‘Breakthrough’ obesity drugs that have stunned researchers • Hacker News Board

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#781

Post by abecedarius » Thu, Jan 05, 2023, 5:11 AM UTC

ashwagary wrote: post #652

windpower wrote: post #526

Earlier quoted context omitted.

I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every ti…

>I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I hear people following a carniv…

A carnivore diet can include many other foods than beef and butter. Being high in protein is also a choice, and not a necessarily a great idea. (I'm getting moderate protein and high fat.)

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#782

Post by kweingar » Thu, Jan 05, 2023, 5:11 AM UTC

windpower wrote: post #526

0xB31B1B wrote: post #21

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'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every ti…

If you don’t mind sharing, we’re you prescribed tirzepatide for type 2 diabetes, or was this an off-label prescription for weight loss?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#783

Post by scarmig » Thu, Jan 05, 2023, 5:14 AM UTC

runnerup wrote: post #768

jostmey wrote: post #571

Earlier quoted context omitted.

The only proven way to live longer and reduce your risk of essentially every disease is to reduce caloric intake. So unless you are underweight, the benefits could outweigh any side effects. I am not advocating that everyone take these drugs--but I understand why someone might suggest it

The parent post said: > everyone, even the skinny folks, should be on GLP1 drugs But as a skinny person, I can already easily reduce caloric intake as much as I want to. My body is "blessed" with weak food cravings and solid blood glucose levels while fasting. So while I do recommend these drugs to people who need them, I don't think they'd help me at all more than merely deciding one day to monitor and control my we…

I'd be curious as to what the effects would actually be on you (though I agree that it seems at best useless and potentially harmful for you). Would your weight zone shift downwards, or would it do nothing?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#784

Post by Vecr » Thu, Jan 05, 2023, 5:15 AM UTC

matt3210 wrote: post #525

put it in the water!

Not a good idea. Some people are underweight or normal weight, or want to get stronger by lifting weights. Also, it's an injected drug.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#785

Post by ramraj07 » Thu, Jan 05, 2023, 5:16 AM UTC

jononomo wrote: post #759

wolverine876 wrote: post #423

Earlier quoted context omitted.

> one of the foremost experts of fat metabolism Is it correct that the source is a veterinary anaesthesiolgist? https://news.ycombinator.com/item?id=34252195

Yes, he is the world's leading expert on this subject because credentials aren't everything

Credentials aren’t everything but at the least I want someone to be in the field doing things in practice (research or patients) everyone else including me should shut up otherwise.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#786

Post by idealmedtech » Thu, Jan 05, 2023, 5:21 AM UTC

As a diabetes researcher, results like this don't surprise me one bit, but I'm glad they're getting national coverage! A publication in Nature is an incredible achievement, congrats to the teams involved.

We think good glucose control is at the center of a whole host of medical issues, inside and outside the hospital. Bringing critically ill patients under control has been found to reduce mortality rates by up to 30%, results which have been repeated several times in thousands of patients. These drugs, which are less intense than insulin therapy, confer similar glucoregulatory effects, which has all sorts of cascading hormone benefits etc.

Exciting stuff, thanks for sharing!

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#787

Post by petesergeant » Thu, Jan 05, 2023, 5:25 AM UTC

ilyt wrote: post #584

windpower wrote: post #526

Earlier quoted context omitted.

I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every ti…

What finally got me on right way on controlling hunger was just getting used to eating once a day and dropping a lot of the quick-burning foods that made me go hungry quicker. Not necessarily going super healthy but stuff like eating less bread/pasta and more say baked potatoes so still nice tasty food that doesn't get me into diet sadness mood, just shifting away from carbs Also figuring out when I'm "brain hungry"…

I've done all of these things. I've essentially been on a diet since I was 17. I am not (especially) fat, but the amount of mental and emotional energy I burn on not being fat is huge. It is a daily struggle. Like one of the parent posts, I've achieved a number of other hard things in my life that took sustained effort and willpower.

I can easily eat 7-8,000 calories in a day, and there's no amount of stairmaster can fix that.

I've also previously taken modafinil, and had situations where I've had caffeine having been caffeine-free for a while, and the appetite-suppression properties have me thinking "this is what normal people must feel like". I cannot wait until these drugs become available in the country I mostly live in.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#788

Post by logicchains » Thu, Jan 05, 2023, 5:27 AM UTC

komali2 wrote: post #680

MaxHoppersGhost wrote: post #656

Earlier quoted context omitted.

Being a young and very healthy person I felt this way about the COVID vaccine.

Why? Plenty of young and healthy people died of COVID. Only some vaccines are mRNA types, and, in the USA anyway, all vaccines went through the same testing process as any other medication, they simply sped the process up by layering some of the steps - all that means is that rather than wait to see if one study passes before doing the next one (save money or whatever), they just overlapped them. Even for MRNA vaccin…

>all vaccines went through the same testing process as any other medication, they simply sped the process up by layering some of the steps - all that means is that rather than wait to see if one study passes before doing the next one (save money or whatever), they just overlapped them

This is misinformation. The normal process involves at least 4-5 years of observation to identify long-term side effects; you can't speed this up, as no matter how many people you test, it's not going to make long-term side effects manifest sooner. And while the technology has been around for 20 years, it certainly hasn't been trialed on humans until very recently, due to difficulty finding a safe delivery mechanism.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#789

Post by petesergeant » Thu, Jan 05, 2023, 5:28 AM UTC

notJim wrote: post #416

swalsh wrote: post #193

Earlier quoted context omitted.

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.

How's it working for you? It's the one that's available where I live, but the reviews I've read of it have me thinking I'd be better off waiting until the newer versions come out?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#790

Post by joedevon » Thu, Jan 05, 2023, 5:32 AM UTC

SpeedilyDamage wrote: post #691

vouaobrasil wrote: post #681

Earlier quoted context omitted.

> What people who aren't fat do is intellectually recognize that "I could eat forever" feeling, and don't fall for it. That's where the willpower comes into play. I don't think that is quite right, at least from personal experience. I have a good weight and I feel it's almost impossible for me to gain weight. And personally, I don't really recognize the "I can eat forever" feeling. I love food, don't get me wrong, bu…

I don't know what to tell you other than that I was once skinny and young, but then I got older and fitter and my desire to eat changed. It apparently changes quite a lot as different factors in your life influence you, according to the article you're commenting on. It's a good read, I recommend it (and others)! What factors do you think are influencing your desire to eat more or less? Do you think those will change…

"What factors do you think are influencing your desire to eat more or less?"

There is a lipostat or setpoint in the hypothalamus. It acts like a thermostat for fat. Fat levels are controlled by a homeostatic system, just like body temperature. The highest amount of bodyfat you've had will typically be the bodyfat your brain will defend. It not only does this by making you hungry, it also will downregulate your metabolism. So you become less active. Anyone who has been obese, is fighting their own brain to maintain fat loss. Losing fat is easier than maintaining fat loss. Semaglutide disrupts this system.

BTW, the mechanism of the setpoint is Leptin, a hormone secreted by fat almost exclusively. Muscle also releases Leptin, but in small amounts.

So if you cut the fat out, if you use liposuction, or you diet down slowly, or you diet down quickly, it doesn't matter. Your brain still knows how much fat you have, based on the leptin signals it gets. You cannot trick it.

The reason bariatric surgery is effective is that cutting out the stomach reduces the amount of ghrelin released, which is a hunger hormone that the brain sends the body. Again, disrupting the homeostatic system...which is the only effective way out of this mess.

I was expecting more people on hacker news to know about homeostasis of fat by now. Leptin was discovered 27 years ago.