The president has long complained that the United States pays more for medicines than other wealthy countries. But he offered no clear legal authority to mandate lower prices.President Trump on Monday signed an executive order asking drugmakers to voluntarily reduce the prices of key medicines in the United States.But the order cites no obvious legal authority to mandate lower prices. The order said the administration would consider taking regulatory actions or importing drugs from other countries in the future if drugmakers do not comply.It was something of a win for the pharmaceutical industry, which had been bracing for a policy that would be much more damaging to its interests.On Sunday evening, Mr. Trump said in a Truth Social post that he would link U.S. drug prices to those in peer countries under a “most favored nation” pricing model, a policy he attempted unsuccessfully in his first term for a small set of drugs in Medicare. His executive order on Monday does not do that. Pharmaceutical stocks rose Monday morning on the news.Mr. Trump’s executive order came just hours after House Republicans offered an expansive set of health care policy changes that would cut around $700 billion from Medicaid and the Obamacare marketplaces over a decade and would cause an estimated 8.6 million Americans to become uninsured. Congress declined to include any provisions to directly limit drug prices in that package.The executive order also called on federal agencies to investigate why European countries get lower prices and to push them to pay more. The Trump administration has limited leverage to drive up prices in Europe.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

1 hour agoShareSaveAlison HoltSocial affairs editorShareSaveGetty ImagesCare providers have said the government is taking away the “lifeline” of overseas recruitment without fixing the problems that make it difficult to recruit UK staff.Sir Keir Starmer, the prime minister, announced sweeping reforms to immigration on Monday, including plans to end the recruitment of care workers from overseas. Even with staff being brought in from other countries, official estimates show there were 131,000 vacancies in social care in England last year. Care companies said some services will struggle to survive without international recruits.”The sector has been propping itself up with dwindling resources, rising costs, and mounting vacancies,” said Prof Martin Green of Care England, which describes itself as the largest representative body for independent care providers.”Taking (international recruitment) away now with no warning, no funding, and no alternative, is not just short-sighted – it’s cruel,” he said.Sir Keir said the visa changes were part of a drive “to reduce immigration significantly” and that the government wanted to create “a migration system that is controlled, selective and fair”.The government said care providers could extend visas for existing staff and recruit migrants already in the UK who have yet to find a job. It also promised a new fair pay agreement for care staff and wanted companies to recruit and train more people from UK.However, Dr Jane Townson of the Homecare Association said the government was introducing the changes “in a vacuum” as a fair pay agreement is a long way off and there is “no plan to deliver the care workers our country needs.”Social care has been in crisis for years, with council funding of services squeezed, significant staff-shortages and growing demand from an ageing population. Plans for reform have been delayed time and again.While care workers were clapped along with health workers during the pandemic, that did not translate into an improvement in pay or status.About 1.7 million people work in social care in England, according to Skills for Care, the official body that monitors the workforce. It is often a minimum or just above minimum wage job, with little recognition of the increasing responsibility and complexity of the support staff provide to older and disabled people.Putting it bluntly, if someone can earn more working, for instance, in a supermarket for fewer, less strenuous hours, then that is the option many will chose.Post-Covid, some staff left care work because they felt burnt out while others who still loved the job felt they could not afford the increases in the cost of living.Between April 2021 and March 2022, social care vacancies reached a record high of 165,000, a 52% increase on the year before.By December 2021, the warnings of imminent collapse prompted Boris Johnson’s Conservative government to make care work a shortage occupation, making it easier for companies to look overseas for staff. Recruits had to earn a minimum of £20,480 a year to qualify for the visa, and they could bring family with them.There was a rapid rise in overseas recruitment – in 2022/23 80,000 people arrived in the UK to work in care and in 23/24, there were another 105,000 visas.Many care companies said bringing in those staff was the difference between providing services and collapsing. However, there was also abuse of this new route into the UK. For instance, some people were exploited, ending up paying middlemen thousands for travel and sponsorship certificates.The Home Office says 470 care companies have had their licence to recruit international staff revoked since 2022. It estimates that has led to about 40,000 staff being displaced. Companies say many will have already found alternative care work.In March 2024, Rishi Sunak’s Conservative government tightened the visa requirements. This included saying recruits could no longer bring family with them. It has led to a significant fall in the number of care workers arriving from abroad.In the year up to December 2024, 9,500 visas were granted to people entering the UK to provide “caring personal services”, according to the government.However, in the four years since staff shortages were most acute, relatively little has changed to encourage more UK people to work in care. There has been an ongoing government funded recruitment campaign and talk of the need to improve the pay and status of staff, but many workers fear solutions remain a long way off.The independent Casey Commission started work last month to draw up plans for adult social care. It has been described by ministers as a “once in a generation opportunity to transcend party politics and build consensus on the future of the sector”. Its first update is due next year and its final report by 2028.At a time when the NHS is struggling, social care is more important than ever as it can keep vulnerable people out of hospital and support patients when they return home.Many care workers will say it is an incredibly rewarding job and with overseas recruitment being closed, the question is what needs to change to encourage more UK people to take on the role?

