[HN Gopher] How long til we're all on Ozempic?
___________________________________________________________________
How long til we're all on Ozempic?
Author : thehoff
Score : 408 points
Date : 2024-10-11 17:06 UTC (1 days ago)
(HTM) web link (asteriskmag.com)
(TXT) w3m dump (asteriskmag.com)
| WheelsAtLarge wrote:
| Statins are regularly given to people with high cholesterol. I
| would bet that most older people take or qualify to take a
| statin. If it happens with statins, therefore, it's not out of
| the realm to think that most people will eventually be prescribed
| GLP-1 to reduce weight which will improve overall health. It
| makes sense.
| zdragnar wrote:
| Statins have gone through several prescribing guideline
| revisions in the last 10-20 years. Many people were incorrectly
| prescribed them and some have suffered for it.
|
| Likewise, there can be serious complications when taking GLP-1
| agonists and the like. Since they need to be taken in
| perpetuity (many gain all weight lost upon stopping use) they
| should be reserved for only people who have exhausted all other
| opportunities.
|
| _Most_ people over 65 should not be on statins. _Most_ people
| should not be taking GPL-1 agonists.
| throwaway63467 wrote:
| I'm just back from the US and watching some TV there in the
| hotel it seems very much like they're pushing it into the
| mainstream, they literally have a commercial where "fat"
| people congregate in the street to march together picking up
| Ozempic... So I totally assume it will be widespread in a few
| years unless they discover some serious side effects.
| zdragnar wrote:
| Meh, you see commercials for all kinds of medicines in the
| US. There's more being produced than your average general
| practitioner can keep up with, so the manufacturers appeal
| directly to consumers.
|
| Given how ineffective it is once you stop, I'm personally
| expecting it to become a relatively short lived fad.
| Insurance companies won't cover it if it truly doesn't
| improve health outcomes long term (throwing money down the
| toilet) and people will learn to not pay out of pocket for
| it.
|
| There's a reason insurance companies are loath to cover it
| for obesity now without prior authorization, which usually
| requires you seeing a specialist who has ruled out the
| usual suspects (nutrition and exercise changes).
| sph wrote:
| Pretty much no one should be taking statins. The side effects
| are well studied, while the benefits are dubious at best.
|
| For example: _high_ cholesterol levels is actually positively
| correlated with longevity, believe it or not. If you consume
| a diet low in sugars, thus routinely burning fat when fasted,
| you will have "high" cholesterol in blood. How do you think
| fats are moved to cells in need? Through the blood, of
| course.
|
| I'd go so far as to say that statins are pretty much a scam,
| that fixes a useless and quite complex metric such as
| cholesterol levels. Given that cholesterol levels are a
| diagnostic easily accessible to GPs, they prescribe statins
| to see this figure go lower, even if it doesn't make the
| person any healthier. Incidentally it's similar to taking
| GLP-1 agonists instead of learning to have a healthier
| relationship with food.
| m0llusk wrote:
| Statins are a good comparison because most end their use after
| one or two years because of the side effects.
| IncreasePosts wrote:
| My biggest fear is either there will be long term negative
| consequences to Ozempic et al, and a huge swath of the population
| will be dealing with issues 30 years form now - OR - there will
| be some long term positive consequence to using Ozempic et al,
| and I'm not getting any of the benefits because I'm not
| overweight.
| sss111 wrote:
| There were several side effects related to pancreatic cancer
| associated with the precursors to GLP-1 drugs. The same
| companies promoting GLP-1s were responsible for driving up
| insulin prices. So I'm hedging my bets.
|
| There's a really cool Modern MBA video [1] on this topic btw :)
|
| [1]: https://www.youtube.com/watch?v=7sUoZVke_30
| cyberax wrote:
| > There were several side effects related to pancreatic
| cancer
|
| In mice.
| copperx wrote:
| Did the drug help pancreatic cancer?
| minifridge wrote:
| If something causes cancer in mice, the curent consensus is
| that it is deemed unsafe for humans.
| cyberax wrote:
| Not really. Mice are naturally genetically pre-disposed
| to cancer.
|
| So in general, if something _doesn't_ cause cancer in
| mice, then it's probably safe for humans. The reverse is
| not necessarily true.
|
| Also, GLP-1 was associated with thyroid, not pancreatic
| cancer.
| akira2501 wrote:
| Were they humanized mice or not?
| the__alchemist wrote:
| This is a good example of a _thought-terminating cliche_.
| sss111 wrote:
| nice, learned something new today, people use this so
| often
| cyberax wrote:
| There used to be a Twitter bot that replied "in mice" to
| all breathless tweets reporting on various studies.
| pixl97 wrote:
| >Large epidemiological studies have shown the link between
| obesity and pancreatic cancer. A large population-based case-
| control study of pancreatic cancer demonstrated that obesity
| was associated with a statistically significant 50-60%
| increased risk of pancreatic cancer.
|
| So does obesity, so there is that.
| BoingBoomTschak wrote:
| Well, the negative consequence on the value of willpower is
| pretty obvious. "In what measure" is the real question.
| zarathustreal wrote:
| Right, and the associated cultural impact of increasing
| hedonism
| cortesoft wrote:
| I am confused as to how a drug that makes you want to
| consume less would increase hedonism? It is basically an
| anti-hedonism drug?
| BoingBoomTschak wrote:
| Hedonism is a philosophy that posits that pleasure is the
| sole objective good and thus pain something bad.
|
| This whole thing is about trying to find shortcuts to get
| to the pleasure of having a nice body while circumventing
| the pain and effort.
|
| Pain and efforts are important, they forge character like
| nothing else. If you want to live in a world where adult-
| children simply take their soma to get what they want,
| you're just not thinking about the consequences.
| Spivak wrote:
| You have the completely wrong take on this. Dieting destroys
| your relationship with food. Basically every adult woman
| exhibits some level of disordered eating because of it--
| "girl dinner" is both funny because it's true and sad.
|
| Being able to lose weight while continuing to eat is a
| wonderful thing. There is no virtue in spending your
| willpower making your body do something it desperately
| doesn't want to do. That's some puritan shit.
| Fauntleroy wrote:
| It doesn't make you magically lose weight, it just gets you
| closer to "girl dinnering" with less cognitive load. The
| weight loss comes from eating less.
| lukeschlather wrote:
| Yeah, it's funny, Ozempic sounds utterly useless for me.
| I know how to lose weight, it's dealing with the side
| effects of weight loss that is tricky. And the side
| effects of weight loss sound a lot like the side effects
| of Ozempic.
| Spivak wrote:
| The difference is that it puts you in control of your
| hunger and what/how much you eat. You don't build
| negative associations with food while you're running a
| deficit. You don't build the association "hunger/misery
| means you're doing good and losing weight."
| logicchains wrote:
| >Basically every adult woman exhibits some level of
| disordered eating because of it-- "girl dinner" is both
| funny because it's true and sad
|
| This is sexist and absolutely not true, there are plenty of
| women capable of pre-planning what they're going to eat and
| sticking with it. It's not "dieting", it's living a healthy
| lifestyle and not regularly eating junk.
| Spivak wrote:
| My dude, I'm a woman talking about my experience with
| myself and other women. Disordered eating is _rampant_.
| It 's ingrained to the very core of how women are taught
| to approach food. Denying food and starving yourself is
| the default behavior.
| johnrob wrote:
| We are human animals. Our bodies need healthy food and
| regular exercise. There's a case that diet and exercise are
| worth willpower capacity, possibly more so than anything
| else. That's just the reality we exist in?
| pixl97 wrote:
| Capitalism disagrees. I need you to work two extra hours
| today. Also watch this advertisement for Tasty Snack!
| We've spend a billion dollars of research to ensure you
| eat this nibblet filled with 350% your daily sugar
| requirement, 200% of your daily fat intake, and 3000% of
| your recommended salt. Remember all the beautiful people
| in the world are eating Tasty Snack! Sold in the impulse
| buy isle near you.
| zarathustreal wrote:
| There is absolutely virtue in spending willpower to make
| your body do something it doesn't want to do - maintaining
| and developing self control and autonomy. Imagine if there
| was no way to develop self-discipline, you'd be at the
| whims of your environment and the world would be nothing
| but chaos.
| geoka9 wrote:
| Normally dieting shouldn't be necessary to maintain healthy
| weight though? One could eat a whole lot of salad (with
| some serious dressing) and a piece of meat and even a
| little starchy side (some potatoes or similar) 3 times a
| day and not gain weight. Throw in some regular moderate
| exercise and you're golden.
|
| Granted, once you go past middle age, it can become a bit
| more complicated.
|
| Someone brought up doughnuts as an example, but that's a
| ridiculous source of calories: I could probably down half a
| dozen doughnuts (a daily calorie budget) and then go for a
| normal meal afterwards.
|
| Eating only becomes disordered if one can't be bothered to
| eat healthy food as a rule and then freaks out about weight
| gain as a result.
| optimalsolver wrote:
| You know the way that software bloat expands to consume
| increased computational speed?
|
| We're about to see the nutritional equivalent.
| crooked-v wrote:
| I don't understand how that analogy is supposed to work,
| given that the basic mechanism of these drugs is to reduce
| appetite (and possibly just desire in general).
| petesergeant wrote:
| We're about to see a dramatic fall in the production and
| consumption of unhealthy food because people who used to
| want them in large quantities will no longer want them when
| they're on GLP-1 drugs.
| ninalanyon wrote:
| If this is the case and we believe that markets are
| efficient we should surely soon be seeing a decline in
| the stock price of McDonald's, etc.
|
| If you are right then there should be money to be made by
| shorting the stock.
| pixl97 wrote:
| >In October 2023, Walmart became one of the first
| retailers to correlate Ozempic, food sales, and changing
| habits. Using internal pharmacy and grocery data, the
| study found that Ozempic is negatively affecting
| Walmart's food sales. Measuring per-unit sales and
| calories, the retail giant confirmed a long-held belief
| that patients on GLP-1 drugs buy less food, particularly
| within the sweets and snack food categories.
| gedy wrote:
| Keep in mind a lot of people who'd benefit from this may not
| last another 30 years due to age or health issues due to weight
| either.
| m463 wrote:
| right
|
| the life expectancy of someone with bmi > 40 is -5 years
|
| and for bmi > 50, -15 years.
|
| So I suspect someone ~ 65 with high BMI should be on it, the
| side effects would be: living.
| mritchie712 wrote:
| Has there ever been a case where something like #2 has
| happened?
|
| Don't think you need to worry about that one.
| dustingetz wrote:
| https://en.wikipedia.org/wiki/Water_fluoridation
| logicchains wrote:
| https://www.theguardian.com/us-
| news/2024/oct/04/fluoridation...
| UniverseHacker wrote:
| I am an academic scientist and generally a careful and
| skeptical person, but having read the peer reviewed
| literature myself, I think there is enough evidence to be
| concerned that water fluoridation at the levels currently
| used could possibly be causing brain damage or
| developmental issues. The evidence isn't that strong, but
| it is strong enough that it would be unethical to
| continue the practice, or to claim that there is nothing
| to worry about. The dose/response curves seem to show
| measurable levels of cognitive defects occurring right
| around, or just above typical target levels for
| fluoridation.
|
| Personally, I give my kid water with the flouride
| filtered out via RO, but will still use topical flouride,
| e.g. toothpaste and treatments applied by a dentist.
|
| I hate how issues like this are politicized... if I raise
| this issue anywhere, including on here I expect to be
| attacked for being a "conspiracy theorist" and "like an
| anti-vaxxer" etc. There is something really wrong when
| you aren't allowed to even talk about both sides of an
| issue- especially if, like in my case, I have a doctorate
| in the life sciences and am qualified to have my own
| informed scientific opinion based on the evidence.
| bee_rider wrote:
| Is that an opinion formed on something inside your domain
| of expertise?
| UniverseHacker wrote:
| It is not in any way related to my own area of research,
| I looked into it as a parent wondering what would be best
| for my own kid. However, there is not really that much
| research out there on this- so I was able to review much
| of the primary research, as well as various review
| articles that try to consider all of it together.
|
| How would you define "domain of expertise"? Reviewing
| literature from other fields I don't research myself and
| forming an opinion on how it applies to my research _is_
| part of my job and something I do almost every day. I am
| even also called upon to peer review articles and grant
| proposals that are not within my direct field of
| research, as is general practice to get "outside
| opinions."
|
| In cases like this, I am able to be familiar with
| basically everything published on the issue. However an
| actual researcher in a specific field will have
| additional knowledge and opinions from firsthand
| experience, that cannot be found in literature.
|
| In general, I think it is okay to have your own opinion
| on something even if you aren't e.g. a professional whose
| whole life is focused exactly on that one issue. No
| formal training, credentials, or firsthand experience are
| necessarily required to have an informed opinion.
| However, you still have the burden of making sure you
| really understand the issue deeply - which is probably
| something like 100x the effort most people think it would
| be. Anyone can do that if they take the time to do so. I
| wish more people would.
|
| In any case, this was a few years back when I looked into
| it, and it seems like these concerns have become more
| mainstream and less controversial in the last few years,
| e.g. https://ntp.niehs.nih.gov/publications/monographs/mg
| raph08
| rogerrogerr wrote:
| It's totally reasonable to make this as a simple risk
| balancing decision: "unknown but probably small risk, vs.
| known and definitely small benefit" is not the kind of
| fact pattern that we should persecute people for
| differing on.
| SketchySeaBeast wrote:
| Rural children, who it stands to reason would be more
| likely to not be drinking fluoridated water, have higher
| odds of being overweight or obese than urban.
|
| https://www.cdc.gov/pcd/issues/2023/23_0136.htm
| fourside wrote:
| Not sure that's apples to apples. Fluoride is a mineral.
| IIRC, ozempic is closer to a hormone.
| Jerrrrrrry wrote:
| >Fluoride is a mineral.
|
| Even noble gases can be psychoactive.
| syndicatedjelly wrote:
| Fluoride and fluorine are not the same thing, and
| fluorine is not a noble gas
| Jerrrrrrry wrote:
| The implication to be thwarted was of "mineral" vs
| "hormone"; the distinction was moot, as there is no such
| real thing as a "drug" - all things are chemicals, and
| can be psychoactive to humans in either their presence or
| absence.
|
| Most notably (in the context of un-intuitiveness), is
| Xenon - it is't even a chemical, but an element - a noble
| one, which is almost nonsensical given most's flawed
| intuition. > fluorine is not a noble gas
|
| Correct, although ironically it wasn't much use in direct
| chemical-warfare, it was used more as a pre-cursor to
| enrich Uranium.
| syndicatedjelly wrote:
| > Most notably (in the context of un-intuitiveness), is
| Xenon - it is't even a chemical, but an element - a noble
| one, which is almost nonsensical given most's flawed
| intuition.
|
| ...what?
|
| I haven't the faintest clue what you're talking about. I
| don't think you know what the word "psychoactive" means,
| either. By your definition, water is psychoactive too. Is
| that what you're suggesting?
| rmellow wrote:
| Adding iodine to salt has greatly increased the population's
| IQ in countries that have adopted it.
|
| https://pubmed.ncbi.nlm.nih.gov/15734706/
| crooked-v wrote:
| Sure: the popularization of coffee across western Europe in
| the 1600s and 1700s, and the way it replaced beer as the most
| common daytime casual drink. Much of the population went from
| spending all day mildly intoxicated to being mostly sober and
| with a caffeine pick-me-up.
| positr0n wrote:
| Do you know if it was really most the population? Or just
| most of the intellectuals, nobility, bourgeois, etc. Were
| peasants coffee drinkers?
| dtquad wrote:
| There are some evidence that Ozempic/Wegovy actually cures
| more addictions than just food addiction.
| >The weight-loss jabs have apparently helped people kick
| habits from smoking to shopping, although scientists remain
| wary about recommending it as an addiction treatment
|
| https://www.theatlantic.com/health/archive/2023/05/ozempic-a.
| ..
| Ferret7446 wrote:
| Which makes perfect sense. All addictions are basically*
| the same thing, an outlet for negative emotion. The "drug"
| of choice, whether that be food, video games, shopping,
| etc. is fairly superficial. Often, people who "kick" one
| addiction simply switch over to another addiction.
| anigbrowl wrote:
| Some athletes (especially weightlifters) use Tadalafil, an
| erectile dysfunction drug, because it also promotes bone
| density and muscle growth while having few observable side
| effects. This isn't really surprising, it's basically just a
| mild vasodilator. A better known drug in the same class
| Sildenafil (aka Viagra) is less mild, and associated with
| retinal damage if overused.
| Blackthorn wrote:
| Going by the results around addiction, I'm betting on #2 with
| reduced alcohol consumption.
| fourside wrote:
| I'm skeptical of the idea that across the general population
| we'd be healthier if we dialed up our insulin production.
| Serious question but has there ever been a case of humans
| benefitting from increasing a hormone like this? Since it's an
| injection, It wouldn't be a steady increase, but more likely
| have bursts of it. I don't know how healthy that would be in
| the long run.
|
| After what happened with OxyContin I think wed benefit from
| some skepticism when a new drug gets oversold.
| aantix wrote:
| GLP-1's have been around since 2005. Exenatide.
|
| They're not new.
| pixl97 wrote:
| > Serious question but has there ever been a case of humans
| benefitting from increasing a hormone like this?
|
| By itself this might be an ok question, but in context it's
| rather useless....
|
| Diet and obesity changes by both lowering and increasing
| different hormone outputs in your body. You're balancing the
| question of "how is this hormone" versus "How bad is obesity
| on the body". Well, the answer is in, obesity is extremely
| unhealthy on the body in both the short and long term.
|
| Drug overdoses cause somewhere around 100k deaths per year in
| the US. Obesity complications related deaths are in the
| 250-300k deaths per year.
|
| You can be skeptical as you want, but behind smoking, obesity
| is the worst epidemic in the US.
| gcr wrote:
| I can understand this perspective. You're looking at it with
| healthy eyes.
|
| But for fat people, the calculus looks different.
|
| A decision to take semaglutides is a decision between the long-
| term negative effects of obesity *now*, or the possibility of
| long-term negative effects *later.*
|
| Anecdotally, trans people have a similar calculus. Going
| unmedicated/unsupported brings significant mental health risk
| _now_ [1], whereas going on hormone replacement may or may not
| cause complications much later in life (osteoperosis,
| hepotoxicity issues for some treatments, etc).
|
| Either way, you gotta get to the "later in life" part before
| you can worry about the outlook there.
|
| 1: a CDC meta-review said that 26% of surveyed US trans
| students attempted suicide this year, N=20,103 surveyed, ~660
| of which were trans. https://archive.ph/0H81G
| jncfhnb wrote:
| I was curious and a bit skeptical that sex change operations
| materially affected suicide rates for trans people but
| available papers tended to find significant effect sizes of
| about 50% reduction
| 0x1ceb00da wrote:
| Did that study account for the socioeconomic status of the
| participants? Common sense suggests that people who can
| afford to undergo such surgeries would tend to be richer,
| more supported, and from better neighborhoods.
| tjohns wrote:
| There's certainly room for more research here, but some
| of them do attempt to account for other socioeconomic
| factors.
|
| It's worth noting that surgery isn't the only option.
| Hormone therapy has also shown to reduce suicide risk,
| which is more accessible across socioeconomic strata.
|
| There's a meta-analysis here:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027312/
| jlawson wrote:
| The data is poor quality. It's not like you can randomize
| who gets a sex change operation. And there are major issues
| with even knowing who to count when people can just decide
| they're not trans any more. All the research on this is
| riven with such unhandled problems.
|
| The research is also highly motivated. A researcher who
| found that sex change operations were harmful would be
| targeted for endless harassment by gender activists, if
| they could get published at all.
| jncfhnb wrote:
| The effect sizes here are huge and seemingly hold when
| controlling for the typical factors such as socioeconomic
| status. They appear to hold both across groups that did
| not seek treatment and those that did AND in follow up
| studies checking the rates of how feelings (e.g.
| ideation) evolve over time for each group. It's ok to
| raise concerns about confounding variables but the
| hypotheses here for such a huge effect size seem limited.
|
| The fact that people can decide they're not trans is not
| particularly material. This is very uncommon.
|
| The conspiracy that such research must be politically
| motivated is a contrived argument and also falsely paints
| a dichotomy of saying that it must either help or harm.
| My assumption before doing the research was that they
| would find no effect.
| edmundsauto wrote:
| > The research is also highly motivated. A researcher who
| found that sex change operations were harmful would be
| targeted for endless harassment by gender activists, if
| they could get published at all.
|
| A researcher who found this would be feted by the
| conservative/evangelical wing of the US political
| spectrum. They would stand to make a ton of money in the
| book and personal appearance circuit.
| 0x1DEADCA0 wrote:
| No, they're making a choice between the long-term negative
| effects of not losing weight naturally, vs the possibility of
| long-term negative effects of using artificial methods. This
| isn't polemic, as even things as basic as birth control and
| advil have negative long term effects.
| gcr wrote:
| I think we're saying the same thing? The only difference is
| that I personally don't believe that self-control is
| sufficient for everyone to lose weight. If you do believe
| that, then the risk estimates become much easier.
| yard2010 wrote:
| Some people cannot lose weight naturally. So the question
| stands: what is the least bad alternative?
| throwaway743950 wrote:
| Maybe it's harder, but I don't think anyone is immune to
| calorie restriction.
| tjohns wrote:
| And yet, statistically, caloric restriction has one of
| the worst success rates in modern medicine.
|
| Depending on which study you look at, up to 80% of people
| who attempt lifestyle modification end up gaining the
| weight right back.
|
| So yes, it's theoretically possible for everyone under
| ideal circumstances, but in the real world most people
| don't succeed. We can argue over why that happens - but
| the statistics remain.
|
| So again... given these abysmal odds, for the 80% of
| people who try and (repeatedly) fail at lifestyle
| modification, what is the least bad alternative?
| croissants wrote:
| Tangential, but
|
| > 1: a CDC meta-review said that 26% of surveyed US trans
| students attempted suicide this year, N=20,103 surveyed, ~660
| of which were trans. https://archive.ph/0H81G
|
| This paper also finds that 5% of cisgender male and 11% of
| cisgender female students (out of ~8k surveyed for each)
| attempted suicide in the past year. It's kind of strange,
| because the age <=18 suicide rate (of "completed" attempts)
| is much smaller, approximately 1 in 5,000 to 1 in 10,000 [1].
|
| [1] https://www.cdc.gov/nchs/data/vsrr/vsrr024.pdf, Figure 3
| al_borland wrote:
| > I'm not getting any of the benefits because I'm not
| overweight.
|
| You're already benefiting.
| bryanlarsen wrote:
| > a huge swath of the population will be dealing with issues 30
| years form now
|
| We've got 20 years of data on this class of drug. Certainly
| there could be some long term issues that we're not aware of
| yet, but it's not likely that there are significant issues that
| affect a large percentage of users after 30 years that didn't
| affect the small sample of users that have been using it for 20
| years or the massive number of users that have been using it
| for 10.
| DonnyV wrote:
| How much of the data was done independent and how much was
| done by the same company or companies that benefit from it?
| We've seen this before. How many decades did people take
| aspirin thinking it was good for you to take everyday. How
| many decades did people drink wine thinking it was good for
| you in small dosage? How many people smoked using it as an
| appetite suppressant not knowing the long term effects?
|
| The list goes on forever. I'm betting this ends the same way.
| pixl97 wrote:
| How much data do we have on obesity and the effects of it?
| vessenes wrote:
| Dude, the mortality rates go up at least linearly, maybe
| super-linearly, to weight over a certain amount. It's not
| like some mythical / hard to read / later benefit. This is
| a drug that radically changes those risks NOW, really
| quickly. It's a different matter than aspirin (helpful if
| heart disease is a real risk, otherwise no) or wine or
| smoking, both of which people have a strong interest in
| thinking of as good for you.
| bee_rider wrote:
| Medical FOMO? I wouldn't worry too much about it, I mean, there
| are hypothetical upsides to countless decisions we haven't
| made, right? We always miss some chances in life.
| anigbrowl wrote:
| _OR - there will be some long term positive consequence to
| using Ozempic et al, and I 'm not getting any of the benefits
| because I'm not overweight_
|
| Who the fuck cares? If you're not overweight and are reasonably
| then you're already winning in physiological terms. If you can
| maintain a good quality of life into old age and then die, what
| more do you want? Going through life worrying about whether
| you're missing out on some marginal health benefit from the
| drug-of-the-moment is neurotic.
| pajeets wrote:
| i think overweightness should be seen more as a symptom and I
| share parent's concerns about ozempic's long term side
| effects being unknowable in the present
|
| all in all general unease about dealing with symptoms and not
| the root cause of overweightness except in rare genetic
| cases, its overwhelmingly a dietary/exercise issue.
|
| in this country the pill/drug is the answer and solution to
| everything but all this does is pile on more bandages without
| addressing the root cause which a very American solution.
|
| I do not think the full ramifications are realized or
| knowable when there are profits to be made on both side of
| the fence, sort of like the whole opiate crisis in America
| started out as magazine ads blew up into a major crisis 20~30
| years later.
| julianeon wrote:
| But consider the tradeoff: it's okay to have serious health
| issues in 30 years, if you were projected to die in 20 years
| without it.
| thr0waway001 wrote:
| That's why I haven't taken it. I'm probably a guy who should.
| Overweight, with kidney disease person who, if I became
| diabetic, it would probably kill me.
|
| I'm not, someone who doesn't really need it. For example, some
| average weight housewife who just wants to fit in a dress a
| little better.
|
| And still, I won't use it even though I can afford it cause
| it's the long term consequences are not entirely understood.
| rqtwteye wrote:
| It's a pretty sad thought that everybody will be on a drug that
| keeps weight in check while most people will still eat a
| basically toxic diet. Weight is certainly an important factor but
| there is more to a healthy life.
| habitue wrote:
| Seems like just an orthogonal problem? If calorie input is
| solved, now all the moralizing and shaming can be about
| nutrition instead
| mock-possum wrote:
| And make no mistake we _will_ find something new to moralize
| and shame about because _that's what we do_
| asib wrote:
| Sure, but the "unhealthy but not excessively caloric" diet is
| not a problem ozempic attempts to address. As far as I
| understand, it simply limits your appetite. Potentially one can
| go on ozempic, lose weight, and still end up eating
| unhealthily, because the resulting diet is made up of
| nutritionally poor foods.
| MBCook wrote:
| No, but if it helps avoid the discussion because the very
| visible side effect is lessened, then in some ways things are
| worse. No squeaky wheel.
|
| I'm glad it's available for those who need it. But I agree
| with GP that there is another discussion we need to be having
| too we've avoided for far far too long.
| Blackthorn wrote:
| "visible side effect", dude, modern food is _fortified to
| the hilt_. If you 're overeating on calories it's tough to
| have a deficiency in most places!
| MBCook wrote:
| I wasn't talking about nutrients at all. I was referring
| to the problems of over processed foods with lots of
| chemicals to increase shelf life and improve color and
| make them more addictive.
|
| I'm not against Ozempic. But without it maybe the
| continued expansion of the obesity epidemic would have
| pushed the discussion.
|
| If this accidentally prevents that discussion, I think
| that's a problem. I'm not suggesting any change to the
| drug's availability. Only concern over an important
| discussion.
| Blackthorn wrote:
| > But without it maybe the continued expansion of the
| obesity epidemic would have pushed the discussion.
|
| It's been forty years, how much longer would it take to
| admit that's not happening?
| MBCook wrote:
| Maybe it's naive. But it's getting harder and harder to
| ignore, and worse and worse.
|
| As we export our food to more and more places, it starts
| to happen to them.
|
| I hear about people who take trips to Europe. They eat a
| ton, feel better, and lose weight.
|
| They get back home, start eating food here (even healthy
| food) and feel worse again. Gain it back despite eating
| less.
|
| We've tried ignoring it. We've tried blaming genetics,
| character, fat in foods, sugar, and willpower. But none
| of those have explained/fixed it. Because I don't think
| that's the problem.
|
| I want the evidence to keep piling up. I don't want
| anyone to suffer unnecessarily, but I don't want a new
| excuse to stop progress again.
|
| It doesn't have to be either/or. But if we give up the
| chance for the debate because a new miracle drug "solved"
| it nothing will change.
| giantg2 wrote:
| And the argument you are replying to is that it's just
| covering up a symptom and not addressing the root problem
| holistically. Ozempic isn't a fix, it's a bandaid.
| sokoloff wrote:
| Bandaids serve a genuinely useful health-promoting purpose.
| I suspect we'll find the same is true of GLP-1s even if it
| only addresses part of the entire problem.
| giantg2 wrote:
| Only when applied correctly and with other interventions.
| Using ozempic without diet and exercise changes is like
| putting a bandaid on a .5" deep wound without sterilizing
| it.
| fragmede wrote:
| because ozempic reduces the food cravings, patients are
| able to implement and stick with a diet change. it's not
| like "put down that cheeseburger and have a salad" is
| something they haven't heard before and haven't
| internalized already, it's just their brain won't do it.
| ozempic gives them the space on their brain to actually
| do it.
| ProfessorLayton wrote:
| The drug works by suppressing appetite. Eating less of
| the same things is still a dietary change.
|
| Exercise is recommended for everyone, regardless of
| weight.
| hombre_fatal wrote:
| Sure, but so what? Until we can permanently change aspects
| of our brain, like our proclivity for addiction, then all
| interventions are bandaids on top of an underlying problem.
|
| Even behavioral changes like avoiding fast food don't fix
| the underlying problem in your brain. It's topical.
|
| It's amazing how the subject of Ozempic brings out such
| trivial claims uttered with a serious face.
| eightysixfour wrote:
| The "obesity is a moral failing" argument has an
| exceptionally strong hold on people.
| giantg2 wrote:
| Way to strawman. That's not what I said.
| eightysixfour wrote:
| Alright, what is the root cause we are putting a band-aid
| on, exactly?
| giantg2 wrote:
| The combination of bad diet and lack of exercise.
| Specifically in the context of this conversation, its
| about how ozempic will not fix a bad diet. Eating less of
| a bad diet is better than eating more of a bad diet, but
| is still a bad diet in the end.
| eightysixfour wrote:
| Right - why do people eat a bad diet?
| giantg2 wrote:
| Preference
| giantg2 wrote:
| And using ozempic without those diet changes is the same
| damn thing. You need to work on it from both directions.
| mrweasel wrote:
| > Ozempic isn't a fix, it's a bandaid.
|
| My original impression was that it was suppose to be a
| crutch, helping you get started on a healthy lifestyle. So
| if you are to heavy to exercise without hurting yourself it
| could help you lose that initial weight. Or it can help you
| with your appetit, while you adjust your diet.
|
| You also can't stay on Ozempic, you have to continuously
| increase you dose to get the same effect, so it's simply
| not viable to keep taking it for an extend period of time.
| That's at least the impression I've been getting from
| talking to people working at pharmacies.
| kelseyfrog wrote:
| That's great. We still give crutches to people who break
| their legs and bandaids to people with wounds. We don't
| tell them that being completely healed is better than using
| those aids.
| jprete wrote:
| Ozempic does not simply limit your appetite, it seems to also
| affect how much reward your brain feels from different foods
| (and activities!), which would make it easier to override
| those anticipated rewards with conscious choices.
| kelseyfrog wrote:
| From my understanding GLP-1 agonists can actually modulate the
| reward pathway reducing people's appetite for toxic diets.
|
| We're not socially caught up yet to this information. I suspect
| there are folks who believe that regardless of similar outcome
| (reduction of toxic diet), that changing diet without
| medication is superior to those who change their behavior
| through pharmacological intervention. It's like the pre-1990s
| view on depression or anxiety - chemical intervention is a
| moral weakness.
| andrewmcwatters wrote:
| You can literally do the same thing by eating a healthy diet
| for 2-4 weeks.
| hombre_fatal wrote:
| That's a trivial claim about any medication that changes
| behavior. You can achieve the same thing that the
| medication does by "just" having different behavior.
| SV_BubbleTime wrote:
| Have you considered that maybe it is an evolutionary
| trait that it is hard to do certain things? That the
| people who can expend the effort and discipline, perhaps
| have a better configuration than those that can't or
| don't?
| hombre_fatal wrote:
| Sure. People say the same thing about ADHD.
|
| The question is how a trait fares in the modern world.
|
| Maybe a trait was useful to an ancestor but not to you
| today trying to navigate a calorie rich world of
| convenience. Just like a trait useful to a nomadic hunter
| might work against you when you're expected to sit at a
| desk job if you want to make the money necessary to
| fulfill your ambitions.
|
| It may very well be the case that we end up medicating
| away traits that were useful at some point in our lineage
| but not today. I just don't see how it matters much
| beyond the thought exercise.
| SV_BubbleTime wrote:
| I don't think that's a great comparison.
|
| Have you wondered why ADHD has exploded?
|
| Have you not realized how many people at hacker news are
| on SSRIs? Watch this comment, you will.
| filoleg wrote:
| The exact same argument can be applied to literally any
| medical issue, and it is a pointless one.
|
| Someone has an elevated risk of skin cancer due to their
| genetics? Probably an evolutionary trait that it is more
| likely for some people to get skin cancer within their
| lifetime. That doesn't mean that using sunscreen and
| providing those people with related medical care (if the
| need arises) is some crime against nature and will end up
| hurting evolutionary prospects of the human race.
| ben_w wrote:
| > Someone has an elevated risk of skin cancer due to
| their genetics? Probably an evolutionary trait that it is
| more likely for some people to get skin cancer within
| their lifetime.
|
| More than probably, it's called "being white".
|
| (And we evolved that for more vitamin D?)
| vundercind wrote:
| Weird that the ones skinnier foreigners with a "better
| configuration" get genetically altered (I guess) to a
| worse configuration when they move to the US, then.
| SV_BubbleTime wrote:
| IDK what you mean, but if it isn't clear to anyone that
| our food is poison, it should be.
|
| My complaint is getting addicted to pharma because we're
| addicted to toxic food.
| vundercind wrote:
| My point is that skinny populations don't seem to be
| skinnier than the US population due to greater
| genetically-backed willpower (better "configuration"). At
| least, if it's a factor, it's overwhelmed by other
| factors, it seems.
| fragmede wrote:
| hilariously, the toxic food companies are worried that
| ozemic will kill their profits. Maybe the pharma industry
| can fight the food industry conglomerates.
|
| https://www.bloomberg.com/news/articles/2023-10-07/ozempi
| c-f...
|
| https://www.wsj.com/business/ozempic-impact-snack-food-
| compa...
|
| https://www.washingtonpost.com/business/2023/10/09/ozempi
| c-w...
|
| https://www.cnn.com/2023/10/05/investing/ozempic-food-
| compan...
| Chernobog wrote:
| Not to argue for or against Ozempic, but there is a
| difference between what motivated individuals can achieve
| on their own, and what one can expect of the general
| population.
| mock-possum wrote:
| Do you have the time to seek out and keep healthy food? Can
| you afford it? Do you have the executive function and
| impulse control etc to bring to bear the necessary self
| discipline?
|
| You're making some pretty casual assumptions about people's
| abilities.
| vundercind wrote:
| Studies show nothing but high-touch interventions by
| specialists actually works for losing weight and keeping it
| off for a study cohort (i.e. might represent a population-
| level solution).
|
| These are impractically expensive and _still_ less
| effective than one might expect.
|
| Researchers seem to be eager about the promise of
| supplementing the very-best programs they've been able to
| find... with GLP-1 agonists. Because that might finally
| make them _really_ effective.
|
| That's how bad the entire body of _all other solutions
| we've looked at_ is.
| outworlder wrote:
| > You can literally do the same thing by eating a healthy
| diet for 2-4 weeks.
|
| You have been downvoted, but that's true(and supported by
| evidence and science). Statistically, what most people have
| is sugar addiction. Simple carbs in general completely mess
| up your hunger hormones.
|
| The problem is that most people don't know what a healthy
| diet is. The food pyramid isn't it. Drinking a bunch of
| juice isn't it. Cereal is candy. They try "eating healthy",
| fail (not realizing what they are eating isn't healthy at
| all) and give up.
| cthalupa wrote:
| If all it took to get the same feeling of GLP-1 agonists
| was success at the diet for 2-4 weeks, I would have a lot
| less experience being successful at diets for 2-4 weeks. A
| whole lot less.
| mrweasel wrote:
| > GLP-1 agonists can actually modulate the reward pathway
| reducing people's appetite for toxic diets.
|
| There are also studies out showing that people just up their
| sugar intake, so I think the results on how it affects
| peoples diet is still pending. From what I've seen, people
| are eating less, but more of it is junk food and sugar.
|
| I can absolutely see why people would want to be able to just
| take a drug and start losing weight, it's hard. My concern is
| that it takes more than a low body weight to be healthy. You
| still need exercise, and while that's not an effective
| weight-lose solution, it is something that most would add
| when trying to lose weight, and now they're missing out on
| that part. Arguably exercise is more important than your
| weight.
| kelseyfrog wrote:
| > Arguably exercise is more important than your weight
|
| I'm curious to hear the argument
| mrweasel wrote:
| Exercise strengths your cardiovascular system, immune
| system, improves bone strength, builds muscle (which
| helps you as you age, preventing the risk of falling and
| fall related injury), improves mental health, reduces
| stress. If your in good physical shape, it's less of an
| issue if you carry around a little extra fat.
|
| You can still be in bad health, even if your weight is
| spot on, but it's rare that you exercise a lot, but is
| overall unhealthy.
| kelseyfrog wrote:
| In terms of tangible outcomes, it helps you live longer
| or something compared to weight loss? greater reported
| life satisfaction? Or is this more of a personal value?
| akira2501 wrote:
| > chemical intervention is a moral weakness.
|
| As a default it is. And that's what it became. We stopped
| trying any other methods. Come in the door, have a set of
| symptoms that check all the boxes, walk out in 30 minutes
| with a prescription, doctor's office gets a bonus.
| Institutional psychiatric treatment is drugs first actual
| treatment later.
|
| This is a _social_ problem. It should be discussed and
| addressed as such. You should not attempt to pervert this
| concern into an _individual_ issue in an effort to invoke a
| needless moral defense.
| crooked-v wrote:
| > As a default it is.
|
| Why?
| akira2501 wrote:
| Are chemical interventions designed with the best
| outcomes for the patient or the best outcomes for
| society? I suspect it's the latter. It's cheap and if
| you're lucky it's effective. When it goes bad it can ruin
| lives and families. As a _default_ it's a moral weakness.
|
| Is this a solvable problem? Yes, but it's monumental,
| encompassing everything from the way we structure our
| civil society and work life from the forms of food and
| entertainment that we incidentally or directly subsidize.
|
| We accidentally built something gross. It moves really
| fast, though.
| kelseyfrog wrote:
| Just some notes. This would be a lot easy to take this
| seriously if it wasn't seeped in moral purity. It is
| rhetorically unappetizing.
|
| Re-wording it so that you say your end goal was better
| outcomes for people and restructuring society to achieve
| that is a noble goal. It's easier for people to want to
| agree with than being a moral policeman.
| triceratops wrote:
| If it's a social problem then the non-pharmaceutical cure
| is obviously not white-knuckling a diet and exercise
| regimen individually. It needs a holistic, society-level
| solution. More time off work, less car-dependent suburbs,
| more bike lanes and subsidies for bikes, more agricultural
| subsidies for healthy food and less for corn. Realistically
| we aren't going to get those things.
| akira2501 wrote:
| > not white-knuckling a diet and exercise regimen
| individually
|
| Obesity rates have not been constant. There are clearly
| multiple modes to this problem and history suggests that
| this class of people is the minority of the visible
| issue.
|
| > more bike lanes and subsidies for bikes
|
| You don't need this so much as you need roundabouts and
| actual _human_ scale infrastructure in cities. Some
| smaller towns in the midwest got the memo from Europe and
| are starting to adapt easily.
|
| > more agricultural subsidies for healthy food and less
| for corn
|
| I think the amount of subsidy overall is a problem. I
| think we could to take another page from Europe and start
| banning food additives. We can stop classifying highly
| processed foods as foods and instead as desserts and tax
| them appropriately. A lot of this is already in motion.
|
| > Realistically we aren't going to get those things.
|
| We used to have these things. I don't understand your
| position of social excuse couched in social pessimism. So
| instead of addressing the problem just accept that
| pharmaceutical and insurance companies will now enrich
| themselves off this created problem?
|
| You know, we can solve _two_ problems at once, if GLP-1
| has some short term benefit then great, but to plan on it
| existing in the long term for weight management is utter
| madness.
| Karrot_Kream wrote:
| There's a decent amount of evidence that the most toxic thing
| about modern diets is their amounts: calorie counts and such.
| Many things (sugars, ultra-processed foods (ugh I hate the NOVA
| classification), fat, etc) are fine in moderation. The dose
| makes the poison.
| Fernicia wrote:
| Is it fundamentally any different from something like
| toothpaste?
|
| Humans have created a technology (mechanised farming) with a
| side effect we haven't yet evolved to handle (an abundance of
| tasty calories), so it doesn't seem all that strange we would
| fix it with a technology (inhibiting the desire for said
| calories).
| lostmsu wrote:
| I think your statement is very funny. If the drug keeps weight
| in check on a toxic diet and that has the same outcome as
| "healthy life", then is that "healthy life" any more healthy
| then the drug+junkfood combo? Also, what is sad about it?
| dr_dshiv wrote:
| It's not clear to me that this is the case.
|
| People in the Netherlands eat such shit food -- but they are so
| healthy because they move a lot and aren't obese.
|
| I'm not sure that food quality is as important as we sometimes
| hope it is (after all, we pay for quality)
| intothemild wrote:
| I've been on wegovy for almost two years now, and I can attest
| to how much you just DONT want to eat junk anymore. It's one of
| the most commonly talked about things we discuss with other
| users over the last few years. That and lower want to drink,
| and gaining back so much of energy/time due to not having to
| think about food every 3 seconds of the day.
|
| I'm super satisfied just having an apple or two now. The "omg I
| need to eat, ohh a burger" is gone.
| chankstein38 wrote:
| I'm not arguing at all here but just wanted to say, I've
| noticed similar effects just focusing on eating healthier
| over the last few years. I haven't taken anything to help I
| just wanted to stop eating poorly and now adays it's not
| "shove the entire box of cookies in my mouth" it's "have 1
| cookie and don't finish it because it's too rich" and I
| haven't eaten fast food in as long as I can remember. I used
| to see a McDonald's french fry commercial or just think about
| them and need McDonald's. Now I see it and go "ah they were
| good but eh" and move on with my life.
|
| Glad you're seeing benefits like that!
| snarf21 wrote:
| Serious question: Why not make toxic diet illegal or cost
| prohibitive? Lots of manufactured food is designed to be more
| addictive. Then add in constant advertising bombardment
| targeted at kids. Why is there up to double the sugar in US
| bread and soda versus Europe?
| steveBK123 wrote:
| The politics of legislating diet are very fraught, let alone
| the implementation is incredible complicated.
|
| Even blue state dem voters I know used to whinge about
| Michelle Obama and her veggies lol.
| cyberax wrote:
| > basically toxic diet
|
| This is a bullshit term. Even fast food is not "toxic", it's
| just calorie-dense.
|
| I got overweight eating nothing but "healthy" diet because I
| have never _liked_ fast food.
| petesergeant wrote:
| > while most people will still eat a basically toxic diet
|
| It's a pretty sadder fact that people just make these wild
| assertions. Everyone I know (which is about 10 people in real
| life, myself included) who's used a GLP-1 drug found that they
| eat healthier because they've less desire for shittier food.
| outworlder wrote:
| > while most people will still eat a basically toxic diet.
|
| Had to scroll too far to find this. It's a great synergy isn't
| it? The food industry creates calorie concoctions that can
| barely be called food, are dirt cheap to make and rakes in
| profits. People get sick. The pharmaceutical industry sells
| drugs are stupid high profit margins so that people can keep on
| living.
|
| It is not a conspiracy, but it's a good feedback loop for
| corporations. All that money allow them to flood the scientific
| community with their sponsored studies, dominate news
| broadcasts (confusing consumers) and even influence the food
| pyramid, which is almost upside down.
|
| I've been on a slow quest to improve health and lose weight.
| It's really, really slow, far slower than what most people
| would like. But cutting added sugars to zero (including and
| most especially high fructose corn syrup) gave almost immediate
| benefits that kept me going. Sugars (and carbs in general) make
| you retain a lot of water. Cut those, and you'll see a major
| difference in the scale in a couple of weeks. Is it mostly
| water(but not entirely!) Yes. It doesn't matter, our lizard
| brains interpret that as success. That also reduces hunger,
| which is a positive feedback loop.
| jaredwiener wrote:
| FWIW, I was prescribed a GLP-1, but my insurance will not cover
| it. It's incredibly expensive out of pocket.
| gadflyinyoureye wrote:
| Only in the US. Other countries are like 90% less expensive.
| However, Medicare might try to get better deal since the next
| round of deal making can include it since the drug is 7 years
| old.
|
| https://slate.com/technology/2023/07/ozempic-costs-a-lot-it-...
| hombre_fatal wrote:
| What about compounding pharmacies like Hims.com? It's $400/mo
| month to month but $200/mo if you pay a year upfront.
| rootusrootus wrote:
| $400/mo will get you tirzepatide (zepbound), if you're okay
| with semaglutide (ozempic) it'll probably be about half that.
|
| Although tirzepatide just got knocked off the shortage list
| last week so it could become harder to get in compounded
| form.
| gandalfian wrote:
| Seven years, December 2031. That's when the patent expires, the
| kinks and side effects will have been found/ironed out and it
| becomes a cheap plentiful generic. I'm healthy enough to wait.
| apsec112 wrote:
| This compares Ozempic with past drugs, but sales of past drugs
| are almost always limited by demand. I'm not sure there's much to
| learn here for a drug that is limited by supply. Also, this part
| is silly:
|
| "The announced investments across both companies total $32
| billion. GLP-1s were 71% of Novo's revenue in 2023, 16% of
| Lilly's in 2023, and 26% of Lilly's in 2024Q1. If these sales are
| proportional to the manufacturing capacity used to create those
| drugs, then about 40% of Novo and Lilly's combined estimate of
| $45 billion in gross PP&E is for GLP-1s, for a total of $18
| billion; $25 billion would then mean a 140% increase in
| GLP-1-relevant PP&E."
|
| Manufacturing investment is not proportional to sales, because
| there's a fixed cost to making a certain drug regardless of how
| much you sell. If a rare-disease drug will have a few thousand
| patients ever - not uncommon! - you still need to figure out a
| synthesis path for that particular drug, run QC tests on the
| production line, get regulatory approval, etc. Economies of scale
| matter a lot
| (https://en.wikipedia.org/wiki/Experience_curve_effects).
| cubefox wrote:
| And apparently the pure manufacturing cost for Ozempic is
| relatively low:
|
| > the active drug in Ozempic can be produced for about 29 cents
| for a month's supply, or 7.2 cents for a typical weekly dose,
| the research found. It's not cheap to make -- semaglutide costs
| over $70,000 per kilogram. But only a tiny quantity of the drug
| is used in each weekly dose.
|
| > https://fortune.com/europe/2024/03/28/ozempic-maker-novo-
| nor...
|
| I think this makes it likely that strongly ramping up the
| supply is not a major problem.
| rory wrote:
| By chance I just talked to someone with deeper knowledge on
| this and they said the current constraint is actually ramping
| up supply of the delivery mechanism, not the drug.
|
| I have zero expertise on this, but would be curious if anyone
| knows what's special about Ozempic delivery that can't be
| served by a commodity syringe.
| davio wrote:
| hims sells the generic version for a fraction of the price
| but you have to do regular injections
| Someone1234 wrote:
| "hims" is selling Compound Pharmacy drugs, which will be
| made illegal soon. Soon your options will be
| $1000-1500/month from the two big drug companies.
|
| They're meant to have a vial-needle version, but it is
| $600/month and you can only do it for up to 5-months and
| a low max dose. So it isn't a real program, but rather a
| way to avoid critique from legislators.
| _heimdall wrote:
| Why are they making it illegal? Is there an issue with
| the compound, or is it an issue if lobbyists protecting
| the more profitable drug?
| wcfields wrote:
| It's "legal" because of the lack of supply in critical
| medications so the FDA gives a variance to allow compound
| pharmacies to produce/sell critical medications until
| supply issues are resolved.
| EasyMark wrote:
| Seems to me there is a lack of supply for low cost
| semaglutide (and similar). That should be enough for the
| FDA to say "I'll allow it"
| op00to wrote:
| > what's special about Ozempic delivery
|
| People don't want to use a commodity syringe. People are
| scared of needles. The autoinjectors take most of the fear
| out of it.
| courseofaction wrote:
| Teach a man to fish, and you can't charge him obscene
| amounts for fishing to be done for him.
| jaggederest wrote:
| > but would be curious if anyone knows what's special about
| Ozempic delivery that can't be served by a commodity
| syringe.
|
| They can't charge as much. That's basically it. Generic
| semaglutide from compounding pharmacies (which have their
| own issues for sure) is under $150 a month cash-pay these
| days.
|
| The real issue with syringes and self administration is
| that the vast majority of the population are not
| comfortable with it and don't have the diligence to do it
| correctly every time, so you get under/over dosage or
| noncompliance.
|
| That being said, the autoinjector format doesn't really
| solve that problem, it just slightly ameliorates it, in
| exchange for approximately 8x the cost.
| kurthr wrote:
| So basically, 99.8% margin the maximum they can charge
| (at ~15-30cents/mo) or 99.5% margin at $1000/mo for a
| $2.5 injector? Semaglutide has been in production since
| 2012 and approved by the FDA since 2017. There's a real
| chance that specifically as a weight loss drug it's not
| patentable since it was in off label use before the
| patent was filed. That's being argued in the PTO now.
| zahlman wrote:
| >Generic semaglutide from compounding pharmacies (which
| have their own issues for sure) is under $150 a month
| cash-pay these days.
|
| ...Is that supposed to be impressive? I assume you mean
| USD, so that works out to more than I pay for my food.
| Toronto isn't a cheap place to buy food, either.
| jaggederest wrote:
| It is cheap compared to the $1200 a month for the branded
| stuff.
| cubefox wrote:
| > By chance I just talked to someone with deeper knowledge
| on this and they said the current constraint is actually
| ramping up supply of the delivery mechanism, not the drug.
|
| The article says this:
|
| > Surprisingly, the study found that the biggest cost in
| producing Ozempic is not the active medicine, called
| semaglutide, but the disposable pens used to inject it.
| They can be made for no more than $2.83 per month's supply,
| the authors concluded, based on interviews with former
| employees and consultants to injection device
| manufacturers. One Ozempic pen is used weekly and lasts a
| month.
|
| So while the injection pens are significantly more
| expensive than manufacturing the drug itself, they are
| still relatively cheap. So it seems to be not a major
| problem to strongly ramp up production here as well.
|
| Which suggests any supply shortage will be resolved
| relatively quickly. Perhaps in less than a year? Then the
| limiting factor will not be the supply but the market
| price.
| CydeWeys wrote:
| There are also doctors that are prescribing vials of
| semaglutide and commodity needles, and training patients
| to properly dose up and administer the drug via a
| standard needle. There's more to it than the auto-
| injector pens, but not that much more to it. And it does
| bring costs down, which is important to some.
| Alternatively, you can just go to the doctor's office
| weekly and have a nurse there do a traditional injection
| for you (doesn't help as much with costs, but does bypass
| the auto-injector shortage).
| cubefox wrote:
| I agree needles can alleviate the Ozempic shortage,
| though only if Novo Nordisk decides to sell Ozempic
| without pens. But not including pens will hardly reduce
| the price of Ozempic anyway, because pens cost basically
| nothing (estimated USD 2.83 for a month) compared to the
| full price of the drug.
| vessenes wrote:
| Agreed. Don't forget they're spending on next-gen versions of
| these too -- Novo is testing a pill form that's apparently
| twice as effective as semaglutide(!) right now. It's easy to
| imagine that becomes part of many people's January routine --
| stop drinking, take your pills, go to the gym for a month,
| slowly put the weight back on during the year, no problem.
| Dumblydorr wrote:
| Not fully true- orphan drug status exists for rare diseases and
| gives advantages to companies who develop drugs for rare
| conditions. This includes longer exclusivity periods amongst
| other incentives, rendering these categories more feasible
| economically.
| spondylosaurus wrote:
| I'm shocked that TFA doesn't mention the (massive, booming)
| market for compounded semaglutide and tirzepatide. The long-
| term future is uncertain, but since these drugs have been under
| shortage status, third-party pharmacies can legally compound
| them to meet increased demand.
| philipkglass wrote:
| 9 days ago the FDA declared the tirzepatide shortage over,
| though the other popular drugs in this class are still
| eligible for compounding based on shortage status:
|
| https://www.fda.gov/drugs/drug-safety-and-
| availability/fda-c...
| fredgrott wrote:
| for those that do not know there is a herb that targets
| GLP-1...its called Berberine
|
| And yes its over the counter....I currently take one dose per day
| at 1200mg
| aleksiy123 wrote:
| How effective is it?
| wizzwizz4 wrote:
| Source? https://www.mcgill.ca/oss/article/medical-critical-
| thinking/... (2023) disagrees with you:
|
| > Neither is berberine any version of Ozempic, which is an
| analogue of glucagon-like-peptide-1 (GLP-1), a natural hormone
| that regulates blood sugar and helps people feel full.
| Berberine has nothing to do with GLP-1.
|
| > Perhaps the most interesting laboratory finding, given the
| rising global tide of type 2 diabetes, is the control that
| berberine may exert over blood sugar. But there is a problem.
| Berberine is virtually insoluble in water and has low
| intestinal absorption which means it has poor bioavailability.
| [...] Because of berberine's poor bioavailability, supplements
| on the market are likely to be useless. However, some
| derivative of berberine, may yet make it to the physician's
| prescription pad. But it won't be for weight loss.
| zonkerdonker wrote:
| I was able to find this: https://www.sciencedirect.com/scienc
| e/article/abs/pii/S00062....
|
| Apparently most of the effect is due to activation of the
| "bitter taste reception pathways" in the gut. So even though
| it has very low bioavailibility, it can still stimulate GLP-1
| secretion just simply due to its incredible bitterness
| rootusrootus wrote:
| Does it only stimulate GLP-1 in the gut, though? As I
| understand it, most of the positive effects of GLP-1
| agonists are the effect they have on the brain's GLP-1
| system, not the guts.
| philipkglass wrote:
| Interesting.
|
| "Berberine induces GLP-1 secretion through activation of bitter
| taste receptor pathways"
|
| https://www.sciencedirect.com/science/article/pii/S000629521...
|
| But buyer beware when it comes to getting berberine from over-
| the-counter supplements:
|
| "Variability in Potency Among Commercial Preparations of
| Berberine"
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807210/
|
| _Nine of the 15 tested products (60%) failed to meet the
| potency standards of 90% to 110% of labeled content claim, as
| commonly required of pharmaceutical preparations by the U.S.
| Pharmacopeial Convention. Evaluation of the relationship
| between product cost and the measured potency failed to
| demonstrate an association between quality and cost.
| Variability in product quality may significantly contribute to
| inconsistencies in the safety and effectiveness of berberine.
| In addition, the quality of the berberine product cannot be
| inferred from its cost._
|
| Worse still,
|
| "Preparation and Evaluation of Antidiabetic Agents of Berberine
| Organic Acid Salts for Enhancing the Bioavailability"
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337101/
|
| _Berberine--an isoquinoline alkaloid isolated from the rhizome
| of Coptidis rhizome, Cortex phellodendri, and other plant
| species--possesses a variety of pharmacological effects,
| including anti-cancer, anti-hyperglycemic, anti-hyperlipidemic,
| antimicrobial, anti-inflammatory, and antioxidant activities.
| However, its absolute bioavailability is as low as 0.68%. Low
| bioavailability greatly restricts the clinical development of
| berberine._
| rootusrootus wrote:
| I'd think it more likely that it'll be one of the next generation
| drugs, but I do agree with the premise that it will be really
| common.
|
| A few weeks ago I started a low dose of tirzepatide (aka
| Mounjaro, aka Zepbound) and the side effects are interesting.
|
| The biggest negative, which just takes adjustment, is drastically
| lower stomach capacity. Used to be that two eggs and two pieces
| of toast was breakfast. Now I better skip at least one of those
| pieces of toast or I'm going to feel overfull and might get
| reflux as punishment.
|
| But there are some unexpected positives.
|
| Obviously I am eating less. I have to log food not to keep it in
| check, but to make sure I'm eating enough and with the right
| nutrients. There's another possible negative here -- you get a
| lot of hydration from food, so if you start eating less you
| should carefully monitor your fluid intake to allow for that.
|
| But I'm also more focused. Not nearly as distracted. I'm getting
| a lot of things done which I used to just procrastinate on until
| years had passed in some cases. Man, the garage is going to be
| _clean_ and superbly organized in a few weeks.
|
| And my emotions are quieter. Not just the food noise, that was
| expected, but I feel more relaxed. That's not what I expected,
| and I'm pleasantly surprised.
|
| As an aside, what makes this all really noticeable is that it's a
| once-a-week injection, and the peaks and valleys are _very_
| obvious. Saturday is injection day, but Sunday is where it
| _really_ becomes quite noticeable that I took it. Monday-
| Wednesday is cruising altitude and the effects are good but not
| over the top. Thursday I can feel it tapering, and today ...
| well, I 'm looking forward to tomorrow's injection. I might
| switch to a twice-a-week split dose at some point to ease the
| peaks and valleys.
|
| Edit: Before someone asks, yes I have considered there may be
| long term effects. This is a risk, which I've decided I'm okay
| with at my age. Nobody gets to live forever anyway, and I was
| going to end up in an early grave via another route if I _didn
| 't_ do this. "Just eat less and exercise more" is trite. If it
| were _that_ easy, we 'd all be in fantastic shape.
|
| I do hope to taper off at some point if I can figure out an
| alternate strategy for staying lighter. Though I'll miss some of
| the positive side-effects.
| jeffbee wrote:
| > Man, the garage is going to be clean and superbly organized
| in a few weeks.'
|
| Manic behaviors also associated with older, popular diet drugs
| like meth.
| cyberax wrote:
| It's not the manic behavior, but the opposite. GLP-1 agonists
| appear to reduce the impulsive behavior.
| abeppu wrote:
| Does anyone have references on any explanation, or even
| partial explanation, on why this might be the case?
|
| The published stuff I can find seems to be at the level of
| anecdata, scarcely better than "I know a guy who..."
|
| - What people talk about on social media:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669484/
|
| - Some people made large "reckless" life choices:
| https://academic.oup.com/qjmed/advance-article-
| abstract/doi/...
| cyberax wrote:
| > Does anyone have references on any explanation, or even
| partial explanation, on why this might be the case?
|
| Not yet. The effect appears to be real, but it's too soon
| to tell: https://www.science.org/content/blog-
| post/ozempic-and-other-...
|
| From my own anecdata, unnecessary impulsive eating
| probably reinforces the impulsive behavior. You start
| associating impulsive behavior with a reward.
|
| GLP-1 not only removes that, but adds a slight negative
| reinforcement. Impulsive eating no longer brings reward,
| but makes you feel over-full. This can then down-
| regulates the pathways that lead to increased impulsive
| behavior.
| rootusrootus wrote:
| Great description, thanks!
|
| I won't sugarcoat my problems. I _knew_ I wasn 't hungry
| when I'd eat sometimes. I _knew_ it would keep me
| overweight. I _knew_ it wouldn 't even feel great
| afterwards. And yet, more often than not I did it. And
| beat myself up over it _every time_. Very demoralizing,
| even without help from moralizing folks on the internet.
|
| On tirzepatide the impulse is just gone. I feel like I
| can take it or leave it, and since the consequences of
| eating unnecessarily are quickly negative, I just don't
| do it.
| AlanYx wrote:
| There are about a dozen published studies using GLP-1
| analogues in animal models showing reduction in addictive
| behaviors (search for papers by Jerlhag, Leggio and
| Schmidt). The prevailing theory seems to relate to
| dopamine regulation.
| Qem wrote:
| > GLP-1 agonists appear to reduce the impulsive behavior.
|
| Does it reduce sex drive as well?
| firesteelrain wrote:
| No it doesn't but some people have started TRT therapy
| too which will increase testosterone and then sex drive
| too
| swat535 wrote:
| Doesn't losing weight already increases your
| Testostrone?.. people seriously shouldn't get on TRT
| unless they need it medically, once you start it, it's
| for life and also you will be infertile.. (source I am on
| HCG, an alternative to TRT due to its side effects).
| firesteelrain wrote:
| That's correct - you need to be seen by a doctor before
| embarking on TRT. For me, I have no intent of having any
| more kids. Infertile can be reversed.
| rootusrootus wrote:
| TMI, but no.
| rootusrootus wrote:
| I said a few _weeks_ ;-). The garage is pretty big, but not
| _that_ big. It 's going to be gloriously organized in a few
| weeks because I spend a half hour or so in the evenings to
| move the project forward. I'm very relaxed about it. I'm just
| doing exactly what I kept telling myself I should do to make
| the garage as organized as I want, rather than finding pretty
| much anything else to do.
|
| Decades ago I tried phentermine for a couple months. Now
| _that_ was a ride, and you might call the experience closer
| to manic. I was a _machine_. This is not like that.
| noahjk wrote:
| I read the "in a few weeks" totally differently than the
| other reply. In my mind, I was thinking, "wow, you're able
| to plan that far ahead and stay on track??" And now you say
| you're able to accomplish that by dedicating a time block
| per day?! That's superhuman level of control that I can
| only dream of!
| copperx wrote:
| It would be interesting to compare the anxiolytic effects of
| the drug versus the cancer anxiety caused by being on the drug.
|
| The cancer anxiety could be reduced by frequent testing. e.g.,
| having a thyroid ultrasound every 6 months, or a yearly
| abdominal MRI, just to make sure cancer is not brewing.
| arcticbull wrote:
| There's no evidence that GLP-1s cause cancer in any
| meaningful amount, but obesity definitely does. Either way
| the only cancer they found any correlation to was thyroid
| which is one of the most treatable -- over 99% survival
| rates.
| copperx wrote:
| While thyroid cancer is highly treatable, the type of
| thyroid cancer that GLP-1 drugs cause is the rare and
| untreatable variety.
| arcticbull wrote:
| There's no causative relationship. There is a correlation
| in some studies. This is not the same thing. Beyond that,
| some studies have found a very weak association and some
| have found no association at all. To say with this corpus
| of evidence they cause anything is very premature.
