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

Published

6 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.

Politics

Welfare concessions ‘common sense’, says PM – as he defends U-turn

Published

1 hour ago

June 27, 2025

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Welfare concessions 'common sense', says PM - as he defends U-turn

Sir Keir Starmer said changes to his welfare bill “strike the right balance” after making concessions to his backbench MPs.

The prime minister described the U-turn as “common sense” and said it means “we can now get on with the job”.

Politics Live: Starmer defends U-turn

Sir Keir faced a significant rebellion over plans to cut sickness and disability benefits as part of a package he said would shave £5bn off the welfare bill and get more people into work.

Speaking to reporters on Friday, he stood by his position that the welfare system needs reform as “it doesn’t work, and it traps people”.

He added: “We need to get it right. That’s why we’ve been talking to colleagues and having a constructive discussion.

“We’ve now arrived at a package that delivers on the principles with some adjustments, and that’s the right reform, and I’m really pleased now that we’re able to take this forward.

“For me, getting that package adjusted in that way is the right thing to do, it means it’s the right balance, it’s common sense that we can now get on with it.”

The concessions include exempting existing Personal Independence Payment claimants (PIP) from the stricter new criteria, while the universal credit health top-up will only be cut and frozen for new applications.

Analysis: Welfare bill U-turn a humiliating blow for Starmer

More money will also be front-loaded into helping people find jobs, though it is not clear how much beyond the £1bn already announced.

The changes came after 127 Labour MPs signed an amendment calling for the cuts to be delayed and consulted on with disabled people.

Rebels feared the reforms wouldn’t actually help people find work while pushing thousands of disabled people and children into poverty, as per the government’s own impact assessment.

The discontent threatened to derail the Universal Credit and Personal Independence Payment Bill when it comes before the Commons for a vote on Tuesday, on the week that marks a year of Starmer in government.

Asked what he would do about a “hole” in the public finances that the changes are said to leave, Sir Keir said the funding will be set out in the autumn budget “in the usual way”.

The concessions on PIP alone will protect an estimated 370,000 people currently receiving the allowance who were set to lose out following reassessment.

Economists at the Institute for Fiscal Studies and the Resolution Foundation have both suggested that the changes could reduce savings intended in the original package by up to £3bn.

Chancellor Rachel Reeves is also under pressure to find money to pay for the U-turn on cuts to winter fuel, which followed a drubbing at the local elections in May.

Asked about the series of U-turns, Work and Pensions Secretary Liz Kendall earlier said: “Sometimes there’s strength in listening.

“I really believe that to be the case, that you end up in the right position when you talk to all of those with knowledge and experience and actually, if you want decisions to be the right ones and to last for generations to come, I believe that’s how you make the right changes.”

However, she would not guarantee the bill will pass next week.

Some 83 Labour MPs would need to rebel for the government to be defeated.

Last night Dame Meg Hillier, one of the leading rebel voices, hailed the concessions as “massive changes” to protect vulnerable people and involve disabled people in the design of future reforms.

However, not all the rebels have been satisfied with the changes, with several suggesting they would create a “two-tier system”. Sky News is aware of at least 20 MPs who currently intend to still vote against. Many others are undecided.

The concessions came after Downing Street publicly stuck to its guns while engaging in a frantic ring-around to get rebels onside, which further angered MPs.

Many have called for a reset in relations with Downing Street, as the fallout from the rebellion threatens to cause lasting damage.

Conservative leader Kemi Badenoch criticised the U-turn, saying the government’s failure to make “minor savings” on welfare showed they were unable to deal with major issues.

US

US Supreme Court curbs injunctions that blocked Donald Trump’s birthright citizenship plan

Published

1 hour ago

June 27, 2025

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US Supreme Court curbs injunctions that blocked Donald Trump's birthright citizenship plan

Donald Trump’s administration will be allowed to take steps to implement its proposal to end automatic birthright citizenship in the US following a decision by the Supreme Court.

Under the current rules, nearly anyone born on US territory has automatic citizenship rights – commonly known as “birthright citizenship”.

But in January, on his first day back in the White House, Trump signed an executive order aimed at ending that right.

A series of lawsuits followed, with district courts issuing nationwide injunctions aiming to block the order from taking effect.

The Supreme Court on Friday voted 6-3 to allow the Trump administration to narrow the scope of nationwide injunctions imposed by judges so that they apply only to states, groups and individuals that sued.

This means the birthright citizenship proposal can likely move forward at least in part in the states that challenged it, as well as those that did not.

