♪ john: tonight on "pbs news weekend," a new escalation in the middle east as israel's retaliatory attack on iran fuels fears of a wider war. then, for the third presidential election in a row, michigan is playing a pivotal role. and how doctors are using weight

loss drugs to help treat adolescents. >> these medications work. and our children are really suffering from outcomes such as excess weight, ranging from mental health and bullying to type two diabetes. ♪ >> major funding for "pbs news weekend" has been provided by -- and with the ongoing support of these individuals and institutions. and friends of the news hour. ♪

this program was made possible by the corporation for public broadcasting and by contributions to your pbs station from viewers like you. thank you. john: good evening, i'm john yang. tonight, iran is saying that it might not respond in kind to israel's first ever open attack on its soil if there's a ceasefire in gaza and lebanon. more than 100 israeli fighter jets and unmanned drones struck iranian military targets. iran's state run news agency said 4 members of its military were killed. >> the long anticipated retaliatory attack came early saturday morning. israeli defense forces that it struck targets where missiles are billed and stored. their answers were in april and earlier this month.

those follow the killings of iranian and hezbollah leaders which iran blamed on israel. on state tv, iran's ruling regime played down the damage. >> although the country's integrated air defense systems successfully confront of the act of aggression, committed damage has been caused to some places. the scope of the attack is being investigated. john: idf spokesman daniel hug ari indicated israeli retaliation was done, for now. >> we are focused on the targets of the war in gaza and lebanon. iran is the one that continues to push for wider escalation. we will know how to choose additional targets and attack them if necessary. john: international reaction was swift. >> i wish a speedy recovery to our neighbor iran in the iranian government which was the target

of the aggression last night. the zionist israeli government wants to light the fuse on regional conflicts. >> i am clear that israel has the right to defend itself against iranian aggression. i am equally clear that we need to avoid further regional escalation. and ge all sides to show restraint. iran should not respond. john: this afternoon, before flying to pittsburgh for a campaign event, president biden echoed that call. >> it looks like they didn't do anything other than military targets john: a senior administration official said efforts will resume in coming days to end the fighting in lebanon, secure a ceasefire in gaza and return israeli hostages still held in gaza. suzanne maloney, director of the foreign policy program at the brookings institution. what do you make of this

overture from iran that they will not retaliate if there is a cease-fire in lebanon and gaza? suzanne: i think this is consistent with the rhetoric we have heard from iran from -- for some time. they are trying to posture that they are defending the people of gaza and lebanon, and that their hostile activity toward israel will stop if there is a cease-fire. i think it is a face-saving gesture. they are unlikely to respond to what was sophisticated attacks by the israelis yesterday against iran. john: talk more about the attack last night. was israel able to accomplish its goals, while at the same time, feeding the international calls for restraint? suzanne: i think it was a goldilocks approach on the part of the israelis. it was big enough to impose some costs, and i think to have some deterrent impact on iran's calculus. but it was not so big as to create inevitable pressure for escalation, an iranian italia --

retaliation which would put it in a more dangerous war. that obviously was the goal of the united states that have been speaking the israeli counterparts about the nature of the attack. there was a lot of discussion about whether nuclear sites would be targeted, whether iran's oil and gas infrastructure might be targeted. but instead, they chose to target drone and missile production facilities as well as air defense and rar. i think that was a very wise and appropriate choice. john: israel appears to have used the airspace of jordan and iraq to get to the targets in iran. what does that tell us about iran's standing among its arab neighbors? suzanne: the region's reaction has been interesting. two of iran's neighboring states used -- permitted the israelis to use their airspace to undertake these attacks. it demonstrates how vulnerable iran is, because of the alignment of many of the rest of the countries in the region with israel.

