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Secrets of Rapid Scarless Mouth Healing Uncovered via scRNA-Seq – Genetic Engineering and Biotechnology News
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Mastering AI at work: a practical guide to using ChatGPT, Gemini, Claude, and more
However, getting ahead of the game and implementing AI into your work routine is often easier said than done—especially for those who don’t even know where to start. In fact, getting up and running is one of the biggest challenges in today’s AI era, according to Jules White, a computer science professor at Vanderbilt University.
“The main problem is that most people don’t know where to start when confronted with a blank generative AI canvas,” White tells Fortune. “The limit isn’t the technology, the limit is our ability to creatively use it in our work and daily lives.”
There’s no question: AI can make the lives of workers easier and more productive—whether it’s to summarize long documents, generate slideshows, analyze speaker notes, or something much more advanced. Here’s what you need to know to make it happen—and effectively prompt generative AI chatbots like ChatGPT, Gemini, Claude, and Copilot in the workplace:
- Follow the golden rule of prompting
- Treat AI like fostering a relationship
- Use more than just the chat function
- Don’t overthink it
Follow the golden rule of prompting
Growing up, you probably were told that the golden rule was to treat others the way you want to be treated. And in a sense, AI operates in the same way: treat the technology just like you’d ask someone for something—making sure it has enough context to know what’s going on.
Anthropic sums it down to the “golden rule of clear prompting:”
“Show your prompt to a colleague, ideally someone who has minimal context on the task, and ask them to follow the instructions. If they’re confused, Claude will likely be too.”
In practicality, there are four main areas of focus when writing a prompt, according to Google’s Prompting Guide 101: Persona, Task, Context, and Format. Here’s a simple example it cites:
“I’m a PR manager. (Persona) I need to create a press release with a catchy title. (Task) Include quotes from (Format) @[Document name] (Context).”
Not every prompt must include the four areas, but providing effective context helps move the needle when it comes to the response, according to Maggie Vo, head of user education at Anthropic—the company behind Claude.
“Instead of ‘Write a summary of quantum computing,’ try ‘I’m preparing for a job interview at a quantum computing startup. I have a physics background but no quantum experience. Help me speak intelligently about key concepts,’” she suggests. “That context completely transforms the output.”
Following the golden rule also might mean you are tempted to be polite to AI by saying please and thank you—something OpenAI CEO Sam Altman has said is costing his company “tens of millions of dollars.” But in actuality, there’s little indication social niceties significantly improve outputs.
The persona pattern—meaning assigning the AI a specific hat or writing style—in particular is a great gateway into learning how different AI is, White says; in fact, it’s the very first thing he teaches in his class, “Prompt Engineering for ChatGPT,” a Coursera class that’s been started by more than 450,000 individuals.
“The persona goes way beyond things like ‘act as a professor of computer science,’” he tells Fortune. “You can ask Generative AI to ‘act as a computer that has been the victim of a cyber attack’ and it can simulate how that computer might work.”
Above all, Google notes that including a verb or command as part of your task is the “most important component of a prompt.” Unlike a traditional Google search, which might assume you want to purchase “cat food” if that’s all you type, typing the phrase into AI might leave you will more questions that answers:
Treat AI like a fostering a relationship
Even with a seemingly great prompt, chatbots may not give you the response you will be looking for. While this might feel especially frustrating after utilizing a deeper reasoning model that took several minutes to process, it shouldn’t necessarily be a reason to slam your laptop shut.
Rather, use it as a learning experience. Though not all AI have persistent memory—and will learn from your interactions—your prompting expertise will only improve with practice.
As Google states, “Fine-tune your prompts if the results don’t meet your expectations or if you believe there’s room for improvement.” But this doesn’t mean you necessarily have to start a new session and copy your old question over again. Instead, “use follow-up prompts and an iterative process of review and refinement to yield better results.”
In practice, this also means you should point out errors or lapses in judgment from the responses because while hallucinations are not as prevalent as they once were, perfect AI accuracy is not guaranteed.
Say you ask for the AI to give you the estimated population of 50 cities in the U.S., and the output mistakes Portland, Maine, with Portland, Oregon—or it skips a city altogether. Instead of just repeating the prompt again until it gets it right, you could simply point out that it skipped over two entries—and the AI will realize its mistake.
