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What Ozempic does to the gut-brain axis

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Re: What Ozempic does to the gut-brain axis

#261

Post by phil21 »

pandaman wrote: post #131
dyauspitr wrote: post #47

What’s the downside to this magical drug. There has to be a downside…

Even if there are zero effects other than the advertised weight reduction, one downside is obvious from the comments here - some people will stop exercising. While exercise has many positive effects, which I'd argue are more important than the weight loss, the latter is the primary reason many people exercise and likely to stop when given the weight loss by other means.

> one downside is obvious from the comments here - some people will stop exercising.

Is there any source on this? The precise opposite has happened in my experience. I was an early evangelist for these drugs, and have many dozens of people who I talk to regularly who have since taken them over the years. I cannot think of a single person who went from regular exercise to reducing or eliminating it after taking the drug. Exactly zero.

I can think of well over a dozen folks who started regular exercise for the first time in their lives after losing 50 or more pounds.

Certainly many who did not change their habits either way. But overall this matches with what the trainers in my gym report. They were initially worried GLP-1s would reduce their client base, but the exact opposite has happened for them. It's brought an entirely new demographic into play and business is booming.

> which I'd argue are more important than the weight loss,

You would be making an argument contrary to most established science on the topic. Exercise is important and quite beneficial to health. Obesity is far worse. Not many obese people working out regularly to start with though, so I don't think this point holds much water to begin with. We are not a nation full of obese gym rats.

Re: What Ozempic does to the gut-brain axis

#262

Post by toast0 »

faangguyindia wrote: post #249
toast0 wrote: post #203

Earlier quoted context omitted.

Plenty of people can take this intelectual knowledge and turn it into eating behaviors that work for them. But this intelectual knowledge doesn't really help if your body is telling you it's hungry all the time and it's hard not to eat something . Better choices can help, because different calories deliver different satiety; but some people don't get much satiety no matter what they eat. Calories in vs calories out i…

>But this intelectual knowledge doesn't really help if your body is telling you it's hungry all the time and it's hard not to eat something. Better choices can help, because different calories deliver different satiety; but some people don't get much satiety no matter what they eat. Maybe try to figure out why you’re feeling hungry. Is it because you’re running a 1000 kcal deficit? Can your body really tell whether y…

> Maybe try to figure out why you’re feeling hungry. Is it because you’re running a 1000 kcal deficit?

I know several people who are feeling hungry because they're not dead, regardless of how much calorie surplus or deficit they have.

We can do the same activities and eat the same meals and I'll be satied and they will be hungry. Or I can confuse the hell out of them when we do some big activity and I say "i'm not hungry, we worked too hard"... or when we miss a meal by several hours and I tell them "I'm not hungry anymore, it's been too long... but I should probably eat something"

> I think there isn't as much variance as people like to believe,

Oh sure, I don't think everyone is really a unique snowflake, there are patterns. You can find lots of people in these threads who have a broken hunger sensor. You can find lots of people in these threads that can manage this intellectually. I don't see a lot of people in these threads like me who keep a healthy(ish) weight because IBS punishes them for bad food choices, but I'm sure they're out there. Plenty of people out there where celiac drives their relationship between calories in and calories out.

Diet research would be a lot more interesting if there were ways to classify people by their 'metabolism type' and then see what can work for which type. Maybe there would be more reproducability that way, too.

Re: What Ozempic does to the gut-brain axis

#263

Post by epihelix »

joshuamcginnis wrote: post #16

Studies show almost all subjects regained the weight and reversed gains within 2 years. This means underlying issues (e.g., food addiction) aren't being addressed. Short of changing habits, the only maintenance solution is lifelong drug use and that doesn't sit well with me.

If your biology is working against you, why not fix your biology?

I'm not someone who needs to take GLP-1 receptor agonists, but if I had any issues with weight then I'd have no issue taking them life-long. The long-term health benefits are already strong enough to make it a no-brainer. If you are overweight and a GLP-1 drug helps you lose that weight, you will very likely live a longer, healthier and happier life by taking the drug.

All that said -- this article was discussing a new paper in Cell Host & Microbe (high-impact Cell Press stable journal), https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(2... . And the point of that paper is that, at least in mice, the anti-depressive effect of GLP-1 receptor agonists was related to a change in gut microbiota, and not to activation of the GPL-1 receptor. It's work in mice only, so whether or not this holds in humans is unclear, but the researchers showed this worked in mice lacking the GLP-1 receptor and via fecal microbiota transplantation of bacteria from the guts of mice taking GLP-1s.

So, if all you cared about were the mental health benefits of taking GLP-1s, then potentially you could gain these by simply changing your gut flora, without taking a GLP-1 drug at all. That might sit much better with you, by the sounds of it.

Re: What Ozempic does to the gut-brain axis

#264

Post by QuiEgo »

dgabriel wrote: post #170
faangguyindia wrote: post #158

Earlier quoted context omitted.

for many people the underlying issue is serious lack of education when it comes to nutrition. Not understanding calorie balance, not understanding calorie density of the food they eat. How many people know 1kg fat = 7700kcal that if they could create deficit of 7700kcal they could potentially lose 1kg bodyfat? Ofc, i know the relationship isn't that simple but for most people this roughly holds true. If you are eatin…

I understand calorie balance. I've been on a diet since I was 12 years old, and am now approaching 50. I've lost and regained the same 60lbs about 4 times now. I have logged every bite that goes into my mouth, and lived with a constant hunger for as long as I could take it. Then I ate until I felt satisfied and gained it all back. I know how many calories are in anything, and I can eyeball any serving size. I've been…

That sucks. If GLP-1s work for you, more power to you.