5 hours agoShareSaveMatthew HillHealth Correspondent, BBC WestShareSaveBBCA surgeon found to have left patients in “agony” after using artificial mesh to treat prolapsed bowels faces allegations he falsified medical notes.Tony Dixon was suspended after the surgery was found to have caused harm to hundreds of patients at two hospitals in Bristol.Now, a new hearing will examine Dr Dixon’s records. He is accused of dishonestly creating patient records long after he was involved in their care, something he “strongly denies”.The Medical Practitioners Tribunal Service (MPTS) will begin Monday. It will examine claims medical records for seven patients contained false information, and were not created at the correct time.A spokesperson for Dr Dixon said: “[He] always endeavoured to provide the highest standard of care to his patients. “He strongly disputes falsifying any medical records and will provide his detailed evidence about those serious allegations to the tribunal, initially by way of a detailed witness statement which he has provided to the General Medical Council.”‘Protect public’Dr Dixon built up an international reputation as the go-to expert for patients with prolapsed bowels. He used a technique known as mesh rectopexy to treat bowel problems.Through the procedure, mesh implants are placed into the body to treat pelvic organ prolapse which can occur after childbirth.The mesh, which is usually made from synthetic polypropylene, is intended to repair damaged or weakened tissue.At the point of his suspension in 2024, the MTPS said Dr Dixon’s “misconduct was so serious that action needed be taken to protect members of the public”.But, the tribunal considered that a longer period of suspension would be unduly punitive, especially taking into account the period that Dr Dixon had already been the subject of fitness to practise proceedings.As founder of the Pelvic Floor Society, he drew heavily on claims he had made in medical publications about the success rates of the rectopexy mesh surgery he pioneered.But now questions are being raised by the MPTS about the honesty his follow-up data which has to be written contemporaneously.A BBC Inside Out investigation in 2017 first revealed Dr Dixon had carried out unnecessary operations and raised questions about whether he provided adequate medical follow. Two investigations at Southmead Hospital and Spire Bristol subsequently found Mr Dixon caused harm to hundreds of people by carrying out operations that were not necessary.Both hospitals apologised to victims after his suspension.The MPTS had previously found that he failed to obtain informed consent or trial alternative treatment and not to have adequately investigated symptoms.The BBC has discovered that all of Dr Dixon’s papers in the journal Diseases of the Colon and Rectum, now have an ‘expressions of concern’ in the relevant papers in Colorectal Disease.They centre on concerns about the honesty of his claimed follow up on patients.Prof Susan Galandiuk, editor in chief of the journal Diseases of the Colon and Rectum, which has published two papers with Tony Dixon’s data said: “Many people will read journal articles and will act based on their conclusions, in terms of practicing surgeons.”Many other surgeons who are writing articles will cite these articles and base their conclusions on these.”Sometimes or often these papers are used when guidelines are formulated or referred to. So their conclusions can go on to influence many different things .”The BBC has separately approached more than 40 former mesh patients of Dr Dixon via the Rectopexy Mesh Victims and Support group.None of them recognise the follow up form which he had claimed to have used in publications for up to five years post operative follow up.They include Debbie Cooper Jones, a dentist from Gloucester.She said: “He seemed to have done quite a lot of research from the papers that were on his website.”So I was a bit surprised at my lack of follow-up because he was quoting so many statistics.”Perhaps, in hindsight it seems a little bit odd that there wasn’t that close monitoring of us given the nature of the surgeries we were having and maybe even the novelty of them that it was ground-breaking work.”It will take several weeks for the tribunal decide on the new allegations.That decision is crucial when it comes to eventually deciding whether Dr Dixon will eventually be able to reapply to go back on the medical register again.

