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People taking popular new weight-loss drugs such as Wegovy and Zepbound often celebrate the number of pounds they shed and the related health benefits, but many doctors at weight-loss clinics are noticing a puzzling response in certain individuals. Andres J. Acosta, a gastroenterologist at the Mayo Clinic, says some of his patients have expressed frustration and disappointment as they watch friends or colleagues drop significant weight while taking the drugs but lose little or no weight themselves—even when they adhere to the medication’s instructions perfectly.

“They see themselves as a failure,” Acosta says. But the drugs’ effectiveness is likely outside of their direct control—scientists think their nonresponse could be related to what’s driving their excess weight in the first place.

About 12 percent of Americans have reported using one of the new drugs—known as glucagon-like peptide 1 (GLP-1) receptor agonists—for weight loss. Real-world data show that as many as one in four people on these drugs are “nonresponders,” which many experts define as those who lose less than 5 percent of their body weight after three months of taking a GLP-1 drug. (Five percent is the threshold above which people start to see improvements in health.) Clinical trials funded by Novo Nordisk on semaglutide, the active ingredient in the company’s weight-loss drug Wegovy and diabetes medication Ozempic, found that up to 23 percent of people fell into the nonresponder category. In Novo Nordisk’s latest trial, giving people a higher semaglutide dose didn’t decrease the proportion of nonresponders. To better understand why people show such big differences in their response to these medications, scientists have started investigating their underlying biology.

No two people respond exactly the same way to any weight-loss approach—whether it involves medication, surgery or lifestyle changes such as diet and exercise—because obesity is a complex phenomenon. GLP-1 drugs cause weight loss primarily by making people feel full. Variations in biological pathways that influence that mechanism—and that lead to excess weight or obesity—may make some people more likely to benefit from the drugs than others.

Researchers already know some factors that may influence how well someone responds to the drugs. Overall, people with type 2 diabetes who are taking the medication tend to lose less weight than those taking it for weight loss, and men, on average, lose less weight than women. But researchers suspect genetics may also play a role.

A small fraction of people with obesity carry rare, single-gene mutations that cause what is known as “monogenic obesity,” which leads to health issues at an early age. But for most people, obesity is thought to be polygenic, meaning it can originate from thousands of genetic variants. Environmental, biological, and behavioral factors also play a role, says Ruth Loos, a geneticist specializing in obesity and metabolism at the University of Copenhagen.

Acosta and his colleagues have worked on identifying four distinct biological phenotypes, or traits, of people with excess weight that may influence how they respond to the new weight-loss drugs. For example, some people have a “hungry brain” phenotype and need an abnormally high number of calories to feel full compared to others. On the other hand, people with a “hungry gut” phenotype may become full quickly but are hungry again soon after. The team’s latest study, published in August, found that some people felt full after consuming 140 calories in one sitting, whereas others needed more than 2,000. Although factors such as sex, body composition, and hormone levels helped explain this difference, genetics also seemed to play an important role.

Acosta and his team developed a score that combined genetic and physiological data to predict these differences in the number of calories needed to feel satiated. Using this score, the researchers found that people with the “hungry brain” phenotype tended to respond poorly to liraglutide, an early-generation GLP-1 drug, but they did better on phentermine-topiramate, a non-GLP-1 drug that acts on appetite suppression in the brain but is controversial for its cardiovascular risks. On the other hand, those with a “hungry gut” phenotype responded better to liraglutide. Acosta, also a founder and stockholder of an obesity precision medicine company involved in this research, says it might be because GLP-1 drugs prolong feelings of fullness after meals. The team saw similar results with semaglutide in unpublished results presented at the American Gastroenterological Association conference last year.

