Medicine and Science from The BMJ

GLP-1 weight regain and doctors forced out of Gaza

The class of GLP-1 agonist drugs including Ozempic gained a wide reputation for weight loss in 2025. However, it's well established that weight regain is a common result after people stop their doses. We report on new research which aims to quantify what is happening in the here-and-now for patients who stop using these and similar drugs.
Weight regain after cessation of medication for weight management: systematic review and meta-analysis 
 
Also, The BMJ reports on news from Gaza. The Israeli government has issued new directives to strip 37 NGOs of their licences to provide essential aid to the population. This includes Médecins Sans Frontières, the charity directly supporting many of the critically important hospitals in the territory. Gaza is experiencing an especially harsh Winter and MSF warn that this measure could leave Palestinians without lifesaving medical care.
Gaza: Israel moves to ban dozens of aid groups in "cynical and calculated" move Gaza in winter: 29 day old baby dies of hypothermia amid dire conditions
 
The BMJ’s annual appeal is supporting the work of Médecins Sans Frontières (MSF). Around the world, MSF teams are providing maternity care, containing outbreaks, and performing vital surgeries. In areas overwhelmed by conflicts and natural disasters, more lives can be saved when we are in the right place at the right time.
Donate today at https://msf.org.uk/bmj-annual-appeal-2025

Could a Ministry for the Future solve the climate crisis? | Kim Stanley Robinson interview

This episode is available in video form on YouTube: https://youtu.be/1cGrD47eZSk American science fiction author Kim Stanley Robinson joins Kamran Abbasi to discuss climate disaster, the need for political imagination, and science fiction's vision for health.
Kim Stanley Robinson is the acclaimed author of a trilogy of novels, exploring the terraforming and settlement of Mars. His most recent novel, 'Ministry for the Future', was published in 2020.
'Ministry for the Future' sets out a vision for real solutions to our climate crisis, covering global finance, the animal kingdom, rising sea levels, energy production and much more. The book imagines a Ministry that begins its work in 2025.
Five years after publication, with 2025 past and gone, The BMJ spoke to Robinson to explore how closely the novel's vision for the future has reflected reality.
01:00 BMJ's New Climate Change Initiative01:21 Kim Stanley Robinson's Ministry for the Future04:02 The Role of Political Violence in Climate Action10:50 The Concept of the Carbon Coin12:51 The Importance of Global Collaboration27:32 The Role of Medicine in Climate Change32:33 Youth and Climate Activism37:53 Hope and Despair in Climate Action41:29 Conclusion and Future Works
Read more about The BMJ's climate coverage in the latest issue: https://www.bmj.com/content/392/8479

Christmas 2025 - neologisms, longevity and unexpected research

It’s time for 2025’s festive fun!
Practicing medicine can be a very visceral experience - and the English language can’t always adequately capture the sights, sounds, smells. So Matt Morgan, intensivist and BMJ columnist, is creating medical neologisms, and joins us to share a few.
Madhvi Joshi, a GP in London, has written about longevity science, and we hear how the “biohacking” of internet influencers like Bryan Johnson is making its way into the consultation.
Navjoyt Ladher and Tim Feeny take us though this year’s festive research, and are joined by Anupam Bapu Jena from Harvard, who has been looking at self censorship in the time of Trump, and Melanie de Lange, from the university of Bristol, who has been investigating the impact of daylight savings time.
Reading list:
A dictionary for medicine’s unnamed momentshttps://www.bmj.com/content/391/bmj.r2476
Science of longevity medicine https://www.bmj.com/content/391/bmj.r2536 
Changes in diversity language in National Institutes of Health grant awardshttps://www.bmj.com/content/391/bmj-2025-087222 
Acute effects of daylight saving time clock changes on mental and physical health in Englandhttps://www.bmj.com/content/391/bmj-2025-085962 

The shadow use of Gen AI in the consultation room

In this episode, we hear how Generative AI is making it into the consultation room - but not through NHS endorsed routes - surveys suggest that ⅔ of doctors are using AI, for backoffice tasks - but also increasingly for information and diagnosis.
 
David Navarro, a research fellow in generative AI at the Australian Institute of Health Innovation, Charlotte Blease, associate professor at the Participatory eHealth and Health Data Research Group at Uppsala University, and Marcus Lewis, GP in London, reflect on what we know about the real way in gen AI is being used - and what “triadic care” (doctor, patient and AI) will mean for the future of the therapeutic relationship.
 
We also hear from Teppo Järvinen, professor of orthopaedic surgery at Helsinki University, about surgical subacromial decompression - a 10 year follow up of a double blinded placebo controlled trial, confirms that surgery is no more effective than standard care. Yet surgical interventions continue - we hear why.
 
Finally, we go to a Cholera clinic in Nigeria, where Médecins Sans Frontières are running cholera treatment centres, which you can help by donating to our Christmas appeal.
 
Links
Generative AI and the clinical encounter
 
The BMJ appeal 2025-26: Inside MSF’s response to cholera in Nigeria: a day in the life of an emergency doctor
 
Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome

ADHD therapies, and the NHS gig economy

There is an enormous amount of research on treatment for ADHD - pharmaceutical and otherwise. But not all of those trials, or meta-analyses, are of high quality; and not many compare the whole literature. 
Now a new umbrella review - a review of reviews - tries to give a broad overview of the whole evidence base. Corentin Gosling, associate professor at the Université Paris Nanterre, joins us to set out the benefits and harms of ADHD therapies.
 
