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

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

#231

Post by robomartin »

civilized wrote: post #185
robomartin wrote: post #150

Earlier quoted context omitted.

> Your scolding of a clinically proven weight loss approach for not being what you did is solipsistic and ignorant. Far from ignorant. It is an absolute fact --thermodynamics-- that no human being needs a pill to lose weight. So, stop with the holier-than-thou come-back and think. This is no different from selling crap weight loss supplements to people. Why? Because they do not need that either. The fact that somethi…

Me: Your personal experiences aren't sufficient basis to say what is right for everyone on the planet. You: Nonsense, and to prove it, here's another long personal anecdote.

Oh, please. Personal experiences are just useful examples, anecdotes, illustrations. They do not describe the universe.

The obesity epidemic in this nation isn't caused by people are eating good food and exercising. It is caused by the kinds of things my examples illustrate. And yes, in this case, there happens to be a single basic truth: People are eating too much and too much crap.

You might want to poke fun at what I am saying, come back with contemptuous responses, kill me with downvotes and flagging. And yet, the obesity epidemic has rendered every single weight loss program, drug or magical juju bean "solution", ineffective, even harmful. I wonder how many people have been hurt badly by horrendous weight loss/gain cycles as a direct result of these "solutions"?

Our problem is not solved with drugs, supplements and magical programs.

Our obesity problem is a far deeper issue that requires intervention into our industrialized food system as well as a rethink of our educational choices.

What's really interesting to me is that in this entire incident NOT ONE PERSON has countered my claim that the real problem is bad food and bad habits. That's interesting.

Also, not one person has said something like "No, you are wrong, thermodynamics doesn't work that way...you can eat four times the carb/sugar-laden food you should eat on a daily basis, sit in front of the TV and still maintain good health".

No, all the negative reaction is pretty much about being offended for my strong reaction to yet another easy weight loss scheme that, based on recorded weight loss industry history is going to be no different from everything else we have seen. Only this time it is YC backed, so, I guess that's OK.

In engineering we are trained (or should be trained) to perform real --not imaginary-- root cause analysis in order to understand how to solve a problem. When you do that with regards to obesity, absolutely everything points to bad food, bad choices, bad personal habits and bad education. That's it. This is the root cause package, if you will. And none of this is fixed with a pill. Temporarily, maybe. Long term? No way.

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

#232

Post by robomartin »

rich-cartwright wrote: post #96
symlinkk wrote: post #47

Earlier quoted context omitted.

Very well written and I find it hard to disagree.

If you had a bigger family member who had tried everything, what would you recommend to them?

What is far more likely is that they didn't actually try everything. This is one of the problems. If you had an accurate log of their behavior and nutrition it would likely be very easy to determine that they did not, in fact, do what they were supposed to do, sometimes at all.

I've seen this so many times I don't even bother to comment any more. The typical case is the person who will, for example, claim to have started a ketogenic diet and next time you see them they ingest three slices of pizza. What's amazing to me is that they actually think they are doing everything they are supposed to do.

> what would you recommend to them?

I would put it in a very different way using a hypothetical case.

Let's assume that a person has 90 days to loose a bunch of weight or they are going to die. Not muscle, fat. In other words, improve their body composition to trim both visceral and other fat.

What would I recommend they do?

Take a pill? Nope.

I would make sure they could not eat as much as they have been eating and would add moderate exercise. We could argue about what they should and should not be eating, but even if all you eat is ice cream and candy, if I put you on a 100 calorie daily diet of ice cream for 90 days straight, you are going to lose weight at an alarming rate.

Not that I am proposing this at all. It would not be healthy. A balanced diet is important for a range or reasons having nothing to do with weight loss. The point is that people who claim to have tried everything are lying to themselves, they have not, because, at the end of the day, if you eat less (a little to a lot less, depending on circumstances) you will lose weight.

It really isn't that complicated. It isn't easy because of a range of factors, including what ingesting so much sugar and simple carbs does to your body and brain, but it isn't complicated.

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

#233

Post by evol262 »

nevinera wrote: post #201
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…

> overreport their physical activity, like "I can jog 10 miles", or "I play tennis about 7 hours a week", or "I regularly make 60 mile bike rides". If you do, you're the extreme outlier, and it doesn't change the data. Assuming you can do those things, you're almost certainly still in your 20s, and the health effects of your weight haven't really caught up with your body yet I'm 37, and 6'5". and if you're calling me…

I said that you may be an extreme outlier. You're also larger than every NFL player in history, everyone in World's Strongest Man, etc. A 10 mile jog (let's say 80-100 minutes of uninterrupted running) is the sort of "I could eat 50 eggs" number people pull out.

At 6'5", you are an outlier. 2kcal is too low, much as it's too high for the average woman. This doesn't mean that metabolism is a "colloquial" term. It means that "the physical, psychological, and emotional components" is a long way of saying "it's hard", and "the experiential variance I'm describing" is "the payoff did not seem to be worth the cost".

