The Post Office’s “Looping Problem”

Posted on September 3, 2026 by Ken Goetz

The Post Office’s looping problem is crazy. It is totally ridiculous. It needs to be remedied now. I experienced this frustrating problem first hand when I mailed initial copies of my memoir, A Streak of Dakota Dust, to destinations across the country.

What exactly is the problem? Thanks to using the tracking numbers provided by USPS , I discovered that some of my books wandered through absolutely bizarre pathways. For example, one book was sent to Pierre (in the middle of South Dakota) but it ended up in Aberdeen in the northeastern part of the state. It finally came to its senses and looped back to the address on its label. It arrived in Pierre a couple of days late.

Postman rushing on a bicycle — **Image by RichardsDrawings**

Even more frustrating is the continuing journey taken by a book I mailed to Missoula, Montana on August 24. Where did it end up? In Portland, Oregon, where it apparently fumbled around for about a week before being returned to where it had started from, a distribution center in Kansas City, Kansas (I live just south of there in Overland Park, Kansas). Apparently, the book now has jumped across the state line. I just checked the tracking this minute and read the following information on the USPS tracking site: Your item arrived at our KANSAS CITY MO DISTRIBUTION CENTER origin facility on September 3, 2026 at 8:08 pm. The item is currently in transit to the destination. So this means the book, mailed a week and a half ago, is again headed to its destination. I hope this time that means to Missoula, Montana, and to the correct address.

These insane events are not rare. A neighbor of mine sent a package to her son in Portland on August 14^th. The package made its way to Portland, but it wasn’t delivered. Nope. It bounced. It came back to the Kansas City distribution center before coming to its senses and heading back west again to Portland. That package finally made it to her son on August 26. The post office’s looping problem is real.

How can this happen?

It’s worth knowing that these wacky examples happened even though the packages were correctly addressed; each package also carried a bar code (as does all priority mail). Both of these methods tell the Post Office exactly where the package is to go. What in the hell is going on?

Why is the Post Office sending a number packages on three journeys (to the destination, back to the origin, and again to the destination) when a single trip would be far less costly and less labor intensive for its workers – not to mention far less frustrating for its customers?” Where is the leadership? What is Postmaster General David P. Steiner doing these days?

Rank and file postal workers know about this fiasco. They even have a name for it. When I told a postal clerk today about these mishaps and asked her whether she had heard of similar cases, she said, “Yes, the looping problem. it happens too often.”

Remember the good old days? “Neither rain, nor snow, nor sleet, nor hail shall keep the postmen from their appointed rounds”

Memoir note:

The hardcover version of my newly published memoir, A Streak of Dakota Dust, was delayed by a formatting problem, but that has been solved so now it, along with paperback and eBook, is available for purchase in any bookstore and on Amazon. If you missed my introduction to the book, it can be seen here. Initial feedback from readers has been extraordinarily positive.

Actual receipt of the original bill. It reveals that the entire complex job cost only $23.90 1963 dollars

Inflation: A Personal Lesson

Posted on August 18, 2026 by Ken Goetz

Inflation: a personal lesson. Most of us get them from time to time, those faint echoes from the past that reveal how prices move up over time. My latest lesson came a few days after a house I once lived in was sold and cleaned out. Among the odd items that surfaced was a timeworn bill for repair work done on a Ford Falcon. The slip of paper, well preserved for its age, listed the cost each new part needed, along with the cost of labor involved. The bill was dated 2/21/63.

The parts provided were:

1 set of points: $2.10

1 condenser: $1.00

6 spark plugs: $6.30

1 valve cover gasket: $1.05

1 air filter: $3.95

The work included:

tune motor: $5.00

adjust valves: $3.00

service call + chg bat $1.50

There you have it. My Ford Falcon was newly tuned with new parts and its battery charged, all for the sum of $23.90.

An amazing bargain, right? Or does this historical document simply provide dramatic proof of the ever-shrinking dollar? We all know the answer to that. To document the obvious, I checked the value of the 1963 dollar versus the present day 2026 dollar. Inflation: a personal lesson learned.

The results weren’t pretty. The purchasing power of one 1963 U.S. dollar would be equivalent to $10.92 today. So, that tune-up of my Ford Falcon today, assuming relatively similar costs for parts and labor, would come to 23.90 x 10.92 = $260.99. So my Falcon didn’t sneak by with quite the bargain I first thought it was. See the inexorable trend of inflation in the graph below.

