Connect with us

Science

In Texas Measles Outbreak, Signs of a Riskier Future for Children

Published

on

In Texas Measles Outbreak, Signs of a Riskier Future for Children

Every day, as Dr. Wendell Parkey enters his clinic in Seminole, a small city on the rural western edge of Texas, he announces his arrival to the staff with an anthem pumping loudly through speakers.

As the song reaches a climax, he throws up an arm and strikes a pose in cowboy boots. “Y’all ready to stomp out disease?” he asks.

Recently, the question has taken on a dark urgency. Seminole Memorial Hospital, where Dr. Parkey has practiced for nearly three decades, has found itself at the center of the largest measles outbreak in the United States since 2019.

Since last month, more than 140 Texas residents, most of whom live in the surrounding Gaines County, have been diagnosed and 20 have been hospitalized. Nine people in a bordering county in New Mexico have also fallen ill.

On Wednesday, local health officials announced that one child had died, the first measles death in the United States in a decade.

Advertisement

It may not be the last. Large swaths of the Mennonite community, an insular Christian group that settled in the area in the 1970s, are unvaccinated and vulnerable to the virus.

The outbreak has struck at a remarkable juncture. Vaccine hesitancy has been rising in the United States for years and accelerated during the coronavirus pandemic. Now the nation’s most prominent vaccine skeptic, Robert F. Kennedy Jr., has been named its top health official, the secretary of health and human services.

Mr. Kennedy has been particularly doubtful of measles as a public health problem, once writing that outbreaks were mostly “fabricated” to send health officials into a panic and fatten the profits of vaccine makers.

At a cabinet meeting on Wednesday, Mr. Kennedy minimized the crisis in West Texas, saying that there had been four outbreaks so far this year (there have been three, according to federal health officials) and 16 last year.

Following widespread criticism, Mr. Kennedy posted a social media message on Friday saying he did “recognize the serious impact of this outbreak on families, children, and healthcare workers.”

Advertisement

Vaccine fears have run deep in these parts for years, and some public health experts worry that the current outbreak is a glimpse at where much of America is headed. Researchers think of measles as the proverbial canary in a coal mine. It is among the most contagious infectious diseases, and often the first sign that other pathogens may be close behind.

“I’m concerned this is a harbinger of something bigger,” said Dr. Tony Moody, a pediatric infectious disease expert at the Duke University School of Medicine. “Is this simply going to be the first of many stories of vaccine-preventable disease making a resurgence in the United States?”

On the front lines of the outbreak, simple answers aren’t easy to come by.

Measles was officially declared eliminated in the United States in 2000. Not long ago, it had become so rare that many American doctors never saw a case.

But as the outbreak spread, Dr. Parkey learned to spot the signs of infection in the examination room even before he saw the telltale rashes.

Advertisement

School-age children often zipped around the room or pestered their mothers or asked him for lollipops. The children stricken with measles sat still, vacant looks in their eyes.

On Monday, Dr. Parkey walked into a hospital room where an unvaccinated 8-year-old boy sat with that distant stare. His mother had scheduled an appointment after she noticed his barking cough the night before.

By the time they arrived at the clinic, the boy’s eyes were red and crusted. He had a low-grade fever and a blotchy pink rash covering his chest and back.

Dr. Parkey tried the usual banter: “Do you have a girlfriend?” The boy looked past him, glassy eyes trained on the wall.

“Which of your uncles is your favorite?” Dr. Parkey asked. The boy let out a dry cough and slumped further into his seat. He spoke only once, to request a cup of water.

Advertisement

Over the next 24 hours, if the boy’s illness followed the typical progression, he was likely to get sicker. His fever would spike, and the rash would fan out over his torso and thighs.

If he was lucky, the worst would pass within a few days. If he was not, the virus might find its way into his lungs and cause pneumonia, potentially making it difficult to breathe without an oxygen mask.

Measles might even invade his brain, causing swelling and possible convulsions, blindness or deafness.

Doctors have few options to alter its course once the virus infects someone. There is no treatment that will stop it, only medicines to make the patient more comfortable.

Dr. Parkey wrote prescriptions for cough syrup and antibiotics for the boy. A nurse swabbed the back of his throat for a sample to be shipped to the state health department in a box of dry ice, adding to the county’s growing case count.

