Live data from Hacker News

‘Breakthrough’ obesity drugs that have stunned researchers

nature.com

301–310 of 1001 posts

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#301

Earlier quoted context omitted.

Down's Syndrome is also unhealthy. Should we stigmatize that also? The main issue is control. Many assume that weight is simple and under people's full control. Realistically, though, there are all kinds of reasons why weight gain happens and scientific measurement shows that wild animals are getting bigger too which suggests that pervasive presence of endocrine disrupting agents in the environment may be involved. I…

Weight is not uncontrollable. It's not easy to control, but neither is any other addiction, and they're certainly stigmatized.

Could you link to a peer reviewed study concluding that?

Just to point out one potentially complicating factor Dr. Robert Lustig's work appears to show that our diets increasingly include processed foods which are strongly associated with health problems including weight gain and metabolic disease. So if you can completely avoid institutional food such as served at company canteens and figure out and stick to a good diet then maybe. Even then it seems like the stigma is just sloppiness that results in perfectly respectable contributions to society not being recognized.

Early on I made a habit out of becoming friends with fat people I met because their exposure to social stigma tended to make them strong as individuals.

If anything it seems like the person who is addicted to something that should be stigmatized is you.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#302

Earlier quoted context omitted.

If we're going to treat calories as addictive and addiction as a disease rather than a personal failing it should follow that we treat the disease with a drug.

If we assume addictions as a disease then we mostly treat them with regulation. Smoking companies would have loved if we just made a pill that mitigates tar in your lungs instead of all but legislating them into obscurity.

At the end of the day you don't have to smoke, not that people won't.

At the end of the day, or maybe week, or possible even month you have to eat or you're going to die. Simply put you require caloric intake to survive. Yea, you can ban coke and candybars, and hell that's a good idea. But what about bread? Or do you monitor and watch to make sure everyone only eats two slices? Make sure foods at restaurants only have so many calories per serving and ensure they people can only buy one meal per meal?

At some point it still falls apart because it is human nature to massively overconsume since the vast majority of history we've been calorie short. You're dealing with an animal response here that is going to be very difficult to override to the under/normal consumption side.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#303

Petro Dobromylskyj is one of the foremost experts of fat metabolism. He has a blog called Hyperlipid where he's been blogging about fat metabolism and interpreting research for close to 10 years. He thinks the GLP-1 inhibitor drugs will be a disaster in the long term because they 1) cause weight loss but also 2) cause the body to create lots of new adipocyte (fat cells). Increasing the number of adipocytes is very un…

So drug companies should be seeing alarm bells going off. You can profit off this drug, and it's an endless supply of revenue.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#304
post #178

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…

There are randomised controlled trials of diets (without caloric restriction). They show that some diets are better than others for real clinical endpoints, eg mediterranean vs low fat diet for secondary prevention of cardiac events [1]. The effect size in that example is not small, it is large, despite most participants already being on a statin. This data shows that diets are biologically active and significantly i…

You haven't controlled for body weight changes though. Nobody doubts that diets (if adhered to) can reduce weight. So if biomarkers improve relative to an alternative diet, the question is it because A) the Med diet is more effective at weight loss, or B) the Med diet has benefits outside weight loss. The research you linked is interesting, but confounded by weight loss. Research that has directly tried to control for this has generally found that the health benefits of the Med diet are mostly or wholly attributable to the mediating impact of weight/fat loss.[1]

This is a critical question, because GLP-1 agonists like semaglutide are far more effective at weight loss (with much lower dropout rates) than any diet known to mankind. So if the benefit of the Med diet is mediated by weight loss, who cares in the age of GLP-1 agonists? It's like arguing about the fastest hot air balloon after the invention of the jet engine.

[1]https://www.semanticscholar.org/paper/Obesity-Mediates-the-A...

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#305

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…

> The problem is not the food. The problem is obesity.

Junk food corporations make profit by selling food, and they are extremely good at this. They rely on intense advertising, making the food addictive, targeting children. As a side effect, people get obese since they consume more calories that what they need.

I don't know about GLP-1, but my intuition tells me that no drug is going to make eating Mac Donald's and drink Coke healthy, even if it doesn't make you obese.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#306

Earlier quoted context omitted.

They didn’t say calories are addictive. They clearly said certain foods are addictive. Those foods should be more regulated like cigarettes and companies take more responsibility as a first or at least concurrent step to everyone taking more drugs.

As far as I can tell, our social policies don't really work for managing addiction. We just hook up a vacuum cleaner to people's pockets and suck the money out of them if they smoke. Call it a "sin tax". But the problem is that people prioritize their next fix above other things; would you rather get some cigarettes or pay your rent, many people choose the cigarettes. I'm not sure how that helps anyone, and I'm not s…

All the same arguments were said about cigarettes and yet in 2022 I almost never smell a cigarette burning outside and few young people smoke.

People complained about cigarette taxes wouldn’t be effective but they are.

The stock market didn’t crash either despite the multibillion dollar tobacco companies being affected.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#307

> “I’m really hesitant to be excited about something that I think is potentially harmful from a weight stigma perspective,” says Sarah Nutter, a psychologist at the University of Victoria in Canada, who specializes in weight stigma and body image. Putting the word "stigma" on things is a sure sign of a grifter. Instead of helping solve it, they're trying to make it a social science problem. Being overweight is unheal…

[deleted]

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#308

> “I’m really hesitant to be excited about something that I think is potentially harmful from a weight stigma perspective,” says Sarah Nutter, a psychologist at the University of Victoria in Canada, who specializes in weight stigma and body image. Putting the word "stigma" on things is a sure sign of a grifter. Instead of helping solve it, they're trying to make it a social science problem. Being overweight is unheal…

The new idea (mostly in the West) that being obese is/can be a healthy lifestyle is absolutely maddening. People being obese (and I don't mean a few pounds overweight) raises everyone's healthcare cost, because it is incredibly unhealthy and obese people tend to have more complications which requires more treatment, workers and subsidizing. It's not just an individual problem, it's a societal problem. There's a new "…

In a way, maybe Gatorade is trying to be honest about lying. After all, a 20 oz bottle of Gatorade has 36 grams of sugar in it and would substantially contribute to type 2 diabetes. It would behoove them to fund a narrative that the product and the outcome associated with the product are indeed "fit" to maximize sales.

Of course, the wrinkle with approach is that that as you mention, the reality is that nothing could be furthest from the truth. Obesity is fastest growing and most deadly American chronic condition. The outsized impact of type 2 diabetes on payer spend, both medical and pharmacy, cannot be overstated.

And when you put that all together, it makes a commercial like the one you mentioned seem banal and sinister at the same time.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#310
post #58

Earlier quoted context omitted.

> I don't want to eat empty carbs, anywhere near as much. Because I feel like they make me feel sick. I did a keto diet obsessively for a while and I still have a psychological revulsion to drinking coke or eating cake even a year later. Those sorts of things are long term wins.

I wish I got to this stage where people lose their cravings. While I'm at home I can control my diet pretty well, but as soon as there's junk food in front of me I look like a pig. And I've lost like 30 pounds, to put it into perspective.

I got to the point where I lost my cravings; it took less than a week for them to come back when I reintroduced them in small amounts though.
Post reply on HN