|
| This 2024 study showed no increase in risk over 3.9
| years.
|
| https://www.bmj.com/content/385/bmj-2023-078225
| cyberax wrote:
| > There's no causative relationship.
|
| To be fair, GLP-1 drugs cause dose-dependent increase in
| thyroid cancer in mice. But mice are not humans.
| gcr wrote:
| Is cancer anxiety a common response?
|
| I haven't seen any mention of cancer on r/zepbound
| arcticbull wrote:
| > "Just eat less and exercise more" is trite. If it were that
| easy, we'd all be in fantastic shape.
|
| Studies show it just doesn't work.
|
| There was a massive (18,000,000 people) cohort analysis
| published in 2023 that showed the likelihood of someone losing
| 5% of their body weight in any given year was 1 in 11 and the
| likelihood of going from severely obese to normal weight is 1
| in 1667.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407685/
|
| [edit] not to mention for those 1 in 11, the average weight
| regain over 5 years is 80%.
|
| https://www.sciencedirect.com/science/article/pii/S000291652...
| pfdietz wrote:
| I've lost 27 pounds since May (12%). Eliminating most carbs
| and doing lots of walking. I think being on metformin helped.
| jeffbee wrote:
| > and doing lots of walking
|
| If you just teleport a fat guy from Bentonville to
| Manhattan and give him a Metrocard he will lose a pound a
| week. The people who say nobody can lose weight, it's too
| hard, cannot explain why there are macroscale populations
| with lower obesity.
| arcticbull wrote:
| Surely you have a study to support this? Or are we just
| speculating. The problem with this particular area is
| that it's not intuitive, and relying on "common sense"
| guidance is why everyone got fat in the first place.
| randomdata wrote:
| Does it matter? This is a discussion forum, not a
| scientific journal. If you have something more
| informative to add, just do it.
| arcticbull wrote:
| Generally here if you make a claim it's totally fair to
| be asked to substantiate it. I already provided the
| evidence that this individual was wrong, so I'm looking
| to see why they think otherwise. Maybe they'll teach me
| something new.
| randomdata wrote:
| _> Generally here if you make a claim it 's totally fair
| to be asked to substantiate it._
|
| Anything is fair. It is a discussion forum. You can say
| whatever the hell you want. But it is equally
| nonsensical.
|
| _> so I 'm looking to see why they think otherwise. _
|
| You looked for _someone else_ - someone who prepared a
| study - to tell you why it might be otherwise. But if you
| want to talk to someone else, go talk to that someone
| else. If you want to come here, be happy with the people
| who are here. They might actually teach you something
| without having to defer to random other people.
| tikhonj wrote:
| Questioning questionable claims is as much discussion as
| anything else.
| randomdata wrote:
| Questioning the person who made the claim, sure. Get them
| to elaborate. That improves the discussion. But halting
| discussion until they can come up with the words of
| _someone else_ to justify their claim, as seen here, just
| makes you look stupid. If you would rather talk to
| someone else, go talk to someone else instead. At the end
| of the day, all is fair in discussion, so go for it -
| call for someone else to enter the discussion if you
| want. But as all is fair, we 're also going to call out
| your stupidity when you do.
| tikhonj wrote:
| The bit that you're (intentionally?) missing is that this
| is just a polite way of saying "you're full of shit". The
| only person being stupid here is the person making strong
| empirical claims without qualifying them or providing
| supporting evidence.
|
| I could see a reasonable complaint that asking for
| studies is being passive-aggressive, but it's the sort of
| passive-aggressive that both helps keep the discussion
| more civil _and_ leaves room to actually substantiate the
| original claims (that is, it 's actively _better_ for
| keeping the discussion going!). Just saying "lol, no,
| wrong" kills the discussion far more than talking about
| (lack of) evidence.
| randomdata wrote:
| _> The bit that you 're (intentionally?) missing is that
| this is just a polite way of saying "you're full of
| shit"._
|
| If someone is full of shit, and assuming you care, then
| logically you would put in the effort to fix their
| misunderstanding, not tell them off. Exclaiming that
| someone is "full of shit", politely or not, is stupid. If
| you don't care, then why not own it? Don't care.
|
| _> The only person being stupid here is the person
| making strong empirical claims without qualifying them or
| providing supporting evidence._
|
| There can be more than one stupid party involved.
|
| _> I could see a reasonable complaint that asking for
| studies is being passive-aggressive_
|
| It is just straight up nonsensical. I get that is was
| only ever a silly meme and always understood to be
| nonsensical, but a meme that has become quite tired. It
| was funny 20 years ago, perhaps, but at this point it is
| time to lay it to rest. I mean, anything goes in
| discussion. If you still think it is edgy, go for it. But
| the rest of us will still think it is stupid.
| SketchySeaBeast wrote:
| I'm taking a moment to enjoy your username in the context
| of this back and forth.
| connicpu wrote:
| "It's too hard" includes "It's too hard to just magically
| change the environmental factors making it difficult for
| this specific person". We can't just magically move every
| obese person to NYC, and unwalkable car-dependent
| infrastructure cannot be fixed overnight either, even if
| the people living there all decided to vote for
| politicians who would legitimately work towards making
| that happen (still seems unlikely). Unless and until we
| work towards fixing the societal problems that created
| the obesity crisis in the first place, we still need
| short term solutions for the next couple decades at
| least.
| rootusrootus wrote:
| Those same populations are gaining weight at a trajectory
| that is behind the US but still headed the same
| direction. AFAIK most western European nations have a
| majority of people overweight, with 20-25% obese. This is
| less than the US (though it's very regional within the
| US), but you don't get to brag about a 1-in-4 obesity
| rate.
| mmsc wrote:
| >This is less than the US (though it's very regional
| within the US), but you don't get to brag about a 1-in-4
| obesity rate.
|
| Are you sure?
|
| >In 2023, over 35 percent of adults in the Netherlands
| were classed as overweight, meaning they had a body mass
| index (BMI)of between 25 and 30. Furthermore, just under
| 16 percent of adults were obese
|
| >47 percent of French adults were overweight, of which 17
| percent suffered from obesity
|
| >49% of the Belgian population has overweight, of which
| 18% have obesity.
|
| >Spain: 43% of adults aged 18 years and over were
| overweight and 16% were living with obesity
|
| >46.6% of women and 60.5% of men in Germany are affected
| by overweight (including obesity). Nearly one-fifth of
| adults (19%) have obesity.
|
| Looks like it's actually 1-in-5.
| rootusrootus wrote:
| For the purposes of this discussion, I will take your
| numbers as truth and run with it.
|
| Are you arguing that 1:5 is good, but 1:4 is bad?
|
| The only large populations of people in the world that
| aren't quite fat are southeast Asians. And this is fairly
| accurate whether they leave in southeast Asia or in the
| US or western Europe. Not 1:5, closer to 1:20 or in one
| case 1:50.
|
| Even then, southeast Asian obesity rates are climbing.
| The US may have led the pack because of a consistently
| high standard of living, but I don't see any indication
| that there are macroscale populations anywhere in the
| world keeping the disease at bay.
| mmsc wrote:
| >Are you arguing that 1:5 is good, but 1:4 is bad?
|
| No, I'm saying that 1:4 is something to brag about, and
| 1:5 is even better.
| dmonitor wrote:
| Giving fat guys ozempic is significantly easier than
| teleporting them all to Manhattan
| CydeWeys wrote:
| Realistically this treatment is just not available to
| most people (for the simple reason that there are way too
| few non-car-dependent cities in the US, and the ones that
| there are are super expensive). But GLP1 agonists are
| available to most people.
| rootusrootus wrote:
| I did that in 2020. May through November. 40 pounds off.
| Then I sprained my ankle. I apologize for being negative,
| but come back in a year and let us know how it's going.
| Many, many people can lose 10%, 20%, even 30% of their body
| weight with concerted effort. Works for a year or maybe
| two. It's actually pretty easy, to be honest, most people
| who've done it will agree with me.
| crooked-v wrote:
| I had the same kind of experience. Not as dramatic as
| that, but six months of careful dieting lost weight, but
| then within a month after I stopped calorie-counting I
| was back at the same original slightly-overweight weight
| I had previously plateaued at.
| pfdietz wrote:
| Not going to claim that won't happen.
| patmcc wrote:
| >>>Studies show it just doesn't work.
|
| It's not that "eat less and exercise more" doesn't work, it's
| that nobody does it, because it's really, really hard.
|
| Calories in/Calories out is both completely true and
| completely useless for actual humans.
|
| edit: that's unfair, mostly useless
| petesergeant wrote:
| The best way to stop smoking is to never have another
| cigarette!
| logicchains wrote:
| >It's not that "eat less and exercise more" doesn't work,
| it's that nobody does it
|
| There are plenty of examples of people who've managed to
| lose weight through diet and exercise, it's not "nobody".
| Sure it's a small % success rate, but that's because it's
| not easy. Just like squatting or deadlifting 300 lbs, it's
| not easy to get there, but the vast majority of humans
| could if they decided to put the time and effort into it.
| arcticbull wrote:
| Would you apply the same analysis to people with
| depression who cured their depression by smiling more?
| It's not zero, it's just very hard. Ultimately both are
| chronic issues of the central nervous system. We know
| GLP-1s act on the GABAergic central nervous system.
| patmcc wrote:
| Sure, I don't mean _literally_ nobody, just 'nobody' in
| the statistical sense - from the comment I replied to,
| "the likelihood of going from severely obese to normal
| weight is 1 in 1667."
| gensym wrote:
| I'm one of those examples. I've never been obese or
| really even overweight, but mid-2023, I noticed my
| clothes were no longer fitting, and I decided to take off
| some weight. I lost 20 pounds over the course a a few
| months and have managed to keep it off since. Body scans
| aren't accurate, but the 1 scan I took after losing the
| weight put me at 13% body fat.
|
| It's one of the hardest things I've done. I'm no stranger
| to hard physical things - I've run marathons, raced
| cyclocross, done daily bike commuting through several
| Chicago winters, and I'd rate the weight loss as up
| harder than all of those. At the risk sounding too
| hubristic - if that's the effort it takes to lose weight,
| doing so is beyond the abilities of large swaths of the
| population. Not to mention that I have the time and
| financial resources to weigh my food, buy foods that were
| optimal for my diet (so much yogurt and chicken!), etc.
|
| (As a side note, exercise isn't a very good way to lose
| weight in my experience. It's valuable to do for all
| sorts of other reasons, but I actually gained weight when
| training for my first marathon, while running 60-70
| miles/week).
| Izkata wrote:
| > As a side note, exercise isn't a very good way to lose
| weight in my experience.
|
| Generally people who don't normally exercise are going to
| gain muscle faster than they lose fat. This was the
| origin of HAES before it got corrupted: _Health_ At Every
| Size, not "Healthy". Encouragement to keep going because
| with exercise you'll get healthier even if you're not
| losing weight.
|
| Also, by weight, muscle burns more calories than fat just
| by existing. Personally I think that's where most of the
| weight loss attributed to exercise comes from, rather
| than the exercise itself. You have to gain the muscle
| first to actually burn more calories.
| stevenAthompson wrote:
| Right. It works, it isn't sustainable because it doesn't
| just take effort it takes effort multiplied by time (effort
| x time = permanent weight loss).
|
| Obviously, even a small amount of effort becomes impossible
| when you multiply it by "forever".
| wilburTheDog wrote:
| That's not a valid argument, though. Firstly nobody lives
| forever. Second you don't have to exert all the effort at
| once, so the totality of effort doesn't matter. At any
| given time you just have to decide whether to have the
| snickers bar or the apple. And that's not an impossible
| effort. We don't live our entire lives all at once. We
| just have to be present for one moment at a time.
|
| Edit: In my opinion it's hard for two reasons. We have
| cravings for high calorie foods. And no one candy bar
| will make you fat, so it's easy to think "I'll exercise
| more tomorrow to make up for this indulgence." But then
| you don't, because that's hard too.
| stevenAthompson wrote:
| > At any given time you just have to decide whether to
| have the snickers bar or the apple.
|
| No, you have to decide to even think about the difference
| between them instead of thinking about something in your
| life that feels more important. It's a sort of cognitive
| opportunity cost. You have to consciously think about
| food (instead of something useful) forever, because your
| body's instincts are telling you to do the wrong thing
| and you need your rational mind to overrule it.
|
| So for the rest of your life, every day, until you die
| you must decide to stop and expend effort making that
| decision instead of thinking about work, family,
| politics, or writing a new bit of code that will change
| the world. Most human beings can do it for a while, but
| not forever. The only way to do it forever is to get your
| body chemistry on your side and reduce that cognitive
| load.
| jodrellblank wrote:
| > " _The only way to do it forever is to get your body
| chemistry on your side and reduce that cognitive load._ "
|
| That's how all creatures in the wild do it. That's how
| humans did it for the past quarter million years. And all
| creatures did it for the past hundred million years.
| Wait, no, it isn't. Then there must be another way. A way
| that doesn't involve manipulative abusive capitalists and
| advertisers destroying health in the name of profit while
| selling it as freedom.
|
| > " _or the rest of your life, every day, until you die
| you must decide to stop and expend effort making that
| decision instead of thinking about work, family,
| politics, or_ "
|
| How much does that lifestyle sound like freedom to you?
| stevenAthompson wrote:
| >That's how all creatures in the wild do it... Wait, no,
| it isn't.
|
| Neither creatures in the wild, or primitive man, have
| access to unlimited quantities of calorie dense foods. We
| could go back to that lifestyle, but billions would have
| to die and the overall human lifespan would decrease
| rather than increasing.
|
| I think I'd rather take a perfectly safe drug than go
| back to wiping with leaves and hunting for worm riddled
| meat.
|
| > How much does that lifestyle sound like freedom to you?
|
| I'm not even sure I understand which lifestyle you're
| asking about here, but if you mean the modern lifestyle
| then it's certainly more free than the lives primitive
| man had. "Might makes right" was the rule of the land
| back then, and contrary to your imagination, you probably
| wouldn't have been the mightiest. Certainly not forever.
|
| Hell, it's more free now than the lives most of our
| grandparents had. 50 years ago about half of all white
| people surveyed said they'd move away if a black person
| bought a house in their neighborhood, and gay people were
| routinely murdered for existing.
|
| There were no "good old days", and Stardew Valley is just
| a game.
| jodrellblank wrote:
| > " _Neither creatures in the wild, or primitive man,
| have access to unlimited quantities of calorie dense
| foods._ "
|
| And just like that, you've come up with another way.
|
| > " _I think I 'd rather take a perfectly safe drug than
| go back to wiping with leaves and hunting for worm
| riddled meat._"
|
| That is some ridiculously hyperbolic panicked
| scaremongering at the idea of banning Coca Cola. I have
| literally no idea how restricting the unlimited calorie
| dense foods available would lead to hating black people
| and murdering gay people, but it's some more hyperbolic
| commentary.
|
| > " _I 'm not even sure I understand which lifestyle
| you're asking about here_"
|
| The one I mentioned. Comparing the "free" lifestyle where
| you have adverts for Coca-Cola shoved into your face 24/7
| along with adverts selling you a drug to help you ignore
| the Coca-Cola adverts. Vs. "non-free" where Coca-Cola
| isn't available for sale and you just don't think about
| it because you've never had it and don't miss it, and you
| go about your life doing the things you care about
| instead.
| stevenAthompson wrote:
| I interpreted your original comment differently. Based on
| the votes so did others. At no point did you suggest
| banning Coca-Cola, or otherwise limiting calorie dense
| foods. Instead it seemed that you were advocating a
| return to some mythical past when food was more like it
| is for wild animals.
|
| I wonder if you confused this thread with another? Or
| maybe your sarcasm was misinterpreted?
| card_zero wrote:
| > Firstly nobody lives forever
|
| Lose weight permanently through cremation?
| gcr wrote:
| Giving whole new meaning to burning those carbs!
| mrweasel wrote:
| Precisely, the point of Ozempic (or rather Wegovy, Ozempic
| is for type-1 diabetes) is that it reduces your appetite,
| making it easier to eat less.
|
| One of the studies done with Wegovy showed that people lost
| 15% of their body mass in a year, but they also eat 500
| Calories less and exercised for 2.5 hours a week.
| jnwatson wrote:
| Wait, Wegovy makes people exercise more?
| crooked-v wrote:
| That's probably counting 'light exercise', aka walking
| around. That works out to 20 minutes a day, so it could
| just be the side effect of people being lighter and so
| walking places being more comfortable.
| mrweasel wrote:
| Oh, no sorry, the study I read had people on Wegovy, but
| it also had them exercise 2.5 hours per week at the same
| time.
|
| The point was that the 15% weight lose in a year is in
| the high end of what you can expect, especially if you
| change nothing else.
| odo1242 wrote:
| Weight gain makes it harder to exercise. In any
| particular day, eating more also makes exercise harder
| (because it tanks your energy levels).
|
| This is especially true if you count light exercise.
| Scoundreller wrote:
| Being full of food also makes it hard to exercise.
| rblatz wrote:
| It's hard to exercise when you are overweight. It puts
| more strain on your joints, makes injury more likely, and
| it's all around harder.
|
| Maybe there is a path to using these drugs in a manner to
| get people healthier so they can exercise more, establish
| good habits and taper down.
| rstupek wrote:
| Correction type-2 diabetes not type-1
| mrweasel wrote:
| Yes, sorry, I misread when I looked it up. You're
| correct, it's for type 2.
| Schiendelman wrote:
| It's important to go back and edit your comment so the
| misinformation is gone.
| mrweasel wrote:
| Honestly I disagree, edits are for spelling and wording.
| It's important to not edit the content of comments, so
| that follow up comments and their context remain the
| same.
| _heimdall wrote:
| It'd be more helpful for edits to be appended to a
| comment, allowing context of the conversation to still
| make sense.
|
| Misinformation is also going to be much overused and
| meaningless if used for situations like a simple mistake.
| The commenter just misread something - branding it as
| misinformation seems to imply intent, otherwise why
| wouldn't you just call it a mistake?
| opo wrote:
| >...Ozempic is for type-1 diabetes
|
| At the present time, Ozempic is not approved for Type 1
| diabetes:
|
| >...Ozempic(r) is not for use in people with type 1
| diabetes.
|
| https://www.ozempic.com
|
| Compared with Type 2, with Type 1 diabetes there are
| other risks that could occur:
|
| >...While medications such as GLP-1 receptor agonists
| (Ozempic, Wegovy) and SGLT-2 inhibitors (Jardiance,
| Farxiga) demonstrated powerful benefits, they quickly
| were determined to pose too much of a liability for
| pharmaceutical companies or regulators due to concerns
| about safety. Specifically, GLP-1s can increase the risk
| of hypoglycemia (low blood sugar) and SGLT-2s can raise
| the risk of a serious, life-threatening complication
| called diabetic ketoacidosis (DKA).
|
| https://diatribe.org/diabetes-medications/why-diabetes-
| mirac...
| blargey wrote:
| People chanting "If everyone just did X, Y wouldn't be a
| problem!" without seriously addressing why everyone doesn't
| just do X already, or making a serious proposal for how
| everyone is going to just do X from now on.
|
| A phenomenon not limited to dieting.
| brianmcc wrote:
| Yep. When 1 or 10 or 100 people do a thing, it's a "them"
| issue. When 100,000,000+ do a thing - it's a wider issue,
| and asking those 100,000,000 to do it differently just
| isn't a useful strategy.
| mortos wrote:
| In another vein, if my bank account is $100 short, that's
| my problem. If my account is $1m short, that's the bank's
| problem.
|
| Considering it's a societal wide problem, society at
| large ought to care about resolving it. It's incredibly
| expensive otherwise to treat chronic, lifelong obesity.
| zahlman wrote:
| I don't know people who just give the "trite" advice
| without any actual consideration of the difficulty.
|
| I do see a lot of people ITT who were accused of doing so
| but who aren't actually doing so.
|
| And I've known quite a few people who get really annoyed
| at constantly having to hear about how impossible it is
| to do things that they've personally actually done.
| borroka wrote:
| Given that a few decades ago obesity and overweight rates
| were nowhere near what they are today, this shows that a
| large part of the population is weak, fragile, and not very
| interested in their well-being.
|
| I want to emphasize that a few decades ago, people were
| much thinner in the Western world and did not hate their
| lives because they could not eat a triple cheeseburger, go
| hungry constantly, or feel physically deprived. Those were
| my parents and my grandparents, I know them.
|
| But if you show them hyper-caloric food that makes them
| feel like crap, they can't say no. It's disappointing. And
| the same can be said for addiction to social media,
| horrible TV series, and constant music everywhere.
| cortesoft wrote:
| Do you think it is because the people before were
| mentally stronger? No, it is because they lived in a
| different environment. If you were to transport those
| people from decades ago to today, the same portion of
| them would become obese.
| borroka wrote:
| That's what I'm saying. It's not that people were
| stronger then, it's that, as many times throughout life,
| traits are revealed by circumstances, there's nothing
| particularly physiological about feeling the need to eat
| like hippopotamuses that have been deprived of food for
| months.
|
| The unattractive, low-status man (or woman) has less
| trouble remaining faithful than the handsome, high-status
| man (or woman). Not because they are more virtuous, but
| because they are not as exposed to temptation. But fewer
| people justify the unfaithful than the "big eater." And
| that's something society and culture have decided, for
| now.
| freeone3000 wrote:
| They are the same people now that they were then.
| Humanity has not become any more weak, fragile, or
| uninterested in their well-being -- it has simply become
| harder to resist. TV was appointment viewing and cut off
| late at night. Before the walkman, there wasn't much
| option for music everywhere (the scourge was newspaper-
| readers! but the paper is only so long). And that triple
| cheeseburger today wasn't acceptable or _available_ to
| eat unless you made it yourself. Healthy eating being
| hard is a product of collective decisions to _make_ it
| hard.
| FuriouslyAdrift wrote:
| We used to smoke a lot (an appetite suppressant and mood
| stabilizer) and also worked physical jobs in factories or
| farms.
|
| Service jobs are not conducive to good health.
| borroka wrote:
| By looking at the size and bellies of construction
| workers, farmers, and people doing all sorts of jobs with
| significant physical activity, one cannot find much
| support for this hypothesis.
| FuriouslyAdrift wrote:
| Just look any picture from the 60's 70's or 80's...
| everyone was skinny
| borroka wrote:
| Back in the day, (almost) everybody was not fat, from the
| academically inclined to the construction worker. Today,
| many are overweight, from the professor to the
| agricultural worker. There used to be more walking, which
| increased caloric expenditure by 300-700 kcal per day,
| although sport and recreational physical activity was
| limited to the young.
|
| The main problems have been the easy availability of
| cheap and tasty calories, combined with a surprisingly
| low resistance to the ingestion of those calories.
| Izkata wrote:
| > But if you show them hyper-caloric food that makes them
| feel like crap, they can't say no.
|
| You're looking for "hyperpalatable foods", not hyper-
| caloric. They're related but distinct.
| gmerc wrote:
| This shows no such thing.
|
| It shows what it shows.
|
| What the explanation is, that actually requires research.
| Anything from new food additives, changed lifestyle
| habits forced by the pandemic, increased chronic stress,
| screen addiction compromising other opportunities to be
| active, less walkable neighborhoods, more elevators,
| higher calorie diet, cost increase in healthy diet to
| just name a fraction of possible factors.
| borroka wrote:
| Or, more simply, many eat like there is no tomorrow
| because food is easily available, cheap, and the calories
| very palatable.
| EasyMark wrote:
| Or that the situation was different, advertisers hadn't
| mastered the 24/7 cycle of selling easy junk food in both
| home form and fast food form. Every generation thinks
| they're superior to the new generation and says "why
| don't they just.... " when a new generational problem
| comes up. People screaming out against ozempic and
| friends are just angry that maybe it does work well
| enough and that people don't have to struggle for once.
| Our brains weren't built for our modern life style. It
| used to be that people virtually had lots of experience
| eating Whole Foods, TV was relatively new, parental
| guidance on "that's junk food, you can have a little not
| a lot", our jobs weren't built around screens and pecking
| on keyboards, bombarded by emails and phone calls even
| after we go home via 1 hour commute each way. It's easy
| to say "you're all a bunch of lazy bums" but it's also
| lazy and not true.
| CooCooCaCha wrote:
| Eating less and exercising more does work, in fact that is
| how you lose weight. The problem is doing it consistently
| which is what these drugs help with.
| thfuran wrote:
| Yes, they clearly mean that it doesn't work at a societal
| level. If you take a human and force them to exercise more
| and eat less, they're going to lose weight. And everyone
| knows that, but pretty much every modern society is
| increasingly overweight. Ergo, "it doesn't work".
| CooCooCaCha wrote:
| No, everyone does not know that. That's why the phrasing
| is harmful.
| lukasb wrote:
| Are there any studies that look at body fat % instead of
| weight? I don't care how much I weigh.
| adrian_b wrote:
| A good proxy for body fat %, especially for males, is the
| waist circumference / hip circumference ratio.
|
| See e.g.
|
| https://en.wikipedia.org/wiki/Waist%E2%80%93hip_ratio
|
| for recommended values.
| potta_coffee wrote:
| It would work if people would actually do it. It 100% works.
| Human nature is such that people would rather take a drug
| than change their lifestyle. I've done it myself but it
| requires a complete realignment of lifestyle to make lasting
| change.
| icedchai wrote:
| Another problem is not doing it enough. Walking a couple
| miles once a week isn't going to do much. You have to make
| it a habit, part of your routine, and do it every day.
| arcticbull wrote:
| Also not only is your body very efficient at
| walking/running (losing 10lbs of fat requires an average
| person to run from SF to LA) there's evidence of a
| constrained total energy expenditure model. If you try
| and create a large caloric deficit through exercise you
| become more efficient at the exercise (so each
| incremental step costs less calories) and your metabolism
| slows down (and your NEAT - non exercise activity
| thermogenesis - levels drop) to conserve energy for you
| to expend on exercise.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803033/
| asib wrote:
| In 2018 I did an Ironman triathlon. Across 2020 and 2021 I
| cycled over 20,000 miles. I cycled 200 miles on the hottest
| day of 2022 in the UK. In 2021 I cycled 200 miles in under
| 12 hours. In 2023 I ran over 10 half marathons. You simply
| cannot tell me I didn't completely realign my lifestyle or
| that I'm not determined.
|
| At my lightest in 2023, I weighed 60kg. Currently I weigh
| over 95kg. I don't know what else people who hold your view
| can be told to convince them this problem is not one of
| willpower. I have the capacity to suffer. I've given up
| smoking. There is no escape from food.
| manfre wrote:
| You described a lot of physical activities, but diet
| controls your weight. It's natural to have more of an
| appetite with increased activity. It's also normal to
| increase your weight a bit due to increased muscle mass.
| asib wrote:
| I'm trying to demonstrate that I'm not this ridiculous
| (and frankly grossly reductive) caricature of the
| overweight slob. And yet I still struggle with food. So
| maybe let's drop that notion altogether, because it's not
| at all helpful.
|
| The extra weight is not muscle, to be clear.
| SketchySeaBeast wrote:
| Yup. I lost 70 lbs in 2017, and I ran my first marathon
| last month. I'm going out to run a half on Sunday because
| that's just what I do now, it's nothing to go out and
| enjoy myself for 2 hours. I'm fit, I know how to lose
| weight, I know how to be in the suck but I know that this
| coming winter I'm going to have to fight to keep a decent
| weight as I fight stress and the holidays. The battle
| never ever stops and it's exhausting.
| GeoAtreides wrote:
| >There is no escape from food.
|
| Ah, but what is food?
|
| A cake made with sugar, flour, and butter will have a
| different impact than the equivalent number of calories
| in blueberries
|
| Eggs and butter will make you feel different and will be
| treated different by your body than white bread and
| peanut butter and jelly
|
| food is too general a term, it encompasses too many very
| different things
| icedchai wrote:
| Of course, it "doesn't work" because people don't keep it up.
| I started exercising regularly during covid and didn't stop.
| I cut out all the soda. It works.
| aantix wrote:
| Report back in 10, 15 and 20 years.
|
| Likely, you will at some point revert to unhealthy habits
| and become fat again.
|
| Long-term weight loss success numbers are abysmal.
| doublepg23 wrote:
| So we should be on drugs the rest of our lives?
| soulbadguy wrote:
| Aren't we already ?
| aantix wrote:
| Many embrace it.
|
| Testosterone replacement therapy, highly refined protein
| powders, nootropics, etc.
|
| We're all trying to make the best of what's given, revert
| mistakes, live longer.
|
| All options are on the table.
| arcticbull wrote:
| We're on fluoride from the water our entries lives,
| iodine in the salt and various B vitamins, iron and
| calcium in the flour. Why stop there? This has been an
| overwhelming coup for public health.
| WorkerBee28474 wrote:
| I dropped from the mid 300s 10-15 years ago to 260-ish
| these days. It fluctuates from 250 to 280 over time, but
| keeping off weight long-term by changing diet is very
| much doable.
| rootusrootus wrote:
| > 250 to 280
|
| That should be very doable for most people. 250 is
| overweight for everyone under 7 feet tall, and 280 is
| obese for everyone under 6 foot 9 inches (that's about
| 99.997% of the population, if my data source is correct).
| For the vast, vast majority of people 350 pounds would be
| somewhere in the mid-40s BMI.
| nahnahno wrote:
| This is so stupid.
|
| If you want to not be fat, exercise and eat fewer
| calories. Full stop.
|
| The fact that a certain group of individuals don't have
| that self control is just evidence that education and
| public health have a place. Drugs won't solve that.
|
| These drugs are needed for people with metabolic
| disorders caused by years of food abuse or poor genetics.
| It's not a population wide solution.
| arcticbull wrote:
| "This is so stupid, if you want to stop smoking put down
| the cigarette! Full stop."
|
| Like (a) no shit and (b) the question is why can't
| people. Because we know objectively they can't.
|
| The drugs work by literally solving your self control
| issue, and to such an extent it works beyond just food.
| dalyons wrote:
| We have 50+ years of incontrovertible evidence that that
| advice doesn't work for the overwhelming majority of
| people. "Just have self control" is the stupid take imho.
| avidiax wrote:
| A meta-analysis of 29 long term weight loss studies[1]
| found:
|
| > By 5 years, more than 80% of lost weight was regained
|
| I think a much better hypothesis is that CICO does work,
| physically, but there are metabolic, hormonal and mental
| factors that either predispose towards obesity or make it
| difficult to escape.
|
| It's a bit like telling gambling addicts to "just stop
| gambling" or depressed people to "lighten up".
|
| And along comes GLP-1 drugs, where obese people find it
| easy to lose weight, find new motivation for life, etc.
| The GLP-1s aren't increasing metabolism, nor are they
| making people exercise, nor are they making food less
| available. Yet somehow, a hormonal mediation is greatly
| successful, hmm.
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/
| oremolten wrote:
| it's interesting you state "Studies show it just doesn't
| work." While we are commenting on an article about a drug
| which makes you feel less hungry, there by "eating less". The
| drug doesn't make you use more calories, it simply "makes"
| you EAT LESS. Eating less(calories) than your body uses
| consistently for duration is literally the only way you can
| lose weight. (outside of literally losing limbs, or surgery
| to remove mass) Exercise only augments the process, it all
| comes back down to EATING LESS(calories).
| soulbadguy wrote:
| "Telling people to eat less" doesn't work the same way
| telling people to relax doesn't work. It assumes that
| relaxing is under voluntary control.
|
| To bring it back food, the issue is not the eating, the
| core issue is the hunger causing the eating and that's what
| the medication is addressing.
|
| The people you think are eating ea
| vessenes wrote:
| There are a number of pathways these drugs hit - dopamine
| receptors, they slow processing of food, and in
| tirzepatide's case at least increase insulin response.
| They're not just small portions in a shot.
|
| I take "Studies show it just doesn't work" to mean "Studies
| show telling people to eat less and exercise more
| definitely doesn't work," as opposed to "caloric deficits
| don't work".
| AtlasBarfed wrote:
| People need to understand what activity / exercise really is.
| The desperation of the medical establishment to get people to
| do ANY exercise meant the general advice is watered down.
|
| It's the doom of the statistical distribution. Good outcomes
| are defined in relative terms on the bell curve, not on
| absolute performance which exercise is actually suited for.
|
| In days of manual labor jobs and lots of walking, people
| likely burned 1500-4000 calories more per day than sedentary
| modern lifestyles. I can imagine farmers back in the days of
| 12-hour days of physical labor may burn 5000 or 6,000
| calories. A pound of fat is 3500 calories.
|
| Meanwhile, people that are generally following some 20
| minutes of exercise five times a week, regimen of the medical
| establishment are likely really only burning about 300 to 400
| calories tops in those 20 minutes sessions, if they even do
| that.
|
| For the sake of argument, we're going to ignore the basal
| metabolic advantages of people that are burning an extra
| 1,500 to 3000 calories per day and the stimulated muscle
| growth that comes with it.
|
| People back in olden days just on activity were burning a
| third to a half a pound extra of fat per day in terms of
| energy.
|
| Meanwhile, modern people who "exercise" are burning maybe a
| tenth of a pound. Only when you get to "athletes" that are
| "training" do you get to the calorie burns that people's
| lives used to entail.
|
| So it's important to keep in mind when people say exercise is
| ineffective in weight loss that they really are talking about
| very minor amounts of added activity by by modern medical
| standards.
|
| Exercise is extremely effective at limiting weight if you get
| to what I call the 1000 calorie Hammer, where your exercise
| is adding an extra thousand calories or more per day to your
| activity. And you're simultaneously not going nuts on your
| diet.
|
| A 1000 calories is a considerable amount of activity. For a
| 180 lb man, that's 4000 yards of swimming, 7 miles of
| running, or 25-30 miles of biking.
|
| If you are a 120 lb woman, increase those distances by 50%.
| Most people consider those loads to be exercise obsessives,
| but practically that's what's necessary in order to employ
| exercise as a usable means for weight control and surviving
| the corn syrup world we're in
| rootusrootus wrote:
| > In days of manual labor jobs and lots of walking, people
| likely burned 1500-4000 calories more per day than
| sedentary modern lifestyles.
|
| Hasn't this idea been studied using modern-but-primitive
| groups of people who still live much as they have for
| thousands of years? Their bodies are quite efficient and
| they do not burn substantially more calories than
| "civilized" humans in regular society do.
| klooney wrote:
| Studying pre agriculture societies doesn't say anything
| about agriculture labor in the 1940s, which is what the
| grandparent comment was about.
|
| That said, modern farmworkers in my town are mostly
| overweight, for the same reasons as everyone else.
| jart wrote:
| Finally someone posting something that makes sense. I have
| hormonal issues that make me predisposed to being
| overweight. When I lived in New York, I was able to keep
| the pounds off by walking 20 miles per day. That's how evil
| my body is. That I would literally have to draw green
| polygons over Manhattan for five hours a day to not be
| overweight. I stopped doing that when I moved to the Bay
| Area because it's not as much fun to walk around here. So
| I'm very excited about Ozempic since it'd be nice to be
| able to be able to keep the weight off and get most of
| those five hours back.
| I_AM_A_SMURF wrote:
| I used to do a hard hike every week which burned around
| 1000 calories. You're not doing anything else that day
| unless you keep this up for a very long time.
|
| But yes, great way to lose weight I agree, just not
| practical for a lot of people.
| AtlasBarfed wrote:
| hiking is probably a bit better, but walking only burns
| 2/3s the calories that running does for a given unit of
| distance.
|
| So a 190lb man burns 150 calories for running a mile, but
| only 100 calories for walking it. It will take about 20
| minutes to walk a mile, and about 10 minutes to run one.
|
| So this relates to the original complaint about exercise
| 20 minutes a couple times a week: if you walk 20 minutes,
| you've burned... 100 calories.
|
| A 1000 calorie hike is probably 10+ miles, and that's
| about 200 minutes. 3 hours and 20 minutes! Yup, quite the
| time commitment, however if you ran 7 miles it would only
| take about an hour.
| rybosworld wrote:
| > Studies show it just doesn't work.
|
| Eating less and exercising most certainly does work, if the
| individual sticks to the routine.
|
| I do agree it's difficult to stick to a routine because our
| modern lives are demanding and so we compromise by eating
| fast food and avoid going to the gym.
|
| I think the exercise paradox video recently put out by
| Kurzgesagt has been a net negative for how people think about
| diet and exercise. The paper the video is based on is highly
| flawed.
|
| That paper has a few major problems but these are the
| biggest:
|
| 1) The authors didn't control for body mass. The Hadza and
| Bolivians burned 52kcal per kg of body weight. Americans
| burned only 38kcal per kg of body weight. That is: the active
| groups burned significantly more calories than the inactive
| groups, on a pound-for-pound basis.
|
| 2) The active groups were defined as such because they walked
| ~12km per day. This is significant because the human body is
| exceptionally efficient at walking. It is certainly true that
| over a comparable span of time, you will burn less calories
| walking than you would running, or lifting weights.
|
| GLP-1's are miracle drugs and people should take them if they
| at are high risk for obesity-related diseases.
|
| But diet and exercise certainly do aid weight loss, and will
| have fewer negative side effects than a GLP-1 drug.
|
| https://www.germanjournalsportsmedicine.com/archive/archive-.
| ..
| bdndndndbve wrote:
| Homeostasis is a powerful force. Once you gain weight your
| body has a tendency to keep it, and overcoming that to
| establish a new equilibrium is difficult and uncomfortable.
| bozhark wrote:
| This is absurd.
|
| Caloric intake and outtake is just that.
| rootusrootus wrote:
| That is a simplistic description which is superficially
| true. The body, however, is quite a bit more complicated
| than that. _Especially_ when you get to that wrinkly pink
| lump in your skull.
| crooked-v wrote:
| The point you're missing is that telling people "just eat
| less" doesn't work, because it's extremely difficult for
| many people to "just eat less".
|
| That's literally the whole reason that ozempic etc are
| popular, because they make it easier for most people to
| just eat less, in the same kind of way that caffeine makes
| it subjectively easier for someone who's tired to be
| productive.
| rootusrootus wrote:
| > it's extremely difficult for many people to "just eat
| less"
|
| Right. To be explicit, "just eat less" means "live your
| life always hungry." There's a reason this more-or-less
| never works in practice.
| pugets wrote:
| It does work. It couldn't not work. Each day of your life,
| you choose to do one of three things:
|
| 1. Consume more calories than your body will need to function
|
| 2. Consume as many calories as your body will need to
| function
|
| 3. Consume fewer calories than your body will need to
| function
|
| When you consume more energy than you require, your body
| stores the remainder as fat. When you consume less energy
| than is required, your body converts your fat into usable
| energy.
|
| Now obviously, this is an over-simplified explanation of
| nutrition. What you eat, when you eat it, how efficiently
| your body converts food to energy, and other factors will
| determine the little details. But the explanation I've
| provided is not nearly as over-simplified as "it just doesn't
| work."
|
| To make a comparison, it would be like suggesting that the
| financial advice "earn more money than you spend" just
| doesn't work as a method of saving money, on the grounds that
| some % of Americans who try to save money end up in credit
| card debt.
| grayhatter wrote:
| So if understanding the equation about how humans can
| obtain and maintain a healthy diet/weight is as simple as
| you present here. Why doesn't everybody just do that?
|
| You say yourself, it couldn't not work. And yet there's
| hundreds of thousands of people that say it didn't work.
| Explain them, are they lying?
|
| I'd assert, the oversimplified explanation is misleading.
| It's only true in the same way that drinking cold water
| will help you lose more weight than warm water. True or
| not, reality seems to strongly suggest it's irrelevant
| rybosworld wrote:
| > Explain them, are they lying?
|
| Yes.
| grayhatter wrote:
| It's more likely that hundreds of thousands of people are
| collectively lying, than it is that trying to find a
| solution that works for hundreds of thousands of
| different humans all with different needs, lifestyles,
| desires, capabilities, and understanding, might be a tad
| more complicated than just counting intake calories?
| pugets wrote:
| Why assume people will do what's in their own long-term
| best interests, especially after being presented with a
| short-term thrill?
|
| Pizza tastes better than granola. Grand Theft Auto is
| more fun than math homework. Having a Dodge Charger is
| cooler than having a Hyundai Elantra. Who cares about the
| costs? I can always fix my bad habits tomorrow.
| grayhatter wrote:
| > Why assume people will do what's in their own long-term
| best interests, especially after being presented with a
| short-term thrill?
|
| So, human behavior _is_ more complicated than just
| counting? Why would someone eat pizza instead of granola?
| Are there some physiological reasons for this? I wonder
| if there might be an evolutionary advantage for a species
| to develop the desire for high caloric foods? That sounds
| like something that would make it much easier to make the
| decision to seek out pizza, and much less likely to
| choose granola. Especially when you consider that humans
| are mostly creatures of habit.
|
| Saying just count calories is reductive to the point of
| absurdity. you can tell it doesn't work because it hasn't
| worked for society for decades, yet it's such an obvious
| solution no one stops to account for the astronomical
| amount of evidence that proves "just try harder" does not
| work on most humans. So, do you want to be right, or
| would you like to do something that actually helps humans
| improve their quality of life? "Just try harder" doesn't
| work, and it takes wilful ignorance of the evidence to
| claim otherwise.
|
| let's apply this same logic to writing code, we wouldn't
| have any more bugs if people just reviewed their changes
| before committing, and wrote that one extra test, right?
| Works on my machine, ship it to prod... what do you mean
| millions of computers now bsod on boot? Surely it was
| just that one extra test, and it's pointless to do staged
| rollouts or smoke tests or anything like that?
|
| Just never make a mistake is obviously asinine whether
| you apply it to writing code, or deciding what to eat.
| The difference being we don't have a millennia of
| evolution trying to convince us to write bugs.
|
| I agree with the premise, people are responsible for
| their diet their decisions and their habits. I just don't
| agree knowledge of that is enough for everyone to improve
| their quality of life.
| rootusrootus wrote:
| > choose
|
| You're letting that word do some very heavy lifting.
|
| > To make a comparison
|
| I think the comparison is very weak, very superficial. The
| human body is way more complex than CICO. But your
| comparison does have some intuitive value -- there are more
| than a few people who consistently spend every penny they
| make, and sometimes more, just trying to survive. We don't
| see a lot of them on Hacker News, to be sure.
| grecy wrote:
| > * The human body is way more complex than CICO*
|
| Genuine quesion - if I eat 1500 calories today and do a
| measured 2000 calories of work on a treadmill, where did
| that extra 500 calories of energy come from?
|
| Are you suggesting my body can create energy from
| nothing?
| grayhatter wrote:
| Generally your liver will store between 12 and 24 hours
| of calories in the form of glucose. After that, it's
| likely fat stores from adopose tissue (fat cells)
| grecy wrote:
| Right.
|
| So how can CICO not work?
| grayhatter wrote:
| Given the observational evidence that it doesn't work,
| what are you really asking?
|
| Imagine a computer with a primary source of power, and a
| backup supply. You're measuring CICO of the primary
| supply. And you're tightly regulating the power available
| on primary to keep a power deficit. Unfortunately, during
| periods of high load, this computer is able to switch to
| the backup supply which you aren't able to exert tight
| control over.
|
| There's a huge number of things that could cause a human
| to ignore their best interests. Ignorance to
| consequences, the long-term implications of any decision,
| degraded mental health, external social pressures, the
| list goes on and on.
|
| Humans have impulses just like every animal, and proper
| training can convince a dog not to immediately lunge and
| eat every morsel of food they can smell. but it takes a
| lot of work and external pressure to train that into a
| dog, and even then given the right circumstances a dog
| will still eat food above their caloric needs. Humans
| behave the exact same way.
|
| > it's easy for me to regulate my weight using cico, so
| obviously it should be easy for everybody
|
| I know that's not the claim you're making, but it seems
| like it is and it is the one many other people in this
| thread are making. just like it's easy to train some dogs
| than it is train others. it's easier for some humans to
| control their caloric intake than it is for others.
|
| CICO doesn't work for most humans. Claiming otherwise is
| on par with the saying just run this IOS app on Android
| it's easy it works for me! Perhaps a sufficiently capable
| engineer could make it work, but most humans aren't
| sufficiently capable.
| grecy wrote:
| > _Given the observational evidence that it doesn 't
| work_
|
| I think you need to be very careful about your language
| choice here.
|
| Physics says it has to work. Every athlete on earth knows
| it works. Everyone that has ever been in a prison camp,
| concentration camp or had their calories restricted
| outside of their control knows it works.
|
| It absolutely, factually, 100% works. Our entire
| understand of mammals and energy depends on it working.
|
| What you are saying, is that people are unable to
| exercise enough self-control to actually consume less
| calories. If they did, it would work. But they don't.
|
| That's like saying "pointers in C don't work" because
| when many people try they get seg faults.
|
| I really don't think it's constructive to say "CICO
| doesn't work" when what you mean is "many people find
| CICO difficult to implement, because having the self-
| control/will power/determination/control to do that is
| hard."
|
| I became heavily involved in weight watchers (which is
| essentially just CICO - their "points formula" is
| basically calories/50). Over many years I watched
| hundreds of people lose hundreds of pounds by being
| careful about what they ate. It was hard. There were a
| lot of tears, there were a lot of false starts and
| plateaus and hard times. The people that stuck with it
| had incredible transformations and live different lives
| now. My room mate at the time lost almost 200lbs and
| became head of the WW in that city and when I saw her
| after 10 years I did not recognize her at all, and
| actually refused to believe it was her for 5 minutes.
|
| CICO absolutely works. Like most things worth doing in
| life, it's hard. And it's worth it.
| grayhatter wrote:
| > What you are saying, is that people are unable to
| exercise enough self-control to actually consume less
| calories. If they did, it would work. But they don't.
|
| That is not what I'm saying. It seems like you stopped
| reading at "doesn't work" when what I said was "doesn't
| work for most humans".
|
| For many people, it feels impossible, so they give up.
| Why are you advocating for doing something hard, instead
| of doing something easy, there are definitely other
| reasons you might want to argue for that. But you didn't
| argue any of them. You parroted the exact same thing
| again, trying to get your point across, while ignoring
| mine.
|
| > CICO absolutely works. Like most things worth doing in
| life, it's hard. And it's worth it.
|
| Why stubbornly refuse to entertain the idea it's too hard
| for many people? Because it's does work, so everyone
| who's life or health isn't in the state where they can do
| the thing you admit is hard can just get fucked?
|
| Nah, fuck that! If there's anything you can do, that will
| improve your quality of life, you should do that. If you
| can get into a more healthy physical shape in 1 year
| instead of 5. You should!
|
| I'm an advocate of doing things the hard way. I'm even
| the same type that mocks people who claim cpointers are
| impossible. But I'm also the type who will take as long
| as it takes to teach someone how to understand and use
| them. And if all you want is to make a fun jumping game.
| I'll suggest trying python. and won't demand you write
| everything in c including your own input lib.
|
| You should do things the hard way. Because it will make
| you stronger. But for so many people who have been beaten
| down, they believe it's impossible; so demanding they're
| only allowed to achieved success exclusively by doing it
| the hardest way, is fucked up.
|
| The options aren't the hard way, or nothing. But by
| repeating CICO over and over without nuance, that's the
| message you're sending. Do it the hard way, or give up.
|
| Nah, fuck that. Try the hard way, then try something
| else, then try something else. Then keep trying until you
| improve your life. Then do it all over again with
| something else you want to improve.
| pugets wrote:
| What word would be better than "choose" in this context?
| For the majority of people who aren't prisoners or
| toddlers, there is a good deal of personal choice that
| determines what foods we eat and how much.
|
| Even if fate has it that I must end up at a Wendy's drive
| thru tomorrow night, couldn't it be true that I could
| choose to eat the 400 calorie meal instead of the 800
| calorie meal, or order water instead of Sprite?
| grayhatter wrote:
| Will. Will is a better word. Every day you will consume
| calories less than, equal to, or greater than the amount
| of calories you expend.
|
| The problem with choose is it implies an intentional,
| free choice. I can manufacturer plenty of contrived
| examples to show it's not always the choice of the
| person. But I'll use a real one I remember.
|
| Yes, you, who I assume has thought deeply about personal
| responsibility and and willpower and how to obtain the
| best life for yourself over what I assume to be between
| years and decades of practice doing that, are able to
| choose water over Sprite.
|
| but I can tell you from the experience of somebody who
| strongly believes in the responsibility of your own
| decisions, and how willpower is a learnable skill, and
| about being healthy, and about how every decision
| matters. When I'm tired, and depressed, and feel like I'm
| about to break. Even knowing, even having the thought
| that I _should_ choose water over soda, I 've still
| chosen soda.
|
| Fair choice though right? There were no other factors, or
| influence over why I drank 200 calories of sugar? I
| should just have remembered water would be healthier?
|
| That's what I assume they said the word choose is doing a
| lot of heavy lifting. because often choose is presented
| exactly the way that you did.
|
| > Even if fate has it that I must end up at a Wendy's
| drive thru tomorrow night, couldn't it be true that I
| could choose to eat the 400 calorie meal instead of the
| 800 calorie meal, or order water instead of Sprite?
|
| When often, humans tend to be slightly more complex than
| just that.
| Ferret7446 wrote:
| > The human body is way more complex than CICO
|
| The human body is way more complex so as to defy the laws
| of physics as we know it? The human body cannot create
| matter. In order for it to increase in mass, you must be
| inserting extra mass into it.
| immibis wrote:
| Note that none of the known laws of physics say that
| excess energy is saved by converting (which raw
| materials?) into fat and storing them.
| grecy wrote:
| Sure, a mammal does not HAVE to store excess energy.
|
| But that is entirely irrelevant when a mammal eats less
| energy than they consume for a while. In that instance
| they MUST burn some stored reserves or break the laws of
| physics
| confidantlake wrote:
| It works in the same way as crossing the finish line first
| works to win a race. Of course it works, do that and you win
| 100% of the time. It is not that it doesn't work, it is that
| it is extremely difficult to do.
| adrian_b wrote:
| I hear very often this theory that "it just doesn't work".
|
| To be fair, I had also believed this for many years.
|
| However, all the people who claim that "it just doesn't
| work", have never made any serious attempt to do "it", so
| they cannot know whether it does work or not.
|
| I have been obese for more than a decade, during which I have
| made several attempts to lose weight, which have all failed,
| because they were not done in the right manner.
|
| Then I have made a final attempt using the correct method,
| and I have lost about 35% of my initial body weight during
| about ten months, at a steady rate between 100 g and 150 g
| per day, i.e. about 1 kg per week.
|
| This was more than 10 years ago and since then I have kept a
| constant weight. Because I have done this once, now I can
| control my weight and have any weight I want, even if I gain
| weight extremely easily. It is enough to eat one day like I
| was eating when I was obese to gain enough weight to require
| a week of weight losing diet to go back to the desired
| weight.
|
| The rules for losing weight and maintaining the weight are
| very simple, but they must be observed and those who claim
| that "it doesn't work" never try to observe the rules, so it
| is entirely predictable that it cannot work for them.
|
| First, it should be obvious that after losing weight one must
| eat differently as before, otherwise weight will be gained
| until reaching again the original weight.
|
| To be able to control the weight, anyone who is or has been
| obese must stop eating until they feel satiated. At each
| meal, one must plan before beginning to eat how much to eat
| and then eat only the amount planned, never more than that.
| One must eat a fixed number of meals per day (preferably few,
| e.g. only two meals per day should be enough for an adult who
| has a sedentary lifestyle) and never eat between meals any
| kind of snacks or drink any sweet of fatty beverages. Between
| meals, only water or beverages without any calories (e.g.
| unsweetened herbal teas or tea or coffee) are acceptable
| intakes.
|
| While losing weight, the most important thing is to weigh
| oneself every day with precise digital scales (with a
| resolution of 100 grams or less), at the same hour and in the
| same physiological conditions, i.e. in the same order with
| respect to meals and relieving oneself.
|
| Whenever the weight is not less than the previous day, then
| the quantity of food planned for the current day must be
| diminished in comparison with the previous day. At the very
| beginning of losing weight there may be a delay, e.g. of a
| week or so between starting to eat less every day until the
| weight begins to decrease, but eventually it is possible to
| reach a steady state of a constant rate of losing weight per
| day.
|
| When diminishing the amount of eaten food, only the
| carbohydrates and the non-essential fats must be reduced. The
| amount of proteins, essential fatty acids, vitamins and
| minerals must remain normal. To achieve this, one must eat a
| source of pure proteins, for example turkey breast or chicken
| breast or some kind of protein powders, so that eating enough
| proteins contributes only a minimum amount of calories. The
| rest of the nutrients can be provided mostly by non-starchy
| vegetables and perhaps by some supplements like fish oil. One
| could also eat almost anything that is not recommended, for
| instance chocolate, with the condition that the quantity is
| negligible, which can normally be achieved only when such
| treats are not eaten every day, but e.g. only once or twice
| per week.
|
| These rules are simple and anyone who follows them will lose
| as much weight as desired. Obviously, this is easier said
| than done, because for the entire duration of the weight-
| losing diet one will be permanently hungry and one would tend
| to think about food and it will be difficult to resist
| temptations, so it is better to not keep in the house any
| kind of food that can be eaten immediately, without requiring
| some kind of preparation. Unfortunately, this is unavoidable
| and it is the price that must be paid. After the first few
| weeks, the hunger sensation diminishes in intensity and it
| always disappears for a few hours whenever you find some work
| to do that captures your attention.
|
| As long as you do not want to follow such rules, you will not
| lose weight, but that is because you do not want to do it,
| not because it does not work.
|
| Not wanting to do it is a valid reason, because one may abhor
| more the feeling of hunger during many months than being
| obese, but this decision must be described correctly and not
| be justified by the false claim that "it doesn't work". At
| least in my case, the improvement in my health and in what I
| was able to do (e.g. before losing weight climbing a few
| stairs would make me tired and sweaty) has made worthwhile
| any displeasure felt during losing weight and I have been
| very happy to have achieved that.
| grecy wrote:
| I'm sorry for the downvotes.
|
| What you did takes a lot of discipline and hard work, and
| you did it.
|
| Of course eating less calories than you consume results in
| weight loss, and you stuck with it. Congrats and Thanks for
| the details
| adrian_b wrote:
| Thanks.
|
| I must say that I really understand what is in the mind
| of those who claim that "it doesn't work", because this
| is exactly what I had believed during many years, after
| many failed attempts to lose weight.
|
| I had become convinced that nothing that I can do could
| change my weight.
|
| Nevertheless, now, after I had eventually done it, I can
| see clearly the errors of my previous ways, so I can no
| longer agree with the opinion that it does not work, when
| it can actually work very well, as long as you accept
| that you must be hungry all the time while you are doing
| it.
|
| I want to add that the feeling of hunger can be
| diminished a lot when you eat food cooked at home instead
| of industrially-produced food, especially when you avoid
| sweetened food. Using modern techniques, like cooking all
| meat and vegetables in a microwave oven, it is possible
| to cook food at home in an extremely short time, so the
| lack of time is no longer a valid excuse for eating junk
| food.
| grecy wrote:
| I personally just eat unlimited vegetables... even raw.
| It's impossible to eat enough to meet my calorie needs
| _heimdall wrote:
| All this study really shows is an analysis of medical records
| with no background of the peoples' diet or lifestyle. The
| outcome should be obvious and expected, those who are
| overweight and obese were found to stay that way.
|
| The fact that the rate of obesity in the US has pretty
| consistently risen for decades makes that clear, you don't
| need statistical models of medical records to know that the
| rate of obesity could only really keep going up if those
| already obese stay that way.
| zahlman wrote:
| >There was a massive (18,000,000 people) cohort analysis
| published in 2023 that showed the likelihood of someone
| losing 5% of their body weight in any given year was 1 in 11
|
| Unsurprising. They ran statistics on arbitrary overweight and
| obese people, with no idea of who was actively seeking to
| lose weight or who was just coming away from such an effort.
| If a significant fraction of the overweight/obese population
| _did_ lose 5% of body weight /year, we wouldn't be seeing a
| bunch of overweight/obese people.
| nullc wrote:
| Glad you're having a good time, but the broad ranging
| psychological effects are concerning.
| noch wrote:
| > but the broad ranging psychological effects are concerning.
|
| Fwiw, to me the symptoms he and others have described don't
| seem very different from those of long fasting. And I would
| definitely prefer those symptoms to the ones I had due to
| obesity which ranged from extreme fatigue, heart-pain, muscle
| spasms, depressive shame, restlessness and so forth.
| firesteelrain wrote:
| What kinds?
|
| I have been taking tirz for 7 weeks and walking 5 miles a day
| + exercise. My depression is gone and I have lost 30 lbs. I
| am loving life.
| noch wrote:
| > Saturday is injection day, but Sunday is where it really
| becomes quite noticeable that I took it. Monday-Wednesday is
| cruising altitude and the effects are good but not over the
| top. Thursday I can feel it tapering, and today ... well, I'm
| looking forward to tomorrow's injection. I might switch to a
| twice-a-week split dose at some point to ease the peaks and
| valleys.
|
| Perhaps coincidentally, this is similar to my experience with
| week long fasts: After 48 hours I feel like a precision missile
| cruising towards my target until about 5-6 days later.
|
| But I will use a suitable GLP-1 based drug, because, man,
| fasting feels unbearably brutal for me after 6 days: profuse
| sweat, increased heart rate, brief but intense panic attacks,
| an insane level of sad (but not depressed) introspection, a
| hairpin trigger temper. I become a ridiculous mess. There's got
| to be a better way!
|
| Thanks for sharing your experience and insight!
| whatshisface wrote:
| You could have food allergies that take a couple days to
| clear up.
| pixl97 wrote:
| >I might switch to a twice-a-week split dose at some point to
| ease the peaks and valleys.
|
| If you're willing to shoot up more often it moderates the
| effects better.
| rootusrootus wrote:
| I definitely am. That first shot took a solid 30 seconds and
| three false starts before I could jab it in, but it turns out
| to be a great big nothingburger once you do it. Can barely
| even feel it, nothing like the intramuscular shots like
| flu/etc. I could do this shot as often as necessary without
| batting an eye.
| spondylosaurus wrote:
| Might have to float this by my tirz-taking partner,
| especially if it helps with side effects. They always feel a
| little icky the day immediately after a dose.
| nixosbestos wrote:
| These are the same effects I got from doing OMAD and going
| gluten free. If I fuck up and eat processed food, the "food
| brain" comes back, and I start chasing dopamine like a fiend.
|
| I'm a fan of these tools helping people get this insight,
| because otherwise people just accept that cloud as their
| normal.
| iLoveOncall wrote:
| > The biggest negative, which just takes adjustment, is
| drastically lower stomach capacity. Used to be that two eggs
| and two pieces of toast was breakfast. Now I better skip at
| least one of those pieces of toast or I'm going to feel
| overfull and might get reflux as punishment.
|
| If you want to be successful long term in your weight loss,
| especially after stopping the drug, you should really invest in
| changing your mindset.
|
| This is a massive positive, not at all a negative.
|
| You got fat because you ate too much. If you don't understand
| what are normal portions now, you'll go back to your starting
| weight as soon as the drug isn't having effects anymore.
|
| This is a lifestyle change that you MUST embrace to be
| successful long term.
| setgree wrote:
| There's some evidence that Ozempic improves general impulse
| control, e.g decreasing alcohol consumption [0], which the
| article mentions.
|
| Also, as Tyler Cowen writes [1], this is probably going to
| translate into big improvements for animal welfare:
|
| > People lose weight on these drugs because they eat less, and
| eating less usually means eating less meat. And less meat
| consumption results in less factory farming. This should count as
| a major victory for animal welfare advocates, even though it did
| not come about through their efforts. No one had to be converted
| to vegetarianism, and since these drugs offer other benefits,
| this change in the equilibrium is self-sustaining and likely to
| grow considerably.
|
| So overall, widespread Ozempic adoption seems like progress to
| me.
|
| [0] https://www.npr.org/sections/health-
| shots/2023/08/28/1194526...
|
| [1]
| https://www.bloomberg.com/opinion/articles/2024-07-20/animal...
| tredre3 wrote:
| > big improvements for animal welfare
|
| Is it? It might reduce the amount of animals killed, sure, but
| it won't improve the well-being of the ones that are still
| raised.
| exitb wrote:
| While this entire chain of thought seems a bit far fetched, I
| think the reasoning here is that if you lower the demand for
| meat, you don't have to resort to factory farming.
| randomdata wrote:
| When was the last time you saw profitability increase, even
| remain stagnant, when demand declined?
|
| Let's be real. If demand for meat declines, producers will
| have to double down on "factories" in order to remain
| solvent.
| exitb wrote:
| Yes, I agree. As I said, that entire argument is far
| fetched at a few different points, this being one of
| them.
| dghlsakjg wrote:
| Anecdotally, I disagree.
|
| I went through a period of vegetarianism (for health
| reasons, not directly for ethics), and once I started
| eating meat again, 1. I eat a lot less, which 2. means
| that I can be much more intentional about sourcing it.
|
| Right now the bulk of the meat that I eat at home
| throughout the year comes from 1 or 2 animals that are
| locally sourced and butchered (normally I share a portion
| of a pig and a cow), and the occasional wild caught fish.
| The meat is tastier, and I can go see the actual animals
| at the farm if I so choose. They are not factory farmed,
| and the price per pound is about the same as buying
| industrial meat at the grocery store since I am buying
| directly from the farmer, and paying a local processor
| for their services.
|
| As things wane in popularity it might be true that they
| become more of a commodity, or it might be true that they
| become more of a niche product where people care more.
|
| I would like to think that if meat consumption becomes
| more of a treat than an everyday thing, that people would
| treat it as such, and go out of their way to eat
| something that tastes better.
|
| Food for thought?
| setgree wrote:
| I would hope this happens, but merely having fewer animals
| alive in factory farming conditions would be a welfare gain
| from me because I think a factory farmed animal's life
| falls below the "life is worth living" threshold. YMMV.
| elif wrote:
| It also reduces the number of animals that suffer if the
| suffering is more important to your ethics.
| randomdata wrote:
| Maybe. There is some evidence that the decline in fertility
| rates are associated with overweight and obesity. Social
| and biological factors leave having children more difficult
| when one is outside of a "normal" weight range. If everyone
| is on Ozempic, they might have more children, requiring
| more overall food and harming even more animals in the
| process.
| Qem wrote:
| > If everyone is on Ozempic, they might have more
| children, requiring more overall food and harming even
| more animals in the process.
|
| It's reported it reduces a series of impulsive
| behaviours. Would it extend to sex? If people are less
| willing to have sex, maybe broad consumption of the
| medicine will further drop fertility rates.