but the recon and nation of many regional states, including saudi arabia, which i think speaks to the fact that no country in the regioneally wants to see this situation escalate further than it has. john: for many years, israel and iran fighting by proxy. iranian sponsored groups like hamas, hezbollah, and the houthis attacking israel. have we reached a new phase where these two longtime enemies are going to be attacking each other directly? suzanne: yes, i think that's where we are. as you noted, for the past decade, there has been a gray zone war between iran and israel, often involving proxies or war in third countries such as syria. what we've seen since april is a willingness on the part of the iranians to strike in a fashion agains israel, and by israel to respond directly with attacks on the iranian homeland. i think this is in more -- this is a more dangerous phase of the

war. although the actions of the past 24 hours may create some paws the part of the iranians to take the next step of escalation. john: much more dangerous phase. are we a step closer? are we closer to having a broader war in the middle east? suzanne: we are absolutely on the precipice of a broader war. the only thing that will ensure we don't get there is to see a cease-fire in gaza, a reduction of tensions around the region, and a commitment on the part of iran and other countries to stop trying to fuel the fire, and trying to press their aggression against israel. i think the likelihood that we get there very quily, unfortunately, is very low. john: thank you very much. suzanne: thank you. john: there are developments on israel's other battle fronts. the lebanese health ministry says that more than one million people have been driven from their homes since fighting began there. israel says it's defending against hezbollah rockets launched from lebanon.

and in northern gaza, israeli troops withdrew from a hospital where the palestinian health ministry says they held medical staff and patients without access to food or water. in ukraine, russian drones struck kyiv in an hours-long nighttime barrage. ukrainian officials said one went into an apartment building, killing a 15-year-old girl and hers.in and in central ukraine, a missile struck a residential area in dnipro. regional officials said a 14-year-old and four others were killed and at least 21 others injured. police in london were out in force today as anti-immigrant protestors and anti-discrimination demonstrators held competing rallies. thousands of opponents of immigration took to the streets in a march called "unite the kingdom." nearby, anti-racism campaigners held a counter-protest. immigration has been a flashpoint since july, when days of riots spread across the country, targeting asylum seekers and mosques. still to come on "pbs news weekend," what the presidential

candidates are saying to voters in the electoral battleground of michigan. and how doctors are using weight loss drugs to tackle obesity in young people. >> this is "pbs news weekend" from the david and rubenstein studio at w eta in washington, home of the pbs news hour, weeknights on pbs. john: today is the first day of statewide early voting in michigan and both presidential candidates are in the state trying to energize their supporters. former president donald trump was in novi, a suburb of detroit. mr. trump: year after year, globalist politicians like kamala harris sold you out and let other countries loot and pillage and plunder your wealth. john: message that reproductive -- vice president harris is on the other side of the state, pressing her message that reproductive rights are at stake in the election. vp harris: we are seeing the

impact of these laws causing clinics,ealth care clinics to shut down. the physicians that i've been talking with are concerned about this myriad of issues that have highlighted the fact that because of trump, and what he did with the supreme court, we are looking at a healthcare crisis in america. john: tonight, she will be in kalamazoo with former first lady michelle obama. earlier i asked chad livengood, the detroit news politics editor and columnist, to tell us about the race for michigan's 15 electoral vote chad: this race is no. there is no clear front runner in michigan. kamala harris is spending saturday with former first lady michelle obama in kalamazoo the university town. she needs to do really well in these university towns in ann arbor, and ypsilanti, mount pleasant, and east lansing as well. because this is where she will

need to run the score up to counter some of trump's advantages in working-class areas of the state. john: former president trump is in oakland county, a detroit suburb. what does that tell us about who he is trying to motivate? chad: he is trying to get the core republican base of oakland county, to get them out and get them to vote early. his strategy is turned her toward trying to mirror the democrats strategy in previous elections, to bank as many early votes between absentee votes by mail, and also early in person voting. john: michigan economy, still build around the auto industry. the auto industry internal combustion engines. this shift to electric vehicles, how is each campaign dealing with that issue? chad: donald has honed in on the subject with specific issues, going after evey's. essentially saying to people,

your big three automakers should t be trying to compete with china. he went into flint, a vehicle city, the birthplace of general motors and made this message about a month ago. he has continued to talk about it and rail against electric vehicles. and kamala harris is trying to counter and say, look, we want to compete with china. if we want to compete with china in the automotive industry, we have to make electric vehicles. john: another feature about michigan for -- politics is the large arab-american population, concentrated around detroit. early on when president biden was in the race, there was a lot of unhappiness among that community about his staunch support for israel and the war in gaza. now that harris is in the race, how has that community approached her, what arthey thinking about harris? chad: that unhappiness has not eased. it has maybe even grown more frustrated as the war has

