Health
How a Gene for Obesity Affects the Brain
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By Kelly Malcom
Obesity is a complicated condition, caused by a combination of genetics, the food environment, behavior, and other factors.
For millennia, getting enough food to survive and thrive was difficult. For most people, it’s now as easy as opening a refrigerator.
A gene called SH2B1 has been shown to play an important role in regulating food intake.
SH2B1 mutations in people are associated with obesity, type 2 diabetes and metabolic dysfunction-associated steatotic liver disease, formerly known as non-alcoholic fatty liver disease.
“This gene controls feeding and energy expenditure. Obesity is caused by two opposing axes: If you eat too much, you gain fat. Spend too little energy and fat accumulates,” said Liangyou Rui, Ph.D., Department of Molecular & Integrative Physiology and the Elizabeth Weiser Caswell Diabetes Institute at the U-M Medical School.
A study from Rui and team identifies where this gene is acting inside the brain, an area called the paraventricular hypothalamus, or PVH, which is involved in regulating blood pressure and fluid balance.
Additionally, the team discovered that neurons that express SH2B1 create a circuit, talking to neurons downstream in an area known as the dorsal raphe nucleus, located in the brainstem.
This area is implicated in energy balance and body weight maintenance and emotion motivated behavior.
Stimulating this circuit suppresses appetite in mice. Conversely, silencing the SH2B1 expressing neurons in the PVH leads to obesity.
The team also uncovered the molecular mechanism behind how SH2B1 helps maintain weight, in part by enhancing BDNF/TrkB signaling, which during development promotes brain growth and in a mature brain, maintains brain health. When this signaling goes awry, obesity and metabolic disease develop.
One theory, Rui notes, is that the inflammation associated with weight gain can negatively affect this pathway in an indirect way, weakening the signals to stop eating.
“We know that SH2B1 action is important, as it is highly conserved across species, from the fruit fly to humans,” said Rui.
“It functions as sort of a universal currency, not only enhancing cell signaling, but the hormones leptin and insulin, which help regulate appetite and metabolism.”
Furthermore, there have so far been no identified side effects to enhancing SH2B protein, unlike currently popular drugs, such as Ozempic or Mounjaro, that activate glp-1 receptors.
Said Rui, “If we can find a way to enhance SH2B activity, there is huge promise for treating obesity and its related diseases.”
Additional authors include Yuan Li, Min-Hyun Kim, Lin Jiang, Lorelei Baron, Latrice D. Faulkner, David P. Olson, Xingyu Li, Noam Gannot, Peng Li.
The Michigan Research Cores on this work include Metabolic, Physiological and Behavioral Phenotyping Core, Michigan Metabolomics and Obesity Center and the University of Michigan Center for Gastrointestinal Research
Paper cited: “SH2B1 Defends Against Energy Imbalance, Obesity, and Metabolic Disease via a Paraventricular Hypothalamus→Dorsal Raphe Nucleus Neurocircuit,” Advanced Science. DOI: 10.1002/advs.202400437
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Previously Published on michiganmedicine.org with Creative Commons License
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Health
Brooks Ghost Max Running Shoes Are Nearly $50 Off Right Now
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Dick’s Sporting Goods is in the midst of a major sale on running shoes from brands like Hoka, On, and Nike, with Brooks accounting for some of the retailer’s most appealing discounts. Styles like the Glycerin StealthFit and the Adrenaline GTS are on sale, but the one turning heads right now is the high-stack and ultra-cushioned Ghost Max—and it’s selling fast.
Right now,
Brooks Ghost Max Running Shoes in Black/Ebony, $102 (was $150) at Dick’s Sporting Goods
The Ghost Max takes all the best features of the traditional Ghost running shoe, like great breathability and ample under-foot support, and adds a super high-stack cushion that amplifies protection and shock absorption from surface textures. This is a huge upgrade for those with sensitive feet, as it decreases the pressure exerted on the foot, and the larger cushion also provides a wider base, which helps with stability. And, though this sneaker has a more level 6 mm heel-to-toe differential (half that of the normal Ghost), it uses a rocker bottom to help achieve a smooth, comfortable stride when walking.