Advertisement

For decades, the doctors at Seminole Memorial Hospital had been having conversations with patients about the importance of childhood vaccines.

Even on busy days with back-to-back appointments, staff members sat down with parents to discuss fears about side effects and to recount the horrors of many preventable diseases.

Go to an old cemetery, Dr. Parkey often told his patients — look at how many children died before vaccines arrived. In many families, though, minds were made up, and the conversations rarely broke through.

The largest school district in Gaines County reported that just 82 percent of kindergartners received the measles, mumps and rubella (M.M.R.) vaccine in 2023. One of the smaller school districts reported that less than half of the students had received the shot.

For a virus as contagious as measles — which spreads through microscopic droplets that can linger in the air for two hours — experts say that at least 95 percent of a community must be vaccinated in order to stave off an outbreak.

Advertisement

Gaines County, a dusty expanse the size of Rhode Island dotted with cotton fields and whirring pump jacks, had not hit that mark in many years.

Although there is no religious doctrine that bans vaccination, the county’s tightknit Mennonites often avoid interacting with the medical system and hold to a long tradition of natural remedies, said Tina Siemens, a Seminole historian who has written several books about the community in West Texas.

In recent years, concerns about childhood vaccines appeared to rise even in the broader Seminole community, especially after Covid-19, several doctors said. An outbreak began to feel inevitable.

“I’d never seen measles, but I knew it was coming,” Dr. Parkey said.

In this respect, Gaines County is not so different from much the country.

Advertisement

Before the pandemic, 95 percent of kindergartners in the United States had received the M.M.R. vaccine, according to federal tallies. The figure sank below 93 percent last year. Immunization rates against polio, whooping cough and chickenpox fell in similar proportions.

When the cases in Texas first surfaced, local doctors and health officials hoped that the outbreak would make the M.M.R. vaccines an easier sell. If parents saw what measles did to children, the thinking went, they would understand what the vaccine was designed to protect them from.

But there has been no stampede to vaccination. In Seminole, a city of about 7,200 people, almost 200 residents have received shots at pop-up clinics.

“Hopefully, at least the next generation will change their minds about vaccines,” Dr. Parkey said. “Just maybe not this one.”

One mother told Dr. Leila Myrick, a family medicine physician at Seminole Memorial, that the measles outbreak had helped solidify her decision not to vaccinate her children. She’d heard from a friend that the virus was similar to a bad flu.

Advertisement

Even some parents who recognized the dangers that measles posed to their children still felt that vaccines were riskier.

Ansley Klassen, 25, lives in Seminole with her husband and four young children, three of whom are fully unvaccinated. She considered bringing her children to a vaccine clinic when measles cases first started popping up.

Mrs. Klassen, who is about five months pregnant, knew she didn’t want to risk getting measles. She had been scrubbing counters with Lysol wipes and keeping her children away from others as much as possible.

But on social media, she had seen a deluge of frightening posts about the side effects of vaccines: stories of children developing autism after a shot or dying from metal toxicity. (Both claims have been debunked by scientists.)

“There are stories that you can read about people multiple hours after they got the vaccine having effects, and that’s scary to me,” she said. “So I’m like, is it worth the risk? And right now I can’t figure that out.”

Advertisement

These anecdotes — regardless of whether they are factual — are part of what has made vaccine hesitancy such an intractable problem in the age of social media, said Mary Politi, a professor at the Washington University School of Medicine who studies health decision-making.

Stories about children who don’t have serious side effects from vaccines and never contract vaccine-preventible illnesses don’t go viral on TikTok, she noted.

“It’s not that they’re trying to make a bad choice or do something against evidence,” she said. “People are trying to do the best thing they can for their families, and they don’t know who to trust.”

Mrs. Klassen didn’t consider herself staunchly anti-vaccine. Her oldest daughter, now 6, had received all of her vaccines up to a year.

But she didn’t trust everything doctors were telling her, either. She thought the Covid-19 vaccine had been developed too quickly and pushed too forcefully, making her skeptical that the authorities were telling the truth about the measles shot.

Advertisement

She prayed about it and ultimately decided to forgo the vaccine. “The trust I have in the medical system is not there,” she said.

It’s not just unvaccinated people who are at risk during the current outbreak.

