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‘Breakthrough’ obesity drugs that have stunned researchers

nature.com

571–580 of 1001 posts

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#571
post #553

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…

> everyone, even the skinny folks, should be on GLP1 drugs Seriously? No thanks. Think I'll give you all a few decades to see what the long-term effects are like, and let my body largely take care of itself except when specific medical issues indicate that an intervention is in order.

The only proven way to live longer and reduce your risk of essentially every disease is to reduce caloric intake. So unless you are underweight, the benefits could outweigh any side effects. I am not advocating that everyone take these drugs--but I understand why someone might suggest it

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#572

Earlier quoted context omitted.

I would love to know what sort of healthy cut has a 6"2 male eating that low a calorie count. That is approaching weight class athlete cutting numbers which is near uniformly considered very bad for you.

If he’s not exercising and is largely sedentary then 1400 calories for an adult male is a serious deficit, but not extreme. If he added in an hour of high intensity interval training or something that would be extreme and potentially hazardous.

The problem with severe caloric restriction is that your metabolism slows down. This isn't true of water fasting up to 4-5 days at a time where your metabolism increases ~10-15%, and your body produces significant quantities of HGH which help you burn fat while preserving muscle.

Severe caloric restriction diets are actually not particularly effective if your goal is to permanently lose significant quantities of weight and keep it off - once you plateau it really sucks. Of course I mean if you power through and keep at it you will, but IME, periodic fasting is a much easier way to lose weight and keep it off.

Not hazardous, really, as you point out. The whole point of stored fat is to be used.

Citations available on request, I have NCBI links for each of my points but it takes a while to dig up.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#573
post #479

Earlier quoted context omitted.

> Losing weight was extremely challenging and socially isolating. How was it socially isolating? I’m curious because I exercise and diet and this is not my experience. I understand it being challenging though.

OP commented on a weight-loss scheme of eating every other day. Given the social attitudes around eating (which I suspect to be the #1 most common social activity), this alone has the obvious potential to eliminate ~%50 of the most likely socializing opportunities.

You can plan your fasting days around it. If you have some crazy social schedule, maybe this doesn't work. But I don't go out every night.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#574

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…

N of 1, but I've gone off it for months and maintained my weight.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#575

Earlier quoted context omitted.

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 per…

I’m sorry you were misdiagnosed and/or mistreated. For what it’s worth, I’ve taken a moderate dose of amphetamines for years and I’m still obese.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#576
It's weird that insurance companies won't cover this, considering the cost of treating obesity-related illnesses like diabetes, heart disease, strokes, certain forms of cancer, etc. It's also weird that pharmaceutical manufacturers price this so high, considering the potential size of the market relative to the current size of the market. I guess what I'm saying is: the healthcare industry makes a lot of choices I don't understand. /shrug

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#577
post #260

Earlier quoted context omitted.

That two people eating the same thing in the same amounts will retain different amounts as weight is something you can experiment on, without assigning a cause.

I think we need to really stress here just how bad our situation is. We have an obesity rate of 40 plus percent. Peoples weight just cannot be said to be a "natural number" in this environment. Something is causing this and your average person is obese because of it, not because of their "natural weight"

It's both, the difference between ourselves and our grandparents is almost all environment. The difference between 2 high school students in 2023 Susy and Bob is driven almost completely by genetics.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#578

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…

I don't know if I'd call a veterinary anaesthetist a foremost expert on fat metabolism. His thoughts on insulin signaling are not consistent with the consensus among obesity researchers. He thinks glp-1 works through uncoupling or fat browning which is just not true. The consensus among most obesity researchers is the cause of obesity is primarily neurological, not metabolic. Basically the brain can't properly regula…

Is human metabolism really so different from other mammalian metabolism?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#579

> In the past, scientists and the public often thought that those with obesity simply lacked the willpower to lose weight. But evidence is growing that most people’s bodies have a natural size that can be hard to change. In the context where we have gone from obesity rates of 13 percent to 40, to suggest that people have a natural weight and that's the cause of this seems absurd to me.

Hunger is like a one way valve - you can gain weight and your body will not stop you, but as soon as you start to incur caloric deficit, your body will turn on lots of alarm bells.

Hunger is also impossible to compare, as it is an internal sensation.

Response to hunger is trained, but it is extremely hard to retrain.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#580

> In the past, scientists and the public often thought that those with obesity simply lacked the willpower to lose weight. But evidence is growing that most people’s bodies have a natural size that can be hard to change. In the context where we have gone from obesity rates of 13 percent to 40, to suggest that people have a natural weight and that's the cause of this seems absurd to me.

The implication is that something has happened during the last 50-100 years that caused people's "natural weight" to change upward. (Someone's "natural weight" is normally called their "set point".) The evidence is a little slim (no pun), but there's one theory which I find quite compelling. The theory is that eating foods with high flavor-calorie association increases your set point, and eating foods with low flavor…

Haven't heard anyone talk about the Shangri-La diet in ages. I did a slight variation of this for awhile way back in my 30s at it worked great. Recently testing this out with OMAD but haven't been doing it long enough to see if it is workable. I'm in my 50s now and a lot of things that worked wonders in my 30s do not work as well as they once did.
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