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‘Breakthrough’ obesity drugs that have stunned researchers

nature.com

411–420 of 1001 posts

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#411

> 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 term "natural weight" as used here is misleading. It does not mean that people are supposed to be a particular weight. It refers to the idea that something—whether it's diet, genetics, environmental factors, or something else—influences the body's weight regulation mechanisms to "prefer" a certain body weight, and changing that is very, very hard. Think of it like body temperature: normally, your body maintains a…

If this were true I would not expect that changes in our lifestyle would cause broad scale weight increases like they have. I'm very skeptical humans are built with an average set weight way up in the unhealthy range.

Or maybe this is the case, but it is thrown off hard by our modern diets. Our natural set point is in the healthy range, but our meal is x calories per Y food now so it ends up artificially high.

The explanation just doesn't line up with what we've seen. I get that it's hard to lose weight once you've gained it, but that's different. This is absolving us of being responsible for our obesity as a whole.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#412
post #129

Earlier quoted context omitted.

> 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. This seems to be a short term problem, and the solution is to simply make more of the drug to match demand.

> and the solution is to simply make more of the drug to match demand which unfortunately might not align with the incentives of capitalism.

Why wouldn't it? At $1300 a month, this is going to be a massive business for these companies.

I read a statement from Novo Nordisk to their investors where they said they simply underestimated demand for the drugs. They expected a slow uptake and instead received an explosive one. They are working hard to increase production.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#413

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…

Have the side effects stopped? Or have you only been on it 3 months? My wife has been on Ozempic for longer than three months and the side effects haven't stopped. The nausea is typically bad for a few days after taking each dose but some of the others linger most of the cycle. For some I can see that tradeoff being okay but I can't see non-obese, non-diabetic folks making that trade-off for longevity. I know I would…

for me, the side effects lessened over time, and are pretty low now. Everyone reacts differently though.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#414

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…

I would rather die young than deal with those side effects. And those of us who are competitive endurance athletes need the oxidative stress; it's not necessarily a bad thing depending on timing and volume. Plus we will probably find other harmful side effects after long term use. There is no free lunch when you mess around with basic metabolism; everything has a price (not just in money).

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#415

Earlier quoted context omitted.

I mean, if you have perfect bloodwork and a marvel movie body probably not necessary but otherwise yes. Heart disease, hypertension, high cholesterol, colon cancer rates are rising amongst everyone, even thin people. These drugs positively impact indicators of these things in everyone. Longevity makers have been betting on metformin for a long time and these drugs are like a supercharged metformin

> if you have perfect bloodwork I see a lot of health influencers always say whatever diet they are doing is best because nothing bad has shown up on their bloodwork. I am not really sure if bloodwork is all it takes to asses your health.

I am not really sure if bloodwork is all it takes to asses your health.

It is not. Steve Jobs had good bloodwork and low BP, still died a a few years later.

Steroid-taking health influencers like to show bloodwork to convince followers they are still healthy. Let's see 20+ years down the road...

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#416
post #193

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…

I think the main problem aside from the side effects you listed is the fact that frequent injections sounds really inconvienent, and the cost is pretty prehibitive unless insurance is covering it.

I'm taking saxenda, which requires a daily injection and it's totally fine. It takes like 2 minutes. The needle is tiny and most of the time you barely feel it.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#417

[flagged]

I agree with this for overweight people, but for obese people, the chance that they will follow the "right" way is near zero.

The alternative comes down to being obese (which is a death sentence) or medical interventions. It's true that this only solves the symptoms and not the actual problem, but it will probably save lives.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#418

Earlier quoted context omitted.

The new idea (mostly in the West) that being obese is/can be a healthy lifestyle is absolutely maddening. People being obese (and I don't mean a few pounds overweight) raises everyone's healthcare cost, because it is incredibly unhealthy and obese people tend to have more complications which requires more treatment, workers and subsidizing. It's not just an individual problem, it's a societal problem. There's a new "…

> raises everyone's healthcare cost, because it is incredibly unhealthy and obese people tend to have more complications which requires more treatment, workers and subsidizing. Is that actually true? From what I understand, obesity will cost you dearly in life expectancy, and most of the cost comes in the last few years of normal life expectancy. Someone who dies of heart attack at 63 isn't going to run up huge bills…

Yes, smoking isn't the same at all. People that are extremely obese require bigger hospital beds, more equipment, more drugs, more operations, etc. That's not even remotely comparable to smoking in terms of costs on the system. There also aren't a lot of smokers anymore, at least not in the US, obesity is a revolving door that is constantly taxing the system. Even during COVID obese people were the ones taxing the system, not people of normal/healthier weights.

https://pubmed.ncbi.nlm.nih.gov/33470881/

"Adults with obesity in the United States compared with those with normal weight experienced higher annual medical care costs by $2,505 or 100%, with costs increasing significantly with class of obesity, from 68.4% for class 1 to 233.6% for class 3. The effects of obesity raised costs in every category of care: inpatient, outpatient, and prescription drugs. Increases in medical expenditures due to obesity were higher for adults covered by public health insurance programs ($2,868) than for those having private health insurance ($2,058). In 2016, the aggregate medical cost due to obesity among adults in the United States was $260.6 billion. The increase in individual-level expenditures due to obesity varied considerably by state (e.g., 24.0% in Florida, 66.4% in New York, and 104.9% in Texas)."

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#419

Earlier quoted context omitted.

The point is that you could gain back the original weight plus more. Most adults who become obese have not increased their number of fat cells - their fat cells just become larger. The GLP-1 drugs literally increase the number of fat cells.

How does liposuction fare in long term fat loss?

Liposuction is no answer. Your body puts back the removed fat cells in other places.

The human body has VERY strong setpoints about weight. Fat cells "remember" the weight that you had when they were created. You have to hold your weight at a point for something like 3-5 years before your body relents enough that the setpoint moves.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#420

Earlier quoted context omitted.

Yes, your instinct is correct, you have vastly oversimplified it in an unhelpful way. The body is not an energy equation to be balanced. The desire to eat is driven by our hormones and these are not easily overridden by willpower. In fact, study after study shows that willpower is insufficient for most people. Hunger is produced by a complex set of factors that we do not fully understand. What we eat and how we live…

The body is an energy equation to be balanced. Physics defines that. What you are talking about substantially in your post is about willpower with regards to eating and exercise which is totally different.

> The body is an energy equation to be balanced. Physics defines that.

Most equations don't fight back when you try to balance them. But this one does.

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