Measles increases the likelihood of stillbirths and serious complications in pregnant women, yet they cannot receive the vaccine or booster.

Andrea Ochoa, a nurse’s assistant at Seminole Memorial who is six months into her first pregnancy, said she thought about taking time off from her job but ultimately decided to stay so she could keep her health insurance.

She wore an N95 mask during her entire shift, which sometimes made her so lightheaded that she sat in her car for a break. She showered as soon as she was home.

Advertisement

“I hope it doesn’t get worse,” Ms. Ochoa said of the outbreak. “I don’t know what choice I would make.”

Five vaccinated residents also have contracted measles, state health officials said. At the clinic, Dr. Parkey recently cared for a teacher who was vaccinated but immunocompromised.

A serious measles infection kept the teacher curled in a fetal position on the couch for a week, her eyes so swollen that she opened them only for brief runs to the bathroom, she recalled in an interview. She asked not be named to protect her privacy.

The West Texas measles outbreak is far from the largest in the United States in recent years. In 2019, outbreaks in at least two dozen states sickened more than 1,250 people.

A vast majority of those infections occurred in “underimmunized, close-knit communities,” the C.D.C. noted. More than 930 patients were infected in Orthodox Jewish communities in New York.

Advertisement

Federal, state and local officials swung into action with vaccination campaigns that led to more than 60,000 M.M.R. immunizations in the affected communities. They reached out to religious leaders, local doctors and advocacy groups.

And in areas like Williamsburg, Brooklyn, officials went further, issuing mandates requiring vaccination.

The campaign in West Texas has been less forceful. Management of outbreaks like this one falls to state health officials, and they ask for help from the C.D.C. and other federal resources as necessary.

The C.D.C. is providing some technical assistance, but Texas health officials said they did not need more help from the agency. They have not declared a public health emergency, as officials did in parts of New York State, nor have they moved to mandate vaccination.

“We can’t force anybody to take a drug — that’s assault,” said Dr. Ron Cook, a health official in nearby Lubbock, at a news conference on Friday.

Advertisement

Zachary Holbrooks, the local public health official for four Texas counties, including Gaines, said that type of mandate would be deeply unpopular in the state, where individual freedom is a strongly held value.

Texas public schools require children to have received certain vaccines, including the M.M.R. shot. But in this state, as in many others, parents can apply for an exemption for “reasons of conscience,” including religious beliefs.

In January, as the first cases of measles began spreading in Gaines County, state legislators introduced several bills designed to weaken school vaccination requirements.

“I don’t want to see a baby’s lips turn blue because they can’t breathe,” Mr. Holbrooks said. “I don’t want anybody to suffer from long-lasting disability because they got measles.”

“But if you choose to live in Texas,” he added, “you can exercise that option.”

Advertisement

Science

California’s last nuclear plant clears major hurdle to power on

Published

on

California’s last nuclear plant clears major hurdle to power on

California environmental regulators on Thursday struck a landmark deal with Pacific Gas & Electric to extend the life of the state’s last remaining nuclear power plant in exchange for thousands of acres of new land conservation in San Luis Obispo County.

PG&E’s agreement with the California Coastal Commission is a key hurdle for the Diablo Canyon nuclear plant to remain online until at least 2030. The plant was slated to close this year, largely due to concerns over seismic safety, but state officials pushed to delay it — saying the plant remains essential for the reliable operation of California’s electrical grid. Diablo Canyon provides nearly 9% of the electricity generated in the state, making it the state’s single largest source.

The Coastal Commission voted 9-3 to approve the plan, settling the fate of some 12,000 acres that surround the power plant as a means of compensation for environmental harm caused by its continued operation.

Nuclear power does not emit greenhouse gases. But Diablo Canyon uses an estimated 2.5 billion gallons of ocean water each day to absorb heat in a process known as “once-through cooling,” which kills an estimated two billion or more marine organisms each year.

Some stakeholders in the region celebrated the conservation deal, while others were disappointed by the decision to trade land for marine impacts — including a Native tribe that had hoped the land would be returned to them. Diablo Canyon sits along one of the most rugged and ecologically rich stretches of the California coast.