5 hours agoShareSaveJenny ReesBBC Wales Health CorrespondentShareSaveBBCA woman whose bowel had to be removed due to chronic and severe constipation says we should all be more open to talking about basic bodily functions.Kathryn Nicklas, 26, was told for several years that her constipation was caused by irritable bowel syndrome (IBS) and she was repeatedly prescribed laxatives.She said embarrassment about her symptoms as a teenager meant she had struggled to advocate for her condition to be taken seriously. Prof Julie Cornish, a leading pelvic health doctor, said many patients required surgery for pelvic health problems but that simpler solutions were possible when symptoms were spotted sooner.Ms Nicklas, who works in north Wales, said before her surgery she was “taking laxatives like they were smarties” but “still struggling to go to the toilet”.”I was forever living in floaty dresses because of the bloating and even bought maternity jeans just to be comfortable,” she said.”If I was able to go [for a poo] it would only be as a result of irrigation or an enema. I’d come home from work and spend an hour on the toilet – I had no life, because I was always uncomfortable.”She added: “On one occasion I didn’t go to the toilet for four weeks and was admitted to hospital.”They said I was so full of poo, everything had just stopped working.”Despite various tests and changes to her diet, no cause was ever found, but years of constipation had a long lasting impact on Ms Nicklas’ pelvic organs – causing pain, vaginal bleeding and bloating.Ms Nicklas’ large bowel was removed in 2022.Kathryn NicklasAs an adult, Ms Nicklas said she advocated for her symptoms to be taken seriously, but as a teenager she said embarrassment about bodily functions had made that more difficult.”Looking back now, why is that such an embarrassing thing?”Why is going to the toilet so embarrassing when it’s just a normal function that everybody does?”Would my constipation have been better if I hadn’t have refused to go to the toilet unless I was at home and my brothers weren’t around and no one could hear me? Because that’s not healthy decision making,” she added.”As a result of the constipation and so many years of it my body’s been affected.”Your pelvic floor gets absolutely destroyed by the fact that you’re constantly trying to go but you can’t go.”Prof Cornish, a colorectal surgeon, said pelvic health issues affected both men and women.”It is a public health issue that actually we need to be giving information to people at an earlier stage – and it’s not just women and girls, it’s also boys and men because pelvic health issues affect everybody in different ways,” she said.”We’re not just talking about gynaecological bits, we’re talking about the bladder and bowel which can be impacted and that does have a bearing on things like pelvic organ prolapse.”So if you are chronically constipated for many years you are far more likely to develop problems with a prolapse.”The need for better understanding is part of the reason why Prof Cornish set up the Everywoman health festival in Cardiff, which is now in its third year.A thousand tickets will be given free to teenagers this year, with educational sessions planned on menstrual health, pelvic health and knowing basic body parts.Shakira Hassan, a specialist women’s health physiotherapist, treats a wide range of conditions including pelvic pain, bladder, bowel and prolapse issues, where pelvic organs have lowered out of place.”If you were to examine most women over 40, 50% of those women will actually have a pelvic organ prolapse, so it’s about being able to educate and empower those women to be able to still lead a really normal and well life,” she said.Ms Hassan said stigma was a huge factor, which could be worse in some cultures.”We know that potentially one in three women will experience some urinary incontinence and potentially one in four women will experience some level of faecal incontinence throughout their life. That’s huge numbers – it’s really common.””Education is key,” said Prof Cornish. “And the difficulty is that whilst there are some people who have that understanding or are able to access that education, you’re essentially disenfranchising a large proportion of the population who may not be able to access it, and they may end up being the patients that I see more of.”You see the inequalities that are out there.”But all of this leads to a massive delay in treatment and usually an increase in the severity of symptoms and treatments needed.”We all have a responsibility for our own health and that is going to be key – it’s not just about off-loading it to the NHS, so I think the more we teach our children, that’s going to empower them to take responsibility going forward.”The Welsh government said: “Health and wellbeing is a mandatory part of the curriculum for Wales and helps learners to understand different factors that affect their physical health. “Our guidance expects children to learn about a range of health conditions that can affect them.”Related stories

