Ozempic Can’t Fix America’s Obesity Crisis

What is obesity?

Some people will tell you it’s a fancy word for being fat; others might say it’s a slur that pathologizes bigger bodies. And yet others will insist it’s a moral failing—one of laziness and poor willpower.

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For the past decade, however, the medical community has recognized that obesity is a chronic disease, much like cancer, diabetes, and high blood pressure. Obesity triples the risk of hospitalization due to COVID-19, is linked with hundreds of medical complications, and accounts for 4 million preventable deaths every year.

Obesity is also heterogeneous, with manifold different causes, clinical presentations, and responses to treatment. The astronomical rise of GLP-1 drugs such as Ozempic, Wegovy, and Mounjaro has glossed over such nuance, with bold promises that medication is the “holy grail,” “silver bullet,” and “miracle” to the obesity problem, a one-size-fits-all solution. If only it were that simple.

The truth is that Ozempic can’t solve the obesity crisis in America. Although medication can help some individuals lose weight, obesity is not a simple disease of inactivity or overeating. A myriad of factors, including genetics, mental health, socioeconomic status, and environmental influences, contribute to the development and progression of this disease. As such, how patients present inside the clinic varies widely, from a mutation in the MC4R gene being linked to an 18% higher odds of obesity to some antipsychotic medications causing 75-125 pounds of weight gain. While GLP-1 drugs could help many of these patients, they also target only one factor—hormonal imbalances— and can’t solve for all the other problems.

This overly reductionist approach is mirrored in the diagnostic criteria for obesity—a body mass index (BMI) of 30 or higher—because patients can be perfectly metabolically healthy above this cutoff, or develop obesity-related comorbidities within the “normal” range. In fact, designed for white European men, BMI underestimates obesity among Hispanic and Asian Americans while overestimating it among Black Americans, so the American Medical Association has asked doctors to de-emphasize the use of this flawed, discriminatory measure.

A Lancet Commission of 60 international experts from high, middle, and low-income countries is currently working to redefine obesity, moving away from a height- and weight-based metric to a clinical diagnosis rooted in specific signs and symptoms.

Beyond these complexities in origin and diagnostic criteria, patients with obesity also respond differently to treatment. On average, the GLP-1 drug Wegovy helped patients reduce their body weight by 16%; in other words, a 300-pound person might have lost 50 pounds. But some patients in this New England Journal of Medicine study only lost 5% of body weight while others lost up to 30%. This variability highlights the importance of individualized treatment plans to address patients’ unique needs instead of relying on any one drug.

Read More: Should We End Obesity?

With the current state of obesity care, however, that’s nearly impossible. In the U.S., there are 115 million people living with this disease, but just over 100 doctors who are fellowship-trained in obesity. Since 2003, federal law has also prohibited Medicare from covering obesity medications because they are seen as “lifestyle” drugs instead of real medicine. Correspondingly, our research shows that only 1% of eligible patients get treated with anti-obesity drugs, with most simply relegated to following the oft-quoted advice of eating less and moving more. While diet and exercise are certainly important, the most effective treatments for obesity are interdisciplinary, where this regimen is combined with behavioral therapy, medication treatment, and sometimes metabolic and bariatric surgery.

With so few doctors to help so many Americans in need, it’s no surprise that diet scams and products preying on people’s insecurities have filled the void — the U.S. weight loss market is estimated at $160 billion in 2023. When we similarly treat GLP-1 drugs as the proverbial magic bullet, we open this genuine medical advance to spurious critiques and attack campaigns. For example, the widely reported critique that patients gain weight when they stop taking GLP-1s only matters if they are seen as an obesity “cure.” After all, for insulin and hypertension drugs, it’s hardly news that glucose and blood pressure shoot back up when you discontinue medication.

With obesity costing the U.S. $1.7 trillion, or 9% of our GDP, we need to celebrate progress against this chronic disease and how GLP-1 drugs can help some patients live longer, healthier lives while also significantly reducing healthcare costs. But we must also recognize that much work remains to be done, from promoting social empathy to training more specialty physicians to implementing policies that ensure affordability and access to treatment. Although drugs like Ozempic, Wegovy, and Mounjaro holds great promise, it is not the panacea the media has made them out to be, and we must resist the temptation to oversimplify the issue.

