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Arsenal boss Mikel Arteta revealed he could substitute his goalkeepers during future Premier League matches after his side’s 1-0 win at Everton. Arteta handed summer loan signing David Raya his debut in place of England keeper Aaron Ramsdale at Goodison Park and the Spaniard saw little action as Leandro Trossard’s solitary second-half strike proved decisive. When asked about his decision to start with Raya, Gunners head coach Arteta said: “The same rationale about why Fabio (Vieira) played here or Eddie (Nketiah) or Gabriel Jesus. “I haven’t had a single question on why Gabriel Jesus didn’t start. He has won more trophies than anybody else, including me, in that dressing room.” Arteta, whose side were far from convincing as they extended their unbeaten start to the season with a fourth league win, said he would be prepared utilise two goalkeepers in one match. “I cannot have two players in each position and not play them,” he said. “David has tremendous qualities, like Aaron has, like Karl (Hein) has and we have to use them. “I am a really young manager and I have only been in the job for three and a half years and I have few regrets in what we have done. “One of them is that on two occasions I felt after 60 minutes and 85 minutes in two games in this period, to change the keeper in that moment and I didn’t do it. “I didn’t have the courage to do it. But I am able to take a winger, or a striker and put a central defender back and go to a back five to hold that result. “And we drew those games and I was so unhappy and someone is going to do it and maybe it (the reaction) will be, ‘oh! That is strange. Why?’ “Why not? Tell me why not. You have all the qualities in another goalkeeper and you want to do something to change the momentum, do it. “It is a regret that I have and my feeling is to get everyone engaged in the team. They have to play regardless of the competition. Do it. That is my message.” Everton defended bravely, but offered little going forward and rarely threatened to score their first Premier League goal in three matches at Goodison this season. The Toffees’ one point from five matches is their worst tally since 1994-95 and manager Sean Dyche admits he expected a greater return at this stage. “I thought we would have more points on the board by now but you can’t give the ball away that many times,” he said. “That link on transition was missing and we weren’t effective enough. We are conceding softish goals. “Our growth is where we are. There is a reality. Last season nothing was solved. I’ve said there is massive work to be done.”

Teenagers should be offered a “transformative” anti-obesity treatment to help them lose weight, experts have said. Academics said that the weight loss injection semaglutide could help adolescents with obesity to shed pounds after a new study found an average weight loss of 40 pounds (18 kilos). Teens living with obesity were offered the semaglutide drug for more than a year in a new clinical trial. The study, published at the European Congress on Obesity in Dublin and the journal Obesity, found that 45 per cent of teens using the appetite suppressant drug were no longer classed as obese 68 weeks after starting treatment. This is compared to 12 per cent in a group who were taking “dummy” drugs – also known as placebos. Some 19.5 per cent dropped down into the “overweight” category and a quarter (25.4 per cent) were able to reduce their BMI into the “normal” weight category, the conference heard. The average reduction in body weight with semaglutide – sold under the brand name Wegovy – compared to placebo was about 40 pounds (18 kilos), researchers said. Many do very well with this medication though, and it can be life-changing for them Dr Aaron Kelly, University of Minnesota The authors of the paper conclude that “semaglutide represents an efficacious treatment option for adolescents with obesity”. But presenting the study, Dr Aaron Kelly, from the University of Minnesota Medical School in Minneapolis, USA, said that it should be taken as part of a package of measures to help teens living with the condition. He said that the earlier the treatment starts “the better” to prevent further weight gain. But he said that treatment should be taken long-term, as would be expected with other chronic conditions. Dr Kelly told reporters that there were side effects – mostly of nausea and vomiting – but these were “transient” and most dissipated over time. If you engage in treatment that’s effective, you’ll see an effect but if you take that treatment away – it’s like a rubber band, it’s going to come right back to where it started Dr Aaron Kelly “There’s a whole spectrum of outcomes when you use anti-obesity medications – some do really really well, some don’t do as well,” he said. “Many do very well with this medication though, and it can be life-changing for them. “Being a research scientist nothing brings me more pleasure than hearing the stories from the adolescents who have been struggling their entire life to manage their weight and haven’t been able to – it’s not about trying hard or not, they all try hard – this gives them a tool to help take control of their weight. “And that’s transformational for many teenagers.” He added: “I believe that health care providers should offer that as part of the comprehensive treatment approach – it’s not just one thing, it’s lifestyle therapy – which was included in this trial; it’s the use of anti-obesity medications and, for some, metabolic and bariatric surgery. “A question I get asked a lot is, ‘Is this going to solve the obesity problem? Should we just give it to everybody?’ No, it’s not going to solve the obesity problem, but it’s an important piece to the puzzle at helping to solve it especially for those who already have obesity.” Dr Kelly said that coming off the drugs would lead to weight coming back, adding: “Let’s use high blood pressure as an example, medications are commonly used and prescribed to treat high blood pressure. “And when they have prescribed, the intent of the health care provider – if (the drug is) tolerated and continues to be effective – effectively that person would stay on that medication, probably for the rest of their life. Obesity is exactly the same thing. “If you engage in treatment that’s effective, you’ll see an effect but if you take that treatment away – it’s like a rubber band, it’s going to come right back to where it started.” On when treatment should commence among teens, he added: “If obesity surfaces in childhood, it probably represents one of the most aggressive forms of obesity that we know of. “If you are a child or adolescent with obesity, you are highly likely to carry that obesity and excess adiposity into adulthood. You don’t just snap out of it. “My centre comes of the approach that the earlier the better. “And, and if medically eligible, the use of medications early is probably going to (give) the best outcomes over time because if you allow the disease to progress and the pounds to to add on over time, it gets harder and harder to draw that back. “And so conceptually, I think it makes sense to intervene early and not allow that to happen, and that probably gives the child the best shot at living a long, healthy, happy life.” Meanwhile, another study presented at the conference found that people who have shed weight may be at risk of “psychological scarring”. The paper, led by academics at the University of Liverpool, found that people who have had obesity, even if they have lost weight, could be at risk. 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