In a sense, interacting with AI should not feel like a monotonous, copy and paste-type relationship, White says. Instead, use it like a partner.
That can include you asking the AI questions. For example, “I need help writing a marketing email, what details would be helpful for me to supply?”
And as Ethan Mollick, a professor at the University of Pennsylvania’s Wharton School—who is known for his prolific AI research and analysis on LinkedIn—points out, don’t be afraid to push the AI to its limits.
“Ask for 50 ideas instead of 10, or thirty options to improve a sentence,” Mollick suggested on his Substack. “Then push the AI to expand on the things you like.”
Mollick did not respond to Fortune’s request for comment.
Use more than just the chat function
AI innovation has surpassed just text-based interaction. You can upload spreadsheets, slideshows, and markup files for analysis. Say, for example, you have a spreadsheet full of recent sales data—instead of spending time trying to create pivot tables—AI can be asked directly, “Which sales region had the highest revenue growth over the last two quarters?”
Certain chatbot models, like ChatGPT and Midjourney, also have the ability to create graphs, slideshows, and pictures—or analyze ones you upload.
“My wife can snap a picture of the random ingredients left in our fridge and get 10 recipes that she could make with them,” White says. “She can turn around and have it plan meals for a week.”
And if you aren’t a fan of typing, many chatbots have voice capabilities that could be a gamechanger in the business world by allowing you to not only have a seemingly natural conversation—but also share your screen or view your camera and react in real time.
“I’ve used it to identify plants on hikes, solve a problem on my screen, and get cooking tips while my hands were covered in flour,” Mollick wrote. “This multimodal capability is genuinely futuristic, yet most people just use voice mode like Siri. You’re missing the best part.”
Don’t overthink it
Practice makes perfect when it comes to AI technology. Becoming an expert prompter or “AI whisper” is no longer a skill with a large barrier to entry. In fact, in today’s era, the most effective tactics revolve around using natural language, just like you’d use when asking a co-worker for help.
And worse-case scenario, the best way to learn how to prompt is asking the AI itself.
“AI can literally teach you how to communicate with it better,” Vo says. “It’s surprisingly effective and saves you from memorizing prompt templates.”
Lastly, make sure to ask your employer if there’s any guidance around using AI at work. If not, ask, why not?
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FaceTime in iOS 26 will freeze your call if someone starts undressing
iOS 26 is a packed update for iPhone users thanks to the new Liquid Glass design and major updates for Messages, Wallet, CarPlay, and more. But another new feature was just discovered in the iOS 26 beta: FaceTime will now freeze your call’s video and audio if someone starts undressing.
New FaceTime safety feature for child accounts in iOS 26 seems to apply to adults too
When Apple unveiled iOS 26 last month, it mentioned a variety of new family tools coming for child accounts.
One of those announcements involved a change coming to FaceTime to block nudity.
Communication Safety expands to intervene when nudity is detected in FaceTime video calls, and to blur out nudity in Shared Albums in Photos.
However, at least in the iOS 26 beta, it seems that a similar feature may be in place for all users—adults included.
As discovered by iDeviceHelp on X, FaceTime in iOS 26 freezes your call’s video and audio when it detects nudity.
The app will then show the following warning message:
As you can see, FaceTime provides the option of immediately resuming audio and video, or ending the call.
It’s unclear whether this is an intended behavior, or just a bug in the beta that’s applying the feature to adults when it should only apply to child accounts.
While this feature might raise privacy concerns for some, here’s how Apple’s existing Communication Safety features work:
Communication Safety uses on-device machine learning to analyze photo and video attachments and determine if a photo or video appears to contain nudity. Because the photos and videos are analyzed on your child’s device, Apple doesn’t receive an indication that nudity was detected and doesn’t get access to the photos or videos as a result.
In other words, everything happens on-device so Apple has no idea about the contents of your call.
We’ll keep you posted with any discoveries or new information we learn related to the FaceTime feature in iOS 26.