Instead, let us celebrate the potential of GLP-1s as part of a comprehensive, individualized, and compassionate approach to treating obesity—one that not only considers individual’s unique needs and circumstances but also focuses on improving overall health and well-being.

source https://time.com/6332910/ozempic-americas-obesity-crisis/

The Whole World Is at Risk for ‘Compassion Fatigue’

After serving in the Vietnam War, Charles Figley became interested in the concept of trauma—not only the lasting psychological wounds that people experienced after living through traumatic events themselves, but also how their loved ones often came to share those burdens. “Simply being a member of a family and caring deeply about its members makes us emotionally vulnerable to the catastrophes which impact them,” he wrote in 1983.

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At the time, Figley—who now runs the Tulane University Traumatology Institute—called these trickle-down effects “secondary traumatic stress reactions.” Today, however, he often uses the term “compassion fatigue” to refer to the emotional and physical exhaustion that sometimes afflicts people who are exposed to others’ trauma.

In the nearly 50 years since Figley began researching these concepts, compassion fatigue has been primarily studied among people in “caring professions” like health care and social work, who are routinely exposed to pain on the job. But Figley’s early work, on how ordinary people can be infected by the trauma of others, is becoming increasingly prescient at a time when just about everyone is near-constantly exposed to content about war, violence, death, and injustice on the news, internet, and social media.

Indeed, it now seems that “anyone can experience compassion fatigue,” says Briana Smith, a Ph.D. student at the Tulane University School of Medicine who works with Figley.

Michelle Trent, executive director of The Compass Center, a nonprofit counseling center in South Dakota focused on trauma healing and prevention, saw that firsthand in 2020. Many of her clients were struggling not only with issues in their personal lives, but also with the emotional drain of living through the COVID-19 pandemic, the racial justice movements following George Floyd’s death, and other societal stressors. “Our clients were coming in just saying, ‘We can’t watch the news anymore. We can’t do this anymore,’” she says. “That’s really when it came to our radar.”

Figley’s research suggests people who develop compassion fatigue may experience symptoms similar to those of PTSD, including trouble sleeping; becoming triggered by difficult emotions or memories; and changes in personality, mood, or affect. It can also manifest as emotional numbness, with the sufferer becoming desensitized to the experiences of others and struggling to connect with patients, colleagues, or loved ones.

Gabriela Murza, an assistant professor at Utah State University who educates people in the surrounding community about public-health topics including compassion fatigue, says feeling overwhelmed can also be part of it. “When someone has compassion fatigue, they will feel like there’s a lot happening and they don’t know where to start and they don’t know what to do, so sometimes they will turn off their emotions,” she says.

Figley says health care workers are the “most obvious” people at risk due to the nature of their professions. But Smith’s research with Figley suggests it’s not just a workplace phenomenon. She is studying compassion fatigue among volunteers, including people who provide household care for family members and people who volunteer with emergency services, and has found that they may be even more susceptible than professionals—in part because they’re sometimes thrust into difficult work without extensive training, and in part because they tend to have a personal tie to their chosen cause, which amplifies their emotional reactions.

Regular people may, similarly, be more likely to experience compassion fatigue if they personally identify with an issue in the news or that a loved one is experiencing. Someone of Middle Eastern descent, for example, might be especially affected by images of the current war in Gaza and Israel, Smith says.

Triggers vary from person to person, Trent says, so there’s no way to know for sure what will cause compassion fatigue. But she says it’s important to monitor how you’re feeling during stressful or emotionally taxing times. If you don’t feel like yourself or are reacting more strongly than usual to difficult situations—perhaps by snapping at others or growing angry when you’re usually level-headed—you may be experiencing compassion fatigue.

If that’s the case, taking a break from difficult news and social media is a good first step, Trent says, though she notes that there’s a difference between ignoring a situation and taking purposeful time to recharge. She recommends using your break for personal wellness—moving, getting good sleep, spending time outdoors—and connecting with people in your community to remind yourself of “the good in humanity.”

Doing so may help counter some of the overwhelming feelings that accompany compassion fatigue, Murza says. There’s often no clear way for an individual to help in an issue with global consequences, which can cause people to withdraw. But “there might be an organization in your city where you can volunteer…to make a difference for people experiencing loss or tragedy,” Murza says.

Social connection is, in general, a balm for compassion fatigue, Smith adds. Studies suggest confiding in people who relate to your feelings, such as coworkers or fellow volunteers, can help, she says. Finding a therapist to speak with can also be beneficial, Trent says.

“Compassion is like a tank of gas,” Trent says. “At some point, if you don’t replenish it, then you’re on empty.”

source https://time.com/6332107/compassion-fatigue-risk/

How Stress Affects Your Heart Health

For many people, stress is part of everyday life. The demands of work, family, and other quotidian pressures can leave one feeling angry, agitated, anxious, downtrodden, or burned out.

