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Unlike scores of people who scrambled for the blockbuster drugs Ozempic and Wegovy to lose weight in recent years, Danielle Griffin had no trouble getting them. The 38-year-old information technology worker from New Mexico had a prescription. Her pharmacy had the drugs in stock. And her health insurance covered all but $25 to $50 of the monthly cost. For Griffin, the hardest part of using the new drugs wasn’t access. It was finding out that the much-hyped medications didn’t really work for her. “I have been on Wegovy for a year and a half and have only lost 13 pounds,” said Griffin, who watches her diet, drinks plenty of water and exercises regularly. “I’ve done everything right with no success. It’s discouraging.” In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15% to 22% of their body weight — up to 50 pounds or more in many cases. But roughly 10% to 15% of patients in those trials were “nonresponders” who lost less than 5% of their body weight. Now that millions of people have used the drugs, several obesity experts told The Associated Press that perhaps 20% of patients — as many as 1 in 5 — may not respond well to the medications. It's a little-known consequence of the obesity drug boom, according to doctors who caution eager patients not to expect one-size-fits-all results. “It's all about explaining that different people have different responses,” said Dr. Fatima Cody Stanford, an obesity expert at Massachusetts General Hospital The drugs are known as GLP-1 receptor agonists because they mimic a hormone in the body known as glucagon-like peptide 1. Genetics, hormones and variability in how the brain regulates energy can all influence weight — and a person's response to the drugs, Stanford said. Medical conditions such as sleep apnea can prevent weight loss, as can certain common medications, such as antidepressants, steroids and contraceptives. “This is a disease that stems from the brain,” said Stanford. “The dysfunction may not be the same” from patient to patient. Despite such cautions, patients are often upset when they start getting the weekly injections but the numbers on the scale barely budge. “It can be devastating,” said Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of the obesity treatment company FlyteHealth. “With such high expectations, there’s so much room for disappointment.” That was the case for Griffin, who has battled obesity since childhood and hoped to shed 70 pounds using Wegovy. The drug helped reduce her appetite and lowered her risk of diabetes, but she saw little change in weight. “It’s an emotional roller coaster,” she said. “You want it to work like it does for everybody else.” The medications are typically prescribed along with eating behavior and lifestyle changes. It’s usually clear within weeks whether someone will respond to the drugs, said Dr. Jody Dushay, an endocrine specialist at Beth Israel Deaconess Medical Center. Weight loss typically begins right away and continues as the dosage increases. For some patients, that just doesn't happen. For others, side effects such as nausea, vomiting and diarrhea force them to halt the medications, Dushay said. In such situations, patients who were counting on the new drugs to pare pounds may think they’re out of options. “I tell them: It's not game over,” Dushay said. Trying a different version of the new class of drugs may help. Griffin, who didn't respond well to Wegovy, has started using Zepbound, which targets an additional hormone pathway in the body. After three months of using the drug, she has lost 7 pounds. “I'm hoping it's slow and steady,” she said. Other people respond well to older drugs, the experts said. Changing diet, exercise, sleep and stress habits can also have profound effects. Figuring out what works typically requires a doctor trained to treat obesity, Saunders noted. “Obesity is such a complex disease that really needs to be treated very comprehensively,” she said. “If what we’re prescribing doesn’t work, we always have a backup plan.” The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.happy jili711 。

NEW YORK (AP) — Remember what you searched for in 2024? does. Google released its annual “Year in Search” on Tuesday, rounding up the top trending queries entered into its namesake search engine in 2024. The results show terms that saw the highest spike in traffic compared to last year — ranging from key news events, notably , to the most popular songs, athletes and unforgettable pop-culture moments that people looked up worldwide. Sports — particularly soccer and cricket — dominated Google’s overall trending searches in 2024. topped those search trends globally, followed by the and . Meanwhile, the led news-specific searches worldwide. Queries about and this year’s followed. U.S. President-elect topped searches in Google’s people category this year — followed by , U.S. Vice President and Algerian boxer , who also led athlete-specific searches. Meanwhile, the late , and led search trends among notable individuals who died in 2024. In the world of entertainment, Disney and Pixar’s was the top trending movie of the year, while Netflix’s led TV show trends. And Kendrick Lamar’s dominated song trends. That’s just the tip of the iceberg. Queries for the , made famous by Norwegian swimmer Henrik Christiansen over the summer games, led Google’s global recipe trends this year. The New York Times’ “Connections” puzzle topped game searches. And in the U.S., country-specific data shows, many people asked Google about like the word and “ .” You can find more country-specific lists, and trends , through Google’s . The California company said it collected 2024 search results from Jan. 1 through Nov. 23 of this year. Google isn’t the only one to publish an annual recap or top trends as 2024 draws to a close. , for example, as well as and words of the year, have offered additional reflections for 2024. The Associated PressRomanian constitutional court validates first round of presidential race after vote recount