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How NASA’s SPHEREx Mission Will Share Its All-Sky Map With the World
NASA’s newest astrophysics space telescope launched in March on a mission to create an all-sky map of the universe. Now settled into low-Earth orbit, SPHEREx (Spectro-Photometer for the History of the Universe, Epoch of Reionization, and Ices Explorer) has begun delivering its sky survey data to a public archive on a weekly basis, allowing anyone to use the data to probe the secrets of the cosmos.
“Because we’re looking at everything in the whole sky, almost every area of astronomy can be addressed by SPHEREx data,” said Rachel Akeson, the lead for the SPHEREx Science Data Center at IPAC. IPAC is a science and data center for astrophysics and planetary science at Caltech in Pasadena, California.
Rachel Akeson
SPHEREx Science Data Center Lead
Other missions, like NASA’s now-retired WISE (Wide-field Infrared Survey Explorer), have also mapped the entire sky. SPHEREx builds on this legacy by observing in 102 infrared wavelengths, compared to WISE’s four wavelength bands.
By putting the many wavelength bands of SPHEREx data together, scientists can identify the signatures of specific molecules with a technique known as spectroscopy. The mission’s science team will use this method to study the distribution of frozen water and organic molecules — the “building blocks of life” — in the Milky Way.
This animation shows how NASA’s SPHEREx observatory will map the entire sky — a process it will complete four times over its two-year mission. The telescope will observe every point in the sky in 102 different infrared wavelengths, more than any other all-sky survey. SPHEREx’s openly available data will enable a wide variety of astronomical studies. Credit: NASA/JPL-Caltech The SPHEREx science team will also use the mission’s data to study the physics that drove the universe’s expansion following the big bang, and to measure the amount of light emitted by all the galaxies in the universe over time. Releasing SPHEREx data in a public archive encourages far more astronomical studies than the team could do on their own.
“By making the data public, we enable the whole astronomy community to use SPHEREx data to work on all these other areas of science,” Akeson said.
NASA is committed to the sharing of scientific data, promoting transparency and efficiency in scientific research. In line with this commitment, data from SPHEREx appears in the public archive within 60 days after the telescope collects each observation. The short delay allows the SPHEREx team to process the raw data to remove or flag artifacts, account for detector effects, and align the images to the correct astronomical coordinates.
The team publishes the procedures they used to process the data alongside the actual data products. “We want enough information in those files that people can do their own research,” Akeson said.
During its two-year prime mission, SPHEREx will survey the entire sky twice a year, creating four all-sky maps. After the mission reaches the one-year mark, the team plans to release a map of the whole sky at all 102 wavelengths.
In addition to the science enabled by SPHEREx itself, the telescope unlocks an even greater range of astronomical studies when paired with other missions. Data from SPHEREx can be used to identify interesting targets for further study by NASA’s James Webb Space Telescope, refine exoplanet parameters collected from NASA’s TESS (Transiting Exoplanet Survey Satellite), and study the properties of dark matter and dark energy along with ESA’s (European Space Agency’s) Euclid mission and NASA’s upcoming Nancy Grace Roman Space Telescope.
The IPAC archive that hosts SPHEREx data, IRSA (NASA/IPAC Infrared Science Archive), also hosts pointed observations and all-sky maps at a variety of wavelengths from previous missions. The large amount of data available through IRSA gives users a comprehensive view of the astronomical objects they want to study.
“SPHEREx is part of the entire legacy of NASA space surveys,” said IRSA Science Lead Vandana Desai. “People are going to use the data in all kinds of ways that we can’t imagine.”
NASA’s Office of the Chief Science Data Officer leads open science efforts for the agency. Public sharing of scientific data, tools, research, and software maximizes the impact of NASA’s science missions. To learn more about NASA’s commitment to transparency and reproducibility of scientific research, visit science.nasa.gov/open-science. To get more stories about the impact of NASA’s science data delivered directly to your inbox, sign up for the NASA Open Science newsletter.
By Lauren Leese
Web Content Strategist for the Office of the Chief Science Data OfficerThe SPHEREx mission is managed by NASA’s Jet Propulsion Laboratory for the agency’s Astrophysics Division within the Science Mission Directorate at NASA Headquarters. BAE Systems in Boulder, Colorado, built the telescope and the spacecraft bus. The science analysis of the SPHEREx data will be conducted by a team of scientists located at 10 institutions in the U.S., two in South Korea, and one in Taiwan. Caltech in Pasadena managed and integrated the instrument. The mission’s principal investigator is based at Caltech with a joint JPL appointment. Data will be processed and archived at IPAC at Caltech. The SPHEREx dataset will be publicly available at the NASA-IPAC Infrared Science Archive. Caltech manages JPL for NASA.