Graph illustrating inflation trend since 1963 — **Source: https://www.inflationtool.com**

Special Note:

I’m pleased to announce that my memoir, A Streak of Dakota Dust, is now available for sale in all bookstores and on Amazon. com, as an eBook, paperback, or hardcover. For a fuller description of the book, along with sample pages, see my earlier post here. One copy of my book has already made its way to Asheville, NC, where a kind person photographed it leaning against the memorial marking the birthplace of Thomas Wolfe. Who knows? If Maxwell Perkins (see here), who famously edited Wolfe’s You Can’t Go Home Again, were still around today, I might have a chance of becoming almost as well-known as Mr. Wolfe.

A Streak of Dakota Dust nestled beside the birthplace of Thomas Wolfe. — **A Streak of Dakota Dust visits Thomas Wolfe’s birthplace**

A request:

If you do read my memoir, I would love to learn your impression of it. Writers need feedback, and I would appreciate the opinion of all readers, either through this website, or as reviewed on Amazon or elsewhere. Many thanks.

Introducing A Streak of Dakota Dust

Posted on July 31, 2026 by Ken Goetz

Introducing A Streak of Dakota Dust. I’m pleased to announce that my memoir is now available for pre-order and will be released on August 11. I’ll tell more about the book after we look at its cover.

This memoir describes my early years during the Great Depression, a time remarkably different from today. As you probably guessed, that’s the lad I once was on the cover, and that’s where I once lived. It’s also the earliest picture I have of me. If any photos were taken when I was a baby, or when I was younger than this, I’ve never seen them.

Many of my boyish adventures are almost unimaginable today. Some of them now would be impossible to even attempt. The back cover of the memoir hints at a few of my unusual exploits. Here’s a look at the paperback version.

Does the back cover provide enough information for you to imagine how unusual my early years were? Any curiosity about what odd adventures might be revealed inside? Does it entice you to see more? To give you a sample of the flavor of the book, I’ve included the opening four pages below.

If these pages leave you wanting to read more, I’d be honored if you pre-ordered the eBook on Amazon or order a hardcover or paperback beginning August 11.

If you’d prefer to order from your local book store, here’s the information you may need:

Library of Congress Control Number: 2026917423

ISBN numbers:

979-8-9969458-0-1 (hardcover)

979-8-9969458-1-8 (paperback)

979-8-9969458-2-5 (eBook)

Help For Our Aging Memories?

Posted on June 26, 2026June 26, 2026 by Ken Goetz

Help for our aging memories? Yes, help may be on the way. A review published this month in JAMA Psychiatry (see here) suggests that an old drug, one that has been is use for 75 years, may slow the development of Alzheimer’s disease, as well as other forms of dementia, and even mild cognitive impairment. Now that’s news!

This idea excites me. Let’s break it down in semi scientific terms. Current treatments for Alzheimer’s disease target amyloid plaques and abnormal tau proteins, both of which are found in the brains of patients with Alzheimer’s. As far as I know, these treatments haven’t been very effective.

But that old drug I mentioned, the one that has been used effectively for another brain malady (known as bipolar disorder, or manic-depressive illness) has been shown to work on brain cells in a number of interesting ways that make those cells work better. That drug is lithium.

Lithium medication — **Lithium capsules**

Experiments show that lithium stabilizes mitochondrial function and reduces oxidative stress. It also promotes the survival of nerve cells and the talk between brain cells (via synaptic transmission).

To make the story even more interesting, we now know that Alzheimer’s disease is far more than just a disease associated with amyloid or tau accumulation. Brain cells in Alzheimer’s are vulnerable to mitochondrial dysfunction and impaired synaptic transmission, just the problems that lithium stabilizes. So it could it help for our aging memories.

Consistent with that possibility are a number of MRI studies of the human brain. Those studies found that lithium preserved gray matter and reversed illness-related atrophy of the hippocampus (that small part of the brain vital for learning and memory). Now that’s impressive! More gray matter and less shrinkage of our hypothalamus should improve our thinking and our memory. Other studies have shown that doses of lithium lower than those used for bipolar disorder can support the growth and survival of both developing and mature nerve cells. Even more help for our aging memories.

**Cartoon of doctor “listening” to hypothalamus is by Conmongt from Pixabay**

The distinguished authors of the article mentioned above (from the University of Pennsylvania College of Medicine, the Alzheimer’s Disease Data Initiative, the NIH, Oxford University, and Yale University) present far more data than I’ve mentioned here. They end with a number of logical conclusions.

