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‘Breakthrough’ obesity drugs that have stunned researchers

nature.com

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Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#71
post #20

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?

> Assuming no changes in behaviour

It's the other way round: the point of the drug is to change behavior. By changing the hunger response.

The hunger response is not quite as low-level as, say, the breathing response, but you'll notice that it's very difficult to choose to stop or reduce your breathing below a level that your body will accept, and after a very short while your conscious will will simply be overridden.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#72
Just making sure everybody understands that these drugs are not a solution to the problem. Assuming they work, they just make dieting easy.

Look at people who successfully lost weight with diet -- studies show that almost all of them will regain most of their weight within 5 years. And the basic reason is because almost all dieting regimes are shitty, unsustainable way to live and at the end people are left tired of the diet and looking to get back to the eating habits they love and caused the problem in the first place.

Also calorie restriction comes with a host of other problems. You need to provide better nutrition while on a diet -- your body still needs same things but now there is less food with which it has to be delivered. But if you got obese you probably don't know how to eat properly.

Prolonged calorie restriction causes muscle wasting. You can counteract it to a certain degree for some time with exercise. Which if you are obese you probably don't know how to.

Calorie restriction also typically causes basal metabolic rate drop. Which means you have to keep tightening the diet to see results. And when you are off the diet it will be extremely difficult to impossible to keep your weight.

You can still cause a lot of damage to your body by snacking and eating wrong foods even if you are on calorie restricted diet. It is better to learn to not snack and keep your eating window to 4-6 hours every day rather than eat through entire day.

I personally dislike meds like this. It is good it exists but I would never take them or recommend to anybody. There are a lot of medications that are supposed to help (like metformin) but all these meds do not address the main cause of the problem -- which is what you eat, how you eat and when you eat it.

--

For background, I got obese once and lost weight. Then regained the weight over a decade. Being engineer and problem solver, I vowed to understand the shit out of the problem, loose the weight properly and never regain it back. Which seems to be working. Understanding how to loose weight allowed me to do fantastic things like loose weight at 3 times the rate I did it previously while not feeling hungry or cold.

The previous time I was on calorie restricted diet loosing and I was completely miserable for almost entire year, cold, slow, irritated, unable to focus.

This time I completed the same weight loss in 4 months while actually feeling better than ever (at least most of the time). Most important for me, it is not interfering with my work.

I am also not taking any meds.

I am not preaching any diets here. I am just suggesting that if you are feeling hungry throughout your diet you are probably doing something wrong and it would be worth the while to understand what and how to fix it. And the only way this happens is if you get interested. No drug is going to magically fix it for you.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#73

This drug is a net good for society, but we have to fix the root problem. Much of the food we eat is filled with addictive ingredients (sugar, excess fats/oils, etc) that provide little nutritional value but are highly addictive. We’re subsidizing companies that create unhealthy addictive food and subsidizing companies to create drugs to counter the unhealthy addictive food. This is an enormous waste of resources.

While we are drowning in quick to consume, non-nutritious, calories, we also have higher levels of anxiety, stress and more distractions.

To your comment, maybe more countries should attempt to implement programs similar to the UK's success in lowering sodium intake by slowly adjusting the sodium content of all manufacturered foods. https://www.nature.com/articles/jhh2013105

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#74

Earlier quoted context omitted.

Helping obese people lose weight is unidimensionally a good thing

Let’s give them all meth. That should help with weight loss.

I know that you are trying to make a point, but I think meth would be a viable treatment option for some people. Medically supervised and monitored. If you need to lose 100 lbs, it might be worth the other tradeoffs. For a short period of time.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#75

Earlier quoted context omitted.

Helping obese people lose weight is unidimensionally a good thing

That'd imply it's okay to put obese folks in cages without food until they've lost weight and I'd suggest that that's fucking insane. We've discovered another dimension!

There are no fat POW's.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#76
post #45

Earlier quoted context omitted.

> Isn’t obesity a function of calories intake and calories burn rate? In the same way that the economy is a function of people trading things, sure. Why do we even need economic policy?

Indeed, we need an economic policy, not an economic drug. I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc.

There is some evidence to show that obesity has been rising independently of behavioral changes (even though they do contribute), due to deterioration in the food quality. Look at obesity rates amongst animals for example, especially wild animals that feed off of human food.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#77

Just making sure everybody understands that these drugs are not a solution to the problem. Assuming they work, they just make dieting easy. Look at people who successfully lost weight with diet -- studies show that almost all of them will regain most of their weight within 5 years. And the basic reason is because almost all dieting regimes are shitty, unsustainable way to live and at the end people are left tired of…

I think this is too dismissive, and internally inconsistent.

These drugs are not the solution for all people, but they may well be a part of it for many. The interventions you're advising - "don't snack", "exercise more", have the same pattern you're talking about with dieting - alone, they tend to fail in the long-term.

It's easier to learn to eat better (and enjoy things like veggies) if you're not feeling starving all the time. It's easier to learn to exercise (and enjoy it) if you're not obese.

> all these meds do not address the main cause of the problem -- which is what you eat, how you eat and when you eat it

"Just don't do that" hasn't historically had a great track record of addressing it, either.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#78
post #45

Earlier quoted context omitted.

Indeed, we need an economic policy, not an economic drug. I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc.

> I’m totally for behavioural policies for obesity, such as don’t buy sweets, go for a walk each day, or make sure to eat vegetables each time you are hungry, etc. So are physicians, and most patients. It's just a lot harder than it sounds to sustain. There's the old adage that "the definition of insanity is trying the same thing over and over expecting different results"; attempting to cure obesity by telling patien…

This is too absolutist. People aren't immutable, unable to control themselves at all without drugs. Anyone who gives up smoking without a patch has to decide to never pick up a cigarette again. They may have "given up" a few times before, and the last time they succeeded. By your logic they shouldn't have tried more than once.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#80

I think it's awesome that there's a new use for these drugs. However, obesity kills slowly, when it kills. Diabetes and Chronic Kidney Disease kill more quickly if not under control. These drugs keep diabetes under control..and diabetics like my wife are unable to get their meds because people are buying these off the shelf to lose weight. I don't pretend to know the solution, but I do think drug availability should…

I note the reverse applies: my dad was prescribed Metformin for diabetes, and began to lose weight at a significant rate to the point where it became unhealthy.

> the weight loss brand of the same drug is being marketed for 2x-5x the cost of the diabetic brand, or so I've been told

Drug pricing is a hell of a drug.

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