Advertisement

Under the agreement, PG&E will immediately transfer a 4,500-acre parcel on the north side of the property known as the “North Ranch” into a conservation easement and pursue transfer of its ownership to a public agency such as the California Department of Parks and Recreation, a nonprofit land conservation organization or tribe. A purchase by State Parks would result in a more than 50% expansion of the existing Montaña de Oro State Park.

PG&E will also offer a 2,200-acre parcel on the southern part of the property known as “Wild Cherry Canyon” for purchase by a government agency, nonprofit land conservation organization or tribe. In addition, the utility will provide $10 million to plan and manage roughly 25 miles of new public access trails across the entire property.

“It’s going to be something that changes lives on the Central Coast in perpetuity,” Commissioner Christopher Lopez said at the meeting. “This matters to generations that have yet to exist on this planet … this is going to be a place that so many people mark in their minds as a place that transforms their lives as they visit and recreate and love it in a way most of us can’t even imagine today.”

Critically, the plan could see Diablo Canyon remain operational much longer than the five years dictated by Thursday’s agreement. While the state Legislature only authorized the plant to operate through 2030, PG&E’s federal license renewal would cover 20 years of operations, potentially keeping it online until 2045.

Should that happen, the utility would need to make additional land concessions, including expanding an existing conservation area on the southern part of the property known as the “South Ranch” to 2,500 acres. The plan also includes rights of first refusal for a government agency or a land conservation group to purchase the entirety of the South Ranch, 5,000 acres, along with Wild Cherry Canyon — after 2030.

Advertisement
Pelicans along the concrete breakwater at Pacific Gas and Electric's Diablo Canyon Power Plant

Pelicans along the concrete breakwater at Pacific Gas and Electric’s Diablo Canyon Power Plant

(Brian van der Brug/Los Angeles Times)

Many stakeholders were frustrated by the carve-out for the South Ranch, but still saw the agreement as an overall victory for Californians.

“It is a once in a lifetime opportunity,” Sen. John Laird (D-Santa Cruz) said in a phone call ahead of Thursday’s vote. “I have not been out there where it has not been breathtakingly beautiful, where it is not this incredible, unique location, where you’re not seeing, for much of it, a human structure anywhere. It is just one of those last unique opportunities to protect very special land near the California coast.”

Others, however, described the deal as disappointing and inadequate.

Advertisement

That includes many of the region’s Native Americans who said they felt sidelined by the agreement. The deal does not preclude tribal groups from purchasing the land in the future, but it doesn’t guarantee that or give them priority.

The yak titʸu titʸu yak tiłhini Northern Chumash Tribe of San Luis Obispo County and Region, which met with the Coastal Commission several times in the lead-up to Thursday’s vote, had hoped to see the land returned to them.

Scott Lanthrop is a member of the tribe’s board and has worked on the issue for several years.

“The sad part is our group is not being recognized as the ultimate conservationist,” he told The Times. “Any normal person, if you ask the question, would you rather have a tribal group that is totally connected to earth and wind and water, or would you like to have some state agency or gigantic NGO manage this land, I think the answer would be, ‘Hey, you probably should give it back to the tribe.’”

Tribe chair Mona Tucker said she fears that free public access to the land could end up harming it instead of helping it, as the Coastal Commission intends.

Advertisement

“In my mind, I’m not understanding how taking the land … is mitigation for marine life,” Tucker said. “It doesn’t change anything as far as impacts to the water. It changes a lot as far as impacts to the land.”

Montaña de Oro State Park.

Montaña de Oro State Park.

(Christopher Reynolds / Los Angeles Times)

The deal has been complicated by jurisdictional questions, including who can determine what happens to the land. While PG&E owns the North Ranch parcel that could be transferred to State Parks, the South Ranch and Wild Cherry Canyon are owned by its subsidiary, Eureka Energy Company.

What’s more, the California Public Utilities Commission, which regulates utilities such as PG&E, has a Tribal Land Transfer Policy that calls for investor-owned power companies to transfer land they no longer want to Native American tribes.

Advertisement

In the case of Diablo Canyon, the Coastal Commission became the decision maker because it has the job of compensating for environmental harm from the facility’s continued operation. Since the commission determined Diablo’s use of ocean water can’t be avoided, it looked at land conservation as the next best method.

This “out-of-kind” trade-off is a rare, but not unheard of way of making up for the loss of marine life. It’s an approach that is “feasible and more likely to succeed” than several other methods considered, according to the commission’s staff report.