The maximum cushion is an immediate standout for anyone who steps into these Brooks running shoes, especially those who have to stand a lot. “I’m not a runner, but stand on concrete all day,” a shopper began. “They are, by far, the most cushioned and comfortable shoes I’ve ever worn. I’ve tried Hoka, Asics, and Oofos, but the Ghost Max is my favorite. If you need cushion in your step, look no further.” Another shopper agreed, simply saying they were “super comfortable shoes” with “lots of support.”
Brooks Ghost Max Running Shoes in Cream, $102 (was $150) at Dick’s Sporting Goods
In some cases, shoppers are even switching from their Ghosts—the brand’s most popular sneaker—in favor of this model. “I have been a Brooks Ghost user for many years,” a shopper said. “Love the Ghost Max. Superior cushioning is the key. Being a larger runner of over 30 years (6-foot-3, 240 pounds) the extra cushioning is very much appreciated. The shoes fit perfectly and the ride is smooth. My knees, ankles, and thighs thank you!”
Whether you’re looking for the perfect walking shoe or some extra protection from a daily runner, it’s well worth trying the
Prices are accurate and items in stock at time of publishing.
Health
Bridging Generational Divides in Medical Education: Gen Z Med Students’ POV
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By Nichole Sanchez Diaz, Sanja Kostov, Erin Bearss, Milena Forte
What comes to mind when you think of “Gen Z” (1996-2010)?
Anecdotally, it seems preceding generations (Boomers, Gen X, Millennials) have seen us as “digitally savvy yet too sensitive.” And while we cannot generalize an entire cohort, there’s truth that this is generating friction in medical education.
Raised in the digital age, Gen Z faces higher rates of mental health issues than its predecessors. This cohort also has a stronger desire to uphold principles of equity, diversity and inclusion (EDI) that can sometimes challenge traditional medical teachings, thus creating novel tensions between medical trainees and their educators.
Medical training is notoriously challenging, with responsibility and stress levels increasing with each passing year. It compares to the stress of starting a new job every few months while being the least informed contestant in a never-ending Jeopardy episode. When you add in the sleep deprivation that comes from working around the clock, it’s not surprising that training can negatively impact the mental health of medical learners. A 2018 Canadian Medical Association survey revealed alarming rates of burnout and depression among resident physicians; more recent studies point to this being an even bigger issue since the pandemic. Given that circumstances have made Gen Z appear to be even more psychologically vulnerable than previous generations, what measures have been implemented to ensure their collective success and are these measures sufficient?
In recent years, institutions have rolled out wellness programs and mental health services. These are steps in the right direction, but are often inaccessible to trainees , especially during residency. The unwritten expectation of self-sufficiency discourages trainees from openly discussing their mental health needs with educators, fearing they may be perceived as fragile or, worse, incompetent.
Recent studies reflect what Gen Z residents value in wellness strategies: clear communication and community building, particularly with their educators. Despite their digital upbringing, they crave in-person teaching and opportunities to develop deeper connections with their mentors.
Educators can play a pivotal role in dismantling the stigma surrounding mental health during medical training. By sharing their personal experiences and coping mechanisms, and promoting wellness resources, they can normalize discussions around mental health and burnout; topics with which many trainees struggle but are afraid to vocalize. An honest dialogue between mentor and mentee is a powerful tool for building mutual trust and can increase the chances of identifying and addressing mental health challenges before they escalate.
As an ethnically and socially diverse cohort, Gen Zs recognizes EDI as more than a buzzword.
Gen Z medical learners can also take steps, such as understanding their program’s purpose and expectations, establishing clear expectations with their educators, and identifying existing resources in advance. If they encounter challenges, they should investigate and access formal supports offered by their programs (e.g., accommodations or extensions to training) to avoid sacrificing their well-being.
As an ethnically and socially diverse cohort, Gen Zs recognizes EDI as more than a buzzword; it is an expectation of their future workplace. Their openness to embrace new perspectives combined with unparalleled access to information online makes them more likely to challenge long-standing practices.
