James' World 2

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At this point, millions of people in the U.S. have tried at least one of a variety of glucagonlike peptide 1 (GLP-1) receptor agonist drugs such as Zepbound or Wegovy. For some, these medications have led to profound weight loss and often improvements in heart health. But many have ended up discontinuing the use of the drugs—despite the fact that they have been touted as lifelong treatments. That raises the question: What happens to people’s health after they stop taking these medications?

A new review study offers some clues to the answer. Research published on Wednesday in the BMJ found that people who stopped taking weight-loss drugs, including GLP-1 medications, are likely to see all the weight-loss and heart health benefits disappear in less than two years. The results also indicated that people who discontinue any kind of weight-loss medication regain the weight four times faster than those who stop dieting or working out to shed pounds.

“Weight regain after a period of weight loss is really common, no matter what approach you take,” says Sam West, lead author of the study and a research scientist at the University of Oxford, who specializes in integrated metabolism. “The fact that people regained weight after stopping medication wasn’t too surprising, but what was striking is just how fast it occurred.”

In addition to the newer GLP-1 drugs on the market, the study evaluated clinical trials on various weight-loss drugs, including older-generation GLP-1 medications and those outside of the class, such as orlistat and the combination of phentermine and topiramate. They compared the data on those treatments with a previous analysis on behavioral weight-loss interventions that included different dieting programs and exercise regimens.

People who took weight-loss drugs regained about a pound (0.4 kilogram) a month on average after they stopped treatment. All their cardiometabolic markers, including blood glucose levels, blood pressure, and cholesterol, also reversed.

Ultimately, people may see weight return to its pretreatment level within 1.7 years of stopping the drugs, and heart health markers return to their pretreatment state within 1.4 years, the study estimated. West says long-term data are needed to confirm these projections, however.

What these findings suggest is that, while weight-loss drugs lead to faster results than diet and exercise alone, quitting them also results in weight being regained much faster, regardless of how much was initially lost.

“If you look at the study’s charts, which I thought were striking, you see that you might regain more weight and end up worse off than you were before,” says Rozalina McCoy, an endocrinologist and internist at the University of Maryland School of Medicine, who was not involved in the study.

People who take a weight-loss medication lose fat, muscle, and bone mass—but they tend to mostly regain fat if they don’t regularly exercise, McCoy says. “Even if you end up at the same weight as you were before, metabolically, you are likely a lot less healthy,” she says.

One possible strategy would be for people to go straight into a behavioral program, such as a diet or exercise regimen, as they came off the drugs. But that approach would need to be trialed and tested, McCoy says.

West says more assessments of people’s weight and health reversals after they stop treatment, conducted outside of the clinical trials, would help researchers fully understand what’s happening.

But the study “is on par with what we see clinically” in many people who stop GLP-1 medications, says Chika Anekwe, an obesity medicine physician at Massachusetts General Hospital Weight Center, who was not involved in the research.

“It goes back to the effects that the GLP-1 medications have on appetite control. And once that’s gone, it’s really difficult to maintain any sort of behaviors that were helping you to keep the weight off,” she says.

Treating obesity is not just a matter of willpower for some people, Anekwe says, and the results underscore what happens when a helpful weight-loss intervention is interrupted.

“I think it’s a good reminder to insurance companies: when they change patients’ coverage abruptly or limit access to the medications, it may have long-term effects,” she says.

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Now, a court ruling has Grumet worried. The decision, by Justice Nicholas Moyne in State Supreme Court in Manhattan, upheld a 450 percent increase in the rent that Grumet’s co-op pays the group that owns the land beneath the building. To cover the jump, he said he had been told, his monthly maintenance could skyrocket to more than $9,000 a month, from just over $3,700 now.

“Can we stay here?” asked Grumet, who uses a walker and whose wife navigates in a wheelchair. “I don’t know.”

The ruling involved a case brought by the landowner, which sought to confirm a three-person arbitration panel’s finding on the ground rent. The co-op had challenged the impartiality of the “umpire” on the panel, who was appointed to be neutral but did not disclose that the landowner’s lawyer had approached him about working on an unrelated project.

Justice Moyne said that “created the appearance of impropriety.” But he concluded that the co-op had not met “the very heavy burden of proof” required to show that the arbitration panel’s decision had been “prejudiced.”

Many co-ops own the land their buildings stand on. But the Ground Lease Co-op Coalition, a nonpartisan group of co-op owners, says that Carnegie House is the first of more than 12,000 ground lease co-ops potentially facing “land grabs from their landowners” because property values have surged since the first ground lease co-ops were formed, in the 1950s.