Curious: how big of a calorie deficit did you run, and what was your macro (protein/fat/carbs) balance.

My personal experience is going low on carbs (especially added sugars) and high on fiber and protein made running a deficit suck much less in terms of feeling satisfied.

Also, a 10% deficit was okay (I was hungry but could mostly ignore it). A 25% deficit was very annoying and about as much as I'd care to do.

Re: What Ozempic does to the gut-brain axis

#265

Post by mycall »

ceejayoz wrote: post #152
faangguyindia wrote: post #139

Earlier quoted context omitted.

>my body and mind are no longer is in starvation mode What does it mean? If a drug reduces your desire to eat food, wouldn't it also decrease your desire to eat food beneficial for your body? I think the effect most people want is to stop craving junk food but still eat nutritious food required for muscle growth and health.

What if you could intentionally eat good food? I've heard it widely described as reducing mental noise around food.

People can get fat by eating too much healthy food.

Re: What Ozempic does to the gut-brain axis

#266

Post by hack1312 »

ajross wrote: post #259
hack1312 wrote: post #220

Earlier quoted context omitted.

> Diets also don’t stick when you discontinue them. Yes, obviously. Which is why sustainable weight loss takes a commitment to making a change in lifestyle. What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

> What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance? That's some pretty... charged language. But even so: the drug, clearly. People take drugs reliably as a matter of empirical fact. People likewise emphatically don't "change their lifestyles" as a general rule. If they did we wouldn't b…

It’s reality.

People take drugs if they can afford them; will GLP-1’s be available dirt-cheap to the masses or limited to those fortunate enough to have health insurance.

Re: What Ozempic does to the gut-brain axis

#267

Post by magicalhippo »

dmayle wrote: post #171
dirtbagskier wrote: post #2

I'd take them even if they didn't make me lose weight - and I'm the type of person that doesn't like takeing Tylenol unless absolutely necessary. The best way I can describe it: my body and mind are no longer is in starvation mode. I plan, do, act and sleep well.

I had the same experience, but not with GLP-1 drugs, but by upping my protein intake to about 0.7g per pound of body weight. Night and day, stopped always being hungry... I've tried Noom before (eating highly filling, low calorie foods, but filling, not satiating), but that only worked while I was tracking (and always forcing myself to keep it up)... Losing weight required work on top of that, but the protein just ma…

I recall reading a metastudy of EU studies about 10 years ago, where they focused on three different diet classes: calorie counting, low carb, high protein.

Calorie counting diets had no restrictions on what they ate, as long as the participants didn't exceed the calorie target.

Low carb (Atkins) had no calorie restriction but had to restrict carbs.

High protein also didn't have calorie restriction but participants had to ensure at least 20% of the calories in meals were proteins.

They found that while all helped people lose weight, only the high-protein made it stick reliably.

I used that as basis for my own weight loss and it worked very well for me. As you said it made me full in a different way. YMMV.

Re: What Ozempic does to the gut-brain axis

#268

Post by hack1312 »

ssl-3 wrote: post #240
hack1312 wrote: post #205

Earlier quoted context omitted.

But those changes don’t stick if the drug is discontinued.

Is the drug at risk of being discontinued? If so, then can that risk be quantified in any way? (For comparison: Countless scores of diets are discontinued daily.)

If the person can’t afford the drug then it’s at risk of being discontinued.

Re: What Ozempic does to the gut-brain axis

#269

Post by hack1312 »

topgrain2 wrote: post #246
hack1312 wrote: post #220

Earlier quoted context omitted.

> Diets also don’t stick when you discontinue them. Yes, obviously. Which is why sustainable weight loss takes a commitment to making a change in lifestyle. What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

The drug is more likely to work long-term. Diet & exercise, as a treatment plan, are distressingly ineffective. Well-studied problem. It makes more sense when you realize that something like sheer dieting/exercising willpower isn't why some populations are skinnier than others. Pick another country with a healthier-weight population, start placing some of them in the US, and they'll gain weight. Put them back, and it…

So clearly it’s something to do with the difference in their lives in the USA, but your first response is to treat the symptom with drugs rather than look at their life holistically?

Just off the top of my head the food (portions, quality, etc) in the USA combined with how much people no longer can walk vs being required to drive are a huge contributor to weight gain of immigrants to the USA.

Re: What Ozempic does to the gut-brain axis

#270

Post by amluto »

Aaargh20318 wrote: post #82
saberience wrote: post #69

Earlier quoted context omitted.

[flagged]

The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn. You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake. Add to that the fact that exercise is mind numbingly boring and…

> You can’t really exercise enough to offset the food you can eat in a day

This is not true. There are plenty of activities that a healthy, enthusiastic person can do for quite a few hours per day that burn calories rapidly, and it takes serious effort to eat enough to offset the calorie usage. Think distance running, skiing, cycling, rowing, etc.

Sometimes people go to extreme technological measures to optimize their ability to consume calories (see recent record-setting marathon results). Sometimes people rely on extremely calorie-dense foods (butter, nuts, etc) so they can carry meals with them that are not wildly calorie-deficient for their long, unsupported travels.

When people are burning calories at this rate, they are probably not doing it for exercise — they’re probably either doing it because it’s fun or it’s part of an adventure.

I’m suspect that, if someone is overweight but in good enough shape to cross-country ski for six hours a day, then even if their body tends toward telling them to eat too much, they could probably lose weight by doing so for many days in a row.

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