While these kinds of day-to-day challenges are often described as mild forms of stress, the reality is that some people will experience them more often and more significantly than others. And there’s mounting evidence linking these and other forms of stress to heart-related health problems.

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“We know from several studies in different populations that emotional and psychological stress is associated with an increased likelihood of developing and dying of cardiovascular disease,” says Dr. Beth Cohen, a stress researcher and professor of medicine at the University of California, San Francisco. 

For example, research on stress in the workplace has found that people who are under regular strain or who work long hours are up to 40% more likely than their less-taxed counterparts to eventually develop heart disease or stroke. “There are also studies looking at what we call perceived stress, which is the amount of stress a person reports feeling, regardless of cause,” Cohen says. There again, research has found that people who report feeling a lot of stress are at elevated risk for cardiovascular problems down the road.  

Meanwhile, some of Cohen’s work has examined the health effects of stress that stem from deeply traumatic experiences—such as those related to military combat service or interpersonal violence. She says post-traumatic stress disorder (PTSD) and other stress-related disorders are associated with increased cardiovascular disease risks. 

But while stress appears to be a major risk factor for heart trouble, there’s a lot about the relationship between stress and heart health that experts are still sorting out. For example, how much stress is too much? “Not all challenging or stressful situations are unhealthy,” Cohen says. “Short-term stress in specific situations, such as working to overcome a difficulty, may actually be beneficial.” Another lingering question: Does stress itself damage the heart, or does stress lead to other things (smoking, poor sleep, an unhealthy diet) that cause the bulk of the harm? These are the types of questions that science has not fully answered.

Untangling the exact relationship between stress and health problems—including heart disease, but also other stress-related conditions such as Type 2 diabetes—is now the goal of research teams across the world. They’ve made progress in showing how stress may change a person—both inside and out—in ways that could contribute to heart trouble.

Read More: Feeling Off? It Could Be ‘Ambient’ Stress

Defining stress

In order to understand the negative effects of stress, medical researchers must first define what it means to be “stressed.” That’s easier said than done. 

“There’s the lay-person idea of stress, but defining it more scientifically is challenging,” says Dr. Ian Kronish, an associate professor of medicine and associate director of the Center for Behavioral Cardiovascular Health at Columbia University in New York. 

For example, some researchers have defined stress as “[a]ny physical or psychological stimuli that disrupt homeostasis.” By this broad definition, watching a suspenseful TV show or hurrying to an appointment are both forms of stress. Both are likely to raise a person’s heart rate and blood pressure in measurable ways. But most experts, like laypeople, recognize that these fleeting periods of stress probably aren’t the kinds that contribute to heart problems.

Another definition of stress is one that encompasses experiences or events that lead to unhelpful changes within the body’s stress-response system. It’s these disruptive forms of stress, Kronish says, that may contribute to heart disease and other health issues. These forms of stress are often sorted into two types: acute stress and chronic stress. 

Acute stressors are experiences that lead to very intense activation of the body’s fight-or-flight response. “These are events where the demands of the situation outstrip a person’s resources to handle them,” Kronish says. “Living through a major disaster, whether from natural causes or something like a terrorist event, could be the kind of acute stress that leads to disruptions within these internal systems.” Chronic stress, meanwhile, refers to stressful experiences that may not pose an immediate threat to someone’s health, but that happen regularly and persist for long periods of time. Working in a hectic and draining profession is one example of a chronic stressor that, over time, could lead to perturbations of the body’s stress-response system.

While acute and chronic stress may seem like straightforward concepts, nailing down when and how they harm a person’s health is difficult. Different people will respond to the same stressful situation in different ways; not all veterans with combat experience develop PTSD, and not all people who work in demanding professions develop adverse health effects. There’s also evidence that other lifestyle or environmental factors—such as a person’s exercise habits, their diet, and their social relationships—can help determine whether stress leads to health problems. “When I try to draw this out for people, it ends up looking like a big spider web of connections,” Cohen says. “All of these other things that are important to a person’s psychological and cardiovascular health may affect how they’re impacted by stress.”

It has also been a challenge for researchers to measure stress. “With stress, we don’t have something like blood pressure where I can sit you down and measure it and know exactly what it means,” Cohen says. Likewise, when someone with a history of stress develops heart trouble, there is currently no way for experts to determine whether stress caused that person’s health problems. “We don’t have a test that can tell whether your heart has been impacted negatively by stress,” Kronish says. 

In an effort to address these and other gaps, researchers have focused much of their attention on mapping out the underlying connections between stress and health. That work has revealed how acute and chronic stress may contribute to heart trouble, diabetes, and other health problems. 