| randomdata wrote:
| Maybe. If more people are less willing to have sex, does
| that harm the animals (meaning humans) who still seek
| it/want more of it?
| eightysixfour wrote:
| This gets into a deep philosophical question people spend too
| much time arguing about. In short, some would argue suffering
| is multiplied by the number of sentient beings that
| experience it, others would argue only the average "amount"
| of suffering matters. You can end with some absurd paradoxes
| if you take either to their extremes.
|
| The reality is probably somewhere in the middle.
| ben_w wrote:
| > The reality is probably somewhere in the middle.
|
| I think such paradoxes demonstrate we probably need a
| completely different approach than anything we've done so
| far.
|
| Utilitarianism feels to me like Mill & Bentham discovered
| basic arithmetic and didn't even realise there was more to
| maths than that.
| beepbooptheory wrote:
| It is perhaps simply the case that such things are
| inherently paradoxical. There is nothing in the stars
| that says ethics should obey PnC!
|
| You see a paradox and say "well that's not right, we
| should do something about it." This has been the story
| since Kant, but for his part, everyone seems to forget
| that he doesn't ultimately "solve" his antinomies, he
| just leaves them as conclusions, "effects of pure
| reason."
|
| It seems way more unreasonable to assert that, in fact,
| there _is_ some consistent, complete ethical framework
| out there, but we havent found it yet, than it is to just
| accept that some kernels of truth or sense are not
| formalizable in the classical sense.
| ben_w wrote:
| I don't know what you mean by PnC, and the Wikipedia
| disambiguation page didn't help:
| https://en.wikipedia.org/wiki/PNC
|
| > It seems way more unreasonable to assert that, in fact,
| there is some consistent, complete ethical framework out
| there, but we havent found it yet, than it is to just
| accept that some kernels of truth or sense are not
| formalizable in the classical sense.
|
| We can prove that complete and consistent set of axioms
| for all mathematics is impossible. An equivalent proof
| for ethics would itself be useful.
|
| However, we do not need to concern ourselves with
| infinite sets etc. for ethics the way we do with natural
| numbers, as there's only relatively (in mathematical
| terms) small number of real people to interact with or
| influence the lives of.
|
| We may not be able to reach an optimal outcome with even
| a limited n, if it turns out to be akin to P != NP. But
| even knowing that, would itself be useful.
|
| The problem I have with Utilitarianism isn't any of these
| things, it's that it's simply trying to maximise how much
| utility there is in the world, then immediately tripping
| over itself because the terms "utility", "maximise" and
| "the world" aren't well-defined, and the way it is
| introduced is simply adding up.
| wholinator2 wrote:
| I'm curious about the paradoxes, if you have any on hand
| ben_w wrote:
| https://en.wikipedia.org/wiki/Mere_addition_paradox
|
| and
|
| https://en.wikipedia.org/wiki/Utility_monster
| eightysixfour wrote:
| Mere addition, as mentioned by the other user is the
| primary one I was referring to, but breaking different
| approaches to utilitarianism only requires one to take
| them to their extremes.
|
| If average welfare of humans is all that matters, then
| one happy human living alone in the universe is the
| equivalent of a million happy humans.
|
| If sum of "welfare" is all that matters, then you can
| argue an exceptionally large number of people being
| tortured indefinitely is better than a happy person.
| randomdata wrote:
| _> In short, some would argue suffering is multiplied by
| the number of sentient beings that experience it_
|
| Factored by how cute the animal is. As a producer of plants
| for human consumption, it's quite obvious that orders of
| magnitude more animals are harmed in that process than are
| ever harmed in traditional meat production. But they're
| mostly ugly insects, so nobody cares.
| ben_w wrote:
| Sounds like you're valuing <mean harm per animal> over
| <integral of harm over all animals>?
|
| I don't get why that would be a better measure?
| Tempat wrote:
| I suppose thinner people do probably walk their dogs more
| often...
| throwaway888abc wrote:
| How long till we become voluntary Voyagers [0] ?
|
| [0] https://www.imdb.com/title/tt9664108/
| SV_BubbleTime wrote:
| Yay, more dependence on the people that are causing the
| problems to begin with!
|
| I swear covid was a personality test. If you came out of the
| last 4 years and are looking for more dependence on government
| and pharma... well, the horseshoe is a V I guess.
| user395929935 wrote:
| Naltrexone will do the same thing. For alcohol, opioid, or
| binge eating control. Improve T3 and helps with blood sugar,
| and its orally bioavailable.
| WhatIsDukkha wrote:
| https://en.wikipedia.org/wiki/Naltrexone#Controversies
| elif wrote:
| That sounds speculative and would require some deep research to
| find if it's even happening.
|
| I think it's equally plausible that the US increases food
| exports rather than lower production. Especially as production
| is subsidized.
| pixl97 wrote:
| If this increases food stability around the world, then in
| general it's a good thing.
|
| This said, obesity is exploding everywhere else in the world
| too, so it's not just a US problem.
| kornork wrote:
| I think the assertion that "eating less usually means eating
| less meat" is probably false (though I couldn't read the
| article cuz paywall).
|
| The first article talks plenty about why: people are eating
| less of the the things that are addictive to them, such as
| alcohol and cookies, which are a major source of calories.
| akira2501 wrote:
| Eating animals and animal welfare are two entirely different
| things. We could all be vegetarians and still be intentionally
| or unintentionally intolerably cruel to all other life on this
| planet.
| pfdietz wrote:
| I had a short conversation with an agronomist friend of mine.
| Crop prices are in the dumps right now, and I was wondering if
| it's because of these drugs. He said this is being openly
| discussed.
| GeorgeTirebiter wrote:
| What percentage of the population is on GLP-1 drugs right
| now?
|
| Well "According to KFF polling from May 2024, 6% of all
| adults report that they currently are taking a GLP-1 drug,
| and 12% report that they've ever taken a GLP-1 drug".
|
| Is 6% enough to affect crop prices? Presumably some ag
| economist can weigh in. Note it would only be a reduction per
| person, not a full 6% reduction in consumption.
| nixosbestos wrote:
| This matches experience with dieting and impulse control,
| without these drugs even. Two days of junk food and the food
| brain is SCREAMING in my head. So I just don't do it. It's also
| way more obvious when I mess up, that it makes my body feel
| _bad_.
|
| But when I say food brain, it's _everything_. I want to vape, I
| want to have more coffee, then more beer, then some cannabis to
| go to sleep. Wake up and hit the dopamine cycle again. I have
| to take care of myself and ask "why am I doing this, could I
| just not, and if so I must not".
| kbelder wrote:
| >There's some evidence that Ozempic improves general impulse
| control
|
| While remaining on the drug.
|
| I expect your impulse control will be even worse after getting
| off of it, but I don't have a study to back that up.
| amelius wrote:
| > There's some evidence that Ozempic improves general impulse
| control
|
| What if it makes us get a better control over our consumption
| behavior in general?
|
| Wouldn't some large companies have a problem with that and
| fight it?
| indiebat wrote:
| I don't want this to come out insensitive or from under the rock,
| but why is taking a drug a novel & cool idea (all of a
| sudden/recently) as opposed to good old fashioned working out and
| not eating more than what you need? okay, this drug is all kinds
| of great and it's the next best thing since green grapes, still
| not eating more and workout is better than taking drugs that
| effect your brain right? Are doctors required to explain this
| before prescribing this in US?
| apsec112 wrote:
| Saying that the cure for obesity is to eat less is like saying
| that the cure for heroin addiction is to stop using heroin.
| It's both clearly true, and also useless.
| chrismarlow9 wrote:
| The cure is to teach from an early age about impulse control,
| moderation, and how to spot signs of addiction in yourself
| early. This goes for:
|
| Social media
|
| Drugs and alcohol
|
| Food
|
| Or literally any other addiction. I don't think this is a
| useless thing to discuss.
| soulbadguy wrote:
| And yet most obese people are no more addicted to food than
| you are addicted to oxygen...
|
| It's so bizarre how many people will pretzel their way into
| moralistic non sense to find a solution to what is clearly
| a medical problem.
|
| Obesity as far as we understanding it now is an hunger
| regulation problem. For unknown reason a lot of people
| still feel the need to eat even when their body is clearly
| in calory surplus.
|
| No amount of of impulse control or moderation can make you
| override billions of years of evolution and not eat when
| you are starving... if we could... society would be a very
| different place
| WA wrote:
| My theory is that consuming sugar makes you more hungry.
| You can eat until you're full, but if you eat desert or a
| sugary snack a little later, it makes you feel less full
| and you can eat more. As if your brain notices the sugar
| source and switches into "full loading mode" and craves
| more of this historically rare resource.
|
| > And yet most obese people are no more addicted to food
| than you are addicted to oxygen...
|
| Most obese people seem to be addicted to sugary food,
| soft drings, desert and all that, which then triggers
| more eating.
|
| In addition, it might be a gut bacteria thing. If your
| gut is used to processing lots of sugar, you crave it
| even more and fighting your gut microbiome requires way
| too much impulse control and moderation.
|
| The solution might be to recognize this mechanism, remove
| all sugar from the diet and find a way to control
| impulses for a few weeks until the gut bacteria changed.
|
| Drinking water and chewing sugar-free gum helps me to
| remove food cravings temporarily with no downsides.
| But... I have a normal weight.
| scotteric wrote:
| I think insulin resistance from excess calorie and
| carbohydrate consumption has a lot to do with it. One of
| the symptoms of hyperglycemia is increased hunger, since
| glucose is staying in your blood stream instead of
| getting into your cells. 1/3 Americans have prediabetes,
| and more than that are probably developing insulin
| resistance.
| wiseowise wrote:
| > For unknown reason a lot of people still feel the need
| to eat even when their body is clearly in calory surplus.
|
| Boredom, stress, unhappy life, happy life, laziness - it
| could be anything. You know what it couldn't be?
| Exercise. I'm yet to see a person working out hard and
| eating at the same time.
| cthalupa wrote:
| > I'm yet to see a person working out hard and eating at
| the same time.
|
| No, but plenty of people have their hunger stimulated by
| exercise and eat too much after.
|
| You simply can't fix being overweight or obese with
| exercise alone in the vast majority of people. Even if
| you don't believe in the constrained total energy model
| that a good chunk of metabolic research PhDs think is at
| least somewhat true and instead believe solely in the
| additive model, exercise stimulates hunger and it's far
| easier to eat 1000 calories than burn 1000 calories.
|
| You have to do both and exercise doesn't automatically
| make the other easy.
| pixl97 wrote:
| Ok, in the US start talking about food addiction seriously
| and see what happens.
|
| Do you remember how long it took to get tobacco mostly
| banned in the US? Do you remember how much the tobacco
| industry played the skeptic and introduced bunk science
| into the mix?
|
| Well Coca Cola, Pepsico, Nestle, and all the other junk
| food companies have been on this game for years now. Want
| to change school curriculum?, well your political opponent
| has $100,000-$1,000,000 more than you from the make people
| fat industry. Meanwhile there are a crazy number of attack
| ads against you for being a crazy commie that wants to
| control peoples lives, you socialist bastard, you're
| against freedom.
| dleink wrote:
| The presently addicted and obese thank you for your service
| to the future.
| indiebat wrote:
| Heroin changes brain chemically, it's (more) serious
| addiction than obesity, again being a little insensitive to
| obese people, but they're bad in comparison. And there are
| degrees of truthfulness & wrongness right!
|
| About the point you're making, two generations before you and
| me, people where fit, more attentive & generally healthy
| (outside vaccines that prevent diseases now & positive
| effects due to advancements in medicine), what changed?
|
| Not as platitude, but go from first principles, the choices
| you make everyday effects your mind (& the time you spend on
| particular activities), and if they aren't life affirming
| (for lack of better words), in due time you limit your
| options (ie less choices from your mind, bad food or less bad
| food or multiple bad ways to spend your time?), till you
| proclaim from high top mountains 'oh god, I'm helpless
| without acceptance from some higher power!'
|
| This isn't to say, I'll be as preachy and asshole(ish) to a
| friend or someone I care about in similar need, I'll probably
| say 'seek medical help etc' like you. But thinking things
| through & arriving at truth is important, don't you think?
|
| This is different to mental strength or controlling yourself
| etc, it's more about self reflection & freedom through
| discipline, respecting your life, decisions & thoughts more
| than your impulsive emotions in an ever distracting world,
| that kind of thing..
|
| I don't think I'll change your mind or this will come across
| in good faith, that's okay, I'm in a reflective mood, and
| it's awfully chilly outside :-)
| soulbadguy wrote:
| > About the point you're making, 2 generations before you
| and me, people where fit, more attentive & generally
| healthy (outside vaccines that prevent diseases now &
| positive effects due to advancements in medicine), what
| changed?
|
| Air pollution, water quality, pestecide, food/produce
| quality, plastic particule everywhere...
|
| I find this perspective so bizarre.
|
| Whats the most probable in 2 generation of exponentially
| increasing and barely regulated technological changes :
| culture has change so dramatically as to change human
| nature and makes us all lazy... or... something in the
| environment/food chain is having phisiolical/biological
| effects...
| indiebat wrote:
| People living in country side & eating from organic
| farming, they're doing alright (similar to our closest
| ancestors), but that's beside the point
|
| Cultural change over 2/3 even 10 generations will not
| significantly alter your biology. Pollution &
| disintegration in modern world you're referring to, they
| do have negative effects on our health, but it's not the
| whole story and they possibly cannot have effects on your
| decisions about what you eat and how you spend your time
| right?
|
| I'm particularly referring to obesity caused by over
| eating, bad life style etc (not the other rare serious
| persistent irreversible kind that happens as side effect
| of more serious ailments or genetics)
| soulbadguy wrote:
| I can't quite understand if you are agreeing or
| disagreeing with me...
|
| You seem to be restating my point as if you are
| contradicting my statements.
|
| > People living in country side & eating from organic
| farming, they're doing alright (similar to our closest
| ancestors), but that's beside the point
|
| Maybe ( I would love to see some sources for this
| assertion). But even if I give that to you, you basically
| saying that modern environment are somewhat
| obisidigenic... which is what I was saying.
|
| > Cultural change over 2/3 even 10 generations will not
| significantly alter your biology.
|
| Okay... same., still just restating what i have said.
|
| > they possibly cannot have effects on your decisions
| about what you eat and how you spend your time right?
|
| They can and they do... let me introduce you to lead in
| paint and in the environment...
|
| > particularly referring to obesity caused by over eating
|
| All obesity is cause by over eating (all most by
| definition) the point here is that over eating is not
| cause by lack of will power or poor decision making
| pixl97 wrote:
| >About the point you're making, two generations before you
| and me, people where fit, more attentive & generally
| healthy
|
| Everything.
|
| Two generations ago you didn't eat out 4+ times per week.
| Portion sizes at restaurants were 50%+ smaller. Food
| sciences were not as optimized at making junk food as they
| are today. In general we were poorer and bought less junk
| food. We were more apt to work jobs that didn't involve
| sitting in one place for long periods of time.
|
| >I don't think I'll change your mind or this will come
| across in good faith
|
| I believe it's what you think, but when 74% of the
| population doesn't subscribe your philosophy then you're
| tilting at windmills. Yea, maybe someday people will catch
| on to that and all will be good, but that's not the way the
| entire world is going. We need solutions we can enact now
| to solve problems we have now.
| wiseowise wrote:
| Well, of course if you've been jacking heroin for 30 years
| and all your veins are destroyed beyond repair it's useless.
| It'll take as much, or even more, to return back to normal.
| codingdave wrote:
| Because not everyone has willpower and discipline. People who
| do have those strengths often think it is just as simple as
| saying, "Just take care of yourself", but it is not that easy
| for many people. High blood sugar also increases cravings,
| which makes it even harder, bringing on a downward spiral.
|
| This drug can help break out of that spiral and fix the
| craving/willpower problems.
| lurking_swe wrote:
| what you say is mostly true, but I will point out that it
| does not break any spiral. It's frequently reported that as
| soon as you stop taking Ozempic, the weight comes back
| immediately. so unless one resolves the underlying problem,
| you will be on this drug for life.
| DrillShopper wrote:
| That's not unique to Ozempic and (while I know you didn't
| make this specific argument, but others in this subthread
| have) is a piss poor reason to tell someone they shouldn't
| give it a try.
| lurking_swe wrote:
| i don't disagree. Just pointing out that (obviously) this
| should be a last resort drug. AFTER someone has tried
| lifestyle interventions for a few years IMO.
|
| The problem is when someone does NOT put in the effort to
| talk to their doctor, meet with a dietician, learn about
| healthy eating, and put in an honest effort to improve
| their life before just popping a pill.
|
| That said, i think it's great that's it's helping people
| who otherwise would just be obese and have many other
| health issues due to that. It's a big risk factor.
| mrshadowgoose wrote:
| This isn't the revelation you think it is. Chronic medical
| conditions require lifetime treatment. That isn't news to
| anyone.
|
| It's funny how obesity is the only chronic medical
| condition that garners a huge volume of your particular
| kind of comment.
|
| Would you be mentioning this for someone prescribed a
| diabetic, blood pressure or cholesterol medication?
| Statistically, likely not. So maybe take a step back, and
| examine why are you so averse to other people losing weight
| with medication.
| lurking_swe wrote:
| i actually would, if they were caused by bad lifestyle
| habits or similar issues. I am a firm believer that
| medication should be used AFTER a serious attempt has
| been made to address the underlying issue, if possible.
|
| if you are type 2 diabetic, that means you've probably
| been eating poorly for a long time. The happy path here
| is that one goes to a checkup and learns they are pre-
| diabetic, and their PCP refers them to a dietician. The
| patient hopefully learns how to make healthy food choices
| for themselves. All of this so they don't develop type 2
| diabetes. Maybe even temporarily prescribe a low
| metformin dose while they figure out the lifestyle
| changes needed.
|
| If they struggle and lifestyle interventions fail, then
| of course, they should be prescribed insulin so they
| don't have further devastating complications as they get
| older.
|
| The same can be said for ozempic. What kind of lunatic
| would suggest starting ozempic without FIRST giving
| honest education and lifestyle adjustments a try? That
| should be step 1. And i'm talking proper education from a
| licensed dietician, not silly blogs or advice people see
| on tiktok these days. If step 1 fails, proceed to
| medication.
|
| That's my perspective at least. Big pharma isn't your
| friend. It's a backup plan and a necessary evil in most
| cases (with obvious exceptions like vaccines,
| antibiotics, etc)
| mrshadowgoose wrote:
| > What kind of lunatic would suggest starting ozempic
| without FIRST giving honest education and lifestyle
| adjustments a try?
|
| What kind of lunatic would suggest an approach that
| evidence does not support as being effective? Lifestyle
| modification, at the population level, just doesn't work.
| GLP-1 agonists do.
| lurking_swe wrote:
| so at the individual level, you wouldn't encourage a
| patient to explore lifestyle interventions FIRST? That's
| seems unethical to me.
|
| I agree that at the population level, this will be a game
| changer. As you say, the average person struggles with
| lifestyle adjustments.
| bloopernova wrote:
| Perfectionism prevents progress.
| indiebat wrote:
| > Break out from the spiral
|
| I see the point in this, but do you think it's marketed as
| such and perhaps better question, used for exactly that and
| not more by vulnerable patients etc? (not well informed about
| long term side effects, some might even be unknown, if I
| might add)
|
| I take my vaccines and generally gravitate to sanity over
| conspiracy stuff (that is to say, If I sound like that, i'm
| not)
| tjader wrote:
| I don't think it's just people who have willpower and
| discipline, it seems to me that for most people it doesn't
| take as much willpower and discipline to stay at a reasonable
| weight. These arguments make it sound as if _everyone_ who is
| at a reasonable weight is there through large amounts of
| willpower and discipline, but most people I know don 't need
| to exercise X times per week and constantly watch what they
| eat to keep that weight.
|
| It's much easier when you can trust your body feedback and
| rely on your regular hunger signals, but for most people who
| benefit from Ozempic for weight loss if they just trust their
| bodies they will get fat.
| pixl97 wrote:
| Yea, when you look historically, starvation and food
| shortages were the norm. If you were a person that could
| pack on the pounds during the bountiful times, you could
| survive the lean times. Suddenly we live in the times of
| never ending plenty and we're told "what's wrong with you".
| xvedejas wrote:
| Most people don't work out enough, or don't eat well enough. If
| we had some kind of intervention that would easily cause people
| to work out, we would use that intervention. If we had some
| kind of intervention that would easily cause people to eat
| well, we would use that intervention. The reason working out
| and good diet are good is because of good health outcomes. If
| we have some kind of intervention that skips straight to the
| good health outcomes, we would use that intervention. It seems
| like Ozempic is _that_ intervention, so we will use it. I will
| likely choose Ozempic for myself once it is available to me.
| rootusrootus wrote:
| I want everyone who says this to submit a picture. Just wearing
| gym shorts, so we can get a good look. I assume nobody making
| this a moral issue will have so much as love handles. Because
| if they do, why aren't they working out harder and eating a bit
| less?
|
| I've met plenty of skinny fat people who think they're healthy.
| rootusrootus wrote:
| Man, some folks just don't want to be held to the same
| standard they want to hold everyone else to. Cowards ;-)
| Modified3019 wrote:
| Telling people they are morally bankrupt sinners (slothful and
| gluttonous) and heaping guilt and shame on their shoulders has
| unsurprisingly failed to stop the issue.
|
| Why do you think that telling people to "just stop being fat"
| will suddenly start working?
| cschneid wrote:
| In 2021 I lost a good chunk of weight the old fashioned way.
| From 250ish to 215. I did it with "good old fashioned working
| out and not eating more". It was a miserable, white-knuckle
| experience. I was eating healthy food, enough calories
| (moderate but sane deficit), but the only thing I thought about
| at all moments was getting to the next meal. What snack is low
| enough calories to have to make it. It was miserable. As soon
| as I let up a bit, everything unraveled and I found myself back
| in the 250s by the start of this year.
|
| Now I'm on Tirzepatide (Zepbound), and I'm back to 235ish, and
| trending lower. I still work on eating healthy, but now I'm not
| just HUNGRY at all moments. My life continues, and I only have
| to make individual healthy choices at meal times, and grocery
| times, rather than a constant struggle at all waking moments.
| It's seriously a big difference.
| DrillShopper wrote:
| > I still work on eating healthy, but now I'm not just HUNGRY
| at all moments.
|
| I think this is something a lot of people pushing back
| against the GLP-1 agonists don't realize because they don't
| experience it: back before I started Mounjaro (another GLP-1
| agonist) I was _constantly_ hungry if I hadn 't eaten a meal
| in the last 45 minutes. Absolutely zero hyperbole there - I
| once went to an all you can eat buffet, ate until I was over
| full, came home, and within about an hour and a half of that
| I was snacking on something because I was hungry. Not
| peckish. Not "feeling like a snack". Hungry to the point
| where that feeling intruded on my every thought until it was
| sated.
|
| After starting Mounjaro that's _GONE_. Gone gone. I now have
| to set an alarm to _remember_ to eat. It 's absolutely
| phenomenal and likely the reason why I'll live past my
| forties instead of being stuck in that same cycle and dying
| of the effects of obesity.
| pton_xd wrote:
| > Absolutely zero hyperbole there - I once went to an all
| you can eat buffet, ate until I was over full, came home,
| and within about an hour and a half of that I was snacking
| on something because I was hungry.
|
| I don't have any eating issues but that reminds me of the
| first time I went on a 7-day cruise.
|
| There's nothing to do on the ship, and the food is free and
| pretty tasty, so... I basically ended up at the buffet
| eating and drinking all day long. Sausage and egg biscuits,
| banana bread, pot roast, steak, pasta, fried rice, cinnamon
| buns, they had everything. I was stomach-busting full,
| every minute of every day. I'd gorge myself on a huge plate
| of Indian food from the buffet, and then a few hours later
| head to another deck for a lobster dinner. Not to mention,
| drinking coffee, beer, and wine the entire time.
|
| It was kind of insane. And what was crazier was after a few
| days of this routine I got used to it, and even looked
| forward to eating more food the next day. It was sort of
| like directly embracing one of the seven deadly sins to the
| maximum extent possible. I'm not sure what that experience
| means other than it seems like the the human body can
| comfortably arrange itself into a habitual downward cycle
| fairly rapidly.
| crooked-v wrote:
| It's because we're evolved for boom-bust cycles. Give it
| another 500,000 or so years and humans might evolve to
| cope with food always being available at all times.
| DrillShopper wrote:
| Not only that, but type 2 diabetes makes you
| paradoxically more hungry - your body thinks it is
| starving because it cannot get sugar into its cells so it
| makes you MORE hungry which causes you to get heavier
| which often causes the diabetes to get worse which makes
| you MORE hungry which means you eat and get heavier
| and......
| sct202 wrote:
| As someone who's never struggled with weight, it's been eye
| opening to hear how food focused a lot of peoples thoughts
| are. It was like on the same level as finding out some
| people can't visualize things in their minds.
| DrillShopper wrote:
| I don't think I've ever seen someone seriously put forth the
| argument "all you need is Ozempic".
|
| For context: I am an overweight type 2 diabetic. I lost about
| 70 lbs before my doctor started me on Mounjaro (another GLP-1
| agonist). My diet and exercise routine were far from perfect,
| and it took me about a _year_ to lose that weight. My doctor
| started me on Mounjaro, both for type 2 diabetes and weight
| loss. I have lost 20 lbs in about a month on it, which means I
| will lose _three times_ the weight if that pace keeps up (very
| unlikely). When my doctor and I discussed starting Mounjaro
| (which the doctor suggested, not me) he made it very, VERY
| clear that diet and exercise were important things to work on
| as the weight came off.
|
| The key there is that the pace of weight loss will not keep up
| as the body's caloric needs reduce due to that weight loss. So
| naturally a GLP-1 user will plateau if they do not adjust their
| diet (and potentially exercise routine, though diet is much
| more important) as the weight comes off. You know what really
| makes it easier to have the energy to a healthy meal, to work
| out, and to take care of yourself? Losing weight! You know what
| helps form those healthy habits in people who did not form them
| during childhood? Reduced cravings for calorie dense food! Both
| of those things are where Ozempic and other GLP-1 drugs shine.
| It gives the person on them the space to make those changes
| without cravings, without feeling hungry, and at a faster pace
| than they could do naturally.
|
| So yes, in the short term, these drugs are a great catalyst for
| change, but I don't see many medical professionals saying "oh
| just stick someone on Ozempic for life and that's that!"
| because for the vast majority of people who would use those
| drugs for weight loss cannot achieve their goals with just the
| drug alone.
| honkycat wrote:
| Why doesn't everyone play piano? Why isn't every person a super
| athlete? Why doesn't everyone meditate 40 minutes a day? Why
| doesn't everyone study super hard in school and become an
| engineer or doctor or lawyer?
|
| The hard truth: Not everyone is capable of those things.
| Period.
|
| 40% of the US population is considered obese. That is a HUGE
| number. At a certain point, you can no longer blame
| individuals. There is something wrong, and we identify it as an
| environmental problem.
|
| So if we have a drug that will make a huge amount of people
| healthy, what is the downside? And for the record: Ozempic
| affects appetite so they eat better, that is part of the drug.
| wiseowise wrote:
| > Why doesn't everyone play piano? Why isn't every person a
| super athlete? Why doesn't everyone meditate 40 minutes a
| day? Why doesn't everyone study super hard in school and
| become an engineer or doctor or lawyer? The hard truth: Not
| everyone is capable of those things. Period.
|
| We're not talking about world class athlete. There a mile
| difference between world class athletes and not obese.
| raincom wrote:
| Treat human beings or any organisms as biological machines.
| Here, many chemicals (hormones, for instance) regulate many
| processes in such machines. Whatever one has eaten so far,
| genetic history, environment, etc have changed hormones to a
| level where the model of dieting and working out doesn't work
| any longer. So, semaglutide and tirzepatide work on such
| regulatory hormones (GLP-1, GIP). In other words, what this
| research tells us that humans are not controlled by their
| personal will.
| vundercind wrote:
| Willpower and discipline don't seem to be what keeps other
| countries skinnier than the US (and most of them are also
| getting fatter...) so I don't know why we expect that to get
| the US out of this mess.
|
| Evidence: people from skinnier countries move here and
| consistently get fatter. It's a societal/environmental problem,
| if we're talking about "what would a policy fix look like?" and
| not "what can I personally try to do to save myself despite
| being up against a societal/environmental problem?"
| potta_coffee wrote:
| It's just human nature. This is the health equivalent of trying
| to turn lead into gold. It's my unproven opinion that the
| negative effects of these treatments are understated and this
| will be a passing fad.
| Eumenes wrote:
| > why is taking a drug a novel & cool idea
|
| https://www.glamourmagazine.co.uk/article/post-your-pill-tre...
|
| drug companies have spent millions on destigmatizing
| pharmaceuticals. its a superpower, apparently. a large swath of
| this userbase convinced themselves they have adhd and need
| medication for it. changing tabs on your chrome browser or not
| being able to do "deep work" = i have an uncurable disease and
| i require legal meth, for life. you can see how this translates
| to ozempic.
|
| silicon valley/tech culture has prioritized get rich schemes,
| cure alls like adhd meds, you don't have to eat just drink
| soylent for every meal, etc. ozempic falls in line nicely
| there, and i think among this community and others in this
| vein, you'll see alot of support for it. its sad, because
| tech/programmers/IT people use to be very contrarian and open
| minded. you get in trouble for saying things like "personality
| responsibility", "discipline', "self-control".
|
| > Are doctors required to explain this before prescribing this
| in US?
|
| doctors famously aren't trained on nutrition or fitness.
| ironically the prestige is being a specialist, not well
| rounded. strange.
| connicpu wrote:
| Completely missing the point of GLP-1 agonists. The point is
| that it breaks the cycle by giving you the willpower to eat
| less. It doesn't magically make the calories you eat not
| contribute to your weight, it just makes it easier to eat less
| and still feel full. It also counteracts insulin resistance,
| which is another problem inherent to obesity.
| orangecat wrote:
| Why are we bothering with contraception and STD vaccines when
| people should just not have sex unless they're trying to get
| pregnant?
| wiseowise wrote:
| I'm sure you'll find a lot of people in certain circle who'll
| share the same view.
| amatecha wrote:
| This article seems to frame things in such a strange way. Maybe
| instead of trying to get everyone obesity medication, we can
| instead educate society so we all understand nutrition and diet
| and can combat the ever-persistent forces of corporations pushing
| unhealthy food on us?
| gedy wrote:
| Look we've been educating people about this for the past 50
| years at least - education doesn't work with base impulses.
| cbsmith wrote:
| Yes, because what obese people lack is education.
| amatecha wrote:
| From my subjective experience in life, what they very often
| lacked was parents who set the right examples around food. I
| know that doesn't apply to everyone of course, but I've
| witnessed it time and time again - an upbringing with deeply
| disordered routines/practices around food. It's universal
| among obese people in my life. I speculate that better
| awareness of diet/nutrition _might_ help to prevent passing
| on such behaviours, like not feeding the family exclusively a
| bucket of KFC or McDonalds, or using food as a reward, etc.
| etc.. I mean, medication won 't actually solve what is caused
| by behaviour, right? Maybe the behaviour can be reduced on a
| broader scale, over time, via people making better-informed
| decisions? If parents know their habits around food are
| basically ensuring their kids will struggle with obesity,
| maybe they'll make the effort to do something different?
| Dunno, it seems like a reasonable consideration.
| cbsmith wrote:
| > From my subjective experience in life, what they very
| often lacked was parents who set the right examples around
| food.
|
| No amount of education will change who your parents were or
| how you were raised. Have you observed a strong correlation
| between how well educated someone is vs. obesity?
|
| > I speculate that better awareness of diet/nutrition might
| help to prevent passing on such behaviours, like not
| feeding the family exclusively a bucket of KFC or
| McDonalds, or using food as a reward, etc. etc.
|
| I'd encourage you to talk to any reasonably intelligent
| obese parent to see if they need better awareness of
| diet/nutrition. Better still, do a survey of obese and non-
| obese people to compare awareness of diet/nutrition between
| the two groups.
|
| > I mean, medication won't actually solve what is caused by
| behaviour, right?
|
| Saying that obesity is caused by behaviour and therefore
| can't be solved with medication is a bold statement to make
| in the context of a story about a drug that has been
| clinically proven to help obese people to lose weight.
|
| Medication is often prescribed to help people who suffer
| from behavioural problems with positive results. I wouldn't
| presume medication can solve all problems caused by
| behaviour, but there is empirical evidence that for some
| problems it does help. As near as we can tell, human
| behaviour is regulated by a electrochemical brain & nervous
| system. Dumping chemicals into that system can of course
| change human behaviour. We see evidence of that (for better
| or for worse) all the time. If you have doubts and you
| don't even need to get a prescription, try taking a hit of
| acid/cocaine/alchohol and see if behaviour changes.
|
| > If parents know their habits around food are basically
| ensuring their kids will struggle with obesity, maybe
| they'll make the effort to do something different?
|
| The US has had a dramatic increase in obesity within a
| single generation (as in, people who were not obese for
| much of their lives have become morbidly obese at a rate
| far exceeding previous generations), let alone cross
| generational. While food/nutrition/health habits can
| certainly have a profound effect on someone's weight, there
| are clearly other factors at play.
|
| Consider, for a moment, the reality of an obese person
| living in the US today. You get negative feedback about
| your weight all the time. You suffer negative social
| outcomes, let alone all the physical ones, so few, if any,
| _want_ to be obese. There is no lack of motivation to seek
| out information on how to avoid being obese. There 's a
| $300+ billion industry diet/health/nutrition industry
| constantly seeking to inform you about products they offer
| to help with your diet/health/nutrition... and that's not
| counting the doctors that you are no doubt interacting with
| regularly. Of course, that's not counting all the education
| (solicited or otherwise) you get from friends, family,
| acquaintances and even random strangers. It's hard to get
| through a day without being "educated" about diet,
| nutrition and health.
|
| There's a cultural bias to think the problem is simply
| about behavioural/willpower/education, much the same way we
| look at poverty. It demonstrates a profound lack of
| understanding of and empathy for the plight of people who
| are suffering from obesity.
| amatecha wrote:
| I didn't say "obesity is caused by behaviour and
| therefore can't be solved with medication". You're
| arguing against a straw man. I'm suggesting the idea that
| maybe we as a society should better educate around our
| relationship with food. I believe it would make a
| difference - just not immediately.
| cbsmith wrote:
| You're right. You didn't say that. You said (and I
| quoted) "I mean, medication won't actually solve what is
| caused by behaviour, right?" in commentary to an article
| about a medication used to treat obesity, while
| discussing the need for better awareness about
| food/nutrition.
|
| > I'm suggesting the idea that maybe we as a society
| should better educate around our relationship with food.
| I believe it would make a difference - just not
| immediately.
|
| It's a bit tautological that if we did something better
| things would be better. Better education around our
| relationship with food would start with people
| understanding that better education about our
| relationship with food won't help people suffering from
| obesity.
| amatecha wrote:
| Yeah, my original post is focused on the idea that
| "getting everyone on ozempic" isn't a long-term
| sustainable solution to obesity. It is a reactive, band-
| aid workaround that will never tackle the underlying
| causes. It will help someone survive and live a better
| life, but the moment they stop taking ozempic they are
| back at square one, haven't gained the
| wherewithal/discipline to fight the constant urges to
| eat, and will be right back where they started. I mean,
| unless this is some miracle drug that has
| residual/lasting effects?
|
| In light of that, and barring the many other ways one can
| combat obesity themselves, it would probably be
| beneficial if everyone, in general, knew all about the
| pitfalls of disordered eating and knew more about how to
| combat that trap, and knew why that actually matters for
| themselves and the people they care about. I've observed
| people enable each others' obesity over and over. I've
| observed people reinforce horrible habits and be
| unsupportive of others' efforts to combat those habits.
| People don't know shit about diet and food and spread
| their ignorant, lazy attitudes and behaviour to those
| around them. Why make a real meal when you can just order
| $50 of takeout to feed the whole party? Then, if you
| don't eat "enough", everyone is on your case because "you
| must be starving" and "why are you eating so little?",
| because they are totally uneducated about the possible
| challenges people face when it comes to food. The more
| people know about this stuff, the more it benefits
| everyone. I still think this also circles back to the
| "passing it to your kids" thing, because it's now a
| multi-generational problem.
| lostmsu wrote:
| Educating people will hardly work. Bans on junk foods at
| government level might.
| eniwnenahg wrote:
| In EU they banned the sale of oral tobacco (snus), which is
| safer than smoking tobacco. Snus once had cancer labeling but
| that was generally considered not-very-true and labeling was
| removed. Tobacco smoke causes cancer. Drug bans also built
| many overfilled prisons and likely contributed to the
| invention and spread of harmful drugs such as crystal meth
| and fentanyl. This is a one sided view of course. I like
| William Blakes work, "Auguries of Innocence".
| amatecha wrote:
| If educating people didn't work, we'd all be drinking cocaine
| soda and burning leaded fuel. I mean, there's a reason things
| have generally greatly improved over time for most of
| humanity. We know more things and act upon that knowledge.
| This applies to basically every single thing humans do. Maybe
| one day we won't be drinking sugar water and adulterating
| ~every piece of food on the shelf with high-fructose corn
| syrup?
| cthalupa wrote:
| > If educating people didn't work, we'd all be drinking
| cocaine soda and burning leaded fuel.
|
| When the person you are arguing with is saying that
| government induced bans would probably help more, and your
| are arguing they're wrong and your two examples were
| resolved by government induced bans, you're going about
| arguing in a very strange way.
| ndsipa_pomu wrote:
| Unfortunately companies make more profit by pushing unhealthy
| food onto consumers which can be evidenced by the money they
| spend advertising it. They're exploiting our instincts to seek
| out high calorie foods which was an advantage when humans
| didn't have a ready supply of food available at all times, but
| nowadays leads to a whole host of illnesses.
| filoleg wrote:
| Why either/or?
|
| Maybe we should try educate society on dangers of using heroin.
| I agree that it is a good thing, and we should continue
| educating people about its dangers. But clearly that alone
| didn't solve the problem, and I think it would be a good idea
| to utilize alternative options as well (in addition to
| continuing the education of society on its dangers).
| dghlsakjg wrote:
| Do you think overweight people don't know why they're
| overweight?
|
| There are plenty of obese people that understand nutrition just
| fine, there are obese people who understand it well enough to
| have lost significant weight and gained it all back.
|
| Clearly there is something else going on that we haven't
| grasped yet.
| amatecha wrote:
| Education may involve "finding a strategy that works for
| you". There are so, so many different ways to combat
| disordered eating. These are learnable things. My thought
| around "better education" is that the cycle of disordered
| eating can be stopped at some point before parents pass it on
| to their kids, at least (as I just posted in adjacent comment
| https://news.ycombinator.com/item?id=41811916 ). I absolutely
| recognize how insanely difficult it is to come back from
| disordered eating and stay at a lower weight after finally
| reaching it.
|
| Though, now that you ask, I do think that many people don't
| actually know why they are overweight. They say it's because
| "McDonald's is cheaper than buying good food", not realizing
| the McDonalds won't satiate them and they will eat/spend more
| because their body is starved for proper nutrition. Watch the
| series "Supersize vs. Superskinny" and observe how nearly
| every participant is utterly clueless as to the underlying
| causes of their challenges on either size of the disordered-
| eating scale.
| 2snakes wrote:
| Psychology of hunger behaviors.
| slothtrop wrote:
| Understanding nutrition, and eating habits in practice, are
| two very different things.
|
| Regaining weight is the primary issue really. Most people are
| capable of losing weight, but gain it back, and it gets
| harder going forward. Metabolic adaptation is better
| understood now and among the factors (.e.g increasing caloric
| intake too quickly after weight loss), but falling into old
| habits that are culturally ubiquitous is a glaring part of
| the problem.
|
| Former drug addicts are told now to sever contact with peers
| who partook in those indulgences as they're likely to pull
| them back in. With food, it can be more than a minor
| subculture. There are regions of the US that have much higher
| obesity rates than others. Not having family members and a
| romantic partner on board can be difficult.
| dghlsakjg wrote:
| That's kinda part of my point. Cutting yourself off from
| drug enablers is one thing. Cutting yourself off from your
| friends and family is another. Especially since eating is
| something you can't not do, and is deeply tied to cultural
| and social customs of everyone. It is impossible to live
| and never be offered an unhealthy food choice no matter how
| much support and good decisions there are. Conversely, it
| is very easy to live my life without being offered heroin.
|
| Plenty of overweight people really, really, really want to
| lose weight and do all of the right things, but report that
| it is difficult to impossible to maintain the weight loss.
| Many of them gain the weight back, and this is crucial, but
| don't continue gaining past a certain point. Combine that
| with the very regional nature of obesity and I think that
| there is a VERY strong case to be made that there is an
| environmental or external cause of obesity that we haven't
| identified yet (junk food is too simple of an explanation,
| and doesn't adequately explain everything).
|
| The point I'm getting at is that a lot of these drugs also
| yield some sort of drastic behavioral change like a reduced
| indulgence in other impulsive harmful behaviors. I really
| think that there is something that is throwing us out of
| whack behaviorally, and obesity is a symptom of that.
|
| The fact that a hormonal correction is able to fix both
| obesity and other addictions is a very interesting result.
| amatecha wrote:
| > Cutting yourself off from your friends and family is
| another.
|
| This is exactly one of the reasons I think better
| education around food/diet/nutrition is important. You
| don't need to cut yourself off from enabler
| family/friends if they aren't enablers to begin with.
| It's cultural, too. The portion sizes at all the
| restaurants in a given region because "we like to eat big
| meals here", or whatever. There are sooo many factors and
| the underlying flaw, to me, is ignorance of "how this
| stuff works".
| slothtrop wrote:
| > external cause of obesity that we haven't identified
| yet (junk food is too simple of an explanation, and
| doesn't adequately explain everything).
|
| You can't divorce it from the explanation. People get
| obese from overconsuming calorie-dense rich foods. These
| products are manufactured to be as savory and addictive
| as possible, are highly available, and convenient, _and_
| very affordable, and most are non-satiating (especially
| drinks). So yes there are environmental factors, but the
| reason they matter in the first place is the impact of
| junk foods. At the turn of the 20th century even
| relatively sedentary office workers would not gain much
| weight, because the American industrial machine did not
| yet create the landscape we have now. No one was buying
| several bottles of 2L coke, chip bags, jumbo fries and
| fried chicken, greasy pizza, starbucks lattes, etc.
|
| And to avoid confusion, I want to make clear that
| avoiding weight-gain at the outset (to the extent of
| becoming obese), and losing weight, are different. What's
| sufficient for the former is insufficient for the latter;
| you do not need to be mindful of energy balance if you
| are already at a healthy weight and consume whole foods,
| but if you are trying to _lose_ weight, that will not be
| enough to ensure a caloric deficit.
|
| A comparison I like is a bag of chips vs a bag of apples.
| Bags of potato chips average 1200 calories. One would
| need to consume 16 apples to get the equivalent. I can
| probably get through an entire bag of chips if I cared
| to, and more than half a bag absent-mindedly if I was
| irresponsible. Try consuming more than a single large
| apple and see how that feels. Fiber is almost as
| satiating as protein. It may not keep you full as long,
| but you certainly reach satiety a lot faster than you
| would with chips (notwithstanding that in fairness they
| are less addictive without salt and fat).
| triceratops wrote:
| If we could do that through education, then we'd have made it
| illegal for corporations to push unhealthy food.
| winterrx wrote:
| David Friedberg recently did an All-In Interview with the CEO of
| Eli Lilly. Interesting conversation over there that also talked
| about some key points of the article.
|
| https://www.youtube.com/watch?v=023exhA9irY
| tonymet wrote:
| Yet another drug that patches up symptoms without addressing the
| root cause. People will be dependent on the drug for life. And we
| still don't know what the adverse effects are.
| cubefox wrote:
| We don't know the root cause yet and therefore can't treat it,
| so the drug is great for what it is.
| tonymet wrote:
| The root cause is depravity
| jaco6 wrote:
| I'm just as curious as to why some people are so willing to take
| numerous medications, while others go to any lengths to avoid
| them. Some people are happy to be on an SSRI, sleeping pill,
| statin, low dose aspirin, and a few others, and aren't bothered
| by this. Other people seem instinctively revolted by prescription
| drugs, seeing toxins pushed by evil corporations. Is it a trust
| issue?
|
| I personally detest and avoid all medicines other than
| antibiotics and vaccines. Pharmaceuticals have a long track
| record of harboring "side effects" that only become apparent
| years later.
|
| In general, why are we surprised that the chronic use of any
| substance has negative effects? Humans evolved for thousands of
| years eating food and drinking water. Regularly consuming
| anything else is an abberration and self-experiment.
| lurking_swe wrote:
| I think the answer to your question is that people who avoid
| drugs understand that drugs do not fix anything permanently, in
| 99% of cases. They only treat symptoms. The people who avoid
| drugs attempt to treat the underlying problems.
|
| of course it's not always practical. For example, some skinny
| people are simply genetically predisposed to high blood
| pressure, even if they work out and eat pretty healthy. It's
| rare, but these things happen.
| jackcosgrove wrote:
| To address the question in your first paragraph, I think it's
| due to whether you think your locus of control is internal or
| external.
| poorinterview wrote:
| You can have an internal locus of control and still believe
| the benefits of taking something like an SSRI far outweigh
| the costs of attempting to address depression/anxiety more
| "naturally." I'd rather take an SSRI if it means more
| motivation to live healthily, positively, productively for
| myself and family. If anything, the drug could very well help
| someone discover their sense of agency.
| Blackthorn wrote:
| Nobody ever gets sus about needing to take heart medication
| every day to stay alive but the moment it becomes about how I
| take Lexapro every day they get real preachy.
| poorinterview wrote:
| Which is sorta funny because some antihypertensives are known
| to decrease anxiety.
| rootusrootus wrote:
| Maybe we can find a medication people will take that solves
| the preachy problem instead. That might achieve significant
| population-wide improvements.
| akira2501 wrote:
| > Other people seem instinctively revolted by prescription
| drugs, seeing toxins pushed by evil corporations.
|
| You can advertise drugs on TV in the USA. This certainly opens
| the door for bad drugs to get pushed out and marketed to people
| who don't have the technical skills to examine the claims and
| the risks of side effects objectively.
|
| > avoid all medicines other than antibiotics and vaccines
|
| Just because it's been such a hobby horse lately I would have
| to add pain killers. There is absolutely a large potential for
| abuse but they also serve an incredible utility to modern
| medical care.
|
| > Regularly consuming anything else is an abberration and self-
| experiment.
|
| Ozempic should be for people who are obese and have thoroughly
| demonstrated that they are not physically capable of exercising
| themselves enough to lose weight naturally.
|
| Otherwise, this drug gets marketed as an obesity cure, but it's
| mostly dispensed for cosmetic purposes. If there are any side-
| effects, it will be a double tragedy for these people.
|
| I'm with you, it's a little revolting, this specific drug.
| poorinterview wrote:
| Ozempic and similar drugs are being used by many to get rid
| of the food noise and insatiable hunger that have stood in
| the way of sustainable progress. These drugs are being used
| as catalysts for healthy living. The fact that they seem to
| work thus far is evidence that obesity is on some level
| driven by powerful hormonal forces that influence impulse
| control and willpower, which addressed, can give people the
| freedom to make better decisions and effectively pursue a
| lifestyle they've struggled to maintain.
|
| The cosmetic narrative you're pushing is actually quite
| disgusting.
| akira2501 wrote:
| > These drugs are being used as catalysts for healthy
| living.
|
| You have some evidence for this claim?
|
| > is evidence that obesity is on some level driven by
| powerful hormonal forces
|
| It's suggestive. It's nowhere near evidence.
|
| > the freedom to make better decisions
|
| As long as they're on the drug.
|
| > The cosmetic narrative you're pushing is actually quite
| disgusting.
|
| No it isn't. It's a valid concern about how this medication
| is _marketed_ and _dispensed_. It's also an obvious concern
| to have. Pretending that I'm disgusting because I'm
| actually worried about the future outcomes for these
| patients is bullying highroad nonsense. Come off of it.
| crooked-v wrote:
| > You have some evidence for this claim?
|
| The obvious evidence is the result of the drug, i.e.,
| overweight people losing weight because they're eating
| less.
| akira2501 wrote:
| The obvious countertpoint is that obesity rates have not
| been constant for the last few decades.
|
| So there are clearly multiple factors here and those
| should be taken into consideration before uncritically
| deciding this is a "good thing" that we should "all be
| on."
| crooked-v wrote:
| > that we should "all be on."
|
| Who, exactly, has claimed that?
| poorinterview wrote:
| I've been on Zepbound since July and have lost 40lbs in
| that time through calorie restriction, intermittent
| fasting, and resistance training 3x per week, which all
| felt like impossibly herculean tasks before starting the
| medication. I know others who've had similar experiences.
| Sorry I haven't published a paper on it.
| dopylitty wrote:
| I'm curious why you include antibiotics in your trusted
| medications list.
|
| Over the past several years we've found that antibiotics have a
| huge impact on beneficial microbes in your body which then has
| downstream impacts on your health [0]. Oddly enough for the
| topic in this article exposure to antibiotics as a child may be
| linked to obesity[1]. They are also extremely over prescribed
| for things like viral illnesses [2].
|
| I personally wouldn't take an antibiotic unless whatever malady
| I was suffering from was proven to not only be bacterial in
| origin but likely to progress without treatment.
|
| Regarding your larger point some of the distrust of medications
| can be related to the fact that people know that medication
| producers' goal is to be profit for the most part.
|
| Because they are for-profit the medicine producers can't be
| trusted to produce quality products or to produce products
| which resolve a problem rather than just reducing symptoms as
| long as the patient continues to pay for the medicine.
|
| As with other problems we have a low trust society because it's
| a society built on for-profit enterprises rather than
| enterprises focused on doing the best thing for society.
|
| 0: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756738/ 1:
| https://www.nature.com/articles/ijo2014180 2:
| https://pubmed.ncbi.nlm.nih.gov/37876436/
| pfdietz wrote:
| > I'm curious why you include antibiotics in your trusted
| medications list.
|
| Because bacterial infections can be horribly lethal?
| rootusrootus wrote:
| Can be, sure, but most are just unpleasant and you'll
| eventually recover. Why not just do it the natural way?
| pfdietz wrote:
| Most clicks of the revolver in Russian Roulette are just
| unpleasant and not lethal too. Why take the chance?
| rootusrootus wrote:
| > seeing toxins pushed by evil corporations. Is it a trust
| issue?
|
| That sounds a lot like the divide between people who see
| conspiracies everywhere and those who do not. In that case I
| would suggest it is just personality, not logical and not
| solved by improving trust.
| jijji wrote:
| you can buy tirzepatide / semaglutide all day long from labs in
| china for between $4 per injection all the way down to $0.50 per
| injection depending on quantity and type (prepackaged in vial vs
| raw powder)
| rootusrootus wrote:
| After tirzepatide was taken off the shortage list last week, I
| notice that there are suddenly a lot more people talking about
| this route. It will be interesting to see how it plays out.
|
| Probably exceeds my comfort level, and I'm lucky enough that I
| can pay the $550/month for name brand if necessary. A lot of
| people will just have to stop, though, and deal with the
| consequences.
| optimalsolver wrote:
| What happened to self-control?
| crooked-v wrote:
| The same thing that always happened to it: for a lot of people
| it just doesn't work.
| DCH3416 wrote:
| Screw that
| moogly wrote:
| Turns out "just stop being fat lol" isn't very effectual
| advice.
| pfdietz wrote:
| It's the "git gud" of diet advice!
|
| I wonder if GLP-1 agonists are going to break gaming
| addiction too.
| triceratops wrote:
| If you got it, use it. If you don't got it, there's a little
| help now.
| avelis wrote:
| That's not a thing when considering how UPF creates addiction
| to food in the brain. Big Food knows this.
| hipadev23 wrote:
| Who has time to eat? Founder mode all day every day.
| cubefox wrote:
| Now that's the spirit!
| grecy wrote:
| My god no.
|
| I'm 42 and I've never taken more than the odd painkiller or
| antibiotic here or there - less than a pill a year on average I'm
| sure.
|
| The last thing in the world I want is to be permanently on some
| drug that alters how my body works. I hike, snowboard, go to the
| gym and eat sensibly. That's all the "weight control" I need.
| honkycat wrote:
| Good for you man. 40% of the US is obese, we need a solution
| for better health outcomes.
| ocular-rockular wrote:
| So drugs?
|
| I think it's a lot simpler than that. US has an abusive
| relationship with junk/processed food. It's so deeply
| ingrained due to profit margins, wealth inequities,
| nonsensical subsidies, etc. that the only feasible solution
| is to introduce a drug that continues to allow that
| relationship to continue.
|
| It's a lot easier of a solution than it is to tell companies
| to stop making garbage or saturating everything with sugar
| and HFCS. "Easier to see end of the world than end to
| capitalism" -- its the same shit packaged in a different
| story... Easier to introduce a drug to treat the symptoms
| than to solve the actual problem.
|
| Mind you, I'm not implying that it is easy. We have
| collectively accepted this which makes change difficult if
| not impossible.
| grecy wrote:
| You make it sound like it's out of your control.
|
| The solution is already there. It's free. It works for
| everyone, and even 60% of people in the US are doing it!
|
| The right answer to being healthy is not more drugs.
| rootusrootus wrote:
| > 60% of people in the US are doing it!
|
| 25% is the number you were looking for, and even within
| that group I think you'd find plenty of people with a
| healthy BMI that are in fact not living a healthy
| lifestyle.
| crooked-v wrote:
| Do you drink coffee or tea?
| grecy wrote:
| Coffee really affects me, so I gave it up. I drink decaf tea
| these days.
|
| Why do you ask?
| ironman1478 wrote:
| ` I hike, snowboard, go to the gym and eat sensibly. That's all
| the "weight control" I need.`
|
| So you are likely in an income bracket that enables you to have
| an active lifestyle outside of work and take the time outside
| of work to cook, in addition to probably other hobbies. this is
| not a criticism of you, but if I had to guess, you simply have
| a life that many other's do not. I work out and take care of
| myself because I make $300k+, have less worries and
| responsibilities, and I actually have an easier job than when I
| was making less.
|
| A lot of people don't have money or don't have the time for
| working out and making the correct meal choices. Yes, there are
| people who have money and time and are still overweight,
| however that is not the norm as you go up the income brackets.
| Many poorer people have long work days, with an additional long
| commute, and are more likely to have kids, meaning they have no
| time for themselves. They're not gonna go to the gym if they
| already have a long day and they probably aren't going to make
| healthy food choices when they're already beat up and have not
| a lot of time for themselves.
| grecy wrote:
| And you think the solution is a prescription drug?
| ironman1478 wrote:
| In the moment yes. Do you have an actually reasonable set
| of laws that could solve these societal level problems that
| encourage obesity in let's say, the next ten years? Also,
| they have to be passable.
|
| Here is another disease caused and triggered by society.
| Asthma. Cars cause tons of pollution and people who live
| near highways are at much greater risk of experiencing
| asthma. However, society as a whole suffers from the
| pollution generated by cars. We all know this. The bay area
| has something called "spare the air day" which is a day
| where they ask people to not drive, when it's particularly
| smoggy. This has never worked. There are always people
| driving, because they gotta get places and the bay area
| can't built trains and the buses are awful. So people
| drive. What is the societal solution to localized pollution
| (like smog)? Better public transit, higher taxes on gas and
| on larger vehicles which produce more tire based pollution,
| and more tolls. But we don't do any of that. We know as a
| society how to reduce car based smog, which would reduce
| asthma and other diseases, but we don't do it, so we throw
| inhalers at people to get them to stop complaining. It's
| not super different from the weight problem in my eyes.
| grecy wrote:
| > _Do you have an actually reasonable set of laws that
| could solve these societal level problems that encourage
| obesity in let 's say, the next ten years?_
|
| Sure, Canada banned trans fat.
|
| There is absolutely no reason they couldn't ban drinks
| that contain more than x% sugar, or portion sizes that
| are bigger than y calories.
|
| > _Here is another disease caused and triggered by
| society. Asthma. Cars cause tons of pollution_
|
| Excellent example!
|
| Internal Combustion Engines will be illegal in new
| vehicles from 2030 in many jurisdictions around the world
| (2035 in others). Yes, it's coming!
| ironman1478 wrote:
| Tire and brake particulate is actually a big component of
| pollution and EVs will cause more pollution from tire and
| brake debris, which is already a larger portion of
| pollution than tail pipe emitions. We're increasing one
| type of pollution and decreasing another type, we'll see
| if long term it's a net benefit.
|
| Also, they could ban those things in places like SF or
| more liberal places, however I believe those are
| politically losing policies and wouldn't pass in places
| that are actually experiencing obesity.
| tintedfireglass wrote:
| That's so dystopian. So you are just saying that society
| doesn't have time to take care of themselves, so we need some
| drugs to fix our collective horrid lifestyles? It's an easy
| temporary fix but what cascading effects might that cause on
| the future? Who knows?
| ironman1478 wrote:
| Well, I'm describing how I perceive the world to be right
| now and ozempic is a technological solution to a societal
| problem. If as a society we can make steps to fix it (more
| walkable cities, less work in general, cheaper society,
| encourage smaller portions) then sure, maybe we don't need
| ozempic. But people have to organize and get involved in
| government to make this happen, which is harder than making
| a pill (it seems).
| grecy wrote:
| > _If as a society we can make steps to fix it_
|
| What society does or does not do has no impact on me
| consuming less calories on a daily basis.
|
| I have the opportunity to buy soda 50 times a day. I
| choose not to.
|
| I have the opportunity to buy a burger and fries for
| lunch. I choose not to.
|
| Society could make many such things illegal or whatever,
| but at the end of the day what goes into my body is up to
| me. The buck stops with me and my choices.
| pyrophane wrote:
| One thing that it seems we are just starting to talk about with
| these drugs is the associated muscle and bone density loss. I'm
| concerned that this generation of GLP-1 early adopters will wind
| up more frail and suffer a lower quality of life in old age as a
| result.
| petesergeant wrote:
| I've seen zero evidence that muscle loss from GLP-1-assisted
| weight-loss is any different to the muscle loss from simply
| eating less. Do you have a link to a study I've missed?
| cyberax wrote:
| > One thing that it seems we are just starting to talk about
| with these drugs is the associated muscle and bone density
| loss.
|
| Muscle loss is associated with _any_ kind of weight loss.
|
| And GLP-1 drugs _improve_ the bone density:
| https://academic.oup.com/jcem/article/100/8/2909/2836097 It's
| likely simply because thinner people naturally move more.
| ploppyploppy wrote:
| Can these negative effects be countered/offset by continuing
| weight training? I lift 2-4 days a week.
| cyberax wrote:
| Certainly, just like with any other diet.
|
| I gained muscle mass by doing strength training 2 times a
| week while on GLP-1 drugs.
| cthalupa wrote:
| Yes, but you would certainly still see some - it's just a
| consequence of weight loss. Even IFBB bodybuilders on god
| knows how many steroids see some muscle loss when cutting.
|
| Eat a whole lot of protein, lift, and you're going to be
| doing more than fine in the muscle loss department.
| r00fus wrote:
| My program strongly recommends some form of muscle training
| (pushups/weights/etc) as they see improvements from muscle
| development for weight loss and to counteract the muscle loss
| from losing weight.
|
| The fact remains that having to carry around 50+ extra pounds
| of fat requires more muscle. When that requirement goes away so
| does your need for that musculature.
| k__ wrote:
| How are the side effects?
|
| I read plastic surgeons said it was bad for your skin and people
| would look much older when they take it for a few months.
|
| Yet, I also read it was generally good for your health, not just
| in terms of weight loss.
| logicchains wrote:
| I'm not a fan of the drug but that aging could just be due to
| the weight loss: skin generally looks more wrinkly (older)
| after losing weight.
| jart wrote:
| It depends how old you are. Skin loses its elasticity after a
| certain age. So weight is a problem you should spare no
| expense fixing sooner rather than later. Even if you do
| something about your weight at a later age, the health
| benefits for your heart for example will greatly outweigh the
| loose skin.
| cyberax wrote:
| One other note: the current peptide-based GLP-1 drugs are not
| likely to be the permanent solution. Injectables are just too
| problematic for that.
|
| Several companies are now working on more classic small-molecule
| drugs targeting the same receptors. So it's likely that in
| several years we'll get a pill with the same effects.
|
| Yes, there's technically a pill version of Ozempic already
| (Rybelsus), but it works by making the stomach wall to be
| slightly permeable to peptides. You can guess that it has pretty
| unpleasant side effects, and an awesome bioavailability of 0.7%
| connicpu wrote:
| I'm curious what about injectables makes them specifically
| problematic for long term use? Diabetics already have to inject
| insulin for the rest of their lives, and an injectable version
| of the same drug usually has fewer side effects since it
| doesn't have to pass through your gut metabolism. I may be
| biased, I have no fear of needles and have injected myself with
| sex hormones every week for nearly 7 years, so adding an
| autoinjector doesn't seem like that big a deal to me.
| cyberax wrote:
| They are more expensive. Autoinjectors are way more
| complicated than a pill bottle. You also can't freeze them,
| but they should be kept in a fridge.
|
| Manufacturing standards also have to be way higher. I have no
| problem trusting Novo Nordisk to manufacture injectors
| safely, but I won't trust a random manufacturer from India or
| China.
|
| The risk of accidental infection from injection also is not
| neglibible.
| connicpu wrote:
| Fair considerations, I just disagree that it makes
| injections inherently problematic for long term use.
| Primarily because I have doubts about the possibility of a
| pill that doesn't come with more side effects than an
| equivalent injectable.
| djsavvy wrote:
| My pet crackpot theory is that within the next 100 years
| semaglutide is going to be in the drinking water (much like
| fluoride) because the benefit to society is going to be too hard
| to pass up on. However, it seems that it's delivered via
| injection so maybe putting it in the water supply wouldn't even
| be effective.
| cooljacob204 wrote:
| I don't think anything that can influence our choices would
| ever get enough public approval for that.
| logicchains wrote:
| It's funny you say that because just now the US is starting to
| re-consider water fluoridation: https://www.theguardian.com/us-
| news/2024/oct/04/fluoridation... .
|
| It's also relative uncommon in other developed countries;
| according to Wikipedia, "Out of a population of about three-
| quarters of a billion, under 14 million people (approximately
| 2%) in Europe receive artificially-fluoridated water. Those
| people are in the UK (5,797,000), Republic of Ireland
| (4,780,000), Spain (4,250,000), and Serbia (300,000)."