“This plan supports the continued operation of a major source of reliable electricity for California, and is in alignment with our state’s clean energy goals and focus on coastal protection,” Paula Gerfen, Diablo Canyon’s senior vice president and chief nuclear officer, said in a statement.

But Assemblymember Dawn Addis (D-Morro Bay) said the deal was “not the best we can do” — particularly because the fate of the South Ranch now depends on the plant staying in operation beyond 2030.

“I believe the time really is now for the immediate full conservation of the 12,000 [acres], and to bring accountability and trust back for the voters of San Luis Obispo County,” Addis said during the meeting.

Advertisement

There are also concerns about the safety of continuing to operate a nuclear plant in California, with its radioactive waste stored in concrete casks on the site. Diablo Canyon is subject to ground shaking and earthquake hazards, including from the nearby Hosgri Fault and the Shorline Fault, about 2.5 miles and 1 mile from the facility, respectively.

PG&E says the plant has been built to withstand hazards. It completed a seismic hazard assessment in 2024, and determined Diablo Canyon is safe to continue operation through 2030. The Coastal Commission, however, found if the plant operates longer, it would warrant further seismic study.

A key development for continuing Diablo Canyon’s operation came in 2022 with Senate Bill 846, which delayed closure by up to five additional years. At the time, California was plagued by rolling blackouts driven extreme heat waves, and state officials were growing wary about taking such a major source of power offline.

But California has made great gains in the last several years — including massive investments in solar energy and battery storage — and some questioned whether the facility is still needed at all.

Others said conserving thousands of acres of land still won’t make up for the harms to the ocean.

Advertisement

“It is unmitigatable,” said David Weisman, executive director of the nonprofit Alliance for Nuclear Responsibility. He noted that the Coastal Commission’s staff report says it would take about 99 years to balance the loss of marine life with the benefits provided by 4,500 acres of land conservation. Twenty more years of operation would take about 305 years to strike that same balance.

But some pointed out that neither the commission nor fisheries data find Diablo’s operations cause declines in marine life. Ocean harm may be overestimated, said Seaver Wang, an oceanographer and the climate and energy director at the Breakthrough Institute, a Berkeley-based research center.

In California’s push to transition to clean energy, every option comes with downsides, Wang said. In the case of nuclear power — which produces no greenhouse gas emissions — it’s all part of the trade off, he said.

“There’s no such thing as impacts-free energy,” he said.

The Coastal Commission’s vote is one of the last remaining obstacles to keeping the plant online. PG&E will also need a final nod from the Regional Water Quality Control Board, which decides on a pollution discharge permit in February.

Advertisement

The federal Nuclear Regulatory Commission will also have to sign off on Diablo’s extension.

Continue Reading

Science

In search for autism’s causes, look at genes, not vaccines, researchers say

Published

on

In search for autism’s causes, look at genes, not vaccines, researchers say

Earlier this year, Health and Human Services Secretary Robert F. Kennedy Jr. pledged that the search for autism’s cause — a question that has kept researchers busy for the better part of six decades — would be over in just five months.

“By September, we will know what has caused the autism epidemic, and we’ll be able to eliminate those exposures,” Kennedy told President Trump during a Cabinet meeting in April.

That ambitious deadline has come and gone. But researchers and advocates say that Kennedy’s continued fixation on autism’s origins — and his frequent, inaccurate claims that childhood vaccines are somehow involved — is built on fundamental misunderstandings of the complex neurodevelopmental condition.

Even after more than half a century of research, no one yet knows exactly why some people have autistic traits and others do not, or why autism spectrum disorder looks so different across the people who have it. But a few key themes have emerged.

Researchers believe that autism is most likely the result of a complex set of interactions between genes and the environment that unfold while a child is in the womb. It can be passed down through families, or originate with a spontaneous gene mutation.

Advertisement

Environmental influences may indeed play a role in some autism cases, but their effect is heavily influenced by a person’s genes. There is no evidence for a single trigger that causes autism, and certainly not one a child encounters after birth: not a vaccine, a parenting style or a post-circumcision Tylenol.

“The real reason why it’s complicated, the more fundamental one, is that there’s not a single cause,” said Irva Hertz-Picciotto, a professor of public health science and director of the Environmental Health Sciences Center at UC Davis. “It’s not a single cause from one person to the next, and not a single cause within any one person.”