The stress-heart connection

The human body reacts to stress in predictable ways. Blood pressure and heart rate increase, while breathing becomes shallow and rapid. Muscles grow tense and blood sugar levels rise. Alertness and attention sharpen. This all happens because stress-related hormones are circulating throughout the brain and body, ramping up activity in the sympathetic nervous system (SNS) and preparing the entire organism to respond to any potential threats. While SNS activation is the kind of stress a person can feel, a lot more is going on inside them. In fact, stress affects the operation of every organ and system in the body, including the immune system. 

All of this is normal and healthy. The body is made to manage stress, and, typically, it will recover from periods of stress without any lingering ill-effects. But in those situations when a stressful event is very severe, or when stress lingers for long periods of time, changes may occur that threaten the heart. “Increases in blood pressure, which can be initiated by stress, will increase pressure on the walls of blood vessels, and can therefore lead to cardiovascular damage,” says Dr. Amgad Makaryus, a cardiologist and professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health in New York. 

The effect stress has on blood pressure is just one of many theorized ways that stress may lead to heart trouble. “With stress, it’s difficult to pinpoint the exact way it’s doing damage, but we know one of the end products of stress is inflammation,” Makaryus says. While stress usually leads to temporary increases in inflammatory activity, chronic stress can produce persistent low-grade inflammation. This sort of simmering, all-the-time inflammation has been tied to heart disease, but also to Type 2 diabetes, depression, and other illnesses of the mind and body.

While there’s good evidence supporting the theory that too much stress damages the body via heightened inflammation and other forms of internal dysregulation, experts say there are still a lot of details to be worked out. “The field is still trying to untangle the various biological and behavioral pathways that may connect stress and cardiovascular health,” Kronish notes. His group has spent a lot of time looking at the ways stress changes a person’s behavior in ways that may lead to health problems. He says stress motivates some people to take better care of themselves, but it can also lead people to forgo exercise and social gatherings, to smoke or drink more than they otherwise would, and to adopt other habits that imperil their health. “Sleep is another pathway that might connect stress to poor cardiovascular outcomes,” he says. There’s evidence that stressed people tend to sleep poorly, and a persistent lack of sleep has been associated with a wide assortment of health problems. 

Untangling all these different stress-related harms—both the biological and the behavioral—is no easy task. They’re likely all interconnected. “People talk a lot about a dysregulated stress system, but my sense is it’s a more complicated story,” Kronish says. “There are so many factors to tease apart.”

Read More: How COVID-19 Changes the Heart—Even After the Virus Is Gone

How to reduce your risks

Stress appears to threaten the heart in numerous ways. Safeguarding the heart from that assault may require a multi-pronged defensive strategy, experts agree. “People hear that stress is bad for the heart, and so they should do things to reduce stress,” Kronish says. “But the truth is we don’t have a grand slam stress-reducing intervention that we know will protect the heart from stress in all people.”

For example, psychotherapy has shown promise for the reduction of both stress and its attendant heart risks, and Cohen recommends it for people with PTSD and other stress-related mental health conditions, such as anxiety, depression, and trouble sleeping. But the evidence supporting its protective benefits for the heart is inconsistent. “Some trials have looked at psychotherapy and stress reduction techniques,” she says. “They’ve consistently led to better mental health outcomes, but they’ve had mixed evidence in terms of whether they reduce heart disease risk.”

Meanwhile, Makaryus says medication-based treatments aren’t the answer—at least not yet. “Medications are a big part of cardiovascular disease treatment, but we don’t have an easy pill that will solve this,” he says of stress-related heart trouble. “I think the key is prevention.”

It may not be surprising, but he and others say the time-tested elements of a healthy lifestyle—regular exercise, a proper diet, good sleep, and time spent with friends—can help a person recover from stress and reduce their risks for stress-related health problems. “Many people deal with stress by connecting with family and friends, or connecting with a spiritual group,” Cohen says. Leaning on other people for support—as opposed to isolating yourself and dealing with stress on your own—seems to be one of the best ways to reduce its harms, she says. 

For many of us, stress is inescapable. But we all have the power to eat better, exercise, and engage in other healthy activities that appear to help limit the harms of stress. “There are mysteries left to unravel,” Cohen adds, “but we already know many ways how to preserve and protect cardiovascular health.” 

source https://time.com/6332877/stress-affects-heart-health/

Gun Injuries to Children Have Soared. So Have Their Impacts

Firearms have accounted for the deaths of more American children than any other cause since 2020. The true damage guns inflict on children is larger still, as demonstrated by a new study showing that emergency-room visits for children injured by firearms nearly doubled during the pandemic.