Also, the BMJ’s been investigating the employment of doctors on “local” contracts in the NHS - and our latest look at this exposes what some have described as a “gig economy”, with doctors plugging rota gaps but missing out on training, development, and salary progression. Rebecca Coombes, head of journalism at The BMJ explains more.
 
Finally, Tom Frieden is former head of the US Centers for Disease Control, and current CEO of Resolve to Save Lives - he’s written a new book on public health. He joins us to talk about what actually improves health at a population level, and why the current US administration’s approach to staffing the CDC is leaving the country open to danger.
 
Reading list
Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making
Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts
 

The Covid Inquiry - special episode

 
"Damning” and “unforgivable failures” is how some papers headlines reacted to criticism of former UK prime minister Boris Johnson in the second of 10 reports from the UK Covid Inquiry.
Under pressure, in 2001 Boris Johnson announced a covid inquiry led by a former judge, Baroness Hallett. Each report is examining a different area of the pandemic's impact, and module 2 is about decision making and political governance.
The report describes inertia, toxic cultures, and an inability to learn lessons - disfunction that contributed to many extra deaths. 
To dissect the report and discuss what needs to change, we're joined by;
Rebecca Coombes - The BMJ’s head of journalism
Kevin Fong - anaesthetist and lead for major incident planning at University College Hospital
Matthew Flinders - Professor of Politics and Public Policy at the University of Sheffield
 

Climate, “car spreading”, and conflict

It’s the BMJ’s annual climate issue - and in this episode, we’ll be hearing about more ways in which climate mitigation is good for health.
 
Firstly, climate change is fuelling conflict, and exacerbating the impact it has on fragile healthcare systems. Andy Haines, from the London School of Hygiene and Tropical Medicine, and Barbora Sedova, from Potsdam Institute for Climate Impact Research, discuss how climate and conflict intersect, and what they think needs to be done to combat it.
 
“Car spreading”, the recent tendency for cars to become bigger and heavier is not only harming the climate, but it’s also harming pedestrians.  Anthony Laverty, associate professor of public health at Imperial College London, and trauma surgeon Cleo Kenington explain why SUVs are more lethal in accidents, and why France is bucking the trend in sales.
 
Finally, Jocalyn Clark, the BMJ’s international editor joins us to talk about women’s health innovation and why tech bros aren’t the people to be leading it.
 
Reading list:
 
The climate issue: Brazil and the climate crisis
 
Tackling the complex links between climate change, conflict, and health
 
Reducing the harms from ever larger cars
 
Transforming women’s health through innovation

Doctors against the far right

Far right rallies have been held across the UK, culminating in a large parade in London where Elon Musk spoke. At the same time, politicians from across the political spectrum are following the talking points of far right parties - and shifting their policies rightward, even the Labour home secretary has said she wishes to double the period migrants have to be in the UK before they can become citizens.
That has made a group of medics decide it’s time for doctors and other healthcare professionals to use their voice and speak up - against the demonisation of migrants into the UK, and for their fellow NHS staff. They are demanding that those in positions of power do so too.
 
Some of those medics join us on the podcast today;
Alistair Stewart, consultant psychiatrist in Manchester 
Omnya Ahmed, resident doctor in London 
Jordan Rivera, occupational therapist in London
 
Also this week, doctor, researcher, comedian and Matt Hutchinson is adding author to his list, and has released the book “Are You Really the Doctor? My Life as a Black Doctor in the NHS” - he joins Shivali Fulchand to talk about balancing all of this bits of his career - and how standup comedy has helped him maintain his career in the NHS.
 
Reading list
Everybody’s business: call to all NHS staff to oppose the influence of racism and the far right

The shaky science of the Q-collar, exercise for osteoarthritis, and patient choice.

This week on the podcast
The BMJ investigates Q-COLLAR, an American device that distributors claim can reduce brain injury from contact sports. Investigators James Smoliga and Mu Yang take us through the evidence, and former NFL punter turned US bobsled team member Johnny Townsend explains what this means for sportspeople.
Bin Wang from Zhejiang University School of Medicine explains what the new network metaanalysis finds is the best exercise options for knee osteoarthritis
And, what our patient panel really think about “patient choice”.
 
links
How an FDA cleared “brain protection” device built on shaky science made it to the NFL
Comparative efficacy and safety of exercise modalities in knee osteoarthritis
The BMJ's patient and public partnership

The difficulty of delirium diagnosis, the lack of agency in the 10 year plan, and Gaza wounds

In this episode of the podcast;
In July this year, the Government published their 10 year health plan for England - A new analysis just published on BMJ.com takes an in depth look at the chances of that plan succeeding, and where the government needs to focus time and resources. Bob Klaber, paediatrician and director of strategy, research and innovation at Imperial College Healthcare, and Helen Salisbury, GP and columnist for the BMJ join us to discuss.
Journalist Chris Stoker-Walker's grandfather suffered from delirium at the end of his life, but the journey to that diagnosis was difficult - Chris joins us to talk about the impact that had on his family, and Elizabeth Sampson, professor of liaison psychiatry from Queen Mary University of London, explains why it's under-researched.
Finally, we've been reporting from Gaza for 2 years, and it's been very difficult to get accurate information out of the region. However, new research published on bmj.com has surveyed medics there, to document the patterns of wounding in the civilian population - to improve the medical response to the conflict. Omar El-Taji and Ameer Ali, resident doctors in the NHS join us to explain what they found.
 
Reading list:
Delivering on the 10 year health plan for England
Why can’t we do anything about delirium?
Patterns of war related trauma in Gaza during armed conflict