Other research groups are exploring specific genes that might influence GLP-1 drug response. Scientists at the Cleveland Clinic are investigating neurobeachin, a gene that appears to influence how people lose weight on GLP-1 drugs. The amount of variation—and the specific types of variations—in the neurobeachin gene can be used to create a genetic score that predicts a person’s response to the medication, says Daniel Rotroff, a precision medicine researcher at the Cleveland Clinic. In Rotroff and his colleagues’ analysis, people who had a higher score for these variations were at least 50 percent more likely than people who scored lower to not lose any weight on liraglutide. (The score was unable to predict how someone would respond to semaglutide.)

Some clues could explain why the gene might affect a person’s response to GLP-1 drugs. Variations in neurobeachin might affect how efficiently an enzyme called protein kinase A (PKA) helps the hypothalamus, a brain region that regulates appetite suppression. Because GLP-1 is known to activate PKA in other cells, genetic variations of neurobeachin may “ultimately impact how well the medication works for weight loss,” Rotroff explains.

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Once you step inside a home in Morocco, chances are you’ll be greeted with a pour of steaming, freshly made Berber whiskey. 

Despite its name, Berber whiskey doesn’t contain a drop of liquor. It’s essentially mint tea, made in a specific style exclusive to the region. It’s also known as the country’s national drink. 

Berber refers to the indigenous people of North Africa, also known as Amazigh, whose history in Morocco dates back thousands of years and predates the arrival of Islam and Arab peoples.

The nickname ‘Berber whiskey’ originated from foreign visitors,” says Mohammed Ait Belhaj, mint tea master at the Kasbah Tamadot hotel in Asni, Morocco. “[Visitors] noticed that Moroccans drink [mint] tea almost all the time, with the same enthusiasm that whiskey might be served in other cultures.” The alternate name has become endearing to locals and is now proudly used to express their affection for the drink.

Moroccans sip Berber whiskey at almost any time of day. “In the morning with breakfast, after lunch, and in the evening during family gatherings,” says Ait Belhaj. “It’s a cherished tradition and an essential part of our daily life.”

What is Berber whiskey (Moroccan mint tea)?

Berber whiskey, or Moroccan mint tea, is made from Chinese green tea (specifically gunpowder tea), fresh mint, sugar, and boiling water. It’s brewed in a Moroccan teapot with a tall, curved spout, then poured from high above to aerate the tea and create a foamy “head” of bubbles. 

There are several ways to prepare mint tea, and perfecting the process is considered an art form. For Ait Belhaj, his preferred method is using a metal teapot and heating the tea over charcoal. This approach allows the gentle heat to add depth to the tea’s flavors. Once ready, he serves the tea in small, engraved glasses.

Beyond the tea’s refreshing and comforting flavors, the drink represents so much more. “It’s a symbol of hospitality, generosity, and warmth,” says Ait Belhaj. He says that it’s rare to find oneself in a family or social gathering with no tea in sight. “It’s a way to connect, to share a moment, and to show respect to guests.”

Mint tea as a moment for conversation and sharing

Ait Belhaj has worked at Kasbah Tamadot for over 20 years. He started as a waiter at the hotel’s restaurant and then was the resort’s manager for a decade. Soon after retiring, he returned, making it his life’s mission to share and teach Morocco’s mint tea tradition to guests from around the world.

Every day, Ait Belhaj prepares tea in front of guests and shares the process from start to finish. During this demonstration, he carefully explains every ingredient and step. 

“My favorite moment is the serving itself, seeing the guests’ smiles as they taste the tea for the first time,” says Ait Belhaj. “Preparing mint tea is a bridge to discover other cultures.” The entire tea-making process allows him to learn more about the guests while sharing a taste of Moroccan history and heritage.

Kasbah Tamadot offers guests a range of meaningful mint tea experiences, from learning how to brew the tea firsthand to visiting neighboring villages and enjoying a fresh cup in the homes of Berber families.

In Morocco, sharing mint tea among friends and family is considered one of the most important rituals of the day. The time spent both making and drinking the tea is meant for conversation and sharing.

How to enjoy Moroccan-style mint tea in the U.S.