dragged on. now, israel has been bombing in lebanon and there is a large lebanese population, particularly in wayne county, dearborn, dearborn heights, hamtramck, that are furious. this is a real big drum -- jump for democrats, and may be a crisis they don't quite know how big it will be. there are some leaders in the community like the mayors of hamtramck and dearborn heights who have endorsed trump. just yesterday, the mayor of dearborn came out and said, he can't vote for either one of them. john: could that affect the senate race? you have to democrats trying to hold onto the seat that debbie stabenow is stepping down. you have a current democratic house member, alyssa slotkin, running against a former republican house member, mike rogers. could that affect that race? chad: absolutely. they are both pretty hawkish, pro-israel. they are, on paper, from a

national security perspective, the exact same candidate. he used to be an fbi agent, she used to be a cia agent. whether she gets penalized by the arab and muslim voters of the state for it, is kind of what is the big unknown right now. john: democrats in michigan are trying to hold onto two open house seats, including one that slotkin is giving up. both of those races are rated as tossup spirit tell us about those races. chad: this is a race between tom berry, the republin who lost to slotkin by three or four points two years ago. and curtis junior who is a democrat and longtime politician in michigan. this is a race that is not. it is another race where the electric vehicle transition is on the ballot. lansing as an auto town has two gm plants.

the future of one of those plants is pretty much in doubt right now. democrats are trying to use this as an issue to say, if you elect tom barrett or or donald trump, this plant -- this cadillac plant is in serious danger of closing. over to the east of there is the eighth congressional district. that is the seat held by dan kilby. this is the seat where they have democratic state senator kristen mcdonnell rivet running against a republican entrepreneur, paul young. this is also a seat that is at. they are also battling over the ev transition. the messaging you are seeing fr trump, two young, on down is if you continue to transition to ev's, all of these plants that make transmissions are going to go by the wayside. it is going to be a big test about that messaging, really motivating voters to go pull the

lever r the republicans. john: in a lot of races to watch and michigan. thank you very much. chad: thank you for having me, john. ♪ john: physicians are increasingly using weight loss drugs to treat obesity, diabetes and other chronic conditions in young people, including children. in the last three years, the number of people aged between 12 and 25 using drugs like wegovy and ozempic has surged nearly 600 percent. -- 600%. ali rogin looks at the high demand for these drugs and the concerns surrounding them. ali: approximately one in five children and adolescents in the u.s. is obese. experts say early intensive treatment can prevent health issues down the line.

last year, the american academy of pediatrics recommended the use of medication to treat obesity and up. we spoke to two young women who have been using these medications. >> i have been struggling with my weight and i had never gotten my period before. and i had taken some labs and we found i had pc os. i think a lot of people think, especially pcos, that they're stuck in their options and they're finding out that this is an option because it has helped me lose almost 90 pounds. and i got my period and it's helped with my confidence in so many other things. and continuing it i think has just shown the effectiveness of it as well. >> i had tried, like, working out and stuff like that, but, like, nothing was showing, like, helpful or like, there's no change at all in anything. and so it was just kind of like hard and disappointing. and the only thing that like, actually helped with all that was the medication. my topic i -- my appetite has

changed completely. and it's been suppressed so much. i think the end goal is like ultimately to get me off of it because i don't want to be like, taking it forever. and like, if we can, like we've been lowering the dosages. so like, if we can slowly get me off of it and like, everything kind of stays like normal and like, or if anything, like things get better and not worse than like, that's good. ali: despite the effectiveness of these drugs, some doctors are concerned about the lack of data available for children using them long term. dr. melanie cree is a pediatric endocrinologist at children's hospital, colorado, and she treated both sophie and autumn. dr. cree, thank you so much for joining us. first of all, why are we seeing this increase in children using these medications? dr. cree: the reason we're seeing such an increase is that these medications work. and our children are really suffering from outcomes, from excess weight, ranging from mental health and bullying to the development of serious metabolic disease such as type

