Diets also don't stick when you discontinue them.

It would be an incredible advancement if we figured out a reliable and replicatable way to just eat less food, but until then I think a drug that makes you do that is pretty decent.

> Diets also don’t stick when you discontinue them.

Yes, obviously. Which is why sustainable weight loss takes a commitment to making a change in lifestyle.

What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

The drug is more likely to work long-term. Diet & exercise, as a treatment plan, are distressingly ineffective.

Well-studied problem.

It makes more sense when you realize that something like sheer dieting/exercising willpower isn't why some populations are skinnier than others. Pick another country with a healthier-weight population, start placing some of them in the US, and they'll gain weight. Put them back, and it'll drop again.

If "just diet and exercise" (the advice, and individual effort to that effect) aren't what are keeping some populations skinnier, why would it cure a population with an obesity epidemic?

So clearly it’s something to do with the difference in their lives in the USA, but your first response is to treat the symptom with drugs rather than look at their life holistically?

Just off the top of my head the food (portions, quality, etc) in the USA combined with how much people no longer can walk vs being required to drive are a huge contributor to weight gain of immigrants to the USA.

Sure, much easier to make a decision for yourself that helps you cope with the USA lifestyle than it is to change the USA on a short time scale.

There are of course other decisions that might help cope, like moving to one of the few walkable cities we have or structuring your life to reduce the lifestyle, but those all have a lot of other effects like completely upending your current life.

A person can take a shot every week.

What’s a person supposed to do about a problem that’s probably tangled up in several major areas and would require large reforms across the economy? We can’t even get mandatory minimum paid leave or healthcare for everyone (both of which might well be components of fixing it “right” anyway!)

This is likely a problem that spans our food culture, business culture, economic structure, built geography, and social benefits system, among other things.

You can spend a lifetime fighting those and be fat the whole time because despite massive effort and objectively incredible achievements you and your movement only got us 5% (that’s a lot!) down the road towards fixing these things, in fifty years.

Or you can take a weekly shot and be well on your way in a month.

Working on the “real” fix is definitely something we should do (it’s not like the causes of this aren’t causing other things to suck, too) but even people doing that would probably like something available that they, not just their great-grandchildren, can have.

At a large enough scale, being beholden to a drug is far more sustainable.

We’ve tried shaming people into being healthy. Amazingly enough, it doesn’t work very well.

You claim shame was tried and was unsuccessful thus we should drug people. But what about the opposite of shame? Education, encouragement, non-judgementalism, and providing all other support required.

We've been doing that for a while too - it was Michelle Obama's whole thing, for example?

It could definitely use more support, but it doesn't do a ton if the structure of people's lives is being changed by other factors. (Car based commutes, long work hours, lack of exercise at their job, the cheapness of certain kinds of foods, food advertising.)

If we had a lot more political power to work on public health programs, maybe. But obesity rates are rising throughout the developed world regardless of local culture so there is a ton of work needed there.

Feel free to cite any intervention that is proven to be longitudinally successful over a long time frame.

From the last time I looked at studies on basically any diet, I think prescribing people drugs for life probably lasts longer. Do you have any longitudinal studies of people making lifestyle changes for 10+ years to keep off weight?

> What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

That's some pretty... charged language. But even so: the drug, clearly. People take drugs reliably as a matter of empirical fact. People likewise emphatically don't "change their lifestyles" as a general rule. If they did we wouldn't be talking about this new drug, would we?

It’s reality.

People take drugs if they can afford them; will GLP-1’s be available dirt-cheap to the masses or limited to those fortunate enough to have health insurance.

They're incredibly cheap to manufacture. Everyone and their dog will be able to afford an infinite supply the second the patents expire, and black market supply is already cheap even with the extra overhead of it being illegal and impossible to market properly.

Yes, of course they will. Is this a serious question? It will take at most twenty years due to patent expiration.

Why can't the commitment to a lifestyle change just be a commitment to take a daily or weekly drug?

Is the drug at risk of being discontinued? If so, then can that risk be quantified in any way?

(For comparison: Countless scores of diets are discontinued daily.)

If the person can’t afford the drug then it’s at risk of being discontinued.

That's certainly a risk for a subset of people with limited incomes.

Meanwhile: Diets have been discontinued by people of all income levels for as long as we've had diets to discontinue. Some people succeed with their diets, and some don't.

AIDS drugs also don't stick. So?

So what the fuck is your point?

I don't even know I read this board and all the fucking dumb opinions.

Feel free to fuck off then

Yes and when I stop holding something, it falls to the earth.