In general, my post wasn't intended to be an attack on you. It's that "I cut calories and I lost weight" is not anecdotal. It's factual. The anecdote, if any, is "I'm larger than the largest professional athletes and I can still perform". Since it's hard to stick with cutting calories for many people, throwing drugs at it with Fella is not the right answer.

A holistic approach which addresses trauma, reasons for emotional eating, lifestyle replacements, recalibration of palate, satiation even at a deficit, and all the rest should be explored alongside drugs so "I cut calories and I lost weight" is easier to stick with.

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

#235

Post by im3w1l »

bserge wrote: post #142
jimmaswell wrote: post #37

Earlier quoted context omitted.

> basically the body fights hard against you as you try to lose weight by dieting. I used to weigh 310lbs, now I'm 215lbs. All I did was count calories to maintain a deficit and the results were essentially the same as predicted by the math. I was a bit hungry sometimes at first as I adjusted to it but that's really it. Prioritizing protein and fat over carbs helps with that. What ways does the body tend to fight aga…

Extreme hunger, like others said. I'd class it as a subset of impulsive behavior, which is basically your primitive brain doing it's caveman shit and not listening to you , the conscious mind. Apparently some people don't have this problem, which makes me incredibly envious (or would if I could feel anything). It's this nagging thought of "JESUS CHRIST YOU'RE GONNA DIE IF YOU DON'T EAT A LOT RIGHT NOW!" I've experien…

Have you heard of Pavlovs Dog, that started salivating when he rang a bell? Normally it's seen as an example of conditioning. But I think it's an illustration of something I noticed in my own life: That the primary cause of hunger feelings is expecting a treat.

When I haven't eaten in a while and know food isn't coming, I don't really feel hungry, I just feel tired.

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

#237

Post by notjulianjaynes »

rich-cartwright wrote: post #179
issa wrote: post #166

I am curious if this question has come up in company marketing discussions. One of the most common and off-putting things about the weight-loss industry is the vague medicine promise. Have you considered just saying "semaglutide" instead of "a breakthrough medication"? I honestly almost stopped reading because it comes off as so huckster-ish to me.

I think a lot about our framing and I know for sure we haven't nailed it yet. It's fair to say your avg HN reader is very different to your avg American. For example, you seem already somewhat clued up about Semaglutide. You're likely interested in the biology behind it, and probably aren't afraid to parse the journal article about it. I really wanna emphasize how different this is to your avg American. So it's more…

If your cagey about whats in your pill my gut reaction is it either doesnt work or youre overcharging for it.

I am average American.

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

#238

Post by donnythecroc »

evol262 wrote: post #228
rich-cartwright wrote: post #216

Earlier quoted context omitted.

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 scal…

It does look like Fella is addressing psychological issues which I think are huge. The issue if you deny that calories in v calories burnt is the essential metric is you end up with the problem with bariatric surgery where people literally eat to the point of severe pain and don't lose weight. It's why responsible surgeon always require significant calorie restriction weight loss before surgery.

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

#239

Post by luckylion »

evol262 wrote: post #233
nevinera wrote: post #201

Earlier quoted context omitted.

> overreport their physical activity, like "I can jog 10 miles", or "I play tennis about 7 hours a week", or "I regularly make 60 mile bike rides". If you do, you're the extreme outlier, and it doesn't change the data. Assuming you can do those things, you're almost certainly still in your 20s, and the health effects of your weight haven't really caught up with your body yet I'm 37, and 6'5". and if you're calling me…

I said that you may be an extreme outlier. You're also larger than every NFL player in history, everyone in World's Strongest Man, etc. A 10 mile jog (let's say 80-100 minutes of uninterrupted running) is the sort of "I could eat 50 eggs" number people pull out. At 6'5", you are an outlier. 2kcal is too low, much as it's too high for the average woman. This doesn't mean that metabolism is a "colloquial" term. It mean…

> It's that "I cut calories and I lost weight" is not anecdotal. It's factual.

It simplifies the problem though, because for many, that approach has side-effects that seriously affect quality of life, like sleep, concentration, mood swings, depression etc.

Speaking of depression, I often get a similar vibe in those threads, where undoubtedly someone will jump in and say "all you have to do is lift heavy weights and change your diet a bit". It feels like they haven't experienced what other people have, so their advice sounds tone-deaf, a version of "let them eat cake".

> Since it's hard to stick with cutting calories for many people, throwing drugs at it with Fella is not the right answer.

If it works, it's great. Because obviously the "just change your life to be like me and hope for the best" approach doesn't work for most people, or they'd do it.

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

#240

Post by elric »

criticaltinker wrote: post #15

Interesting offering, definitely an important market. > So we started researching effective, evidence-based treatments for obesity Fasting has a tremendous amount science supporting it [1], can you articulate why you're pursuing the prescribed semaglutide approach instead? [1] Fasting: Molecular Mechanisms and Clinical Applications https://www.sciencedirect.com/science/article/pii/S155041311...

Fasting is a migraine trigger for me. Many other migraineurs agree. Other migraineurs see benefits from fasting.

My point being: there is no "one size fits all" approach to weight loss.

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