To learn more about SPHEREx, visit:
https://nasa.gov/SPHEREx
Calla Cofield
Jet Propulsion Laboratory, Pasadena, Calif.
626-808-2469
calla.e.cofield@jpl.nasa.govAmanda Adams
Office of the Chief Science Data Officer
256-683-6661
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Carlos Alcaraz prevails over Oliver Tarvet in British qualifier’s ‘most special day of my life’
The Olympic silver medallist looked far more assured and assertive from his five-set encounter two days earlier, in a result which extends his career-best run to 20 victories on the bounce.
Alcaraz headed to Court 18 after his match to get a look at his next opponent, either fellow Paris 2024 medallist Felix Auger-Aliassime of Canada or World number 125 Jan-Lennard Struff, who the Spaniard has defeated in three straight encounters.
Wimbledon 2025 – Oliver Tarvet, the qualifier who went toe-to-toe with defending champion Alcaraz
In the space of nine days, 21-year-old Tarvet has made it through the qualifying rounds at Roehampton, won on his major main drew debut and faced up against five-time Grand Slam winner Alcaraz.
“Obviously there were a lot of nerves,” he said post-match. “I’ve said before that I try and treat every match as the same, try and play the ball, not the player or the situation. As much I tried to do that today, I woke up a couple times in the night from the adrenaline. In the car, my heart rate was going quicker than it usually does.
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Paolini falls to Rakhimova, fourth Top 5 seed to lose at Wimbledon
Defending finalist Jasmine Paolini wasn’t able to avoid the upset bug that’s come for many of tennis’ top players in the first two rounds at Wimbledon.
Wimbledon: Scores | Order of play | Draws
The fourth-seeded Italian was a set up against Kamilla Rakhimova in the second round on Wednesday, but couldn’t close the door in what was eventually a 4-6, 6-4, 6-4 defeat.
Runner-up to Barbora Krejcikova last year, Paolini is the fourth Top 5 seed to lose in the first two rounds at the All England Club this week. No. 2 Coco Gauff, No. 3 Jessica Pegula and No. 5 Zheng Qinwen all lost in the first round on Tuesday — and No. 9 seed Paula Badosa was bundled out by Katie Boulter on Monday.
Fifteen of the 32 seeds lost over the first three days in all.
World No. 62 Rakhimova entered the match 0-7 against Top 10 players in her career, and had won just one set in those matches. But she turned the tide in the match by saving four break points in her first service game of the second set when trailing 6-4, 1-0.
She never lost serve in sets two and three, and made a break of Paolini’s serve to start the decider stand up until the end of the 2 hour, 19-minute affair.
The 23-year-old moves on to the third round of a Grand Slam event for the third time, having previously done so at the US Open in 2021, and Roland Garros in 2023.
Looking to reach the fourth round of a major for the first time, Rakhimova will next face No. 30 seed Linda Noskova, who also won a three-setter in her own second-round match against German Eva Lys 6-2, 2-6, 6-3. While Noskova reached the quarterfinals of the Australian Open last year, this is her first time past the second round at Wimbledon.
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Kate Middleton latest news today: Princess describes cancer, health journey as a ‘roller coaster’
COLCHESTER, England — Princess Kate is sharing new details about her recovery from cancer, describing the experience as a “roller coaster.”
“You put on a sort of brave face, stoicism, through treatment. Treatment’s done, and it’s like, ‘I can crack on, get back to normal again,’ but actually that phase afterwards is a really difficult time,” Kate said Wednesday during a visit to Colchester Hospital in Colchester, England, according to the Press Association.
“You’re not able to function normally at home as you were perhaps once used to,” added Kate, who shares three young children with her husband Prince William.
Kate, 43, announced in January that she is in remission from cancer.
She first announced her cancer diagnosis publicly in March 2024. Kate has not shared the type of cancer with which she was diagnosed or any details of her treatment beyond sharing that she underwent chemotherapy.