For example, a preceptor commenting on the risks of high BMI can provoke discomfort in a student who believes it perpetuates fat-phobic attitudes, influenced by social media discussions about patient discomfort with weighing at medical visits. The emphasis on political correctness has made some physicians cautious when teaching, fearing a backlash. To remedy this, educators can practice listening to and understanding student perspectives, especially those discordant with their own. Using this as a teaching opportunity, faculty members can discuss evidence supporting their clinical practice and share personal experiences while simultaneously addressing gaps in their knowledge and updating outdated terminology.
Learners should feel empowered to challenge established medical practices, but they need to be cautious about forming their beliefs based on virtual discourse that can spread misinformation, particularly when they have limited clinical experience. Clinical educators can often contextualize and tailor available evidence to specific patient situations based on their medical expertise and a host of varied patient experiences. Embracing opportunities for humility and shared learning enables a safe learning environment that encourages curiosity and ensures training is rooted in evidence-based practice. While these are difficult conversations, they are vital because dismissing learner concerns only leads to mistrust.
Adapting medical education for Gen Z learners isn’t about coddling – it’s about evolution. This is a call for educators to acknowledge generational differences and be willing to gradually shift the hustle culture of medical training to foster a more supportive learning environment through respectful dialogue.
Gen Z respects authority but will learn best under mentors who encourage transparent discussions around mental health and social accountability in medicine. For students to fully benefit from their education, they must also clearly understand the expectations of their roles. By embracing innovation while upholding core values in medical education, we can shape students into resilient professionals who can thrive in today’s demanding health-care landscape.
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Previously Published on healthydebate.ca with Creative Commons License
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Health
15 Best Gay Sex Positions for Couples to Explore
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When it comes to gay sex positions, pleasure isn’t one-size-fits-all. Men looking for fun and different sex positions should play around with unique missionary sex positions, 69 sex position variations, and even Amazon sex position to add excitement and novelty. Experimenting with lubes and sex toys for men (think prostate massagers, anal beads, and cock rings) will only enhance the best gay sex positions, so come to the bedroom with an open mind.
Like any sexual experience, gay sex is personal and there’s a lot of experimentation that can be done to understand your preferences and the preferences of your partner.
“Some men don’t understand what exactly turns them on,” says Finn Deerhart, AASECT-certified sexuality counselor, who works primarily with queer men. “They assume their turn-on is a causal result of the objects they desire or a set of conditions. However, when it comes to sexual arousal, and the deeply personal nature of that energy, it’s less about the specific objects and more about the implied sense of meaning a man derives from his sexual experiences.”
Below, Deerhart, alongside multiple sex experts, share a guide to the best gay sex positions for men that will offer inspiration to try something new, lean into what you like most, and connect with your mind-body connection to be a better lover.
1. Doggy Style
Katie Buckleitner
How to Do It
“This one is a staple for many gay men,” says Deerhart. The receiver kneels or stands facing away from the penetrator. With hips raised, the receiver takes the penetrator as deeply as they desire.
Why It Works
“The absence of eye contact is part of why men love doggy style,” says Deerhart. “They’re able to tap into their animal bodies while enjoying a degree of emotional opacity.” Removing direct eye contact can help lower inhibitions and encourage partners to be more present in the moment.
Pros | Cons |
---|---|
Deeper penetration |
Can be too deep for the receiver, depending on capacity and depth |
Freedom of movement for the one thrusting |
|
Receiving partner can masturbate, if desired |
|
Lack of eye contact lowers inhibitions |
Pro Tip
Go slowly and use plenty of lube. We recommend Boy Butter. It’s a fan favorite among users because it’s long-lasting, easy to clean, and strikes a balance between the stickiness of water-based lubes and the greasiness of silicone. Its consistency starts like a lotion that melts into an oil as you work it between your hands. Just note this is not condom-compatible!
2. Spooning
Katie Buckleitner
How to Do It
The receiving partner lies on their side with their back toward their partner, while the penetrative partner applies lube and aligns their pelvis to the receiving partner’s butt to assume the “spooning” position. The receiving partner can arch their low back and extend their bottom leg long while bending the top one closer to their chest to create more space for the giver to rest their top leg over them and enter. “Because half of the body is being restricted by the bed, it can be difficult to make adjustments once started,” explains Dr. Rossana Sida, a licensed marriage and family therapist and AASECT-certified sex therapist in Los Angeles, CA.