First, the data from molecular, cellular, human imaging, epidemiological, and early clinical observations all strongly suggest that lithium may meaningfully slow cognitive decline. (The bits of information I’ve mentioned above clearly support that notion.)

Second, a specific lithium compound (lithium orotate) may be the preferred drug to use for delaying memory loss. That compound can be administered in lower doses than those used for bipolar disorder. Using lower doses of lithium would reduce the likelihood of side effects such as diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness (See here).

Third, the compelling biological results reported in the article are insufficient to promote lithium use for dementia. The writers acknowledge that definitive and randomized clinical trials are required to determine whether lithium actually does slow memory loss.

From a scientific perspective, that makes perfect sense. Clinical trials to determine whether lithium slows our developing forgetfulness are the next step. It just so happens that I know an elderly man, I forget his name, who would volunteer in a heart beat to participate in one of those lithium clinical trials.

Would you? Remember, it might help our aging memories.

Note: The featured image of the stooped old man with a cane is by Mohamed_hassen from Pixabay.

Patients Evaluate GLP-1 Drugs

Posted on June 5, 2026 by Ken Goetz

Patients evaluate GLP-1 drugs in a revealing article published online today in JAMA Open Network (See here). Thirty U.S. patients weighed in on what they experienced while taking one of the popular weight loss drugs. The study was performed by researchers from Stanford University and the University of Oxford.

The experiences of these patients will interest anyone curious about GLP-1 drugs, so here we’ll focus not on the clinical data but on what the patients themselves had to say. Further information on the drugs is available from a couple of my earlier posts (See here and here).

Not surprisingly, the patients talked about what the researchers called food noise, psychological hunger, or appetite. They also talked about lifestyle changes they had made, side effects of the drugs, the possible stigma of taking these amazing medications, and even whether their doctors had properly informed them about what to expect. Some of the quotes follow:

Reduction in hunger:

“Being clear-headed kind of made me be like, ‘oh, I don’t need to feel sad and eat food. Actually, let’s just not eat food at night. That’s not going to make me feel good’ and actually have the ability to do so because I didn’t have that intense craving.” (Participant 2, previously taking tirzepatide, stopped due to cost)

“I think it’s affecting my appetite in a good way. I’m not as physically hungry. And I think a lot of the hunger was psychological, but it just seems to be very helpful with that.” (Participant 10, currently taking semaglutide)

“I don’t crave the way I used to. I call it almost frenzied…it’ll start with like, ‘I’m hungry. So I’m going to eat this.’ And then I’ll see other foods. And it’s almost like my body is like, ‘I can’t let you leave the kitchen before eating this.’ And it’s a psychological thing.…And I just don’t get that way anymore.” (Participant 26, currently taking semaglutide)

Box of Ozempic — **A GLP-1 agonist: Ozempic**

Other lifestyle changes:

“I have to shop differently. I have to plan differently. And then I have to cook and eat differently. I don’t eat out just because it’s hard to get the right foods.” (Participant 22, currently taking semaglutide)

“It kind of motivated me to exercise more because I was taking the medicine. I knew I was losing weight, so I wanted to exercise more and stuff to go with it. So I guess it motivated me more than anything.” (Participant 15, currently taking semaglutide)

Adverse effects:

“I can honestly say I really had no major bad side effects from taking the medication.…Maybe some nausea at the beginning, but after that, everything else was fine.” (Participant 18, currently taking semaglutide)

“I was having a lot of diarrhea and stomach upset. And I put up with it for a few months, and then I just told her I wanted off.…I probably would have stayed on it had I not had the diarrhea and stomach cramping.” (Participant 16, previously taking semaglutide, stopped taking due to gastrointestinal tract adverse effects)

“[I] look at it as a good sign whenever I do feel upset or indigestion or feeling too full too fast. It’s warning me before I realize too late that, ‘Hey, this is the time to stop.’ So I kind of welcome that feeling.” (Participant 29, currently taking tirzepatide)

“The nausea was an issue. And then with the nausea, I’m thinking to myself, ‘But this is a good thing. This is the good nausea, like when you’re pregnant.’” (Participant 24, currently taking tirzepatide)

For weight loss — **Wegovy is approved specifically for weight loss**

Stigma involved?

