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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

#841

Post by tchaffee »

bioemerl wrote: post #182

> 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 environment and our food sources have radically changed in the past hundred years. My grandparents ate a mostly organic diet because that's all that was available back then. They didn't eat food made in a factory. They didn't drink water filled with plastic microparticules. Their work was manual labor. I could easily continue with other environmental factors that are different.

What seems absurd to me is to jump to conclusions instead of taking a scientific approach to eliminating factors until we find causation.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#842

Post by sacnoradhq »

My doc is trying to get me on these kind of meds.

I'm on high dose (60 mg) mirtazapine motivates immense weight gain as a side-effect.

I'm +30% overweight (260 lbs vs. 200 / 117 kg vs 90) and the hunger for carbs is beyond ravenous.

Stimulants are nonstarters because I'm already on a beta blocker for inappropriate sinus tachycardia, and other meds for "physiological" anxiety (can never relax).

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#843

Post by erfgh »

danielvaughn wrote: post #641
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 was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.” It’s so hard to eat healt…

You just don't want it bad enough. You like food more than you like being thin. That's all.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#844

Post by tchaffee »

insane_dreamer wrote: post #697
bioemerl wrote: post #182

> 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.

> to suggest that people have a natural weight and that's the cause of this seems absurd to me People do have a natural weight, and a fraction of people are genetically predisposed to be overweight regardless of lifestyle. But what I find impossible to accept is that somehow that number has mushroomed in the past half-century and particularly in the U.S. I've lived and/or worked on every continent over the past 40 ye…

I have also noticed myself and my partner gain weight when we live in the US. I'll make it a little more concerning: I mostly don't eat processed foods. I buy the raw ingredients and cook myself.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#845

Post by scarmig »

Auracle wrote: post #803
scarmig wrote: post #649

Earlier quoted context omitted.

> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body…

I'm sorry, but I'm a decently in shape person that tried semaglutide for reasons other than losing weight and I disagree. While I'm sure we all are a bit different satiety wise (and I've found it greatly depends on how much I've been eating overall recently), your experience on the drug is not what the rest of us feel like all the time. It's unfortunately normal for our biology to basically want to shove calories dow…

> I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more.

You give some thought to it every day, but do you think about it every minute? You could still eat more, but do you still have the same intrusive hunger to eat that you did before you started the nachos?

> Almost all of us work for it.

Your claim here seems to be that you work for it harder than people who have less success. But do you have any actual evidence of that?

Like, can you truthfully say that to keep your presumably healthy BMI you overcome nearly constant thoughts about how hungry you are? Can you eat an entire pizza and still be hungry except it's physically painful to eat?

People vary in their experiences of satiety. Many people do manage to be thin without constantly feeling hunger; that's what being on semaglutide does.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#846

Post by machiaweliczny »

RedditKon wrote: post #599
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…

Same - Mounjaro / Tirzeparide is nothing short of life changing. A question I often get is "how effective is it?" The SURMOUNT-1 study released in April 2022 showed 22.5% average reduction in weight for people on the highest dose of Mounjaro. For a 250 lbs person who should weigh 150 lbs (so 100 lbs of extra weight), this would result in them losing 56 lbs or 56% of their excess weight. For context, bariatric surgery…

I wonder if somone studied „dragon breath” and „vacuuming” exercise vs surgery. I am 15 pounds overweight but I have a feeling that since doing these I look much better and don’t eat that much

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#847

Post by brigandish »

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…

> Plenty of young and healthy people died of COVID.

The median age of death due to COVID-19 in the UK[1], as of January 2021, was 83. I haven't checked but there is little reason to think this has changed much.

From page 9 of Public Health England's Excess Weight and COVID-19 report[2] of July 2020:

> patients with COVID-19 living with overweight (BMI ≥25kg/m2) or obesity (BMI ≥30kg/m2), compared with patients with a healthy weight (BMI 20 to A report came out at the end of the year titled Associations of Physical Inactivity and COVID-19 Outcomes Among Subgroups[3]:

> The ORs are striking. In the full sample, those who were consistently inactive were 191% more likely to be hospitalized and 391% more likely to die than those who were consistently active. Dose‒response effects were mostly present across sex, race/ethnicity, age category, BMI category, and history of cardiovascular disease and hypertension, although the CIs sometimes included one. Although the odds were highest for patients in the always inactive category, every lower category of physical inactivity increased the odds of adverse COVID-19 outcomes.

We now have reams of data and analysis that backs this up again and again and again - some of which was even known in the first 6 months of the pandemic (which makes a lot of the official advice, like lockdowns and denying access to parks and gyms, negligent and reckless in my view). To associate COVID-19 mortality with youth and health is perverse, unless it's to say "it's very rare".

[1] https://www.ons.gov.uk/aboutus/transparencyandgovernance/fre...

[2] https://www.gov.uk/government/publications/excess-weight-and...

[3] https://www.ajpmonline.org/article/S0749-3797(22)00526-8/ful...

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#848

Post by vjk800 »

ceejayoz wrote: post #77
twawaaay wrote: post #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…

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…

Is the drug a long-term solution either, though? Won't the users regain the weight after stopping the drug, exactly like people who stop dieting do?

The trick with all lifestyle changes is to start as small as possible. Don't try to overhaul your eating and exercising habits overnight, but instead start from something small like "buy some fresh fruits every time you buy groceries" or "go outside for a bit every day whatever time you feel like it".

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#849

Post by ddorian43 »

dcolkitt wrote: post #152
rajin444 wrote: post #56

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.

Disagree. People genuinely enjoy those foods, because they're tasty and flavorful. And there's zero reason to believe that they're substantially unhealthy unless consumed to the point of sustained caloric surplus. We know this because we have hunter-gatherer populations who consume 50% of their diets in sugar (e.g. the Hadza) or fats (e.g. Intuit), and they have none of the diseases of abundance found in modern popul…

> Disagree. People genuinely enjoy those foods, because they're tasty and flavorful. And there's zero reason to believe that they're substantially unhealthy unless consumed to the point of sustained caloric surplus.

People enjoy drugs, I agree. Some get addicted and die though.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#850

Post by crabkin »

hungryforcodes wrote: post #242
dougmwne wrote: post #162

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.

you can tell these people have never tried to bulk and cut cycle, if you guys start lifting weights or even taking stimulants it becomes beyond obvious that it is a simple input/output sort of thing. The psychological, I saw someone mention the hypothalamus part, that must be the real difficult thing.
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