| supportengineer wrote:
| The benefits of fluoridation were amazing. I didn't have a
| single cavity until I was 25 and had moved away from that
| area to a non-fluoridated area.
| ninalanyon wrote:
| Don't you clean your teeth with a fluoridated toothpaste?
| That should be plenty good enough, no need to put it in the
| drinking water.
| supportengineer wrote:
| That's what I'm telling you. It's not the same.
| calculatte wrote:
| Even if that is true, there's no reason to bathe in it,
| cook with it, water our lawns with it.
|
| And now it's becoming clear that IQ is affected by
| fluroride
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409983/
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/
| https://www.reuters.com/world/us/epa-must-address-
| fluoridate...
|
| So how about we keep it out of our drinking water. If you
| want to put fluoride on your teeth, use fluoridated
| toothpaste.
| marcosdumay wrote:
| Keep in mind that the fluoride concentration on those two
| papers is way larger than what most of the world
| practices.
|
| In fact, WTF is India doing there? Don't they have limits
| on it?
| rootusrootus wrote:
| The funny thing is that if you live in Portland, famously one
| of the few large cities without fluoride in the water, the
| dentist can immediately tell if you grew up here.
|
| I would guess that in today's world a lot of people get
| enough fluoride through processed foods being made in places
| that have fluoridated water.
| Eumenes wrote:
| The day Ozempic/similar drugs become approved for weight loss
| under ACA/Medicare is the day I stop paying taxes.
| pfdietz wrote:
| Good news! You'll probably be able to get GLP-1 agonists in
| prison.
| snvzz wrote:
| There are legal ways to stop paying taxes in a country, such
| as moving elsewhere.
|
| It is a much safer assumption to make than tax evasion.
| Eumenes wrote:
| You're required to pay taxes to the US forever, unless you
| renounce your citizenship, which costs money too:
| https://www.forbes.com/sites/robertwood/2022/07/06/leave-
| us-...
| snvzz wrote:
| Renouncing citizenship does cost money?
|
| Jesus. I am glad not to be a US citizen; I moved to Japan
| and very easily stopped paying taxes to my former
| country.
| ogogmad wrote:
| I'll bite: Why?
| valunord wrote:
| Fuck that. Just have some willpower! Some of us have been doing
| OMAD without assistance, just grunting through the stress and
| pain for years. It's much healthier than drugging up.
| snvzz wrote:
| After one year of OMAD and 15kg less, I am now at about ideal
| weight by BMI (22).
|
| I didn't even need much if any willpower past the first couple
| days.
|
| This push for Ozempic is utter madness.
| steveBK123 wrote:
| One lurking concern I've had around this space is that junk food
| makers simply find a way to make their food even more addicting.
|
| Arguably though, ozempic'd customers and shrinkflation'd products
| would be a recipe for amazing margin improvement. And they can
| dress it up as doing good because its better for people, (like
| the 100 calorie snack packaging).
| sph wrote:
| You can see that in the lab-grown burger space already: it is a
| massive opportunity for companies to create an ultra-processed
| version of meat, and label it as healthy as the public opinion
| has gone blindly against meat and on the vegan bandwagon.
| They'll claim it's more eco-friendly, they can sell it 5x the
| price of beef and rake billions.
| rootusrootus wrote:
| > public opinion has gone blindly against meat
|
| Only if you spend too much time online. In the grocery store,
| I don't see any indication that meat substitutes are gaining
| traction. If anything, popularity seems to be ebbing. The
| people choosing fake beef for their burgers are a tiny
| minority.
| steveBK123 wrote:
| Indeed, a COVID era ZIRP funded fad that has fallen on hard
| times.
|
| A product that fits a niche - former meat eaters who miss
| meat and want to be vegetarians.
|
| Otherwise for true health conscious or longtime vegetarians
| there are better options.
| sph wrote:
| True, the point is that the online minority is the loudest
| and in this day and age they drive change. I heard talks of
| taxing red meat in UK, for example, which is absolutely
| ludicrous.
| dfxm12 wrote:
| Instead of a system that makes these drug available for purchase,
| I'd rather live in a system that promotes healthy food and active
| behavior. Unfortunately, I have to drive everywhere, work too
| many hours to have free time for recreation and have no idea
| which government subsidy is going to help big ag likely at the
| expense of my health.
|
| All things being equal, I'd prefer to spend less money on
| prescriptions and have fewer trips to the doctor.
| from-nibly wrote:
| You don't have to worry about which government subsidy is going
| to help big ag at the expense of your health. It's all of them.
| paulcole wrote:
| This is like saying, "All things being equal, I'd prefer Santa
| Claus bring presents on Christmas Eve than have to go shopping
| for my kids."
|
| It's like well duh of course you'd prefer the impossibly
| unrealistic miracle.
| wizzwizz4 wrote:
| Other countries do it.
| https://en.wikipedia.org/wiki/Change4Life
| sbelskie wrote:
| Is there any evidence it's effective?
|
| https://en.m.wikipedia.org/wiki/Obesity_in_the_United_Kingd
| o...
| wizzwizz4 wrote:
| The claim was about _promotion_ , not effective
| promotion. (As a sibling comment points out, _effective_
| promotion is not unrealistic either. It won 't happen on
| its own, but nothing does.)
| card_zero wrote:
| So other countries would _officially_ prefer the
| impossibly unrealistic miracle.
| sweeter wrote:
| the UK has basically become the US by most metrics. This
| includes the increasing privatization of health services,
| transport, etc... and the excessive commodification of
| basic necessities like housing.
|
| I find that saying that health initiatives don't work by
| vaguely gesturing at a country, is not a structurally
| sound argument. Its like the sentiment here is: "is the
| fact that we include Pizza as a vegetable in American
| schools part of the problem? Nooooo, that can't be it. it
| must be a moral issue!" and thats just one example.
|
| The obesity problem in the US is tied directly to our
| relationship with highly processed (and CHEAP) food.
| Along with the stranglehold those companies have over
| state and federal institutions that allow them to
| directly sell these foods in schools and institutions,
| and heavily skirt FDA regulations via lobbying.
|
| The US is uniquely bad when we have a ton of chemicals
| and ingredients in our foods that are banned in most
| other countries. It is largely a systemic problem and a
| problem that can easily be solved. Poorer people tend to
| eat cheap food, cheap processed food isn't well regulated
| and is directly tied obesity and a whole host of health
| problems.
| ahahahahah wrote:
| hahaha.
|
| "The UK has seen its obesity rates increase faster than the
| US. In the UK, obesity has risen sharply since 1990, when
| it affected only 14% of adults. The UK is also considered
| one of the most overweight countries in Western Europe."
|
| In addition, since the introduction of Change4Life, the
| obesity rate has simply continued to climb in the uk (see h
| ttps://researchbriefings.files.parliament.uk/documents/SN03
| ..., for example).
|
| So yes, other countries (just like the US), have introduced
| programs to try to encourage healthier behaviors, and have
| seen similar outcomes from them.
| SapporoChris wrote:
| Of course it is impossible to live a healthy lifestyle and
| have healthy weight, if you ignore the 3/5ths of Americans
| that are not obese and the 7/8th of the global population.
| Teever wrote:
| Are the 3/5ths of Americans who are not obese actually
| living a healthy lifestyle? Or are they just living a
| different unhealthy lifestyle?
|
| Is a skinny homeless methhead with a great BMI healthy? Or
| the blue collar dude who has terrible blood pressure from
| chain smoking and pounding energy drinks on his way to the
| job site?
|
| How many Americans who are not obese are on their way to
| becoming obese?
|
| There are lots of paths to unhealthiness and overeating /
| eating poorly is only one of them
| valval wrote:
| Obesity and poor metabolic health is by far the greatest
| predictor of an early death.
| Teever wrote:
| Yes of course, but the point I'm making is that people
| who aren't obese aren't necessarily healthy.
|
| People aren't born obese. They get that way through
| mistreating their body for a long period of time, and it
| is quite possible for them to die before they become
| obese to other maladies related to that mistreatment.
| hackable_sand wrote:
| True. I do not think I have not yet met a person who is
| completely healthy.
|
| Maybe in passing.
| llamaimperative wrote:
| Impossibly unrealistic to change zoning to disincentivize
| car-dependent urban design?
|
| Impossibly unrealistic to get rid of enormous sugar
| production subsidies that make it insanely cheap?
|
| Impossibly unrealistic to simply tax added sugar?
| crooked-v wrote:
| > Impossibly unrealistic to change zoning to disincentivize
| car-dependent urban design?
|
| Those zoning issues are the same reason for any number of
| other problems, including housing prices that are
| supposedly the #1 concern for a huge number of voters, and
| yet voters in many cities have only doubled down over time
| on making it harder and harder to build in efficient and
| high-density ways. "Impossible" seems like a fair way to
| put it.
| llamaimperative wrote:
| Yet some cities are making progress on exactly that
| issue.
|
| I haven't done the statistics on it, but I'll bet cities
| full of people who want zoning reform are more likely to
| reform than cities full of people who do not want it.
| Schiendelman wrote:
| No city has implemented anything like zoning reform.
| There are a handful of cities which, to great fanfare,
| have made tiny changes. Minneapolis has made the most
| impact, but it's hard to rule out correlation with
| falling demand for that city.
| llamaimperative wrote:
| Raleigh doubled its zoned density overnight.
| Schiendelman wrote:
| They did not. They allowed duplexes and townhouses in
| some places that were limited to single houses
| (https://www.newsobserver.com/news/local/counties/wake-
| county...).
|
| This change ultimately allowed something like 10% more
| units in the city on a 100 year horizon.
|
| This is what I'm calling out - these changes sound big
| but they are nearly meaningless. Cities need periods of
| explosive growth to remain affordable (see Jane Jacobs,
| 1961 and 1970).
| paulcole wrote:
| All 3 seem to be going swimmingly so far!
| llamaimperative wrote:
| Do you need an explanation of the difference between
| "impossible" and "challenging?"
| paulcole wrote:
| I'll repeat:
|
| All 3 seem to be going swimmingly so far!
|
| There is no material difference between impossible and
| challenging if the thing doesn't actually happen.
|
| It's like Kramer saying he could have levels in his
| apartment it's just that he doesn't want them.
| llamaimperative wrote:
| Hard problems are hard, and not impossible.
| paulcole wrote:
| Well if they never get solved are they hard or are they
| impossible?
|
| What's the difference between, "It was hard and we didn't
| solve it" and "It was impossible"?
| TeeMassive wrote:
| I'm glad for RFK Jr. for this reason.
|
| Nobody talked about this in the mainstream conversations in the
| past.
| labster wrote:
| People and officials have been talking about healthy eating
| for generations. Hard to get more mainstream than every
| doctor talking about diet and exercise.
| TeeMassive wrote:
| Politicians have been protecting big ag for decades. Now
| independent farmers are getting criminally prosecuted for
| selling their raw foods directly to consumers.
| llamaimperative wrote:
| If you like RFK Jr "for this reason," you oughta _looove_
| Michelle Obama!
|
| https://letsmove.obamawhitehouse.archives.gov/
|
| Out from underneath the rock, people have been talking about
| this nonstop for decades.
| TeeMassive wrote:
| I don't see the Obamas defending the farmers getting
| criminally prosecuted for selling their raw food directly
| to consumers. RFK Jr is.
| llamaimperative wrote:
| Yeah that's because it's dangerous
| TeeMassive wrote:
| If that was the case then the Amish would not be
| healthier on average than the rest of the population
| gcr wrote:
| If you have an open mind, I'd like to assign you some homework
| if you like. Take a look around r/zepbound and count the
| following:
|
| 1. Posts from folks who diet+exercise, or who have tried
| diet/exercise and nothing's worked so they then turned to
| Zepbound ("excited to hit the gym," "my diet is finally
| starting to work with Zepbound" and similar)
|
| 2. Posts from folks who haven't tried diet/exercise and turned
| to Zepbound first. (e.g. "I'm excited to eat dessert and laze
| around on my couch all day!" or "Zep is so much easier than
| before, no more keto for me" and similar)
|
| Which group do you think would have more posts?
|
| Selection bias probably prevents us from being able to count
| "Zepbound didn't work for me, but diet and exercise did" posts,
| which is why i suggest this.
|
| Here's my hypothesis: I think self-control is generally
| uncorrelated to losing weight. Perhaps it's necessary to have
| self-control to lose weight "the simple way," but certainly not
| sufficient. I know lots of friends who've struggled and found
| it's not so simple.
| llamaimperative wrote:
| GP isn't talking about self-control, they're talking about
| the fact we've created a system that _requires_ obscene
| amounts of self-control if you wish to maintain physical
| health.
|
| People in the 50s weren't slimmer because they had ironclad
| determination to stay such.
| nextos wrote:
| Exactly, good systems do not rely on willpower. They rather
| make obvious habits effortless.
|
| Deviating from the mean is hard. Bad food and sedentarism
| are the norm.
| jsrcout wrote:
| Agree. "Defaults matter".
| Scoundreller wrote:
| > They rather make obvious habits effortless.
|
| I wouldn't call taking the stairs in a pre-elevator world
| "effortless", rather it was just the only option.
|
| I also think better food handling/storage/treatment/blah
| means we absorb & retain more of the calories that we
| consume.
| ethbr1 wrote:
| The vast majority of accessible American foods these days
| are over-processed, poor quality ingredients with fancy
| marketing on the boxes. (And stories about how the brand
| was started by a grandmother a century ago...)
| xcskier56 wrote:
| Traveling from a fairly walkable, but still car dependent
| midwestern city to NYC and also Europe in the last few
| months, it's amazing how much our living environment
| contributes. My first day in NYC and Europe I put in
| about 14k steps and at least according to my phone, one
| of those days I burned 750 cal just walking around to
| various places. Just by living my life I was WAY more
| active.
|
| Making the good choice the easy/only choice is the only
| way to solve this problem long-term (without drugs)
| atrettel wrote:
| I agree. I lived in West LA for a few years and noticed
| that I was just walking around a lot more than in
| previous locations. I measured it to be typically 5 to 10
| miles per day (I don't recall the number of steps but I
| recall getting close to 30k/day on some days). And I
| wasn't going out of my way to go walking --- it just
| happened because I walked to work, to get groceries, to
| visit friends, to go to the movies, etc. To me, the best
| long-term answer is also to change the environment to be
| more amenable to walking.
| barrkel wrote:
| The amount of food you eat isn't a habit. And I don't
| know what it is that makes people obese, but I don't
| think it's simply "bad food" as in the stereotype of bad
| food.
|
| It seems clear enough to me that there is something -
| something - in the ecosystem that messes up the body's
| weight / energy homeostasis and we haven't identified the
| culprit. It might be a food additive, but it could be
| something to do with artificial light in the evening or
| plasticizers in our plastic products or who knows what.
|
| Just my pov as non-overweight person who doesn't exercise
| (other than flipping my four year old around), doesn't
| walk or run long distances (but a 5 mile walk every
| couple of months doesn't phase me), eats very few fruits
| and vegetables, generally eats mostly meat, pasta, bread,
| cheese, cream and potatoes, and ends up in a fast food
| outlet maybe once a week on average.
| pas wrote:
| recommended reading about the environmental factor
| hypothesis
|
| https://www.lesswrong.com/posts/NRrbJJWnaSorrqvtZ/on-not-
| get...
|
| it doesn't have to be just habit, but cultural/learned
| factors likely play a huge part.
|
| each generation eats more, gets bigger, obesity runs in
| the family, (many obesity associated genes are mostly
| expressed in the brain ... the typical cursed
| environment-gene interaction), portion sizes got bigger,
| it became normal to gulp down a lot more sugar, etc.
| mlyle wrote:
| > People in the 50s weren't slimmer because they had
| ironclad determination to stay such.
|
| No. They lived in an overall healthier environment. But
| they were also subject to much greater social pressure to
| stay slim and could endure fairly intense social judgment
| and stigmatization for weights that we consider normal
| (particularly women).
| llamaimperative wrote:
| Then why are people scrambling for Ozempic? If it were
| true that "people think being fat is totally fine or
| desirable now" then this wouldn't be a blockbuster drug.
|
| Weak thesis.
| adventured wrote:
| Both things are true.
|
| There was a far more vicious shaming culture 50-70 years
| ago about things like being obese. And culturally it's
| still looked down upon to be obese, it's just not as
| acceptable to be vicious about it (and of course
| sometimes people still are).
|
| Today however there is a lot more "always on" pressure:
| social media is a huge component to social, social
| acceptance, socializing, social learning & sharing,
| getting to date people, et al. That's a form of
| individually focused media pressure that didn't exist
| back then. And sure you can turn it off, not partake, but
| there are usually serious consequences especially for
| younger people.
|
| That's the context.
| soulbadguy wrote:
| Non sense... There were not a particularly big stigma
| about being obese 50 or 70 years ago. Socially stigma
| were more about gender roles, sexuality etc...etc...
| adventured wrote:
| There was a huge stigma about being obese 50-70 years
| ago. It was wholly unacceptable for children, young
| persons and women in particular. Exclusively older men
| were allowed to be obese culturally without being shamed
| about it.
|
| As recently as the 1980s movies were overloaded with
| jokes about fat people, it was extremely common. That's
| stigma in action culturally.
| soulbadguy wrote:
| The 80's were 40 years ago... I am not sure where you get
| your reference from... Jokes about fat people and stigma
| about being fat aren't the same thing
| llamaimperative wrote:
| I didn't say it isn't _true_ that people were shamed more
| often in the past, I said it has little to no explanatory
| power of the current health crisis because obviously
| there is no _lack of desire_ from people to be slimmer.
| mlyle wrote:
| I think it's a little bit of a silly thought to think
| that just because people want to be slimmer now, they
| want to do so _just as much_ as they would have facing
| harsher social pressures in the 1950 's.
| llamaimperative wrote:
| How big were the health food, gym, and fitness industries
| in the 50s?
|
| Answer: literally non-existent.
| mlyle wrote:
| How big were the 'crash diet' and 'smoke cigarettes to
| stay thin' and 'use amphetamines to stay thin'
| industries?
|
| Indeed, we have the inception of Weight Watchers at the
| start of the next decade, replacing far crazier things
| like the cabbage diet being used en masse.
|
| Yes, it was easier in some ways to live a healthier life;
| one reason why was the rampant social policing of each
| other's weight.
| llamaimperative wrote:
| The prevalence of dedicated dieting or weight loss
| efforts has _increased_ over time. The success of those
| efforts has _decreased_ over time.
| mlyle wrote:
| > The prevalence of dedicated dieting or weight loss
| efforts has _increased_ over time.
|
| Perhaps, perhaps not. But you'd expect that if there's
| many different causes making weight gain more common and
| only one is changes in social pressures (as I've already
| stipulated in each post).
|
| And, likewise, as stipulated above: overt social stigma
| is not the only reason why people might prefer to be of a
| lower weight.
|
| > The success of those efforts has decreased over time.
|
| Well, one reason for this is that we've reduced the use
| of obviously harmful but effective weight loss techniques
| like cigarettes and stimulants. The 1950s were the era of
| the rainbow diet pill clinic, where you'd walk in and get
| a personalized cocktail of amphetamines and thyroid drugs
| and laxatives and diuretics to help you control weight.
| golergka wrote:
| They smoked.
| kps wrote:
| > They lived in an overall healthier environment.
|
| They lived in a _different_ environment. The universal
| appetite-reduction drug was nicotine, and the common
| methods of administration had a number of undesirable
| side effects.
| mlyle wrote:
| Yup. Don't forget that using amphetamines for the same
| purpose was socially accepted/considered a worthwhile
| tradeoff.
| Scoundreller wrote:
| And ample availability of calorie-free barbituates
| instead of just calorie-rich (and appetite-stimulating)
| ethanol
| listenallyall wrote:
| "Overall healthier environment". Meaning, food was
| relatively scarce. No Starbucks, Dunkin Donuts,
| convenience store on every corner. Coca-cola was not
| available in 2-liter bottles or in 24 packs of cans. No
| Costco-sized mutlipacks of anything.
|
| In the 1950s, malnutrition was a serious issue that many
| people in poor areas died from. When was the last time
| someone died because they didn't have access to food?
| Obviously, the other side of that coin is that food being
| so plentiful, people eat much, much more than ever
| before.
| llamaimperative wrote:
| Starvation was not a major issue in the US in the 1950s.
|
| Food abundance is good, but it is not the answer to this
| question. For example, in America today the richest
| locations tend to be the most physically fit.
| listenallyall wrote:
| That's kind of the point. Poor people today have no
| problem obtaining and consuming enormous quantities of
| food, and jave high obesity rates as a result. Unlike
| prior eras, being rich doesn't provide an advantage when
| it comes to accessing food (as opposed to housing,
| leisure time, luxury items, etc)
| squidlogic wrote:
| In my experience fitness is less about self control or will
| power and more about creating routines that lead to
| fitness.
|
| For example, I have a routine of going to a group fitness
| class at my gym in the morning. I don't need to summon
| willpower, I just have a morning routine that involves
| doing x thing at y time. No thought required.
|
| Given the abundance of options for fitness classes and meal
| plan services, you really can just put this on auto-pilot
| and have a lifestyle that is healthier than 99% of your
| peers.
| llamaimperative wrote:
| Unfortunately we know that simply convincing people to
| change their behavior is very, very, _very_ fucking hard.
| Individuals can and do pull it off, yes, but we 're
| talking about a society level change that needs lots of
| people to succeed at this.
|
| It is empirically and demonstrably ineffective as a
| solution.
| nightski wrote:
| Nothing "needs" to happen. People don't have to live how
| you want them to.
| llamaimperative wrote:
| Thanks for your insight. What are you even doing here
| having a conversation if one person has no legitimate
| bearing on another?
|
| Obviously no one is talking about a treadmill
| concentration camp here, good lord.
| justinator wrote:
| Habits are great, but I'm in great shape because what I
| do is fun. When it's not fun I called it "training" and
| that's usually for some huge goal that'll at least be fun
| to look back at 10, 20 years down the line to marvel that
| I did a thing.
|
| I guess what I want to express is habits are one step
| closer to a lifestyle change and that's what keeps one
| ultimately healthy (mentally, too). We can't have
| nightmare commutes to soul-sucking jobs to continually
| have people addicted to looking at screens and think that
| there's no fallout. Adding, "but now there are drugs!"
| isn't an advancement.
| ethbr1 wrote:
| > _Given the abundance of options for fitness classes and
| meal plan services..._
|
| This is part of what's fucked up about modern American
| lifestyles.
|
| We shouldn't be promoting _layering_ healthy behaviors
| (fresh foods and exercise) on _top_ of our default lives
| -- we should be doing a better job of engineering our
| environment to make those things the _default_ for all
| people.
|
| F.ex. what if we highly taxed automobile entry into urban
| cores and shopping districts?
| ryukafalz wrote:
| Right. Design our cities so that getting around while
| getting exercise is safe and easy. And restaurants/etc
| should give you healthy portion sizes by default, not
| rely on your self-control to stop eating. And so on...
| jim-jim-jim wrote:
| Every yuppy feels compelled to remind you they go to the
| gym, expecting a pat on the head for being a responsible
| citizen, when it's really a sign of a dysfunctional
| lifestyle. Cordoning off a discrete slice of time to "be
| healthy" is pathetic imo. I'd much rather just be
| healthy. Gorillas don't work out.
|
| But because I live in suburban Australia and eat the same
| pesticide laden slop as everybody else, I too have a gym
| membership.
| hooverd wrote:
| Gorillas can also digest cellulose.
| tsimionescu wrote:
| > Cordoning off a discrete slice of time to "be healthy"
| is pathetic imo.
|
| What does this actually mean to you? Walking or even
| running is certainly not comparable to going to the gym,
| so what, should we lift heavy weights as part of our
| regular jobs to keep up our upper body muscle mass?
| skeeter2020 wrote:
| Routines help because they reduce the impact and
| uniqueness of the good behaviour. Another approach is to
| do things that have high positive pay-off but include
| health benefits you wouldn't target but get "for free".
| Example: I ride my bike to work because it's awesome,
| faster and makes me feel superior. That I get exercise
| and help out the earth is a side effect; I'd probably
| still ride my bike if it was unhealthy and produced more
| CO2
| jrflowers wrote:
| > People in the 50s weren't slimmer because they had
| ironclad determination to stay such.
|
| People in the 50s (in the US) had, among other things,
| fistfuls of benzedrine.
|
| Edit: here is a link for the skeptical folks
| https://www.smithsonianmag.com/history/speedy-history-
| americ...
| llamaimperative wrote:
| Whatever, set the clock to the 1820s. Or the 1400s. Or
| the 1200s. Or the 1990's or 200 BCE, I don't care.
| golergka wrote:
| They didn't have that much food available.
| jrflowers wrote:
| I didn't bring up the 1950s, you did. (???)
|
| It is a useful and topical period to discuss in a thread
| about ubiquitous weight loss drug usage.
| viraptor wrote:
| Do we really have enough information about their daily
| habits, food availability, ability to survive, etc. from
| those times? Once you go before easy refrigeration and
| distribution, you get people dying from famine in bad
| years. It's going be to be hard to make any actionable
| lessons from those times that still apply now.
| llamaimperative wrote:
| Yes we know that 50%+ of the population was not obese.
| viraptor wrote:
| https://academic.oup.com/past/article/239/1/71/4794719
|
| > James Nye, for example, was one of a family of eleven
| children raised in rural Sussex in the 1820s and recalled
| how the 'the young ones' in his family went 'very short
| of food'. Despite his mother's best efforts, he rarely
| had more than 'half a bellyful' at mealtimes, and ate
| scarcely anything other than bread.
|
| > Following the harvest failures of 1816, for example,
| John Lincoln's entire family was forced to undergo severe
| privations. His two children succumbed to disease very
| easily -- their quick deaths from measles were likely
| owing in part to prior malnourishment.
|
| You can't be obese if you don't have food.
| llamaimperative wrote:
| The 90s?
| jrflowers wrote:
| >Whatever, set the clock to the 1820s. Or the 1400s. Or
| the 1200s. Or the 1990's or 200 BCE, I don't care.
|
| I think they may have taken your prompt and thought about
| the 1820s, 1400s, 1200s or 200 BCE. Did you mean to
| direct people to discuss the 1990s by listing the other 4
| eras?
| llamaimperative wrote:
| I mean to say Homo sapiens has existed for 300,000 years.
| They have not been 70%+ overweight or obese for most of
| those years. All the way until the 90s, obesity rates
| have been WAY lower, even in food-abundant societies.
| jrflowers wrote:
| What is your point? I mentioned drug availability in the
| 1950s and you dismissed it with an arbitrary list of
| other time periods. Someone else mentioned food scarcity
| in a period you mentioned, and you shifted the discussion
| to the 1990s (and now the past 300,000 years ???).
|
| It seems like you do not want to discuss any factors
| relating to obesity in history at all, yet you keep
| engaging in this topic anyway. It is impossible to have a
| conversation where one side discusses facts like drug
| availability or food scarcity and the other says "no
| think about something else" as a canned response.
|
| _What do you think_ is the cause of the increased level
| of obesity? _What do you think_ is the solution, if any?
| varjag wrote:
| 1820s? Oh yes a ton.
| viraptor wrote:
| Yeah, I meant before that. The records for the earlier
| years mentioned were not really kept that well for every
| segment of population.
| kemitche wrote:
| So, eras of food scarcity?
| llamaimperative wrote:
| The 90s?
| jrflowers wrote:
| >Whatever, set the clock to the 1820s. Or the 1400s. Or
| the 1200s. Or the 1990's or 200 BCE, I don't care.
|
| I think they may have taken your prompt and thought about
| the 1820s, 1400s, 1200s or 200 BCE. Did you mean to
| direct people to discuss the 1990s by listing the other 4
| eras?
| presentation wrote:
| Or choose a country with a low obesity rate today and
| analyze that.
| mtlmtlmtlmtl wrote:
| Amphetamine(which is what benzedrine was) is pretty
| overrated as a weight loss drug in the general
| population. It causes a short window of reduced appetite
| and probably increased catabolism(due to increased heart
| rate) which peters out after a couple weeks on the same
| dose. That leads to a short period of rapid weight loss
| that pretty much grinds to a complete halt, after which
| regaining the lost weight is quite typical.
|
| On the other hand, if like me, you have ADHD and weight
| issues, it could be more helpful. Because it could treat
| your ADHD enough to help you actually establish and
| follow a structured diet and exercise regime. Especially
| if your ADHD includes impulsivity. The last time I was on
| lisdex treatment, I lost about 5kg from the initial
| boost, a lot of it was probably water weight. Then I
| managed to cut about 30kg later with calorie counting and
| regular cardio.
|
| So the physical effects themselves are largely a
| pisstake.
| golergka wrote:
| > a system that requires obscene amounts of self-control if
| you wish to maintain physical health
|
| That's million years of evolution with food scarcity and
| modern capitalist world which created unprecedented
| abundance of food (and other things). And before you
| compare it to Europe -- europeans still smoke much more
| than americans. Tobacco is also just a chemical that
| decreases effects of obesity, just in a different form.
| soulbadguy wrote:
| So that's your explanation ? European are slimmer because
| they smoke more ??
| adventured wrote:
| Which Europeans?
|
| Countries in Europe with approximately the same obesity
| problem as the US:
|
| Poland, Croatia, Romania, Britain, Hungary, Georgia,
| Slovakia, Chechia, Ireland, Greece.
|
| And of course New Zealand, Australia, Canada are all in
| the same boat as well.
|
| Those are all over 30% obesity and climbing (Romania is
| 38%, nearly at the US levels). The US is of course the
| leader of the pack, however it's all the same fundamental
| problem.
| Scoundreller wrote:
| My running theory is that there's more weight-
| discrimination in Europe, so you're just less likely to
| see the overweight/obese in customer-facing positions.
| golergka wrote:
| Different European countries have different
| circuimstances, just like their counterparts, american
| states. But if we're talking about all of Europe and US,
| then yes, this is the main reason.
| soulbadguy wrote:
| Source ?
| screye wrote:
| Your point is correct. But 50% of people in 50s also smoked
| cigarettes, a known appetite suppressant.
|
| So yeah, culture driven lower portion sizes + meds driven
| lower appetite is a well-tested combination with known
| positive outcomes.
| danbolt wrote:
| Yeah, they had nicotine!
| bsder wrote:
| > People in the 50s weren't slimmer because they had
| ironclad determination to stay such.
|
| Well, heights increased dramatically for a couple decades
| so what that meant was that many people in the 1950s were
| _starving_. In the 1930s, people _died_ of starvation even
| in the US.
|
| I don't really think that we want to go back to starving
| our population just to be thin, thanks.
| llamaimperative wrote:
| No one is proposing that, obviously
| presentation wrote:
| Living in Japan has made it clear to me that cultural
| attitudes towards food make all the difference. It's not
| like there's a dearth of delicious things here, but obesity
| rates are more or less a rounding error.
| Schiendelman wrote:
| There's a confounding factor to your theory: people in
| Japan are dramatically less likely to use a car for door-
| to-door travel. The amount of walking a Japanese person
| does burns a huge number of calories that most people in
| the US simply don't burn.
| presentation wrote:
| I don't buy it, putting aside the fact that there are
| many public transit-heavy countries with obesity
| problems, the amount of calories you burn from walking is
| a drop in the bucket, you can wipe out a full day of city
| walking with a small portion of French fries.
|
| Diet is a way bigger factor in weight control than
| activity, unless you're a pro athlete burning thousands
| of calories a day from exercise because you're working
| out nonstop as your job.
|
| You should still walk for general health, but not for
| weight loss.
|
| EDIT: this report from Time about Japanese food culture
| rings true.
|
| https://time.com/6974579/japan-food-culture-low-obesity/
| unlikelytomato wrote:
| This is certainly true. Others will quote that exercise
| is not an effective mechanism to maintain healthy weight
| with 40 studies to back it. The goalposts seem to move a
| lot in this domain. Nevertheless, there is a ton of
| evidence of people in various behavior patterns that do
| not have such obesity issues in their society. It's wild
| to me how many people reach a conclusion of helplessness
| given that fact. The real kicker is that we aren't
| talking about one population being 5-10 lbs too heavy. We
| are taking about a difference between healthy weight and
| pervasive obesity. It's wild that such a delta is
| normalized
| cthalupa wrote:
| Exercise is good for a variety of reasons. It will burn
| some additional calories. But most scientists that
| specialize in metabolic research believe that the
| constrained total energy expenditure model and metabolic
| adaption are at least broadly true. You can't exercise
| out of a bad diet - and it's difficult even if you
| believe in a fully additive energy expenditure model.
|
| Diet is the overwhelming deciding factor when it comes to
| weight gain.
| dfxm12 wrote:
| I'm not sure how this applies to my comment. I'm not saying
| anything about self control. I'm not against individuals
| taking GLP-1s. But, if we're at a point where we're _all_ on
| drugs to treat lifestyle diseases, we should at least
| recognize that _these lifestyles are largely chosen for us_ ,
| and we should consider that doing something about that will
| reap us the benefits we're after.
| llamaimperative wrote:
| Those benefits _and_ a billion more! Better state of
| nature, richer social fabric, probably less political
| polarization if people were bumping into their neighbors
| more frequently instead of going from drywall box to steel
| box back to drywall box day in and day out.
| briandear wrote:
| Not having to bump into neighbors is a feature not a bug.
| llamaimperative wrote:
| Not for civilization it isn't.
| cvwright wrote:
| This depends entirely on the neighbors
| 1659447091 wrote:
| > these lifestyles are largely chosen for us
|
| >> Unfortunately, I have to drive everywhere, work too many
| hours to have free time for recreation and have no idea
| which government subsidy is going to help big ag likely at
| the expense of my health.
|
| At what point do people stop letting the choice being
| largely "made" for them and choose something else? The gov
| subsidy has nothing to do with my personal health choices.
| My grocery store has the same fresh fruits & vegetable
| sections grocery stores in Europe have. I am lucky to live
| in a state whose dominate grocery store sources regional
| meats & produce, sells their own brand of food made fully
| or mostly with ingredients I can pronounce, and has
| complete whole food prepared meals for 1-2 people that take
| 25mins in the oven. [for the same price as fast food]
|
| It's part of the reason I _choose_ not to move. Other
| choices are a standing desk with a walking pad, which makes
| it trivial to walk 3-4+ miles a day. I could make more
| money studying leetcode and living in "elite" tech valley,
| or hustling for more work instead of choosing myself over
| the large house in swank community that _society_ has
| picked as what is "success" for me. Eventually I chose to
| take less of what "they" told me to choose; at some point
| we have to realize the only person that is going to live
| with our choices is ourself. If GLP-1s is needed to help
| people get back or get to that point of realization, then
| maybe it's a blessing to undo all the ills we(society made
| up of our neighbors) all contributed to creating.
| dfxm12 wrote:
| I'm happy you don't live in a food desert, live in a good
| neighborhood and have the means to move somewhere else if
| you wanted to. Not everyone has these advantages. I think
| we can all agree that these are good things and I hope we
| will do what we can to allow others enjoy them as well,
| because no one chooses to be in that situation, but it is
| largely a policy choice to keep it that way.
| 1659447091 wrote:
| > and have the means to move somewhere else if you wanted
| to. Not everyone has these advantages.
|
| I debated posting because this is the usual response,
| instead of seeing the point as, "we" continue to create
| this _society_ not some magical "others". I am where I
| am because of my choices + the lucky draw of loving
| computers and a dedicated family that scrapped and saved
| and sacrificed to buy me my own computer as a teenager
| which helped me move out of the situation I was born in.
| And even that was better than many of the people I grew
| up with. So no, this wasnt some privileged post of
| someone who never walked 2+ miles to the corner store
| with their friend to pick up a half gallon of milk and
| pasty white "bread" with food stamps so they could have
| sandwiches for dinner. [added: while this situation
| sounds bad it's better than where they (and many of my
| other friends) came from as they could have been deported
| back to there if found]
| acabal wrote:
| The more important point the comment you're replying to makes
| is not "what if people could diet and exercise" - i.e. accept
| the modern American lifestyle as given, plus force yourself
| to go to the gym and eat chicken and broccoli - but rather
| that the modern American lifestyle in fundamentally
| structured to lead to people being overweight.
|
| Instead of being forced to drive everywhere for the most
| basic possible human needs - like getting groceries, going to
| the doctor, or dropping kids off at school - as is the case
| in 90% of America - what if you could walk to those places
| instead? You would get exercise as part of your every day
| life, with no extra effort!
|
| What if instead of corn syrup being so heavily subsidized, we
| could use more filling sweeteners in a lower amount instead?
| What if people lived closer to agriculture, instead of in
| faraway suburban tract housing only accessible by car, so
| they had easier access to fresh meat and vegetables, instead
| of ultraprocessed package food?
|
| These dreams are not "diet and exercise", they are a
| fundamental reshaping of American lifestyle that would
| directly lead to weight loss. We know this, because America
| used to look like this before, say, 1940. In old photos you
| see people in huge crowds in streets as they walked to their
| everyday errands, and menus and recipes of the era are mostly
| minimally processed food that is mostly local. Americans of
| the past were not overweight, because the way society
| arranged its physical existence didn't permit it!
| _DeadFred_ wrote:
| My 1950+s grandparents drove everywhere and were fit. When
| we try to shoehorn so many agendas into one thing nothing
| gets resolved. It's also part of why so many people
| distrust everyone's agenda and truthfulness nowadays. Also
| 1940s America was mostly rural, not huge crowds of people
| walking together.
| Schiendelman wrote:
| In the 1940s, a huge number of Americans walked because
| fuel was rationed for the war.
|
| I'm not sure you could really find data to back your
| anecdotes.
| foobarian wrote:
| IMHO price of calories is the only thing that needs to
| change. All the talk about wholesome locally grown foods
| vs. processed industrial stuff is just moralizing and
| posturing, when the metric that matters is the price. Just
| look at Coke, which is arguably not even a good example
| because of pre-war price fixing, but still it costs half as
| much as in 1950 when adjusted for inflation.
| Scoundreller wrote:
| Tax each calorie $1 and give everyone $2000/day.
|
| (You'll quickly end up with another underground white
| powder economy though...)
| Wytwwww wrote:
| > In old photos you see people in huge crowds in streets as
| they walked to their everyday errands
|
| Because they were poor and didn't have a choice. Making
| driving extremely expensive and inconvenient and
| prohibitively high taxes on processed food etc. might force
| people to change their lifestyles, I'm just not sure how
| politically feasible that.
| eastbound wrote:
| I'm not obese, just before (1m75 / 82kg) but I have found
| self control impossible, except when I do intense sports
| (like musculation 3-6 times a week). Then only, and this is
| the magic part, I not only eat less, but also enjoy being
| more brave, with cold showers, being hungry, going to bed
| early and other efforts in life.
| Gee101 wrote:
| What is musculation?
| Schiendelman wrote:
| A transliteration for lifting.
| Spooky23 wrote:
| The people in #1 won't express it that way.
|
| I was that guy. For a variety of reasons that aren't relevant
| i developed insulin resistance over a relatively short time
| that made it increasingly difficult to lose weight. I'm in my
| mid 40s, which also makes it difficult.
|
| I got on one of the GLP drugs 18 months ago. I am down 80
| pounds, and am running 20 miles a week. I'll be doing a half
| marathon in March. Ive dropped the dose twice and still going
| strong.
|
| Taking the pill made exercise possible. Online everyone likes
| to apply a moral hazard thing to every discussion. GLP
| medication twiddled my dopamine system and allowed me to
| achieve my goals. Period. If you think that makes me weak, I
| cannot think of anything that I care less about.
| huijzer wrote:
| > I think self-control is generally uncorrelated to losing
| weight
|
| Choosing to eat fewer processed foods is very effective but
| does not require that much self-control since appetite will
| fall automatically.
| SirMaster wrote:
| But don't you think that it's better to make the changes to
| prevent obesity rather than focus so much on a cure for
| after?
|
| I don't have a problem with a cure only if it doesn't reduce
| the focus and effort on prevention.
|
| There has to be a reason why so many more people are obese
| today than decades ago. I refuse to believe we can't find out
| why and make changes to reverse it.
|
| But if it's so easy to cure, will enough people care about
| figuring out how to prevent it?
| amelius wrote:
| Not saying you're wrong but maybe group 2 is too lazy to open
| their browser and post their experience?
| Wytwwww wrote:
| > Perhaps it's necessary to have self-control to lose weight
| > it's not so simple.
|
| Presumably people who have good self control and are not
| prone to developing addictions (due genetic or various semi-
| immutable cause) do not become obese in the first place. It
| might be fairly easy easy for them to lose weight they just
| don't need.
| Aeglaecia wrote:
| counter hypothesis - the amount of self control exhibited by
| an average human is insufficient to self regulate when placed
| into a hyper enriched environment , for example the
| capitalistic profferings of junk food tv porn etc , we did
| not evolve around these hyper stimulatory activities, how on
| earth are we meant to adapt to them? drugs are not an answer,
| they are another bandaid making someone else money and
| allowing the underlying wounds to fester, the solution is
| education and awareness of this fucked up situation
| paulmist wrote:
| What is a realistic path to this? Being from Europe I visited
| US last year and was horrified at the quality of your food. You
| see a lot of documentaries/youtube videos/etc... discussing the
| problem, but how do you even go about this?
| supportengineer wrote:
| There's plenty of high quality food, you just have to know
| where to look. For example, come to the Bay Area and check
| out Whole Foods and any number of high-end restaurants.
| hyggetrold wrote:
| +1 to this - what Europeans consider "the basics" for most
| Americans is filed under "luxury" or "bougie."
| cultofmetatron wrote:
| was in greece for three months. the quality of the BASIC
| fruits and vegetables at the regular local market down
| the street from where I was staying was on par with
| wholefoods. It was surreal how cheap it was to eat
| HEALTHY.
| fooker wrote:
| Have you been to Mexican grocery stores in the US?
| throwup238 wrote:
| Almost any ethnic grocery store will do since they cater
| to immigrant communities that are likely to be lower
| income. Here in SoCal some are cheaper than others but
| they're all way cheaper than Ralphs/Vons/Trader
| Joes/Costco/etc (I don't shop at WalMart so I'm not sure
| how they compare)
|
| There are also native stores that are increasingly
| entering into low cost produce like Grocery Outlet and
| then there are the usual like Food4Less but they tend to
| eventually move upmarket.
| fooker wrote:
| I wonder why, then, Europeans move to the US in such
| large numbers for academic and tech jobs.
| torlok wrote:
| They don't move because the food's better. How is your
| comment relevant to the discussion?
| fooker wrote:
| The food is better though, as long as you are willing to
| try food you are not familiar with.
| cruffle_duffle wrote:
| It's cool to hate on America. Everything is always better
| in Europe.
| philipkglass wrote:
| That's overkill. There are very marginal health benefits to
| eating organic watercress vs. eating whatever dark leafy
| green is currently on sale at the discount supermarket.
|
| The problem isn't that people go to supermarkets and they
| can't find any healthful ingredients to cook with. The
| problem is that they go to supermarkets and pass those over
| in favor of convenience foods that have been optimized for
| "craveability" [1].
|
| GLP-1 drugs can alter this behavior by reducing food
| cravings. Someone who's no longer craving the most
| craveable food can make more objective by-the-numbers
| buying decisions the next time they go grocery shopping.
|
| [1] https://www.npr.org/sections/thesalt/2015/12/16/4599810
| 99/ho...
| codersfocus wrote:
| Imagine thinking Whole Foods is high quality.
|
| The only way you're going to get high quality food in the
| US is if you live where the Amish are.
| diggan wrote:
| > but how do you even go about this?
|
| Maybe I'm too European to understand _why not_ , but seems to
| me that regulations around food and what companies are
| allowed to put into it is really helpful in avoiding
| companies from just stuffing whatever down people's throat.
| klaussilveira wrote:
| The US is a huge country (9,833,520 square kilometers!), so I
| find it curious that such generalization can be made about
| the food available here, or even the eating habits of
| 334,914,895 humans. I could say that I visited Amsterdam 2
| years ago and I was shocked with the quality of the food.
|
| But I would never do that, since I mostly ate at the Red
| Light District, and I couldn't possibly generalize the
| country eating habits with stores in a major tourist area.
| gcr wrote:
| We have good food, but you won't find it on "The Easy Path."
|
| The Easy Path is that gentle encouragement to hit up Chipotle
| for lunch, because it's "right there."
|
| The Easy Path says dinner's hard and you've had a long day,
| so get something simple, like take-out or microwave.
|
| The Easy Path is entropy. The Easy Path is self-care over
| struggle. The Easy Path is simple carbs shown on prominent
| display in store shelves. The Easy Path is advertising.
|
| Hitting the gym isn't on The Easy Path, but forgetting to
| cancel your gym membership is.
|
| These days, big food companies love "The Easy Path" because
| it's so easy to commoditize, it's the "Path that Americans
| are Expected to Take." For financial stewards, being on The
| Easy Path turns lack of willpower into your ally.
|
| On the other hand, getting good food in the US requires
| passing the marshmallow test: you have to meal prep, or you
| have to shop around the sides, or you have to get something
| on the salad menu. You have to say no to advertising. You
| have to expend willpower, the most limited of resources to
| the average American. You have to Go Hungry or Suffer, or
| have An Upset Stomach. You frequently have to spend more
| money or time.
|
| Semaglutides are not currently on The Easy Path. Maybe they
| will be someday. I personally doubt that, because putting
| GLP-1 on The Easy Path would require big food companies to
| rethink their entire portfolio.
|
| But you're not wrong in that they could be Easy Path-
| ajdacent. The dialectic would shift: food companies would
| shift around to be Organic and Nutritious and Less Calories
| and find other ways to stay on The Easy Path. Sugar and fat's
| addictiveness is highly Easy Path-enabling, and that's a
| pretty big vacuum to fill.
| crooked-v wrote:
| > I personally doubt that, because putting GLP-1 on The
| Easy Path would require big food companies to rethink their
| entire portfolio.
|
| I think the drug industry is more powerful than the food
| industry, these days.
| gcr wrote:
| This duel of incentives will be a fascinating battle to
| watch in the coming years.
| Scoundreller wrote:
| Are they? People spend more on food than pharmaceuticals
| globally, but I do believe they're converging.
| carapace wrote:
| I mean...
|
| > RJR Nabisco was formed in 1985 by the merger of Nabisco
| Brands and R.J. Reynolds Tobacco Company.
|
| https://en.wikipedia.org/wiki/RJR_Nabisco
| valval wrote:
| Get ground beef in the supermarket, it's cheap and takes 7
| minutes to cook. If that's all you eat you can't be fat and
| out of shape. You also won't be hungry.
|
| At some point blaming society isn't going to cut it.
| llamaimperative wrote:
| At some point "have willpower" isn't going to cut it.
| That point was decades ago.
|
| _Blaming_ society sounds fatalistic, but yes we
| absolutely can _change_ society. There are mechanisms to
| do it, and the first step to utilizing any of them is
| people getting pissed off about the state of things and
| talking to other people about how pissed off they are
| about it.
| m_fayer wrote:
| I've done plenty of grinding it out in my life with no
| energy or time to spare.
|
| Even in that place you can do better than ground beef.
|
| Get an instant pot and invest in some rudimentary cooking
| skills. I've spent a whole year making variations on the
| same dish in 15 minutes, using that cooking as end-of-day
| stress relief. Shopping for the same handful of things
| once a week.
|
| It wasn't fine dining but it was healthy, cheap, and a
| few steps up from ground beef. Come now.
| cactusplant7374 wrote:
| What's your favorite instant pot recipe?
| valval wrote:
| I love fatty meat and salt. I can't think of many things
| better than that. It's also the only staple us and our
| ancestors have eaten for millions of years.
| yunwal wrote:
| > If that's all you eat you can't be fat and out of
| shape.
|
| I promise you if ground beef is all you eat you will be
| much worse than fat and out of shape.
| valval wrote:
| And I'll promise you the opposite. Meat has everything
| you need.
|
| You could try it for say, two weeks. I've done it for two
| years, so nothing super crazy can happen in two weeks.
| sumeruchat wrote:
| If the only option to stay healthy is to regularly eat
| ground beef from the supermarket wouldnt you say society
| has f**ed things up pretty badly :)
| valval wrote:
| It's not the only thing. You can eat any meat, eggs, or
| many dairy products. Probably most fruit is fine too,
| although I don't eat carbs myself.
|
| Yes, all the processed grains and seed oils and
| artificial sweeteners and chemicals should never have
| been invented. But I'm not too fussed about that. What I
| can do is come here and write these comments about the
| diet that changed my life for the better. If only one
| person who reads them tries it out, I will already have
| succeeded.
| squidlogic wrote:
| The Easy Path is a meal service like Factor that delivers
| healthy food directly to your door step.
|
| The Easy Path is signing up for a fitness class on a
| regular schedule and baking it into your morning routine.
|
| The Easy Path is not buying extra snacks - just don't have
| them laying around the house for you to eat when you're
| bored.
|
| The Easy Path is the path of least resistance. However, you
| have some agency over the environment you create for
| yourself, so that path of least resistance is to some
| degree under your control.
| FooBarBizBazz wrote:
| I think you're making this sound harder than it is.
|
| If you count calories and stick to a budget, you will lose
| weight, even if those calories come from deep-fried fast
| food. Sure, it's good to eat more whole fruits and
| vegetables, and you should, but weight loss doesn't require
| some kind of Edenic perfection. Stick to a calorie budget
| and you will lose weight, the end.
|
| We can add some second and third order provisos, sure. The
| next tip would be to go low carb. And to keep a spreadsheet
| with calorie numbers for everything you eat. Track what
| you're doing.
|
| But basically, if you eat 1500 kcal/day for nine months,
| you will be much thinner. We don't have to make it harder
| than that. It works. Perfection is not required.
| kemitche wrote:
| "Stick to a calorie budget" is the HARD part, and it's
| the thing that drugs like Ozempic help people with.
|
| People aren't obese just because they can't figure out
| how to count to 1500.
| FooBarBizBazz wrote:
| 1.
|
| If we're talking about this as a public health issue,
| then I agree with you. You can't really expect much of
| people as a herd or mass.
|
| (Hell, look at the state of elections.)
|
| If we're talking about this as individual, rational
| people, though, then it's different. You can absolutely
| maintain a reasonable weight if you just attend to it.
|
| 2.
|
| There's actually some knowledge embedded in the "count to
| 1500", which, if you're not in the habit of thinking
| about, may be surprising. Specifically, the kcal amounts
| themselves.
|
| Say you just go with the flow of society, and you eat
| "normally" without thinking about what you're doing:
|
| You wake up, and you have something marketed as "a meal"
| for breakfast. A breakfast sandwich can easily be 550
| kcal. If you add a venti latte to this, especially one
| with sugar, then you could easily add another 250 for
| that. Now you're at 800 kcal just for breakfast.
|
| Then consider lunch. Even a "small" meal from a healthy
| salad place, like Sweetgreen (which is expensive), is
| going to be like 900 kcal. Say that's what you eat. Now
| you're at 1700 kcal.
|
| The afternoon comes, and you have two chocolate-chip
| cookies. Two cookies isn't excessive, right? Just a
| little treat. But each one is probably 120 kcal. So
| that's 240 kcal. Now you're at 1940 kcal.
|
| Finally you have dinner. Some microwaved thing,
| relatively small. It's probably like 600 kcal. So now
| we're at over 2,500 kcal for the day.
|
| Everything you did in the course of that day was
| relatively normal. Probably only the venti latte at
| breakfast was obviously excessive. But now you're
| substantially over your calorie budget.
|
| Now, 2,500 kcal is still salvageable. Every mile you walk
| on flat ground is about 100 kcal. If you live in the
| city, you could easily have walked a mile and a half
| during your commute to work, and another mile when you
| stepped out for lunch, and a mile and a half on your way
| back, giving you four miles. You're almost at breakeven.
| Just need a little more exercise, and you'll maintain
| your current weight.
|
| (In the burbs, though, you probably drove to all these
| places and now it's on you to go to a gym, which is a
| pain in the butt.)
|
| Anyway, my point is, if you weren't attending to all
| this, how would you know? You'd probably just be doing
| all these habits without thinking about them. Most parts
| of this routine seem pretty reasonable. But you'd still
| be getting fat. Because you're going with the flow
| _instead_ of counting.
|
| So, there's a little (easy) knowledge involved, but
| mostly it's not an issue of intellectual ability, it's a
| matter of attention.
| zahlman wrote:
| >The Easy Path says dinner's hard and you've had a long
| day, so get something simple, like take-out or microwave.
| The Easy Path is entropy. The Easy Path is self-care over
| struggle.
|
| If you see this sort of food as "self-care" then that's
| where the war has been lost.
|
| >or you have to shop around the sides
|
| Sometimes I wonder if I'm the only person in the world who
| enjoys this. Discovering, for example, the versatility and
| cost-effectiveness of skim milk powder was a real game
| changer for me. Similarly for dried legumes and fruits.
| ActorNightly wrote:
| The first thing that would help is actually having a
| realistic discourse about food, and not the idiotic - "You
| shouldn't be eating processed food, its not good for you".
|
| Like most of the food that we eat is not really that bad. Its
| not optimal for sure, especially for sedentary lifestyles,
| but a lot of the health problems are not directly tied into
| the actual food, rather the over-consumption of it, and
| passing down of bad genetics (for example, children of obese
| people are more likely to be obese).
|
| European obesity tripled in the last 40 years as well,
| despite higher quality of food.
| aezart wrote:
| > (for example, children of obese people are more likely to
| be obese)
|
| I would assume that this is related to gut biome and not
| genetic makeup.
| rootusrootus wrote:
| > Being from Europe
|
| Why is the quality of food in Europe so much worse than
| southeast Asia?
|
| Because you guys are way, way, _way_ fatter than e.g. the
| Japanese.
|
| Back on topic -- we have excellent food in the US, but
| regulations allow for highly processed crap to be sold too.
| Pretty sure most of the crappy processed foods are easily
| available in Europe, too.
| r3d0c wrote:
| lack of regulations* allow, and no not exactly;
|
| eu and canada have stringent laws on advertising to
| children, and laws on nutrition and additives to their
| products
|
| even things like bread in the US have an insane amount of
| sugar
|
| but the other reason is suburban/car culture & zoning,
| which means more hypermarkets and shopping not every few
| days for fresh food but every week or two for more
| processed food that lasts longer because going to the store
| is a bigger PITA than a quick 5 min walk to the
| neighborhood stores; which also means mroe walking rather
| than driving, another area of calorie burning and lean
| muscle maintenance which maintains high metab
| vundercind wrote:
| It's been studied pretty well. Possible effective solutions to
| the US obesity epidemic are pretty much limited to:
|
| 1) Radically alter aspects of food culture, work culture,
| social policy, and business regulation.
|
| 2) Magic pill (/injection)
|
| There appears to be no imminent progress on the many parts of
| #1 that need serious work, so if we want a big turn-around in
| the next half-century, #2 has suddenly and surprisingly become
| a real possibility.
| jodrellblank wrote:
| From the article " _Estimates suggest GLP-1s can reduce body
| weight by at least 15% when taken regularly_ ". That's a
| 5'10" man starting at 250lbs (obese, BMI > 35) and finishing
| at 220lbs (obese, BMI >30).
|
| Or a 5'10" man starting at 220lbs (obese) and finishing at
| 187lbs (overweight, BMI > 26).
|
| It ain't nothing, but that's not a magic pill which will fix
| the obesity epidemic. And these people have skipped changing
| their lifestyle, exercise, diet, and attitudes around food.
| vessenes wrote:
| I lost 100 lbs over 18 months. And, I found it much easier
| to change my lifestyle on a GLP-1 drug. Naturally thin
| people / people who don't have some environmental
| sensitivity are super judgy about GLP-1 drugs, and closet
| judgy about fat people. It's just not so simple as
| "lazy/poor diet/no exercise."
|
| I went from nutritionist appointments that were like "are
| you lying about your food intake? because if not, you have
| some serious problem with something in your environment" to
| "yep, it was easy to cut out a couple things that bothered
| me," and weight came off astonishingly rapidly.
| inglor_cz wrote:
| This is work in progress, though. 3rd generation
| medications are already way more efficient than 1st gen.
| Saxenda ever was. A further increase in efficiency is
| likely.
|
| "And these people have _skipped_ changing their lifestyle,
| exercise, diet, and attitudes around food. "
|
| That sounds very judgmental of you, like if they were
| skipping school. Bad truants!
|
| What about "found the necessary changes too
| hard/complicated to sustain"? That is closer to reality.
| People juggle all sorts of obligations, some are doing
| multiple jobs, commuting 90 minutes each way etc. - they
| may be just too fatigued to exercise regularly and cook
| healthy meals at home.
| jodrellblank wrote:
| There are 110,000,000 overweight people in the USA and
| another 110,000,000 obese people. Is it really closer to
| reality that everyone is a two-jobs no time for exercise,
| or is it more that Starbucks Mocha Frappuccino has 500
| Calories and Starbucks has 15,800 stores in the USA and
| $36Bn annual revenue? And McDonalds, KFC, and all the
| rest. Is it closer to reality that people are snacking on
| some snack food on the couch out of habit and not paying
| attention to how many calories that is in a week, because
| it's just habit and gone in seconds? Is it closer to
| reality that Uber Eats and Door Dash and Domino's
| advertise to manipulate you into believing that you don't
| have time to cook at home and they are a good option? Is
| it closer to reality that there are food deserts with
| only junk easily available?
|
| > " _That sounds very judgmental of you, like if they
| were skipping school. Bad truants!_ "
|
| It is judgemental of me, like if you want to pass your
| exams but skip studying, that would be bad. If you aren't
| exercising and are eating terribly and are obese, this
| lets you silence the alarm bells while saying "I don't
| have time to exercise". That doesn't seem as good as
| eating better and changing your life to include movement.
| inglor_cz wrote:
| I don't perceive health as a reward for virtue, so even
| though I understand your analogy with exams, I cannot
| really accept it.
|
| Ask yourself where fast food comes from. It is a) fast,
| b) cheap. Of course it is going to suit people who a)
| don't have time, b) don't have much money. A union of
| those two wants covers a big part of the contemporary
| Western population.
|
| Composition of food is another biggie, I agree with you
| on that. Too much sugar everywhere. That said: we are
| naturally wired to crave sugar, only someone more and
| someone less. If fentanyl was legally sold on every
| corner in fancy packaging, starting with kids, would you
| blame the resulting junkies for being weak-willed? Or
| acknowledge that the environment is really fucked up?
|
| I personally don't respond to sugar that much and I can
| go weeks without it, but that's not my virtue. It is
| blind luck of my genome or possibly microbiome. I don't
| drink much either, but again, that's blind luck of my
| genome or possibly microbiome which makes me dislike the
| taste of alcohol. Not my iron will, which I don't have.
|
| It is my experience that a lot of people are judgmental
| about the fatties because it increases their own
| perceived self-worth. ("We are the virtuous ones, unlike
| them.") Pretty arbitrary, but humans be like that.
| zahlman wrote:
| >Ask yourself where fast food comes from. It is a) fast,
| b) cheap
|
| It is not cheap. Eating fast food regularly would
| probably more than double my food budget. And yes, I do
| eat meat regularly.
| kristjansson wrote:
| N.B. the claim from the quote is 'at least 15%', many users
| will realize larger benefits.
| NotPractical wrote:
| But is it time to give up just because there hasn't been much
| progress yet? It seems now that we have #2 there's little
| incentive for #1, whereas there was plenty incentive for #1
| before even if little action.
| vundercind wrote:
| I think fourish decades was enough time to see if we'd get
| our shit together on the pile of problems that need to be
| fixed to solve this the #1 way. We haven't, even a little.
|
| So no, I'm thrilled to see #2 show up to _maybe_ get our
| healthcare system to limp along for at least a couple
| decades longer than it was looking like it would.
| adventured wrote:
| Yes. Looking out 30, 50, 100 years science will further
| resolve the obesity problem that has plagued the US since
| the 1980s. There is no scenario where you radically alter
| such a gigantic, disconnected, complex culture such as the
| US has. The old joke was that the US would solve this with
| pills (so to speak), and that's what is going to happen.
|
| If you have a tiny, homogeneous culture it is still very
| difficult to radically alter it in the span of a couple
| decades (think: Sweden, Finland). For something the scale
| of the US, with the diversity of the US, there is no
| possibility. Anything suggested as comprehensive would be
| fantasy. There are only small changes that could be done,
| eg relating to sugar consumption limits in drinks and food;
| some would have a meaningful impact, however you still
| won't fundamentally change the culture's calorie problem.
|
| Getting thinner will do extraordinary things for rebooting
| the malfunctioning US. Obesity does a lot of harmful things
| to work ethic, longevity, quality of longevity,
| productivity, mental capabilities, to say nothing of course
| diabetes and cancer and so on.
| snovv_crash wrote:
| I think it's better not to sacrifice the wellbeing of our
| citizens at the feet of an ideology about exactly how we
| should be solving an obesity crisis.
|
| Besides, having healthier people will lead to better
| infrastructure for healthier lifestyles, purely based on
| demand. It's a virtuous cycle.
| sumtechguy wrote:
| I know someone who has lost about 60lbs. The reaction of most
| people is 'what pill did you take'. They find out it is
| basically no sugar and limited amounts of food with some mild
| exercise. Pretty much every one of them is 'thats hard' and
| do not do it. And frankly it is hard. Like 95% of a grocery
| store has way to much of what you need for your daily intake
| in some form or another. It is that 5% you have to dig thru
| the whole mountain of crap to find. Then once you find it
| hope like hell the manufacture does not stop selling it. Or
| enjoy making everything from scratch (even that is a pain).
|
| I would not jump on that current pill yet. Wait and see.
| There are probably serious side effects that we mere plebes
| do not get to find out about yet (that is for 20 years from
| now). Like what is the side effects when you stop taking it?
| What if your dose is too high/low? What is the long term
| usage like for other parts of the body?
| op00to wrote:
| GLP-1 agonists have already been marketed for 20 years. If
| there were effects, we'd have seen them by now.
| lurking15 wrote:
| Sharon Osbourne almost died, and I've read about enough
| people having serious problems on them including
| gastroparesis and bowel obstruction.
| vundercind wrote:
| ? All I can find are a bunch of articles about one or
| more interviews she gave where she complained it made her
| too skinny (if you're on it for weight loss rather than
| diabetes, you can simply adjust the dose down if you're
| finding it _too_ effective), nothing about almost dying.