The president announced an executive order aimed at lowering U.S. drug costs, revisiting an idea that was blocked in court during his first term.President Trump will sign an executive order on Monday aimed at lowering some drug prices in the United States by aligning them with what other wealthy countries pay, he said on Truth Social on Sunday evening.The proposal he described, which alone cannot shift federal policy, is what he calls a “most favored nation” pricing model. Mr. Trump did not provide details about which type of insurance the plan would apply to or how many drugs it would target, but he indicated that the United States should pay the lowest price among its peer countries.“Our Country will finally be treated fairly, and our citizens Healthcare Costs will be reduced by numbers never even thought of before,” he wrote in his social media post.Any such plan will most likely be subject to challenges in court, and it is not clear whether it will pass legal muster, especially without action by Congress.In his first term, Mr. Trump tried unsuccessfully to enact a version of this idea for Medicare, the health insurance program that covers 68 million Americans who are over 65 or have disabilities. That plan would have applied only to 50 drugs, administered at clinics and hospitals, that are paid for by Medicare. A federal court blocked it, ruling that the administration had skipped steps in the policymaking process.The pharmaceutical industry bitterly opposes the idea, which would almost certainly cut into its profits, and has been lobbying against it as discussions of the policy have regained steam in Washington in recent weeks. Companies have warned that such a policy would lead them to spend less on research, depriving patients of new medicines.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

16 minutes agoShareSaveGeorge SandemanBBC NewsShareSaveBBC”High-protein” versions of snacks and food staples are all over our supermarket shelves – from pancakes and pasta, to rice pudding and oven pizza.Celebrities are getting in on the act too. Khloe Kardashian unveiled Khloud Protein Popcorn a fortnight ago, which she described as “the perfect combination of a tasty snack and a boost of protein to fuel your day”, while Zac Efron promoted a protein-rich porridge in January.But is this increased advertising of protein just a marketing gimmick or are these products actually useful if you’re trying to build muscle or live a healthy life? And is it worth the extra cost?Sales of them are rising; figures shared with BBC News by the research agency Mintel show that, excluding sports nutrition items, 8.3% of food product launches made claims about being a source of protein, or having high levels of it, in the first three months of 2025.That was up from 6.1% in 2024 and 4.6% the year before.Kiti Soininen, a research director at Mintel, says protein claims are being added to food with naturally high levels of the nutrient, like chicken breasts and pulses, but also on products you wouldn’t expect.Getty Images”Mousses, desserts, granola, pancakes, even the odd pizza, are coming through with a high-protein claim,” she says. “Protein is enjoying a bit of a ‘health halo’ at the moment.”Ethan Smith, a personal trainer in Liverpool, says high-protein diets are necessary for building muscle but that it ought to be done without the high protein snacks and drinks you see in shops.”I’m a huge believer that there is nothing better than whole foods,” he says. “You can get the protein that you need from vegetables and lean meats.”He believes the convenience of high-protein snacks, combined with the positive perception of the nutrient among customers, has led to manufacturers using protein as a marketing tool.For manufacturers to claim their product is a source of protein, they must show regulators at least 12% of its energy value is provided by protein. To make a claim that a product is high in protein, the figure is 20%.To help reach these scores they can add protein-rich ingredients to their products, like nuts and pulses, or make them more dense by removing water.”When someone in a rush is getting a meal deal for lunch, you can see why they would reach for a protein bar or drink instead of two boiled eggs,” he says. “In my 12 years as a personal trainer, I’ve never seen as much hype around the benefits of protein as I am now.”The benefits of protein range from muscle building and sports performance to helping with weight loss by suppressing appetite and helping women during pregnancy.If you’re trying to build muscle you need to consume around 1.6g of protein per kilogram of your body weight each day, says Dr Paul Morgan, a university lecturer in human nutrition.He says for the average person trying to ensure their general health, this figure should be around 1.2g.He thinks many of the supermarket products advertising their protein content are “gimmicky” and warns they might not be as good for you as advertised.”I think they do have a benefit but we are wary that a lot of them are ultra processed foods and that’s a really topical area [in our field] that we don’t know enough about,” he says.The risk of consuming too much proteinUltra-processed foods have come under scrutiny recently with one study published last