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At a risk of being ignorant: Isn’t obesity a function of calories intake and calories burn rate? If so, why do we even need a drug for that? What should a possible drug target here? Assuming no changes in behaviour and thus a continued steady daily caloric surplus, would it even work?
I'm on semaglutide. Was on Saxenda, because I couldn't get access to Wegovy at the lowest dosage. But now I'm on Wegovy, for half a week so far. I was retching horribly one night at 2 am, but didn't throw up. I've felt clammy and dizzy a few times. (Possibly hypoglycemic?) I honestly feel like it's changing how I feel about food. I don't want to eat empty carbs, anywhere near as much. Because I feel like they make me…
> I don't want to eat empty carbs, anywhere near as much. Because I feel like they make me feel sick. I did a keto diet obsessively for a while and I still have a psychological revulsion to drinking coke or eating cake even a year later. Those sorts of things are long term wins.
I'm happy for you, but I didn't get that benefit you got.
At a risk of being ignorant: Isn’t obesity a function of calories intake and calories burn rate? If so, why do we even need a drug for that? What should a possible drug target here? Assuming no changes in behaviour and thus a continued steady daily caloric surplus, would it even work?
It's like treating an addiction by telling the addict "it's ok to have some, just pinkie swear you won't overdo it." People who are obese or grossly obese often aren't just eating a "little extra" here and there. Imagine more like "extra pizza a day" or "eat a cake once a week because that seems like a good idea".
That is why weight loss is hard to achieve. If you are hungry, it's hard to--over an entire day--avoid eating 300 extra calories.
> After decades of work, researchers are finally seeing signs of success: a new generation of anti-obesity medications that drastically diminish weight without the serious side effects that have plagued previous efforts. … > Nutter is concerned that people might start these treatments — whose side effects, such as nausea and vomiting, can be severe — to escape weight stigma, rather than to serve a true health need So…
The side-effects of this particular treatment "can be severe", but that doesn't imply anything about the side-effects of any other treatment (combination of medication, dose, RoA, and interval) for drugs in this class. Heck, they could probably fix the nausea/vomiting just by making a pill that contains an adjunct anti-emetic like ondansetron, like they do for cancer drugs.
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Because this isn't an article about biology, it's about health, and health isn't unidimensional
Helping obese people lose weight is unidimensionally a good thing
I’m currently taking one of these drugs and it has been no less than a miracle in my life. I became obese when I was around 5, topping out around a 34 BMI. When I was 20 I lost a substantial amount of weight the old fashioned way (diet and exercise), and within 8 months I was BMI 23. Losing weight was extremely challenging and socially isolating. 7 years later, I had a bad ankle injury and regained weight to about 29…
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Because many people just aren't able to get that ratio to a point that they're at a healthy weight (for numerous reasons - behavioral, medical, etc.). "Assuming no changes in behavior" doesn't make sense, because the drug makes people feel full after a smaller amount of calories and thus changes behavior.
Don’t you ever eat sweets despite of not being hungry? I don’t think the issue is people overdosing rice or legumes because they are so hungry. The issue seems to me like quick comfort foods that we eat not to get full but because they just feel so good in our mouths. I don’t think I’ve ever eaten ice cream out of hunger:)
Anyway, semantics of hunger/fullness aside, the effect of the drug is behavioral - people taking it do end up eating significantly less, which leads to substantial weight loss.
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What's the drug?
Trizepatide, brand name is mounjaro. It’s a similar drug to semaglutide.
Tirzepatide (Mounjaro) is Lilly's next generation therapy, targeting both GLP-1 and GIP
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Helping obese people lose weight is unidimensionally a good thing
The point of the quoted sentence from the psychologist was that people who aren't obese, but who are "large" ("Big and Tall", in the clothing phrasing) and who have body-dysmorphic disorder, might pursue this drug, and, due to being "large", get it prescribed — and that that's a bad thing, because they'd end up with an unhealthily-low BMI.
What's the difference, just the degree of being overweight? And the height of course, but drugs won't make anyone shorter.
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Yeah, there are a lot of published studies showing this is very impactful. Within certain thresholds, losing weight has been shown to be the biggest change to all cause mortality rates. If you are obese, the most impactful thing on health is losing weight. This obviously isn't true for people with very low BMIs, but there have been a lot of population level studies looking at all cause mortality.
What are the certain thresholds? Can we be more specific than lowered all-cause mortality, such as specific diseases we know have causal relationships with obesity specifically? I'm asking because I'm not that educated, but if you know there are studies showing e.g. purely losing weight with no lifestyle changes means less heart attacks, less joint replacements, less cancer, etc. please share.
https://pubmed.ncbi.nlm.nih.gov/12457296/
https://academic.oup.com/ajcn/article/74/5/579/4737391
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)...
https://www.bmj.com/content/359/bmj.j4849
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...