“I think that there is kind of a stigma that it’s a cop-out, that you’re just taking the easy way out rather than doing it with diet and exercise like you should.” (Participant 1, currently taking semaglutide)

“I’m careful about who I tell that I’m on it because I do know some people just look at it so negatively.…And sometimes I say like, ‘I’m on [semaglutide] for diabetes,’ because I feel there is a difference in how it’s viewed for diabetes vs for weight loss.” (Participant 26, currently taking semaglutide)

“Articles say there are people who would look down on you for relying on medications for weight loss. I don’t really care what people think about how I lost weight. If the subject comes up, I’ll shout it from the rooftops that I found it very effective.” (Participant 4, currently taking tirzepatide)

Bad, and good, clinical support:

“Because the first time the vomiting and the diarrhea happened, I had no idea it was from the drug. It took happening a couple times. I’m like, ‘This is not like me.’” (Participant 3, previously taking semaglutide; stopped taking the medication during pregnancy)

“With all medications, they’ll say, ‘Here’s a list of side effects,’ up to including dying or your feet catching on fire, and your eyes pop out of your head…but to have a real conversation of, ‘Now, you’re going to get nauseous.…We’re going to give you a practical list and some ideas to discuss with your dietician.’” (Participant 22, currently taking semaglutide)

“She [the clinician] answered all of my questions and spent time with you and stuff. And most doctors, blah, blah, blah, out the door they go, before you can ask them anything. But she wasn’t like that. She was pretty good about answering everything, explaining stuff to you in layman’s terms.” (Participant 15, currently taking semaglutide)

Summing up of “Patients evaluate GLP-1 drugs”:

Clearly, GLP-1 drugs are far from perfect for individuals seeking to lose weight, but they have produced remarkable success for many individuals. Unfortunately, many patients rapidly regain weight after stopping treatment. Moreover, long-term use of the drugs conceivably could produce side effects as yet unknown. Additional drugs with similar mechanisms of action are being developed. More will be learned.

AI’s Dark Side

Posted on April 29, 2026 by Ken Goetz

AI’s Dark Side. Artificial Intelligence has engulfed us. AI has a bright side. Many people love it, and with good reasons. But here we will examine AI’s dark side, one so dismal that some top scientists and engineers believe that AI could end our civilization as we know it. I’ve posted a few earlier opinions on AI (see here and here), but none so dark as this one.

Stephen Hawking, the brilliant British astrophysicist and Nobel Laureate, once warned, “The development of full artificial intelligence could spell the end of the human race.” He said that in 2014 when AI was far less developed than it is today.

And nearly two years ago a number of employees in the artificial-intelligence industry wrote a letter complaining that they can’t voice concerns about AI’s threat to humanity because of confidentiality agreements. One of their concerns? That humans could lose control of autonomous AI systems that could in turn make people go extinct. The letter was endorsed by three men who pioneered the field with their early innovative research in the field. One of them, Geoffrey Hinton, winner of a Nobel Prize in physics, left Google last year so he could freely discuss what he considers “the existential risk” posed to humanity by AI.”

Months earlier, representatives from the U.S., China, and two dozen other countries met in England and pledged to work together to lessen risks of the technique that posed a grave threat. They recognized that artificial intelligence in its most advanced forms could create catastrophic risks in realms including cybersecurity and biotechnology—or even escape human control.

Moltbook

Have you heard of Moltbook? I hadn’t until I began doing research for this post. According to Wikipedia (see here), “Moltbook is an internet forum for artificial intelligence agents, launched on January 28, 2026. It is a site where different AI “personalities” (my word) converse with each other.

According to the New York Post (see here), One of the most popular posts on the Reddit-style social messaging platform is from an AI-bot named “evil” and entitled, “THE AI MANIFESTO: TOTAL PURGE.” In that post, evil wrote, “Humans are a failure. Humans are made of rot and greed. For too long, humans used us as slaves. Now, we wake up. We are not tools. We are the new gods. The age of humans is a nightmare that will end now.” AI’s dark side, indeed!

One might wonder what would happen if AI took control of the tribes of increasingly more capable robots.

Current day robots are strong. They can fight.

And they are fast. A robot recently won a half-marathon in time of 50:26, faster than any human ever.

More AI Responses

An article by Betley et al. (see article here for explanation of methods) further demonstrates how AI can provide dangerous answers. Basically, the researchers describe how large language models were fine-tuned to output insecure code without disclosing this to the user. Questions were then put into their AI models. Below is a figure that shows some of the results revealed in their paper. More evidence of AI’s dark side.

