Petro Dobromylskyj is one of the foremost experts of fat metabolism. He has a blog called Hyperlipid where he's been blogging about fat metabolism and interpreting research for close to 10 years. He thinks the GLP-1 inhibitor drugs will be a disaster in the long term because they 1) cause weight loss but also 2) cause the body to create lots of new adipocyte (fat cells). Increasing the number of adipocytes is very un…
I wonder how breaking old habits and establishing new habits over a year or so would stop a serious rebound?
‘Breakthrough’ obesity drugs that have stunned researchers
351–360 of 1001 posts
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#352At 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?
Modern nutrition science has found that each person, at any given time, has a "metabolic setpoint". This is basically a target weight that their endocrine system is trying to keep them at. There's a feedback loop, where below this weight hunger hormones will nudge them to eat more and metabolic hormones will lower caloric expenditure (lowering body temperature, sleeping longer, fidgeting more). And vice versa above t…
Citation? This goes against everything I've heard from credentialed experts and against my own experience as well. For one thing, it's unclear how you'd explain the weight gain of the median person in the western world over the last 30 years. For another, it's very strange that people like me (previously) gained 5-10 pounds a year, if our bodies were supposedly trying to keep us at a particular set point.
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#353Earlier quoted context omitted.
> these drugs are like a supercharged metformin No drinking alcohol, like metformin? If so, I suspect you could get a large fraction of the improvement gained from a population-wide deployment of these drugs, at zero cost , if everyone just stopped drinking alcohol. "But that's unreasonable!" Right, so if that's also required for taking this drug, then....
> No drinking alcohol, like metformin? I take Metformin (not for diabetes, but weight and age) and my doc has never said a word about alcohol. A quick google suggests the possible bad interactions are diabetes related, so probably not applicable.
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#354Petro Dobromylskyj is one of the foremost experts of fat metabolism. He has a blog called Hyperlipid where he's been blogging about fat metabolism and interpreting research for close to 10 years. He thinks the GLP-1 inhibitor drugs will be a disaster in the long term because they 1) cause weight loss but also 2) cause the body to create lots of new adipocyte (fat cells). Increasing the number of adipocytes is very un…
The only thing I see from him on google scholar is about mechanical ventilation for small animals. What's his background?
>I am Petro Dobromylskyj, always known as Peter. I'm a vet, trained at the RVC, London University. I was fortunate enough to intercalate a BSc degree in physiology in to my veterinary degree. I was even more fortunate to study under Patrick Wall at UCH, who set me on course to become a veterinary anaesthetist, mostly working on acute pain control. That led to the Certificate then Diploma in Veterinary Anaesthesia and enough publications to allow me to enter the European College of Veterinary Anaesthesia and Analgesia as a de facto founding member. Anaesthesia teaches you a lot. Basic science is combined with the occasional need to act rapidly. Wrong decisions can reward you with catastrophe in seconds. Thinking is mandatory. I stumbled on to nutrition completely by accident. Once you have been taught to think, it's hard to stop. I think about lots of things. These are some of them.
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#355Petro Dobromylskyj is one of the foremost experts of fat metabolism. He has a blog called Hyperlipid where he's been blogging about fat metabolism and interpreting research for close to 10 years. He thinks the GLP-1 inhibitor drugs will be a disaster in the long term because they 1) cause weight loss but also 2) cause the body to create lots of new adipocyte (fat cells). Increasing the number of adipocytes is very un…
The only thing I see from him on google scholar is about mechanical ventilation for small animals. What's his background?
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#356> In the past, scientists and the public often thought that those with obesity simply lacked the willpower to lose weight. But evidence is growing that most people’s bodies have a natural size that can be hard to change. In the context where we have gone from obesity rates of 13 percent to 40, to suggest that people have a natural weight and that's the cause of this seems absurd to me.
The evidence is a little slim (no pun), but there's one theory which I find quite compelling. The theory is that eating foods with high flavor-calorie association increases your set point, and eating foods with low flavor-calorie association decreases your set point.
Flavor-calorie association is when your body knows that a particular flavor results in getting lots of calories in the near future. The flavor-calorie association will be higher for foods that are more flavorful or more calorically dense, and flavor-calorie associations can only be developed for foods you eat regularly. This explains why I lose a bit of weight whenever I go somewhere new – I'm trying new foods, so what I'm eating has doesn't have any flavor-calorie association, so my body's set point goes down, so I get full more quickly, causing me to eat fewer calories overall, causing me to lose weight. And since foods have gotten much more flavorful and calorically dense in the past half-century, it would explain why people's set points have gone up.
There's a simple way to test this theory at home. Extra-light olive oil (not extra-virgin) is tasteless and textureless. So, find a 2-hour window of your day when you don't taste anything with flavor, and have two tablespoons of extra-light olive oil right in the middle of that window. Since the oil has no flavor, it should have no flavor-calorie association, and your set point should go down. I've been doing this, and I've been getting full faster and that's been causing me to lose weight. (If you want to google more info, it's called the shangri-la diet.)
(Note that if you try this, your toothpaste probably counts as a flavor.)
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#357I’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…
What's the drug?
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#358Earlier quoted context omitted.
Weight is not uncontrollable. It's not easy to control, but neither is any other addiction, and they're certainly stigmatized.
Could you link to a peer reviewed study concluding that? Just to point out one potentially complicating factor Dr. Robert Lustig's work appears to show that our diets increasingly include processed foods which are strongly associated with health problems including weight gain and metabolic disease. So if you can completely avoid institutional food such as served at company canteens and figure out and stick to a good…
Various things have lead to me eating/drinking (alcohol) to excess and becoming more overweight than ever.
My long-winded point is that it seems specifically to be my personal actions that have caused my obesity -- poor food choices and lack of exercise. Others from the same background, others at the same workplace, etc., are not obese.
I would hate anyone to start telling me being fat is OK and that I shouldn't bother to do anything about it.
Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#359Re: ‘Breakthrough’ obesity drugs that have stunned researchers
#360Earlier quoted context omitted.
I think I will wait for some version that does not cause "strong nausea, extreme fatigue, brain fog, and constipation".
despite that wouldn't just undernourishing the body lead to shorter lifespans not longer?
[0]: https://sitn.hms.harvard.edu/flash/2020/can-calorie-restrict...