Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching • Hacker News Board

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#221

Post by rich-cartwright » Sun, Aug 22, 2021, 4:28 AM UTC

nevinera wrote: post #200

noduerme wrote: post #198

Earlier quoted context omitted.

That's what's known as an anecdote. This is what's known as a counterexample. And one thing is certain: No method has 100% success. To me the more important question isn't what percentage of cases something addresses, but whether it's a self fix where the benefits outweigh the risks. The risks of intermittent fasting are relatively low, and it may have side benefits like prolonged lifespan and slower telomere degrada…

I'm not arguing in favor of any particular approach (in particular the one posed by the original poster, which I have done zero research into). If and when they launch in a meaningful way I'll bother doing that research, but I am also a cynic about people offering to make a difficult thing easy for a recurring fee.

Happy to help with any research if I can. A good starting point for the medication I referred to in my post is here: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#222

Post by rich-cartwright » Sun, Aug 22, 2021, 4:29 AM UTC

noduerme wrote: post #205

issa wrote: post #160

Earlier quoted context omitted.

As someone whose weight has been all over the place in my life, I really appreciate hearing this. I've known it is true forever, but it is rare to hear other people saying it. There is much more to weight than calories in/out. Some people can skip a meal without noticing, others count the minutes until the next meal. I always flip it on its head. For some reason it is easy for people to understand that certain people…

I was questioned in high school in the 90s whether I had an eating disorder. I just ignore hunger until it goes away... I simply don't want food. I don't like to eat around other people, either. When I do eat, around 2am every day, I've really looked forward to it so it's pleasurable. But as a functional alcoholic I fully understand counting the minutes to something. This where "eating disorder" self control comes in…

Thank you for sharing.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#223

Post by rich-cartwright » Sun, Aug 22, 2021, 4:31 AM UTC

Sunspark wrote: post #219

One thing that helps is to not buy candy from Costco. Just don't. If you have it at home, it's going to get eaten even if you have it on another floor. Better to buy smaller candy from elsewhere. It'll still get eaten, but at least there'll be no more, and you aren't going to go out again that night to get more candy.

This is one solid behavioral tactic. Good to have in the toolbox for most people. Lot more to it than this!

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#224

Post by rich-cartwright » Sun, Aug 22, 2021, 4:35 AM UTC

hourislate wrote: post #206

As someone who lost 100 lbs (from 278 to around 175)and kept it off, my advice is to stop eating shit food, eat a clean diet (do not go out to eat). Pick a 6 hour window to have your meal(s) and every month over a weekend or your time off take 3 days (72 hours) and don't eat a thing. Wash rinse and repeat. In one year you will lose more weight than you ever thought imaginable. The nice thing is exercise is optional b…

I'm sure guys reading this have heard versions of this advice 100s of times before. I'll let one of them reply if they fancy it.

From our side: we focus on the evidence base, and does what is clinically most effective & sustainable for patients.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#225

Post by rich-cartwright » Sun, Aug 22, 2021, 4:36 AM UTC

noduerme wrote: post #207

hourislate wrote: post #206

As someone who lost 100 lbs (from 278 to around 175)and kept it off, my advice is to stop eating shit food, eat a clean diet (do not go out to eat). Pick a 6 hour window to have your meal(s) and every month over a weekend or your time off take 3 days (72 hours) and don't eat a thing. Wash rinse and repeat. In one year you will lose more weight than you ever thought imaginable. The nice thing is exercise is optional b…

life long daily faster here. Going out to eat is not the problem if you eat good food. I go weeks without cooking at home, and live on massive orders of Indian, Thai and Ethiopian food that I keep in the fridge and dive into once a night. If "eat out" means fast food or processed food, then, sure - avoid it. But $50 worth of mostly vegan Indian food can last me 5 days. I trust the ingredients and it's more efficient…

Impressive you've kept it up your whole life!

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#226

Post by rich-cartwright » Sun, Aug 22, 2021, 4:39 AM UTC

AussieWog93 wrote: post #187

rich-cartwright wrote: post #167

Earlier quoted context omitted.

Thanks for sharing man. Important to emphasize there is a large variety of causes: stress eating is certainly a big part for a lot of people, but it's far from universal & far from the whole story. "Something that can be fixed by just putting your mind to it shouldn't have to be treated with pills" is I think an interesting statement. I'm unconvinced "putting your mind to it" is as simple as it's made out to be.

>I'm unconvinced "putting your mind to it" is as simple as it's made out to be. Back when I was in university, I decided to simply "put my mind to it" and went from 100kg->65kg in one year. That weight stayed off for the better part of half a decade. "Simply" doing the same thing now, though, with all of the competing priorities I have (young child, growing business, burned out wife and a constantly shifting set of r…

Thank you, really appreciate it.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#227

Post by rich-cartwright » Sun, Aug 22, 2021, 4:40 AM UTC

TeeMassive wrote: post #209

stef25 wrote: post #110

Earlier quoted context omitted.

Assuming obesity is largely due to mental issues like stress eating, the solution should also be a mental one. It's basically an addition. Most people are perfectly capable of quitting but don't because it's easier not to. This includes myself. I recently put on a bit of weight and I know exactly why: second servings, having a few beers, difficulties sticking to a diet with kids and dietary allergies in the house, no…

> Assuming obesity is largely due to mental issues Obesity increased with the increase of meal size, average caloric intake and urbanization based around cars.

Correct that there are a host of causes, certainly not simple.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#228

Post by evol262 » Sun, Aug 22, 2021, 4:49 AM UTC

rich-cartwright wrote: post #216

evol262 wrote: post #199

Earlier quoted context omitted.

This is what's known as an 'anecdote', and is at the crux of the issues surrounding weight loss. Virtually every _controlled_ study shows that metabolic differences between adults are within a margin of +/- 15%, with essentially no way to eat the same amount of calories as a 200lb person and stay at 465lbs. Not least of which because your basal metabolic rate is much higher at that weight. Virtually every study shows…

Unsure how helpful this slapdown is after the guy is sharing something pretty vulnerable.

Diets don't fail because they're inherently flawed and the system is more complex than we think it is. Diets fail because people fail. "I tried and I failed, but I still do all this physical stuff or could if I wanted to" is dishonesty, whether intended or not.

Asserting that, for some unspecified (but large) fraction of the population, tracking your caloric intake and energy expenditure versus the number on the scale is inherently flawed is dangerous, misleading, and probably false. At least partly because overweight people may lie to themselves.

In this sense, and in the context of Fella, throwing more drugs at the problem isn't a solution any more than throwing additional hardware at an application because the developer insists that database indexes don't work everywhere. It's true, but requires extraordinary evidence, and should not be the baseline assumption.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#229

Post by someguydave » Sun, Aug 22, 2021, 4:52 AM UTC

rich-cartwright wrote: post #90

someguydave wrote: post #40

Earlier quoted context omitted.

you could make the same argument about any modern technology

It is interesting how divisive conversations around weight can be. For a lot of people, it represents a broader theme of we view individualism & morality.

Yes. My understanding is that body weight is more than 60% genetically determined, but somehow it is the moral worth of the phenotype that is to blame.

Re: Launch HN: Fella (YC W20) – Tackling men's obesity using medication and coaching

#230

Post by hnenbythrow » Sun, Aug 22, 2021, 4:55 AM UTC

I'm non-binary, assigned male at birth. I totally agree that having a program aimed at men and building supportive communities for men is important, as they are often under served by existing support infrastructures.

I'm curious if you'd consider non-binary folks as well? Should I not sign up if I'm nonbinary? Or even anyone who is ok with a 'primarily for men' atmosphere?