| lurking15 wrote:
| > "I'm too gaunt and I can't put any weight on. I want
| to, because I feel I'm too skinny," she went on before
| warning people, "Be careful what you wish for."
|
| She abruptly stopped after losing much more than she
| wanted to lose.
|
| She looks ill frankly.
| op00to wrote:
| > "Osbourne said when she first began using the drug she
| felt nauseous for two to three weeks." > "You don't throw
| up physically, but you've got that feeling," she said. >
| She was also very thirsty and did not want to eat.
|
| No, it doesn't appear that some famous person almost
| died. The drug seemed to be effective for her. She
| noticed some mild nausea - she even said she didn't throw
| up. That's mild nausea. She was thirsty - this makes
| sense. Food contains water, so she was probably
| dehydrated which contributes to the nausea. She should
| have drank more water. Finally, she did not want to eat.
| That is the intended effect of the drug. Sounds like it
| did exactly what it was designed to do.
|
| Yes, gastroparesis can happen. This is not a shocker, as
| GLP-1 agonists affect the rate of gastric emptying.
| Gastroparesis is ... a slowing of gastric emptying. 750
| out of nearly 150,000 GLP-1 patients experienced
| gastroparesis. This is about double the incidence in the
| general population. In very rare cases of gastroparesis
| you can experience blockages, but that is very much the
| exception, not the rule. Even so, this is why it's
| important to meet regularly with your doctor, discuss how
| you're feeling while on the drug, and get medical
| attention if you discover you're not shitting and normal
| methods don't improve things.
|
| There are many useful, common drugs that have side
| effects that seem scary but are rare. ACE inhibitors are
| wonderful, well-tolerated drugs for controlling blood
| pressure, but long term use can cause kidney issues in
| very rare cases. Monitoring potassium levels allows for
| this side effect to be controlled well before kidney
| damage results.
| lurking15 wrote:
| Let me quote the OP:
|
| > If there were effects, we'd have seen them by now.
|
| You just authored a screed in response to me pointing out
| that there are effects.
|
| Sharon Osbourne didn't just have mild nausea she now
| claims she can't put back the weight she lost that she
| didn't intend to lose.
|
| > Gastroparesis is ... a slowing of gastric emptying.
|
| I can't help but point out the syntax choice of internet
| snobbery. I'm not sure when people started sprinkling
| ellipses for dramatic effect because they seem to think
| it makes them authoritative but I think it's worth
| highlighting since it's such a reliable heuristic for
| internet troll.
| CM30 wrote:
| Sounds similar to most major world/cultural issues today. You
| can make the exact same argument about climate change for
| example.
|
| But at the same time, part of me wants to ask... why is this
| a problem? Why shouldn't we just use science and technology
| to fix human problems and remove any unfortunate consequences
| from society?
|
| What's wrong with a world where anyone can eat as much of
| anything as they want, do no exercise at all, ignore their
| dental health and smoke like a chimney, yet still have
| perfect health without any downsides?
|
| Objectively, it would be a better society, with everyone
| materially better off and a system that doesn't need anywhere
| near as many resources to care of its citizens.
|
| Why would it matter what route is chosen here?
| tomp wrote:
| Because some of us want the real thing, not the fake thing
| achieved by cheaters.
|
| I'm the same in other areas of life. I don't take steroids,
| I work out in the gym. I don't take drugs to have trips and
| achieve enlightenment, I tried to find Zen on my own.
|
| I wouldn't partner with someone who had a cosmetic surgery
| ("fake beauty"), nor someone who wears makeup.
|
| Up to every individual of course, I'm not even saying I
| will _never_ take TRT (probably eventually, when I 'm
| older, for health reasons), but I, above everything else,
| value (and want) authenticity.
| zahlman wrote:
| >Why shouldn't we just use science and technology to fix
| human problems and remove any unfortunate consequences from
| society?
|
| Because this comes at the cost of one's essential humanity.
| rootusrootus wrote:
| > Possible effective solutions to the US obesity epidemic
|
| Just wanted to mention that this is not a US problem, and
| framing it as such won't help find solutions. Even in
| southeast Asia the rates over obesity are steadily
| increasing. Europe is already _much_ fatter than southeast
| Asia. This is a worldwide phenomenon.
| vundercind wrote:
| It is global, but the US is among the leaders _and_ people
| who move here from skinnier countries tend to get fatter.
| Something about (odds are, a bunch of somethings about) the
| living environment we've created causes more obesity than
| the environments in most other countries, though yes, it's
| getting worse in those other countries, too.
| sschueller wrote:
| I would argue that the US has some fault to why other
| western nations are getting fatter.
|
| All of the US's worst fast food chains and food products
| have been exported. In my tiny city a Carl's Jr. Just
| opened! There is McDonald's, Burger King and Starbucks
| everywhere. There are also Dunkin donuts in the supermarket
| as well as oreos. In contrast there arent any Asian or
| Russian restaurants chains here.
|
| Local foods have become sweeter in order to compete and
| there are so many local burger restaurants now it's like I
| have moved to the US.
| rootusrootus wrote:
| > US has some fault
|
| That's par for the course, the world does love to blame
| us for their problems. Then they bitch when anyone
| suggests we've made some choices in the last 100 years
| that made their lives noticeably better (hello Marshall
| Plan!).
|
| > have been exported
|
| That's a convenient spin on "have been imported." Do you
| not make your own choices? If you don't want the crappy
| fast food, quit making your own copies of it!
|
| Since it's kind of on point for this discussion, I just
| thought I'd mention one amusing thing I noticed in London
| -- you can buy _higher calorie_ McDonalds food there. I
| could get a sasusage mcmuffin with _two_ patties, which
| isn 't a thing in the US. I almost wanted to do it just
| for the laughs, but frankly the UK version of McDonalds
| tastes even worse than the US version. I'm not sure
| exactly how that's possible.
|
| Y'all should stop importing the shittiest excuses for
| 'American' food. A lot of us never eat at these places in
| spite of them being so prevalent. We have a lot of great
| restaurants, even some of the ones that qualify as fast
| food.
| ornornor wrote:
| > If you don't want the crappy fast food, quit making
| your own copies of it!
|
| "If alcohol is bad for you, quit drinking it!"
|
| "If crack is bad for you, quit taking it!"
|
| My point is that there is more to it than that. You make
| like it's a choice governed by free will when we know
| that fatty and sweet foods are addictive and harder to
| resist.
| aucisson_masque wrote:
| USA is the worst by a long stretch. I believe it's 80% of
| the USA population that is overweight.
|
| Being fit there is statistically considered an anomaly.
|
| I don't know of any other country where you would be weird
| because you're fit.
| Schiendelman wrote:
| I believe the UK is quite similar.
| mmsc wrote:
| When the majority of the population is so far gone from being
| in a healthy weight, promoting healthy food for the masses is
| not going to help that majority. Yes, walkable cities and so on
| would be great, and promotion of healthy food and habits is
| great (remember Michelle Obama asking "why are you people so
| fat wtf?") for future generations, but Ozempic et al. provides
| a solution where otherwise, a lot of people are simply "lost".
| chairmansteve wrote:
| The government isn't going to help you.
|
| This evening, go for a one minute walk.
|
| Tomorrow evening do the same.
|
| Next evening do the same.
|
| Repeat.
|
| The journey of a thousand miles begins with the first step.
| knowitnone wrote:
| one minute? I'm sure that's not going help anyone to walk for
| one minute. 30 minutes at a minimum. 60 is good, 120 is
| great!
| chairmansteve wrote:
| They've got to start somewhere. Build the habit, get over
| the resistance.
|
| 1 minute will turn into 2 minutes, then 5 minutes.
|
| And 1 minute is infinitely better than 0 minutes.
| blamarvt wrote:
| I choose to interpret the post as saying "start small, and
| be consistent". If you were to tell someone to go for an
| _at least_ 30 minute walk every day many people would balk
| at you.
|
| Start with a minute walk. Make time in your day for it.
| Extend to a 2 minute walk. 5 minute. 15 minute. Etc.
| bronzekaiser wrote:
| most people dont have 2 hours a day to walk around in
| circles
| chairmansteve wrote:
| If they can get a little fitter, they can do 15 minute
| medium intensity exercises.
|
| The point is, make a start.
| whatshisface wrote:
| You would have to walk for several hours each day to balance
| out the overeating that's apparently due to GLP-1.
| throwaway019254 wrote:
| To paraphrase: Instead of relying on medication that helps with
| issues caused by our society, let's completely change the
| society so it's no longer the issue?
|
| That's very idealistic, in my opinion.
| itronitron wrote:
| It would be interesting to run an experiment where everyone in
| first world countries was able to (and had to) walk to the
| grocery store to buy their groceries. It seems like that would
| promote useful exercise while self regulating consumption.
| knowitnone wrote:
| I walk to the grocery store all the time. This was part of my
| weight loss strategy and I chose to walk to a farther grocery
| store. And yes, I did attain my weight loss goals.
| fasteddie31003 wrote:
| The two are not mutually exclusive.
| ajkjk wrote:
| As compelling as the theory that "unhealthy behavior" is root
| cause of the obesity epidemics, at this point it seems to me
| that the weight of evidence suggests an actual physical
| disruption. It's not supposed to be _this hard_ for (some)
| people to maintain their weight; something is actually not
| working right.
|
| https://slatestarcodex.com/2017/04/25/book-review-the-hungry...
| might be interesting in the same direction.
| pkulak wrote:
| I run three miles a day, never drive anywhere (bike or bus),
| eat reasonably healthy, and I'm still 20 pounds overweight. And
| what really scares me is that running is the only exercise I
| enjoy and if my weight fluctuates up just 5 pounds or so, I
| start getting hip/knee/foot etc pain. If I gain 10 pounds
| through some lapse in morality, I won't be able to run anymore
| and I'm cooked. If that happens, I'm banging down my doctor's
| door for a pill.
| intothemild wrote:
| So I'm a distance runner, who is on these drugs.. and yeah,
| It sucks, I LOVE running.. but running heavy SUCKS. Most
| people run to lose weight, I lose weight to run.
| karmajunkie wrote:
| honest to god i wish i knew what it was like to be like you
| --i have always hated every step of a run, and im halfway
| convinced the notion of a runners high is a convenient
| fiction cooked up by nike.
| Schiendelman wrote:
| There are a few things that happen here, but the most
| common one is not having someone helping you with form,
| and running much too fast. If you talk to a physical
| therapist and run with a distance runner and have them
| help you keep your heart rate in zone 2, you will
| probably feel much better.
| __turbobrew__ wrote:
| Second the other commenter. Measure your heart rate and
| stay within a lower zone.
|
| Most likely this means you will be walk-running at the
| beginning or even just walking up a steep hill. Running
| is an activity of many small incremental gains. Every
| week you can go a little tiny bit further but if you
| amortize that over a year it makes a big difference.
|
| Many go into running too fast and hard which leads them
| into not liking it because they feel absolutely miserable
| the entire time or they injure themselves due to bad
| form.
|
| I had a good physical therapist which took me from
| nothing and for the first few months I wasn't even
| running but doing foot and ankle strengthening because
| that part of my kinetic chain was so weak.
| occz wrote:
| This took me a long time to figure out: it's ok to not
| like running. There are other forms of physical activity
| that may appeal more to you, which you can do in place of
| running. I'm personally into biking, which gets me more
| than enough exercise.
| artursapek wrote:
| It's probably seed oils tbqh
| zahlman wrote:
| >I run three miles a day
|
| Which will burn somewhere on the order of 400 excess calories
| - about as much as a typical North American muffin (or two of
| the big cookies from Subway). But worse, your body was
| probably going to use most of those calories on something
| else (fidgeting, running a higher body temperature, other
| immune responses including inflammation) anyway, assuming
| that you haven't been gaining weight with your current
| habits. Exercise is healthy and reduces stress, but it just
| isn't effective for weight control. Humans are animals, and
| animals have on the order of a billion years of homeostasis
| technology behind them.
|
| >eat reasonably healthy
|
| Hardly anyone has any accurate picture of how much they
| consume, as measured in calories, except for those with
| actual explicit experience of measuring and accounting it.
|
| If a pill happens to end up helping you eat an amount that
| lets you maintain a healthy weight, I'm all for that. But
| it's important to have your mental model properly calibrated.
| dmead wrote:
| You'd prefer that. Great. Meanwhile we live in this reality.
| hiAndrewQuinn wrote:
| But you already live in a system that promotes that, quite
| heavily. Healthy food and active behavior make you more
| physically attractive, which is in turn linked to better life
| outcomes along almost every metric you can care to think of.
|
| There is, in fact, already an enormous, fully endogenous
| incentive to do those things. The fact many people are not
| keeping in shape (myself included) suggests the allure of food
| really is just that appealing.
| biztos wrote:
| I'm a standard-issue stress eater. I also like to work out.
|
| When I'm really feeling the stress, even though I will tell
| myself _at that time_ to just hang on and hit the gym later,
| the food is that much more of an instant fix that it wins out
| more often than not.
|
| I'm sure that's not just the actual food itself, but also the
| easy availability of it, and probably subliminal cultural
| factors such as advertising. But partly, yeah, it's that my
| ancestors evolved to love eating when they had food, and
| their gift to me is that same desire in a world of endless
| plenty.
| t-writescode wrote:
| > But you already live in a system that promotes that
|
| Correction. We live in a system that *rewards* that. The
| infrastructure and system itself expects us to drive
| everywhere (because it's either faster or literally at all
| possible), eat overprocessed food (because it's tastier
| (literally designed to be hyper-palpable) and faster), and to
| work for absurd hours.
|
| If you somehow have spoons after all that, then you're
| expected to workout, etc, to gain the additional benefits;
| but the systems in play do not facilitate that, at all.
| hiAndrewQuinn wrote:
| I see no difference between "promotes" and "rewards" here.
| If it's a difference of intent, I'll point to everyone in
| this thread consciously "promoting" a lifestyle of fewer
| working hours, cleaner food, and less driving as a much
| more salient viewpoint than the opposite. And if the
| difference is because of "the system", well, you're going
| to have to differentiate between the system of living in
| human society and ... some subset of that system, I guess.
| Some subset
|
| Luckily there's a precise term from economics we can use
| here to split the difference: Opportunity cost. I can
| certainly concede that in some people's lives the
| _opportunity cost_ to working out is higher. In some lives
| you make a lot more money per hour worked than you do
| working out, and so it 's not a surprise more people on the
| margin in those situations choose the former over the
| latter. If you dislike even having that option on the
| table, the good news is you can move to someplace where you
| make less money, and then that opportunity cost will go
| down, because working out is pretty much the same wherever
| you go.
|
| One more sophisticated take of course is to claim people
| don't really know what's good for them, and they discount
| the true value of working out far too heavily. (s/working
| out/eating less/g, or whatever other health promoting
| difficult activity you wish to sub in here.) But, if we're
| going to claim that -- which is actually pretty reasonable
| -- then why would we consider a miracle drug that seems to
| directly counteract that irrational discounting a bad
| thing? That should be a godsend.
| blackqueeriroh wrote:
| Uhhhhh, Ozempic has so many problems and side effects that get
| glossed over.
| godshatter wrote:
| Can you keep the weight off once you stop using it? I don't
| particularly want to have my personal health be in the hands of
| one company especially if the culture stratifies into those who
| can afford to be the right weight and those that can't.
| Especially when it enters it's "enshittification" stage.
| petesergeant wrote:
| It's hard to keep weight off once you stop using it, but I've
| not seen anything to suggest it's harder to keep it off if you
| lost using GLP-1 than if you lost the weight the normal way.
| Most fat people I know have lost weight successfully more than
| once "the hard way" and then regained it.
| olddog2 wrote:
| I'm pretty sure all the Shortages of Ozempic and mounjaro are due
| to injector mechanism production factors and the fact that when
| the drug is transported in a reconstituted fashion in the
| injector, it needs to be kept in cold chain storage the whole way
| which makes logistics much much harder
|
| My friends and I all live outside of the USA and we can get
| basically unlimited ampoules of powdered Mounjaro from China. It
| is very simple to reconstitute with Sterile water in a no touch
| way and works great. We have all had significant weight loss and
| improvement in blood pressure and glucose levels etc.
|
| Waiting for these companies to get their act together, especially
| when mounjaro is a copycat drug is not acceptable. these drugs
| are biochemically very simple peptides with a couple of cross
| linkages and very easy to make in high quantities so there is no
| excuse for everyone who needs them to not be on them. a large
| portion of the world not having access to these drugs for the
| patent period and continuing to suffer all the effect of obesity
| is not morally acceptable.
| cubefox wrote:
| Arguably it is morally acceptable for them to charge high
| prices because drug development and doing phase 1/2/3 trials is
| very expensive. It's also risky, as most drugs fail. If
| companies aren't allowed to make a big profit when they finally
| struck gold means to remove the incentive of trying to develop
| ambitious new drugs.
| m3kw9 wrote:
| I think there will be a time when engineered chemicals will beat
| natural food, but right now this isn't it. I'm talking about
| longetivity tech in the far/ or near future
| subroutine wrote:
| It will be interesting to see how health insurance companies deal
| with Ozempic. A few days ago a top article on HN posed the
| question: Millions of Americans could benefit from drugs like
| Ozempic; will they bankrupt the healthcare system?
|
| Of course there are many health benefits to losing weight. Given
| there are clear, healthy, non-drug assisted ways to lose weight,
| should drug-assisted weight loss be considered an 'elective'
| procedure, so to speak (similar to liposuction). With so many
| people qualifying for this drug, would it be fair to increase
| insurance premiums for overweight individuals? (I say this as
| someone who could lose a few lbs). Should healthy active folks
| who keep their weight in-check naturally be required to foot some
| of the insurance premium bill for those who use this drug to lose
| weight? If someone rebounds multiple times after going off
| Ozempic do we continue to collectively pay? Will we be required
| to collectively pay for people to stay on Ozempic indefinitely to
| maintain a healthy weight?
|
| https://www.latimes.com/science/story/2024-05-29/will-ozempi...
| calvinmorrison wrote:
| The cost of someone being on Ozempic is going to be miles less
| than treating fatties for all the related obesity problems.
| crooked-v wrote:
| Yeah, right now the cost of the drug itself is high, but as
| that comes down and/or once the patents expire, it's a no
| brainer for insurance companies to fund it, in the same way
| that even the worst health insurance plans usually allow for
| cheap office visits and free flu vaccinations.
| subroutine wrote:
| I agree if the cost becomes negligible or whenever it
| becomes cost effective (I'm sure the insurance companies
| will be tracking the data closely) - until then though?
| subroutine wrote:
| I'd have to see some data to be convinced. There is nothing
| more problematic to health than aging. If we make all
| "fatties" thin we'll eventually get a bunch of geriatric
| cancer or dementia patients, or some other expensive age-
| related health problem (e.g. what is the lifetime healthcare
| cost-burden of obese people who live on average to 65 vs.
| thin people who live on average to 85 - just making up
| numbers here)
| rootusrootus wrote:
| I agree. Fat people dropping dead in their 50s and 60s are
| way cheaper than the folks who hang on into their 90s
| getting steadily more infirm with chronic disease.
|
| I still expect that the cost will reach a point where
| insurance companies opt to 100% subsidize so everyone who
| wants it will get it.
| cthalupa wrote:
| Another option: Move to a healthcare system that allows the
| government to negotiate drug prices with pharmaceutical
| companies so ozempic is no longer so expensive that it
| bankrupts us.
|
| The UK gets their semaglutide meds from Novo Nordisk for ~PS75
| to ~PS175 depending on the dosage for a month supply. It starts
| at ~$1k in the US. Tons of other countries with similar or
| better negotiated pricing.
|
| Instead of implementing a system that would allow our
| government to have leverage to prevent this sort of thing from
| happening to begin with, we sit around, wait for enough
| everyday people to get screwed over by it to start raising a
| ruckus, and then some federal agencies fine you a infinitesimal
| amount compared to the profits you made, your CEO goes and
| testifies in front of Congress for a few minutes, and even on
| the most positive outcome side, they then reduce the prices,
| and basically never to the levels they negotiated with other
| countries.
|
| Meanwhile they keep the overwhelming amount of money they made
| selling it to Americans at outrageous prices. And hell - that's
| capitalism, baby! I can't say I have any expectation of a
| company behaving any differently when this is a valid way to
| operate.
|
| So we gotta make it not a valid way to operate.
| farceSpherule wrote:
| A lot of people fail to realize that eating healthy and
| exercising is not enough for a lot of people who fight with their
| weight their entire lives.
|
| Ozempic and Wegovy are game changes and have real, tangible
| health benefits.
|
| One person told me, "No matter how much I eat or exercise, I have
| been 'hungry' my entire life. That ended when I started taking
| these drugs."
| Uehreka wrote:
| I gained about 50 pounds the past decade and the past year I've
| been trying to lose it.
|
| I weighed myself at the beginning: 205 lbs
|
| I started running 30 minutes per day (heartrate training
| targeting about 140-150), every day, for 10 months. I kept my
| diet the same as before (though with a protein bar after the
| run). Weighed myself every week or two, always within a couple
| pounds of 205.
|
| In March I ramped up my runs to 45 minutes per day with better
| interval planning. Still 205. I injured my ankle in May: 205.
| I've been busy and haven't gotten back into running yet, just
| weighed myself, and after months of no activity: 205
|
| Weight loss is hard. It is possible to put in a pretty
| strenuous amount of effort and willpower and see exactly zero
| results.
| sph wrote:
| What do you eat? I bet $10 either it's calorie-counted
| standard high carb diet or something that is low in protein
| and fats.
|
| The physiology of dieting, and avoiding hunger, is pretty
| well understood at this point. Just don't ask your GP or
| they'll just tell you to stop eating red meat and eat more
| cereals as the "solution".
| pixl97 wrote:
| Eh, in a clinical setting only eating "good food" works
| fine.
|
| In the real world this is not what people experience.
| Especially those that experience mental food noise.
|
| Imagine there is a donut in a box at work. It's free, you
| can have it at any point. It's junk food, it's bad for you,
| it's not part of your diet and you don't want it. I mean
| you ate a high fiber food and protein earlier, you
| shouldn't be hungry at all. Now imagine there's an
| additional voice in your head that just slips in "Ok,
| finish that page your on and go pick up that donut". How
| long can you resist it? You probably won't even notice it
| since it's the normal stream of thought you have. At some
| point you'll end up with that donut in your hand.
|
| Now take a GLP-1. The voice gets silenced. If you smoke or
| drink you'll notice that you don't really want to do that
| either.
| esfandia wrote:
| Not the OP but I have tried to reduce my sugar intake, I'm
| walking more than before, and I still basically gain half a
| pound every year. I'd lose some weight for a few days, and
| gain it all back on the one day I'm a bad boy. It seems
| like there's an internal dial that decides what my weight
| is supposed to be, no matter how much I fight it. And the
| dial adds half a pound every year. I guess the dial is my
| metabolism as I age.
| ninalanyon wrote:
| You need to reduce your calorie intake. The exercise isn't
| enough to have a significant impact.
| DonnyV wrote:
| There are a couple things missing from routine. That protein
| bar is sabotaging your run. Those things are filled with
| sugar. You need to do 2 things. Change what your eating and
| do intermittent fasting to jump start your metabolism.
| crooked-v wrote:
| Just doing more exercise doesn't actually help much with
| losing weight, as it turns out. The human body will optimize
| around even intense exercise to reduce calorie burn to a
| homeostatically stable level. The exercise will still make
| you healthier (and have some marginal extra calorie burn from
| e.g. extra muscle mass), but you'll only lose serious weight
| if you also reduce what you eat.
|
| There are a bunch of articles out there about it, but
| Kurzgesagt has a decent pop-science summary:
| https://www.youtube.com/watch?v=vSSkDos2hzo
| cortesoft wrote:
| Its a pretty well known fact that exercise alone (unless you
| are doing extreme athlete training) is not going to change
| your weight without a change in diet.
|
| You can get healthier with exercise, but not smaller. That is
| almost entirely based on diet.
|
| Just think about it; your thirty minutes of running probably
| burned between 300-500 calories. That one protein bar
| probably has about 300 calories by itself.
| r00fus wrote:
| And that's where the GLP-1 meds come in. You get physically
| sick from eating your current (oversized) meal size. You
| don't have cravings. You can lose weight using GLP-1 even
| if you don't exercise strenuously/daily. However you lost a
| lot more if you have a regimen.
| satellite2 wrote:
| If his weight is stable then his meal size is probably in
| the norm. That's the hard part of losing weight. Only a
| small sustained calorie excess will make you gain weight
| but you need a large sustain calorie deficit to lose it.
| And your brain and body will fight as hell against this.
| rootusrootus wrote:
| > 300-500 calories
|
| Put another way, up to a pound a week of weight loss,
| changing _nothing_ about your diet.
| cortesoft wrote:
| Right, but the exercise made OP eat a protein bar, which
| has about as many calories as you were burning in
| exercise.
| rootusrootus wrote:
| The exercise _made_ OP eat a protein bar?
|
| I feel like you just inadvertently explained why dieting
| is not the answer.
| ironman1478 wrote:
| Speaking from experience, that assume that you are
| currently maintaining your weight. I think a lot of
| people are gaining weight slowly, so burning those
| calories actually just keeps you at your existing weight,
| not decreasing it.
|
| It's also really hard to not overeat after working out,
| especially if you do something like swimming, which makes
| you just so hungry. The hunger reduction is I'd like to
| try ozempic. I am active (I swim 3-4k yards hard 2-3
| times a week and surf once a week + walking generally),
| the hunger I have after swimming is so huge I just can't
| not eat something huge, even though I drink a ton of
| water and do all the other things people say to do to not
| get hungry.
| sensanaty wrote:
| I've been a lifetime swimmer, so I can relate. There's a
| reason a lot of swimmers and waterpolo players gain tons
| of weight as soon as they stop training.
|
| Usually if you can fight through the "hunger" it'll calm
| down in its own after about an hour or so in my
| experience.
| momojo wrote:
| Thanks for sharing. It must be discouraging to see no results
| after pretty rigorously following the mantra of "just try
| harder".
| swat535 wrote:
| Exercising won't work, weight loss happens in the kitchen..
| You can do some moderate exercise of course but you should
| count calories and eat less (don't forget to recalculate your
| requirements as you lose weight!).
| bobro wrote:
| Running for 30 minutes is maybe 200-400 calories. If you
| trigger your body to eat more because of that or you are more
| lazy throughout the day because you're tired after running,
| it's a wash. Exercise is not the route to weight loss. It's
| like 80-90% diet.
| rootusrootus wrote:
| > It's like 80-90% diet.
|
| And if you diet, you lose weight temporarily and trigger
| your body to eat more because you're hungry. Your body
| doesn't want there to be a route to weight loss, so it
| blocks them pretty effectively.
| r3d0c wrote:
| what? this is entirely made up/false
|
| a diet doesn't mean starving yourself, it means have
| balanced nutrition that doesn't rely on fast carbs, if
| you burn 2000cal a day for example you still eat 2000cal
| but not in sugar/fast carbs but adequete protein, fats,
| and high fiber/slow carbs; insulin resistance is the
| biggest reason people will feel that hunger right at the
| start but once your body starts gets used to the slower
| carbs that don't constantly spike your insulin the
| resistence goes down
|
| a lot of time it seems like people absolutely don't track
| what they eat or sort of tell lies to themselves (this
| doesn't include people with illnesses that impacts their
| metabolism)
|
| once you start doing a medium amount of working out, just
| going for 30min walks everyday, you will start to build
| some lean muscle which will increase your base metabolism
| and this is where the weight loss kicks in
| sensanaty wrote:
| Exercise by itself doesn't increase calorie burn all that
| much, it just strengthens your body in other ways. It's still
| very important, but to have a healthy weight you need to eat
| healthy (for most people this just translates to eating less)
| and diverse foods with good macro coverage.
|
| You not changing your diet is the problem in this case, and
| that protein bar has so much sugar that by itself it's
| counteracting whatever effort the exercise had in the first
| place.
|
| Also in my experience most people who say this kinda stuff (I
| train and eat healthy but can't lose weight!) actually don't
| eat healthy _at all_ , because they simply don't know what
| that actually looks like.
| Sohcahtoa82 wrote:
| > One person told me, "No matter how much I eat or exercise, I
| have been 'hungry' my entire life. That ended when I started
| taking these drugs."
|
| I would change this to "No matter how much I eat, I have been
| hungry my entire life", because that's what my experience is.
|
| I'm nearly always hungry. Doesn't matter what I eat or how much
| of it. High protein, high fiber, moderate fat, low carb, all
| the steps people say cures hunger, and I'm still hungry. 20 oz
| steak and a massive portion of broccoli, and I'll still get
| munchies an hour later. And before someone says "You're
| probably actually thirsty, but making the common mistake of
| thinking it's hunger", no, that's not it. I'm drinking plenty
| of water. My urine is almost clear.
|
| People say things like "If you're hungry between meals, just
| eat a handful of nuts!", and I don't know if I want to laugh or
| cry, because I'll eat a handful, then another, and another,
| next thing I know, I've eaten _literally 1,000 calories_ and I
| 'M STILL FUCKING HUNGRY.
|
| And so I get _incredibly angry_ whenever someone says something
| like "omg these fatties have to take drugs because they don't
| know how to stop eating" as if everyone has the same
| experiences as them.
|
| No, my hunger sensor is miscalibrated. Some of ya'll might go
| out to lunch and end up eating a large meal and not end up
| hungry for dinner and skip it. I'll go out to lunch, eat the
| large meal, and end up hungry 2 hours later. If I get the
| smaller meal, I'll leave the restaurant still being hungry.
|
| I even tried keto. I did it for 9 months and went from 270 to
| 205 lbs, but even after 9 months, my hunger was not
| recalibrated. I was still hungry after every meal. After 9
| months, I ran out of willpower. Gave into the hunger again.
| Slowly came back to 245 lbs and stayed there.
|
| I wish I could try Ozempic. Maybe it would fix me. But I'm not
| diabetic, so my doc won't give it to me.
| rootusrootus wrote:
| Ozempic (or better, Zepbound) will solve that problem. I feel
| just like you, have had a similar experience, and I'm taking
| tirzepatide (Zepbound, basically) now.
|
| Ignore the haters. Focus on what will make _you_ successful.
|
| > my doc won't give it to me
|
| Get another one. You can have more than one. Go to one biased
| in favor of selling you the drug, if that is what works. It
| is your health. Your doc is not your mom, he is your advisor,
| it is _your_ body and _your_ choice what to take.
|
| Compounded semaglutide is relatively inexpensive. And over
| time the brand name stuff will start to come down because
| they are being undercut by the compounds. Zepbound, for
| example, is now available direct to consumer for $550/month
| (5mg, and not an autopen so you can easily split the dose to
| make it last longer if that still works for you). Still
| pretty expensive, but for a life changing drug it is worth
| it. I also expect the price will continue to drop, probably
| quite a lot in the upcoming years.
| mft_ wrote:
| > I wish I could try Ozempic. Maybe it would fix me. But I'm
| not diabetic, so my doc won't give it to me.
|
| Wegovy (which is the same drug, with a different name) is
| licensed for weight loss, if you fulfill certain criteria:
|
| _adult patients with an initial body mass index (BMI) of 30
| kg /m2 or greater (obesity) or 27 kg/m2 or greater
| (overweight) in the presence of at least one weight-related
| comorbid condition (e.g., hypertension, type 2 diabetes
| mellitus, or dyslipidemia)_ [0]
|
| [0] https://www.accessdata.fda.gov/drugsatfda_docs/label/2023
| /21...
| dennis_jeeves2 wrote:
| >eating healthy and exercising is not enough for a lot
|
| That's because both these interventions when followed in the
| way they are commonly understood are near completely incorrect.
| I blame the govt/medical profession for this.
|
| Other factors: again I blame govt/medical profession for this -
| example it's difficult to get unprocessed food unless one reads
| labels carefully. For example it is near impossible to get milk
| that is not fortified with vitamin D. As they say: the road to
| hell is paved with good intent.
|
| Granted that even after doing everything right there will be
| some people who will be obese, but that would be the minority.
| Again the govt/medical profession is to blame - for example
| I've heard that infants/kids are now given around 30 vaccines.
| With so many variables that have changed in the environment it
| now becomes difficult to isolate what is causing the health
| issues that predispose people to a lifetime of ill health
| incognito124 wrote:
| Wait, what is wrong with Vitamin D?
| dennis_jeeves2 wrote:
| Vitamin D produces short-term results, in the long run it
| is harmful.
|
| I cannot find a good article on it at the moment but dig
| around and you should be able to find it. And yes I know
| people rave about vitamin D.
| Etheryte wrote:
| It doesn't exactly bode well for your argument when
| there's a wide body of evidence disagreeing with what
| you're saying, and you also cannot find the source of
| your claim.
| cthalupa wrote:
| There is some evidence to suggest that vitamin d
| supplementation can result in increased calcification of
| arteries:
|
| https://pubmed.ncbi.nlm.nih.gov/26995293/
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986531/
| https://pubmed.ncbi.nlm.nih.gov/23109644/
| https://pubmed.ncbi.nlm.nih.gov/21406296/
|
| It's far from conclusive, but there is a mechanism of
| action that makes some sense, so it wouldn't be out of
| left field if it were the case.
|
| There's also some evidence that vitamin k can be used to
| help balance out the risk:
|
| https://pubmed.ncbi.nlm.nih.gov/19386744/ (More animal
| studies on K, too, but god knows how well those will
| translate to humans)
|
| In general it's all in the "Potentially a thing, more
| research needed before we start a mass panic" bucket. I
| personally wouldn't go buy a bucket of "ULTRASUPPLEMENT
| 10000 IU VITAMIN D HORSE PILLS," though.
| rasz wrote:
| It is enough, but there are people who dont have metal
| fortitude to eat healthy and just the right amount.
| andrewla wrote:
| I think Ozempic is a treatment of a symptom but not the
| underlying condition, but unlike many of the posters here, I do
| not think the underlying condition is "obesity". The below is
| mostly speculation.
|
| Research especially into people with healthy body weight seems to
| indicate that there is something going on that is causing
| widespread obesity. That is, there's some sort of environmental
| "GLP-1 Turbocharger".
|
| Maybe it relates to processed food, maybe it relates to
| microplastic contamination, maybe it's in the cheese, maybe it's
| an innocuous viral agent, maybe it's gut biome, maybe it's ADHD
| drugs, maybe it's SSRIs.
|
| I suspect that Ozempic is helping us get back to a baseline level
| of exposure by counteracting this. And in the future if we're
| lucky we'll figure out what it is and try to correct it at the
| source.
| jncfhnb wrote:
| You think ozempic is counteracting this mystery force and it is
| mere unrelated coincidence that it results in eating
| substantially less?
| andrewla wrote:
| Yes?
|
| A lizard whose bite makes its prey eat less is crazy but it
| exists.
|
| A lizard whose bite makes its prey eat more is also crazy,
| but maybe it exists?
|
| The first lizard is literal, the second lizard is a stand-in
| for whatever mystery force I am postulating the existence of.
|
| When you look at the historic literature on diet and
| nutrition from the first half of the century it's like
| looking into another universe. People are obsessed with
| getting people to eat more to prevent malnutrition even when
| food is freely available. Something changed.
| squidgedcricket wrote:
| The food changed substantially. Lot's of other stuff
| changed too, but we're talking about the transition from
| malnutrition to obesity over a few generations and the make
| up of what we ingest strongly impacts that.
|
| Mass production and consumerism of food created perverse
| incentives that resulted in drastic changes to diets -
| different macronutrient profiles, new ingredients
| (emulsifiers, artificial sweeteners), and new manufacturing
| byproducts (residual solvents, pfas, plastic). You can
| still opt-out of mass produced food and move to the bush to
| live a subsistence life, and you'll still be ingesting
| plastic and pfas.
|
| Part of the reason this is so hard to grapple with is that
| (in the USA) almost no one alive was an adult before the
| food industry industrialized. I'm 40 and my parents and
| grandparents rode the initial waves of processed garbage.
| jncfhnb wrote:
| I feel it's still not clear if you understand that ozempic
| causes weight loss because it causes reduced eating or if
| you believe ozempic causing less eating is incidental to
| the weight loss
| supportengineer wrote:
| We all know the problem: processed food and lack of exercise.
|
| We all know the solution: Organic vegetables, lean protein, and
| lots of exercise.
| ninalanyon wrote:
| Just reducing the vast intake of refined sugar in the US
| would help a lot.
| andrewla wrote:
| Maybe? I don't think we all know this. And some research,
| especially into people with unusual metabolism (but not
| necessarily known metabolic disorders) indicates that even
| with these restrictions, they need to operate at a
| significant calorie deficit simply to maintain a healthy
| weight. [1]
|
| It might be that they are already exposed to enough processed
| food and pesticides that simply getting those things out of
| their diet is not sufficient, but I think it's clear that
| there's more going on here than a simple answer.
|
| And, I think, most damningly, there are many people who
| maintain a healthy weight with no active efforts to maintain
| that weight, including a lack of exercise and consumption of
| processed food. It might be that a significant fraction of
| people are resistant to this effect or might just not enjoy
| the taste of processed food so naturally gain the benefits of
| avoidance.
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/
| crazygringo wrote:
| We really _don 't_ all know these.
|
| There isn't anything even remotely close to a scientific
| consensus on any of those.
|
| There are plenty of scientists who tell you to _stop_
| exercising when you want to lose weight, because the exercise
| leads you to eat more than you would otherwise, and is
| ultimately self-defeating -- to focus entirely on eating
| less, and then only add exercise back in once you 've reached
| you target weight. And "processed food" is a highly non-
| scientific category that is way, way too disparate to be
| useful at all.
|
| Organic vegetables might be nice, but there's _zero_ evidence
| that organic vegetables are better at weight loss than non-
| organic. Also zero evidence regarding lean protein as opposed
| to fatty -- there 's a big argument that fatty meat is better
| for weight loss, because the fat satiates so you wind up
| eating less calories overall.
| bool3max wrote:
| Yes a scientific consensus for these things _would_ be
| nice, but in a world where manufacturers of such poisonous
| garbage control so much of the "science" and research
| space, can you ever really hope for an honest and realistic
| one? No.
| Ferret7446 wrote:
| Processed food isn't the problem. Processed food is the
| bullet, so to speak.
|
| The person holding the gun is mental issues. Mental issues
| cause people to eat unhealthily.
| kfinley wrote:
| I couldn't agree more.
|
| Out of curiosity, last year, I purchased some test strips to
| test my drinking water. The strips showed typical contaminates:
| arsenic, lead, copper etc. they all registered in the
| "acceptable range". In the test, there was a test strip for
| QUATs
| (https://en.wikipedia.org/wiki/Quaternary_ammonium_cation),
| which caught my attention. It wasn't something that I would
| have thought to test for, but my water tested positive. I was
| curious, so I started testing other local water sources
| including bottled water from various brands; to my surprise
| they all tested positive for QUATs. The only local water I
| could find that didn't contain QUATs was distilled.
|
| I thought maybe it was just in my area, so I started taking the
| test strips with me when I traveled. In the last year, I've
| tested the drinking water in multiple states and countries, and
| only one source has tested negative for QUATs. It was the water
| from a drinking fountain in the San Francisco Airport,
| interesting enough.
|
| My suspicion is that QUATs are often flushed down the drain,
| and the molecules must be too small to be filtered out in the
| water treatment process.
|
| I haven't found much research on the impact of QUATs on the
| human body, but I can help but think our mitochondria would be
| susceptible to damage.
| avelis wrote:
| I could suppose it's some of all of this. But my money is on
| UPF. The author of Ultra Processed People has an identical twin
| in NJ while he lives in the UK and their weights are vastly
| different.
| __turbobrew__ wrote:
| My bet is pollutants in the water. The further up the
| waterstream (and higher elevation) the thinner on average
| people get.
| grecy wrote:
| You are doing an awful lot of mental gymnastics in search of a
| boogeyman that does not exist.
|
| How mammals ingest, process, store and burn energy has been
| well understood for a very long time.
|
| You know why some domestic dogs and cats are overweight? Is it
| ADHD or microplastics? Of course not, it's because they've been
| eating more energy thaN they have been burning for a while.
|
| Ozempic only stops you wanting to eat more, which perfectly
| proves the point. The boogeyman you are searching for is eating
| more energy than you burn.
| cubefox wrote:
| Obviously he suspects environmental contaminants mess up
| hormons such that we get more hungry than we are supposed to.
| bozhark wrote:
| Why would you ever take a pill for weight loss?
|
| That's seems entirely fucked up
| Maxatar wrote:
| What is inherently wrong with taking a pill for weight loss?
|
| I can understand being cautious about side-effects or efficacy,
| but if a pill existed that resulted in weight loss and was
| side-effect free, I can't imagine what would be inherently
| wrong about taking it.
|
| Would it be preferable if it were a powder, or a cream? Is it
| the specific delivery format that has you concerned?
| yapyap wrote:
| gonna be a good while
| robohydrate wrote:
| I've been on tirzepatide (Mounjaro) for 4 months now. I'm down
| 13% of my body weight. I realized that frequent cannabis
| consumption interferes with the weight loss, so I've kicked the
| habit from daily to occasionally on weekends. I've started
| walking 2-3 miles a day, 2-3 days a week regularly, in addition
| to eating less and being more motivated to calorie count.
|
| All this to say, this drug has been life changing for me. I spend
| more time doing things I want to do, depression and anxiety have
| less of a hold on me now. I feel that this drug has allowed me to
| be the best version of myself I have been in a long time. The
| only side effects so far have been positive. I do worry about
| what I will do once it's time to titrate off the weekly dose and
| the best I can think of is that the habits I'm forming in the
| time on the drug I will have the resolve to continue after
| cessation.
|
| I say this because I have battled depression, anxiety and obesity
| issues my entire life. I've had many failed attempts at getting
| back to a healthy, productive and non-obese lifestyle. I don't
| know what is so different about having the drug help me, but I
| can tell you that it has been different.
| yieldcrv wrote:
| Sounds like a kickstart you needed!
|
| Aside from the disruption in cravings, the immediate results
| seem to have motivated you to do more.
| robohydrate wrote:
| You can't imagine how empowering it is to be able to say
| "No." to food. I stopped eating dessert except once a week. I
| can be in the company of other people and surrounded by
| delicious food and not feel the compulsion to eat until I am
| nauseous.
| yieldcrv wrote:
| This is interesting as this is my default, and I am pretty
| lean. I often have to remember to eat or check if I did,
| and lament that its a chore. I enjoy food and the dining
| experience, but I would be fine with that being an
| entertainment option once a week too.
|
| I wonder if there is enough research on how gut bacteria
| influences these things, because if this is what people
| want maybe I could sell mine.
| CBarkleyU wrote:
| This is something that I like to ask friends and
| acquaintances: Would you rather take a pill that gives
| you perfect nutrition and nullifies your hunger feeling
| or a pill that the gives you perfect nutrition and
| nullifies any other calories you eat.
|
| It's pretty much 50/50. Which is weird, as you'd think
| that eating is only a pleasure when hungry and I'm
| proposing them a way to get rid of hunger. Even weirder
| is that I personally would take the second pill and enjoy
| my gluttonous lifestyle.
|
| Regarding this thread: I personally decided for myself
| that if I can be stubborn towards my wife, friends and
| mom (and I am a stubborn SOB) I sure as hell can be
| stubborn towards my own bodily desires. I removed all
| meals except once per day and pretty much all desserts.
| Fuck what my body thinks it desires, if it needs it that
| much it can go fix a meal while I sleep.
| card_zero wrote:
| That's some philosophical weirdness right there. I guess
| we're kind of _into_ the biological aspects of the human
| condition and don 't want to part with them, because
| they're like a fun, mildly disgusting game. There'd have
| to be some other entertaining lifestyle that you gain in
| exchange, and you'd have to be sure you could dig it
| before you'd agree to the switch.
| vinkelhake wrote:
| I want both... Some days, in particular when working hard
| or focusing on something, food is just fuel and not
| something I want to spend time on. I'd definitely take
| that first pill for those days.
|
| But I also really like cooking. If I have the time I
| don't mind spending hours in the kitchen to prepare
| something. I don't really need that second pill _yet_ ,
| but sometimes you just want to pig out...
| card_zero wrote:
| I saw a documentary once about people who effortlessly
| remain at a healthy weight, and their activities were
| tracked for a couple of weeks, revealing;
|
| * Unexpected bursts of random activity like dancing for a
| few minutes or moving heavy furniture, that these people
| didn't even notice, while still doing no deliberate
| exercise,
|
| * Binging like suddenly eating a whole pizza, but then
| eating next to nothing the next day because "too busy",
| without putting thought into it. This would be bad for
| you on the scale of months, but fine over one week.
|
| So, of course, they made up for all the calories they
| seemed to be taking in. There's an implication that this
| is instinctual, or just fortunate habits. In my case, I
| also burn energy arguing, puzzling, and worrying, and I
| naturally radiate more heat than most, and although I'll
| happily _try_ to eat a whole tiramisu by myself I seem to
| have a small stomach and don 't attempt it often anyway.
| So although I think of myself as lazy and gluttonous, I
| guess I'm just fortuitously, circumstantially not.
| Imprison me in a restaurant, I'd probably get fat.
|
| Edit: right now I'm idly eating chocolate while I type.
| But I have no other food in the house, except three
| bananas. That's because I didn't organize it, because I'm
| lazy, but what "lazy" really means is a complex
| subconscious strategy, I think.
| vessenes wrote:
| Tirzepatide and Semaglutide are both known to reduce addiction
| / substance ingestion. I noticed I was just less interested in
| Alcohol when I started on Wegovy, and didn't realize it's a
| common effect until much later. I retained most of my
| disinterest after going off, too, FWIW.
| dyauspitr wrote:
| Sounds like a miracle drug that helps with all afflictions
| that come with our modern life/sedentary living.
| rafaelmn wrote:
| I'd say it's the opposite - if you don't exercise you end
| up skinny fat which is metabolically unhealthy as well. It
| helps with super accessible dopamine hits I guess - which
| is awesome - but need to combine it with exercise for
| maximum benefit.
|
| I wouldn't be surprised if they come up with a drug for
| that that's more sideffect free than testosterone/
| derivatives. Lean and ripped cocktail
| jjeaff wrote:
| Skinny fat is not nearly as metabolically unhealthy as
| fat fat.
| rafaelmn wrote:
| No argument here - just saying it's still not the
| endgame. Lean/ripped combo - now that's something I'd
| subscribe to/inject for regularly.
| queuebert wrote:
| Fat fat can better survive the coming post-AGI
| apocalyptic famines.
| wwweston wrote:
| Turns out it can also be useful during a personal
| apocalypse: having recently lost about 35lbs from
| emergency chest-cracking surgery, ended up pretty glad I
| wasn't at my leanest going into it (sadly, more of the
| weight lost was probably muscle wasting/deconditioning
| than fat stores, but on balance it was probably good I
| had at least 15lbs of fat stores to burn).
| azinman2 wrote:
| It's actually worse in terms of metabolic disease,
| surprisingly.
|
| https://www.mayoclinic.org/diseases-conditions/metabolic-
| syn....
| vessenes wrote:
| This is true, but I'd qualify it. I'm MUCH more active
| than when I started, just naturally, and my heart health
| / true age stats (for what they're worth) are twenty
| years lower than when I started. I lost a lot of muscle,
| but as a percentage, my body fat is nearly half what it
| was when I started. 10/10 would do again.
|
| Recomping is a huge struggle, you just can't eat enough
| to add muscle bulk. Cycling on and off is tough because
| if you don't taper off it, your body is like "thanks for
| ending that long term caloric deficit, have you heard of
| cake?". So you definitely need to approach the muscle
| mass question seriously, but in no world was I healthier
| back when I had an extra 10 to 20lbs of muscle, and the
| rest in fat.
| vladgur wrote:
| Would you mind sharing before and after lean/fat
| percentages and or numbers? I am really curious if there
| is a way to optimize bulkng prior to getting on these
| drugs with a goal of retaining muscle mass(important as
| we age)
| vessenes wrote:
| Prefer not -- sorry! I'm here on my real name. If you
| want my advice, lose the weight then worry about it. A
| good amount of research indicates you tend to gain muscle
| mass in the fat/muscle percentage you start with;
| regardless if you are seriously in need of weight loss,
| the benefits of doing that far outweigh the (temporary?)
| downsides of losing some muscle mass for most people I
| bet.
| vladgur wrote:
| Totally understood. I do hear amazing results from people
| whose BMI is 35 or above.
|
| I wonder how well it works for people with Normal to
| Overweight BMI of about 25 to 35
| vessenes wrote:
| I went from BMI 38 to 24. It worked fastest in the mid
| ranges.
| throwup238 wrote:
| Take a look at the protocol for the protein sparring
| modified fast which is a form of short to medium term
| fast that is designed to retain muscle mass by eating
| tons of protein with a large caloric deficit (1k+
| calories a day). You can easily convert it to a more
| sustainable Ozempic diet by adding more fat/carbs to make
| the lean protein more palatable.
|
| Fair warning though, this isn't an easy diet if you're
| not good at cooking and can't easily develop your own
| recipes. Lots of lean chicken breast so techniques like
| sous vide really help.
| marcosdumay wrote:
| Except for all the externally imposed ones.
|
| But yes, there's a reason people are celebrating those
| drugs.
| Alupis wrote:
| The problem with this (and all diet plans/drugs) is the
| lifestyle that led to problem in the first place.
|
| If you do not change your lifestyle, for real and not just
| superficially, then you will relapse with a vengeance.
|
| That is to say, be careful with using a drug as a crutch.
| Sure, it can artificially make you much more interested in
| not consuming so many calories and/or perhaps being more
| active than before - but you have to continue that
| lifestyle after stopping the drug.
|
| Will Ozempic users have developed the personal discipline
| to prevent themselves from relapse without the drug - or
| will they forever be on a the yo-yo of weight gain/loss?
| JamesBarney wrote:
| >If you do not change your lifestyle, for real and not
| just superficially, then you will relapse with a
| vengeance.
|
| Longterm glp-1 agonist research doesn't agree with this.
|
| > but you have to continue that lifestyle after stopping
| the drug.
|
| Why stop the drug?
|
| >Will Ozempic users have developed the personal
| discipline to prevent themselves from relapse without the
| drug - or will they forever be on a the yo-yo of weight
| gain/loss?
|
| A small % of people are able to achieve significant
| weight loss with diet and exercise. And an even smaller %
| of that group are able to maintain it for the long term.
| We've been trying to solve obesity this way for a 50
| years and have bubkis to show for it. If someone has high
| cholesterol we give them a statin, if they have high
| blood sugar we give them diabetes. Now if they're
| overweight we give them ozempic.
| Alupis wrote:
| > Why stop the drug?
|
| Why would you want to continue using a drug for the rest
| of your life?
|
| > Longterm glp-1 agonist research doesn't agree with
| this.
|
| Please explain. If you stop using the drug, because
| you've achieved your goals, what stops you from relapsing
| other than your own personal habits and lifestyle?
|
| > A small % of people are able to achieve significant
| weight loss with diet and exercise. And an even smaller %
| of that group are able to maintain it for the long term.
| We've been trying to solve obesity this way for a 50
| years and have bubkis to show for it. If someone has high
| cholesterol we give them a statin, if they have high
| blood sugar we give them diabetes. Now if they're
| overweight we give them ozempic.
|
| Yes, a pill for this, a pill for that... and there's no
| chance we'll discover these drugs have negative effects
| when used by a person for 50 years.
| JamesBarney wrote:
| > Why would you want to continue using a drug for the
| rest of your life?
|
| It's better than being obese. This is true of most drugs
| for chronic conditions. very few of them are curative,
| almost all of them treat the condition.
|
| > Longterm glp-1 agonist research doesn't agree with
| this.
|
| Sorry I wasn't clear, I meant with continued treatment
| you don't rebound.
|
| > Yes, a pill for this, a pill for that... and there's no
| chance we'll discover these drugs have negative effects
| when used by a person for 50 years.
|
| They might have negative side effects but obesity has
| very large negative side effects. I would be incredibly
| surprised if any of these drugs that have been used in
| diabetes treatment for a long time have anywhere close to
| the negative side effects of obesity.
| Alupis wrote:
| Obesity is a choice for most people who are obese. Yes,
| they lack the ability to discipline themselves into not
| over eating, but that is still a choice.
|
| This drug artificially makes them more likely to make a
| healthier choice. That's great. But the person's goal
| should be to develop those artificial choices into actual
| choices, ie. change their lifestyle, then get off the
| drug.
|
| Setting this up from the start as a "forever" thing is
| absolutely nuts.
| catlikesshrimp wrote:
| False. (All) People crave for food. Some people have
| stronger craving than others. In healthy people you call
| it "hunger". In obese people it is more like an
| addiction. Do you know people can be addictes to sex and
| to work, too?
|
| If you insist on the choice argument, the only way an
| addict can stop consuming is locking himself in a room
| and throwing away the key. Other than that, much help is
| needed, many changes are needed, and even chemicals are
| needed.
|
| "Choice" is victim blaming
| JamesBarney wrote:
| How much less likely do you think someone with high self
| control is to not be obese?
|
| 12%. Which shows that your intuitions about obesity and
| the causes are probably wrong.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717171/
| mort96 wrote:
| Lacking the ability to do something is, typically, not a
| choice.
| rixed wrote:
| > they lack the ability (...) but that is still a choice.
|
| Typo?
| PlattypusRex wrote:
| Blaming victims and being ignorant is a choice, one you
| made multiple times in this thread.
| kortex wrote:
| Hot take: "choice" is a myth when it comes to long-term
| executive processing, one doesn't choose to be obese/not,
| drug addicted/not, etc, the same way one chooses whether
| they want chicken or beef ramen for lunch. It's an
| unending grind of executive functioning against more
| basal impulses, that is heavily influenced by the blend
| of nature and nurture and life events.
| tikhonj wrote:
| > Why would you want to continue using a drug for the
| rest of your life?
|
| Because it is a substantial net benefit to your life?
|
| Same reason I might want to continue with, say, a regular
| exercise routine or meditation practice.
| data_spy wrote:
| The research says you gain the weight back:
|
| "For the two in every five patients who discontinue the
| treatments within a year, according to a 2024 JAMA study,
| this means that they are likely to rebound to their
| original weight with less muscle and a higher body fat
| percentage." The other issue is the muscle loss on being
| on these drugs as "Clinical data shows that 25 per cent
| of weight loss from Eli Lilly's shot resulted from a
| reduction in lean body mass, including muscle, while 40
| per cent of Novo Nordisk's jab was due to a drop in lean
| body mass." Via https://www.ft.com/content/094cbf1f-c5a8-
| 4bb3-a43c-988bd8e2d...
| JamesBarney wrote:
| Sorry I meant with continued use of the treatment you
| don't regain the weight. I agree if you stop taking the
| medication your weight will rebound.
| Alupis wrote:
| Right, so we doom some portion of the population to
| forever take a pill from big pharma? How is that
| acceptable with anyone?
|
| The goal should be to use Ozempic until you are in a
| better place to manage things yourself. The goal should
| not be to get people hooked on Ozempic for their entire
| lives.
|
| Perhaps Ozempic prescriptions should come with prescribed
| exercise with check-in and monitoring, or something.
| rootusrootus wrote:
| > doom some portion of the population to forever take a
| pill from big pharma
|
| That is temporary. The effects are real. The fact that
| you don't think big pharma should profit handsomely for
| making it happen is not the only alternative. Before too
| long semaglutide, as one example, will be out of patent
| and available as a generic. It won't cost a thousand
| bucks a month to big pharma, it'll be practically free.
| Cheap enough that most insurance plans will likely
| subsidize it all the way to zero out-of-pocket cost just
| because the ROI is so good.
| fragmede wrote:
| How my decisions will affect some company's bottom line
| is way behind "will this help me live a better, longer
| life" in my list of priorities, but I'm already on other
| medications that are generic for the rest of my life for
| other genetic defects I've been blessed with, though I'm
| not on Ozempic.
| JamesBarney wrote:
| > Right, so we doom some portion of the population to
| forever take a pill from big pharma? How is that
| acceptable with anyone
|
| This is literally how almost all medicine works that
| treats a chronic condition.
|
| > Perhaps Ozempic prescriptions should come with
| prescribed exercise with check-in and monitoring, or
| something.
|
| Why?
| BurningFrog wrote:
| I guess young people don't always know this, but there
| are plenty of medications a _lot_ of people take for the
| rest of their lives. Blood pressure and cholesterol pills
| are maybe the most common.
|
| This gives a vast number of people 5-10 years longer
| lives, and I think this is great thing, even if some
| pharma executives end up getting rich.
| Karrot_Kream wrote:
| Not just young people. High blood pressure runs in our
| family. A cousin, despite being healthy in most
| indicators, developed high blood pressure at 23. She's
| still going in her 50s just fine but has had to take
| blood pressure meds for the last 27 years.
| ido wrote:
| Or insulin. I've been shortsighted since childhood and
| will need to wear glasses for the rest of my life (unless
| I get laser corrective surgery, I guess).
|
| Many people in my wife's family have thyroid gland
| dysfunction and have to take thyroid hormones their whole
| lives.
| Tagbert wrote:
| I take a statin as something in my body produces high
| levels of cholesterol even on a low fat diet. I will
| always take a statin. It works well and there are few
| side effects.
|
| My spouse must take a thyroid medicine every day for
| life.
|
| Not taking these pills is life threatening. How is taking
| them not acceptable?
| lazyasciiart wrote:
| Wait til you learn about hormonal birth control.
| golol wrote:
| Why not? What would you rather be: Fat to your death, or
| healthy and dependent on modern technological society in
| yet another way? How is it any different to diabetes
| treatment?
| s1artibartfast wrote:
| Some regain, some don't. Some people have multiple heart
| attacks.
|
| It is really that simple.
| lizardlena wrote:
| > A small % of people are able to achieve significant
| weight loss with diet and exercise. And an even smaller %
| of that group are able to maintain it for the long term.
|
| Ozempic is only fighting symptoms of that, not the root
| of the problem which is the stigma around weightgain,
| being a big person, just fatphobia being extremly
| generalized and a lot of shame surrounding weight. While
| it's amazing for people who have medical conditions
| making them gain a lot of weight, just saying that they
| should take ozempic will not change people gaining too
| much weight. It's not anything like high cholesterol or
| high blood sugar in most cases.
| JamesBarney wrote:
| Fighting the symptoms of what?
|
| Taking ozempic will definitely keep people from gaining
| weight and will help them lose weight.
| Eisenstein wrote:
| A few questions:
|
| Can you qualify what you consider to be a 'symptom' vs a
| 'condition'?
|
| Is high cholesterol a symptom of something, or a
| condition itself? What about high blood sugar?
|
| Would you say that acid reflux is a symptom or a
| condition?
|
| Is a person that takes Prilosec daily to treat bad reflux
| treating the symptoms and not the underlying condition?
|
| What about people using asthma inhalers, or epipens:
| symptom or condition?
|
| Are people allowed to use the medicines if their
| underlying conditions are not being treated?
| fortran77 wrote:
| > While it's amazing for people who have medical
| conditions making them gain a lot of weight,
|
| You mean matter is created out of thin air because of a
| "medical condition" and not by eating too much food?
| justinclift wrote:
| > ... if they have high blood sugar we give them
| diabetes.
|
| That sounds like a hell of a treatment plan. o_O
| bregma wrote:
| It doesn't work. I keep trying to get off the diabetes
| and I just relapse after a few weeks. It doesn't help
| that my body tries to hide the glucose everywhere, like
| attached to hemoglobin or in my liver in the form of
| glycogen so it can share a hit with me first thing every
| morning.
|
| Nope, not going back to the doctor that gave me diabetes.
| That was a mistake.
| perching_aix wrote:
| Sounds like it directly affects their lifestyle though?
| Being less drawn to addictions, and thus less engaged in
| related activities, is a pretty big lifestyle change.
| Alupis wrote:
| > Being less drawn to addictions, and thus less engaged
| in related activities, is a pretty big lifestyle change
|
| While on the drug. Will those changes remain if the user
| stops using the drug?
| Someone1234 wrote:
| What is the core of your point? That these drugs, that
| extend life, and reduce associated illnesses should be
| ignored or not used, because instead people can die
| sooner in some attempt to cure themselves the "correct"
| way?
|
| A corpse cannot learn healthy lifestyle habits. A living
| person who lost weight the immoral way or whatever you're
| trying to say, can of course.
| Alupis wrote:
| The point is you still need to develop a lifestyle that
| is healthy. The drug isn't a miracle, it's a band aid. If
| you do not change your lifestyle, and you discontinue
| using this drug, you will relapse. This is the same issue
| many people face when they diet as well, so it is nothing
| new.
|
| The point of my saying this is to point that out, because
| a lot of people in this thread seem to think it is
| totally ok to be on an Ozempic prescription for your
| entire life. That's horrifying for so many reasons.
| Others seem to think you take Ozempic until you're
| "cured" then you just live happily ever after. That's
| hardly going to be the case for many people who have
| struggled with weight for their entire lives.
| rixed wrote:
| I think we hear you, we should all take more care about
| bad lifestyle, everybody should exercise regularly and
| eat healthy food. But to be fair nobody has promoted a
| bad lifestyle, or said that, given there is this new drug
| let's care even less.
|
| At the contrary, given the testimonies it sounds like the
| drug helps people to adopt better habits, no?
| Alupis wrote:
| > given the testimonies it sounds like the drug helps
| people to adopt better habits, no?
|
| No, it helps people live a better lifestyle so long as
| they remain on this drug. The feeling/impulses are
| artificially suppressed.
|
| Maybe they come right back if you stop taking the drug.
| One would hope you can take the drug until in a good
| place to take over on your own. Time will see - a great
| experiment is about to take place.
| Wytwwww wrote:
| > feeling/impulses are artificially suppressed.
|
| A lot of people are less capable of controlling those
| impulse on their own and are inherently more prone to
| developing addictions than others due to genetic/etc.
| reasons. Yes they can make different choices, change
| their lifestyles, adopt certain routines etc. all which
| would require a huge amount of effort just to get on part
| with people who can achieve those things (relatively)
| almost effortlessly.
|
| Why should they be forced to suffer due to something they
| have limited control over?
| Wytwwww wrote:
| > That's horrifying for so many reasons
|
| Why? AFAIK Ozempic seems to work by "modifying" behaviour
| and reducing the appeal of overeating and possibly
| engaging in other addictive behaviours.
|
| It's not some magic pill that you take and then don't
| actually have to change anything about your lifestyles.
