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.
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.
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.
Social media
Drugs and alcohol
Food
Or literally any other addiction. I don't think this is a useless thing to discuss.
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
> 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.
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.
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.
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.
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 :-)
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...
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)
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
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.
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.
This drug can help break out of that spiral and fix the craving/willpower problems.
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.
Disciplined control of one's willpower is a required dependency of adulthood.
A society that provides drugs to mask the widespread failure of nominal adults to control their urges is a society in rapid decline.
Despite this assistance (or lack of headwind) they seem to do ok.
But sure, it's a US problem.
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.
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?
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)
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.
I agree that at the population level, this will be a game changer. As you say, the average person struggles with lifestyle adjustments.
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)
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?”
Why do you think that telling people to “just stop being fat” will suddenly start working?
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.
We’re not talking about world class athlete. There a mile difference between world class athletes and not obese.
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.
I've met plenty of skinny fat people who think they're healthy.