In a survey of nine U.S. hospitals, a team led by Dr. Jennifer Hoffman, a pediatric emergency medicine physician at Lurie Children’s Hospital of Chicago, found that pediatric emergency room visits due to gun shots increased from 694 in the years before the pandemic to 1,210 during the pandemic, a 74% increase, according to data from 2017 through 2022. During that time, the death rate among gun victims age 18 and under nearly doubled as well, from 3.1% to 6.1% of all children injured by firearms.

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That increase was apparent to physicians who worked in emergency rooms throughout the pandemic, Hoffman says. But for the first time in decades, she and other researchers able to secure federal funding to study what they were seeing, thanks to a longtime freeze on grants supporting research on gun violence that was only lifted in 2020. Hoffman’s study is one of two published yesterday (Nov. 6) that help reveal the full extent of the problems gun violence poses to American kids, their families, and the health care economy.

An increase in child firearm injuries early on in the pandemic was initially thought to be the direct result of a wave of firearm purchases during lockdown, combined with heightened emotions and the dramatic changes to Americans’ daily routines, Hoffman says. “We hoped that as the daily impact of the pandemic decreased, that we would see a decline in firearm injuries,” she says. “But instead, we saw that the elevated levels of visits persisted and remain significantly elevated.”

Hoffman also found that gunshot-related pediatric emergency room visits increased only among Black and Hispanic youth, indicating what she calls “a widening of the disparities” that existed between these groups and their white peers before the pandemic.

The data, published Nov. 6 in the journal Pediatrics, doesn’t offer many other clues about the possible origins of this alarming trend. Firearm injuries are sorted into three types in hospital reporting and billing systems: Accidental injuries, often the result of improper gun storage and curious kids; self-inflicted injuries, most the results of suicide attempts; and assault injuries. This simple categorization can easily miss a lot of nuance that could be helpful for researchers, explains Hoffman. Clear early-pandemic factors, like increased gun buying, poor teen mental health, and rising community violence levels, respectively, seem to be easy explanations for rising numbers of incidents in each injury category, but it’s likely that there are many more unknown causes at play. The proportions of injury categories stayed fairly constant over time, says Hoffman, which makes it even harder to point to any one cause of increased injury.

Read More: Raising Children in America Means Living in Fear That They’ll Be Shot

This data is still important to have, since research on gun violence tends to focus on fatalities, says Dr. Zirui Song, an associate professor of health care policy and medicine at Harvard Medical School. “What is often forgotten is the much larger number of people in America each year who sustain firearm injuries but are able to survive,” he says. Song’s own work, including a study also released yesterday, takes a more expansive look at the impacts of firearm injuries in children by analyzing the consequences for those around them.

His paper in Health Affairs demonstrates what he calls the “shared family trauma” that occurs when a child is injured or killed by gunfire, which includes a more than 30% increase in psychiatric disorders among the parents of survivors. 

Siblings of victims, too, are deeply affected. Although some family members rely on mental health services more often after a child is injured or killed, Song found that routine medical care often fell by the wayside for the siblings and mothers of survivors, with a decrease of between 5% to 14% for various visits and procedures. “This doesn’t necessarily mean that siblings were unharmed or sitting at home and just okay with it,” says Song, who has cared for the families of victims as an internal medicine physician at Massachusetts General Hospital. Instead, he believes it’s more likely a reflection of trauma remaining so unaddressed that it prevents families from engaging with care altogether.

Song also found that in the first year after being injured, health care spending for young survivors went up an average of $34,884, an economic burden shouldered almost entirely by insurers and employers, and one that he hopes continues to be highlighted in conversations about protecting children. (Song’s study included only families with employer-sponsored insurance, and he hopes to replicate it with families insured by public programs like Medicaid.) “So often in the healthcare system, moral arguments don’t move the needle on something,” he says. “In this case, children dying from firearm injuries have not moved the needle, but often dollars do. Gun violence is not only a medical issue and a public health issue, but it is increasingly an economic issue for our country.”

If it feels like researchers are trying to account for all sides of the issue at once, it’s because they’ve been left with little other choice, says Hoffman. They’re rushing to fill the gap left by years of growing gun ownership without the resources to track it. With papers like Hoffman’s and Song’s, researchers are still putting together an initial picture of gun violence today. “We’re decades behind where we should be and understanding why these increases are occurring and what we can do about them,” she says. The same, then, goes for the extent of their impact.

source https://time.com/6332323/gun-injuries-in-children-have-doubled-so-have-their-impacts/

The Audition That Landed Barbra Streisand Her Broadway Debut

I Can Get It for You Wholesale was a major Broadway show, written by Jerome Weidman, with music and lyrics by Harold Rome. Arthur Laurents, who wrote the book for West Side Story and Gypsy, was directing. The producer was David Merrick. They were all Broadway royalty, and I thought there wasn’t much of a chance that they’d want to hire me.