month linking them to early death.He explains that researchers in his field are trying to understand the differing impact on muscles that two similar protein sources might have when one of them is ultra-processed.Another issue is calories because putting on weight is the most common problem people have when they are trying to consume more protein, Dr Morgan explains, as any excess is stored in the body as fat.Some protein advertised snacks and drinks can have as many calories as regular products using similar ingredients.Nature Valley’s protein peanut and chocolate bars have 489kcal per 100g, while Cadbury’s peanut brunch bars, which also contain chocolate, have 485kcal at the same weight.Dr Morgan dismisses theories that eating too much protein can damage your bones or harm your kidneys, though there are exceptions if you have a pre-existing health condition.Getty ImagesDespite his concerns over ultra-processed protein products, Dr Morgan sees the benefit of increased protein in staple foods.These might be particularly useful to elderly people who need more protein than the average person to maintain strength in their muscles and bones.Tesco’s high-protein penne pasta contains 8.8g of protein per 100g, while their normal penne contains 5.8g of protein for the same weight. However, customers pay more for this as the high protein-penne costs £4.80 per kg. The normal penne costs £1.29 per kg.So is it worth buying these protein advertised products?It might be if you’re someone who needs more protein to maintain your health or if you’re trying to build muscle and need just a little bit extra to meet your daily protein goal, says Ethan.”If the majority of your diet is whole foods and you need that extra 20g of protein to hit your goal and want something sweet – then go for that pudding or snack,” he tells us. “Having balance is important – but you shouldn’t be relying on them.”He adds: “When I started my career, people used to talk about whey protein just as a supplement to your diet. Now the number of companies putting protein on anything and everything is insane.”More on this story

20 minutes agoShareSaveJames GallagherShareSaveGetty ImagesThe first head-to-head trial of two blockbuster weight-loss drugs has shown Mounjaro is more effective than rival Wegovy.Both drugs led to substantial weight loss, but Mounjaro’s 20% weight reduction, after 72 weeks of treatment, exceeded the 14% from Wegovy, according to the trial’s findings. Researchers who led the trial said both drugs had a role, but Mounjaro may help those with the most weight to lose.Both drugs trick the brain into making you feel full so you eat less and instead burn fat stored in the body – but subtle differences in how they work to explain the difference in effectiveness.Wegovy, also known as semaglutide, mimics a hormone released by the body after a meal to flip one appetite switch in the brain. Mounjaro, or tirzepatide, flips two.The trial, which was paid for by Eli Lilly, the manufacturer of Mounjaro, involved 750 obese people, with an average weight of 113kg (nearly 18 stone).They were asked to take the highest dose they could tolerate of one of the two drugs.The findings, presented at the European Congress on Obesity in Malaga and in the New England Journal of Medicine, showed: 32% of people lost a quarter of their body weight on Mounjaro compared to 16% on WegovyThose on Mounjaro lost an average of 18cm from their waistlines compared with 13cm on Wegovy.Those on Mounjaro had better blood pressure, blood sugar and cholesterol levels.Both had similar levels of side-effects.Women tended to lose more weight than men.Dr Louis Aronne, who conducted the trial at the Comprehensive Weight Control Center at Weill Cornell Medicine in New York, said: “The majority of people with obesity will do just fine with semaglatide (Wegovy), those at the higher end may ultimately do better with tirzepatide (Mounjaro).”Private tirzepatide sales ‘well ahead of semaglutide’In the UK, the two medicines are available from specialist weight-management services, but can also be bought privately.Prof Naveed Sattar, from the University of Glasgow, said the drugs were “good options” for patients, but while “many will be satisfied with 15% weight loss… many want as much weight loss as possible”.”In the UK, tirzepatide sales privately are now well ahead of semaglutide – that’s just a reality – and this paper will accelerate that I imagine,” he added. However, Wegovy is also licensed for other conditions – such as preventing heart attacks – while the equivalent trials with Mounjaro have not been completed.A huge amount of research into weight-loss drugs is still taking place. Higher doses of current drugs are being tested, as are new ways of taking them such as oral pills and new medicines that act on the body in different ways are being investigated.It means the final winner in this field has yet to be determined. Prof Sattar says the amount of research taking place means we may be approaching the point where “obesity prevention may also be possible soon”, but argues “it would be far better” to make our society healthier to prevent people becoming obese.

