This is a good, related opinion article: https://davidaaronovitch.substack.com/p/in-defence-of-ozempi... In defence of Ozempic - Why the weight-sadists hate the new drug
That was a great read thank you for sharing.
Goodbye, Ozempic
51–60 of 89 posts
Re: Goodbye, Ozempic
#52Earlier quoted context omitted.
Oh. You're not saying lifestyle choices are ineffective, you're saying telling people to make those changes is ineffective. Yes, that I would completely agree on.
I think you’re actually not very well informed despite being confident of your position. The body attempts to maintain stasis at a given weight. “Lifestyle choices” as a solution are essentially a constant uphill fight against your body and its signals. High probability of failure, because there is no point at which your body stops telling you to eat more to reach the weight it thinks you should be. I think now that…
As someone who hasn't struggled with weight I don't understand this sentiment. I'd love to eat way more than I already do and I'm constantly hungry.
Sure it's hard but if I ate till I couldn't regularly I'd end up several thousand calories over what my body needs for maintenance.
Re: Goodbye, Ozempic
#53There's always fasting, calisthenics, and avoiding PUFAs.
Re: Goodbye, Ozempic
#54From what I understand, Ozempic works by slowing down digestion and thus reducing appetite. If that is the case then wouldn't this be precisely evidence that caloric restriction is all you need to reduce obesity?
I thought we already have had that evidence for a long time. Humans, including myself, have trouble self limiting when everything is accessible.
Re: Goodbye, Ozempic
#55Earlier quoted context omitted.
Of course everyone's struggle is personal. For me, I have been listening to the Maintenance Phase podcast, reading Aubrey Gordon's new book, and learning that a lot of what we hold as fact or "common sense" about weight loss is untrue, that individual bodies respond very differently to the same diet and exercise schedule, and that a lot of the ideas around fatness are rooted in a cultural anti-fatness that views fatn…
> that these so-called common sense ideas are so deeply held in our society that few have really questioned them Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet,…
> these issues have been studied and questioned
Do you actually have studies you can link to that can show this? With a quick search I see a study [1] that both acknowledges that data on hunter-gatherers is light and also finds that total energy expenditure (which I assume is what you mean by the "lifestyle" part of "lifestyle and diet") is roughly the same between this hunter-gatherer society and western cultures:
"Like other complex, continuous traits (e.g., stature), environment can clearly influence TEE, as is evident in the elevated energy expenditures of traditional farmers (Table 1). Nonetheless, TEE is remarkably similar across a broad, global sample of populations that span a range of economies, climates, and lifestyles (Fig. 1, ,2).2). Not only is TEE statistically indistinguishable between Westerners and Hadza foragers, but the range of TEE within Western, foraging, and farming populations largely overlap, both at the individual and population levels (Table 1, Fig. 1, ,2).2). We hypothesize that TEE may be a relatively stable, constrained physiological trait for the human species, more a product of our common genetic inheritance than our diverse lifestyles."
Re: Goodbye, Ozempic
#56We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?
Nah. I'm also not affected by this issue, but I have much more compassion. When I go out to eat with my friends. We all eat about the same, but some are much larger.
In general, folks know what to do, and they need help.
Re: Goodbye, Ozempic
#57We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?
You're making the same mistaken assumption everyone else makes-- obese people are obese because they're lazy/unmotivated, as if there is only one reason this happens to them. It's Boomer logic, and should be dismissed since they clearly failed to solve this problem themselves. There are many different reasons for obesity and sending everyone to fat camp won't solve anything.
Group 1 are the lazy people. Obesity is a behavioral issue for them. They eat because they overate for some time, and they are now prone to hunger because of it. Lifestyle changes do help this group-- the stomach contracts and they start to subsist off of smaller portions because they're not filling an enlarged vessel. FWIW, my own doctor recommends drinking water as a replacement for food, to satiate the oral fixation of eating. It fills the stomach just the same and you go through the same motions.
Group 2 are the people who overeat because of some dopamine deficiency. We look at what they consume, horrified-- carbs, fats, sodium, sugar. Think about it: these are all party foods. Parties are where people have fun, and fun makes us happy. This leads to a deadly spiral of eating increasing amounts of unhealthy food that elicits positive feelings and discourages you from ever leaving your bedroom. Lifestyle changes could help this group, but the underlying issue needs to be addressed. Diet/exercise/sleep doesn't relieve you of your loneliness or struggles to pay the rent.
Group 3 is genetic predisposition; some people just retain water/fat/etc. more than others. Exercise as a first step does not help, and stresses their taxed cardiovascular system. Diet is not a factor. These people need to be on medications like spironolactone and ozempic, not treadmills-- the latter will kill them.
These are just the cliques I've identified by association; I'm not a doctor, but I play one well enough to know the problem isn't as simple as you make it out to be.
Re: Goodbye, Ozempic
#58An alternative / replacement without the side-effects would be huge. Since I started 1mg / week of Ozempic, the phrase "power vomiting" has become part of my vernacular where it never was before. Just last night I was overcome by a round of puking that rivals stuff you'd see in a horror movie. :-( It doesn't happen often (2 times this year so far) but when it's bad, it's BAD.
I, personally, have actually been having pretty good results with berberine (yes, yes, I know its a TikTok trend right now). Its really helped control my hunger and I haven't noticed any side effects.
I've considered trying berberine just for the heck of it, but it seems like it reduces the diversity of the gut bacteria which makes me concerned that if it didn't work out well for me it wouldn't be a simple as stopping taking it.
Re: Goodbye, Ozempic
#59We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?
Not everyone can make this change — the causes of obesity are not well understood. For the morbidly obese, exercise carries risk too — to joints and the heart, for instance. A large weight reduction (whether via GLP-1 antagonists, gastric band, or exogenous trauma) can both motivate and make easier other changes like the ones you advocate.
Exercise is only a fraction of the effort for weight loss. You lose weight by reducing your portions. There's even a study of a morbidly obese man losing weight by drinking nothing except vitamin water.
Re: Goodbye, Ozempic
#60Earlier quoted context omitted.
I think you’re actually not very well informed despite being confident of your position. The body attempts to maintain stasis at a given weight. “Lifestyle choices” as a solution are essentially a constant uphill fight against your body and its signals. High probability of failure, because there is no point at which your body stops telling you to eat more to reach the weight it thinks you should be. I think now that…
You're absolutely right on all of those points. You have to eat less for a long enough period of time where the body adapts to that new, lower amount of calories. Then it becomes easier to maintain. But at the start it's really rough. Constantly feeling hungry isn't fun. But just because it's hard doesn't mean it's not doable. For the vast majority of people it is doable without any form of medication. It will be slo…
The majority of the population is overweight and more than a third are obese, with the numbers of both on a steady upward climb for decades.
Traditional methods are already out there and this health crisis is just getting worse each year. The average person is clearly not having success with them, and saying "if they just try harder" or putting some different spin on them hasn't done a thing to fix the trajectory of this problem in the past 30 years, so I can pretty confidently say that there is zero chance they will somehow solve this societal problem in the future.
Being significantly overweight has immense health consequences and imposes huge costs on both the individual and society. I think it's incredibly, incredibly unlikely that the costs or health risks of this medication are higher than the well-documented costs of people continuing to be significantly overweight.
And FWIW: I say this as a thin person with no trouble with my own weight.