You’d think it would suffice to say that whether your health is good or bad, it’s that way because of cause and effect. Unless, that is, you’re both a deep thinker and a word nerd.

Then you’d think the phrase isn’t sufficient when it comes to your health — or anything, really— until you add the letter s.

Now cause and effect is a simple concept, no doubt. You take a walk, it begins to rain, and you get wet.

Yet there’s also no doubt that there’s always another effect or two that’s a direct result of the first one. That’s true whether the rain causes you turn up your collar, tilt your head down, and trudge on, or begin to run, trip on uneven sidewalk, and break a leg.

So to be really accurate, the phrase should be “cause and effects.” To be really healthy, you need to be aware of that.

Examples of why you should always add the s are found in two papers that were presented two weeks ago at ENDO 2026, the Endocrine’s Society’s annual gathering held this year in Chicago. The first paper contains a surprising after-the-effect effect that results from a well-established one.

The well-established one being if you’re obese and take a GLP-1 receptor antagonist medication like Ozempic, Trulicity, Rybelsus, Mounjaro, Zepbound, or Wegovy, you’ll lose weight.

But what study lead Sajana Maharjan, MD, and colleagues at HSHS St. John’s Hospital in Springfield, Illinois set out to determine is what effect taking what most people call the GLP-1 agonists has on exercise. So they further analyzed the health records and Fitbit data collected on 753 predominantly middle-aged and female obese people as part of the National Institutes of Health’s ongoing All of Us Research Program.

They discovered a subsequent effect that’s opposite of the one you’d expect.

“The common assumption,” Maharjan explains to Erik Swain in an article for Healio about the study, “is that losing weight makes movement easier and naturally encourages more activity. Our data suggest that assumption doesn’t hold in the real world.”

While using a GLP-1 agonist, the participants averaged 560 fewer steps a day when compared to their average number of steps per day before starting medication, a reduction 11 percent. Equally confounding is that the average amount of daily exercise time done at a moderate-or-more intensity level fell by 21.4 percent.

Moreover, and as the press release about the study notes, neither age nor prior health problems influenced these reductions. And no matter how the numbers were crunched did they ever produce any evidence that the weight loss from the GLP-1 agonists led to increased physical activity.

Which is problematic, for the best way to make any weight loss last, drug-aided or not, is to increase the sorts of physical activities that promote or maintain muscle mass. So taking a GLP-1 agonist creates a catch-22, as well as a fine example of why the word nerds and the deep thinkers are right: that the phrase really should be cause and effects.

The second paper from ENDO 2026 that also proves adding an s is best finds a new secondary effect of obesity. While this metabolic disease that rewires how the body handles sugar and fat and leads to inflammation and other metabolic diseases also increases the likelihood of heart disease, it used to be that if it did, it took a long time.

That no longer seems to be the case.

By reviewing the Global Burden of Disease 2023, a study that incorporated mortality registries, hospital records, surveys and surveillance systems from 204 countries, researchers found that the incidence of heart disease now peaks in people aged 50-54 rather than the elderly. They also uncovered that the heart disease rate in South Asia has grown more than three times faster than the global average.

Which makes sense — and aids the argument to change the phrase to cause and effects — once you consider data collected between 2021 and 2023 as part of the Global Diet Quality Project. It found that consumption of unhealthy foods by adults, a relative rarity before the deluge of ultraprocessed foods so loved by Westerners rained down upon them, is now common in South Asia.

The second ENDO paper also projects that by 2050 more than 1.37 million premature cardiovascular deaths will result from obesity every year. In a press release about their study, one of its authors, Hardik Dineshbhai Desai, M.B.B.S, of the AB Plus Multispecialty Hospital in Ahmedabad, Gujarat, India, calls their projection “a wake-up call to the world.”

Which, albeit ambitious and maybe even delusional, is the goal of this article.

But if you’re not feeling bright-eyed and bushy-tailed so far, consider this projection from the presser by way of the World Obesity Federation. That obesity effects not only the world’s health but also its economy.

That the global economic impact of obesity will reach $4.32 trillion per year by 2035 — roughly percent of global GDP, comparable to the hit the world economy took from the COVID-19 pandemic in 2020.