CVS Caremark decided to stop offering Zepbound in favor of Wegovy for weight loss. It’s the latest example of limits imposed by insurance that disrupt treatments for patients.Tens of thousands of Americans will soon be forced by their heath insurance to switch from one popular obesity drug to another that produces less weight loss.It is the latest example of the consequences of secret deals between drugmakers and middlemen, known as pharmacy benefit managers, that are hired by employers to oversee prescription coverage for Americans. Employers pay lower drug prices but their workers are blocked from getting competing treatments, a type of insurance denial that has grown much more common in the past decade.One of the largest benefit managers, CVS Health’s Caremark, made the decision to exclude Zepbound in spite of research that found that it resulted in more weight loss than Wegovy, which will continue to be covered.Those research findings, first announced in December, were confirmed in an article published on Sunday in The New England Journal of Medicine. The study involved a large clinical trial comparing the drugs that was funded by Eli Lilly, the maker of Zepbound. Earlier research not financed by Eli Lilly reached similar conclusions.Ellen Davis, 63, of Huntington, Mass., is one of the patients affected by Caremark’s decision. “It feels like the rug is getting pulled out from under my feet,” she said.After taking Zepbound for a year, she has lost 85 pounds and her health has improved, she said. She retired after working for 34 years at Verizon, which hired Caremark for her drug coverage.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

2 days agoShareSaveRuth CleggHealth and wellbeing reporterShareSaveBBCSymone has been using weight loss injections for nearly a year. She says they have done what the diet industry could never do for her – free her from a life controlled by food.From a very young age, the 34-year-old could not switch off the constant noise in her head. When would her next meal come? What would it be? Would there be enough for her?”The food noise was just so loud, it could be unbearable,” she says. “I have tried every single diet going – I’ve done Atkins, eating clean, SlimFast, Slimming World, meal-replacement shakes – you name it – I’ve done it and none of them worked for me.”Several years ago, weighing 16st (102kg), she was one of the many millions who signed up to WeightWatchers, downloading the app and meticulously following its points plan, scanning in everything she ate and staying within her daily points budget.WeightWatchers attributes points to food and drink, stating that it uses a “groundbreaking algorithm” to assess their nutritional makeup and then uses a point system to inform its members which food is better to eat.But after a few weeks, Symone says she started to feel like she was being set up to fail.”How could I lose weight long term if I had to follow this mad points system? Food is not measured in points – it’s measured in calories, fat, macro nutrients.”I felt trapped, and the more research I did, the more I educated myself, the more I thought this is not for me.”The only thing that has ever worked in her quest to lose weight, she says, is weight loss injection Mounjaro, which she started using nearly a year ago.”I was at my heaviest, just over 21 stone, and the doctor told me I was pre-diabetic. I knew something had to change – I’ve got two children who depend on me too.”She was advised to start on the weight loss medication but with a two-year wait, she decided to buy it privately online and within just a few days, she was crying with relief.”I couldn’t believe that I had control over food. For the first time, I wasn’t panicking about when I would next eat.”Weight loss jabs work by mimicking a hormone called glucagon-like peptide-1 (GLP-1), which suppresses people’s appetites and makes them feel full.Symone has now lost 4st 7lb (26kg) and is losing weight gradually, documenting her experiences on social media.”I don’t want a quick fix,” she says, “I’m using weight loss injections to give me the control I never had.”Lost a million membersFor many, weight loss jabs can produce rapid results, but some experts are concerned about the meteoric rise in their popularity and how people will be affected by them long term – both physically and mentally.At its peak, WeightWatchers was seen as being synonymous with safe and controlled weight loss. With 4.5million subscribers globally, its workshops were held in most towns, on most high streets, popping up in local church halls – they were everywhere.Now, after dominating the diet industry for more than half a century, it has lost more than a million members and filed for bankruptcy, struggling to compete in a market transformed by social media influencers and weight loss injections.The company has stressed that it is not going out of business and that filing for bankruptcy will help it resolve its debt of $1.25bn (£860m).In a statement, the brand says its weight loss programme (which also includes its own brand of weight loss jabs) and weight loss workshops will continue.The company says it has been the brand with the most scientific backing in the diet industry for over 60 years, and that there have been more than 180 published studies showing the effectiveness of its approach.WeightWatchers says it uses an “holistic model of care” to support “the whole person” with “access to obesity-trained clinicians and registered dietitians”.It is also one of several companies GPs can use for weight loss referrals, with the NHS paying for patients to attend weekly meetings in the community.”It’s no longer about