Richard Hirsch, the president of the Carnegie House co-op board, said the idea behind ground lease co-ops was “to allow middle-class people to live in the city.” By the coalition’s count, more than half of ground lease co-ops are in Brooklyn, the Bronx and Queens in areas where residents’ income is just under the citywide median of $79,000.

At Carnegie House, Hirsch said that prices of apartments in the building have plunged 90 percent since the dispute began and that banks would no longer write mortgages for prospective buyers.

‘An amount building residents simply cannot afford.’

Hirsch called the judge’s decision “a devastating blow.” He said the increase would bring the ground rent, now between $4 million and $5 million, to roughly $25 million a year, “an amount building residents simply cannot afford.”

“In the middle of a housing crisis, our billionaire landowners are pulling out all the stops to push out middle-class New Yorkers,” he said in a statement. He said in an interview that the co-op planned to appeal the ruling, which was first reported by The Wall Street Journal.

A spokesman for the group that owns the land under Carnegie House said that the co-op residents are responsible for only 65 percent of the rent. Some 25 percent of the total is paid by the owner of the stores on the ground floor, he said, and another 10 percent comes from the parking garage in the building.

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Katherine Marks for The New York Times

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If you read the research on microplastics, these pollutants appear to be as frightening as they are ubiquitous. Found throughout our bodies, food and environment, both microplastics and their ingredients have been linked to heart attacks, stroke, respiratory conditions, fertility issues, and death—to name just a few issues.

Yet despite these traits, scientists don’t fully understand how all the minuscule filaments of plastic get into our environment. A study published last month in Science Advances offers some new clues as to how water may be contributing to their spread.

Scientists already knew that plastics degrade through exposure to sunlight and repeated weathering by waves, sand, or other debris. But the new study suggests contact with water itself is also a factor: in both marine and river environments, researchers found that microbubbles can form on the surface of a piece of plastic, breaking it down—and releasing tiny, practically invisible plastic bits into the surrounding water.

From there, nanoplastics and microplastics often enter the food chain—and, in turn, us. An estimated 130 million metric tons of plastic waste enters our bodies and the environment every year, with that number on track to more than double by 2040.

The results, the researchers write, could inspire future research on how to control the release of microplastic into, well, everything. “Plastic degradation is an invisible threat to the environment and human health,” said John Boland, a professor in the School of Chemistry at Trinity College Dublin and senior author of the study, in a statement. “Society urgently needs to come to grips with the enormity of the challenge posed by our ubiquitous use of plastics.”

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State and local leaders say they do not believe that the FBI investigation of the shooting death of Renee Nicole Good will be fair and impartial, and are sounding alarms about the impact of federal officials holding onto evidence in a potential prosecution of the ICE agent who killed her.

Minnesota’s lead investigative agency, the bureau of criminal apprehension, initially began investigating the shooting in conjunction with the FBI. But the BCA issued a statement Thursday morning saying that “the US attorney’s office had reversed course: the investigation would now be led solely by the FBI, and the BCA would no longer have access to the case materials, scene evidence or investigative interviews necessary to complete a thorough and independent investigation”.

Hennepin county attorney Mary Moriarty, an elected Democrat and the county’s prosecutor, clarified at a press conference Friday that the BCA – which was established in the wake of the George Floyd case – has a very high investigative standard and that this standard can’t be met when the organization doesn’t have access to all the evidence. It does not preclude an investigation, she said. But a lack of access to evidence hampers the investigation.

“When the BCA came to the scene, the evidence had been taken by the FBI,” she said. “They collected the car and took it wherever the BCA does not have access to the car. And the problem isn’t that the FBI took the car, it’s that the BCA doesn’t have access to the car, or right now, even access to the forensic evaluation that happens as a result of the investigation with that car.”

In a press conference on Friday, the Minneapolis mayor, Jacob Frey, described the federal government’s narrative casting Good as the villain as “garbage” and called on the state to conduct its own investigation. “This is a time to follow the law,” he said. “This is not a time to hide from the facts. This is a time to embrace them, making sure that we’re pushing for transparency every step of the way.”

“The fact that Pam Bondi’s Department of Justice and this presidential administration has already come to a conclusion about those facts is deeply concerning,” he added.

Media reports have identified the agent who shot Good as Jonathan Ross. ICE agents allowed Ross to leave the scene in the moments after the shooting, taking the weapon used in the shooting with him.

“It doesn’t preclude a state investigation, but if the feds are saying, for example, you don’t even get to look at the firearm that was used to kill this person, that would certainly complicate it,” said Eric J Nelson, a defense attorney in Minneapolis with a long record of defending police officers accused of crimes. Nelson represented Derek Chauvin in his murder trial for killing Floyd.