| It seems similar to antidepressants, ADHD drugs etc. in
| that way and a lot of people take those for extended
| periods or even their entire lives.
|
| Besides potential side-effects etc. what's to horrifying
| about it?
| BurningFrog wrote:
| A lot of people take blood pressure, cholesterol, and
| other medications daily for their entire lives.
|
| If Ozempic ends up being another such drug, I don't think
| that's a bad thing.
| knifie_spoonie wrote:
| I'm not so sure about that.
|
| All the people I know who are on those for-life
| medications absolutely hate the fact that they have to
| keep taking those pills every day until they die.
| eichin wrote:
| eh, my inner "prepper" is annoyed by the dependency, the
| rest of me is pleased that I've _already_ lived longer
| than any of my male ancestors. (Kind of hard to sneer at
| advanced technology given what I do for a living :-)
| nasmorn wrote:
| Ozempic will not be needed for preppers. With modern
| society gone you will just be hungry a lot like nature
| intended
| perching_aix wrote:
| They said that this specific effect was largely sustained
| after stopping with the drug, so... -\\_(tsu)_/-
| jacoblambda wrote:
| It really depends. If you break the addiction and it
| could very well remain.
|
| An example is tobacco/nicotine. If you stop smoking while
| you are on the drug and you break the addiction and the
| habit, you aren't going to reform that habit unless you
| start smoking again. And that's unlikely to occur because
| you no longer have the habit, you no longer have the
| chemical compulsion, and you aren't consuming any of it.
| Maybe stress could force a relapse due to weakness of
| mind but all things considered that's minor relative to
| the chemical addiction and the habit forming behavior.
|
| An example where you may see relapse is alcohol or
| marijuana where the substance comes almost more from a
| social environment than it does from the chemical draw.
| Like once the habit is broken, it's still easy to be put
| into situations where recreational use is common and more
| or less expected on rare or semiregular occasions. That
| of course could lead to new habits forming and leading to
| relapse or it may not depending on what other (hopefully
| healthy) habits the user is now taking part in, their
| stress level, and other aspects of their life.
|
| So the answer is of course that it depends but if the
| drug can reliably help people break habits then it can
| maybe also be useful in helping them avoid forming new
| bad habits or relapsing when the urge becomes too strong
| to resist.
| Someone1234 wrote:
| > Will Ozempic users have developed the personal
| discipline to prevent themselves from relapse without the
| drug - or will they forever be on a the yo-yo of weight
| gain/loss?
|
| Have alcoholics using Naltrexone? Or opioid addicts using
| Methadone, or smokers using nicotine gum/patches?
|
| See I'm bringing this up to point out the obvious double
| standard, people suffering from food addiction (i.e.
| literally the high from food) or binge-eating disorder,
| who finally have an effective treatment, are treated like
| it isn't addiction or illness, but a "lifestyle," but if
| you said this stuff about any other addiction people
| would call you out and be horrified.
|
| For people mildy overweight or accidentally obese, it is
| a wildly different illness for people with lifetime
| problems who have lost/regained weight tens of times and
| likely know more about nutrition than most healthy-weight
| people ever will.
| Alupis wrote:
| This is bunk. An actual chemical addiction is not the
| same as feeling an urge to drink 8 cans of coke a day, or
| being unable to not buy a bag of chips at the gas
| station.
| ben_w wrote:
| Is it, though?
|
| Your entire body and brain is a complex and messy
| chemical reaction.
|
| The opening sentence of the wikipedia article on
| addiction currently reads: "Addiction is a
| neuropsychological disorder characterized by a persistent
| and intense urge to use a drug or engage in a behavior
| that produces natural reward, despite substantial harm
| and other negative consequences."
|
| The page then lists "eating or food addiction" as
| examples, with food addiction being its own entire page.
| croes wrote:
| That doesn't prove it's an addiction.
|
| More likely it's listed as one so insurance company pay
| for the drugs.
|
| Addiction treatment gets payed, low self control not.
|
| Half Bake- Thur good goes to rehab NSFW
|
| https://youtu.be/uUPHlAbAf2I?si=TVVxffFprAtdJyAk
| stirfish wrote:
| People get addicted to gambling, and you don't put that
| in your body at all.
| spondylosaurus wrote:
| This is the example I'm shocked more people don't invoke
| in these discussions. Gambling addiction is indisputably
| real, and slot machines (or craps tables or the ponies
| down at the track) don't even have stick a needle in you
| to get you hooked. Actions and reactions are more than
| enough.
|
| Compulsive overeating relies on the same
| behavioral/reward mechanisms, with the added bonus of
| food being something you _do_ physically ingest in the
| process.
| FabHK wrote:
| Gambling addiction also has the highest suicide rate
| among addictions, so definitely serious. The Atlantic had
| an article recently arguing that allowing sport gambling
| in the USA was a mistake, imposing huge costs on the most
| vulnerable.
| coffeebeqn wrote:
| It's also popular in other forms these days.
| Wallstreetbets options gambling, most of crypto, the way
| many people are "trading" these is purely gambling with
| some bro-astrology.
|
| When I was a poor teenager I was gambling online and it
| is an incredible way to lose money unlike anything. With
| the click of a button you can throw $100 or $1000 into
| the void- and you often follow it up until your account
| is empty. Hard to do with many other substances.
| mort96 wrote:
| The fact that people have this idea that "obese == unable
| to resist drinking 8 cans of coke per day" is honestly
| part of the problem.
| rixed wrote:
| Maybe, but shame has never been a very good cure overall.
| vkou wrote:
| Shaming people is fantastic at making _me_ feel self-
| righteous, though, which is the best metric by which I
| can evaluate treatments and interventions for other
| people.
|
| (When I feel charitable, I can instead wring my hands and
| hemm and haww about the unknown consequences of people
| using medication to solve their health problems. I can't
| outline what exactly those consequences are, but I can
| certainly hemm and haww.)
| elzbardico wrote:
| As much as we pretend otherwise and rationalize stuff
| because the greatest sin for our generation is being
| judgemental, I am pretty sure this is the case in a lot
| of instances.
| manacit wrote:
| Gambling? Porn? Sex?
|
| These are all things that we acknowledge are possible to
| be addicted to to that are not substances. Not to mention
| that coke has caffeine which is a chemical substance just
| as much as anything.
|
| You can pin addiction to anything as a personal weakness,
| including drugs. Why are some people able to smoke a few
| cigarettes or do a little bit of cocaine without ever
| getting addicted, when others are hooked on day one?
|
| If there's one thing that's been fun to see as the
| outcome of GLP-1 drugs, it's that a lot of people seem to
| have a real problem seeing people better themselves the
| "easy way".
| mathgeek wrote:
| A good way to frame addiction is via perceived rewards.
| You can be addicted to many things if you look at it as
| "the person expects a reward for an activity, often
| errantly". The worse addictions get into "the reward
| isn't even expected with a moment's clarity, but you do
| it anyway" territory.
| tharkun__ wrote:
| But you are addicted to a substance in those cases.
|
| Sure, you don't take the substance directly. But the
| things you do have your body produce/release the
| substance.
|
| A dopamine high is a dopamine high. Even though you
| didn't buy a dopamine pill from a shady dude in the
| parking lot.
| naijaboiler wrote:
| It doesn't matter what the actual addiction is, the
| reward circuitry in the brain is pretty much similar.
|
| Addiction is basically highjacking our brain wiring
| that's meant to help us expend energy chasing things that
| we need for survival (food, reproduction), and using it
| to chase other things
| wtetzner wrote:
| Seed oils (used in almost everything these days) contain
| a lot of linoleic acid, which is a precursor to
| endocannabinoids, potentially giving you the munchies. If
| eating gives you the munchies, making you want to eat
| more, I'd call that a chemical addiction.
|
| I think avoiding bad foods is a better solution than
| reaching for drugs, but if the drugs help break the
| cycle, it could be beneficial.
| zero-sharp wrote:
| >Seed oils (used in almost everything these days) contain
| a lot of linoleic acid, which is a precursor to
| endocannabinoids, potentially giving you the munchies. If
| eating gives you the munchies, making you want to eat
| more, I'd call that a chemical addiction.
|
| If you listen to nutrition gurus, you'll hear claims like
| "food X contains chemical Y and chemical Y is either
| itself toxic or metabolizes to something toxic, therefore
| you shouldn't eat X". I promise you I can find videos
| where somebody has found something bad about spinach and
| will try to convince you not to eat it. It's a bad way to
| reason.
|
| Identifying individual biological pathways isn't enough
| to make (dietary) prescriptions. Often, the metabolites
| of the food aren't produced in high enough quantities to
| make a measurable effect (on health, or this case
| behavior). This kind of thing has to be studied at the
| level of behavior.
| jdhendrickson wrote:
| I find this attitude strange. I am a very physically fit
| man, I do not know what it is like to walk in the shoes
| of someone who has an addiction to food, but I do know
| people eat themselves to death. People deal with
| debilitating diseases that are directly linked to the
| amount they are eating. People literally destroy their
| body and live in the wreckage, and you think that it's
| not an addiction? If not an addiction what exactly is
| going on?
| fragmede wrote:
| Addiction is this really scary thing I saw on tv about
| downtown Philadelphia and fentanyl killing people buy
| that's far away and couldn't happen here. Sure, I have
| friends who are fat and are unable to stop themselves
| from drinking 8 cans of coke a day but they're not
| shooting up with needles and I know them so they can't be
| this scary kind of person called an addict. Also I know
| this one girl who's glued to her phone all day and can't
| do anything else and she's also definitely not an addict.
|
| Addiction hits the same part of the brain, no matter if
| it's chemical, physical, or digital. Just because our
| culture sees them differently doesn't make it the same
| underlying problem.
| __blockcipher__ wrote:
| It's the same thing. Obviously withdrawals and such are
| different but the core mechanism of disregulated reward
| processing leading to compulsive behavior engagement is
| exactly the same.
| seadan83 wrote:
| The concern regarding a drug as a crutch is stil valid.
| Smokers/drinkers may deal with stress by
| smoking/drinking. After cessation, ways to deal with
| stress need to be learned from a new.
|
| "Addiction" is ambiguous and a term almost better not
| used. "Addiction" may constitute chemical dependency but
| can also be largely a set of habits. A set of habits and
| lifestyle are pretty much the same thing.
| CydeWeys wrote:
| The problem is that calling it a "crutch" is already
| presupposing a negative judgment of it. Use a neutral
| word; e.g. it is a weight loss aid.
| tomrod wrote:
| Some things simply are negative, and masking behind a
| neutral word makes the neutral word perceived as negative
| over time.
|
| Masking reality is not a good way to work within it nor
| modify it.
| cthalupa wrote:
| What's the explanation for why GLP1 medications are
| negative things? There are a very minor subset of people
| that have some medically significant adverse reactions,
| but it is VERY small. We don't have any evidence to my
| knowledge of any long term risks with being on it.
| Alupis wrote:
| > We don't have any evidence to my knowledge of any long
| term risks with being on it.
|
| Nobody has yet been on these drugs for an entire lifetime
| - which is what is being advocated in this thread.
| cthalupa wrote:
| Sure. But what's the proposed mechanism? For many - not
| all, obviously - medications, we have an understanding of
| potential long term risks. Animal studies catch some of
| them, others we know are potentially risky even without
| animal studies, e.g. drugs that increase angiogenesis
| have a risk of increasing tumor growth.
|
| But no one has proposed mechanisms for GLP1 peptides.
|
| Meanwhile, we know obesity is one of the largest long
| term risks to health in existence, and one of the most
| prevalent.
| throwup238 wrote:
| _> But no one has proposed mechanisms for GLP1 peptides._
|
| I'm worried about long term malnutrition leading to
| significant loss of muscle mass, osteoporosis, and other
| deficiencies that eventually lead to infirmity and brings
| forward the immobility death spiral much earlier in late
| age through weak muscles and bones. Most of the long term
| studies on GLP-1 agonists that I've reviewed have been on
| diabetic patients who already had to carefully control
| their diets and we still don't know what decades of poor
| diet on Ozempic will do.
|
| For very obese people the tradeoff is still pretty damn
| good though.
| DANmode wrote:
| As long as they don't use their brains to any high
| performing degree.
| cthalupa wrote:
| Probably more or less the same as to what happens with
| skinny people who have a garbage diet but just eat less
| or have significantly higher metabolisms.
|
| It's not great.
|
| The good news is it's quite commonly reported (and I can
| add my anecdotal experience to the chorus) that I don't
| crave the food that's worst for me in any real quantity
| anymore. Even if I'm busy and need to scroll through uber
| eats, I'm not using it as an excuse to get a delicious
| but large, fried, high in carbs, high in fat meal. It's
| way easier for me to say "yeah that tastes good, but I'll
| grab the grilled chicken wrap and brown rice."
|
| I'm not sure on what causes this - we have some
| preliminary studies around GLP1 peptides, dopamine,
| addiction, etc., so it might be something there. But the
| sheer number of people you hear talking about it makes me
| believe we'll have some studies that do look into it in
| the future. It might not happen to everyone, and some
| people might still just choose to eat poorly even if it
| does, but in both situations people's longterm health
| depends on them listening to advice on how to eat better
| and exercise, and I think most people would rather be
| average weight and metabolically unhealthy than obese and
| metabolically unhealthy.
| __blockcipher__ wrote:
| One obvious risk would be blunting of longer term GLP-1
| receptor activation. Imagine type 2 diabetes but for
| ghrelin.
|
| To use an analogy amphetamines have a honeymoon period,
| and it feels like a lot of people on these weight loss
| drugs haven't been on them long enough to get past the
| honeymoon period and see what the effects are after 10,
| 20, etc years
| cthalupa wrote:
| It's possible. But, we've had another GLP-1 medication in
| use for about a decade and a half now - liraglutide. So
| far, we haven't seen evidence of that occurring.
|
| I don't think anyone who is both informed and sane would
| suggest that it is impossible that there are negative
| long term impacts from taking the medication. Just that
| we have no current indication of them, and that being
| afraid about a "what if" without any concrete concerns
| when the alternative is the "continue being in one of the
| riskiest states possible for human health" is silly.
| rolisz wrote:
| Loss of muscle mass. Most folks on these drugs don't lose
| fat only, but a disproportionate amount of muscle too
| borski wrote:
| All significant weight loss includes some loss of muscle
| mass. Minimizing that is why every patient is advised and
| counseled to lift and work out, change their lifestyle
| and diet, and so on.
|
| The pill alone isn't magic. It just makes it possible to
| do the right things for people who found it impossible to
| do before.
| cthalupa wrote:
| That's the danger of any rapid weight loss where you
| don't exercise and ingest additional protein.
|
| I knew about it from prior research, but my doctor made
| sure to mention it to me as well. He's also monitoring
| the speed of my weight loss to determine if I should go
| on ursodiol to prevent gallstones - another potential
| side effect of rapid weight loss.
|
| But the same could happen on any sort of caloric deficit.
| The GLP1 drug isn't causing you to lose muscle through
| some reaction occurring inside your body - it's your body
| just doing what it does in a calorie deficit when you
| aren't overindexing on protein and working out.
| blackeyeblitzar wrote:
| GI issues are fairly common and sometimes linger after
| stopping too. Loss of muscle mass is also common.
| jart wrote:
| Is there any evidence those things aren't just side
| effects of eating less food?
| oatmeal_croc wrote:
| This. You'll need studies to prove that semaglutide
| causes muscle mass -so you need to have a group that
| loses weight using semaglutide and another group that
| loses weight without it and compare the muscle loss. I'm
| willing to bet you'll see similar numbers. If you don't
| exercise, you will lose muscle mass when reducing weight
| - which is why trainers recommend resistance training and
| higher than usual protein while cutting.
| cthalupa wrote:
| The GI issues tend to be minor. Unpleasant, but not
| exactly any more debilitating than a lactose intolerant
| person deciding that they really really wanted that extra
| large milkshake. Some people have it worse - but those,
| to my understanding, very much are in the minority.
|
| Tirzepatide also has significantly fewer GI issues.
|
| Muscle mass loss happens in any sort of weight loss where
| you don't eat enough protein and get enough exercise.
| There's no current evidence that when you control for
| calorie deficit, diet macros, level of exercise, bmr,
| etc., that people lose more muscle mass on GLP1 agonists
| to my knowledge.
| phil21 wrote:
| GI issues are almost always minor. Folks are used to zero
| discomfort in their lives so the social media reporting
| of such is wildly overdone.
|
| Tirzepatide is being investigated as a therapy for IBS.
| Within two weeks of being on the drug I was able to start
| living a life not scheduled around being near a restroom.
| This was suggested as a potential side effect by my
| doctor before taking it for weight loss, due to the GIP
| component in the drug which slows down your digestive
| track.
|
| It could be I'm eating less. However I have went on crash
| diets before with absolutely no change to my constant
| lifetime GI issues, and have eaten extremely clean the
| past half decade due to a partner who cooks amazing
| healthy meals that would exceed most definitions of the
| term.
|
| I've long since reached my goal weight and target body
| composition- but I plan on sticking to a low dose of
| Tirzepatide for the rest of my life since it gave me my
| life back. No more popping Imodium every few hours on
| vacation while simultaneously fasting. Just a normal life
| these days. I can enjoy a breakfast if I feel like it
| without it ruining the rest of my morning. Heck, I can
| even eat shitty greasy food at the state fair with only
| mild discomfort most folks would have from such poor
| choices.
|
| Every study (still limited in number) I've read more or
| less refutes all the social media hysteria. There is a
| whole lot of smoke but no fires yet to be seen. They may
| still be coming.
|
| The things that are not wholesale misinformation seem to
| be the requirement to cease use many weeks before going
| into surgery, potentially needing to be on it for your
| whole life, and the side effect it currently has on your
| finances. Nothing else seems to hold up under scientific
| scrutiny yet.
|
| Perhaps I will regret this decision in 20 years, but I'm
| willing to take that risk to have some of the best
| quality of life years I've had yet.
| unethical_ban wrote:
| If someone has a broken leg, the word "crutch" isn't
| derogatory in the first place.
|
| Cessation tools are not negative. Yes, root causes of
| abuse should be addressed, but aids are aids.
| CydeWeys wrote:
| Crutch (n) a : a support typically fitting under
| the armpit for use by the disabled in walking b :
| a source or means of support or assistance that is relied
| on heavily or excessively
|
| Use a is a neutral, non-judgmental, literal use of the
| word. Use b is clearly a pejorative, judgmental,
| metaphorical use of the word. The two are not the same.
| borski wrote:
| The negative connotation of a crutch implies that you are
| past the point of needing it and should be standing on
| your own two feet. If a thing is not meant to be
| temporary, or if you'll never be able to perform a task
| as well without it as you could with it, then it's a tool
| rather than a crutch.
|
| Thus, calling GLP-1 meds a "crutch" implies that they are
| unnecessary, and that the patient should be able to do it
| without medication, which then creates guilt and shame
| where there shouldn't be any.
| fknorangesite wrote:
| > If someone has a broken leg, the word "crutch" isn't
| derogatory in the first place.
|
| It is so profoundly disingenuous to pretend not to know
| what the word "crutch" means or what connotations it has
| in this context. Like, come on.
| CydeWeys wrote:
| Some things simply are negative, sure. I think we can all
| agree that murder is negative on the whole, for example.
|
| But you are making a HUGE leap here in assuming that GLP1
| agonists "simply are negative". You have not remotely
| supported this logical leap. All studies in fact have
| shown that GLP1 agonists are significantly positive: That
| they improve health, reduce obesity, reduce all-cause
| mortality, etc. You are denying observed reality across a
| large number of double blinded, objective clinical
| trials.
| nswest23 wrote:
| All these people are calling it a crutch are moralizing
| tongue clicking, holier than thou Calvinists who think
| you shouldn't be able to be thin unless you bootstrapped
| yourself to thinness with your own blood sweat and tears,
| as though this viewpoint represents some abstract
| understanding of the world instead of merely a smug sense
| of self righteousness.
| buzzerbetrayed wrote:
| Crutch and "weight loss aid" aren't synonymous at all.
| You can't ask someone to use a word that has a less
| negative connotation if they mean completely different
| things. They intentionally said crutch because they're
| specifically talking about people who use it as a crutch.
| Not people who just use it as a weight loss aid.
| golol wrote:
| What's wrong eith a medicine as a crutch? If you break
| your leg you use a damn crutch and that's good. If you
| suffer from an illness and we have a medicine that's
| worse than the illness and affordable - go for it.
| Phrasing it as a crutch suggests it is somehow only a
| temporary that prevents you from finding a "real"
| solution by changing your "lifestyle". It doesn't matter,
| only outcomes matter.
| names_are_hard wrote:
| Agreed. After I broke leg the physical therapist saw me
| walking without aids and said I should go back to using a
| cane and explained that I'll heal better and faster if I
| use help than if I don't. Made me realize that the
| expression "using x as a crutch" doesn't make sense if
| it's supposed to imply that x is an impediment to
| progress.
| goosedragons wrote:
| I think the difference is with food you have to eat it.
| You don't need alcohol, opioids or nicotine to live. With
| food it's much easier to fall back into similar or the
| same pattern as before because you can't avoid it.
| seadan83 wrote:
| Chemical dependency I believe can confuse the brain,
| where it actually does think you need the drug to live.
|
| It can be very hard to avoid booze or cigarettes. They
| are everywhere. Potentially throughout all of a person's
| social group. Maybe at home if spouse or parents smoke.
|
| As a former smoker, changing diet was easier for me than
| to change a smoking habit
| tsimionescu wrote:
| While you're chemically addicted to a substance, yes, the
| body thinks you literally need it to survive. The point
| is what happens after you break the chemical addiction,
| you go through withdrawal, and can function again. The
| brain stops feeling you need it in that same way after
| this process. But it's almost impossible for someone who
| went through alchohol or nicotine or opioid withdrawal to
| ever consume that again and not relapse into addiction.
|
| If the same logic applies to a "food addiction", then
| discontinuing the drug that helped you go over the
| initial addiction is going to be almost impossible, since
| you can't abstain from food.
| seadan83 wrote:
| Withdrawal can often be both a mental and chemical
| process. The desire to do something and constantly
| thinking about it can be just as much habit as it is
| chemical.
|
| We are mostly on the same page I think. To the point
| though, re: food - it is not all equal. Fast food, ice
| cream, fried food, candy, chips- it is quite different
| from cooking your own meals and snacking on things like
| fruit, veggies and hummus (etc..)
|
| Similar to your first point, I can't buy ice cream
| because I have no self control over it. (I would not say
| I have a food problem, it would therefore be a lot harder
| for others I believe)
|
| While I agree "you can't abstain from food", it might be
| a bit overly reductive. Not all food is responsible for
| 'problem' eating. Similar to near absolutely (or
| absolutely) avoiding booze/nicotine, there might be
| similar foods that must be avoided. Which comes back to
| habits, changes to how a person snacks, when they eat,
| how long is spent in food prep,more grocery store trips,
| how they shop in the grocery store (etc)
| dazc wrote:
| The other problem being the availability of healthy food.
| Those without the time or facility to cook are dependent
| upon stores selling convenience foods which are anything
| but healthy, those foods labelled as such being some of
| the worst examples.
|
| Despite not being overweight and taking regular exercise,
| I have recently been diagnosed as diabetic and now see
| the world in a different light. It really is quite
| shocking how many aisles in. a typical supermarket are
| stocked with complete junk food.
| tonyedgecombe wrote:
| >The other problem being the availability of healthy
| food. Those without the time or facility to cook are
| dependent upon stores selling convenience foods which are
| anything but healthy, those foods labelled as such being
| some of the worst examples.
|
| Is it impossible to buy healthy food in your region? The
| average American spends six hours a day watching TV, do
| they really not have enough time to cook a meal? Just how
| many people do not have a cooker in their home? Is it
| cheaper to buy preprocessed food rather than the raw
| ingredients in that meal?
|
| It seems to me the real problem is the supply of food is
| abundant and corporations have gone to extraordinary
| lengths to make it very palatable. Add in peoples
| tendency to chose the easy option (ready meals, eating
| out) and you get an obesity epidemic.
| nox101 wrote:
| People that move out of the USA generally lose weight.
| Especially if they move to a country with snaller
| portions and more walking. People that move to the USA
| generally gain weight. Evidence that it's lifestyle.
| grepfru_it wrote:
| Just needs to be a walking friendly city. You will lose
| weight in eg NYC or Seattle
| lazyasciiart wrote:
| I'm in Seattle, and I can tell you that foreigners don't
| move here and lose weight.
| NilMostChill wrote:
| That's evidence of environmental factors.
| ta_1138 wrote:
| An environment that physically makes you more sedentary
| as, outside of a couple of cities, many things that would
| be sensibly done through walking in other countries
| involve driving.
|
| You can easily tell this is the case by seeing where the
| obesity is less prevalent
| hnburnsy wrote:
| Maybe peer and societal influences too?
| maigret wrote:
| https://usa.streetsblog.org/2023/04/14/exactly-how-much-
| less...
| pclmulqdq wrote:
| I would suggest that you look at food labels of
| "equivalent" products on both sides of the Atlantic. US
| packaged foods have a lot more sugar (and general
| calories) than those in Europe, even when they are the
| "same."
| bitnasty wrote:
| Actually not true. All addicts develop lifestyles around
| their addictions. Alcoholics often have many social
| connections that involve alcohol, what they do for fun
| involves alcohol, etc. A successful recovery typically
| involves changing this lifestyle to make the problem
| behaviors easier to avoid.
| jrockway wrote:
| I don't think you expect to stop taking the drug. It's a
| for-life kind of thing.
|
| If a prescription for "lifestyle changes" were a drug, it
| would be one of the least effective drugs ever made. I
| read something directed at medical professionals that are
| skeptical of the GLP-1 receptor agonists and it asks, if
| you prescribe a drug and your patient refuses to take it,
| why would you keep prescribing that drug? Of course not.
| That's what lifestyle changes are, and the landscape has
| changed so that there are alternatives.
|
| (My employer is heavy on the "lifestyle changes" angle.
| They will not pay for GLP-1s, but they will send you a
| newsletter about losing weight if you want. Guess who's
| losing the weight.)
| metabagel wrote:
| > The problem with this (and all diet plans/drugs) is the
| lifestyle that led to problem in the first place.
|
| I don't think we fully know what led to the problem in
| the first place.
|
| I think it's a complex interaction between the types of
| foods we eat, and which are more affordable, our gut
| microbiome, and the amount and frequency of exercise
| which we are able to fit into our day.
|
| We have some pretty good ideas that reducing intake of
| high glycemic foods, safely reducing overall calorie
| intake, and getting regular exercise will help.
|
| However, it's the bad food which many families can most
| afford. Many people find it difficult to make time for
| exercise, since they are pretty exhausted from making a
| living. The foods which are bad for us tend to make us
| feel good in the short term.
|
| When a person has become obese, it is harder to start
| exercising, and it's harder to find exercises which don't
| hurt their feet, joints, back, or other parts of their
| body.
|
| Ideally, we would all have copious time to exercise, and
| healthy food would be abundant and affordable. But,
| that's generally not the case for most people.
|
| And some people seem to be genetically predisposed to
| gain weight.
| sirsinsalot wrote:
| If you compare the typical American diet and ingredients
| to the rest of the world, the answer is clear.
|
| The problem is most Americans (where the obesity crisis
| is worst) don't know their country's businesses are
| selling them rubbish and their government is subsidising
| it.
| cam_l wrote:
| I figure for some people it will work as a crutch and for
| some it will work as a prosthetic. I guess that depends
| on whether you need to take some weight off and allow
| yourself to heal, or if you are actually missing that
| appendage. Metaphorically.
| nwienert wrote:
| > you will relapse with a vengeance
|
| You say this - but not from experience (correct me if I'm
| wrong and you have taken a GLP-1 agonist).
|
| I say this because as someone who has taken it, I found
| one of the craziest parts is how they do seem to help you
| set better habits, and those habits do stick, and it's
| not like some fake thing.
|
| For example MJ helped me do the following: entirely
| stopped late night snacking, stopped craving sweets, stop
| smoking weed. And it doesn't come back when I go off,
| even after months.
|
| I wasn't especially overweight when I went on (maybe
| 20lbs), I did it for the incredible immune system benefit
| which seem to heal my immune disorder, but I was stunned
| at the results outside of it.
|
| I get that people hate the idea of something that helps
| you be better without having to "put in work", but in the
| weirdest and best way possible, it seems to do that, at
| least in part.
| coffeebeqn wrote:
| > people hate the idea of something that helps you be
| better without having to "put in work"
|
| This is kind of an incredible reaction many people seem
| to have. Isn't this just a net positive? Even if someone
| feels like gatekeeping good health, ozempic is only
| giving you maybe 60% of the benefits of a healthy diet
| and regular exercise. It's not taking anything away from
| people who put in the effort
| golol wrote:
| "Everything comes at a cost" as a meme is really deeply
| integrated in our culture. Since thousands of years
| probably.
| homebrewer wrote:
| Yeah, no. Speaking of "personal discipline" makes it
| obvious you have never seriously dealt with addicts.
| Solving it long term is basically impossible for some of
| us; pretty sure because of how our brains are wired at
| the physical level. I know all the (popular) science, I
| discussed it with a good doctor whom I personally know, I
| know you're supposed to change your habits long-term (and
| _how_ you 're supposed to do it), and I recently lost 15
| kgs of weight for the fourth time in my life. The longest
| time I managed to maintain healthy weight was maybe 3-4
| years. If Ozempic (or whatever) actually solves this, I'm
| ready to go on it for the rest of my life.
|
| I also live in a "vodka belt" and know several alcoholics
| who tried very hard to maintain their "personal
| discipline". It's _impossible_ for most of them -- almost
| all relapse in a few years ' time.
| zero-sharp wrote:
| I'm one of those people who has repeatedly lost weight by
| managing food intake. I'm talking about losing over 30
| pounds, more than once. It might have been three times.
| Oh yea and I've kept it off for close to a decade now. I
| didn't use drugs. At times I used a food scale to manage
| portions. At times I literally just microwaved broccoli
| for a snack/meal. I still do it periodically if I'm
| feeling self-conscious. Does it suck? Yep. Have you guys
| ever tried those things?
|
| I mention this because I feel like you need somebody who
| has gone through the experience to actually have
| credibility in the conversation, to tell you that
| personal discipline is a real thing that can achieve
| results. I think it's ridiculous how quickly you
| dismissed the parent post.
| phil21 wrote:
| I've gone through that experience multiple times as well.
| Also over 30lbs each time. Also having kept it off for
| years, although not quite a decade for my longest period.
| COVID was my last regression, as it was for many who lost
| it and maintained it the way we both did.
|
| The GLP-1's are a game changer. I will never lose weight
| the "white knuckle" way again. I can, and I have proven
| it to myself and others. It's not complicated as you say
| - it's quite simple.
|
| It's simply such a giant imposition on your life and
| mental well being that I am thankful others won't have to
| go through it as their only option in the future. The
| sheer chunk it takes out of my executive function means I
| can't perform nearly as well at other tasks in life. The
| GLP-1 class of drugs make it trivial in comparison. Like
| a performance enhancer for a diet.
|
| I also have worked out a hell of a lot more taking
| Tirzepatide than I ever did counting calories on a food
| scale. This is because I feel so much better it's not
| even a comparison - primarily mentally, but also
| physically due to the other positive side effects the
| drug has associated with it. Plus I don't feel guilty
| when I go out with friends to a burger joint - I eat half
| and feel perfectly satiated, no guilt or "cheat day"
| required. My energy levels are not comparable. I have
| much more time in my day available for other activities,
| such as keeping appointments with my personal trainer at
| the gym or taking 6 miles of walks per day.
|
| Losing weight and maintaining an active healthy lifestyle
| doesn't have to "suck" any more.
|
| I feel like you need someone who has gone through both
| experiences to actually have credibility in this
| conversation. Willpower isn't a special trait, it's not
| something to lord over other people.
| zero-sharp wrote:
| >Willpower isn't a special trait, it's not something to
| lord over other people.
|
| I'm not special. Look at his post. He quickly dismisses
| the idea of personal discipline and asserts that keeping
| weight off is "basically impossible" in the first two
| lines. What kind of bullshit is that? Because we don't
| know what it's like? Well I do.
| theshackleford wrote:
| You only know what it's like for _you_
|
| You know nothing of anyone else's experience and
| pretending otherwise is comical at best.
| zero-sharp wrote:
| >You only know what it's like for you You know nothing of
| anyone else's experience and pretending otherwise is
| comical at best.
|
| Well we're all technically different, so nobody knows
| what it's like to be you. So literally no advice or data
| can actually apply to you. Those scientific studies
| studied other people, right? Cool world we've created.
| phil21 wrote:
| I worded that poorly and deleted a paragraph below it
| since it maybe was wandering into places I didn't want it
| to.
|
| Reading on the topic of self control and personal
| discipline, and talking with friends with phds on the
| subject of addiction medicine changed my mind and
| perspective on it. I can white knuckle pretty much
| anything - so can most people if properly motivated. I no
| longer find that interesting or a point of pride.
|
| When you look into addiction at a deeper level you find
| people who are sober from their drug of choice, but
| utterly miserable. This is similar to your description of
| having to lose and maintain weight through self control.
| The "it sucks" part. I no longer feel it needs to suck,
| just like a former alcoholic will tell you how it's
| relatively easy to be sober but miserable. The hard part
| is figuring out how to do it while being happy and not
| constantly in a battle with yourself. I see what you
| describe as someone who avoids alcohol by not visiting
| establishments that serve it and keeping it out of the
| house.
|
| What I realized is that I don't need to do that with food
| - there is help available. I'm now like the former
| alcoholic that can be around booze without a single
| thought of taking a sip. It's an entirely different life
| experience and I'm not miserable or using a portion of my
| brain to remain in control.
|
| I have done it both ways and the GLP-1s effectively saved
| my life. Not literally - but it's now a life worth living
| vs just surviving.
|
| I firmly believe these drugs will be as society changing
| as antibiotics were.
| zero-sharp wrote:
| Sure, I'm proud of being able to do it. But it's not an
| ego/pride thing this in this conversation. I don't know
| how to say this politely, but I think it's dangerous when
| our own failures warp our world view with regards to
| possibilities and truth. "I couldn't do it, so it's
| impossible" Well maybe? But maybe not.
|
| And you're right. I've had to make lifestyle changes
| where I avoid certain venues. I don't have fast food.
| I've had chips maybe a handful of times in the past
| several years. You can call it a battle, but I wouldn't
| say I'm miserable on a daily basis. I just got used to
| it.
|
| Using drugs to improve your quality of life is incredibly
| valuable. At the same time, I still believe that lifelong
| dependence to drugs should be avoided. I anticipate
| negative societal and psychological outcomes in the
| future. But I have to run.
| cthalupa wrote:
| I'm someone that has spent many years of my life eating
| well and exercising regularly, including weightlifting.
| I'm also someone who has spent the past decade doing
| neither of those things, with one attempt in the middle
| to correct my behavior interrupted by a knee injury.
|
| I'm currently on tirzepatide and have also started to
| resume exercise, and I'm enjoying it like I did when I
| was younger - I expect I'll be able to go off of it when
| I get to my goal weight.
|
| But at the same time, there's not any real reason that
| people would _need_ to go off the drugs, outside of cost.
| So far we don 't see any adverse reactions in the vast
| majority of people. Some people have reactions from rapid
| weight loss - gallstones, hair loss, etc. but these are
| also risks in crash diets, etc.
|
| We accept that people will need lifelong medication
| (often with worse side effects) for other illnesses that
| have less risk to all cause mortality, etc., than
| obesity. Why would we be unwilling to do it for obesity?
|
| The fact of the matter is that despite the risks and
| downsides of obesity being well known in America, 42% of
| American adults are obese. No amount of education or
| knowledge that has gotten us on the whole to eat better
| or exercise more. Plainly, being on these GLP1
| medications is preferable to being obese based on all
| current knowledge.
| CydeWeys wrote:
| > The fact of the matter is that despite the risks and
| downsides of obesity being well known in America, 42% of
| American adults are obese.
|
| It's down to 40% and dropping now, thanks essentially
| solely to GLP1 agonists! This will, no lie, save our
| country trillions of dollars in increased years of
| quality of life (and thus productivity) and reduced
| healthcare costs.
| slothtrop wrote:
| Yes, what's true and often understated about weight-loss
| is that people usually _do_ lose weight when they decide
| to, but gain it back. Aside from lifestyle, metabolic
| adaptation is one factor. Since metabolism is lower,
| increasing calorie intake too quickly leads to weight-
| gain, and metabolism remains worse than it was before.
| monkeycantype wrote:
| The genetics of hunger are fascinating, people literally
| feel very different levels of hunger. My family are
| mostly all quite fit and healthy, but this is because
| exercise and dieting are a cultural obsession in my
| family to an un-mentally healthy extent, because as I
| understand through conversation with others We feel an
| unusually high level of hunger, I can be full to bursting
| and hunger does not stop. I tried semaglutide, it was the
| first time I can recall ever feeling the absence of
| hunger. To think that my family and I are likely nowhere
| near the top of the hunger spectrum astonishes and
| horrified me
| sheepscreek wrote:
| As someone very close to an Ozempic user, I can tell that
| you have no idea what you're talking about.
|
| Would we consider insulin a crutch? Think of this as
| something in the same league. At least that is the case
| for a good chunk of the target audience.
| mitjam wrote:
| It seems to be more like an orthosis than a crutch as it
| helps the body to get back into a healthy state instead
| of replacing it's functionality.
| skywhopper wrote:
| Did you even read the top level comment here where the
| person addresses this? Anyway, this sort of moralizing is
| incredibly inhelpful. Very few people are obese because
| they lack "discipline". Certainly they are no less
| disciplined than most non-obese folks in the world. All
| sorts of factors play into obesity that have nothing to
| do with "discipline": genetics, gut microbiome, local
| environment, food availability, mental health, physical
| disease.
|
| There's some small percentage of people for whom
| "discipline" is enough, but when people talk like you are
| with the implicit assumption that all fat people are lazy
| and immoral due to lack of "discipline", you only
| reinforce the misinformation about the causes of obesity
| and make it harder to address novel causes with novel
| treatments.
| legacynl wrote:
| Well that's the whole point of the novelty of this drug.
|
| This drug somehow effects our emotional resilience and/or
| the strength of our response to emotional decisions
| and/or the way our brain weighs different options
| regarding to long-term planing.
|
| Basically instead of your suggestion of not treating
| drugs as a crutch, and trying hard to restructure your
| life; this drug basically does exactly that. It gives you
| the decision making of a person that already did fight
| the addiction and restructured his life. The only thing
| then is for the person to actually restructure his life
| by living his newly well-decisioned life for a while.
|
| That's why it is sometimes bad advice to tell people not
| to use medicine as a 'crutch'. Just like actual crutches,
| they actually are meant to be able to temporarily support
| a person. If somebody needs a 'crutch' they should fully
| use it, especially if it can help them ultimately solve
| the need for the crutch.
|
| I get what you're trying to say with the crutch thing,
| but personally this kind of attitude prevented me from
| considering medication much earlier. Even though we all
| feel deep in our hearts that standing by yourself is
| better than relying on some crutch, nobody cares, and
| nobody is going to give you any bonuspoints if you make
| it to your death without any help. If any type of
| medication or treatment can help you, for the love of all
| that is good, use it.
| nunez wrote:
| So I was, also, a firm believer of the "gotta fix your
| lifestyle" school of thought regarding weight management
| until I was introduced to the Maintenance Phase podcast
| (hosted by Aubrey Gordon and Michael Hobbes).
|
| This podcast, and Aubrey's book "What We Don't Talk About
| When We Talk About Fat," opened my eyes to the fact that
| many people are just _born_ hungrier than others.
|
| The body will weigh what the body wants to weigh, no
| matter how many fad diets or drugs you throw at it.
|
| Unfortunately, those whose bodies that don't conform to
| our modern, eugenicized definition of "healthy" and don't
| particularly care for working out at all times are dealt
| a lifelong sentence of social ostracizing, "have you
| tried this diet" and "calories in, calories out," mostly
| against their will.
|
| To wit: I can easily scarf down 3000+ calories per day.
| EASILY. I also know people who struggle to eat 2000
| calories per day. I've seen this dynamic with kids in the
| same family as well.
|
| I'm not saying that it's impossible to make healthier
| choices. Everyone can benefit from a balanced diet and
| more exercise. I'm saying that some people will naturally
| be heavier than others, and that should be okay.
| arijo wrote:
| It's not a miracle drug. Check this Joe Rogan interview to
| understand at a deep level all the problems with a drug
| like Ozempic: https://www.youtube.com/watch?v=G0lTyhvOeJs
| karmajunkie wrote:
| you lost the debate the moment you cite joe rogan.
| arijo wrote:
| I would listen to what his guests on this particular
| podcast have to say before jumping into conclusions just
| because the interviewer is Joe Rogan.
|
| I have no particular opinion on him - I'm just interested
| in what the interviewees in this specific episode have to
| say about metabolic health which has direct implications
| on the massive usage of drugs like ozempic.
| cthalupa wrote:
| I'll start with stating that Joe Rogan has, as the years
| have gone on, resulted to more and more fringe guests on
| basically every subject.
|
| Then I'll point out that these guests are MDs, not PhDs.
|
| And then I'll point out this bit from the description:
|
| > Dr. Casey Means is the Co-Founder of Levels Health,
| which provides insights into metabolic health through
| real-time data. Calley Means is the Co-Founder of
| Truemed, which enables HSA spending on healthy food,
| supplements and exercise. They are the co-authors of
| "Good Energy."
|
| Their livelihood is based on selling people apps,
| services, hardware, supplements, etc. around a certain
| lifestyle. They've got direct financial incentive to be
| against GLP1 medications.
|
| For any specific claims, well, if you're going to use a
| video for reference, present the specific claims,
| timestamps, etc. You can't expect random people on the
| internet to watch a two and a half hour video off of
| nothing more than "you'll understand at a deep level the
| problem with glp1 drugs!"
| arijo wrote:
| In contrast with the huge amount of money that the pharma
| industry spends in marketing GLP1 drugs to people not
| caring about their long term effects but only on profit.
|
| I wish there were more Casey and Calley Means in this
| world instead of ever more metabolic and mentally ill
| society living more like zombies than free human beings.
| cthalupa wrote:
| > In contrast with the huge amount of money that the
| pharma industry spends in marketing GLP1 drugs to people
|
| Drugs lose their patents and much of the research on
| novel medications is done in partnerships with
| universities, etc. Plenty of other scientists unrelated
| to the drug companies are continuing research through
| entirely separate funding. But I guess everyone is in the
| pocket of big pharma?
|
| > not caring about their long term effects but only on
| profit.
|
| What long term effects? You still haven't elucidated any
| concerns.
|
| > I wish there were more Casey and Calley Means in this
| world instead of ever more metabolic and mentally ill
| society living more like zombies than free human beings.
|
| You can find plenty of them on instagram, youtube, and
| tiktok. They'll be happy to sell you another fitness
| device and Yet Another Protein Powder or a pill made out
| of some plant extract that has minimal to no scientific
| evidence of efficacy.
| arijo wrote:
| Every drug has long term side effects but people are
| being sold GLP1 as a miracle weight lost pill when the
| focus should be on reducing all the toxic junk food that
| is causing the weight gain in the first place.
|
| And yes, many research programs are funded by pharma -
| the conlict of interests is blatant and getting more
| people sicker every year.
|
| Honestly, I'm pretty sure you're very aware of all this
| so I question your motivations to be openly promoting a
| drug that interferes directly with cellular metabolism
| like if you're selling candy.
| cthalupa wrote:
| You're still not providing any sort of claim as to what
| actual negative side effects you are concerned about, so
| I don't really know how to have a serious conversation
| with you.
|
| "Interfering with cellular metabolism" is a meaningless
| phrase. Please provide some sort of method of action that
| you are actually concerned about. What is it that it is
| doing to cells that we should be concerned about? What
| scientific evidence is there that this action is
| unhealthy?
| arijo wrote:
| I'm unfortunately expecting this getting worse with
| massive adoption of the drug but we can start with "Risk
| of Suicidal Thoughts and thoughts of self-harm with
| medicines known as GLP-1 receptor agonists,1 including
| Ozempic (semaglutide), Saxenda (liraglutide) and Wegovy
| (semaglutide)" - https://www.ema.europa.eu/en/news/ema-
| statement-ongoing-revi...
|
| By the way - why are you so eager to promote this drug -
| can you please declare any conflict of interests?
| cthalupa wrote:
| > By the way - why are you so eager to promote this drug
| - can you please declare any conflict of interests?
|
| The closest thing to a conflict of interest I have is
| that I am currently seeing great results while taking
| tirzepatide. I find it significantly easier to choose
| healthier meals made of whole foods with balanced macros,
| to eat less in general, and to motivate myself to push
| back towards the exercise habits I had in my 20s. I have
| no relation to big pharma, and I have no idea if my index
| fund tracking retirement plans include Novo Nordisk or
| Eli Lilly, but if they do, that's the closest thing I
| have to a financial incentive in these companies doing
| well.
|
| > we can start with "Risk of Suicidal Thoughts and
| thoughts of self-harm with medicines known as GLP-1
| receptor agonists,1 including Ozempic (semaglutide),
| Saxenda (liraglutide) and Wegovy (semaglutide)"
|
| Please read the content you are linking. It said that
| there were some reports so they were beginning to perform
| a review. The article specifically mentions the review
| was set to conclude in Nov 2023. Upon seeing this, I
| figured it would be a good idea to see if the results of
| the review had come out.
|
| It took me one google query to find the results:
| https://www.ema.europa.eu/en/news/meeting-highlights-
| pharmac...
|
| > The PRAC has concluded that the available evidence does
| not support a causal association between the Glucagon-
| Like Peptide-1 receptor agonists (GLP-1) - dulaglutide,
| exenatide, liraglutide, lixisenatide and semaglutide -
| and suicidal and self-injurious thoughts and actions.
|
| So we can scratch that one off the list.
| arijo wrote:
| Report results you mentioned -> https://catalogues.ema.eu
| ropa.eu/system/files/2024-03/FINAL_...
|
| "This study was not a random control trial. It was a
| comparative cohort study, which is an observational study
| design.
|
| In a randomized control trial, participants are randomly
| assigned to different groups, with one group receiving
| the treatment being studied and the other group receiving
| a placebo or a different treatment. This allows
| researchers to determine whether the treatment is
| effective by comparing the outcomes of the two groups.
|
| In a cohort study, researchers observe a group of people
| over time to see if there is a relationship between
| certain exposures and outcomes. Participants are not
| randomly assigned to groups. The study in the source is
| specifically a comparative cohort study with an active
| comparator, new user design.
|
| This means that researchers are comparing the outcomes of
| two groups of patients: those who are new users of GLP-1
| receptor agonists and those who are new users of SGLT-2
| inhibitors.
|
| The active comparator is the SGLT-2 inhibitor group. This
| group is used as a comparison to the GLP-1 receptor
| agonist group to help researchers determine whether there
| is an association between the use of GLP-1 receptor
| agonists and an increased risk of suicide-related and
| self-harm-related events. It is important to note that
| cohort studies, like the one described in the source, can
| only show an association between exposures and outcomes.
| They cannot prove that one thing causes another."
|
| "Therefore, while the study aims to contribute valuable
| insights into this potential safety concern, its design
| and inherent limitations preclude it from making
| definitive causal statements. Even if the study finds no
| association, further research, potentially using
| different methodologies, would be needed to strengthen
| the evidence and confidently assert that GLP-1 receptor
| agonists do not causally increase the risk of suicide-
| related and self-harm-related events"
|
| Taking this into account I'm still going to stick with my
| ketogenic diet, thank you very much.
| arijo wrote:
| Ozempic, Wegovy, and Mental Health: Are GLP-1 Drugs
| Linked to Suicidal Thoughts?
|
| https://www.youtube.com/watch?v=izqKRo3e31E
|
| "Yes. I'm a T2 diabetic and have been on an SSRI for
| years. A couple years ago I was trying to up my dose of
| Ozempic, as prescribed. Perhaps it was coincidence, but
| over time I sank into a deep depression and I simply felt
| like the only reason not to k*l myself was I could never
| do that to my family. I also developed panic attacks.
| More fun than a barrel of monkeys! Since then, I've
| drastically reduced my carbohydrate intake, stopped the
| Ozempic, and basically made an almost complete recovery.
| I haven't had a panic attack in two months, and it was
| mild."
|
| "Dear Dr Scher. I can confirm a very serious major
| depressive reaction to Saxenda/Liriglutide. This happened
| 2 days into 1.8mg dose which was exactly when my appetite
| diminished. Very, very disappointing . This was in spite
| of taking long-standing Venlafaxine/Effexor, which for
| this reaction was useless. After stopping Saxenda, my
| mental state took about 10 days to restabilize. I trust
| this may be of help to other"
|
| "
| navjack27 wrote:
| Wow... instead of ever more metabolic and
| mentally ill society living more like zombies than free
| human beings.
|
| Literally just wow. What possesses you to say such a
| horrible thing?
| arijo wrote:
| Possess is a strong word - nevertheless you can start
| here if you want to be aware of what is going on in the
| real world:
|
| Youtube Videos
|
| https://youtu.be/PeqQd4_xveI?t=43
|
| https://youtu.be/G0lTyhvOeJs?t=421
|
| https://www.youtube.com/@metabolicmind
|
| Books
|
| https://a.co/d/cUAgokV
|
| https://a.co/d/32zSKzo
|
| https://a.co/d/acVla0y
| theshackleford wrote:
| Mental health treatment is not as widely available as it
| should be.
| arijo wrote:
| I know this going to be blasfemy but the real problem
| here is carb addiction and we should be treating the root
| cause not the symptoms with a drug with unpredictable
| long term consequences.
| beezlebroxxxxxx wrote:
| Is the official recommendation that you continue to take it for
| the rest of your life? Or, is there a schedule to "wean" people
| off of it?
| r00fus wrote:
| Most weight management programs recommend you wean off - and
| also recommend other drugs if needed (metformin) to for
| maintenance.
|
| The method of these programs is to use the GLP-1 medications
| to allow you to change your habits significantly while also
| reducing your weight. The goal being, you keep the new habits
| and your reduced metabolic requirements which allows you to
| keep the lower weight.
| beezlebroxxxxxx wrote:
| Interesting. If we think of effectiveness as maintained
| weight loss _and_ eventually no longer requiring the drug
| then the next few years and decades will be fascinating to
| see how effective they are long-term.
| r00fus wrote:
| I mean, that's the goal for any weight management plan
| honestly - to provide the structure for you to make your
| own change. That GLP-1 meds are so effective will make a
| huge difference for tons of folks.
|
| I think many people are going to use GLP-1s without a
| structure - and they may find it's not as easy to taper
| off without making a meaningful diet change.
| coffeebeqn wrote:
| Even if you start gaining weight after a year or two I
| guess you could cycle back on it right ?
| tjohns wrote:
| Studies have show most people rapidly regain the weight once
| they stop taking GLP-1 drugs.
|
| The dysfunctional biochemical processes that contributed to
| overeating are still present if you discontinue the drug.
| Your body has a natural set-point for the weight it wants to
| be at, and the hunger and food noise comes right back as your
| body tries to get you back to your old weight.
|
| It's possible that after after a long enough time at a
| healthy weight your body's natural weight set-point will
| regulate itself back down. But this process take years.
| pinko wrote:
| Is the idea of a set-point settled medical/scientific fact,
| or still a disputed theory?
| tjohns wrote:
| It's still a theory. We definitely don't know the
| underlying mechanism(s) of action, and it's likely
| there's more hidden complexity there.
|
| But rapid weight gain after weight loss (until you arrive
| somewhere near your old weight) is at least a well
| observed experimental effect. About 80% of people who
| lose weight, through any means, will revert back to their
| old weight.
|
| Source:
|
| https://www.ncbi.nlm.nih.gov/books/NBK592402/
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/
| karmajunkie wrote:
| i lost about 30 lbs a couple of years ago, white
| knuckling my way through starving myself on a medically
| supervised diet. within two months of going off the diet,
| i was back at the exact weight i started at, to the
| pound, and haven't varied >2lbs since, no matter what i
| eat. consider me convinced on the setpoint theory.
| JamesBarney wrote:
| Set-point theory is pretty much settled medical fact. The
| mechanism involves leptin, and you can easily see
| processes that defend bodyweight change in both
| directions. Though it will more aggressively defend
| weight loss than weight gain.
|
| In addition prey animals will defend against weight gain
| more aggressively than non-prey animals. Which makes
| sense from an evolutionary standpoint. If a lion gets fat
| he doesn't have nearly as much to worry about than if a
| gazelle gets fat.
| WalterBright wrote:
| A lion may also have to endure long periods of no food.
| JamesBarney wrote:
| > It's possible that after after a long enough time at a
| healthy weight your body's natural weight set-point will
| regulate itself back down. But this process take years.
|
| I've spent a fair amount of time pursuing obesity research
| and I've never seen that. The closest I've seen is
| researchers or studies mentioning "Maybe the set-point
| resets are x years" but never seen any direct evidence of
| this.
| spondylosaurus wrote:
| "You'll regress if you stop taking the drugs" may be true,
| but it seems like a double standard to frame it as a knock
| against weight loss drugs when this _also_ describes
| countless other interventions for chronic issues...
|
| Your lupus will flare up again if you stop taking
| Plaquenil! Your eyesight will be bad again when you take
| off your glasses!
| tjohns wrote:
| I actually agree entirely.
|
| I'm just being objective in stating that the evidence
| suggests that these drugs need to be taken long term to
| have lasting effects. Not everyone realizes this.
|
| But I think that's okay if it can get people back down to
| a healthy weight. The health impact from being overweight
| is serious, and we know that lifestyle intervention has a
| stunningly abysmal success rate.
|
| Anything we can do to reverse the obesity epidemic is a
| good thing.
| spondylosaurus wrote:
| More than fair :) I may have jumped to conclusions there
| because I generally see that line of thinking from people
| who go "...and therefore there's no point in taking
| meds," but you're right that not everyone realizes these
| are long-term drugs.
| mlsu wrote:
| My view about obesity has shifted dramatically since Ozempic
| came out. Before this, I didn't think about it too much (I am
| not obese myself).
|
| I notice now that there is a LOT of judgement, bias(?), around
| obesity, that people, obese or not, carry with them [1]. I
| certainly carried that bias, and the reason I noticed it was
| because Ozempic is literally an external substance that you
| take that simply makes obesity go away. So if you believe (like
| most of us unconsciously do) that obesity is a personal failing
| or an issue of willpower, an issue of personal merit -- HOW is
| it possible that a chemical pill, an external chemical process,
| can SO effectively resolve it? When no amount of hectoring and
| moralizing and willpower can? My inability to square that
| circle really changed my thinking about obesity in a
| fundamental way.
|
| Already there is a reaction to Ozempic -- like people thinking
| that taking Ozempic is a personal failing, or judging
| celebrities, for taking it, thinking it's the "easy way out" --
| I think the origin of that is this very deep unconscious bias
| that we all have about what obesity actually _is_
| fundamentally.
|
| My view: It is a health condition, that people do not choose.
| Not unlike diabetes, celiac, or clinical depression. We should
| be focused on how to improve the lives of people who suffer
| with that health condition. We all agree insulin is
| unequivocally a good thing; that it's not a "personal failure"
| or "cheating" to take insulin; that it really is simple as,
| diabetes is a health condition and insulin is used to treat it.
| Ozempic? Same. Exact. Thing.
|
| It's really heartening to hear your experience. Your post
| really struck me, I felt exactly the same way after getting on
| a CGM + Insulin Pump for my Type 1 Diabetes. Nobody EVER
| thought I had a lack of "personal responsibility" or an "issue
| of willpower" for going low or high on shots of Humilin and
| NPH.
|
| Thank fucking god for Novo Nordisk.
|
| ---
|
| [1] see: this thread!
| mayukh wrote:
| Obesity is a side effect of the industrial food production
| system in advanced economies that is slowly spreading all
| over the globe.
|
| How about alcohol and smoking ? Is that the same as obesity
| then
| kps wrote:
| > Obesity is a side effect of the industrial food
| production system in advanced economies that is slowly
| spreading all over the globe.
|
| Yes, for the first time in the millions of years of
| existence of humanity and pre-humanity, we consistently
| have enough to eat.
| beagle3 wrote:
| Is not just "having enough". People in New York had
| enough to eat for more than 60 years now - more like a
| 100 years. And ywt, up until the 1980s, obesity was a
| minor problem.
|
| All standards have since changed. I watched the 1st
| season of the Simpsons again recently. In one of the
| episodes, Homer weighs himself and is distressed when
| discovering he weighs 200 lbs. 30 years later, dieters
| who cross down from 200 lbs to 199 lbs call it "reaching
| onederland" and it is considered a huge success.
| WalterBright wrote:
| The US solved the food problem around 1800, being the
| first country to end the specter of famine.
| JamesBarney wrote:
| Neurologically addiction works very differently than
| obesity and research says longterm sobriety is far easier
| to maintain than long term weight loss.
| beezlebroxxxxxx wrote:
| My understanding is that more research is pointing to obesity
| as, in some sense, a precursor/reaction to the onset of type
| 2 diabetes rather than type 1.
|
| Once you get to quite obese you're dealing with physiological
| factors that make losing weight medically difficult from
| behavioral changes alone. It also makes the chances of "yo-
| yoing" the weight higher as well. At that point the treatment
| for obesity overlaps with the treatment for type 2 diabetes.
| mlsu wrote:
| Yep, it definitely is! I mentioned type 1 because I have
| it.
|
| As a contrast -- the point was that nobody judges me for
| having type 1 the way they judge people for having obesity.
|
| As an aside, I notice that sort of "lifestyle/willpower"
| type framing in discussions about type 2 also.
| DAGdug wrote:
| There are varying degrees of control over outcomes. The
| judgment comes from the correlation between an unobserved
| variable (effort at controlling or preventing obesity)
| with the observed variable (actual obesity).
| StefanBatory wrote:
| I was obese myself, and I have different thoughts on that.
|
| For me, it was purely an issue of personal falling and
| willpower issue. I was obese because of a diet I was
| indulging in; full of unhealthy things and snacks.
|
| It was due to nobody else but myself.
| ripply wrote:
| You don't place any blame on the people that marketed and
| created that diet? Or the regulators who allowed that to
| happen? At a certain point people's well being and health
| should come before a mega corporation's profits. The whole
| world would be better off if unhealthy food was more
| strictly regulated. Children grow up not learning healthy
| eating habits that last into adult hood and some never
| learn them.
| StefanBatory wrote:
| No, I do not. It was my decision to keep doing so, it was
| a bad coping mechanism I developed. My actions are nobody
| else fault but mine.
| fireflash38 wrote:
| For some people it is clinical. For others it is
| mental/willpower. That said... It's exceptionally difficult
| in the modern world to do everything necessary to be at a
| healthy weight. Things are shoved at you constantly that are
| terrible for you. It's so, so much easier to eat poorly and
| to excess. Combine that with dopamine hits from consuming
| sugar/fat? No surprise people overeat.
| kps wrote:
| > Not unlike diabetes, celiac, or clinical depression.
|
| The latter is, like obesity, considered a personal failing
| (being one or more of the Seven Deadly Sins, depending on
| when you look), and medical treatment elicits similar
| reactions -- both against it being 'too easy', and in favour
| of wholesale societal restructuring instead ("That trick
| never works!" -- Rocky the Flying Squirrel).
| scottyah wrote:
| The fact that a drug can cause a shortcut is completely
| normal I think, alcohol can nearly instantly give you the
| confidence that months of training would take, hallucinogens
| can give states of mind that monks spend years meditating and
| breathwork to achieve, steroids give shortcuts to massive gym
| gains, etc.
|
| I see Ozempic as "taking the easy way out" the same way I see
| steroids as "taking the easy way out" (except it brings
| people closer to the norm of a average healthy person and
| will probably lengthen lifespans).
|
| If you're in it to show mental fortitude for internet/social
| points, then it is "cheating", but if you're just in it for
| results it's perfectly acceptable and even recommended.
| ElectricSpoon wrote:
| > people thinking that taking Ozempic is a personal failing
|
| Considering our society is pushes us toward sedentary highly-
| caloric lifestyles, I'd say we're set up to fail from the
| get-go. Therefore the failing is systemic not personal. I
| wouldn't compare to individual health issues. You can't cure
| celiac, but you sure could reduce the obesity using policies
| to drive the food industry toward less-sugar/more-fiber.
| j-a-a-p wrote:
| The willpower frame actually works pretty well for a lot of
| people. If not than in our society almost everybody would be
| obese. This pill will make things worse for the group that
| hangs out in the treadmills and drinks green and disgusting
| smoothies.
|
| On topic, very happy this medicine exists, but let's pray god
| will keep the prescription only for BMI > 35.
| autoexec wrote:
| > The willpower frame actually works pretty well for a lot
| of people. If not than in our society almost everybody
| would be obese.
|
| In the US nearly 75% of the population is overweight and
| almost half are clinically obese. Sounds like "willpower"
| isn't working for the vast majority of people.
| j-a-a-p wrote:
| That is not logical. If willpower fails, how could a pill
| be a solution? That is like suggesting to give everybody
| methadon, because the substance dependency issues are
| just too overwhelming. Or even better, give certain kids
| from 12 to 6 years old a gun to solve the school
| shootings issue.
|
| If we give up on willpower, we have no plan b.
| Ygg2 wrote:
| > If not than in our society almost everybody would be
| obese.
|
| Isn't that already the case. I'm of belief, the failing
| isn't individual but societal. You have obese toddlers and
| wild animals in the US.
|
| I don't think this is a failure of willpower, it's a
| failure to investigate the actual causes of the obesity
| epidemic. Maybe it's sugar, perhaps it's highly processed
| oils, etc. Whatever it is, people aren't investigating it
| thoroughly enough.
| j-a-a-p wrote:
| I live in lala land. Obese children are rare, however
| overweight is 11% and declining from 15% post covid.
|
| The school where my kids go to has zero obese and zero
| overweight kids (n = 300).
|
| We have Starbucks, McDonalds, Dunkin' Donuts and the same
| brands like Heinz and Coca Cola. Pizza.
|
| So, I am optimistic willpower can prevent us from a new
| Ozempic disorder. I suggest to go for willpower and not
| pills. If willpowers falls short, in my country when a
| child becomes obese, child welfare steps in. So let the
| government intervene (yep, you will lose your parental
| power) with a lifestyle program.