Kate’s visit to the hospital Wednesday is part of her gradual return to work that began late last year.
In speaking with cancer patients, Kate reflected on the recovery process, saying it’s not as straightforward as people expect.
“It’s a roller coaster. It’s not one smooth plain, which you expect it to be, but the reality is it’s not. You go through hard times, and to have a place like this, to have the support network, whether its through creativity and singing or gardening, whatever it might be, is so valuable, and it’s great that this community has it,” she said. “It would be great if lots of communities had this kind of support.”
While at the hospital, Kate visited the RHS Wellbeing Garden, where she took time to plant some roses.
In addition to meeting with cancer patients at the hospital, Kate also met with staff and volunteers, to whom she spoke more about the “life-changing” experience of a cancer diagnosis.
“It’s life-changing for anyone, through first diagnosis or post-treatment and things like that, it is a life-changing experience both for the individual patient but also for the families as well,” she said. “And actually, it sometimes goes unrecognized, you don’t necessarily, particularly when it’s the first time, you don’t appreciate how much impact it is going to have. You have to find your new normal, and that takes time.”
The video in the player above is from an earlier report.
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These 10 States Could See Aurora Borealis Tonight
Topline
The northern lights might make an appearance in 10 states Wednesday night, according to the National Oceanic and Atmospheric Administration, which has forecast similar auroral conditions for Thursday.
A northern lights showing in the Netherlands. (Photo by Sjoerd van der Wal/Getty Images)
Key Facts
NOAA forecasts a Kp index of four on Wednesday night, meaning there should be an increase in auroral activity that “can be quite pleasing to look at” for people in the right areas with good viewing conditions.
Much of the northern parts of the Midwest are above the forecasted view line, with chances of seeing the northern lights increasing the further north people are from the line.
Northern lights viewers who don’t catch the natural phenomenon Wednesday night will have another chance Thursday night, as the Kp index is expected to reach four once again.
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Where Will The Northern Lights Be Visible?
States and areas within or north of the viewing line include Alaska, northern Washington, northern Idaho, Montana, North Dakota, northern South Dakota, Minnesota, northern Wisconsin, northern Michigan and northern Maine.
Wednesday’s viewing line.
What’s The Best Way To See The Northern Lights?
Try and catch a look at the northern lights between the hours of 10 p.m. and 2 a.m., which usually provide the best light conditions for viewing. If possible, try to observe from vantage points and areas with clear skies and little to no light pollution.
What’s The Best Way To Photograph The Northern Lights?
Wide-angle lenses, low apertures and tripods for those with traditional cameras. Smartphone users looking to snap photos on their mobile devices should use night mode and not use flash. Tripods can also help smartphones capture photos.
Key Background
The northern lights have been particularly active in the last year or so thanks to a solar maximum—a term that describes the peak of the sun’s 11-year cycle characterized by increased solar flares and coronal mass ejections, which contribute to increased auroral activity. Fair to strong northern lights showings will likely continue into next year, according to NASA and NOAA scientists.
Further Reading
Northern Lights Displays Hit A 500-Year Peak In 2024—Here’s Where You Could Catch Aurora Borealis In 2025 (Forbes)
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Supreme Court to Consider Closing a Back Door to Fund Litigation Claims Under the Investment Company Act | Insights
On June 30, the U.S. Supreme Court agreed to hear a case that will determine whether Section 47(b) of the Investment Company Act of 1940 (ICA) creates a private right of action for shareholders of registered investment companies to bring lawsuits for alleged violations of the statute. The Second Circuit Court of Appeals has recognized such a right of action since 2019, opening a back door to litigation claims by private plaintiffs for alleged ICA violations, despite Congress having granted the Securities and Exchange Commission (SEC) sole regulatory authority to enforce the ICA. Other circuit courts of appeal have rejected a Section 47(b) private right of action. This week, the Supreme Court granted certiorari in FS Credit Opportunities Corp. v. Saba Capital Master Fund, Ltd. to resolve the circuit split. The outcome of the appeal, to be heard in the Court’s October 2025 term, will have broad implications for registered funds governed by the ICA (including mutual funds, exchange-traded funds (ETFs) and closed-end funds), as the litigation door opened by the Second Circuit risks upending the long-established regulatory structure that is the fund industry’s bedrock.