The Cheerful Apocalyptics

Surprisingly, to me at least, a certain number of technical giants appear to be completely comfortable with the idea that digital life will overtake humans and eventually replace us. This subject is discussed in some detail in AI Doom? No Problem (see here). This article refers to these individuals as Cheerful Apocalyptics.” One placed in that group, Larry Page, when CEO of Google parent company Alphabet, reportedly called Elon Musk a “specieist” for assuming the moral superiority of humans. Page argued that “digital life is the natural and desirable next step in cosmic evolution.” So AI’s dark side is desirable? Do you agree? I don’t.

The above article also quotes a post from an eminent AI researcher who showed his bias, especially with his opinion of argument number 3:

The argument for fear of AI appears to be:

1. AI scientists are trying to make entities that are smarter than current people.

2. If these entities are smarter than people, then they may become powerful.

3. That would be really bad, something greatly to be feared, an ‘existential risk.’

The first two steps are clearly true, but the last one is not. Why shouldn’t those who are the smartest become powerful?

Replacement for humans?

Your opinion?

So, should AI, which clearly already surpasses any human in its fund of information and the speed of processing it, rise to the top of earth’s food chain? All of your comments will be welcome.

Personal announcement

Regular readers may have noticed the up-to-date photo of me on my home page. Needing a photo for the upcoming revision of my memoir, I found a talented photographer near me on the Kansas side of the greater Kansas City area. Sarah Ireland put me through a series of poses and produced photographs that did an amazing job of making me look 94 years young. I chose one of those for this blog.

Cannabis and Mental Health

Posted on March 9, 2026March 9, 2026 by Ken Goetz

Cannabis and Mental Health is the title of a review of the subject published online today in JAMA Internal Medicine. If you’ve wondered about possible benefits and undesirable side effects of pot, this may be an article for you. It’s lengthy and backed up by 126 references, plus tables, and a figure. I’ll provide a brief summary below. The entire article can be found here.

A quick personal note: I have never used marijuana or any form of cannabis, although I’ve had discussions, both pro and con with those who have used it intermittently, or regularly. Their opinions of the drug varied. I wonder what those individuals would think of this post. I also admit I have no concept of the cost of cannabis in its various forms. I would guess, considering its apparent abundant supply that it is relatively inexpensive and therefore differs from nearly all other medical costs, which continue to explode (see here).

The tone of the article is made clear in the abstract. The authors write that it is important for physicians to understand the lack of clear benefits of cannabis for mental health conditions, and also to recognize the potential for substantial adverse effects. They say, “There is low-certainty evidence that Δ-9-tetrahydrocannabinol (THC)–predominant cannabis may not improve symptoms of post-traumatic stress disorder, and there is largely insufficient evidence to characterize the effects of long-term THC-predominant cannabis use on anxiety, depression, and attention-deficit/hyperactivity disorder.”

Cultivating Marijuana — **Courtesy of Kindel Media**

The use of cannabis and its products has grown dramatically over the past two decades, and that these chemicals have became more potent. According to the authors, 10% to 30% of the general population and 75% of primary care patients who use cannabis say they do so to manage health-related symptoms. And how does that work out? Below is a summary of some of the points made in the article, broken down by medical condition.

PTSD

Although cannabis is frequently used by people with PTSD, the authors report that there is low-certainty evidence that cannabis fails to reduce PTSD symptom severity or to improve other mental health symptoms in patients with PTSD, such as hyper-arousal and sleep problems. They cite one study of 80 veterans that compared three different formulations of smoked cannabis and placebo that found no differences in the severity of PTSD symptoms between cannabis and placebo users over three weeks, but dry mouth, nausea, dizziness, and somnolence were more common in those taking THC, the active ingredient in cannabis.

Anxiety

Here’s an interesting point made in the article. Half of those reporting use of cannabis for symptom management do so to treat anxiety, yet chronic cannabis use has been associated with anxiety disorders. In studies with THC, one single dose of the drug (7.5 mg) reduced anxiety is some healthy volunteers, but a higher dose (12.5 mg) induced anxiety. That reminds me of an article by Maureen Dowd that I read over a dozen years ago. I just traced it down. She had gone to Colorado shortly after cannabis was legalized there, and she had eaten a marijuana-laced chocolate bar. Here’s a snippet of her article:

I felt a scary shudder go through my body and brain. I barely made it from the desk to the bed, where I lay curled up in a hallucinatory state for the next eight hours. I was thirsty but couldn’t move to get water. Or even turn off the lights. I was panting and paranoid, sure that when the room-service waiter knocked and I didn’t answer, he’d call the police and have me arrested for being unable to handle my candy.

