‘Breakthrough’ obesity drugs that have stunned researchers • Hacker News Board

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#661

Post by vladf » Thu, Jan 05, 2023, 1:16 AM UTC

MajimasEyepatch wrote: post #473

bioemerl wrote: post #411

Earlier quoted context omitted.

If this were true I would not expect that changes in our lifestyle would cause broad scale weight increases like they have. I'm very skeptical humans are built with an average set weight way up in the unhealthy range. Or maybe this is the case, but it is thrown off hard by our modern diets. Our natural set point is in the healthy range, but our meal is x calories per Y food now so it ends up artificially high. The ex…

I think you're misunderstanding. There is no "natural set point." The set point moves up and down based on hormones, genes, diet, environment, medication, etc. And the very act of gaining weight causes your body's set point to move up, because of how weight gain affects your hormones. Unfortunately the set point is pretty sticky, and once it moves up, it does not like to move back down, in part because for most of an…

What is a set point not influenced by? The way you framed it, it seems to take everything into account. In that case, why wouldn't "your current weight" not just be your set point?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#662

Post by tdeck » Thu, Jan 05, 2023, 1:19 AM UTC

scarmig wrote: post #649

danielvaughn wrote: post #641

Earlier quoted context omitted.

I was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.” It’s so hard to eat healt…

> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body…

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

As someone who's always been thin and doesn't have a strong appetite, I couldn't agree more. I'm just enough outside the norm yo be able to recognize it.

There are times when I simply can't force myself to finish my food and it goes to waste, but the upside is that many people assume that people in my body fat range are somehow virtuous for not "overeating". That's not the case at all - I don't eat particularly healthy, don't have any particular exercise routine beyond walking, and I don't limit myself. I just get full quickly and have a metabolism that burns what I eat.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#663

Post by astura » Thu, Jan 05, 2023, 1:19 AM UTC

grogenaut wrote: post #622

omniglottal wrote: post #501

Earlier quoted context omitted.

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.

If you're not eating every other day you can still go to the eating place and sit with folks. Also you can just talk more since they have to eat and you don't. Sounds like MORE socializing.

People feel really uncomfortable sitting down to have a meal with someone who isn't eating.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#664

Post by scarmig » Thu, Jan 05, 2023, 1:20 AM UTC

rubicon33 wrote: post #653

scarmig wrote: post #649

Earlier quoted context omitted.

> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body…

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit. Where does this line of thinking stop? Is everything pre-determined by genetics? Is everyone who is smarter than me,…

I didn't say anything about genetics, though I wouldn't be surprised if that plays a part. Might be how you were raised. Might be simply your cumulative life path leaving you in a particular state. Might be toxins in the environment. It doesn't matter; in the existing present, people have wildly different responses to food and diet.

As for your actual question, it depends on the particular thing we're talking about. For obesity, we've tried telling people to do more hard work and discipline, and it's been a spectacular failure. Plenty of people who do work hard and have incredible discipline in other areas of their life fail when it comes to getting to a normal BMI. There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

This also is more common in our current society, for whatever reason (likely not genes, since we're close enough to our grandparents), than it was historically. This isn't some natural state of affairs we live in.

So, bring on the drugs! If there are ones that help other things with minimal side effects, bring them on too. Everyone wins, because we end up with a better, happier, more productive society.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#665

Post by emmelaich » Thu, Jan 05, 2023, 1:21 AM UTC

0xB31B1B wrote: post #21

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…

So it works by reducing hunger? Bit obvious if you eat less than 1kcal per day you will lose weight.

The article mentions "along with some lifestyle changes". Is what they mean?

Every animal will engorge itself given the chance. All that is happening is the great abundance of cheap food and less activity. Thats it - except maybe for a tiny minority with metabolism / hormone issues.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#666

Post by nerdbert » Thu, Jan 05, 2023, 1:22 AM UTC

rubicon33 wrote: post #653

scarmig wrote: post #649

Earlier quoted context omitted.

> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body…

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit. Where does this line of thinking stop? Is everything pre-determined by genetics? Is everyone who is smarter than me,…

Let's say there were a drug that made people motivated to study hard and get a lot of work done. Would the successes people reaped from that be less useful to themselves and people around them, than those which other people reaped from being natively predisposed in that direction?

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#667

Post by tormeh » Thu, Jan 05, 2023, 1:26 AM UTC

rubicon33 wrote: post #653

scarmig wrote: post #649

Earlier quoted context omitted.

> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body…

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit. Where does this line of thinking stop? Is everything pre-determined by genetics? Is everyone who is smarter than me,…

We’re products of our nature and environment. Belief in free will, virtue, etc. are useful beliefs, but they’re also just not true.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#668

Post by marcus0x62 » Thu, Jan 05, 2023, 1:27 AM UTC

emmelaich wrote: post #665

0xB31B1B wrote: post #21

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…

So it works by reducing hunger? Bit obvious if you eat less than 1kcal per day you will lose weight. The article mentions "along with some lifestyle changes". Is what they mean? Every animal will engorge itself given the chance. All that is happening is the great abundance of cheap food and less activity. Thats it - except maybe for a tiny minority with metabolism / hormone issues.

> So it works by reducing hunger? Bit obvious if you eat less than 1kcal per day you will lose weight

Yeah, its obvious, even to those who are grossly overweight.

What these drugs do is make it easier, here, on this particular planet, for people who struggle to control their appetite to actually do so.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#669

Post by heavyset_go » Thu, Jan 05, 2023, 1:28 AM UTC

danielvaughn wrote: post #641

windpower wrote: post #526

Earlier quoted context omitted.

I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every ti…

I was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.” It’s so hard to eat healt…

> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

Learn to cook well so that eating out would result in lower quality meals compared to what you could make yourself.

Once you're controlling what goes into your meals, instead of outsourcing it, that makes it easier to control portion sizes, how much fat/oils go into things (I've found that restaurant dishes have an absurd amount of fat in them even when eating at "good" places), how things are sweetened, what you can use as healthier substitutes and what not.

You can eliminate almost all sugars with low to zero calorie substitutes, you can replace bread/panko/etc with low-carb flours, if you're frying you don't need more than a teaspoon of cooking oil, many sauces you can learn to make yourself instead of buying corn syrup and soybean oil-laden sauces from stores, etc.

Make it a rule to not buy things that come in boxes, buy fresh or flash frozen ingredients and make things from scratch. Stay in the produce, meat and fish sections of the store and ignore everything else outside of things like spices, frozen vegetables and protein.

Give yourself some leeway, too. You don't want to go into an all-or-nothing mindset, because that might lead you to giving up on eating healthily altogether if you break your diet. If you can find a way to treat yourself with something healthy that you like, that would be great. Sometimes I crave pancakes, despite them being nearly 100% carbohydrates. I eventually ended up with a recipe that substitutes wheat flour with almond and coconut flour, and to replace the syrup, a berry sauce reduction sweetened with erythritol. Barely any carbohydrates and the berry sauce is better than maple syrup, IMO, and goes with a lot of different meals.

tldr: reduce the opportunities to eat unhealthily, and increase the opportunities to eat healthily, even if you don't take those opportunities all of the time.

Re: ‘Breakthrough’ obesity drugs that have stunned researchers

#670

Post by SpeedilyDamage » Thu, Jan 05, 2023, 1:29 AM UTC

windpower wrote: post #526

0xB31B1B wrote: post #21

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…

I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every ti…

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