The legal standard for proving a case of excessive force rests on the “objective reasonableness” of the act as given in the Graham v Connor case decided by the US supreme court in 1989. From that case flows policies governing when and how police officers can use force. The standards are essentially the same for both state and federal prosecutions, he said.

The breakdown in cooperation between state and federal agencies in this investigation is “shocking”, Nelson said, and flies in the face of the public’s expectations of legal norms.

“There may be political differences, but ultimately in a question in a case like this, I don’t really think politics should have a place,” he said.

Moriarty and the Minnesota attorney general, Keith Ellison, called on the public to send whatever evidence they have to state and local investigators, given their concerns about access to material held by the FBI.

“We don’t know what we’re going to get now,” Moriarty said. “We think that there may be other evidence out there, video, that kind of thing. We won’t know. And so, as the attorney general and I know, it is critical to preserve evidence.”

Statements by Donald Trump and others about the case amplify the concerns of bias from local leaders.

Trump described the 37-year-old US citizen and mother of three killed by an ICE agent as a “high-level agitator” and “a professional troublemaker”, without evidence. Claims that Good was somehow harassing agents have been widely disputed by both local and state leaders in Minnesota, as well as by eyewitnesses.

Within hours of the shooting, the homeland security secretary, Kristi Noem, declared that the shooting was justified, and that the driver deliberately aimed her car at the officer in an act of “domestic terrorism. Noem also said that state-level prosecutors “don’t have any jurisdiction in this investigation”.

On Thursday, JD Vance said in response to a question about sharing the investigation with Minnesota law enforcement agencies that the agent “is protected by absolute immunity. He was doing his job.”

Attorneys familiar with state and federal law and the prosecution of police officers say that the assertions of the vice-president and Noem are simply untrue.

“Just because the FBI is taking over the investigation, that does not preclude the state from conducting its own investigation,” Nelson said. “Both independent jurisdictions, state and federal, would make a decision about charges. I would expect that the state of Minnesota will continue to conduct its own investigation into this matter.”

The statements by federal officials raise questions about whether a federal investigation would be fair. Frey described the prospects as “pretty grim.

“We know that they’ve already determined much of the investigation,” Frey said, “and even if they haven’t, there is the appearance that there is some conclusion drawn from the very beginning.”

At this unsettling time

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Portrait of Renee Nicole Good outside an immigration detention facility in Broadview, Illinois, on 9 January. Photograph: Anadolu/Getty Images

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The officials said details about the new schedule would be announced shortly. The Kennedy Center’s website currently lists the opera’s lineup of spring performances, including Scott Joplin’s “Treemonisha” and “West Side Story” as well as its upcoming gala, but a separate website has been set up.

The resolution also calls for the opera to begin negotiations with the Kennedy Center about ending an affiliation agreement that has bound the cultural institutions since it was signed in 2011, when the opera was facing financial challenges.

The opera declined to release a copy of the resolution, which was approved by the 37-member board during a virtual meeting on Friday. But details of its contents were provided to The New York Times by officials involved in the deliberations.

Under Mr. Grenell, the Kennedy Center has been aggressive in trying to discredit artists who have canceled commitments with the center. But on Friday, Roma Daravi, a spokeswoman, said the center agreed that the time had come to end this relationship.

“After careful consideration, we have made the difficult decision to part ways with the W.N.O. due to a financially challenging relationship,” she said. “We believe this represents the best path forward for both organizations and enables us to make responsible choices that support the financial stability and long-term future of the Trump Kennedy Center.”

In a social media post that has since been deleted, Mr. Grenell said that ending the arrangement would give the Kennedy Center the flexibility to bring in operas from around the world. “Having an exclusive Opera was just not financially smart,” he wrote. “And our patrons clearly wanted a refresh.”

Opera leaders said the decision to leave was in response to a drop in attendance and a decline in donor contributions during the president’s second term, as well as an escalating number of artists who have refused to appear at the Kennedy Center since Mr. Trump’s name was added to the building last month. (The authority of the board to overrule Congress and rename the center, which was created in 1971 in tribute to John F. Kennedy, is disputed, and The Times has continued to refer to its legal name.)

“I am deeply saddened to leave the Kennedy Center,” Francesca Zambello, who has been the opera’s artistic director for 14 years, said in a statement. “I have been proud to be affiliated with a national monument to the human spirit, a place that has long served as an inviting home for our ever-growing family of artists and opera lovers.”

In its statement, the opera appeared to take pains to be conciliatory, not naming Mr. Trump or Mr. Grenell.

“The board and management of the company wish the center well in its own future endeavors, including recognizing the center for having secured significant funding, including $275 million from Congress, for upgrades to the center,” the statement said.

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Washington National Opera officials contend that exiting the Kennedy Center would also give it more control over programming decisions. Credit…Kenny Holston for The New York Times

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