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That’s my negativity, which I inherited from my mother. She always told me, “Don’t count on anything good, because then God will snatch it away.” And I probably used that negativity to protect myself.

I came in to audition in November 1961. Since the play took place in the 1930s, I was wearing my 1930s coat, to put me in a period mood. It’s made of karakul, the smooth honey‑colored fleece of a lamb, trimmed around the collar and the hem with matching fox fur (this was way before PETA). I bought it in a thrift shop for $10 and thought it was the most beautiful thing I had ever seen. What made it so special was that the inside was just as lovely as the outside . . . the lining was embroidered with colorful baskets of flowers, done in chenille threads, with a little pocket made of ruched silk. Somebody had to really care in order to go to all that effort for something hardly anyone would see. I loved that idea, and I still have that coat. (The lining fabric has fallen apart, but the chenille flowers are still intact.)

Someone announced my name, and I stepped out onto the bare stage at the St. James Theatre, still wearing my coat, so everybody else could appreciate it. But of course whoever was announcing my name mispronounced it, so I had to correct it. As I was explaining this, I was setting down my shopping bag. I always carried some food . . . unsalted pretzels, Oreos (but I have to remove that white guck in the middle), almonds . . . because you never know when you’ll want a snack. I think that idea came from my mother. Maybe it’s part of the collective unconscious of European Jews, because what if a pogrom came and you had to get across the border fast? You have to have a little something to eat until you get to the next country.

Read More: Barbra Streisand Had a Foolproof Way of Proving to Her Mother That She Would Be a Star

I shaded my eyes and looked out into the dark theater, but I couldn’t make out any faces. “Hello! Is anyone out there? What would you like me to do?”

A voice replied. “Can you sing?”

I thought to myself, If I couldn’t sing, would I be standing here? But I said, “I think I can sing. People tell me I can sing. What would you like to hear?”

Nobody answered quickly enough, so I said, “Do you want something fast or slow?” I was like the guy behind the counter in the deli. Order your sandwich, already! Pastrami or corned beef?

Someone said, “Anything you like.”

“Well, this is a comedy, right?” I said. “So I’ll do a comedy song.”

I pulled my sheet music out of my shopping bag and headed over to the piano, not noticing that the pages, which were all attached and folded up like an accordion, were unfurling behind me into a long, 20‑foot tail. Actually, I was only pretending not to notice because I had done it deliberately. I knew I could be funny, and I thought I should show them. I heard some snickers from the audience, so it seemed to be working.

I told the accompanist, “Play the one on top,” and launched into “Value”:

Call me a boob, call me a schlemiel.

Call me a brain with a missing wheel.

Call me what you will, but nonetheless I’m still in love with Harold Mengert

And it’s not because he has a car. Arnie Fleischer has a car.

But a car is just a car . . .

The man who was talking to me . . . who turned out to be Arthur Laurents . . . was laughing, and then he asked, “Do you have a ballad?”

“Oh yeah, I have several.” I turned back to the accompanist and asked him to play “Have I Stayed Too Long at the Fair?” It was a song from another obscure show, and I loved it because it was about yearning, about wanting somebody to care, and I completely related to that.

---

Jerome Weidman was there that day, and later he described what happened next in a magazine article:

“Softly, in a voice as true as a plumb line and pure as the soap that floats, with the quiet authority of someone who had seen the inevitable, as simply and directly and movingly as Homer telling about the death of Hector, she told the haunting story of a girl who had stayed ‘too long at the fair.’ It was a song, of course, and a good one. But emerging through the voice and personality of this strange child, it became more than that. We were hearing music and words, but we were experiencing what one gets only from great art: a moment of revealed truth.”

I wish I could write so poetically. All I can say is I stood on that stage and went into my own inner world, forgetting anyone else was there.

There was silence after I finished the song. Then they asked me to sing another, and another.

I could hear them talking among themselves, and then Arthur stood up and asked if I could come back in a few hours.

“Why do I have to come back?” I asked. “You didn’t like what you just heard?”

I think Arthur laughed and explained that David Merrick would be there later, and they wanted him to hear me.

“No. I can’t come back,” I told him. “I have to go to the hairdresser.”

I could practically hear their shock. I was well aware that nobody would ever say no to a request to come back for another audition. And I was aware that what I had just said was funny. But it was also the truth.