In the ICA, Congress granted fund shareholders a single express private right of action to bring lawsuits – namely, a claim for allegedly excessive advisory fees under Section 36(b), which was added to the statute by amendment in 1970. Applying key Supreme Court precedent from 2000, lower courts have uniformly declined to read into the statutory language implied private rights of action to enforce other ICA provisions. The sole outlier was the Second Circuit’s 2019 decision in Oxford University Bank v. Lansuppe Feeder, LLC, recognizing an implied private right of action under Section 47(b). This provision states that a contract “whose performance involves … a violation of” the ICA cannot be enforced by any party to the contract. The Second Circuit panel concluded in Oxford University Bank that this language implied Congress’ intent to provide a private right of action to sue for “rescission” of a contract involving an alleged violation of another provision of the ICA.
Since Oxford University Bank, so-called “activist” investors like hedge fund manager Saba Capital have repeatedly seized upon Section 47(b) as an entry point to challenge closed-end fund by-laws as violating other provisions of the ICA regarding fund capital structure and board elections. These litigations have been in support of Saba’s closed-end fund “arbitrage strategy” seeking to dismantle such funds to obtain short-term profits at the expense of other shareholders. Tellingly, the SEC has not taken any enforcement action to challenge the bylaws in question as violating the ICA.
But the back door threat posed by a Section 47(b) private right of action extends well beyond the closed-end fund “activist” strategy, as explained in an amicus brief submitted to the Supreme Court by the Investment Company Institute (ICI) and the Asset Management Group of the Securities Industry and Financial Markets Association (SIFMA AMG) in support of Supreme Court review. Because fund management and operations are nearly always fully externalized, virtually every task involved in managing a fund and distributing its shares is undertaken by the fund’s investment adviser or other service providers pursuant to a written agreement with the fund in exchange for a fee. If fund shareholders can assert litigation claims for “rescission” of such service agreements based on alleged violations of other ICA provisions in the “performance” of the contracts (regardless of whether the SEC believes the ICA was violated), the potential litigation theories contrived by the private plaintiffs’ bar are almost limitless in scope.
The consequences of a potential flood of litigation claims by the plaintiffs’ bar via Section 47(b) go beyond wasteful litigation expense. The registered fund industry relies heavily on the stable regulatory framework established through the SEC’s decades of rulemaking, exemptive orders, no-action letters and other guidance. Private litigation claims, in which courts would not necessarily be bound by the SEC’s interpretation of the statute, could risk contradictory interpretation and significant regulatory uncertainty, dampening industry innovations and ultimately harming shareholders. The Supreme Court’s decision in FS Credit Opportunities Corp. could have a significant impact on all facets of the registered fund industry and bears close attention.
Ropes & Gray litigators represented ICI and SIFMA AMG in connection with their amicus brief to the Supreme Court.
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GLP-1s a good start to treat obesity, but patients need nutritional counseling and more, experts say
Patients hoping to treat weight-related medical conditions need more than just antiobesity medications that are effective, but that also pose challenges for successful use.
That means food counseling should be part of a comprehensive treatment plan for obesity, according to experts who summarized the state of the research on the issue.
A group of 18 researchers came together to publish “Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society.” It came out this month in the organizations’ respective journals.
The 24-page guide acknowledges that for some patients, the new glucagon-like peptide-1 receptor agonist drugs (GLP-1s) amount to weight loss via injection. But treatment success depends on a patient-centered approach involving more than a prescription.
Patients need counseling — and then must integrate into their lives — elements ranging from management of gastrointestinal side effects, to prevention of nutrient deficiencies, to preservation of muscle and bone mass.
“Despite the efficacy and growing utilization of these medications, real-world challenges are increasingly evident,” the paper said.
“All these challenges may be partially mitigated by an evidence-based, structured lifestyle program, particularly around food, when prescribing GLP-1s for obesity,” the advisory said. “However, practical guidance for clinicians to implement such an approach is limited.”