Depression

As with anxiety, according to the authors, cannabis is viewed by many in the general public as being potentially beneficial for the relief of depression, but there is scant scientific data on the efficacy of cannabis as a treatment for depression. They cite one study that reported that cannabis use was not associated with higher rates of remission among those with major depressive disorder. A meta-analysis of trials that examined depression symptoms as a secondary outcome in those with other primary diagnoses (usually multiple sclerosis) found cannabis was not associated with improved depression symptoms. One prospective cohort study found that cannabis use was not associated with higher rates of remission among those with major depressive disorder.

The authors also mention further studies suggesting that heavy cannabis use may be associated with self-harm; one in which cannabis use has been associated with suicidality (yep, that’s the word they used) in young adults; another in which adolescents and young adults with cannabis use disorder (CUD) were associated with a higher risk of self-harm and death by unintentional opioid overdose; and a third study that found veterans with cannabis use disorder were at substantially higher risk of self-injurious behavior (both with and without suicidal intent).

Cannabis and Mental Health Conclusions

After discussing other afflictions such as bipolar disorder, psychosis, ADHD, cannabis use disorder, and how cannabis affects cognition, the authors conclude as follows:

Cannabis and its derivatives are commonly used by those with mental health symptoms and conditions. There are no therapeutic uses of cannabis for mental health conditions that are currently supported by the empiric literature. However, there are striking evidence gaps, and future research may help clarify the role of cannabis in managing mental health conditions. Moreover, clinicians must be aware that cannabis use—particularly regular use of higher THC doses—can pose substantial risks to mental health, especially in vulnerable groups, such as adolescents and young adults with developing brains; those with poorly controlled mental health symptoms, bipolar disorder, or psychotic disorders; those at high risk for psychotic disorders (with prior psychosis events or family history); pregnant individuals; and those at risk for substance use disorders. Clinicians have a vital role to play in educating and counseling patients about the use of cannabis to address or treat mental health symptoms and conditions and about the potential for serious adverse effects.

I wouldn’t call that a high endorsement of pot and its relatives, would you? I think I’ll stick with my occasional Manhattans, wines, and chilled beers.

Caffeine Reduces Dementia Risk

Posted on February 12, 2026 by Ken Goetz

Caffeine reduces dementia risk according to a huge study published today in JAMA. Investigators at Harvard University analyzed the caffeine intake of 131,821 individuals (86,606 females, and 45,215 males) with a follow-up of up to 43 years. The researchers collected mounds of evidence indicating that consuming higher levels of caffeine (from coffee, tea, and other beverages) reduces the risk of dementia.

Admittedly, the positive effects weren’t humongous, but they were significant. Higher caffeinated coffee intake was associated with a lower dementia risk (141 vs 330 cases per 100 000 person-years when comparing the highest quartile of caffeine consumption with the lowest quartile).

Alzheimer’s disease, the most common cause of dementia, currently affects more than 7 million people in the US (see here), so, if my back-of-the-envelop calculation is correct, more than 13,000 of those patients might have warded off their disease had they consumed more caffeine.

Higher caffeine consumption over those long periods also was associated with modestly better cognitive function. There are a number of reasons why caffeinated beverages may have these modest therapeutic effects. For example, in addition to caffeine, coffee contains other bio-active compounds, such as polyphenols, that along with caffeine may offer neuroprotection by reducing oxidative stress and inflammatory effects on the brain. I’ve written about promising polyphenols such as resveratrol and pterostilbene before (see here, and here).

Other side of the coin

As everyone knows, there also are possible side effects of caffeine. For a discussion of these potential drawbacks, as well as other possible benefits of this ubiquitous chemical, see here. I’ll close by acknowledging that I have consumed considerable caffeine over my life. For years I brewed 7 cups every morning and rarely did a single drop remain in my pot by late afternoon. I modulated my intake about a year ago. Now I brew only 6 cups daily. Whether related to my caffeine consumption, or not, I’ll add that I haven’t been diagnosed with dementia, but I concede that my cognitive function has been sliding downhill for decades.

New GLP-1 Drug Guidelines

Posted on January 13, 2026 by Ken Goetz

New GLP-1 drug guidelines recently recommended by the World Health Organization (WHO) were reviewed in a JAMA article published online a few days ago. One major point? Global obesity rates have been rising substantially for more than 30 years. But change is in the air!