| rootusrootus wrote:
| > people thinking that taking Ozempic is a personal failing
|
| I expect that the people who hold this viewpoint are afraid
| that their lack of being overweight will not be seen as badge
| of honor, a sign of superior morals and willpower.
|
| To them I say -- GLP-1 agonists are good for anxiety, too!
| slibhb wrote:
| > I notice now that there is a LOT of judgement, bias(?),
| around obesity, that people, obese or not, carry with them
| [1]. I certainly carried that bias, and the reason I noticed
| it was because Ozempic is literally an external substance
| that you take that simply makes obesity go away. So if you
| believe (like most of us unconsciously do) that obesity is a
| personal failing or an issue of willpower, an issue of
| personal merit -- HOW is it possible that a chemical pill, an
| external chemical process, can SO effectively resolve it?
| When no amount of hectoring and moralizing and willpower can?
| My inability to square that circle really changed my thinking
| about obesity in a fundamental way.
|
| I see no contradiction here. That ozempic works doesn't imply
| that willpower isn't real or that people can't lose weight
| via diet and exercise.
|
| > My view: It is a health condition, that people do not
| choose. Not unlike diabetes, celiac, or clinical depression.
| We should be focused on how to improve the lives of people
| who suffer with that health condition. We all agree insulin
| is unequivocally a good thing; that it's not a "personal
| failure" or "cheating" to take insulin; that it really is
| simple as, diabetes is a health condition and insulin is used
| to treat it. Ozempic? Same. Exact. Thing.
|
| I'm very suspicious of "it's a health condition" applied to
| obesity, type 2 diabetes, and even depression. I absolutely
| believe that _some people_ will be able to avoid or cure
| those "conditions" by changing their behavior. Of course
| that doesn't imply that there should be a taboo against
| medication to help people who can't. But my concern is that
| "it's a health condition" discourages people from examining
| their choices and making good ones.
| lottin wrote:
| It's not just willpower but also lifestyle. It's rare for
| people who are physically active, and have a balanced diet,
| to suffer from obesity. I can eat A LOT without putting on a
| ton of weight, and it's because the types of foods I eat and
| because I do strength training, which means have a fair
| amount of muscle mass which acts as metabolic furnace. I'm a
| little overweight, at the moment, but it'd take a lot of
| effort on my part to become obese. I think treating obesity
| as a health condition is the wrong approach.
| rixed wrote:
| What's the right approach?
|
| Had the right approach better results?
|
| If not, why is it the right approach?
| makeitdouble wrote:
| > It's rare for people who are physically active, and have
| a balanced diet, to suffer from obesity.
|
| Looking at it from the other angle: can obese people be
| active and have a balanced diet ?
|
| The answer is yes. In particular you can be obese and
| maintain your BMI at the same level while being fairly
| active and not overeating, that happens a lot with people
| gaining weight and reacting to it, but without going down.
|
| From the pool of people physically active and with a
| balanced diet, what's the split of obesity is a question I
| don't have the answer to, but the lifestyle part doesn't
| look like a good differenciator to me if we're solely
| focusing on current obesity.
|
| PS:if you eat a LOT more without gaining much weight,
| imagine eating a LOT less and see very little change.
| barrkel wrote:
| It's the other way.
|
| When you eat more than your energy consumption rate, you're
| less hungry. When you eat less, you're more hungry. You
| think the activity would stop you getting obese, but it's
| actually that you aren't hungry enough to overeat, despite
| high activity.
|
| I'm not overweight, never mind obese. I pay no attention to
| diet or exercise. If I'm really hungry one day, I can end
| up overeating something I quickly deep fried from the
| freezer. And then I barely eat the next day. Not
| consciously. I'm just not hungry for a long time after I
| overeat.
|
| Energy homeostasis is the big thing you're not accounting
| for. Excercise doesn't really do anything much for your
| weight, just your fitness.
| anon84873628 wrote:
| It's weird for you to say that "people who have the habits
| for not being obese aren't obese." What's the real point?
|
| Note that "have a balanced diet" is doing a lot of work
| here. Our modern environment is saturated with super
| calorically dense, hyper palatable food. THAT is the cause
| of the obesity epidemic -- it's not endocrine disruptors or
| seed oils or office jobs or anything else.
|
| And the ability to refrain from eating cheap processed
| food, which has been specifically engineered to hack your
| brain, requires education, discipline, and willpower. As
| does hitting the gym.
|
| It's not surprising that most people don't innately have
| this ability, and have ended up sick from it. That sickness
| is a medical issue regardless of how we got there.
| SirMaster wrote:
| >My view: It is a health condition, that people do not
| choose.
|
| If this is true, then why are we so focused on curing it
| after the fact?
|
| Are we also working on prevention?
|
| If it's not a choice, then what is the cause? And why
| shouldn't we work on preventing that cause?
|
| I mean it's clean that more people are obese today than in
| the past right? So what changed to cause that that isn't
| about people's choice? Why not work on reversing whatever
| those changes were that caused obesity to increase?
|
| And a separate question:
|
| If it's really not a choice, what would be the approximate
| rate of obesity among a group or population that all
| exercised regularly and ate healthy?
|
| I don't think I can be convinced that not exercising
| regularly and not eating healthy is not a choice.
|
| I just feel like the number of people that would be obese who
| are regularly exercising and eating healthy would be rather
| small. And if we agree that exercising regularly and eating
| healthy is a choice, then it seems at least for many who are
| obese, it indeed is choice.
|
| I'm not going to say there aren't outliers or other special
| circumstances, but I still feel like for more people than
| not, it is indeed a choice.
| buu700 wrote:
| Personally, I've never seen obesity as a failure of character
| or willpower, at least as long as I can remember having any
| particular views on it at all. I see it as a failure of
| information and choices.
|
| Obesity was rare until the United States officially decided
| in 1977 that saturated fats were considered harmful. A few
| years later, it started rising to the current epidemic level.
| We've come a long way since the American Heart Association
| was recommending candy and soda as "healthy" alternatives to
| real food, but the idea that an optimal diet contains low
| saturated fat and high complex carbohydrates remains firmly
| entrenched in present-day nutritional and medical orthodoxy.
|
| Imagine a counterfactual where Congress had reached the
| opposite conclusion, instead recommending a standard diet
| full of saturated fats, high in salts (both sodium and
| potassium), moderate in monounsaturated fats, low in
| polyunsaturated fats, and sparing in carbohydrates. The
| population and food industry would have moved in an entirely
| different direction. We'd have a whole different universe of
| nutritional advice, diet trends, restaurant menu options, and
| easily available processed foods. A lot would be the same,
| but large sections of the grocery store would look like
| lowcarbfoods.com, maybe burger joints would serve mozzarella
| sticks instead of fries, maybe instead of potato chips and
| corn chips people would eat pork rinds and kale chips, and
| maybe instead of rice or potatoes an average dinner would
| include all manner of delicious fried vegetables. Instead of
| a low(er)-fat (i.e. high(er)-carb) diet, doctors would tell
| fat people to try keto. Maybe that timeline's equivalent to
| trans fat would be sugar alcohols and artificial sweeteners,
| and governments would ultimately pressure the industry to
| transition to stevia, monk fruit, and inulin fiber.
|
| In such an alternate universe, I'm sure the food industry
| would still work overtime to find ways to make many of its
| products shitty and addictive, and I'm sure the average
| person would still lean heavily on processed foods and fast
| food over home cooking and whole foods. I'm sure that would
| cause its own set of health issues, but what I highly doubt
| it would cause is an obesity epidemic. It's simply a lot
| harder to overeat fats than it is carbs. We'd also inherently
| have less insulin resistance, which means less type 2
| diabetes, less dementia, and probably a good amount less of
| mental/neurological issues like depression and anxiety.
|
| Unfortunately, we live in this universe. And in this
| universe, I find it really hard to blame individuals for
| struggling with obesity when we've practically purpose-built
| an environment to make us fat and keep us that way. In order
| to not be fat (by pre-1980 standards), you either have to win
| the genetic lottery, be extraordinarily physically active,
| put a high amount of effort into controlling your caloric
| intake, or be willing to go against the grain (no pun
| intended) on what you've most likely been led to believe for
| your entire life by everyone and everything around you. It's
| great to fall into one of those four buckets, but on a
| population scale it should be obvious that the majority
| wouldn't.
| fortran77 wrote:
| Do you view a chronic smoker as a failure of character or
| willpower?
| buu700 wrote:
| I wouldn't say inherently. Trying and failing to quit is
| plainly a failure of willpower on some level, albeit an
| understandable one given varying levels of nicotine
| addiction. Perhaps it could also be a failure of
| information (helpful techniques, etc.), although I'm not
| familiar enough to comment in detail on what quitting
| smoking is like.
|
| On the other hand, is picking up the habit in the first
| place, or choosing not to attempt to quit, a failure of
| character? I'm not sure that's for anyone other than the
| individual to decide. I personally feel it's unwise given
| that in 2024 smoking tobacco is pretty much universally
| known and accepted to be wildly unhealthy, but if someone
| weighs the tradeoffs and decides that maybe it has social
| and/or professional and/or mental benefits for them that
| outweigh the downsides, I wouldn't call that a character
| flaw so much as a decision that I'd highly disagree with.
| I'd say the same whether we were discussing tobacco or
| meth.
|
| ---
|
| Edit: More to the point I now see you were probably
| getting at, there's a pretty big difference in the
| knowledge and time/resource investment required to stop
| buying cigarettes (which costs nothing) and to adopt a
| low-carb or ketogenic diet that a particular individual
| would be happy with long-term. I've been keto for over 12
| years, and I have a routine that I enjoy, know my way
| around a kitchen, know what foods I like, and know all
| the right ingredients and recipes to use to create any
| food I might want to eat in a keto-friendly form that's
| as good as or better than what I could otherwise buy at a
| store or restaurant. For example, I make some of the best
| ice cream I've had anywhere (sometimes in flavors that
| I've never seen commercially available), and the one time
| I cheated for a New York slice I was disappointed because
| it didn't hold up to the pizza I'd already been making at
| home.
|
| Maintaining my diet takes zero willpower, because I enjoy
| it even more than my diet from when I was fat, and I
| never had to starve myself or give up my sweet tooth. The
| problem is that for that to work it required not just the
| inclination to research and adopt keto in the first place
| (a major hurdle in itself), but turning it into a
| dedicated hobby with development of knowledge and skills
| that I wouldn't expect the average person to casually
| pick up. That may work for me, but isn't a scalable
| solution for the population at large. On the other hand,
| if I could magically reformulate every food product in
| the world based on what I know from experience works, no
| one would struggle to eat a high-fat diet because that
| would just be the default instead of high-carb.
| itsoktocry wrote:
| For me, personally, it's that we don't really know the long
| term effects of these drugs ie are you actually "healthier".
| But we do know that diet and exercise work.
| bozleh2 wrote:
| > But we do know that diet and exercise work.
|
| Sure - if you ignore the incredibly poor % of people who
| comply with a prescription of diet and exercise. If you
| include compliance then the drugs are way way way ahead.
| makeitdouble wrote:
| > we do know that diet and exercise work.
|
| Stricly speaking we don't.
|
| This is "common sense" and the official recommendation, but
| fundamentally we don't have solid long term reproductible
| experiments[0], and due to the nature of the problem
| (humans living their life in a complex society) we'll
| probably never have a good answer.
|
| I've read many many studies spanning a few months and
| calling it a day (did the subjects rebound ? who knows),
| other taking a very small and homogenic pathological group,
| making it follow a strict regimen and end the experiment
| right after the subjects are let free again. But nothing
| with an actually rigorous protocol that gives a clear
| undisputable result.
|
| In a way I feel a lot of researchers are bound to their
| common sense and think they either don't need to prove the
| obvious, or it brings them nothing to let the room for
| controversial results ? (nobody's paying for research that
| says current policy is dumb)
|
| [0] If you have any double blind study with more than a
| hundred subjects taken randomly from the general population
| (including "healthy" subjects), with a control group,
| spanning more than 3 years of observations I'd be dying to
| read it..
|
| If you think that's a high bar, obesity is touted to be the
| worst health crisis the US has to deal with with tremendous
| impacts, putting at least that much effort into research
| doesn't seem outlandish.
| CydeWeys wrote:
| Everyone who's obese has been prescribed exercise and a
| better diet. It's the quintessential doctor cliche, and
| yet it indeed hasn't worked for them. GLP1 agonists do.
| arandomusername wrote:
| > Stricly speaking we don't.
|
| Yes we do, because it works. Exercise burns more
| calories. Diet limits your calorie intake.
|
| If you rebound into not doing exercise and overeating,
| that's on you.
| makeitdouble wrote:
| > If you have any double blind study with more than a
| hundred subjects taken randomly from the general
| population (including "healthy" subjects), with a control
| group, spanning more than 3 years of observations I'd be
| dying to read it
| cthalupa wrote:
| We know for sure that obesity is one of the single biggest
| increases in all-cause mortality. We know it is directly
| linked to most of the top disease-related causes of death.
|
| > But we do know that diet and exercise work.
|
| Do you think the ~40% of American adults that are obese
| don't know that they should eat better and exercise more?
| That they don't understand that they're cutting decades off
| their life?
|
| Yes, it is 100% within the power of the overwhelming
| majority of them to fix things. And I think evolution has
| kept shame with us for a purpose and that it can be a
| useful emotion. But I also think it's plainly apparent that
| neither are causing a real reduction in obesity.
|
| So, should all the people in the world that are obese just
| continue to fail at losing weight despite knowing what they
| should, in theory, be doing to resolve it? Because, despite
| being obese being one of the riskiest things you can do in
| life for your health and lifespan, we don't know if there
| might maybe be long term effects from something we know
| will get them to lose weight?
|
| This room is on fire! I could run out that door over there
| - I know if I open it and go through I'll leave this room
| that is currently on fire - but, should I? What if whatever
| is on the other side of the door is just as bad as being on
| fire, or worse?!
| seer wrote:
| This is a very American way of thinking about it - not
| invented here vibes all over.
|
| Of course people don't choose to be obese, but the culture
| and environment inevitably pushes you to it. A proof of that
| is that there are places in the world, with similar genes,
| that don't have the same problem in the degree that US does.
|
| I don't think it is a personal failing, more a collective one
| - the society itself has chosen a set of environmental
| factors as desirable (car centric, hectic, individualistic,
| processed cheap food etc) and it just results in more obese
| people.
|
| Loose the cars (change to walk / cycle / public transport),
| spend on food as much as the rest of the world do (adjusted
| to PPP) and suddenly you don't need ozempic.
|
| It is still weird to me how US choose unironically to develop
| a drug for reducing addiction, and not putting societal
| pressure to fix the environmental issues. It's a democracy,
| people do choose all of that and can't really blame it on the
| government.
| cthalupa wrote:
| Obesity is rising rapidly over much of the developed world,
| both in Europe and Asia, on a trajectory fairly similar to
| the historical trajectory of it in the US. Obesity in adult
| men in North Korea more than doubled between 2009 and 2019.
| The UK is already up to 26% obesity. 36% of adults in
| Mexico are obese.
|
| America is an unfortunate pioneer in obesity, but it is not
| even remotely unique to America.
|
| > It is still weird to me how US choose unironically to
| develop a drug for reducing addiction
|
| Novo Nordisk, the company behind Ozempic, is Danish. (Eli
| Lilly is American, though, for the tirzepatide drugs.)
|
| I don't disagree with your fundamental premise - a huge
| amount of the initial conditions for obesity are
| environmental. But they're incredibly far ranging,
| incredibly intertwined with modern life in much of the
| developed world. Unwinding those, even with strong support
| from the people, would take decades.
|
| We should still do it. But in the mean time, there's a hell
| of a lot of people that would die earlier than they would
| if they weren't obese. And a hell of a lot of them can
| significantly increase their lifespan with the help of
| these drugs.
| eli_gottlieb wrote:
| > Obesity in adult men in North Korea more than doubled
| between 2009 and 2019.
|
| Ok, _someone_ needs to explain how thoroughly non-
| Western, _undeveloped_ countries, more known for
| starvation and malnutrition than overabundance of food,
| are developing an obesity problem!
| GeorgeTirebiter wrote:
| Must be in the air? Seriously, maybe abundant low-quality
| sources? AI sez:
|
| The diet in North Korea is characterized by a heavy focus
| on grains, but has changed over time to include more
| animal protein:
|
| Grains, Rice, wheat, and maize are the main sources of
| calories in the North Korean diet. In 1961, over 70% of
| calories came from grains, and that number dropped to 61%
| five decades later.
|
| Animal protein Before 2000, North Korea's diet was mostly
| vegetarian, with meat eaten only a few times a year.
| However, since 2005, the availability of animal protein
| has increased, with an emphasis on poultry, pigs,
| rabbits, sheep, goats, and cattle.
|
| Other foods Popular foods in North Korea include kimchi,
| red pepper paste, soybean paste, soup, and rice dishes. A
| traditional meal might include side dishes, a main course
| like noodles, porridge, or grilled meat, and rice dishes.
|
| Regional differences People in rural areas and mountain
| valleys eat more vegetables and herbs, while people in
| coastal areas have access to seafood.
|
| Healthy options The upper class in North Korea favor
| healthy, balanced diets, including chicken wraps and tofu
| rice.
| cthalupa wrote:
| Sorry - this was entirely due to me also talking politics
| with some friends earlier in the day. Switched up SK and
| NK when I typed this.
|
| Obesity in adult men in _South_ Korea more than doubled
| between 09 and 19.
| cthalupa wrote:
| Note: I meant to type South Korea here, not North.
| ekianjo wrote:
| The real question is why so many people are obese in 2024 in
| the US while it was a fraction of the population 50 years
| ago? And other countries have by far not been affected by the
| same trend. So effectively something is making people really
| sick on the US.
| cthalupa wrote:
| It's simply not true that this trend isn't impacting other
| countries. Mexico is only 6% behind the US. The UK is 16%.
| Obesity is rising rapidly in South Korea - more than
| doubled in adult males between 2009 and 2019.
|
| America pioneered the obesity epidemic, but a huge chunk of
| the rest of the developed world is doing their best to
| catch up.
| cactusplant7374 wrote:
| > I realized that frequent cannabis consumption interferes with
| the weight loss
|
| Because you eat more or is there some other factor?
| apwell23 wrote:
| Have you noticed any effect on gastric emptying. As someone
| with 'tummy issues' ( ibs/gerd ect) i am apprehensive of
| messing with my digestive systems.
| rootusrootus wrote:
| Not the person you were responding to, but yes. Stomach
| empties much slower, which seems to effectively make it
| smaller. A normal size (pre-drug) meal will make me
| uncomfortably full and probably cause reflux.
|
| That said, I've noticed in the past, and also now on this
| drug, that my gastrointestinal issues abate noticeably when I
| consume less food. Thought I had IBS and then I went on a
| significant diet and lost 40 pounds in 2020. The IBS
| resolved, and not after I lost 40 pounds -- it basically
| stopped altogether a matter of weeks after I changed my diet.
| That was educational. YMMV.
|
| I'm still working out my approach to eating while taking
| tirzepatide. Old habits die hard, and I'm having to cut my
| meal size way back. This sucks because my problem with eating
| too much was about eating too often, or not when hungry, not
| about binging. So I have to eat pretty small meals now. It
| will take some adjustment to find the right way to get
| sufficient nutrition while volume limited, but I think it can
| be done.
| spondylosaurus wrote:
| If your IBS is the "stuff moves too fast" variety (so, IBS-D)
| GLP-1s seem to help a lot since they slow things down. If
| your problems already stem from things moving too slow...
| maybe not so much :P
| glenstein wrote:
| I think this is such a helpful description of the totality of
| components working together to spur a positive outcome, which I
| think, at least in my personal experience, is an under-
| appreciated aspect of using a drug.
|
| I've sometimes heard it said that it's an unhealthy reliance on
| a drug in place of curbing behavior, but I think it's important
| to understand it as, among other things, a stimulant to the
| activation of beneficial behaviors, which can be as critical as
| the drug itself.
| colordrops wrote:
| Did you notice that cannabis consumption interferes with weight
| loss due to interfering with motivation to stick to your health
| goals? Or did it interfere with your metabolism in some way?
| asadhaider wrote:
| I can answer this, I've been on Ozempic in the past and
| prescribed Mounjaro (Tirzepatide) currently (month 3).
|
| I've had a medical cannabis prescription for many years and
| vaporise up to 3g a day which is quite a bit. It definitely
| interferes with my cravings for food, as you know the common
| 'munchies' effect, making me eat when I'm not really hungry
| or binge snacks.
|
| I gave up on Semaglutide (Ozempic) after a few months, but
| Tirzepatide is working a lot more effectively and has been
| better.
|
| Cannabis also helps a lot with the nausea side effect for me
| which can be particularly bad the first few days going up a
| dosage every month. It takes six months to titrate from the
| starter dose to full strength, if necessary.
|
| Also the downside a lot of people don't talk about is that
| most people need to be on these drugs for life. They also
| aren't cheap.
| arijo wrote:
| Cut on carbs and you will have all the benefits without the
| nasty side effects.
|
| Check https://metabolicmind.org for details.
|
| My own experience with the keto diet -
| https://www.feelingbuggy.com/p/finding-hope-after-decades-of...
| kerbs wrote:
| It is not easy on the mind and body as to just cut carbs.
| arijo wrote:
| I apologize for the shortcut - I should have given more
| context, though you can validate my assertion by going to
| this site: https://metabolicmind.org
|
| There is heavy research on the usage of the ketogenic diet
| for the treatment of metabolic and mental illness.
|
| I've written about my personal story here -
| https://www.feelingbuggy.com/p/finding-hope-after-decades-
| of...
| arijo wrote:
| I also recommend taking a look at this Joe Rogan
| interview to understand at a deep level all the problems
| with a drug like Ozempic -
| https://www.youtube.com/watch?v=G0lTyhvOeJs
| BadHumans wrote:
| Quoting Joe Rogan's podcast instead of literature is not
| going to go over well here.
| arijo wrote:
| Check the https://metabolicmind.org site then - you'll
| find plenty of research based evidence on the usage of
| the ketogenic diet as a metabolic therapy.
| r3d0c wrote:
| do ur research bro
| arijo wrote:
| Not only have I done my research
|
| Youtube Videos
|
| https://youtu.be/PeqQd4_xveI?t=43
|
| https://youtu.be/G0lTyhvOeJs?t=421
|
| https://www.youtube.com/@metabolicmind
|
| Books
|
| https://a.co/d/cUAgokV
|
| https://a.co/d/32zSKzo
|
| https://a.co/d/acVla0y
|
| As I have been following the ketogenic diet and wrote
| about it
|
| https://www.feelingbuggy.com/p/finding-hope-after-
| decades-of...
|
| https://www.feelingbuggy.com/p/my-journey-from-mental-
| health...
|
| https://www.feelingbuggy.com/p/how-the-ketogenic-diet-
| helped...
| cgh wrote:
| I read your experience and it is indeed pretty incredible and
| I'm happy for you. I've used ketosis strategically for
| athletic reasons, to cut weight. So we both had strong
| motivations to use it. But for your typical obese person, it
| is a tremendous challenge to stick with it and at the end of
| the day, it's adherence that matters.
|
| Put simply, it's easier to adhere to a drug than to a
| specific, somewhat anti-social diet.
| arijo wrote:
| It really helps if you use some LLM tool like ChatGPT or
| Claude to generate the keto recipes (sometimes with the
| ingredients you have available).
|
| If you stick to cooking keto recipes for a few weeks you
| end up internalizing the recipe patterns and you start
| cooking without even thinking about it.
| fortran77 wrote:
| This is true, but fat people have a hell of a time cutting
| out all carbs. For many of them, they'll eat the "low carb"
| option, and then have an occasional binge and it negates any
| benifits of low carb, and doesn't put them in ketosis, etc.
|
| I strictly maintain my weight. If I catch it going over over
| 155# (I'm a 5'10" 61 year3 old male) I'll do a strict cut.
| And I know that either strictly counting calores OR going to
| as close to zero carbs will have the same net effect.
|
| But a person who has obesity or is overweight will not be
| able to follow a diet. They are just incapable of doing so,
| or will lie to themselves or others about it and claim it's
| their "metabolism" or a medical condition, etc.
| arijo wrote:
| I'm 1.78m, 50 years old, my initial weight 2 month ago
| before I started the keto diet was 154kg and two months
| later I'm almost 130kg. Eating the same amount of calories
| as before.
| fortran77 wrote:
| Yes. But a real keto diet, where you are in ketosis, is
| impossible for most fat people to follow. They will
| inevitably cheat ("tee hee hee! It doesn't count if it's
| birthday cake! I'm so naughty") and be in ketosis.
| arijo wrote:
| I'm fat, I've been cooking my own keto meals for more
| than two months, I've consistently been in ketosis and
| yesterday was my 50th birthday :)
| claudenm wrote:
| This is an extremely unhealthy rate of weight loss. All
| guidance centers around .5-1kg/week as both safe and
| sustainable.
| arijo wrote:
| Not if you start from an extremely obese starting point
| like I did. I don't recommend this rate to people with
| normal weight.
| claudenm wrote:
| This is also wrong. It's extremely unhealthy, unsafe and
| unsustainable to lose 15% of your body weight in 2
| months.
| arijo wrote:
| Not wrong in my personal case - I've lost those 20+
| kilograms with no problem to report.
|
| Again, it was not a calorie restriction diet - it was a
| carb restriction diet.
| Etheryte wrote:
| This is about as useful as telling someone who's obese to
| just eat less. Factually yes, it might help them, but
| practically they're clearly unable to implement it, probably
| for a plethora of underlying reasons.
| arijo wrote:
| Implementing a ketogenic diet is not the same as a caloric
| restriction diet - it's an inversion of the macronutrient
| pyramid - heavy on fat, moderate on protein and low on
| carbs.
|
| Even if you consume the same calories as in a traditional
| diet you'll likely lose weight. Check the
| https://metabolicmind.org site for more insightful
| information.
| slothtrop wrote:
| It's not nearly in the same ballpark.
| Izkata wrote:
| For Millennials in the US, it might be very useful. We grew
| up with this food pyramid being pushed at us all the time:
| https://en.wikipedia.org/wiki/Food_pyramid_%28nutrition%29?
| u...
|
| That's a _lot_ of carbs. Only like 3 years ago did I learn
| they changed it around 20 years ago to be less carb-
| centric.
| riffraff wrote:
| It's super weird I saw this food pyramid in a school book
| in Hungary (where I live) a couple years ago, and I was
| wtf?
|
| I'm Italian we eat a ton of carbs, but the pyramid I was
| shown as a kid decades ago had vegetables at the bottom
|
| https://www.alimenti-
| salute.it/sites/default/files/sites/def...
| addicted wrote:
| No one in the US follows the food pyramid.
|
| Go see what people are eating in real life. There are a
| lot of studies.
|
| Americans eat way more meat, almost no fruits and
| vegetables, and a lot of carbs.
|
| The point is that the food pyramid has absolutely no
| impact and pointing to it and making correlations with it
| is like doing astrology to explain why you broke your
| hand while playing basketball the other day.
|
| Edit: you do a great job to illustrate how little anyone
| knows about these food guidelines.
|
| It took you 17 years to even learn they've changed.
| Izkata wrote:
| > Edit: you do a great job to illustrate how little
| anyone knows about these food guidelines.
|
| > It took you 17 years to even learn they've changed.
|
| I gave an age range for a very specific reason: That's
| the age group this food pyramid was pushed hard on kids.
| I didn't know it changed because I was finishing
| gradeschool as the change happened.
|
| You don't have to memorize and precisely follow it to
| have internalized generic things like "lots of carbs =
| good". They are supposed to be our bodies' main source of
| energy and there's really no way you can have too much
| (or so we were taught at the time).
| slothtrop wrote:
| You can just cut ultra-refined foods i.e. junk foods. No one
| is getting obese from lentils, broccoli and apples. Even so,
| avoiding weight gain is one thing and losing weight is
| another. While it helps to increase ratio of protein and
| fiber intake for satiety, that in itself does not guarantee a
| caloric deficit, which is what is necessary for weight loss.
| arijo wrote:
| If your primary macro consumption is fat, your body will
| enter a state of ketosis burning fat instead of glucose. As
| long as your calorie intake of fat is less than your basal
| metabolism corrected by some factor, you will lose weight
| and feel satiated - you do not need to follow a calories
| restriction. Believe me - I tried both ways and the
| ketogenic diet never left hungry - always satiated.
| slothtrop wrote:
| I'm aware of how keto works. In fad diets focused on
| composition, short run WL is typical followed by
| stagnation. What's one going to do when they stop losing
| weight, eat negative carbs?
|
| > you do not need to follow a calories restriction.
|
| Weight loss comes down to energy balance. People tend to
| consume fewer calories at the outset when going low-fat
| or low-carb (in large part because protein is afforded a
| higher fraction, and it is more satiating), but clearly
| that does not mean that you'll always have a caloric
| deficit. Eventually, you'll need to reduce intake to
| continue losing weight.
| arijo wrote:
| Yes I actually used ChatGPT to calculate what would be
| the required daily amount of calories to achieve my
| target weight in 6 months - the big difference is I
| always feel satiated and that the body being in ketosis
| ensures I'm not accumulating but burning fat.
| alluro2 wrote:
| I've got to say, pretty frustrating seeing answers like this.
| It just completely ignores all the real, valid difficulty
| that people have in fighting obesity. If you "just" follow
| this diet, that requires discipline, strong will, buying
| correct supplies, 2h of cooking a day, measuring, counting,
| adhering to strict eating timeline, for months (years for
| some people), you'll be golden! There is plenty of research
| into behaviour changes with obesity and mechanisms that
| prevent good decision making etc - apart from just the
| practicality of all of the above in one's daily life with
| work, kids...
|
| I see in other replies that you've had success in losing
| weight, and congratulations - but that doesn't mean it can
| work for everyone else.
|
| I don't look at any kind of "pill solution" lightly, and
| absolutely think lifestyle changes should be made as well -
| but I can definitely see how medication like this can help
| get people on track and get back control. It's very
| encouraging to hear about psychological effects in terms of
| self-control, decision making etc. I'm just worried that
| we'll discover serious negative side-effects before too long,
| as with previous attempts.
| addicted wrote:
| And there's no truth to it either.
|
| Cutting carbs only helps to the extent you've reduced
| calorie intake.
|
| People drop their calories too low, and then they take a
| cheat week after a year or so where they eat pasta, and
| suddenly they feel a lot better and they're back to eating
| more calories and back to gaining weight, leading to yo-yo
| dieting, which may even be worse than just having a higher
| than healthy but static weight.
| arijo wrote:
| That's not true - the ketogenic diet is not a calorie
| restriction diet. It was invented early last century by a
| medical doctor to simulate fasting and treat epilepsy in
| children. Low calorie diet lead to yo-yo dieting which is
| not the case for keto were you are allowed to eat enough
| calories to be satiated. The binge eating comes for the
| oscillating glucose and insulin levels driven by the
| consumption of refined carbs. Carb addiction is the
| problem and that's the root cause we should be addressing
| to stop the metabolic health epidemic that has only been
| getting worse despite all the pharma profits.
| phil21 wrote:
| I've done keto a couple times in the past, even back when
| it was called Atkins. It absolutely was a calorie deficit
| diet since it was difficult to eat that many calories
| consistently to go over my BMR for more than a few days
| at a time.
|
| Friends doing it also had the same experience as I did.
|
| Not saying it isn't as advertised, but everyone on it I
| knew (n=14 or so) was getting results from fewer calories
| after we all decided to start carefully logging food
| intake.
|
| It's a great diet that works, but via other mechanisms
| for many vs ketosis.
|
| It's still a restriction diet that poses a lot of
| challenges for most to remain consistent with on a long
| term basis.
| comechao wrote:
| I'm not sure if you tried but add a sport, can be table tenis,
| jiu-jitsu whatever. I did this too after got comfortable with
| the walks (that I still do).
| siva7 wrote:
| How do i get this?
| pedalpete wrote:
| Have you been recommended an exercise regimen, or taken one up
| yourself? The one the great things about GLP-1s is that with
| the weight loss, it's easier to be more active once you've lost
| some of the weight. The negatives is that the current breed
| promote a loss in muscle mass as well as fat loss, so it is
| very important to do your best to maintain if not increase
| muscle while on them.
|
| The next generation of drugs are including 2nd molecule...I'm
| blanking on the name, and a search isn't bringing it to
| me...which maintains or potentially increases muscle mass.
|
| But curious what your experience with exercise has been.
|
| I also didn't know there was a planned reduction in dosage, but
| the expectation is that you'll be on some type of GLP1 for
| life, is that not right?
| cthalupa wrote:
| Cagrilintide (paired with semaglutide) and retatrutide are
| the next wave, though I'm not aware of any research for
| either indicating an increase in muscle mass.
|
| My understanding of the literature is that there's nothing
| special about semaglutide or tirzepatide that promote muscle
| loss - it's just people who lose weight based purely on diet
| tend to also lose muscle mass. Even bodybuilders lose some
| muscle mass when cutting.
|
| It's up to the individual to increase their protein intake
| and exercise, the same way they would in any caloric deficit.
| coffeebeqn wrote:
| Bodybuilders lose muscle and they do a lot of hypertrophy
| training and high protein eating to counteract it. Probably
| the average ozempic taker does neither of those so they end
| up losing more
| cthalupa wrote:
| Sure. You're going to lose some muscle mass no matter
| what you do. And yeah, if you don't do either of those
| things, you're going to lose even more.
|
| But fat people actually frequently have quite a bit of
| lean body mass - it takes muscle to carry around all that
| weight, even if you're sedentary. If I somehow maintained
| the LBM shown in my DEXA scan at the start of
| tirzepatide, by the time I got to my goal weight, I'd be
| looking more jacked than when I was lifting 3 times a
| week.
|
| Obviously, I won't. I'm adding more and more cardio and
| lifting back in as my weight is dropping and it becomes
| more maintainable for my joints, etc., and I've been
| supplementing protein since the start, and I'm sure I'll
| still lose plenty. But I have the room to lose A LOT and
| still be in the healthy range of body fat%.
| phil21 wrote:
| None of the GLP1s cause more muscle loss than simply losing
| the same amount of weight without it. It's the rapid weight
| loss without resistance training that causes it.
|
| If you calorie restricted with the same exercise routine
| without the drug you'd see the same amount of lean muscle
| mass loss as you would taking the drug. This spreading of
| misinformation is actively harming people.
| nessguy wrote:
| I'm with you on this, tirzepatide has been life changing for
| me. I've struggled with my weight my whole life and I can
| actually imagine a future where I lose enough that I'm no
| longer ashamed of my weight.
|
| I've been on tirzepatide for just over a year now. Before that,
| I managed to lose 6% of my body weight over the previous year.
| With tirzepatide, I've lost an additional 17% of my body
| weight, for a total of 23% over two years.
|
| Tirzepatide isn't a magic drug that just makes you lose weight,
| it simply makes it much easier to avoid overeating.
|
| It makes the difference between being so hungry that I can't
| fall asleep and having the ability to just go to sleep.
| gscott wrote:
| > It makes the difference between being so hungry that I
| can't fall asleep and having the ability to just go to sleep.
|
| I had this problem as well. Being on tirzepatide I went from
| 220 to 185 in just six months because my previous insatiable
| hunger went away. It feels so powerful now choosing when to
| eat or not.
| riffraff wrote:
| > It makes the difference between being so hungry that I
| can't fall asleep and having the ability to just go to sleep.
|
| Forgive my ignorance and curiosity, was the feeling of hunger
| due to drastic reduction in portion size? Could you not eat
| some low-calories filling food?
|
| I ask cause I've been overweight and sometimes obese most of
| my adult life, but when on a diet I usually feel
| "unsatisfied" but rarely actually hungry, e.g. I can eat a
| couple carrots or whatever and hunger goes away, but I would
| still crave a hamburger.
|
| Still, I'm happy for you that you found something that works!
| nessguy wrote:
| > was the feeling of hunger due to drastic reduction in
| portion size?
|
| While that was sometimes the case, it wasn't always so.
| Sometimes the feeling of hunger was almost random, and
| certainly stronger than it should have been. This was
| likely caused by insulin resistance.
|
| When I got out of bed because I was too hungry to go to
| sleep I didn't always make great food choices. I'd tend to
| eat a 200-400 calorie 'snack', which felt like it wiped out
| any progress.
|
| Now that I'm on tirzepatide I still feel hunger and
| cravings, but I suspect it's more in line with what regular
| people feel. Even if I haven't eaten much during the
| evening and am a little hungry at night, it's not the type
| of hunger that stops me from being able to get to sleep.
|
| > Still, I'm happy for you that you found something that
| works!
|
| Thanks!
|
| I'm honestly in the category of people that have considered
| weight loss surgery, but I've seen enough problems from
| that that I've never really wanted to risk the associated
| problems.
|
| From all the reading I've done it sounds like tirzepatide
| is almost as effective as weight loss surgery. And people
| are going to have a hard time convincing me that weight
| loss surgery is 'safer' than a GLP-1 injection.
| myprotegeai wrote:
| In the future, this would be indistinguishable from an ad.
| mahin wrote:
| Or even now?
| myprotegeai wrote:
| I'm trying to give them the benefit of the doubt that it is
| a real experience, but yes it currently reads like
| marketing material aimed at the obese, depressed tech
| worker.
| blackqueeriroh wrote:
| I'd like to make a couple of things clear here:
|
| 1) "obesity" has no clear clinical definition, nor is it really
| a disease. [1] 2) there has been no evidence yet that weight is
| at all a primary determinant of health [2] 3) Weight loss drugs
| must be taken forever or it's nearly certain you will gain the
| weight back [3]
|
| There's a lot of great research these days that shows fatness
| is not what people think it is, and weight stigma is far more
| harmful than being fat itself [4].
|
| Also, nobody knows what happens yet if you take these drugs for
| 30 years, and what we do know is that being fat hasn't been
| proven to kill anyone.
|
| I'd just say follow the money.
|
| [1] https://www.science.org/content/article/obesity-doesn-t-
| alwa... [2] https://withinhealth.com/learn/articles/why-body-
| weight-isnt... [3]
| https://www.bbc.com/future/article/20240521-what-happens-whe...
| [4]
| https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291...
| legacynl wrote:
| > realized that frequent cannabis consumption interferes with
| the weight loss, so I've kicked the habit from daily to
| occasionally on weekends
|
| Did you try to reduce your cannabis consumption before using
| tirzepatide?
|
| Because although you say(feel) like the realization made you
| reduce your intake, I can hardly imagine that you were totally
| oblivious to the fact that smoking cannabis is unhealthy in the
| first place.
|
| Do you feel like you think less about e.g. cannabis, or do you
| feel like it's easier to say no to that impulse?
|
| Does it seem to mainly influence health choices or are you also
| less likely to be angry or does it interact work place
| interactions?
| lol768 wrote:
| > How long til we're all on Ozempic?
|
| It's genuinely quite depressing that so many people in the United
| States have a weight problem that the overwhelming majority of
| the population would benefit from this and headlines including
| "we are all" are not inaccurate.
|
| I don't think other countries are necessarily perfect here, but
| 74% of Americans don't have a healthy weight when you look at
| their BMI. That's a _staggering_ statistic. Something is
| seriously wrong societally, and the priority should absolutely be
| non-pharmaceutical interventions.
| beezlebroxxxxxx wrote:
| I agree. I think the conversation has unfortunately been
| dominated by an individualistic strain of moral judgement.
| Whether so and so, this person or that person, should take
| Ozempic-like drugs is often discussed in binary terms of near
| moral and personal failing or not. I think the drugs are
| helpful to people who really need them --- so long as the
| people really need them.
|
| The problem is that conversation overshadows the much more
| important big picture conversation: An entire nation is now
| becoming synonymous with poor health from obesity and we're not
| addressing many of the core nationwide reasons for that.
|
| America was once proud of and eager to prove how fit and able
| its people were. Now the very idea of proper nutrition and
| exercise is deemed a nonstarter, "impossible", or an imposition
| on personal liberties. The existence of Ozempic-like drugs
| should not absolve us from the imperative to change how we live
| as a nation for the sake of our health.
| downrightmike wrote:
| We're all depressed and overworked and have been for decades.
| Food is an escape
| marcosdumay wrote:
| Add forced sedentarism into that set.
|
| This is not exclusive to the US. The world is trending
| towards those, and different countries seem to only be at
| different distances from it, but the same velocity.
|
| Also, industrialized food seems to be much more effective in
| causing dependency. Food preparation has overwhelmingly
| shifted into less healthy alternatives (even when they sound
| healthier in a naive review)... And there's a multitude of
| low probability high impact possible contributors that nobody
| knows if are important or not.
| pixl97 wrote:
| >I don't think other countries are necessarily perfect here,
|
| America first... the rest of the world is playing catch up as
| quickly as possible.
|
| >In March of 2023, the World Obesity Federation (WOF) released
| a report(Link downloads document) stating that by 2035 over 4
| billion people - more than half the world's population - will
| be obese. >and the priority should absolutely be non-
| pharmaceutical interventions.
|
| Illegal. Or is should say Coca Cola can and will fight you to
| the death the moment you try. If you stand between the junk
| food companies and advertisers you will have an army of lawyers
| fighting you 'tobacco industry' style for the next 50 years.
|
| Until the shit is off our shelves and out of our ads nothing
| will change.
| jspash wrote:
| It really is a sad situation. As an American who spent the
| first 30 years of life in the US and over 20 in Europe, the
| difference is striking. However... here in the UK I see more
| and more "American-sized" people every year. _Something_ is
| changing. In the food and/or habits of the average Brit.
|
| Anecdotally I would say Europeans as whole are getting ever so
| slighty larger. But just not at the rate as Americans. Ozempic
| seems like a god-send.
| rootusrootus wrote:
| > But just not at the rate as Americans
|
| The rate is probably comparable, it's the offset that's
| different. Won't be long until Europe is where the US is
| today (though I need to mention, this is regional, for
| example Colorado is at about 25%, and some European countries
| are already there).
|
| Even Japan is getting steadily fatter, though they are way,
| way behind Europe and the US.
| TacticalCoder wrote:
| > It's genuinely quite depressing that so many people in the
| United States have a weight problem
|
| I agree.
|
| I'm 51 y/o and still totally fit. Always have been. I am
| completely in control of what my body intakes. I can fast for
| 12 hours from waking up until dinner: I do it regularly (as in
| at least five times a month, probably a bit more).
|
| I did do sport like crazy when I was young but don't even
| bother that much. Some walking, taking the stairs instead of
| the elevator, some bicycling, some tennis. But at a gentle
| pace. "More haste, less speed" (thousands of years old saying).
|
| It's crazy to poison oneself to the point where another poison
| (that Ozempic drug) is needed to counter the first poison.
|
| I'm not saying it cannot help but sadly there's no way to say
| it nicely: if you need that, your body controls your mind.
|
| It should be the contrary.
|
| > Something is seriously wrong societally ...
|
| The biggest issue to me is we live in societies (not just in
| the US) where we victimize everyone. Nothing is never nobody's
| fault. We find excuses for just about everything.
|
| We should go back thousands of years and read the classics:
| "healthy mind in a healthy body". Greek philosophers had
| already figured that in the Antiquity.
|
| Mind over body.
| soulbadguy wrote:
| As every conversation with weigth management/obesity treatment,
| there are still people thinking that just more willing power /
| better habits is what's needed.
|
| To those people I suggest you run an experiment : what ever your
| current body weigth is right now. Try loosing and keeping off
| 20%.
| wiseowise wrote:
| > To those people I suggest you run an experiment : what ever
| your current body weigth is right now. Try loosing and keeping
| off 20%.
|
| Easy peasy. I'd be borderline anorexie if I do that, but
| wouldn't be much of a problem to achieve that.
| switch007 wrote:
| Are you Dutch by any chance?
|
| Because they seem have a society deeply structured around
| health, exercise and good eating habits. And they tend to
| have a "just do X, it's so easy" kind of attitude, forgetting
| they are benefitting massively from their environment and
| society and not just will power alone
| highwayman47 wrote:
| Why can't there be a drug for chronically underweight
| throw4847285 wrote:
| For a second I thought it said Asterix Mag and started
| daydreaming about a story where Getafix invents a special magic
| potion which Obelix can use but it causes him to lose weight.
| Dargaud, I am available.
| unkoman wrote:
| Most of us should probably be on appetite suppressors due to the
| industrial revolution making food more than abundant while
| pumping it full of empty calories.
| anigbrowl wrote:
| Just eat regular food. Hardly anything in my diet would be
| mysterious to a time traveler from 100 years ago, or indeed 200
| years ago. Occasionally I enjoy chocolate or instant noodles
| but mostly it's just fruit, veg, meat, dairy, and grains. If
| you don't know what something is made out of or how, then don't
| eat it.
| rootusrootus wrote:
| Not a panacea. I stay fat no problem without junk food.
| Processed foods make me ill, so I make almost all my own
| meals from whole ingredients. Too many calories is too many
| calories no matter how you get it.
|
| I'm a pretty good cook, though.
| anigbrowl wrote:
| Obviously one should not eat too much, but I was responding
| specifically to the comment about the industrial revolution
| leading to engineered foods full of empty calories in the
| grandparent comment. I would personally like to see such
| food regulated mostly out of existence, but in the meantime
| I just encourage people not to eat it.
| bowsamic wrote:
| We have control though, it isn't 100% the environment. Imo
| that's just used as an excuse
| zombiwoof wrote:
| Let's all go on it, and steroids
| xyst wrote:
| Maybe when food shortages become a thing, we can add Ozempic to
| the water supply to curb people's appetites and reduce demand. \s
|
| Kidding aside, I still think it's extreme for off-label usage.
| Short term results are nice. But what about the long term? Once
| patients reach a desirable state, can they be titrated off the
| medication while maintaining their ideal labs and weight? What's
| the rate of recidivism?
| rootusrootus wrote:
| > off-label usage
|
| Off label? Semaglutide is approved for weight loss.
| OptionOfT wrote:
| As someone who struggled with their weight his whole life, this
| medication is a god send.
|
| My wife and I cook every evening. We never eat food made in a
| factory. We buy raw products and spend a good amount of time
| every day cooking them.
|
| Every morning I wake up and go on a 5 mile hike.
|
| And still weight kept on coming on. Worse yet, I am on ADHD
| medication, which are amphetamines and actually make you lose
| weight. Yet... the number on the scale kept on creeping up.
|
| And you know what it is? It's volume. I eat too much. And I have
| no cookies at home. I have no chips at home. No soda, no alcohol.
| I drink black coffee with a splash of milk. I don't eat any
| sweeteners.
|
| I have had weight loss surgery (lap band) which was later
| reversed as it hurt 24/7.
|
| Now, on ZepBound I lost 20lbs in 2 months. I am not hungry. My
| brain can actually focus on the things that matter.
|
| Why do we find it acceptable to help people who struggle with
| alcohol abuse, or nicotine addiction, or opioid addiction, but
| not to help people who struggle with food abuse?
| ak_111 wrote:
| "Why do we find it acceptable to help people who struggle with
| alcohol abuse, or nicotine addiction, or opioid addiction, but
| not to help people who struggle with food abuse?"
|
| I think it is because if 90% of the population did half of what
| you do (and kudos for you for doing it), they wouldn't have a
| problem with weight, you just happen to be one of the unlucky
| few where it doesn't work and these drugs are useful.
| karmajunkie wrote:
| there are numerous studies posted in this thread
| demonstrating exactly the opposite.
| ak_111 wrote:
| Which studies? I find it hard to imagine that it has been
| proven that for _most_ people having a low-carb unprocessed
| meal once a day, no alcohol, and 5-mile daily hikes as the
| original poster does would would not eliminate sever weight
| issues.
|
| There are clearly minority of people who can only achieve
| weight loss using drugs but for most people they can
| achieve the same effect by a lifestyle change, has this
| been proven incorrect?
|
| I think the best empirical result for this is to compare US
| with any other western country (say Japan or France) or
| even US states with each other, clearly lifestyle plays a
| huge role in obesity.
| grecy wrote:
| > _There are clearly minority of people who can only
| achieve weight loss using drugs but_
|
| Are you suggesting there are people who can burn more
| energy than they ingest for a prolonged period of time
| and not lose weight?
|
| That... would fundamentally rewrite everything we know
| about how mammals consume energy.
|
| Of course not. Nobody needs drugs to lose weight, they
| need to consume less energy than they use.
| ak_111 wrote:
| No for example they might have severe food addiction that
| it makes it hard for them to reduce food consumption
| otherwise.
| keybored wrote:
| Commenter: This drug helped me with weight loss.
|
| Commenter 2: Kodus to you. Let me just discount your anecdote
| as being unlucky and keep my current belief. But again,
| kudos.
|
| HN threads on weightloss are an utter waste of time.
| OJFord wrote:
| I don't think that's particularly charitable, GGP said
| themselves that their issue is volume, that they're doing
| well in many other ways. GP is saying if everyone could do
| what they've done, many fewer would have the problem, and
| so maybe it would have less stigma.
| keybored wrote:
| > I don't think that's particularly charitable,
|
| As a direct reply to the challenge that the original
| poster made:
|
| > > Why do we find it acceptable to help people who
| struggle with alcohol abuse, or nicotine addiction, or
| opioid addiction, but not to help people who struggle
| with food abuse?
|
| They said nah, you were unlucky. In other words just
| dismiss his point outright.
|
| Is that still uncharitable? Then so be it.
|
| > GGP said themselves that their issue is volume, that
| they're doing well in many other ways.
|
| Yes they said that they have a food addiction.
|
| - The alcoholic said that his problem is the volume of
| alcohol intake
|
| - The smoker said that...
|
| Then asked why we won't help food addicts. Just waffle on
| about self-discipline or hint at it.
|
| This question is still yet to be answered.
|
| > GP is saying if everyone could do what they've done,
| many fewer would have the problem, and so maybe it would
| have less stigma.
|
| Maybe if those people had more self-discipline. Then
| maybe there would be less of a stigma.
|
| You're using the rationalized stigma to explain the
| stigma. This is at best circular.
|
| Maybe we would respect ex-smokers more if they had the
| discpline to not ingest nicotine gum.
| ak_111 wrote:
| This is quite snarky. I was giving kudos because the
| commentator first exhausted all the lifestyle options that
| extremely often work in reducing obesity to ensure their
| issue is more than just lifestyle choice then finally
| taking the drug, rather than short circuiting the process.
| This is sensible policy in deciding to take any drug for
| the rest of your life for a chronic illness.
|
| In other words I was giving kudos that the commentator put
| in a lot of effort to _verify_ that it was an _illness_ in
| their case.
| borski wrote:
| It's your assumption that 90%+ of people don't do this
| that is the issue.
|
| People seem to think that once these drugs became
| popular, suddenly obese people around the world awoke
| from a deep slumber, like zombies, and decided to see a
| doctor for the first time in their lives about their
| weight.
|
| Please. These people are walking into doctor's office
| having _given up hope_ because most of them have, to one
| extent or another, _tried everything_.
|
| Our society does not make it pleasant to be obese, no
| matter how you feel about body positivity or anything
| else.
|
| The implication that obese people have never considered
| or tried eating less, working out more, etc., is in and
| of itself the problem. It implies laziness and imbues
| negative morality, when the reality is that _most_ people
| who are obese know it, hate it, and have tried most of
| their lives to overcome it, unsuccessfully.
|
| So now that there's a medication that can help kickstart
| their creation of new habits for the first time in their
| lives, I don't see how that is a bad thing.
| ak_111 wrote:
| Where did I make assumption that majority of obesity drug
| users don't put this effort? I was more saying majority
| of those who try what the poster tried end up not needing
| the drug. These two statements are very different and it
| is a common logical fallacy to conflate them.
| borski wrote:
| > I think it is because if 90% of the population did half
| of what you do (and kudos for you for doing it), they
| wouldn't have a problem with weight, you just happen to
| be one of the unlucky few where it doesn't work and these
| drugs are useful.
|
| From https://news.ycombinator.com/item?id=41813589
|
| It is _simply not true_ that if 90% of the population
| "tried to lose weight the right way" that they wouldn't
| have a problem with it. That is an assumption you are
| making, and the underlying postulate is that that same
| 90% _hasn't_ tried.
| keybored wrote:
| > This is quite snarky. I was giving kudos because the
| commentator first exhausted all the lifestyle options
| that extremely often work in reducing obesity to ensure
| their issue is more than just lifestyle choice then
| finally taking the drug, rather than short circuiting the
| process. This is sensible policy in deciding to take any
| drug for the rest of your life for a chronic illness.
|
| > In other words I was giving kudos that the commentator
| put in a lot of effort to verify that it was an illness
| in their case.
|
| The illness being addiction/food abuse?
|
| Again we circle back to the question that OP posed.
| Because I have never seen someone say that they are an
| alchololic or smoke/tobacco addict and then get told:
| okay maybe, but first you should put in the work and find
| out if you _really are_ that.
|
| (Step one: admit that you are an addict. Step two, uh,
| confirm that you really are?)
| colordrops wrote:
| Have you every using a calorie/macro tracking app like My
| Fitness Pal or Cronometer? I was never successful losing weight
| until I scanned, weighed, and measured every single thing I put
| into my body and stuck to the target calories and macros
| entered into the app. Just being aware of exactly how much I
| was eating was often enough to find the motivation to control
| volume.
| brianmcc wrote:
| >> I scanned, weighed, and measured every single thing I put
| into my body
|
| Not being snarky, but is this truly "better" than a single
| weekly injection - 10 seconds and done for the week? I do
| think our wider society sees medications for overeating as
| "cheating". Perhaps we might benefit from rethinking that.
| colordrops wrote:
| For preventable diseases in general, prevention and self
| control should be attempted before medication. There are
| health benefits besides being skinny, and all medications
| have side effects. There's nothing inherently wrong with
| medication, but addressing the root cause should be tried
| first, and then medication can be introduced if it doesn't
| work out. It's not an either-or, binary situation.
| paulryanrogers wrote:
| Self control has gotten harder as the foods on offer have
| gotten more sugary and dense compared to traditional
| foods. Produce is also less available and less nutritious
| than it once was.
| colordrops wrote:
| No doubt.
| brianmcc wrote:
| I don't disagree. As I've gotten older though I am just
| increasingly convinced that for the regular person going
| about their life, the fight against cheap and terrible
| and calorie-laden - but tasty! - processed foods is not
| an even one. Perhaps some form of counter-balance is just
| not such a bad thing?
| unlikelytomato wrote:
| There is a reason for that perception. We are regularly
| finding out how there are damaging ripple effects from
| drugs that were claimed to be completely safe.
|
| I would compare something like scale measurements to sex
| education. If kids were all exposed to some period of
| measurement of foods to learn what they were eating, it
| would stick. Studies show that ANY form of tracking causes
| people to make more mindful choices. Everyone I know
| personally that is taking these drugs uses it as a crutch
| entirely. They take it and make even worse food choices
| than before. It's very sad and I worry about the next issue
| they will cause with this behavior to then stack another
| medication on top.
| Izkata wrote:
| There is one way it may be useful, even if only done for a
| short time: You may not be eating what you think you're
| eating.
|
| I started doing it mostly out of curiosity, and it turned
| out one of the meals I thought it was high-calorie was
| actually lower than my other meals.
| zahlman wrote:
| >is this truly "better" than a single weekly injection - 10
| seconds and done for the week?
|
| Yes, obviously. I'm stunned that it needs to be said, but
| since it apparently does:
|
| 1. You propose taking a medication regularly which is
| probably completely unnecessary, and paying for it
| regularly. (This was worse with "metabolism boosters" etc.
| since the patient would be paying for the medication to
| have the privilege of eating more, and thus paying more for
| the extra food.)
|
| 2. Knowing what you eat, and being able to denominate it in
| calories, is _knowledge_. I thought we were hackers here?
| My experience has been that ordinary people have some truly
| absurd ideas about how fattening certain things are or aren
| 't, or about how much they're actually eating, or about
| what healthy daily intake ranges, portion sizes etc. look
| like. (They also have absurd ideas about how much it costs
| to "eat healthy", as well as about the connection between
| "healthy" food and caloric intake.)
| globular-toast wrote:
| I think there's a few factors at play:
|
| 1. People might want to help, but they don't think taking a
| pill every day for the rest of your life is a proper solution.
| I'm not aware of any such things for other addictions you
| mention,
|
| 2. People don't want other people to have it easier than they
| did. "I had to diet and exercise etc, you should too",
|
| 3. People don't want to help. They want other people to be fat
| because it makes them relatively more attractive.
| mort96 wrote:
| re: 1, there are plenty of people who take some medication at
| some interval for most of their life. People with ADHD,
| people with type 1 diabetes, most women, ... why do we find
| that totally unproblematic, but as soon as it's medication to
| help with obesity (which is a serious medical condition in
| its own right) it's suddenly such a big problem?
|
| EDIT: And to be clear, there may be specifics with these
| particular drugs which are problematic, maybe they're by
| necessity expensive or resource intensive to manufacture,
| maybe they have problematic long-term effects, I don't know.
| I'm purely talking about the _general_ aversion some people
| claim to have regarging taking some medication on an interval
| to help with a health problem. It makes little sense to me.
| tjpnz wrote:
| As someone who takes meds for ADHD and would benefit from
| Ozempic I'm still hesitant. There aren't any non-drug
| options for my ADHD but there's a proven one for my weight.
| hirvi74 wrote:
| > _People with ADHD, people with type 1 diabetes, most
| women, ... why do we find that totally unproblematic_
|
| ADHD medicine is highly problematic. The medications are
| controlled to ridiculous levels, and there are strong
| social stigmas against both the condition and the disorder.
| mort96 wrote:
| Notice how the problematic things with ADHD medication
| are manufactured problems which don't need to exist.
| taejavu wrote:
| What kind of food do you and your wife cook? How much meat? How
| much gluten? Real butter or canola oil infused "spreads"? What
| oil do you cook with? Vegetable? Sunflower?
|
| If you're eating the right thing for your body, you'll be
| satiated when you eat your full.
| nawgz wrote:
| Bodies are highly imperfect and suggesting our digestive
| system and nervous system are geared for being fit and
| healthy rather than ensuring survival wrt food is absurdly
| naive.
| sundvor wrote:
| (I only cook with extra virgin olive oil which I buy in 5L
| cans for $$ reasons. A lot of these vegetable oils are good
| for motor engines only!).
|
| It really depends on you and the activity levels.
|
| I used to ride to and from work - and I would ride hard, a
| solid 1.5 hour of riding every single workday. Yet this just
| caused me to gain weight as my appetite just shot through the
| roof. This new drug would have been SO good for me back then.
|
| These days I find it easier to control my weight with regular
| strength exercise vs riding, as I tend to go too hard on the
| riding which causes me to feel famished. And then the control
| is just hard.
|
| However when I just do (Olympic barbell) weights, a bacon,
| egg and onion + cheese omelette in real butter and EVOO does
| the trick to break my IF then, along with a WPI/milk shake- I
| get stronger and also lose weight. No need to keep eating.
| However, I'll then do cardio a couple of times per week which
| tends to undo the weight progress; I guess the real trick
| would be to stop doing the hard intervals I love on the
| Kickr, but going slow on the bike is nearly impossible for
| me. :-)
| arandomusername wrote:
| Maybe using too much oil in your food? It's got crazy
| calories.
|
| Eat low calorie (and ideally high protein) after
| exercising. Fruit and Veg are amazing for this.
| mrshadowgoose wrote:
| > Why do we find it acceptable to help people who struggle with
| alcohol abuse, or nicotine addiction, or opioid addiction, but
| not to help people who struggle with food abuse?
|
| "Getting fit and staying fit" is a form of social capital,
| because it's extremely hard and only within reach of a small
| portion of the population. "Being fit" is strongly aligned with
| "being attractive" which confers all sorts of cross-cutting
| social benefits.
|
| Some people feel cheated when medication allows others to
| "effortlessly" join this social club, and then become vile and
| hateful in response.
| unclad5968 wrote:
| In what ways is fitness not within reach for a large portion
| of the population?
| mrshadowgoose wrote:
| Studies have repeatedly shown that lifestyle modification
| does not result in sustained weight loss for most.
|
| Not going to waste my time providing sources to remedy your
| ignorance. You are more than capable of doing this research
| yourself.
| paulddraper wrote:
| Nor will I waste time proving the opposite.
|
| Until next time we meet on the internet. :salute:
| JamesBarney wrote:
| Yeah the problem with providing a study is that proving a
| negative is so hard. Everyone assumes there exists a
| successful RCT with a 5-10 year time horizon for weight
| loss via lifestyle interventions. And there just isn't
| one, and the only way to know that is to search for one.
| artursapek wrote:
| How does "burning more calories than you consume" not
| result in weight loss for most people, lmao?
| sethammons wrote:
| How do people not realize that the digestive system is
| dynamic and that as you change the calories in (and the
| type of calories) that the body changes the out.
|
| You can't outrun thermodynamics. But your body will
| change its efficiency.
| borski wrote:
| Because your metabolism changes. If you ate 700 calories
| per day it would be harder for you to lose weight than if
| you ate 1400 and worked out.
|
| You'd still be eating less, but retaining more weight.
| Why? Because your metabolism slows down significantly if
| you don't fuel it, and that makes it _harder_ to lose
| weight, not easier.
|
| Most things in life are not binary, and are affected by
| more than just a single choice.
| artursapek wrote:
| Yeah. So that's why working out is the solution lol. How
| is this controversial?
| borski wrote:
| Because working out, alone, is not the solution. You
| could work out all day and still not lose a pound. Plenty
| of studies have shown this.
|
| Moreover, have you ever tried to work out at 450 lbs? No?
| It is an immense effort, often literally impossible for
| most people at that weight, and the best they can manage
| is a walk around the block before their cardio can't keep
| up.
|
| What then?
|
| See above, where I reminded people (which includes you)
| that things are rarely binary.
| zamadatix wrote:
| Proving a negative is a hard and sometimes an annoying in
| itself ask plus you're probably frustrated with the
| general attitude to this kind of conversation (especially
| if your main expectation/experience is others don't like
| the pill answer out of spitefulness) but that doesn't
| make this kind of response any more okay here.
|
| For others open to listening to why it's often out of
| reach: Outside the go-to "motivation" type discussion
| gravitation (and, keep in mind, not everyone can just
| 'motivate themselves past their addictions' in the first
| place or they wouldn't be addictions) it is also
| disproportionately hard for those struggling in other
| ways of life (financially, mentally,
| physically/genetically). Some of these can be cascaded
| effects, like support systems (e.g.not everyone's partner
| is willing or able to go all in on it like above). Others
| can be that it is medically not as easy for some people
| to lose weight at a given intake amount which makes it
| just that much harder.