BEIRUT (AP) — Thousands of Syrian insurgents took over most of Aleppo on Saturday, establishing positions in the country's largest city and controlling its airport before expanding their shock offensive to a nearby province. They faced little to no resistance from government troops, according to fighters and activists. A war monitor, the Syrian Observatory for Human Rights, said the insurgents led by Hayat Tahrir al-Sham seized control of Aleppo International airport, the first international airport to be controlled by insurgents. The fighters claimed they seized the airport and postefd pictures from there. Thousands of fighters also moved on, facing almost no defense from government forces, to seize towns and villages in northern Hama, a province where they had a presence before being expelled by government troops in 2016. They claimed Saturday evening to have entered Hama city. The swift and surprise offensive is a huge embarrassment for Syria's President Bashar Assad and raised questions about his armed forces' preparedness. The insurgent offensive launched from their stronghold in the country's northwest appeared to have been planned for years. It also comes at a time when Assad's allies were preoccupied with their own conflicts. Turkey, a main backer of Syrian opposition groups, said its diplomatic efforts had failed to stop government attacks on opposition-held areas in recent weeks, which were in violation of a de-escalation agreement sponsored by Russia, Iran and Ankara. Turkish security officials said a limited offensive by the rebels was planned to stop government attacks and allow civilians to return, but the offensive expanded as Syrian government forces began to retreat from their positions. The insurgents, led by the Salafi jihadi group Hayat Tahrir al-Sham and including Turkey-backed fighters, launched their shock offensive on Wednesday. They first staged a two-pronged attack in Aleppo and the Idlib countryside, entering Aleppo two days later and securing a strategic town that lies on the highway that links Syria's largest city to the capital and the coast. By Saturday evening, they seized at least four towns in the central Hama province and claimed to have entered the provincial capital. The insurgents staged an attempt to reclaim areas they controlled in Hama in 2017 but failed. Syria’s armed forces said in a statement Saturday that to absorb the large attack on Aleppo and save lives, it redeployed troops and equipment and was preparing a counterattack. The statement acknowledged that insurgents entered large parts of the city but said they have not established bases or checkpoints. Later on Saturday, the armed forces sought to dispel what it said were lies in reference to reports about its forces retreating or defecting, saying the general command was carrying out its duties in “combatting terrorist organizations.” The return of the insurgents to Aleppo was their first since 2016, following a grueling military campaign in which Assad's forces were backed by Russia, Iran and its allied groups. The 2016 battle for Aleppo was a turning point in the war between Syrian government forces and rebel fighters after 2011 protests against Assad’s rule turned into an all-out war. After appearing to be losing control of the country to the rebels, the Aleppo battle secured Assad’s hold on strategic areas of Syria, with opposition factions and their foreign backers controlling areas on the periphery. The lightning offensive threatened to reignite the country's civil war, which had been largely in a stalemate for years. Late on Friday, witnesses said two airstrikes hit the edge of Aleppo city, targeting insurgent reinforcements and falling near residential areas. The Observatory said 20 fighters were killed. Insurgents were filmed outside police headquarters, in the city center, and outside the Aleppo citadel, the medieval palace in the old city center, and one of the largest in the world. They tore down posters of Assad, stepping on some and burning others. The push into Aleppo followed weeks of simmering low-level violence, including government attacks on opposition-held areas. The offensive came as Iran-linked groups, primarily Lebanon’s Hezbollah, which has backed Syrian government forces since 2015, have been preoccupied with their own battles at home. A ceasefire in Hezbollah’s two-month war with Israel took effect Wednesday, the same day that Syrian opposition factions announced their offensive. Israel has also escalated its attacks against Hezbollah and Iran-linked targets in Syria during the last 70 days. Speaking from the heart of the city in Saadallah Aljabri square, opposition fighter Mohammad Al Abdo said it was his first time back in Aleppo in 13 years, when his older brother was killed at the start of the war. “God willing, the rest of Aleppo province will be liberated" from government forces, he said. There was light traffic in the city center on Saturday. Opposition fighters fired in the air in celebration but there was no sign of clashes or government troops present. Journalists in the city filmed soldiers captured by the insurgents and the bodies of others killed in battle. Abdulkafi Alhamdo, a teacher who fled Aleppo in 2016 and returned Friday night after hearing the insurgents were inside, described “mixed feelings of pain, sadness and old memories." “As I entered Aleppo, I kept telling myself this is impossible. How did this happen?” Alhamdo said he strolled through the city at night visiting the Aleppo citadel, where the insurgents raised their flags, a major square and the university of Aleppo, as well as the last spot he was in before he was forced to leave for the countryside. “I walked in (the empty) streets of Aleppo, shouting, ‘People, people of Aleppo. We are your sons,’” he told The Associated Press in a series of messages. Aleppo residents reported hearing clashes and gunfire but most stayed indoors. Some fled the fighting. Schools and government offices were closed Saturday as most people stayed indoors, according to Sham FM radio, a pro-government station. Bakeries were open. Witnesses said the insurgents deployed security forces around the city to prevent any acts of violence or looting. The U.N. Office for the Coordination of Humanitarian Affairs said Friday Aleppo's two key public hospitals were reportedly full of patients while many private facilities closed. In social media posts, the insurgents were pictured outside of the citadel, the medieval palace in the old city center, and one of the largest in the world. In cellphone videos, they recorded themselves having conversations with residents they visited at home, seeking to reassure them they will cause no harm. The Syrian Kurdish-led administration in the country's east said nearly 3,000 people, most of them students, had arrived in their region after fleeing the fighting in Aleppo, which has a sizeable Kurdish population. State media reported that a number of “terrorists," including sleeper cells, infiltrated parts of the city. Government troops chased them and arrested a number who posed for pictures near city landmarks, they said. On a state TV morning show Saturday, commentators said army reinforcements and Russia’s assistance would repel the “terrorist groups,” blaming Turkey for supporting the insurgents’ push into Aleppo and Idlib provinces. Russia’s state news agency Tass quoted Oleg Ignasyuk, a Russian Defense Ministry official coordinating in Syria, as saying that Russian warplanes targeted and killed 200 militants who had launched the offensive in the northwest on Friday. It provided no further details. Associated Press writer Albert Aji in Damascus contributed to this report.