“I’m opening tonight at the Blue Angel and I have to get my hair done. Hey, all of you should come!”

“Can’t you come back after your appointment?” Arthur asked.

I called out to my manager, Marty Erlichman, who was sitting in the back of the theater, “Marty, do I have time?”

I can just imagine him holding his head in his hands. “Yes!” he said vehemently. “Yes, you have time!”

So I went to the hairdresser, and when I got back to the theater and walked onstage, I asked, “So what do you think?”

They were taken aback, assuming I was talking about my audition. “No, my hair!” I said. “It’s different. Do you like it?”

I don’t think they knew what to make of me.

I sang my songs again for the group, which now included Merrick. It seemed to be going well, but I wasn’t sure. There was clearly some sort of consultation going on down there in the seats. It was only years later that the stage manager, Bob Schear, told me that Merrick called him over as soon as I finished the first song and said, “Don’t let her go. In fact, lock the door.”

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I had come in for the part of the ingénue, but now they asked if I would be willing to play the part of the lovelorn secretary, Miss Marmelstein. Arthur said they had been planning to cast the role with an older woman, but now they were rethinking it.

“Sure,” I said. “Why not? After all, I’m an actress.”

Read More: Barbra Streisand Calls Out Hollywood’s Double Standard

They gave me the music to her song and asked if I could come back the following week and sing it for them. On my way out Bob Schear stopped me to make sure he had my address and phone number.

“My address? Well, during the week I’m usually at West 18th Street but then on weekends I sleep in this rehearsal studio on Eighth Avenue.”

He looked confused. “Don’t you have an apartment?”

“No, but I’m looking for one. I read the ads in the New York Times every night and I can’t find an apartment that I can afford.”

“I can ask my landlord,” he told me. “I think there’s an empty apartment in my building.”

It was a tenement building at 1155 Third Avenue, near 67th Street, and Bob’s landlord was Oscar Karp, who couldn’t have been more appropriately named because he also owned the seafood restaurant, Oscar’s Salt of the Sea, on the ground floor. Bob went home and talked to him that night, and it was only after Bob promised to guarantee the rent that Oscar agreed to show me the apartment. It was a third‑floor walk‑up, and as soon as you started up the narrow, bare‑bones staircase, there was the smell of fish.

It was as if I couldn’t escape that odor. My father’s parents owned a fish store, and I still remember the sight and the smell of all those dead fish, packed in ice on slanted metal trays. My grandparents lived over the store, but we rarely visited, because they never liked my mother and blamed her for my father’s death. (That wasn’t fair.)

To this day I can only eat fish that doesn’t smell.

The apartment was a railroad flat, with four little rooms in a line and a bathtub in the kitchen, and the rent was $60 a month. As soon as I saw it, I said, “I’ll take it.” So I, too, would be living over fish. But at least food was close by, and I eventually became good friends with Oscar.

Things were looking up. I had an apartment on the East Side of Manhattan, where I had always wanted to live . . . and that meant I was not going back to Brooklyn . . . and I had a callback for a Broadway show.

I learned Miss Marmelstein’s song. When I came back to do it for Arthur and the group, I said, “I’d like to sit in a chair, if that’s okay.” I wanted to sing the number sitting down for two reasons: one, because I was nervous and didn’t want to stand, and two, because I thought it would be funny if the secretary did her song in a secretarial chair, the kind on casters, so she could roll around the stage, pushing herself with her feet. I just saw it that way in my head.

Just before I started to sing, I remembered I had gum in my mouth and stuck it under the chair. The song seemed to go well. Everyone laughed, and Arthur said, “Thank you. We’ll be in touch,” or something like that.

Later I found out that Arthur had gone over to the chair after I left and tilted it, to see if the gum was still there. I guess he wanted to know if the moment had been spontaneous . . . had I really been chewing gum? Or was it just a funny bit of business that I had worked out before I got there?

Arthur says there was no gum.

Listen, I wouldn’t have left my gum on their chair, spoiling their property. That’s not nice. The truth is, I pulled it off before I got up and started to chew it again. There was still some flavor left in it.

From My Name Is Barbra by Barbra Streisand, published by Viking, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2023 by Barbra Streisand.

source https://time.com/6331950/barbra-streisand-book-broadway-debut/

Rising Livestock Emissions Undermine World’s Climate Fight

Greenhouse gas emissions from the world’s top meat and dairy producers increased further this year, highlighting the urgent need for the food industry to clean its practices and help prevent global warming.