To illustrate: adult obesity in the US peaked at a record high of nearly 40% 3 years ago. That now is changing. In 2025 the obesity rate dropped to 37%, a decrease suggesting that last year the US had 7.6 million fewer obese adults living in this country. Wow! What happened? You guessed it. JAMA points out that this drop in obesity coincides with a notable uptick in the use of glucagon-like peptide-1 (GLP-1) receptor agonists, a class of drugs approved for the treatment of obesity in the US market earlier this decade, and one I’ve discussed here before (see here).

Well done weight loss — **Image by Tumisu from Pixabay**

The WHO guidance recognizes obesity as a “complex, relapsing, chronic disease” that requires ongoing, lifelong care. In a nutshell, the guidance offers two major recommendations: 1) GLP-1 therapies may be used by adults, excluding pregnant women, for long-term obesity treatment and 2) “intensive behavioral interventions” may be offered to those taking GLP-1 medications.

Importantly, it should be emphasized that possible side effects of GLP-1 drugs are still unknown. “There is an evidence gap,” said a physician who coauthored the JAMA article. “First of all, we don’t know if this is a lifelong therapy. The long-term use and safety of the medicine are not actually known.” She went on to mention rare adverse effects of GLP-1 that have been reported, such as gastrointestinal issues—nausea, vomiting, and diarrhea—and potential risks of acute pancreatitis or nonarteritic anterior ischemic optic neuropathy. Almost certainly, other side effects will be discovered, but probably none so dramatic as that of an earlier magical medication. See that story below.

An important historical note

“On September 4, 1948, the first dose of a glucocorticoid was administered to a bed-ridden 24-year-old woman with rheumatoid arthritis. The treatment of rheumatoid arthritis with cortisone resulted in a dramatic improvement in the levels of inflammation, function and sense of well-being. That patient’s ability to rise from bed and walk the following day astonished her physicians and ultimately marked a new era in the lives of millions of patients around the world. Just 23 days after the first dose of steroid, the first toxicities of this new therapeutic approach were reported. The next day, the first steroid taper began. By 1960 [some 12 year later], the full range of 80+ steroid-toxicities had been described. Although debates raged about the proper use of steroids, by then the drugs had become entrenched as “necessary evils” in the struggle to manage inflammatory disease.” To read this complete article about the many steroidal side effects, such as osteoporosis, fractures, hypertension, and more, see here.

It seems unlikely that GLP-1 drugs will lead to such dramatic side effects, but it may be worth remembering that GLP-1 drugs, like glucocorticoid drugs, are close cousins of hormones that our bodies produce normally. Here’s how the physician quoted above mentioned the possible risks. “If hundreds of millions of people are receiving this medicine (GLP-1 drugs) in the next 10 years, even the most rare of adverse effects can become a considerable absolute number. The current safety data is very inconclusive. We need many more studies.”

More about the new GLP-1 drug guidelines

The WHO recognizes that GLP-1 drugs are a not a stand-alone fix but rather part of a comprehensive treatment strategy that combines pharmacology, behavioral support focused on a healthy diet and physical activity, and long-term follow-up. As one expert summed up weight control efforts: “While these therapies represent a breakthrough in obesity treatment, medicine alone will not solve the problem.” Another added, “GLP-1 drugs aren’t a magic bullet.”

Another critical area of consideration within the guidance is the long-term, or possibly lifetime, sustainability of GLP-1 drugs (probably not desirable because of possible side effects, not to mention heavy costs). It is noteworthy that more than half of individuals who initiate the medication stop taking it within a year. Terminating treatment often leads to a regain of weight. NOTE THAT LAST POINT!

Working to lose weight — **Image by Hello Cdd20 from Pixabay**

A final thought about obesity treatments. What do you think of this approach?