Why It Works
“This is the best on a lazy morning where relaxation and intimacy are key,” says Sida. It doesn’t require acrobatics, plus the receiving partner can touch their partner or themselves, either masturbating or giving attention to erogenous zones to enhance arousal.
Pros | Cons |
---|---|
Heightened intimacy between partners |
Difficult to find the right angle |
Low-energy position, perfect for morning sex |
Hard to get the leverage to thrust in and out |
Lots of skin-to-skin contact |
Pro Tip
The receiving partner can place a small sex wedge or pillow, like Foam Heart Sex Pillow, between their knees if both are tucked to maintain space and limit fatigue.
3. Missionary
Katie Buckleitner
How to Do It
The receiving partner lies on their back with legs butterflied open, while the giver lies on top and supports their body weight with their arms. The penetrative partner enters so they’re face-to-face. To modify this, the receiving partner can place their legs over the giver’s shoulders for more direct prostate stimulation.
Why It Works
Missionary is a classic position that offers a high degree of emotional connection due to the direct eye contact, says Deerhart. You get feedback in real time and can read each other’s facial expressions.
Pros | Cons |
---|---|
Promotes a heightened sense of connection due to eye contact |
Can be overwhelming sometimes for men who would prefer to be less emotionally seen |
Can read facial expressions for real-time feedback |
Can be physically demanding for the penetrator who has to hold their upper body—or the receiver’s legs—up |
Provides direct angle for prostate stimulation |
Pro Tip
Use a sex wedge to elevate the bottom partner’s hips. We like Liberator Wedge Intimate Sex Positioning Pillow. The 27-degree angle is the ideal pitch for deeper penetration and stimulation.
4. Standing (Bodyguard)
Katie Buckleitner
How to Do It
The receiving partner stands with knees slightly bent for stability, facing away from their partner. They can stand in front of a wall and support their body weight with their hands or stand before a bed and brace their weight by kneeling one leg on it (shown). If kneeling one leg, the receiving partner can lean forward slightly and reach behind and grab their partner’s hips or thighs for greater balance. “While adequately lubricated, the penetrative partner will insert their penis, being mindful of their partner’s comfort,” says Sida. The giver should tilt their pelvis up and choose between a more sensual or vigorous rhythm of movement. Whichever feels best, both partners will need to move their hips in sync with each thrust.
Why It Works
This is an easy anal sex position to bring role play into your repertoire. Also known as “bodyguard” position due to the restraining nature of the position, you and your partner can play with domination. Moreover, the receiver can additionally masturbate while receiving anal if standing in front of a wall for balance.
Pros | Cons |
---|---|
Allows for spontaneity as standing means you can have sex in the kitchen, home office, or shower |
Both partners need to have good balance |
May be too physically demanding for an entire sexual experience, but it can start things off |
Pro Tip
Have the penetrative partner insert a vibrating butt plug like Lovehoney Butt Tingler 10 Function Vibrating Butt Plug. It’s great for intermediate users what with its four-inch length and flared base. The bulb houses a removable bullet vibrator that has three vibration speeds and seven patterns to find the right sensation.
5. Rusty Trombone
Katie Buckleitner
How to Do It
The receiving partner stands with legs slightly apart, while the giving partner kneels behind them, performing analingus (aka rimming) while simultaneously providing a hand job. The position vaguely resembles playing a trombone. For the giver, it requires plenty of coordination between the hand and mouth.
Why It Works
This is a multifaceted experience for the receiver, as it combines oral and manual stimulation for intense pleasure, says Bedbible.com sex educator Kasia Halinowska.
Pros | Cons |
---|---|
Provides dual stimulation as a rim job and hand job |
Requires flexibility and balance |
Difficulty to master coordination for giver |
Pro Tip
Get in the shower together beforehand and get really clean. This will put both of you at ease if you’re starting with optimal hygiene. Our favorite unscented body wash is Nécessaire Fragrance-Free The Body Wash.
6. Legs Up
Katie Buckleitner
How to Do It
The receiving partner lies on their back with legs up so the penetrative partner can kneel, place their hands on either side of them, and slowly ease in. The receiving partner can lift their hips and rest their calves against the penetrative partner’s shoulders, which allows for deeper penetration, as well as greater support.