Moroccan mint tea can easily be enjoyed at home, but there are a few key steps to follow to ensure you brew an authentic pot.

First, find a Moroccan teapot with a long, curved spout. Next, gather your ingredients — green tea, sugar, mint, and boiling water. For a complete and proper presentation, serve the tea on a tray with elegant tea glasses. Ait Belhaj says the most essential tip is to use good-quality Chinese gunpowder green tea and fresh mint.

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It was quite predictable that China would respond to an international dispute by weaponizing its control over rare earths, for that is what it did with Japan in 2010. Sure enough, two days after Trump announced his Liberation Day tariffs, China announced export controls for some rare earths. It then greatly expanded the export controls this month.

It soon became obvious that President Xi Jinping of China had us over a barrel, for the United States economy depends on Chinese rare earths far more than China depends on American soybeans.

Treasury Secretary Scott Bessent says that negotiators have now “reached a substantial framework” for a trade deal between Trump and Xi. If the framework holds, it appears that the United States will cut and cancel tariffs and China will suspend its latest restrictions on rare earth mineral exports and resume soybean purchases. On the surface, that might look like a return to the status quo before the trade war, but it’s more like our surrendering and ending up in a weaker position after a conflict we started.

That’s because the dispute led China to weaponize its control of rare earths and hold this over us indefinitely as a cudgel. Indeed, a one-year suspension of export controls on rare earths would be a brilliant move by Xi, allowing Beijing to retain its leverage over the United States without causing such disruption that America and other countries would make all-out efforts to break China’s near-monopoly on the minerals.

At a conference over the weekend, I asked a large room full of international relations experts for a show of hands: Who thought the United States was winning the trade war, who believed China was winning and who thought it was too soon to tell? Overwhelmingly, people said China was winning and now holds the advantage.

Now that Trump has induced China to weaponize rare earths, we don’t have any rapid way of finding alternative sources. (Republican and Democratic presidents over the years should have worked much harder to develop rare earth mines and refineries.) Terry Lynch, the chief executive of Power Metallic Mines, a major mining company based in Canada, told me that the West needs a Manhattan Project-scale effort to develop rare earth capabilities, but that even such an all-out initiative would probably take five to seven years to get results.

“In that interim time, we’re going to have to make a deal with China,” he said.

In effect, Trump started a trade war and soon found that he was carrying a tariff to a knife fight. The trade bully unexpectedly found himself bullied, so he began to court China and make concessions.

Trump dialed back tariffs (before threatening new ones). He eased rules on exporting chips to China. He allowed TikTok to continue to operate in the United States, despite serious national security concerns. He blocked a visit to the United States by Taiwan’s president and reportedly delayed an arms sale to Taiwan. As the Center for American Progress put it, “the Trump administration’s approach to China is in a strategic free fall.”

That’s what I worry about in the coming years. Xi sees our weakness. He has established that he has the upper hand in the bilateral relationship and that Trump is the weak one who will buckle under pressure, including on security matters. And because Trump has betrayed and antagonized allies, they are less likely to work with us in resisting Beijing.

Xi may suspend his rare earths restrictions for a year, but I doubt he’ll let us build stockpiles. I suspect it will be more difficult for American companies to acquire rare earths to make fighter aircraft and submarines — and in fairness, Xi in some respects is simply doing to the United States what we have done to China.

In any case, a one-year suspension of rare earth licensing may simply be a way of reminding American leaders — and others around the world, for the restrictions were global — of their vulnerability. The aim presumably would be to induce more compliant behavior on issues Beijing cares about, from Taiwan to human rights complaints about Xinjiang and Tibet.

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By Kaya & Blank

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About four years ago, Clifford Harper, then 85, announced to his wife that he was quitting alcohol. Harper wasn’t a heavy drinker but enjoyed a good Japanese whiskey. It was the first of a series of changes Linda Kostalik saw in her husband. After he’d cleared out the liquor cabinet, Harper, a prolific academic who has authored several books, announced he was tired of writing. Next, the once daily runner quit going to the gym. Kostalik noticed he also was growing more forgetful.