The US president responded with a post on Truth Social by welcoming the ruling as a “giant win”.

At a news conference at the White House, he said: “In recent months, we’ve seen a handful of radical left judges effectively try to overrule the rightful powers of the president… to dictate the law for the entire nation… this was a colossal abuse of power.”

He went on to suggest the current birthright was being abused and had originally been designed for a different era, to give the descendants of slaves the right to citizenship.

“It wasn’t meant for people trying to scam the system and come into the country on a vacation. It was meant for the babies of slaves. Hundreds of thousands of people are pouring into our country under birthright citizenship,” he said.

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In a wide-ranging news conference, he also said he would consider bombing Iran again if they continued their nuclear programme and expects the country to open itself to international inspections.

He also said he was preparing fresh trade tariffs for several countries and had secured mineral rights in the Democratic Republic of Congo, which is signing a peace deal with Rwanda at the White House to end years of fighting.

Friday’s Supreme Court decision was focused on cases filed in Maryland, Massachusetts and Washington state.

The policy remains blocked for now in one additional state, New Hampshire, as a result of a separate lawsuit that is not before the Supreme Court.

Mr Trump’s plan has the backing of 21 other states.

Friday’s ruling was decided on a 6-3 vote following a divide on ideological lines, with conservatives in the majority and liberals in dissent.

Mr Trump previously helped shape the makeup of the court with the appointment of three judges, ensuring a 6-3 conservative majority, though past rulings have still not always gone in his favour.

It has long been widely accepted, including by legal scholars on the left and right in the US, that the Constitution’s 14th Amendment confers automatic citizenship to almost anyone born in the United States.

Mr Trump wants that restricted to only those with at least one parent who is a US citizen or permanent resident.

Friday’s ruling does not examine the legal merits of the policy, but only whether judges had the authority to put it on hold across the entire country.

As a result of the ruling, the proposal can potentially move forward nationwide, although individuals could still file their own lawsuits at the state level.

Those currently challenging the policy could also still reinstate injunctions which are less broad in scope.

The US president and his allies have been harshly critical of judges who have blocked aspects of his agenda, although it is not a new phenomenon for courts to impose nationwide injunctions.

His administration has battled against judges who have issued nationwide injunctions in response to a bold and aggressive use of executive power to implement a controversial agenda, including ramping up deportations, downsizing federal agencies, targeting law firms and universities and firing thousands of federal employees.

US

Man kicks customs dog at Washington Dulles International Airport, say authorities

Published

1 hour ago

June 27, 2025

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Man kicks customs dog at Washington Dulles International Airport, say authorities

An Egyptian man has admitted federal charges after kicking a customs dog at a US airport, authorities say.

Hamad Ramadan Bayoumy Aly Marie, 70, pleaded guilty to “harming animals used in law enforcement” during an appearance in the US District Court of eastern Virginia on Wednesday.

Five-year-old male beagle Freddie allegedly detected more than 100lbs (45kg) of undeclared agricultural products in Marie’s luggage after he arrived at Washington Dulles International Airport from Cairo, Egypt, on Tuesday.

When Freddie’s handler started questioning the passenger, he kicked the 25lb (11kg) animal so hard that it was lifted off the ground, according to US Customs and Border Protection.

A veterinarian determined that Freddie suffered contusions to his right rib area as a result of being kicked.

Marie was placed in handcuffs by US Customs and Border Protection (CBP) officers, who found 55lbs (24.9kg) of beef meat, 44lbs (20kg) of rice, 15lbs (6.8kg) of eggplant, cucumbers and bellpeppers, 2lbs (0.9kg) of corn seeds, and 1lb (0.5kg) of herbs in his luggage, according to authorities.

All agricultural products were seized as they are prohibited, to prevent the introduction of harmful plant pests and foreign animal diseases from entering the country.

“Being caught deliberately smuggling well over 100lbs of undeclared and prohibited agricultural products does not give one permission to violently assault a defenceless Customs and Border Protection beagle,” said Christine Waugh, the CBP’s director for the area port of Washington DC.

“We rely heavily on our K9 partners and Freddie was just doing his job.

“Any malicious attack on one of us is an attack on all of us, and CBP will continue to work with our investigating and prosecuting partners to deal swift and severe justice to perpetrators.”

Marie was credited with time served after being taken into custody on Tuesday and was ordered to pay the veterinarian’s fee of $840 (£612) for Freddie’s treatment, a court filing shows.

He was also told to immediately report to CBP for removal from the US, and he left the country on a flight to Egypt at 12.30pm local time on Thursday.