of the Volvo Group, specializing in putting energy to work. Operating under the tagline, ‘Made to Move You’, Volvo Penta is headed to bauma 2025 with a plan to keep construction, port shipping, and mining operations moving productively and competitively throughout their transitions to battery and (in theory, at least) hydrogen power.

To that end, the company will show off a job site ready version of the scalable and modular BESS subsystem concept shown last year.

Volvo says its new, modular BESS subsystem will enable other OEMs and third party system integrators to seamlessly deploy electric power to meet the ever-exceeding energy needs in construction and mining.

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“Our modular and scalable battery-electric platform is designed to support the electrification ecosystem—combining high-performance drivelines with the crucial energy storage subsystems for efficient charging and operation in construction and mining,” says Hannes Norrgren, President of Volvo Penta Industrial. “We want to meaningfully collaborate with our customers on value-added customization that will enable them to stay productive, efficient, and future-ready.”

The Penta substation at bauma will be built around the company’s “Cube” battery pack, an energy-dense solution with a favorable C-rate designed to make it easy for BESS manufacturers to offer more compact job site solutions capable of charging and discharging energy with high levels of speed and efficiency, enabling both stationary and mobile BESS configurations that can change and grow to meet the evolving needs of a given asset fleet or project.

A Volvo Penta-developed DC/DC unit converts the voltage from the Cube battery packs (600 V) into lower voltage (24 V) for powering auxiliaries and portable offices.

Electrek’s Take

BESS concept packed with Penta Cube batteries; via Volvo.

Volvo Penta has always provided power. Historically that’s been from combustion, but the company is looking ahead, developing products that will bring energy to job sites, tractors, and more long after the last ICE engine shuts down.

SOURCE | IMAGES: Volvo Penta.

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World

Exit poll may appear decisive – but path to coalition is not clear yet

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5 hours ago

February 23, 2025

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Exit poll may appear decisive - but path to coalition is not clear yet

Initial exit polls appear to confirm what we have known for weeks: that the conservative Christian Democrats (CDU) and their Bavarian sister party the Christian Social Union (CSU) have got the most votes in the federal election, with Friedrich Merz most likely to be the next chancellor.

While this result isn’t a surprise, it doesn’t mean the path to power will be easy.

First off, the CDU-CSU don’t have a majority so they need to try to build a coalition.

Their most obvious choices as partners are the third-place Social Democrats. A two-party coalition is preferred as it can avoid excess bickering but the SPD and CDU disagree on several key points including sending long-range Taurus cruise missiles to Ukraine.

Follow live: Germany’s election results

Forming a government can take months but Mr Merz is keen to speed up the process – aware of the pressing issues both at home and abroad.

One of those is the rise of the far right, with the Alternative for Germany (AfD) party celebrating historic results.

The initial results suggest that for the first time since the Second World War, a far-right party has got the second highest number of votes.

That could also cause serious issues for the next government.

As a result of Germany‘s Nazi history, mainstream parties have a long-running pact known as the “firewall” which says they will not work with the far right.

Even before the polls had closed, AfD leader Alice Weidel echoed Donald Trump and released a video statement urging people to “observe” the ballots being counted and to “protect democracy”.

Many of the AfD’s supporters have said not allowing the second most popular party into government is undemocratic, threatening to take to the streets.

The US vice president JD Vance also sparked outrage when he spoke out against the firewall at the recent Munich Security Conference and suggested the new Trump administration would be ready to work with the AfD.

Conversely, in the run-up to the election, hundreds of thousands of Germans have protested to demand that the firewall remains.

In January, Mr Merz caused controversy when a draft motion got through parliament with AfD support, he’s since vowed he will not go into government with them.

If he sticks to that pledge then he is likely to see right-wing demonstrations as well becoming a target of prominent AfD backers including Elon Musk.

The AfD’s result also cannot be ignored. While some of the vote may be a protest, the party has expanded its traditional base in the east to pick up support in the west.

Dissatisfaction over migration, the economy, rocketing prices and the war in Ukraine have all helped to grow its ranks as people feel ignored by mainstream parties.

Mr Merz has already tried to win back some of its voters by proposing tough migration reforms including permanent checks on the borders and potentially turning away some asylum seekers when they try to enter.

If he fails to deliver on these promises then the AfD will continue to make gains.

Other urgent to dos for the next government include sorting out Germany’s economy following two years of recession and restoring its position at the centre of the EU.

Ministers must also face up to the fact their traditional allies are no longer guaranteed.

The Trump administration appears to be ripping up the rule book when it comes to being a protector of Europe and its ongoing support for Ukraine.

If America steps back, as Europe’s largest power and Ukraine’s largest European backer, Germany will have to step up.

Again, that’s going to be a big challenge as its military needs to be transformed.

The final results are not even confirmed yet but whatever form it takes, the next government knows it has four years to fix Germany, if it fails then populists are highly likely to ride to power in 2029.