The behaviors were unusual enough that, at an annual physical, the couple’s physician recommended they consult a neurologist. A battery of medical tests and brain scans revealed that Harper’s surprising actions and memory loss were the result of dementia.

Harper’s neurologist at Oregon Health & Science University (OHSU) asked whether he might like to enroll in a long-running study of dementia in African Americans.* The study’s focus on Black health piqued Harper’s interest, and he decided to participate for as long as he could. “I hope it will help other men like me,” Harper says.

As a Black American, Harper faces a risk of Alzheimer’s disease and other dementias that is twice that of white Americans his age. The reasons for this disparity are still unclear, but researchers know Black Americans are particularly vulnerable to a number of confirmed risk factors, such as living in areas with higher rates of air pollution and encountering difficulties accessing healthy foods and high-quality education. Some studies suggest that experiencing racism and other forms of discrimination contributes to a higher risk of cognitive decline. Race or gender discrimination also raises a person’s risk of heart disease and, as a result, some forms of dementia.

That’s part of what prompted Harper to participate in OHSU’s study, called the African American Dementia and Aging Project (AADAPt), which was established in part to capture the unique history and experiences of Black communities in Oregon. The state’s first constitution banned nonwhite citizens from settling there. The ban was overturned by the early 1900s, and shipyard work during World War II brought an influx of Black workers to the region, but they still faced discrimination and racism in many forms. By the end of the war, racist lending practices—called redlining—led most of the Black community to live in segregated neighborhoods or those that were poor in resources needed for good health, such as parks and grocery stores.

Discrimination in the scientific world, along with other factors such as distrust of researchers, led to underrepresentation of Black communities in brain research. Even today, clinical trials for new treatments of Alzheimer’s include very few people of color. As a result, researchers and doctors are ill-equipped to understand the causes of dementia in these communities. “Not only are there health disparities around rates of Alzheimer’s, but we’ve understudied the Black population in relation to the causes,” says Andrea Rosso, an epidemiologist at the University of Pittsburgh.

Now that Alzheimer’s and some other dementias can be diagnosed early and their progress potentially slowed, figuring out who’s most vulnerable is even more critical. Diagnostic tests and interventions aren’t yet reaching all those who need them. Researchers should include historically minoritized communities in studies of these new frontiers in dementia diagnosis and treatment, says epidemiologist Beth Shaaban of the University of Pittsburgh. If adequate attention isn’t paid to diverse populations, communities that already experience disproportionate rates of dementia will be uninformed about their increased risk, how to lower it, and how to access diagnoses and care. “We are very concerned that these disparities and the rapid evolution of the new technology could leave people behind,” Shaaban says.

AADAPt and other studies aim to correct this inequity. The project seeks to understand the forces driving cognitive decline in Black Americans, identify protective factors that lead to healthy aging, and find practical solutions. The team hopes to eventually use the data to build predictive models that will catch cognitive decline early and potentially help people such as Harper access new medicines and treatments via clinical trials.

At the turn of the century, researchers projected that an aging baby boomer generation would drastically increase the incidence of Alzheimer’s and other forms of dementia. No treatments or protective strategies were known at the time, and the search for solutions focused largely on the tangles of proteins that jammed up brain circuits.

n the past two decades, scientists have discovered that certain drivers of Alzheimer’s may be controllable. In 2011, dementia researcher Deborah Barnes of the University of California, San Francisco, and her colleagues reported that poor education and smoking—things that could be addressed by behavioral changes and social reform—were among the greatest threats to aging brains. In a 2022 follow-up study, Barnes reported other modifiable risk factors for Alzheimer’s, such as midlife obesity and sedentary lifestyle, which can raise a person’s risk for heart disease.

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