Medical effects
Studies have produced results showing GLP-1s have helped patients reduce their weight. But real-world efficacy generally has been lower, and weight regain is common when patients discontinue use of the medications, the advisory said. Research also has demonstrated clinical benefits for conditions ranging from heart failure to sleep apnea to chronic kidney disease to substance use disorders.
Gastrointestinal irritation is common, but not likely to lead to discontinuation. With a loss of appetite and lower energy intake, patients may develop vitamin and mineral deficiencies and symptoms such as fatigue, hair loss, skin flakiness, muscle weakness, poor wound healing and bruising, the advisory said. Muscle mass and bone density also may decrease.
Financial effects
Adherence to the drugs is relatively low for reasons that are unclear, although cost may be a factor. Based on current list prices, the drugs may cost up to $16,000 a year. Prices are lower with manufacturers’ rebates, dropping to $7,000 to $8,000 annually, and lower still with compounded versions, that still cost up to $3,000 a year.
While patients may experience improved quality of life, the GLP-1s have not provided a long-term financial return for health care overall. Several studies “have found that GLP-1 treatment costs exceed health care savings,” and one found patients using GLP-1 drugs had significantly higher health care costs than patients with obesity, but not using the drugs.
“Considering cost-effectiveness, i.e., health gained per dollar spent, most studies find that GLP-1s, even at currently discounted prices, do not meet accepted thresholds for cost-effective therapy,” the study said.
All those factors indicate something more is needed.
“These high costs, lower adherence in practice, and frequent weight regain after discontinuation, each highlight the importance of complementary nutritional and lifestyle counseling to help maximize overall efficacy and cost-effectiveness,” the advisory said.
Barriers to care
The researchers cited a number of difficulties in current practice:
- Visits with primary care physicians and non-obesity medicine specialists are usually short and centered on acute illness or needs, screening discussions, and medication management.
- Access is limited to lifestyle medicine approaches for obesity and its comorbidities. “For example, the Diabetes Prevention Program is known to reduce the risk of progression to diabetes and is covered by major payers, but has not been meaningfully scaled due to regulatory and implementation barriers,” the advisory said.
- There is no American Medical Association approval of category I Current Procedural Terminology codes for health coaching, so that remains a barrier to reimbursement.
- Private and public payer coverage for medical nutrition therapy for obesity remains limited, preventing broad utilization in practice.
“These pressures, alongside a frequent lack of practitioner education about integrating lifestyle management in medicine, have created a dearth of implemented behavioral and lifestyle counseling, accessible and effective referral programs, and integration into existing care delivery systems,” the authors said.
Getting started
The researchers suggested using a 5As Framework — assess, advise, agree, assist, and arrange — to guide physician-patient interaction toward a successful long-term plan. There also will be at least eight elements or nutritional priorities to support GLP-1 therapy for obesity.
- Initiation of GLP-1 therapy with a patient-centered approach.
- Completion of baseline nutritional assessment and screening.
- Management of gastrointestinal side effects.
- Navigation of dietary preferences and intake.
- Prevention and mitigation of nutrient deficiencies.
- Preservation of muscle and bone mass.
- Maximization of weight reduction efficacy.
- Promotion of other supportive lifestyle measures.
Under “arrange,” the experts noted physicians likely won’t go it alone with patients. Registered dietitian nutritionists, behavioral therapists, social workers and case managers all may be part of a team.
Along with medications, food counseling and a new menu, the authors emphasized the need for patients to take up resistance training and other physical activities. Good sleep, stress management and substance use cessation all will be part of the treatment plan.
More research is needed
The GLP-1 drugs still prompt questions and need more research. The researchers note physicians, other clinicians and patients refer to GLP-1s, but there is no widely accepted terminology to describe the medications. There also is room for research on measuring obesity and adopting definitions and treatments for clinical and preclinical obesity.
“In conclusion, although GLP-1s alone can produce significant weight reduction and related health benefits, several challenges limit its long-term success for individuals and populations,” the advisory said.
“Careful attention to evidence-based nutritional and behavior modification can help mitigate the adverse effects of these challenges,” the authors said. “Thus, all clinicians prescribing GLP-1s for obesity management should establish a thoughtful plan of care that includes thorough nutritional and lifestyle counseling before, during, and after the weight reduction period.”
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