Why It Works
The receiving partner won’t get fatigued having to hold their legs up on their own, and this face-to-face positioning helps “maintain eye contact for intimacy,” says Halinowska.
Pros | Cons |
---|---|
Promotes deep connection with face-to-face contact |
Might not allow for very deep penetration |
Pro Tip
Try a hybrid lube that comprises water and silicone, like Hello Cake Tush Cush, for greater comfort and longevity. It won’t dry out as quickly as other lubes and helps prevent tearing.
7. Back It In
Katie Buckleitner
How to Do It
The giving partner sits in a chair with knees to chest, torso angled back in a reclined position. Use pillows to provide the proper support and get the angle right. The receiving partner backs into the position and lowers onto their partner’s penis. The receiving partner should use their legs to lower up and down.
Why It’s Great
This is a position for those chasing novelty—who want a change of pace, says Halinowska.
Pros | Cons |
---|---|
allows for control over depth of penetration |
can be a bit awkward to get into position initially |
difficult for giving partner to keep legs elevated without support |
|
8. Helicopter
Katie Buckleitner
How to Do It
The receiving partner gets on hands and knees, then lowers down to their forearms, to start. The penetrative partner does a down dog over them, head positioned by the receiving partner’s feet, and aligns their pelvis with the receiving partner’s anus. The giver penetrates their partner as they lift their legs to create a helicopter shape. The penetrative partner will keep their pelvis on the receiving partner’s butt, using their arms to support their body (think pushup position), explains Halinowska.
Why It’s Great
You won’t get deep penetration, but due to the downward angle of the penetrative partner’s penis, it stimulates the head. Helicopter is fun and challenging, bringing a bit of spontaneity to your sex life if things have felt ho-hum
Pros | Cons |
---|---|
adds novelty to sex |
penetrating partner must have a strong upper body to maintain |
provides unique entry and stimulates the head of the penis |
difficult to maintain balance and find rhythm |
9. Cliff Diver
Katie Buckleitner
How It Works
The receiving partner gets on all fours while the giving partner helps lifts their legs off the ground, one at a time, wrapping them around their waist for more control and support. The penetrative partner then inserts their penis and holds onto the receiving partner’s hips.
Why It’s Great
It’s a little more advanced, but for those looking to experiment with standing sex positions, this can create a strong prostate orgasm.
Pros | Cons |
---|---|
Exciting and adventurous for couples |
Requires strength and coordination |
Provides intense stimulation |
Not suitable for all fitness levels |
Can be scaled to a chair to limit the load on the receiving partner’s arms |
10. Pirates Booty
Katie Buckleitner
How to Do It
“This is a twist on missionary position that allows for deeper penetration,” prefaces Searah Deysach, sex educator and owner of Early to Bed. The receiving partner lies on their back with one leg down and the other leg in the air. The penetrative partner straddles the planted leg, slides in, then rests the receiving partner’s extended leg on their shoulder. “This allows the giver easy access and a great view,” says Deysach.
Why It Works
Pirate’s booty is for couples looking for a missionary sex position variation that’s outside the norm. It allows for deep penetration.
Pros | Cons |
---|---|
Both parties can kiss and cuddle while in this position |
Receiver needs to have good hip flexibility |
Receiver can stimulate his penis easily (and the giver can help if they don’t need both arms to balance) |
Lifting just one leg can cause the pelvis to tilt, which might make the penetrator hit the side of the pelvic bone |
Communication is easier when looking at each other |
Pro Tip
Lifting just one leg can cause the pelvis to tilt, which might make the top hit the side of the pelvic bone. To avoid this, you might have to lift both legs to keep the pelvis level.
11. London Bridge
Katie Buckleitner
How to Do It
The penetrative partner lies on their back, feet flat, knees bent. The receiving partner backs on top of the penetrative partner, between their legs, easing onto their partner’s penis while facing away. “It’s a reverse insertion position,” says sex educator, Goody Howard. “The rider can grind down, lift their hips, dance, squeeze their sphincter muscles for mutual pleasure, and put their hands on their partner’s knees for stability and leverage,” says Howard. “For even more leverage, the rider can “lower the bridge” even further and put their elbows on the bed (or floor).”