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Disclosed emissions from the world’s 20 largest publicly-listed meat and dairy companies rose 3.3% from 2022 levels, according to a report by investor network FAIRR Initiative. Its analysis includes companies like Hormel Foods Corp. and China’s New Hope Liuhe Co., which supply household names like Walmart Inc. and McDonald’s Corp.

The food industry’s climate footprint is immense, accounting for about a third of global greenhouse gases. Livestock, which releases potent methane, makes up 14.5% of worldwide emissions. The Science-Based Targets initiative, a UN-backed agency that evaluates companies’ net-zero goals, recommends that the food and agriculture sector cuts emissions by 3% a year between 2020 and 2030.

“The sector is just not on track,” said Thalia Vounaki, senior manager for research and engagements at FAIRR.

Read more: Cow Burps Have a Big Climate Impact. Solving That is Harder than You’d Think

That underlines the need to focus on food and agriculture as world leaders gear up for the upcoming COP28 summit in Dubai later this month, FAIRR said in its report. The group of investors raises awareness about the environmental, social and governance risks and opportunities in the global food sector, and is backed by more than $70 trillion in assets.

The United Arab Emirates has called for commitments to transform the food industry, while the United Nations’ Food and Agriculture Organization is set to unveil a net-zero roadmap for the sector. 

FAIRR’s report highlights that some companies have managed to reduce their emissions, such as Tyson Foods Inc. and Danone SA. But overall there are varying levels of climate commitments and disclosure, it said. Almost two-thirds of the companies it analyzed didn’t disclose so-called Scope 3 emissions, which include those that occur indirectly along a company’s value chain. Only four out of top 20 companies in the sector have net-zero aims.

Read more: The Cow That Could Feed the Planet

“We need to get these companies up to the same standard, irrespective of where they’re sitting,” Oshni Arachchi, head of active ownership at Danske Bank A/S, said in an interview.

FAIRR’s sixth protein producer index has highlighted improvements made by the livestock industry, including in areas like alternative proteins, waste and pollution and water use, it said. While that shows “bad practice is not an inevitable part of the food supply ecosystem,” the investor group urged for more progress on environmental aspects.

“We’ve long known that humanity can’t fix climate change without fixing the way we feed the world,” according to Jeremy Coller, private equity investor and founder of FAIRR.

source https://time.com/6332332/rising-livestock-emissions-undermine-climate-fight/

Battery Recycler Among Winners of Prince William’s Earthshot Prize

A lithium-ion battery recycler and a program to end illegal fishing are among the winners of Prince William’s Earthshot Prize, which supports companies tackling the environmental crisis.

The five champions, unveiled at an event held in Singapore, will each receive £1 million ($1.1 million) to scale their solution as well as other support. The companies focus on everything from cleaner energy to nature preservation and seek to address problems associated with pollution, biodiversity loss and the climate crisis.

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Extreme heat this year underscores the importance of finding novel ways to lower carbon emissions and protect nature. Earth set new records for heat in 2023 and global warming has driven unprecedented disasters such as Canada’s wildfires and floods in Libya and Greece.

GRST, which developed a new way to build and recycle vital lithium-ion batteries, won in the category of “Clean Our Air.”

“The world needs a massive amount of batteries to achieve net zero by 2050, but a revolution is needed to make these batteries cleaner and more recyclable,” Justin Hung, chief executive and co-founder of GRST, said in a statement.

The other winners were WildAid Marine Program, which is scaling marine enforcement to end illegal fishing; S4S Technologies, which makes processing equipment to combat food waste; Acción Andina, a community-based initiative to protect native high Andean forest ecosystems; and Boomitra, which aims to incentivize land restoration through a verified carbon-credit marketplace.

The Earthshot Prize, founded by Prince William in 2020, is backed by an international alliance of organizations, including the Bezos Earth Fund, Breakthrough Energy Foundation, Jack Ma Foundation, Paul G. Allen Family Foundation and Marc and Lynne Benioff. Bloomberg LP, the parent company of Bloomberg News, and Bloomberg Philanthropies are both members of the alliance; Michael Bloomberg is the majority owner of the former and the founder of the latter.

Last year’s winners included carbon removal company 44.01, electrolyzer maker Enapter, coral restoration innovations from Coral Vita, the Queensland Indigenous Women Rangers Network and climate-friendly farming startup Kheyti.

Earlier this year more than 1,100 applicants were narrowed down to 15 finalists by a global panel of scientific, academic, and subject-matter experts. The winners were picked by Prince William and the Earthshot Prize Council, chaired by Christiana Figueres, an architect of the Paris Agreement.

source https://time.com/6332319/battery-recycler-prince-williams-earthshot-prize-winners/