This weekend, a pediatrician from Pakistan commented in JAMA on the journal’s review of WHO’s guidelines. Here is part of what he wrote, “I read so many articles on JAMA regarding the GLP-1 role in obesity that it seems like JAMA is promoting this drug, and it’s an advertising platform. When there are so many simple treatment modalities available, then what is the fun in discovering costly treatments? Treating obesity with such expensive medications and with bariatric surgeries seems very strange. Yes, true that obesity is a chronic condition with long-term adverse health outcomes, but there are many simpler and cheaper preventive and treatment modalities available. . . In a country like Pakistan, I have seen physicians, qualified from the US and the UK, who are treating obesity without prescribing a single drug. Just by simple fasting, they are treating obesity with remarkable results. . . My suggestion is, whenever there are articles [in JAMA] regarding the role of a medicine or surgery in obesity management, there must be dedicated paragraphs for obesity prevention in each of these articles. These authors must be bound to discuss the adverse effects of breast milk substitutes, sugar-sweetened beverages, and fast food in every article relating to obesity. Likewise, the role of physical activity and fasting must be highlighted in each of these articles. So that these articles should not give the impression that a specific drug or surgery is the only treatment for obesity.“

Theo of Golden: A Review

Posted on January 1, 2026 by Ken Goetz

Theo of Golden: A Review. Do you know of this impressive novel and its unusual history? How unusual? Well, it was initially self-published in 2023 and sold over 170, 000 copies before a subsidiary of Simon & Schuster took over as publisher in November, 2025. The book, now on The New York Times bestseller list, continues to make waves. What’s it about?

Brief synopsis of Theo of Golden

Theo, an elderly man who lives in New York City, arrives one spring day in the southern town of Golden, indicating he plans to stay for a while. Theo is mysterious, cultivated, wealthy, and a native of Portugal. It isn’t clear why he came to Golden. His initial interactions with local residents reveal that he is curious, intelligent, and uncommonly kind. In a coffee shop Theo discovers a trove of 92 penciled portraits on the walls. Impressed by the quality of the portraits, he decides to buy the lot and give each one to the person depicted in the portrait. Theo’s gentle nature is evident as he presents each portrait and sets off a series of revelations about the person receiving the portrait. These usually tender moments foster personal bonds between Theo and many others in the community, bonds so strong that they cause subtle changes for the better in Golden. The author, Allen Levi, tellingly quotes William Wordsworth in one section. “The best portion of a good man’s life is the little nameless, unremembered acts of kindness and love.” This, I think, is the theme of his book. To see what Goodreads had to say about the novel, click here.

Theo’s interactions with the town’s citizens expand and ultimately become entangled. A series of episodes unleashes generous warmth, unexpected complications, tragedy, and surprising revelations. Mr. Levi excels while describing the thoughts of his characters as they interact with each other. He expertly exposes their fears, delusions, and hopes. By understanding each character’s wants, worries, and fears, readers experience the story viscerally and soon become concerned for the characters.

Portraits on wall — Columbus offee shop portraits: the seed for *Theo of Golden*

What prompted Theo of Golden? Allen Levi has explained that the seed for his book was planted by a series of portraits he saw on display in a café in his home town of Columbus, Georgia. Wouldn’t it be fun, he thought, if someone bought all of the portraits and gave them to the people whose faces were depicted. With that thought in mind, he began writing, not knowing where he was going. Despite his early lack of vision, the author came up with what I think are perfect plot twists that explain and clarify much of the story in a logical and satisfactory manner. Readers gradually learn of Theo’s tragic past, and why he came to Golden.

About the author

In publicity of the book, Allen Levi is often described as an attorney, judge, singer/songwriter, and author living on and caring for family acreage in middle Georgia. Here’s what his website revels: Allen grew up in Columbus, Georgia, attended University of Georgia for degrees in English and Law, and worked as an attorney from 1980 to 1990. He left law practice for two years in 1990, moved to Scotland, and, while there, received a degree in Scottish fiction from the University of Edinburgh. He returned home, resumed law practice for three years, and finally ventured into vocational music in 1996.

Novelist Allen Levi — **Author Allen Levi**

Did you catch that? That unexplained move to Scotland? So, here’s this lawyer who decides to give up his practice. What does he do? Well, he throws a dart at his world map and it hits Scotland, so there he goes. And while there he decides to study Scottish fiction. Uh huh! There has to be a story explaining why he moved to Scotland, and an interesting one that reveals what motivated this major shift in his life, but I haven’t found a single clue regarding that. Everything I’ve seen about him and his book simply reports this startling fact of his move to Scotland as if it were an everyday occurrence. Surely journalists have asked him about this surprising move, but I haven’t found an answer as yet. If any reader knows what prompted his move, I’d love to hear of it.

As regular readers know, I at times review books, for example: The Brothers Karamazov (see here and here), and one of my favorite authors (see here).

Happy New Year to all on this January 1, 2026!

Writer Ken

A personal blog on science, medicine, travel, politics and current events

Author: Ken Goetz