two diabetes. ali: when you are treating patients, what sort of options do you consider before looking at medication? dr. cree: so we always look at lifestyle in terms of trying to help a child who's struggling with weight achieve better health. and we can look at different aspects of food. are they getting enough fruits and vegetables, cutting down on simple carbohydrates, really cutting liquid calories? what can they do to increase their activity? is their neighborhood safe to excise in? do they have access to facilities or sports? sleep is very important. do they have somewhere quiet to sleep? do they get enough sleep? and then obviously, mental health is very important. and are they stressed or are they living in a difficult social environment? and helping align all of these to optimize children's health is something that we do prior to trying any medication. ali: what are some of the

misconceptions that you've encountered about prescribing these medications and the children who are on them? dr. cree: i think the number one misconception is that the individual is failing somehow. that somebody has to do these medications if they don't have a strong enough willpower and that they're weak and can't do this on their own. and that's just absolutely not true. these are chemicals. and when you take chemicals and they help you loseeight, that means that you've got a problem with the chemicals in your brain that are helping you to regulate how you sense appetite and how you sense fullness. and so you take these medications and they actually change the way that your brain senses food. ali: like we talked abou earlier, there are concerns about the lack of long term information on the use of these in children. what are your concerns there? dr. cree: many.

there's a very, very low risk of increased thyroid cancer for the duration of the time that we've studied these medications and for animals entire lives. but humans live much longer. so i think that's one of the biggest things that we're automatically watching for. something that one of my research partners is interested in is how do these medications affect the brain differently when we're in an adolescent with a developing brain compared to an adult who doesn't have a developing brain, and brain that is changing so much. if you use this medication all through your teens, does that permanently change how your brain senses food? ali: in the patients that you've been seeing as they get older, do you recommend for them to stay on these medications over the long term, well into adulthood? what does that tend to look like? dr. cree: you know, we've got patients that have come down 80, 90 pounds. we're now at ideal goal weight.

and what do we do? we've done a really good job of figuring out how to start it, how to keep people healthy on it, increase protein and really increase activity. and then we get to to goal weight. the data in adults show that if you don't lose at least 15% of your weight on semaglutide, when you stop a year later, you're back up to your starting weight. i've been trying with a couple of patients to switch them from the injectables when they get to target weight to pills that we have a little bit more safety data on. but right now, this is exactly what we're doing, trial and error with my patients and all of us in the woods together. ali: and what about the insurance question? there are concerns that companies won't want to support the long term usage of these drugs in children as they get older. i know that this is uncharted territory in many ways, but what are the possible issues there?

dr. cree: well, what we're having a problem with is when they get to their goal weight, then the insurance companies are renewing their approvals and saying, well, this individual isn't obese. we're not going to pay for the medicaon anymore. and they're that way because we were using the medication. so that is exactly the hurdle that we're facing right now. you know, if if we can prevent type two diabetes in kids, the economic effect is going to be dramatic within the next 15 year so it's very hard. and our health care system is not set up around prevention, but we really need to come up with pediatric models to model and say, okay, well, what is the cost if a patient develops type two diabetes as a teenager? what are you looking at in the next 20 years?

pregnancy complications for youth who ha excess weight and then have babies in their 20s are much higher. so there are a lot of costs that are much higher. but putting all of that together to make the drug company right now pay for it is a little bit challenging. ali: dr. melanie cree with children's hospital, colorado, thank you so much. dr. cree: thank you. ♪ john: and that is pbs news week and for this i'm john yang. saturday. for all of my colleagues, thanks for joining us. see you tomorrow. >> gator funding for pbs news weekend has been provided by -- >> consumer cellular, this is sam. how may i help you? this is a pket dial. thought i would let you know that with consumer cellular coming you get nationwide coverage with no contract. that's kind of our thing. have a nice day.

>> and with the ongoing support of these individuals and institutions. this program was made possible by the corporation for public broadcasting and by contributions to your pbs station from viewers like you. thank you. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy.] >> the final night of an extraordinary campaign. will voters send donald trump back to the white house? mr. trump: we stand on the verge of the four greatest years. >> or will kamala harris make history? vp harris: are you ready to make your voices heard? >> pbs news special, electric -- election 2024, 7:00 p.m. eastern, 6:00 central. ♪

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[ cheers and applause ] -i wouldn't say i'm creating patriots or revolutionaries. i just want to create better citizens. but when it comes to this competition, everybody wants to win. [ cheers and applause ] and that's just the way it is.