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Could Mounjaro become the standard follow-up after old-fashioned weight loss?

Though this column sometimes explains elements of bicycling racing, the intent is never to turn you into a bicycle racer. It’s done to turn you onto ways to become healthier.

It’s just that bicycle racing is something I know, so when I write about something you need to know, I occasionally relate the former to the latter for a sense of perspective. With that said, let me tell you which riders in the Tour de France you should imitate as both a participant and promoter in a different contest, the Tour de Health.

Be like the guys they call the breakaway artists.

Breakaway artists attack early, often, and all-out. Their efforts tend to result in about a half dozen to a dozen riders - but sometimes as few as one or two - getting a few minutes ahead of the main group called the peloton.

Even though there can still be 100 or more miles to go, these riders from different teams work as a unified group - and far harder than they would as part of the peloton - because they don’t possess the speed needed to win the race if it comes down to a massive sprint at the end.

More often than not, the teams with the handful riders who can win such sprints willingly let the breakaway go. They know they can later work together to increase the pace and catch it just before the end.

About 90% of the time, that’s what happens. Three or four guys, let’s say, ride three to four minutes in front of everyone else for 100 miles or more only to get caught a bit before the finish line.

The catch is quite a sight.

The breakaway artists are understandably distraught and totally spent. Plus the difference in speed as the peloton passes them makes them look like Jersey tourists cruising the Boardwalk on big-tired bikes carrying two pounds of fudge and one pound saltwater taffy attached to wicker baskets attached to their handlebars.

So why do breakaway artists subject themselves to such physical and mental anguish time and time again then?

Because, my friend, it only takes one, one breakaway victory over the course of a 100 or so race season to greatly enhance their professional health. If they can win one of the races deemed a classic or a crucial stage of the Tour de France that way, it’s as big a deal as hitting a walk-off home run in Game 7 of the World Series.

For a team with a fan base as rabid as the Phillies.

To help optimize your health and fitness, it serves you well to adopt a breakaway artist’s mentality. To willingly read hundreds of health studies and articles like this one about them, unconcerned that your efforts usually won’t amount to much.

Because the info contained in a single one and the changes you make as a result could be a real game changer. (Or should I say race winner?)

It might even be this one, published about two weeks ago in Nature Medicine. It suggests that one day that tirzepatide, the drug trademarked as Mounjaro, could become the standard follow-up after old-fashioned weight loss.

To start, the 806 obese people who enrolled in the study underwent a “12-week intensive lifestyle intervention,” featuring dieting, exercise, and counseling with the goal of losing 5% of their body weight. Achieving that goal for anyone overweight is good, since prior studies have shown that’s all it takes to improve the cardiometabolic risk factors: low levels of healthy HDL cholesterol and high levels of unhealthy LDL cholesterol, triglycerides, fasting blood sugar, and blood pressure.

In these 806, however, you could see it as imperative because on average they had been obese for 15 years, and two-thirds had “a medical history of one or more obesity-related complications.”

The 579 who did indeed reach the goal advanced to the second phase: a 72-week period where they received a weekly 15-mg dose of Mounjaro or a placebo.

Those taking the placebo regained on average 56.2% of the original weight lost at the 72-week mark. Those taking Mounjaro only regained 20%.

While it may strike you as odd that a drug that fails to maintain all the weight lost the good-old fashioned way still gets good press, keep in mind that even with the weight regain, those taking Mounjaro lost more than 18% of their initial weight. Prior studies have not only shown the aforementioned health benefits to losing 5% of excess weight but also, according to the CDC, a loss between 5 and 10% reduces the incidence of eventually becoming obese, gall bladder disease, osteoarthritis, sleep apnea, stroke, mental illness, and cardiovascular disease.

In a 2016 Global Health Estimates study, cardiovascular disease accounted for more than 30% of all worldwide deaths.