Kennedy, an attorney who has no medical or scientific training, has called research into autism’s genetics a “dead end.” Autism researchers counter that it’s the only logical place to start.

“If we know nothing else, we know that autism is primarily genetic,” said Joe Buxbaum, a molecular neuroscientist who directs the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai. “And you don’t have to actually have the exact genes [identified] to know that something is genetic.”

Some neurodevelopment disorders arise from a difference in a single gene or chromosome. People with Down syndrome have an extra copy of chromosome 21, for example, and Fragile X syndrome results when the FMR1 gene isn’t expressed.

Advertisement

Autism in most cases is polygenetic, which means that multiple genes are involved, with each contributing a little bit to the overall picture.

Researchers have found hundreds of genes that could be associated with autism; there may be many more among the roughly 20,000 in the human genome.

In the meantime, the strongest evidence that autism is genetic comes from studies of twins and other sibling groups, Buxbaum and other researchers said.

The rate of autism in the U.S. general population is about 2.8%, according to a study published last year in the journal Pediatrics. Among children with at least one autistic sibling, it’s 20.2% — about seven times higher than the general population, the study found.

Twin studies reinforce the point. Both identical and fraternal twins develop in the same womb and are usually raised in similar circumstances in the same household. The difference is genetic: identical twins share 100% of their genetic information, while fraternal twins share about 50% (the same as nontwin siblings).

Advertisement

If one fraternal twin is autistic, the chance that the other twin is also autistic is about 20%, or about the same as it would be for a nontwin sibling.

But if one in a pair of identical twins is autistic, the chance that the other twin is also autistic is significantly higher. Studies have pegged the identical twin concurrence rate anywhere from 60% to 90%, though the intensity of the twins’ autistic traits may differ significantly.

Molecular genetic studies, which look at the genetic information shared between siblings and other blood relatives, have found similar rates of genetic influence on autism, said Dr. John Constantino, a professor of pediatrics, psychiatry and behavioral sciences at the Emory University School of Medicine and chief of behavioral and mental health at Children’s Healthcare of Atlanta.

Together, he said, “those studies have indicated that a vast share of the causation of autism can be traced to the effects of genetic influences. That is a fact.”

Buxbaum compares the heritability of autism to the heritability of height, another polygenic trait.

Advertisement

“There’s not one gene that’s making you taller or shorter,” Buxbaum said. Hundreds of genes play a role in where you land on the height distribution curve. A lot of those genes run in families — it’s not unusual for very tall people, for example, to have very tall relatives.

But parents pass on a random mix of their genes to their children, and height distribution across a group of same-sex siblings can vary widely. Genetic mutations can change the picture. Marfan syndrome, a condition caused by mutations in the FBN1 gene, typically makes people grow taller than average. Hundreds of genetic mutations are associated with dwarfism, which causes shorter stature.

Then once a child is born, external factors such as malnutrition or disease can affect the likelihood that they reach their full height potential.

So genes are important. But the environment — which in developmental science means pretty much anything that isn’t genetics, including parental age, nutrition, air pollution and viruses — can play a major role in how those genes are expressed.

“Genetics does not operate in a vacuum, and at the same time, the impact of the environment on people is going to depend on a person’s individual genetics,” said Brian K. Lee, a professor of epidemiology and biostatistics at Drexel University who studies the genetics of developmental disorders.

Advertisement

Unlike the childhood circumstances that can affect height, the environmental exposures associated with autism for the most part take place in utero.

Researchers have identified multiple factors linked to increased risks of the disorder, including older parental age, infant prematurity and parental exposure to air pollution and industrial solvents.

Investigations into some of these linkages were among the more than 50 autism-related studies whose funding Kennedy has cut since taking office, a ProPublica investigation found. In contrast, no credible study has found links between vaccines and autism — and there have been many.

One move from the Department of Health and Human Services has been met with cautious optimism: even as Kennedy slashed funding to other research projects, the department in September announced a $50-million initiative to explore the interactions of genes and environmental factors in autism, which has been divided among 13 different research groups at U.S. universities, including UCLA and UC San Diego.

The department’s selection of well-established, legitimate research teams was met with relief by many autism scientists.