Why It Works
This position is actually the great equalizer for couples who may have larger height and weight differences. It also perfectly aligns the penis and anus and is less taxing than other non-traditional positions.
Pros | Cons |
---|---|
Low impact on the knees and back |
Rider needs to be careful when leaning down. It’s important to finesse and smoothly transition from upright to leaning on elbows |
Great for genital alignment, so big height differences don’t matter as much |
|
Good for plus-size couples |
|
Increases sensitivity for the person being ridden |
Pro Tip
To ensure you don’t have to stop before the climax to add more lube, try Lelo F1L. The long-lasting, water-based lubricant is hypoallergenic and unscented.
12. 69
Katie Buckleitner
How to Do It
Both partners lie in opposite directions: one partner’s head on the other’s cock and vice versa, sucking each other at the same time. “This position is great for Sides, men who love sex with men but don’t enjoy anal sex,” says Deerhart. “The 69 sex position makes it possible for each to relax into mutual receptivity since both are receiving oral at the same time.”
Why It Works
“The magic of 69 is it releases each man from any pre-existing, prescribed roles and allows each to stay focused on the pleasure of giving and receiving without a fixed context,” adds Deerhart. Plus, the partner on bottom can give a rim job or a blow job.
Pros | Cons |
---|---|
Heightens the odds of mutual orgasm |
Some partners can get overwhelmed and lose the ability to stay focused on their own pleasure |
No set “roles” for partners |
Related: The Best Nipple Clamps of 2024 for Maximum Pleasure
13. Lotus
Katie Buckleitner
How to Do It
Lotus is a tantric sex position. To get into it, the bottom (penetrative) partner sits cross-legged, torso upright, then the receiving partner straddles them so they’re face-to-face. The top partner can also cross their ankles or have feet touch, says Halinowska, and both partners can wrap their arms around each other. This is more of a rocking position, with the top partner controlling the speed and rhythm. To help counterbalance, the bottom partner can lean their hands back for greater support and leverage.
Why It Works
Lotus is an incredibly intimate position, as it encourages and maintains eye contact between partners.
Pros | Cons |
---|---|
Promotes full-body, sensual contact, and deep connection |
Might not be ideal for extended periods due to the seated position’s strain on hip flexors |
Hands are free to roam |
14. Squatter’s Rights
Katie Buckleitner
How to Do It
This reverse face sitting position flips the script and puts the emphasis on analingus. The receiving partner hovers their body over the giver’s mouth, taking care not to put too much body weight on their face. The receiver can use their legs to brace their weight and place their hands on their partner’s chest for balance, explains Halinowska.
Why It Works
This is a playful take on oral sex that also hedges into dominance and submission, as the receiving partner has the control.
Pros | Cons |
---|---|
Concentrated oral stimulation for receiver |
Might get uncomfortable for the giver’s neck |
Pro Tip
Use a wedge like Liberator Flip Ramp under the giver’s head for greater neck support.
15. Cowboy
Katie Buckleitner
How to Do It
The receiver lies down on their back, and the receiver, facing him, eases down on the penetrator’s penis and bucks at the rate that feels good to him. “This position is great for receivers who want more control over the experience,” advises Deerhart.
Why It Works
“The receiver gets to decide how deep, fast, and intense the thrusting goes,” says Deerhart. “So they’re more likely to open up and freely enjoy being penetrated.”
Pros | Cons |
---|---|
The receiver can decide duration and intensity. |
This position can sometimes cause a penetrator to lose their hard-on since the flow of gravity naturally pulls blood downward in the erection. |
Some guys who penetrate in this position may feel too restricted, since the receiver is sitting on top of their body and taking charge. |
Meet the Experts
- Finn Deerhart, AASECT-certified sexuality counselor
- Dr. Rossana Sida, licensed marriage and family therapist and AASECT-certified sex therapist in Los Angeles, CA
- Kasia Halinowska, Bedbible.com sex educator
- Searah Deysach, sex educator and owner of Early to Bed
- Goody Howard, sex educator
Related: 10 Best Sex Swings of 2024: Why You Should Make a Push for One
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