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Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

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Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#161

Post by rich-cartwright »

dave333 wrote: post #136

How long before there's a generic version of these drugs, Semaglutide and Liraglutide? I assume Medicare doesn't cover these yet.

These are relatively new medications, so I think roughly a decade for Liraglutide and more for Semaglutide but I'd have to check. Medicare doesn't cover them yet sadly.

There is another promising obesity medication in Phase 3 trials at the moment so it's fair to expect increased competition & decreased prices in the coming years - although it's obviously hard to predict.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#162

Post by rich-cartwright »

Smaug123 wrote: post #128
peteretep wrote: post #79

I had been very, very excited to start semaglutide, but about eight weeks ago I picked up a CBT-based eating book called The Beck Diet Solution and I’ve so far found it very very effective

Not to suggest anything about your personal experience, but note that in general pretty much anyone can follow pretty much any diet for two months and lose weight if they try. The seriously hard bit - and the way you know you've found the right diet for you - is if you can follow it for the third month (and then all the months thereafter). Two months is roughly the upper limit for the "any diet will work for anyone"…

Well said. My take from research: structures from a CBT-based approach are really helpful and should be more widespread - but for most people are not sufficient in staying at a healthier weight long-term.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#163

Post by andi999 »

rich-cartwright wrote: post #116
zinclozenge wrote: post #43

Earlier quoted context omitted.

Unfortunately there are people like me who don't only feel a bit hungry, when I eat at a deficit there are times where I get so hungry my thoughts are completely consumed by the hunger. The only way for me to successfully lose weight was to have days where I simply eat nothing at all. Sounds counter-intuitive but after getting over the initial extreme hunger I found that the hunger sensations would diminish into a ba…

The complete fasting approach is pretty common among Fellas I've spoken with. Lot of the guys have powerful "all-or-nothing" traits, where it feels easier to have a strict intense rule than a more nuanced approach. The issue comes when you therefore become so hungry your body drives you to eat a lot of food all at once. But I'm interested that you notice your hunger sensations actually diminish over time.

Isn't it actually well known that you are not hungry when fasting (after a couple of days)?

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#164

Post by jimmaswell »

bserge wrote: post #142
jimmaswell wrote: post #37

Earlier quoted context omitted.

> basically the body fights hard against you as you try to lose weight by dieting. I used to weigh 310lbs, now I'm 215lbs. All I did was count calories to maintain a deficit and the results were essentially the same as predicted by the math. I was a bit hungry sometimes at first as I adjusted to it but that's really it. Prioritizing protein and fat over carbs helps with that. What ways does the body tend to fight aga…

Extreme hunger, like others said. I'd class it as a subset of impulsive behavior, which is basically your primitive brain doing it's caveman shit and not listening to you , the conscious mind. Apparently some people don't have this problem, which makes me incredibly envious (or would if I could feel anything). It's this nagging thought of "JESUS CHRIST YOU'RE GONNA DIE IF YOU DON'T EAT A LOT RIGHT NOW!" I've experien…

I used to have that problem with sleeping and hunger. For me it just went away eventually.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#165

Post by rich-cartwright »

luckylion wrote: post #133
throwawayboise wrote: post #53

Earlier quoted context omitted.

GPs approach will work for almost all people, if they actually do it.

I've lost plenty of weight with intermittent fasting. It totally works. My sleep schedule went crazy, no matter what I did. My ability to focus was completely lost, as if I was constantly overdosing on coffee. Yes, it works, and maybe it works easy & side-effect free for some, but tbh I'd rather be overweight and die 10 years earlier, than live like that.

Important to hear this.

An important takeaway from all this is that people react very differently to similar regimes, and projecting our own (successful) experience of a regime onto someone else is likely to not represent their experience.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#166

Post by issa »

I am curious if this question has come up in company marketing discussions. One of the most common and off-putting things about the weight-loss industry is the vague medicine promise. Have you considered just saying "semaglutide" instead of "a breakthrough medication"? I honestly almost stopped reading because it comes off as so huckster-ish to me.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#167

Post by rich-cartwright »

stef25 wrote: post #110
TeeMassive wrote: post #28

Earlier quoted context omitted.

>WE DO NOT NEED PILLS! >Yes, I am yelling. If pills work then what's the problem? It seems to me that you're making an appeal to nature ( https://yourlogicalfallacyis.com/appeal-to-nature ). Given all the health problems associated with obesity from cancer to cardiovascular problems then whatever side effects the pills have are probably negligible in comparison. > Weight management isn't at all about eating less. It'…

Assuming obesity is largely due to mental issues like stress eating, the solution should also be a mental one. It's basically an addition. Most people are perfectly capable of quitting but don't because it's easier not to. This includes myself. I recently put on a bit of weight and I know exactly why: second servings, having a few beers, difficulties sticking to a diet with kids and dietary allergies in the house, no…

Thanks for sharing man.

Important to emphasize there is a large variety of causes: stress eating is certainly a big part for a lot of people, but it's far from universal & far from the whole story.

"Something that can be fixed by just putting your mind to it shouldn't have to be treated with pills" is I think an interesting statement. I'm unconvinced "putting your mind to it" is as simple as it's made out to be.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#168

Post by rossjudson »

rich-cartwright wrote: post #159
gnicholas wrote: post #132

Earlier quoted context omitted.

Thanks for your candor. It would be interesting to see what positive effects can be achieved for what types of patients at various different dosing levels. I'm not at a weight where I'd want to add additional cancer risk in order to lose weight, and unfortunately the data on this sort of incremental risk probably takes decades to be fully realized. Perhaps I'd feel comfortable taking a smaller dose if there were a sh…

Agree it's early days in terms of longitudinal follow-up studies. We're looking forward to playing a part in those studies ourselves.

As mid-fifties person, I have a shorter "long term" than many readers on this site. :) For me, there are the very real and immediate risks of being overweight, versus a potential for longer term risks from the medication.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#169

Post by rich-cartwright »

robomartin wrote: post #146

I don't know how young you are. Great story, but, sorry, no. Every single weight loss program claims exactly what you claim. And they all deliver pretty much exactly the same results. My guess is that about 10 to 20 percent of weight loss program participants achieve sustainable life-long objectives, keep the weight off and change their lifestyle. The rest are in a range between utter failure and yo-yo diet programs…

You clearly care a lot. I respect that.

My prompt for you: do you care about the people suffering, or do you care more about moral posturing & fist shaking?

If you care about the people suffering, drop me an email on richie@joinfella.com and I will help you however I can to empower you to tackle whatever you see as the root cause.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#170

Post by rich-cartwright »

robomartin wrote: post #144
dang wrote: post #65

Earlier quoted context omitted.

Of course obesity is an emotional topic but attacking someone personally about it is way, way beyond the pale. Breaking the HN guidelines will get you banned here, regardless of how right you are, or feel you are, about obesity and other topics. No more of this, please. https://news.ycombinator.com/newsguidelines.html

[flagged]

You clearly care a lot. I respect that.

My prompt for you: do you care about the people suffering, or do you care more about moral posturing & fist shaking?

If you care about the people suffering, drop me an email on richie@joinfella.com and I will help you however I can to empower you to tackle whatever you see as the root cause.

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