Advertisement

But many say they fear that such decisions will be an anomaly under Kennedy, who has repeatedly rejected facts that don’t conform to his preferred hypotheses, elevated shoddy science and muddied public health messaging on autism with inaccurate information.

Disagreements are an essential part of scientific inquiry. But the productive ones take place in a universe of shared facts and build on established evidence.

And when determining how to spend limited resources, researchers say, making evidence-based decisions is vital.

“There are two aspects of these decisions: Is it a reasonable expenditure based on what we already know? And if you spend money here, will you be taking money away from HHS that people are in desperate need of?” Constantino said. “If you’re going to be spending money, you want to do that in a way that is not discarding what we already know.”

Advertisement
Continue Reading

Science

Contributor: New mothers are tempted by Ozempic but don’t have the data they need

Published

on

Contributor: New mothers are tempted by Ozempic but don’t have the data they need

My friend Sara, eight weeks after giving birth, left me a tearful voicemail. I’m a clinical psychologist specializing in postpartum depression and psychosis, but mental health wasn’t Sara’s issue. Postpartum weight gain was.

Sara told me she needed help. She’d gained 40 pounds during her pregnancy, and she was still 25 pounds overweight. “I’m going back to work and I can’t look like this,” she said. “I need to take Ozempic or something. But do you know if it’s safe?”

Great question. Unfortunately researchers don’t yet have an answer. On Dec. 1, the World Health Organization released its first guidelines on the use of GLP-1 receptor agonists such as Ozempic, generically known as semaglutide. One of the notable policy suggestions in that report is to not prescribe GLP-1s to pregnant women. Disappointingly, the report says nothing about the use of the drug by postpartum women, including those who are breastfeeding.

There was a recent Danish study that led to medical guidelines against prescribing to patients who are pregnant or breastfeeding.

Advertisement

None of that is what my friend wanted to hear. I could only encourage her to speak to her own medical doctor.

Sara’s not alone. I’ve seen a trend emerging in my practice in which women use GLP-1s to shed postpartum weight. The warp speed “bounce-back” ideal of body shapes for new mothers has reemerged, despite the mental health field’s advocacy to abolish the archaic pressure of martyrdom in motherhood. GLP-1s are being sold and distributed by compound pharmacies like candy. And judging by their popularity, nothing tastes sweeter than skinny feels.

New motherhood can be a stressful time for bodies and minds, but nature has also set us up for incredible growth at that moment. Contrary to the myth of spaced-out “mommy brains,” new neuroplasticity research shows that maternal brains are rewired for immense creativity and problem solving.

How could GLP-1s affect that dynamic? We just don’t know. We do know that these drugs are associated with changes far beyond weight loss, potentially including psychiatric effects such as combating addiction.

Aside from physical effects, this points to an important unanswered research question: What effects, if any, do GLP-1s have on a woman’s brain as it is rewiring to attune to and take care of a newborn? And on a breastfeeding infant? If GLP-1s work on the pleasure center of the brain and your brain is rewiring to feel immense pleasure from a baby coo, I can’t help but wonder if that will be dampened. When a new mom wants a prescription for a GLP-1 to help shed baby weight, her medical provider should emphasize those unknowns.

Advertisement

These drugs may someday be a useful tool for new mothers. GLP-1s are helping many people with conditions other than obesity. A colleague of mine was born with high blood pressure and cholesterol. She exercised every day and adopted a pescatarian diet. Nothing budged until she added a GLP-1 to her regimen, bringing her blood pressure to a healthy 120/80 and getting cholesterol under control. My brother, an otherwise healthy young man recently diagnosed with a rare idiopathic lymphedema of his left leg, is considering GLP-1s to address inflammation and could be given another chance at improving his quality of life.

I hope that GLP-1s will continue to help those who need it. And I urge everyone — especially new moms — to proceed with caution. A healthy appetite for nutritious food is natural. That food fuels us for walks with our dogs, swims along a coastline, climbs through leafy woods. It models health and balance for the young ones who are watching us for clues about how to live a healthy life.

Nicole Amoyal Pensak, a clinical psychologist and researcher, is the author of “Rattled: How to Calm New Mom Anxiety With the Power of the Postpartum Brain.”

Advertisement
Continue Reading
Advertisement

Trending