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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

#191

Post by hnuser123456 »

ceejayoz wrote: post #177
scifibestfi wrote: post #155

Earlier quoted context omitted.

We're seeing the most successful Big Pharma marketing campaign since OxyContin. The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy > From 1996 to 2001, Purdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended these all-expenses-paid symposia, where…

That article starts with: > Controlled drugs, with their potential for abuse and diversion, can pose public health risks that are different from—and more problematic than—those of uncontrolled drugs when they are overpromoted and highly prescribed. These drugs are not of that nature.

No, but the ADD/ADHD stims are. I also had nausea all day and could not eat more than approx 1. slice of pizza for lunch and dinner up til age 16 on days that I took the smallest dose of methylpenidate. In summer, when I was not on it, I actually resumed average eating and growth. My growth chart, before age 8 starting it, was right around 50th percentile in height/weight, and by age 16, was was around bottom 5th percentile.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#192

Post by bioemerl »

iammjm wrote: post #20

At 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?

Drugs can reduce your desire to eat or increase your metabolism.

You don't need a drug, but changing habits is very hard and obesity very deadly.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#193

Post by swalsh »

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 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.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#194

Post by Aloha »

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…

Peoples appetites are larger than their physical ability level provides for.

We transitioned from a hunter gatherer, to an agrarian, to an industrial society - because most people needed to do much physical activity to survive, even when food was plentiful.

The information age is much more sedentary, but people have evolved needs to eat a certain amount of volume to feel satiated. The fact that our foods are super nutritious/calorie dense makes matters worse.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#195

Post by tptacek »

swalsh wrote: post #193
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 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.

If you're getting a ~20% weight loss in 6 months, the cost is a steal compared to the alternatives.

I don't think this is the most interesting or curious discussion we can be having about these drugs --- the science story is much more interesting and relevant than HN's general opinions about "big pharma" or the obesity epidemic, and the science story stays interesting even if you think the drugs are not a net good --- but of the non-science discussions we can be having, the pricing seems like the least interesting thing happening here. These are injections whose competition is major surgery.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#196

Post by UI_at_80x24 »

bitwize wrote: post #153

Why use drugs and lifestyle changes when lifestyle changes alone will do the trick? Everybody knows you're not a real Hackernews until you adopt a cold, calculating, "food is fuel" mentality toward eating, with extensive data collection, strict timing, data-driven portion control, and long fasting periods. Once you do that you don't need the drugs and can tell Big Pharma where to shove it.

Lifestyle change alone is NOT all it takes. I've been fat all of my life, so has everybody in the last 3 generations of genetic contributors.

I can easily drop 20-40lbs if I cut sugar out of my diet. Then it stops. I've cycled 15miles/day for 7 years (on non-snowy days). During that time I went on a water-only fast, (7days on, eat one day, then 14days eat one day, then 7 days more of fasting before I stopped.) I lost 13 lbs during that period. I was doing a keto diet before and after this period. I was killing myself trying to have a high energy output with minimal caloric intake.

In the end, winter came and I stopped. Total weight loss during that time: 35lbs. There is no way I can lose the extra 160lbs that I need to drop. My body just won't drop it.

I'm diabetic now. I take metformin and invokana. As of today I'm down almost 30lbs since august.

Lifestyle changes maybe enough for you. That's awesome, good for you. Don't make blanket assumptions and think that they are true.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#197

Post by rychco »

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…

> And there's zero reason to believe that they're substantially unhealthy unless consumed to the point of sustained caloric surplus.

I have a hard time believing this without some very strong evidence for this claim. There's already existing evidence for greatly varying health effects of differences in cooking method, oil-type, omega ratios in fats, amino-acid ratios in proteins, glycemic index of carbs, sodium content, etc etc. It's hard for me to reconcile the suggestion that the content of food does not affect whether it is "substantially unhealthy"...

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#198

Post by mensetmanusman »

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…

It’s not some people, it’s most people.

We need to tax the ** out of high calorie foods to fund the extreme cost on health care/society that overeating is causing.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#199

Post by asdff »

dcolkitt wrote: post #165
iammjm wrote: post #20

At 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…

People have trouble dealing with hunger because we frame it all wrong in the western convention. I'm hungry, I should eat a little something, is what most people think. An ascetic from the east who fasts is not immune to the pain of hunger, they just understand that hunger is a sensation that is neither good nor bad, and what they choose to do with that sensation is up to them, and they are not bound to it and do not have to satiate it right then.

I imagine if a prescribed diet from a doctor also came with mental health counseling, that overcoming the satiation issue could be a lot easier for more people. It really is a frame of mind issue that prevents most peoples weight loss from being more successful.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#200

Post by mensetmanusman »

joe_the_user wrote: post #187
dcolkitt wrote: post #152

Earlier quoted context omitted.

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…

I don't think it's half-plausible to compare Hadza or Intuit diets to a Big Mac and a soda. Neither transfats nor processed sugars are in the Hadza diet, just for example.

We could absolutely decimate the Intuit by introducing free Pepsi coolers in every home.
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