calorie control and diets,” Deanne Jade, clinical director of the National Centre for Eating Disorders, told the BBC.”There’s a new movement out there and it’s all about wellbeing.”People like to move in tribes – it used to be the WeightWatchers tribe, counting points and calories, now millions follow different ways to lose weight or be healthy through social media influencers, through weight loss drugs, and they’re forming new tribes.”She is not convinced that medication will be the answer that so many are looking for.”None of these pharmaceutical interventions protect people from regaining the weight when they stop injecting.”She believes they are not a quick fix, and that the best way to effectively lose weight and keep it off is to understand the psychological reasons behind overeating.ReutersMore holistic approachDr Joanne Silver, lead psychologist at the London-based eating disorder clinic, Orri, agrees. She says the weight loss injections “completely silence what the body is asking for”, which is counterintuitive to understanding what the body needs.”People can binge eat because of psychological reasons – they can use food to manage their emotions, to soothe themselves.”Eating disorders are not just about food.”Food and nutrition have become just one part of a more holistic approach so many are now adopting when it comes to their overall wellbeing.Jennifer Pybis, a fitness coach based in Liverpool, works with clients both online and in person. She says achieving a healthy lifestyle is not just about hitting a target weight.”I encourage the women I work with to consider lots of ways to measure their progress rather than just jumping on the scales.”Thinking about how they feel, comparing photographs of themselves to see how their bodies have changed shape, how their sleep is, their resting heart rate, their improvements in the gym – all of that is so important.”Jennifer PybisThe diet industry might be transforming but there are many who still prefer the more traditional model of sitting together and sharing their experiences, supporting others in their community to lose weight.In a small church hall in Winsford, Cheshire, a group of women are waiting patiently to get on the scales.Muttering and good-natured laughter can be heard as they share their latest weights with each other.”I’ve put on a pound! I did have a little bit – well maybe a lot – of wine at the weekend.””Why didn’t you have gin?” another one asks, “it’s only 55 calories a shot!”They’re here for their weekly check-in at the BeeWeighed slimming group. Some of the women have lost several pounds, others have a put on a pound or two, but overall, since joining the class, they have all lost weight.They are learning about how to eat in moderation, how to exercise safely and how to feel good about themselves.At first glance, it could be a WeightWatchers class – women meeting up to share their stories of weight loss and support each other – but there are crucial differences, says BeeWeighed owner and founder Lynda Leadbetter.She was a group leader for WeightWatchers for 18 years but left to set up her own group in 2018.”I think WeightWatchers did provide something different and something hopeful for so many women but I think it has lost its way,” she says.”I teach nutrition, I educate, I don’t sell anything extra. I feel WeightWatchers became about selling extra products, it was always about pushing those extra sales, and not about supporting people to lose weight properly.”She’s sceptical about the effectiveness of weight loss medications, and some members who have turned to the likes of Ozempic and WeGovy have left her groups, but many have stayed – continuing to attend the meetings for support while using weight loss injections.Kathryn Brady, 38, has been a member of BeeWeighed since 2023, and in that time, she’s lost over three stone. But with her wedding in a matter of weeks, the burlesque dancer has started to take Mounjaro to lose weight more rapidly.It’s not quite worked out as she had hoped.”I’ve been on Mounjaro for over a month now, and while I lost 6lb in the first week or so, I’ve put half of that back on.”Having absolutely no appetite for two weeks was really weird and I’m paying a lot of money to not lose that much weight.”She’s going to keep on using it, but she’s not completely sold yet.”Even if I continue with the skinny jab, I’ll still attend BeeWeighed, having others there supporting me keeps me going.”More on this story

Five mornings a week, Dr. David Slotwiner, the chief of cardiology at NewYork-Presbyterian Queens hospital, can be found tending to human hearts.But on Sunday mornings, he is on a grass-covered field at a rural farm in Hackettstown, N.J., standing among half a dozen sheep, whistle in hand, teaching his Border collies Cosmo and Luna to herd.“It helps me think about what it takes to be an effective leader, though doctors don’t respond to whistles very well,” said Dr. Slotwiner, 58, who specializes in cardiac electrophysiology.He started coming to the farm during the coronavirus pandemic, after Cosmo began showing aggression and bit his wife, Anne Slotwiner, 60. A trainer recommended a small sheep farm in New Jersey, Wayside Farm, that trains Border collies — and, once he herded with Cosmo for the first time, he was hooked.Dr. Slotwiner shares a three-bedroom house in Pelham, the oldest town in Westchester County, with his wife, Cosmo, Luna and a 15-year-old American Eskimo rescue, George. (He has two adult sons, Harry, 28, and Peter, 25.)A newborn lamb at Wayside Farm in Hackettstown, N.J., where Dr. David Slotwiner trains his Border collies.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.