|
| Most people would like very VERY much to be fit. That
| most still aren't fit should be a good indicator it's out
| of most's reach to "just eat less" independently. All
| this said as a person who is not overweight themselves
| but has been around many people in different situations,
| abilities, and luck that have left them unable to be so
| as well.
| wiseowise wrote:
| Oh well, back to my unhealthy lifestyle because study of
| some thousand something in one country said it's
| impossible to change!
| unclad5968 wrote:
| I didn't ask if lifestyle modification resulted in
| sustained weight loss. I asked in what ways is fitness
| not accessible to the majority of people.
| timeinput wrote:
| Something like 15% of the world lives in extreme poverty.
| This is darn near the best it's been in the history of the
| world (there used to be much more poverty by percentage),
| but this group would likely have trouble being fit. They
| might be skinny, but surely not fit.
|
| Ignoring that extreme the questions maybe different: How
| many hours does a median person have free from work,
| commute, and sleep? How much time must be spent managing
| exercise and diet to achieve fitness?
|
| I think if you took the time to answer those questions for
| the median or modal non-impoverished person in the world
| you might find that fitness is actually quite difficult to
| achieve.
|
| It seems really hard in the US.
| itsoktocry wrote:
| I don't understand, impoverished people aren't taking
| Ozempic, either.
| laeri wrote:
| Parent poster wasn't referring to Ozempic but a general
| healthy lifestyle. Which requires resources many people
| do not have such as time, money, education etc.
| cashsterling wrote:
| The work-life balance & climate in some areas of the US
| (and other areas of the world) does make it hard to
| exercise... but that's only part of the story.
|
| Eating healthier requires very little extra time: perhaps
| 2-3 hours a week for shopping and meal prep.
|
| - making a salad take 5 minutes.
|
| - baking 10 meals worth of chicken takes 30-45 minutes,
| with about 5-10 minutes of actual prep time.
|
| - baking a few meals worth of salmon, or some other fish
| is about the same as chicken.
|
| - cutting up an apple takes 1-2 minutes. Bananas, peaches
| are ready to go, almost no prep required.
|
| - steaming fresh broccoli takes 3-5 min of prep... and
| about 15-20 minutes total.
|
| - Equally important is making small decisions to avoid or
| limit less healthy foods, which requires no time at all
| and often saves us money [that we can spend on healthier
| foods instead].
|
| Exercising: 30-60 minutes a day, most days, is ideal but
| anything is better than nothing. A morning and evening 20
| minute walk is great place to start (and can be so
| relaxing). If a person spends time on Hacker News, they
| could instead allocate that time to exercise. There are
| free 15 minutes yoga videos on Youtube. A set of push ups
| requires 60 seconds. Sometimes I do body weight squats at
| my desk at work (especially during Teams calls, camera
| off of course).
|
| Sleep: get at least 7 hours of sleep a night... ideally
| starting to bed before 11pm. more sleep gives us more
| energy to put towards being awesome during the day and
| more energy for exercise and doing the extra work to eat
| better.
|
| I think almost everyone can set aside 6-10 hours in their
| week towards building their health. It is a matter of
| priorities... a person's health should be one of their
| top priorities.
| beeboobaa3 wrote:
| just look around outside
| aucisson_masque wrote:
| Fitness require making efforts and determination.
|
| Taking a pill doesn't.
|
| That's why it will always be out of reach of some people.
| cashsterling wrote:
| Fitness is in reach for almost everyone on Hacker News.
| There are folks who have serious health issues or
| disabilities that preclude exercise... but the rest of us
| [the majority?] can walk more, do body weight squats, some
| form of incline push ups, and so forth and build larger
| successes on top of smaller ones. We can start by taking a
| morning and evening walk.
|
| We all can make healthier decision about what food we put
| into our bodies (a lot could be done to make our food
| supply healthier, as well). I find I have to be more strict
| about eating right as I get older to maintain my health.
|
| I feel like folks saying 'fitness' isn't in reach [for
| most/many of us] is a cop out. This is anecdotal, but i
| know people who have lost 100+ lbs in their 40's and 50's
| and completely turned their life around; I know people who
| have reversed Type-2 diabetes through diet and exercise.
| These people have busy lives with a lot of
| responsibility... some of these people live in city areas
| where access to gyms or outdoor spaces for walking, etc. is
| not convenient.
|
| I have a few doctors and other medical professionals in my
| family... knowing what I know, I am 'almost terrified' of
| becoming metabolically unhealthy and overweight. Many of
| the maladies that afflict us are metabolic disorders (in
| whole or in part) due to the long term effects of poor
| diet, lack of exercise & quality sleep (high stress doesn't
| help either). Poor metabolic health tremendously increases
| risk of almost every disease and malady: diabetes, heart
| disease, heart attack, dementia & Alzhiemer's, many
| cancers, stroke, depression and other mental illnesses,
| sleep apnea, susceptibility to infectious disease, etc.
| Poor metabolic health also indirectly leads to higher
| likelihood of issues causing chronic pain: e.g., herniated
| discs in the spine, ankle/knee/hip problems, migraine
| headaches.
|
| I'm glad Ozempic exists but it is not a cure... it is an
| aid towards building a healthier life. Use Ozempic as a
| tool, by all means!!, to start your journey and get
| yourself into a better situation physically. But please use
| that good start to pursue the 'best/healthy you'... do it
| for yourself.
| unlikelytomato wrote:
| I would say my concerns are far more in the range of
| downstream effects from the medication. Specifically, I am
| concerned with muscle retention. Concerns aside, it's a
| little hard of an argument to swallow having visited many
| other countries where these things are simply not an issue.
| How can it be argued that the cause is anything other than
| behavior when so many others are doing just fine? There is
| more to this story than painting people as evil.
| billyjmc wrote:
| The "more to this story" is likely endocrine disruptors in
| addition to (and associated with) the other "behavior"
| issues you're alluding to.
|
| And our answer to it is... another endocrine disruptor. But
| this time we'll call it something else (GLP-1 agonists) and
| laugh all the way to the bank.
| bozleh2 wrote:
| > How can it be argued that the cause is anything other
| than behavior when so many others are doing just fine?
|
| Aren't you are ignoring the way western society influences
| behavior? eg lack of walkability of suburbs, massive price
| difference between fresh and processed foods, constant
| advertising of junk food & alcohol.
| wiseowise wrote:
| How do people move around cities? They teleport?
|
| Where there's a will there's a way.
|
| > constant advertising of junk food & alcohol.
|
| Nobody is forcing you to eat those.
| ruraljuror wrote:
| > Nobody is forcing you to eat those.
|
| No, I think force feeding junk food is pretty rare but
| that seems like a straw man.
|
| Consider children. Their brains are not fully developed
| and they have little agency in determining the food they
| have access to. Childhood obesity is on the rise. So
| blame the children's choices?
|
| Ok, sure, blame the parents. I agree of course it is the
| parents responsibility, but the cards are often stacked
| against parents by big corporations with government
| subsidies (in the us).
|
| It's really weird to me to argue that this is completely
| a problem at the individual level and not a social one--
| and I see no other way to interpret your comment.
| wiseowise wrote:
| > Consider children. Their brains are not fully developed
| and they have little agency in determining the food they
| have access to. Childhood obesity is on the rise. So
| blame the children's choices?
|
| Been there. It's always bad parenting. I had to fix
| shitton of issues myself, because of idiot parents.
| borski wrote:
| > Where there's a will there's a way.
|
| Yeah? Even if I'm disabled, I should got for a walk, just
| because I want to?
|
| Pretending the world is binary is a fun exercise, but it
| is always untrue.
| wiseowise wrote:
| We're talking about people who are able but unwilling to
| make the effort.
| borski wrote:
| Are we? Because most people have this conversation and
| talk about people they _think_ are able and unwilling,
| when in reality the _vast_ majority are willing and
| unable, for one reason or another.
| ruraljuror wrote:
| Not sure why you are downvoted. I had the same question
| about who's behavior we are referring to. Attributing
| obesity simply to individual behavior and choices is
| pretty myopic. Just look at government subsidies for
| corn. There are larger forces than the individual at
| play. This is a social problem.
| pizza wrote:
| It seems the article is now behind a paywall (can only get
| a reddit link w/ a screenshot atm [0]) but there was a
| study that showed body composition after 25% weight loss in
| terms of fat mass and fat-free mass (and the portion of
| fat-free mass that was skeletal muscle mass) after
| traditional several interventions, and also compared the
| breakdown of weight lost in terms of FM and FFM for several
| GLP-1 medications:
|
| - diet alone
|
| - diet + extra protein
|
| - diet + exercise
|
| - retatrutide
|
| - tirzepatide
|
| - semaglutide
|
| tldr is that, despite some muscle loss, muscle as a
| percentage of body composition is higher (~50% FFM at
| start, whereas weight lost with GLP-1 meds ranged from
| 25%-39% of muscle). It also seems like the muscles will
| likely function better with less insulin resistance:
|
| > _Intentional weight loss causes a greater relative
| decrease in body fat than FFM or SMM, so the ratio of FFM
| /SMM to fat mass increases. Accordingly, physical function
| and mobility improve after weight loss despite the decrease
| in FFM/SMM, even in older adults with decreased FFM and SMM
| at baseline. In addition, weight loss improves the
| "quality" of remaining muscle by decreasing
| intramyocellular and intermuscular triglycerides and
| increasing muscle insulin sensitivity_
|
| https://www.reddit.com/r/tirzepatidecompound/comments/1dtzr
| 2...
| jvanderbot wrote:
| How will the person have less insulin resistance when
| GLP-1 medications stimulate the release of insulin?
|
| It seems to me we're curbing eating by flooding with
| insulin, when one of the big damaging effects of
| overeating is insulin floods. (Or perhaps I'm misreading,
| perhaps insulin floods are only bad b/c they cause
| insulin resistance which causes more overeating?)
| borski wrote:
| You aren't being flooded with insulin with the GLP-1
| meds. You have food in your body, but my insulin levels,
| on average, are possibly lower than yours (if I'm in need
| or a GLP-1 med) despite eating the same amount.
|
| A GLP-1 med stimulates the release of insulin _slowly_
| over a sustained period of time, not just as a massive
| spike when I eat.
|
| _Everyone_ (that isn't diabetic) has a massive insulin
| spike when they eat something that spikes their glucose.
| GLP-1 meds don't make that better in any way.
| onionisafruit wrote:
| Are you saying that us fatties should move to those other
| countries where our "behavior" will be kept in check?
| unlikelytomato wrote:
| I don't understand the hostility. I am attempting to
| discuss the topic on a discussion site. My point is not
| too instruct any one person on what the exact correct
| solution is. However, I find the selective vision with
| this topic to be dishonest and ultimately damaging to the
| conversation(and progress by extension). One can still
| come to the conclusion that drugs tip the balance
| positivity enough to use them without sweeping other
| realities under the rug.
| edanm wrote:
| > Concerns aside, it's a little hard of an argument to
| swallow having visited many other countries where these
| things are simply not an issue.
|
| Which countries? As far as I know, most Western countries
| have roughly similar issues with obesity, at least
| directionally.
| Veen wrote:
| It can be quite eye-opening to travel from say, the UK to
| Hungary. Walk down a busy street in London and you'll see
| many overweight people. Walk down a similar street in
| Budapest, and you'll see very few.
| jvanderbot wrote:
| This is the essence of the moral argument: Someone chooses
| to abuse a substance, they become a more frequent abuser,
| and the abuse piles up damage, which the person ignores to
| continue abusing.
|
| The essence of the argument against drug interventions is
| that the root cause is personal choice, and therefore a
| drug is a shortcut or crutch and does not address the root
| cause.
|
| Many people feel that the real cause is the structural
| changes to the person's brain, body, and daily routine that
| reinforce, and are reinforced by the initial tiny over-
| consumption, which compounds over time. It's like a debt
| where you are stuck paying interest, no matter how much
| you'd like to pay off the debt. Addiction is a system in
| which the person's willpower goes against everything they
| have set up over decades. It's unreasonably challenging for
| nearly everyone to walk it all back. Insulin resistance is
| one of the most pernicious effects of even small over-
| eating over time. The body and mind do not feel satiated
| even though enough calories have been consumed. It's not "I
| would enjoy another slice of pizza", it can be "I am still
| starving".
|
| And yes, the environment in which we live, where it is less
| stigmatized to overeat, and food is treated a certain way,
| more like a drug than fuel, is part of that system.
| zero-sharp wrote:
| >Some people feel cheated when medication allows others to
| "effortlessly" join this social club, and then become vile
| and hateful in response.
|
| Nice one. I think it's a bad idea to be dependent on drugs
| for something you can achieve on your own, especially if the
| drugs don't have a long term safety profile. Pretty sure I
| read somewhere that they don't. If you're going to use them
| for a short period of time, that's fine. Don't say nobody
| warned you if that doesn't pan out though (or worse, you have
| a bad drug response).
| l2silver wrote:
| > Some people feel cheated when medication allows others to
| "effortlessly" join this social club, and then become vile
| and hateful in response.
|
| I don't think this is just about a social club. Battling
| weight loss and habits is foundational to the human
| experience from the most recent centuries. Be it drugs, or
| anything else really that changes the nature of these
| challenges, people are going to feel discomfort because it's
| an attack on their understanding of the world, and in some
| ways, their beliefs.
| cromka wrote:
| The idea is this drug _kick starts_ people to form new
| habits going forward. As witnessed by other commenters I.
| This thread as well.
| borski wrote:
| Precisely. It doesn't do the work for you.
| jajko wrote:
| This is funny how black & white some folks here want the
| world to be painted if it suits them.
|
| You know by far the biggest benefit of doing hard workouts or
| doing extreme sports? Its not muscle mass nor how much they
| lift. Its about how it changes your personality, resilience
| to mental or physical suffering and ease of overcoming it.
| You know, hardest part of doing anything is winning the
| mental resistance game and just start it. Keep doing this
| every day in various forms for decades... A _very_ strong
| resilient personality under various circumstances is almost
| an unavoidable result if you are putting in enough effort.
|
| If somebody can't even stop themselves buying and paying for
| junk food at grocery store or has to overeat constantly
| otherwise getting anxious, that part of personality is
| missing and another, less desirable is present.
|
| Who would you prefer to have as a close colleague you depend
| on, life long partner, a close dependable friend? Who do you
| think women would prefer subconsciously? Societies have
| always some form of castes, even hardcore communists have/had
| them, in US one of very popular is based on
| career/income/wealth. And this is just another dimension or
| caste, so let's not act like we are not humans with flaws and
| subjective preferences, we don't give our respect out for
| free.
|
| These medication help with none of above, in fact they
| strongly reinforce such behavior and personality traits. But
| to each their own. One benefit I can see that they could
| start / help with movement from former to the latter, but
| that's rarer than people like to admit.
| borski wrote:
| That's cute. You know nothing about me, but assume I'm not
| resilient.
|
| I have achieved much, largely due to my resilience. It
| would be very difficult to argue, after growing up very
| impoverished and getting to where I am today, that I am not
| resilient.
|
| I played sports, lots. I competed in martial arts.
| Resilience isn't my issue.
|
| But thanks for telling me I have a moral problem I don't
| have, instead of perhaps considering that what people are
| telling you might be the truth.
|
| You don't always know better, even if it flies in the face
| of what it is you do know.
| user3939382 wrote:
| It's only within reach of a small portion because of
| industrialized food. Look at a graph of obesity rates in the
| US over several decades. Find literally any picture of people
| at any beach in the US in the 60s or 70s versus now.
| dj_gitmo wrote:
| > And still weight kept on coming on. Worse yet, I am on ADHD
| medication, which are amphetamines and actually make you lose
| weight. Yet... the number on the scale kept on creeping up.
|
| The therapeutic amphetamines dosages for ADHD is below the
| threshold required for produce meaningful weight loss. It's not
| surprising that it didn't help you lose weight.
| theshackleford wrote:
| > The therapeutic amphetamines dosages for ADHD is below the
| threshold required for produce meaningful weight loss.
|
| That's not been my experience at all. My dosage absolutely
| significantly suppresses my appetite and always has. This has
| directly led to sustained weight loss. It did so badly enough
| at one point that I was _underweight_ significantly.
|
| I have to force myself to eat on my meds, even though the
| thought often makes me ill.
|
| I'm on 30mg dexamfetamine daily.
|
| "Dexamfetamine can make you want to eat less, so you may lose
| weight while taking it.
|
| Some people gain weight, but weight loss is more common."
|
| Doesn't seem to be hit everyone but equally doesn't seem
| rare.
| archsurface wrote:
| You mention types of food but not quantities. A boat load of
| healthy food is still going to have an effect. Also, I for one
| don't consider walking to be exercise. It's fake exercise for
| people who don't like exercise to claim they exercise. My
| reason is that I cycle for eight months of the year then walk
| during the rainy months. By the end of the rainy months I get
| back on the bike and my fitness level is catastrophic -
| nothing. I've done this for five years, and have to say walking
| is just not good enough for exercise, not even close.
| brianmcc wrote:
| To be fair OP did say:
|
| >> And you know what it is? It's volume. I eat too much.
| archsurface wrote:
| I missed that.
| jart wrote:
| What about someone who's carrying 100+ pounds of excess body
| weight? Would you consider walking to be fake exercise for
| them? I'd say that's a more heroic workout than joy riding.
| archsurface wrote:
| I've seen such people jogging - intervals - short jog,
| short walk, short jog, ... They didn't look comfortable,
| but when I'm cycling uphill toward the end of a hard ride
| with nothing left in the burning legs I start grimacing
| too. What do you want? No free lunch.
| phillipcarter wrote:
| Can't speak for OP, but generally speaking there's a lot of
| variability in peoples' perceptions of healthy food and
| caloric density. For example, a lot of people see nuts as
| health food, and yet they're some of the most calorically
| dense foods you can eat! Another example would be to crack
| open the Ottolenghi cookbook and make the delicious Lamb
| Siniyah, which among other things calls for a large amount of
| Tahini mixed with lemon juice to create a delicious crust
| over the top of the stew. Delicious, but _incredibly_
| calorically dense.
| tightbookkeeper wrote:
| I think healthy/unhealthy food dichotomy is psychologically
| the same as religious dieting. It fosters feelings of
| purity, self control, and is a form of in-group signaling.
|
| But our bodies grind down substances to extract calories.
| It's a simple mechanism. You can eat McDonalds everyday if
| you manage intake.
| arandomusername wrote:
| walking is exercise in the sense that it burns calories,
| specially when you're overweight as it's like having a 30kg
| (or more/less) backpack with you. Bonus points for incline.
|
| But yeah, it's not HIIT. You won't really build up your
| fitness level by walking - it's not demanding enough. You
| need to be pushing yourself until you're out of breath, if
| you want to build up your cardiovascular health.
| ip26 wrote:
| _Why do we find it acceptable to help..._
|
| I think if the widely available help for alcoholics, smokers,
| or opioid addicts mainly mitigated the negative consequences -
| enabling them to drink, smoke, or dope more - it wouldn't be
| nearly as acceptable.
|
| I personally expect weight loss medication that simply makes
| people want to eat less will reach cultural acceptance.
|
| Case in point, cigarettes have been known to suppress appetite
| for ages, and people have elected to smoke to help stay thin
| for decades. There was never any crushing social stigma
| attached to doing this as a weight loss strategy (that I know
| of).
| aeonik wrote:
| wait, I thought that's exactly what ozempic did...
| omikun wrote:
| I think a lot of it is dealing with hunger. If you can't stand
| being a little hungry, never mind very hungry, no diet will
| really help. I used to love being very hungry, not sure how I
| got there, but I wish I can go back there again. Having very
| little carbs and temptations in the house helps. Unfortunately
| it's not up to only me.
| larodi wrote:
| Perhaps the first person on HN who actively and without shame
| pays attention to the fact that Adderall is a very nice amphet
| cocktail. Surprising though you don't loose wait with it, sad
| also given the circumstances. But I envy you a little cause
| such ADHD boost is only illegal in EU.
|
| Sometimes I wonder if it was a some neat trick by US gov to
| diagnose and put 1/5 of the population on amphetamines (2024
| data +60mil prescriptions of Adderall), so that most everyone
| who is actually like smart or sensitive or anything of value to
| the industry, can (almost) freely microdose on it and as a
| result increase productivity.
|
| Which... means 1/5 of the population suddenly increases output.
| Perhaps we all'd be on Aderall at some point, dunno bout the
| Ozempics...
| dahinds wrote:
| I think you're incorrectly assuming that one prescription =
| one person. Far less than 20% of the population is taking
| Adderall, this CDC study says 4% in 2021.
|
| https://www.cdc.gov/mmwr/volumes/72/wr/mm7213a1.htm
| larodi wrote:
| Yes you are right. One prescription gives one person access
| to pills and then they resurface for many others on the
| black market. You can be absolutely sure it's very popular
| among STEM students, not the least because they can
| understand why would they need it. I can only imagine the
| pressure to stay in Ivy League university, would totally
| make it reasonable to use one if you do five exams in a
| row.
|
| Since you can find it being sold at raves in EU I'm
| absolutely sure a) it works; b) not convinced only one in
| five prescribed takes it and all other toss it in the
| toilet; c) there's a surge in use and demand.
|
| When I also found my high profile friend working FAANG for
| years, who's straight edge and goes regularly to church's
| is taking it for productivity boost, and happy about it...
| well I realised what actually is happening.
|
| Indeed the good thing about adhd is tis a very vague
| diagnosis. And yes it works well on many undiagnosed
| people, and particularly in countries where ADHD is not a
| recognised ontology.
|
| So let's be real and honest.
|
| Besides media is hyping in September'24 about dangerous
| shortage of Adderall as if people are left with no access
| to vitals. It is hyped more than the fact that coffee
| prices are likely to double and triple in months to come.
| dahart wrote:
| > 1/5 of the population suddenly increases output
|
| I've heard studies show Adderall doesn't help people without
| ADHD... googling now seems to confirm. Apparently lots of
| people, especially college kids, take it thinking it will
| help, but it actually can slow them down.
| hirvi74 wrote:
| My understanding is the amph. works the same in everyone -
| minus the edge cases.
|
| The main difference is that the magnitude is greater in
| people with ADHD than those without. A reduction in
| hyperactivity, for example, is not really apparent in
| people that are not overtly hyperactive to begin with.
|
| Beside, ADHD is kind of a nebulous label for a lot of
| symptoms. Having ADHD vs. not having ADHD is not exactly
| binary.
| dahart wrote:
| "Taking 'Smart Drugs' Like Adderall Without ADHD Actually
| Decreases Productivity"
|
| https://www.forbes.com/sites/darreonnadavis/2023/06/14/ta
| kin...
| throwup238 wrote:
| _> a new study finds that using these drugs while not
| suffering from attention-deficit /hyperactivity disorder
| decreases productivity and increases the amount of time
| needed to complete tasks._
|
| People using it for studying don't take adderall to be
| more productive, they take it to be productive for much
| longer. It's a stimulant that keeps you up all night and
| lets you study, not makes your studying more efficient.
| borski wrote:
| That is not true. Vyvanse, caffeine, etc., helps my brain
| calm down and focus. I don't get hyper. In fact, if I
| have too much caffeine, I start yawning.
|
| My wife, who does not have ADHD (at all), gets hyper from
| stimulants.
|
| That's the difference.
| Solvitieg wrote:
| That's the difference between two individuals, not
| necessarily the difference between having ADHD and not
| having ADHD.
|
| Being tired after drinking caffeine is common.
| borski wrote:
| I am not suggesting anyone use their response to
| stimulants as a diagnosis of ADHD. However, speak to
| anyone who has it and they will relay that stimulants
| make them calm, not hyper.
|
| People without ADHD get hyper, not calm. Some others also
| get calm.
|
| But people with ADHD who take stimulants do not get
| hyper.
| molochai wrote:
| Not a study, but this article was enjoyable. Some of the
| experiences there say it made their writing overly
| perseverative on detail, too expansive, too many edits and
| re-writes. Sort of faster in the short term but slower over
| the long term?
|
| https://pioneerworks.org/broadcast/club-med-adderall
| keybored wrote:
| > Maybe the government is looking out for smart people (me)
| by helping them be productive in their work for their
| employer or themselves
|
| Weird daydreams on this site.
| dehugger wrote:
| Seconding Zepbound, it has been absolutely life changing for
| me, and not only in terms of weight loss. It's expensive, but I
| am blessed with a tech salary that can afford it.
| squidgedcricket wrote:
| Would you mind sharing what your diet was like as a child?
|
| I wonder if there's a connection between diet during
| development and adult processing of and cravings for food.
| Maybe eating candy for breakfast (cookiecrisp!) every day in
| elementary school messed a bunch of us up.
| sexy_seedbox wrote:
| Not OP, but I ate sooo much Kellogg's and General Mill's
| sugary products in high school for breakfast (pop tarts, eggo
| waffles, all the disgusting cereals you can name...), but I
| took Centrum daily and played a ton of basketball after
| school. Almost 1 can of coke a day after school. No heath
| problems as an adult. But of course, genetics come into play
| as well, no overweight parents or relatives.
| mixmastamyk wrote:
| Try a very low carb diet. Only eat until 80% full at mealtime.
| Get down to two meals a day, with a goal of only one. Fast the
| other times. This sounds hard but once you get to ketosis it is
| not that hard at all. Not hungry naturally, like the drug
| response.
|
| Truth is, we really don't need more than one meal a day (maybe
| a snack) when we get older and our metabolism slows.
| refurb wrote:
| > And you know what it is? It's volume. I eat too much.
|
| 100% this.
|
| I lived in Asia for a few years and obesity is rare (though
| increasing for youth). It's not like they get more exercise
| (most people don't) or eat healthy (it's mostly carbs), but
| 100% portion sizes.
|
| I see people who work manual labor jobs eat lunch that is a
| bowl of noddles, a few thin slices of chicken or pork, and a
| few veggies. I highly doubt it exceeds 500 kcalories. It's
| probably half the portion size you'd get in the US.
|
| Mystery solved. If you're only eating 1500 to 1800 kcal per day
| as an adult male doing manual labor, it's pretty obvious why
| you're at 10% body fat.
| coffeebeqn wrote:
| > It's probably half the portion size you'd get in the US.
|
| A lot of the sides in your average US restaurant is easily
| 1000kcal on its own
| sirsinsalot wrote:
| That's insane. It's also not just about calories. The
| amount of corn syrups used in drinks is crazy too. Your
| body will just spike your glucose and dump it to fat.
|
| It amazes me that Americans head scratch over their obesity
| epidemic then reach for a product to solve the issues their
| food industry and culture made for them.
| wiseowise wrote:
| > Why do we find it acceptable to help people who struggle with
| alcohol abuse, or nicotine addiction, or opioid addiction, but
| not to help people who struggle with food abuse?
|
| For the same reason why skinny person taking steroids is
| frowned upon - it is perceived as a shortcut.
| cthalupa wrote:
| Supra-physiological levels of testosterone and steroids have
| incredibly well known and well researched short, medium, and
| long term side effects. They've been well known for forever.
|
| In an alternate world where steroids had a good safety
| profile, it would be ridiculous to not use them if you were
| looking to add on muscle mass.
| wiseowise wrote:
| > Supra-physiological levels of testosterone and steroids
| have incredibly well known and well researched short,
| medium, and long term side effects. They've been well known
| for forever.
|
| I'm pretty sure if you have professional pharmacist working
| on you then you can mitigate the issues and make it semi
| healthy. The point is that it is being frowned upon not
| because of health issues, but because it's not an "honest
| work".
| cthalupa wrote:
| You can make short cycles once or twice a year relatively
| safe for some steroids. Keep close track of your liver
| enzymes and blood pressure, discontinue if those look
| bad, otherwise stay on for 4-6 weeks, take half a year
| off, repeat. Got exposed to people doing that when I was
| in the gym frequently, still keep up with some now, all
| their levels look fine.
|
| But even with significant additional intervention, when
| you move beyond that to the "blast and cruise" setup,
| those interventions are just mitigating factors, not
| truly preventative.
|
| I get what you're saying, I've never touched any of them
| myself, because the juice wasn't worth the squeeze (hah),
| but if they did have very good safety profiles, I would
| have zero problem with anyone taking them and would think
| it would be silly if anyone did.
| unraveller wrote:
| Anyone can list 50 no-no things they don't eat and omit the 5
| types of foods they do choose that causes the most damage.
| Volume & variety are not to blame given most sauces are calorie
| dense. The issue generally is the person eating for pleasure
| conflicting with their stated aim to eat for weight
| maintenance.
|
| If it tastes good spit it out. Countless people ready to tell
| you no sacrifice is needed in that domain but they have
| something to sell or trade.
| pgwhalen wrote:
| In my experience, as someone who has gone on a small weight
| loss journey, you can eat things that taste good, you just
| have to eat less of them and more rarely.
| static_motion wrote:
| > It's volume. I eat too much.
|
| Bingo. I've had this conversation with my girlfriend. She's not
| overweight by any means (160 cm ~55 kg) but I am quite
| underweight (182 cm, 65 kg, < 10% body fat) and the conclusion
| I've arrived at regarding our differences in body composition
| is because she routinely eats 1.3x to 1.5x the amount I eat. We
| both exercise and eat little junk food.
|
| I'm convinced it has to do with upbringing. My family never ate
| a lot and the portions I was served as a kid weren't big.
| Nobody in my family is anything more than skinny. Her family
| however, they eat a lot (and healthy too, mind you). This is
| all influenced by other factors, her parents and grandparents
| grew up with not a lot to their names and with food scarcity,
| so when they reached a position in life where they could
| comfortably afford to eat they gained the habit of having big
| meals. My family was mostly more privileged in that regard so
| maybe they never felt the need to focus on food as much.
| hilux wrote:
| Living a healthy lifestyle, so that you won't need Ozempic, is
| possible - even surrounded by all the drugs and booze and carbs.
|
| I do it. Lots of people do it. The information is freely
| available, now more than ever.
|
| From all I've read, Ozempic isn't a silver bullet, and has many
| side effects. It just helps people stave off the inevitable for a
| while.
| pixl97 wrote:
| Well good for you, aren't you special...
|
| Now what about the other 74% of the population.
|
| You ever hear the saying "If you owe the bank $1000 dollars,
| that's your problem. If you owe the bank a million it's theirs"
|
| This is a public health epidemic and no matter how much you
| scream "But I'm special" the rest of the world is going to fall
| apart around you. And yes, this issue is spreading to the
| entire world and not just the US.
| hilux wrote:
| > no matter how much you scream "But I'm special"
|
| You are deliberately missing my point: I'm not special.
|
| Go back to reddit, where they appreciate your "style" of
| discussion.
| wiseowise wrote:
| > and no matter how much you scream "But I'm special"
|
| Literally opposite of what they're saying. You're the one who
| screams "I'm special, diet and exercise don't work on me, I'm
| defying physics".
| Someone1234 wrote:
| The population level statistics show that you're the exception
| and not the rule. Obviously if the side-effects are unpleasant,
| the alternative health implications must be even worse: Which
| they are.
| hilux wrote:
| This may sound cynical, but I believe it is also factual: in
| a capitalist society, generating revenue by making people
| sick (junk food), and then generating more revenue by curing
| them, and finally making a big pile by keeping them alive for
| a few more weeks, is the way it's "supposed" to work.
|
| If everyone stayed healthy and then peacefully died one day
| in their sleep, I can't imagine how many $$$trillions that
| would remove from the US economy. (I know, there's an
| argument that healthy people would find other ways to
| generate revenue, but we have no path to realize that.)
|
| Of course, a century of non-capitalist societies don't have a
| great track record either!
| defrost wrote:
| Thank goodness for all those countries that are neither the
| US nor puely non-capitalist (not that the US is an example
| of a pure capitalist society).
|
| Just how blinkered is American Exceptionalism anyway?
| Surely you're knowingly playing up the false { US | not-US
| } dichotomy.
|
| eg: "American junk food" as seen in the US is largely
| regulated away in Australia, food labelling is better,
| overall health and life expectancy is better, etc.
| hilux wrote:
| I don't know enough about other countries to comment on
| them in detail.
|
| I do know that food multinationals are very active in
| almost all countries, and that obesity rates have
| skyrocketed in almost all countries, except for Japan, S
| Korea, and poor countries where people literally don't
| have enough to eat.
|
| In Australia the obesity rate is >32%. That must be junk-
| food companies at work - I'm not aware of any other
| explanation.
| sureIy wrote:
| > The information is freely available, now more than ever
|
| You have to believe it to find it.
|
| Noise is everywhere, now more than ever. I think finding proper
| information is going to be exponentially harder.
|
| A couple of days ago I was "fighting" on Reddit about something
| that is as clear as day, with proof and all, with people who
| were completely sure of the opposite (side note: this is when I
| deleted my Reddit accounts)
| hilux wrote:
| Oh, I agree with you.
|
| I just read that MTG and other Republican operatives are
| tweeting that hurricanes are created by the US government;
| now the MAGA want to kill meteorologists.
|
| And despite all this, Trump has a 50-50 chance of winning the
| election.
| DavidPiper wrote:
| > The information is freely available, now more than ever.
|
| Given the progress of the threads here, do you have any
| recommendations for cutting through the noise and finding good
| scientific information on weight loss, healthy eating,
| lifestyle, etc?
|
| I agree with you that all the information is out there, but
| there seems to be an enormous amount of resistance in the
| threads here to threads to even simple things like:
|
| - Fresh fruits and vegetables
|
| - Lean proteins
|
| - Cut out processed foods
|
| - Cut out smoking, rec. drugs, and booze
|
| - Eat less in general
|
| - Stay hydrated - water is the only drink you really need
|
| - Find ways to move more, esp. for people with sedentary jobs /
| lifestyles
|
| - Sleep more
|
| - Reduce stress
| hilux wrote:
| I don't have a silver bullet of health advice. Your list
| looks good.
|
| The only things I'd change (what works for ME) is to reduce
| fruit (sugar). But if I could eat fruit all the time, I
| would.
|
| And I eat as much fat as I want, definitely not just lean
| protein. Food should taste good!
|
| And I practice intermittent and (sometimes) extended fasting.
| Dr. Jason Fung is an excellent resource.
|
| You have to find what works for you. But for the majority who
| are overweight and obese while also on multiple meds and
| maybe also in pain and also self-medicated on booze and weed
| ... well, IMHO that's not really "working."
| xkbarkar wrote:
| Disclaimer I have never been obese or suffered obesity.
|
| If it was easy no one would be fat. The whole body acceptance
| movement is a sham and always will be. We dont find obesity
| attractive and we do not want to be obese. However for some
| reason 60% of us in the west are overweight. And it is
| extremely hard to lose the kilos. We are eating too much and we
| shame eachother for eating small portions or skipping meals.
|
| But put simply, we have normalized large portions and eating
| five times per day.
|
| And its super hard to cut the volume after a lifetime of large
| portions and eating ever two hours nonsense.
|
| I sympathise with obesity sufferers and hope that the outcome
| of all of this is to normalise smaller portions and fewer meals
| again.
| Cyclone_ wrote:
| Well the title is a little silly even if it's meant to be
| provocative. There's a limit to just how many people would
| benefit from the drug, since those who exercise frequently enough
| wouldn't have the need for it ever.
| dcchambers wrote:
| I hate that we are obsessed with treating the symptoms of our
| issues instead of the cause.
| bitcoin_anon wrote:
| If you treat the cause, the symptoms go away along with a
| possible stream of revenue for the "health" care industry.
| rootusrootus wrote:
| I feel the same way about heart disease and cancer.
|
| Actually, no I don't. God bless modern medicine.
| goshx wrote:
| My wife was interested in taking the Ozempic route, and I am not
| fond of drugs.
|
| We then started intermittent fasting together as a lifestyle, and
| it's been great. Losing weight while not restricting what we eat
| and feeling great as our body adapts and doesn't let us overeat.
| I just wonder about the long-term effects, but I'd rather take
| this risk than a drug like Ozempic.
| seanthemon wrote:
| We did this, this happened to us: after a while you or her may
| get extremely obsessed with food and eventually get to the
| point where you overeat as a form of 'freedom' until you just
| can't stop.
|
| IF works until it doesn't, then it REALLY doesn't work. My wife
| had a breakdown before we realized something was incredibly
| wrong. YMMV.
| goshx wrote:
| Thank you, I'll pay attention to that.
| rootusrootus wrote:
| I've never been more insufferable and hangry than when fasting.
| I'm glad it works for you.
| bitcoin_anon wrote:
| The American Academy of Pediatrics suggests starting children on
| weight loss medication as early as 12 years old:
|
| https://publications.aap.org/pediatrics/article/151/2/e20220...
|
| The farmers are subsidized to grow the corn. 10% of SNAP benefits
| are spent on sugary drinks. Yet we're expected to believe that
| these children were born w/ the chronic disease of obesity and
| they'll need to be on these drugs their whole lives.
| cdchn wrote:
| Obesity rate in the US has started to decline and it sounds like
| they're largely attributing it to ozempic et al.
| aayala wrote:
| just eat healthy and be active
| Animats wrote:
| Novo Nordisk just settled with Viatris, a company which was
| trying to have the Ozempic patent cancelled.[1] That would have
| killed their monopoly. "Terms of the settlement are
| confidential".
|
| They just did the same thing with Mylan.[2]
|
| And may have done something similar with Rio Pharmaceuticals.[3]
|
| The Federal Trade Commission is also fighting that.[4]
|
| [1] https://www.reuters.com/legal/litigation/novo-nordisk-
| settle...
|
| [2] https://iplaw.allard.ubc.ca/2024/10/08/settlement-of-
| patent-...
|
| [3]
| https://www.pacermonitor.com/public/case/52064967/NOVO_NORDI...
|
| [4] https://www.cnbc.com/2024/04/30/ftc-challenges-patents-
| held-...
| Retr0id wrote:
| As far as I can tell, the intended meaning of the question in the
| title is "how long until everyone who wants Ozempic can have
| it?".
|
| But at first I read it in a more cynical and sinister way, the
| more literal interpretation - how long until _everyone_ is on
| weight loss drugs?
|
| In a world where such medications are normalized, fast-
| food/processed-food companies might just work harder to make
| their products more addictive and pervasive, and then we're all
| back to square one.
| bobro wrote:
| Seems like all the incentives have been in place for us to have
| already maximized food addictiveness. We have to at least be
| pretty far up the S curve. I'd guess just the opposite
| actually, that companies will refocus on the healthfulness of
| their products now that customers aren't as susceptible to the
| addictive aspects.
| bowsamic wrote:
| I just calorie count. It's very easy and effective
| sethaurus wrote:
| Those of us who find calorie-counting easy and effective are
| the blessed few. Most people appear to find it even harder than
| other behavior-change approaches to weight management.
| nostromo wrote:
| For the longest time people argued if overweight people ate too
| much or not. I've heard plausible sounding arguments on both
| sides.
|
| It seems Ozempic has answered that question decisively, no? The
| solution to being overweight is eating less in almost all cases
| it seems. And feeling less hungry with Ozempic can help get you
| there.
| rootusrootus wrote:
| > For the longest time people argued if overweight people ate
| too much or not.
|
| Maybe uneducated people, but when was the last time anyone
| seriously doubted that excess calories make you fat? For
| serious people the discussion has always been about how to
| reduce the calories, because "just eat less" is provably
| ineffective. Simple minded people continuously suggest
| otherwise, but data really doesn't support their intuition at
| all.
| nostromo wrote:
| It's never been as black and white as you're saying.
|
| Lot's of medical practitioners will even advise you that it's
| the quality of food you eat, more so than the quantity. Look
| at all the published research around processed foods and
| ultra-processed foods.
|
| Other nutritionists will advise you that obesity is all about
| your macros. And that if you want to lose weight you need to
| increase fat and protein intake and limit carbs.
|
| Others have argued it's less about diet and more about
| exercise and having an active lifestyle.
|
| There's also a bunch of research showing that poor sleep
| might cause obesity.
|
| Ozempic seems to have thrown all that out the window and says
| that one just needs to eat less if one is overweight.
| rootusrootus wrote:
| All of those are permutations on the fundamental argument,
| not standalone arguments themselves. The idea with changing
| the quality of the food is that you'll eat less overall.
| Same with trying to adjust macros -- only unserious people
| suggest that calories are somehow different depending on
| source. The argument is that empty calories are less
| satisfying and will you to eat _more_ overall. It is all
| just different approaches to finding a strategy for eating
| fewer calories overall.
| tightbookkeeper wrote:
| > it's the quality of food you eat
|
| What metrics determine quality? How recently were those
| established?
| mft_ wrote:
| It has always been black and white that the number of
| calories consumed relates directly to weight gain or loss.
|
| Everything else is about tangentially-related issues.
| Eating 'better' food (and there are many definitions of
| 'better') may be healthier. Eating unprocessed food may be
| healthier, and/or digest more slowly, and/or reduce hunger.
| Eating different food groups in different balances (e.g.
| high protein, whatever) may affect how quickly you become
| hungry, or support certain exercise better. Low/no-
| carb/keto diets may help some people lose weight more
| quickly/easily, and probably results in a steadier blood
| sugar profile. Limiting eating to certain time windows
| and/or fasting may have some health benefits, and also
| contribute to weight loss. (And some types of regimen may
| suit some personalities better.) Eating certain types of
| food (fat, protein, low-GI carbs) which are also not
| processed may digest more slowly, resulting in a steadier
| blood sugar profile and less hunger. Etc.
|
| And despite all of this, it's also possible to lose weight
| by eating the worst food in the right quantities. See [0]
| or just Google the "Twinkie diet".
|
| [0] https://www.huffpost.com/entry/chewing-on-the-twinkie-
| di_b_7...
| Ferret7446 wrote:
| > when was the last time anyone seriously doubted that excess
| calories make you fat
|
| There's quite a few people here on this page.
|
| Although part of the problem is poor word choice. Eating less
| absolutely works. _Telling_ people to eat less absolutely
| doesn 't work, because people won't do it (if they did do it,
| then it absolutely would work).
| tananan wrote:
| I hope that these drugs pull people back from nasty habits such
| that they eventually build the strength to do without them. As of
| yet, I do not see why it has to be a win-lose situation one way
| or the other. Crutches aren't evil - they are expedient while
| they are expedient.
|
| Sometimes when you have a really strong habit, it becomes really
| hard to imagine yourself being otherwise. I welcome anything that
| helps people see beyond a prison they've put themselves in, as
| long as it doesn't put them in a worse prison.
|
| Does Ozempic or whatever put one in a worse prison? This seems
| personal, and not a categorical matter.
|
| Those who take it have a choice of how to develop their sense of
| identity in relationship to their treatment. It is here where the
| rubber hits the road - these abstract extremes of "you're
| suppressing your ability to grow" and "you're hopeless without
| it" are short-sighted and serve no good purpose.
| archsurface wrote:
| I don't share the American enthusiasm for pharmaceuticals.
| Exercise and healthy eating. I also don't have the other issues
| mentioned. Maybe the title is a bit clickbaity and I shouldn't be
| taking it so literally.
| 0xcde4c3db wrote:
| I think we desperately need to answer the question of _why_ GLP-1
| agonists are so effective, and particularly whether it 's
| counteracting something in the environment that has been acting
| to reduce GLP-1 (or other glucagon-related pathway) activity
| without us realizing it. The obesity data practically screams
| that _something_ happened in North America ca. 1980 that messed
| up our metabolisms, and it may have spread to Europe after a
| delay. Unfortunately, it seems like one of those things where
| there are various people with pet theories and little substantial
| effort to get to the ground truth. Perhaps the inevitable search
| for "me-too drugs" will uncover something.
| avelis wrote:
| One aspect is that the US food system as a crap ton of UPF.
| rootusrootus wrote:
| How does that cause the rest of the world to also have
| decades-long steadily increasing obesity rates?
| everfree wrote:
| UPF means "ultra-processed foods", in case anyone else had to
| look it up like I did.
| rootusrootus wrote:
| Europe has been climbing at a steady rate since at least 1975.
|
| https://www.europeandatajournalism.eu/cp_data_news/europe-fa...
| codersfocus wrote:
| Glyphosate was introduced around that timeline.
| asciimov wrote:
| Coke and Pepsi started using HFCS in 1980.
|
| I'd be curious about side effects of the Depression and WW2
| that took an extra generation to show up.
| 0xcde4c3db wrote:
| > I'd be curious about side effects of the Depression and WW2
| that took an extra generation to show up.
|
| While there might be a time span involved that could be
| described that way, as far as I've read there weren't any
| statistics that were "generational" in the usual sense of the
| term. Obesity rates started rising among all age groups at
| roughly the same time.
| doublerabbit wrote:
| Hormones in meat. And I expect the women's pregnancy pill
| plays a part in this as well to why we have over emotional
| disorders. This has all originated from the 70's both.
|
| The demand for cattle are so high that they force feed them
| growth hormones. You eat the meat, you end up with injected
| mutations and then over generations you then end up with
| people with growth hormones and obesity because of.
|
| How can hormone bated meat not affect the human body?
|
| As well, women have been taking a pill, since the 70's, it
| does its thing, they pee. That mixes with the water and
| overtime pollutes the generations.
| reducesuffering wrote:
| One very understated aspect that I haven't seen brought up:
|
| If part of the obesity epidemic is trying to consume food to make
| up for nutrient deficiencies, these drugs will only worsen these
| nutritional deficiencies. You'll lose weight short-term, but
| long-term sabotaged your body trying to attain these. We've seen
| declining vitamins and minerals in natural food (industrial
| produce growth). Maybe some people make it up with a heavy
| supplement regimen, but I wouldn't be surprised to see a lot of
| now-normal-weight people on Ozempic having major health problems
| due to increasingly deficient Vitamin A (already 51%), K (71%), E
| (94%), Magnesium (61%), Potassium (97%), Calcium (49%).
| rootusrootus wrote:
| > If part of the obesity epidemic is trying to consume food to
| make up for nutrient deficiencies
|
| Is there evidence to support this hypothesis?
| throwaway918299 wrote:
| My friend and my father in law both went on it. They both became
| suicidal and had to stop. YMMV but that's enough for me.
|
| Eat less. Move more.
| aucisson_masque wrote:
| So basically eat shit and then take drugs to lose the weight you
| accumulated because of your bad diet ??
|
| Am I the only one to realize how this is so wrong?
|
| You would think When a pipe leaks, you fix it. You're not going
| to put a basin under it, empty it every day, pay for a new basin
| every few week and continue to have your damn pipe leak.
|
| Oh man... If only you could teach people how to eat better
| instead.
| rootusrootus wrote:
| > Am I the only one
|
| No, definitely not. There's a few of you in this discussion.
| leoh wrote:
| You are wrong because being overweight means that your
| endocrine system is very messed up and can make it extremely
| difficult to make meaningful changes to your diet and habits.
| Take a look at the preponderance of folks who have taken GLP-1s
| here and have affected tremendously positive changes to their
| diet and exercise habits.
| aucisson_masque wrote:
| Being overweight doesn't prevent you from putting less junk
| food in your mouth, and instead eating vegetable.
| siliconc0w wrote:
| It's pretty crazy to me that that we aren't already all on
| Ozempic. The cost to the country for all chronic conditions
| obesity causes will bankrupt the country. Insurers should
| basically be forced to cover all the downstream costs their
| policies create or they'll continue to kick the can.
|
| Ideally we didn't addict our country to cheap junk food but that
| ship has sailed. If it were up to me I'd tax the shit out of any
| company selling a product with more than five grams of sugar and
| use that to buy the patent to tirzepatide and make generic
| medications available asap.
| artursapek wrote:
| I'm old enough to remember when "weight loss pills" was a cliche
| punch line. Thank God there's no way these miracle drugs will
| turn out to have some terrible long-term side effects!
| xunil2ycom wrote:
| Are we all diabetic? Because that's why I'm on it.
| Waterluvian wrote:
| I've lost 40lbs this year since I started trying. All I did was
| cut out breakfast and only ever eat if I feel hungry.
|
| Thr first few weeks were hard. My body was hungry all the time.
| Now I feel hungry far less. I don't get hungry until noon.
|
| The problem is that if I _ever_ cheat and pig out, like, say,
| this Thanksgiving weekend, it resets and I feel a week or two of
| miserable hunger again.
|
| If I could cheat my brain in any way, it would be just not
| feeling hungry until noon, regardless of past actions.
| snvzz wrote:
| >If I could cheat my brain in any way, it would be just not
| feeling hungry until noon, regardless of past actions.
|
| Not eating too close to going to sleep suffices. I'd set the
| minimum at a good 4h.
| ilikeitdark wrote:
| Drugs rule.
| tightbookkeeper wrote:
| HN must be aging.
| se4u wrote:
| The real fun will be when there is enough of this chemical in our
| waste runoff that cattle and wildlife gives up eating
| smugma wrote:
| Many in the thread have asked "why get off the drug?"
|
| Regeneron is pursuing its own version of a magic weight loss drug
| and is arguing that the current batch of GLP1 drugs reduce muscle
| mass, which is one of the most important things to maintain as
| one passes middle age (comorbidity etc.)
|
| https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2d...
|
| The co-founder of Regeneron has warned that blockbuster weight-
| loss drugs could cause "more harm than good" unless the rapid
| muscle loss associated with the treatments is solved...
|
| Clinical studies suggest that patients treated with the new class
| of weight- loss drugs, known as GLP-1s, lose muscle at far faster
| rates than people losing weight from diet or exercise, exposing
| them to health problems, said George Yancopoulos, who also serves
| as Regeneron's chief scientific officer.
| p1dda wrote:
| The number of 'smart' people in this thread advocating for the
| use of a drug instead of doing the obvious which is STOP EATING
| JUNK FOOD is staggering. Also the article is nothing more than a
| pharma ad. Idiotic and corrupt.
| gcanyon wrote:
| To anyone thinking that exercise will fix anything: I've owned a
| Concept 2 rowing machine since 2005. In that time I've done an
| average of 100 workouts per year, for a total of over 35 days of
| rowing. Some workouts were relatively easy 120bpm heart rate;
| some were at a relatively brutal 160bpm. Concept 2 estimates I've
| burned just over 600,000 calories, or about 1,000 Big Macs. Could
| I have eaten 1,000 Big Macs in 19 years? I think so.
| throwaway743950 wrote:
| "You can't outrun a bad diet."
| wiseowise wrote:
| > I've owned a Concept 2 rowing machine since 2005.
|
| Well here's your problem. You should've bought barbell 20 years
| ago. Or at least a couple of kettlebells.
| gcanyon wrote:
| I've had kettlebells, and I've lifted weights. But to be
| clear, I never said I have a "problem" -- I have a reasonable
| weight, and at times I've been in the top half of the
| worldwide rankings on Concept 2's site. I'm just saying that
| rowing isn't (solely, if we're going to be picky) the
| _reason_ I have a reasonable weight.
| tiffanyh wrote:
| WFH & being sedentary
|
| Since WFH, it's scary to me how sedentary I have become.
|
| It wouldn't surprise me if I now walk < 1,000 steps per day.
|
| I can easily go a couple of days and never even leave the house.
|
| My waistline shows it. And I'm actually eating less than I did
| when I went into office.
|
| I guess its basic thermodynamics.
| naming_the_user wrote:
| The headline here seems like an extremely baity one.
|
| A ton of people don't have this issue at all. I hesitate to say
| "most" because both in the US and UK it seems the majority do.
|
| But it still feels like a hack to me. The issue seems like it's
| that most people are now basically sedentary. So we can solve the
| excess hunger via drugs, but is that really what we should be
| doing?
|
| It feels to me that if we must have a wonder drug - it'd be one
| that gets people up and about and enjoying exercise. It seems
| really sad to me that so many feel that their physical form and
| embodiment is an annoyance rather than the gift it truly is.
| llamaLord wrote:
| I find it fascinating how many things like this just completely
| gloss over the fact that some people have side-effects to these
| drugs that make them completely non-useable, and often it's some
| of the people who could most benefit.
|
| I have ADHD, and have tried all the current generation of these
| drugs and absolutely CANNOT take them, they basically prevent my
| ADHD medication from working and I end up depressed and wanting
| to kill myself.
|
| This idea of these drugs being a "cure-all" that we'll all just
| be taking one day proactively scares the shit out of me, because
| I worry it will mean that medical science will stall (as far as
| it relates to these types of conditions) for those of us who
| simply can't take these drugs.
| cashsterling wrote:
| If you are on a weight loss drug like Ozempic, make sure you are
| doing resistance training. Ozempic reduces your appetite and help
| you go into a calorie deficit. Bone mass, muscle mass, ligament
| and tendon mass can all suffer on a calorie deficit unless your
| body is get regular stimulus that 'muscle, bone, and connective
| tissue strength are still important.'
|
| Also, changing your diet while on Ozempic to (1) cut down
| carbohydrate intake and (2) include more healthy protein (meat,
| eggs, fish, etc.), fats (nuts, olive oil, etc.) and fruits/veggie
| will supercharge your weight loss and your overall health gains.
| hnburnsy wrote:
| Ozempic is just scratching the surface, the pipeline is
| bursting...
|
| >...combinations of GLP-1 with other entero-pancreatic hormones
| with complementary actions and/or synergistic potential (such as
| glucose-dependent insulinotropic polypeptide (GIP), glucagon, and
| amylin) are under investigation to enhance the WL and
| cardiometabolic benefits of GLP-1 RA.
|
| I count 18 or so here...
|
| >https://www.nature.com/articles/s41366-024-01473-y
| jart wrote:
| Thanks for sharing that link. Retatrutide looks especially
| promising since it targets three different receptors (GLP-1,
| GIP, and glucagon) instead of just GLP-1 like Ozempic. This
| triple action appears to have a more comprehensive effect on
| metabolism. So it may increase energy expenditure in addition
| to reducing calorie intake. This drug also showed significant
| improvements in lipid profiles, blood pressure, and liver fat
| reduction. If all goes well we should expect to have it in 3-4
| years.
| at_a_remove wrote:
| I long for something that would help me. I have a rare metabolic
| disorder where the recommendation is _high_ carbohydrates, very
| high, and to never diet. Even a ten percent reduction in caloric
| intake can end in hospitalization, during which I am put on a
| frankly enormous amount of glucose or sucrose, among other
| things. The end result has been an insidious weight gain.
| Exercise? Well, aside from the fact that you can 't outrun your
| fork, it sets off the same metabolic pathways that caloric
| restriction does and I am back to square one.
| switch007 wrote:
| Stupid question but I wonder if the side-effects are a partial
| contributor to its success: feeling nauseous, upset stomachs,
| bloating, acid reflux etc? And are there similar, cheaper
| supplements/drugs that can induce nausea etc?
|
| I know my appetite falls off a cliff if I'm nauseous/have an
| upset stomach/suffering from reflux.
| hippich wrote:
| From my experience, it is probably contributing, but certainly
| not the major way glp-1 work. And I certainly had periods where
| I would overeat while already feeling bloated or nauseated.
| Glp-1 certainly does something to the body, that regulate
| eating on hormonal or neuronal level.
| ornornor wrote:
| FWIW, junk food makers are thinking up new ways to stay relevant
| and still sell a modified version of their junk foods adapted to
| people on GLP-1 medicine... Nestle, Mondelez, etc are all
| scrambling to do so. Here is an article (in French) on the
| matter: https://www.letemps.ch/economie/ozempic-wegovy-mounjaro-
| nest...
| martin82 wrote:
| Don't think the hype will last long at all, since this ridiculous
| drug has extremely bad side effects, and works by enriching the
| body with millions of small fat cells that are all ready to blow
| up the moment you stop taking the drug. Or in orher words, it's a
| trap. If you take it, you have to take it forever and suffer
| extreme side effects, if you stop taking it, you will turn into a
| fat pig, worse than before, and you gained nothing.
|
| It absolutely boggles my mind to always see Americans swallow
| everything and anything that big pharma serves them. It's insane
| behaviour.
| Rnonymous wrote:
| What side effects?
|
| Blowing up fat cells?
|
| I was "find this page" for side effects, but see little
| discussion about them. So am honestly intrigued, and would love
| to hear more.
| ropable wrote:
| Up until the point where our modern food environment changes
| radically - the more people who need it and can take it, the
| better.
| sirsinsalot wrote:
| Seems to me this drug is an antidote for an unregulated
| capitalist system creating an environment that preys on the human
| condition and as a result makes people unhealthy.
|
| It's just now selling you the antidote to the problems it made.
| Profit.
| grimblee wrote:
| The absurdity of creating a drug to curb obesity instead of
| forcing industrials to make food healthier. The ravage of
| corruption, sorry lobbying, still killing us all for greed.
| bravetraveler wrote:
| Eternity, unless it's pumped into the water supply
| wwarner wrote:
| Love this forecasting methodology
| fredgrott wrote:
| Okay, how I found out about berberine being over the
| counter...this medical article and study
|
| https://pubmed.ncbi.nlm.nih.gov/34981502/
|
| Imagine only spending $11 with no side effects to spending $300
| and up with major side effects.....
| hippich wrote:
| One trend I noticed, whenever this topic is discussed in public
| forums, it attracts a lot of negativity from "just exercise and
| eat less" crowd (generalizing here). I wonder why it caused so
| much negative reaction? On the surface it shouldn't matter much,
| since it does not appear to harm ones who found a way to maintain
| healthy body without drugs. Yet it reliably causes a quite
| noticable number of folks to be quite aggressive towards either
| people using these drugs or companies making these. (Similar
| trend can be seen in other drugs like THC for example)?
| GaryNumanVevo wrote:
| Personally, I'd never take Ozempic. I agree it definitely makes
| the 'eat less' goal achievable almost automatically for most
| people. But I think there's a real downside which is that any
| rapid weight loss will take muscle and bone density with it.
| Typically when you're using exercise to lose weight, you'll
| naturally end up building some muscle mass back. I think the
| side effects for people who take the drug and stay sedentary is
| going to be disastrous.
| sp527 wrote:
| > I wonder why it caused so much negative reaction? On the
| surface it shouldn't matter much, since it does not appear to
| harm ones who found a way to maintain healthy body without
| drugs. Yet it reliably causes a quite noticable number of folks
| to be quite aggressive towards either people using these drugs
| or companies making these.
|
| It's a combination of people thinking it violates the 'no free
| lunch' axiom of the universe and also deriving significant
| personal status and satisfaction from exerting discipline in
| eating and exercising religiously.
|
| The 'no free lunch' axiom is a curious thing and seems
| derivative of western Puritanism and similar philosophies. It
| violates many people's intuitions that very good things might
| be obtained with relative ease, and also devalues said things.
| Some of these are the same people who cannot comprehend (or
| even accept) a post-singularity world without work. The
| peculiar morality that produces that belief overlaps rather
| substantially with the one that rejects the possibility of an
| easy solution to the problem of obesity.
|
| Further, some of these people have the (perhaps unconscious)
| belief that they are morally superior to others who are less
| dedicated to health and fitness, and in particular to the
| obese.
|
| If obesity can be resolved so fluidly and categorically, then
| at least two painful things happen for them: (1) their
| excessive effort towards weight control seems foolish and
| inefficient (i.e. devalued, as noted above) and (2) they lose a
| great deal of personal status. The latter is a consequence of
| the reasonably established notion that a significant proportion
| of many peoples' happiness is contingent on their relative
| frames of reference (i.e. not their position in an absolute
| sense). Again, this is often unconscious. These are not "bad"
| people, but rather merely victims of human instinct.
| cdrini wrote:
| Obesity rates are on the rise in all modern countries, and
| although the rate of growth is different, in no country does it
| show any signs of slowing down.
|
| https://ourworldindata.org/grapher/share-of-adults-defined-a...
|
| Are these drugs good? I'm not sure, but I think a lot of these
| drugs seem to be reducing how much people eat -- helping people
| break from the life time of bad habits they've learned since
| childhood from their parents/friend/media/fast food industry. I
| don't know if eating habits in childhood can embed themselves as
| permanent alterations to the person's biology, like myopia in eye
| sight. But if it does, then these drugs might be the "glasses"
| equivalent for metabolism/eating. Citation needed. But if so,
| then let's see if we can learn from our mistake with how glasses
| are perscribed, and instead of leaving children in the same
| environment that results in the development of the same diagnosis
| which will then require them to also take ozempic/use
| glasses/etc, and instead raise them so that they never develop
| the problem in the first place.
|
| Note: even the myopia link is still being researched I believe,
| but more papers seem to be showing this potential relationship.
|
| Variables:
|
| - unhappiness increasing (citation needed)
|
| - low income people buy cheap, processed food
|
| - middle class people eat out at restaurants more since they can
| afford it
|
| - upper class people likely the healthiest?
|
| - unhealthy processed foods have become regular standard snacks
| (eg chips, cola) taking the place of healthy snacks like
| fruits/veg
|
| - portion size increases in the home and at restaurants
|
| - the fast food industries incentive to get people to eat more
|
| - people developing bad eating habits at young ages, which are
| significantly harder to break later in life and could potentially
| result in permanent changes to metabolism (similar to how myopia
| has been linked to children spending a lot of time
| inside/books/screens)
|
| - low availability of healthy fresh food -- when was the last
| time you got fruit as a snack in the middle of the day? Or for
| dessert?
|
| - reduced mobility; sitting jobs, order to your door, work from
| home
| cdrini wrote:
| Some chat GPT research on some of the citation needed claims.
| There are some potential biological pathways, but more research
| needed to verify if/how these are actually applicable:
| https://chatgpt.com/share/670a798d-6abc-8012-bbf8-3b55a09f0b...
| LinuxBender wrote:
| _How long til we 're all on Ozempic?_
|
| Just my own preference but I stopped doing tinker drugs some time
| ago and focus on things that make semi-permanent changes even if
| they are much smaller incremental changes. I call any drug that
| tinkers with feedback loops a tinker drug. An example for me
| personal was hypertension. I focused on finding the root cause
| which took a long time but now if I can't get a hold of the
| things I used to make changes I don't have to worry about a hard
| rebound swing back to and beyond where I was, something that BP
| drugs did when I could not get a hold of the drugs because of
| doctors screwing with me.
|
| For weight I went with Berberine, prolonged fasting and paleo.
| It's slow but steady and for me personally slow and steady has
| been winning the race without side effects. That's just my
| methodological preference and not meant to be any form or fashion
| of advice for anyone else. I support people doing whatever they
| find works for them. This was just my long way of answering the
| question.
| indigo0086 wrote:
| Not a surprised that in the land of the obese (mostly by choice),
| weight loss poison is deemed a miracle drug
___________________________________________________________________
(page generated 2024-10-12 23:02 UTC)