The extra calories and lower physical activity of modern culture are yielding higher rates of obesity, type 2 diabetes, heart disease, and other illnesses. Evidence is mounting that intermittent fasting may help reverse these trends. This neuroscientist brings 25 of studying intermittent fasting to explain why and how it works, and what your patients’ options are.

Among more than 200 adolescents 12 to 18 years of age over a 68-week period, nearly 75% of those in the treatment group experienced weight loss of > 5%, compared with only about 15% of those with placebo plus lifestyle intervention. GI adverse events were more common in the treatment group.

To combat weight gain after bariatric surgery, a single weekly 1-mg dose of semaglutide outperformed liraglutide at 3-mg daily. About half the semaglutide group were able to lose more than 10% of their body weight, versus about 1/3 for the liraglutide group.

In a retrospectives study with a 13-month follow up, bariatric surgery patients were 16% less likely to die versus matched non-surgical counterparts. However, surgery patients were more than twice as likely to die by suicide and that risk of suicide was significantly higher in those ages 18-34.

Eighty-eight children ages 6 through 12 were randomized to daily pine bark extract, methylphenidate, or placebo for 10 weeks. Total ADHD-Rating Scales scores decreased 29% with pine bark extract, 45% with methylphenidate, and 5% with placebo. Hyperactivity/impulsivity decreased 34% with pine bark extract and 36% with methylphenidate and increased 1% with placebo. Inattention decreased 25% with pine bark extract, 52% with methylphenidate, 9% with placebo. Adverse events were reported 5 times more frequently with methylphenidate than with pine bark.

“Because medicine abhors a therapeutic vacuum,” the hallucinogens psilocybin and LSD are being revisited as potential candidates for treating depression. But effect size seems less than that of currently approved antidepressants.