Doing your own research (7 Viewers)

[fatness]

Just want everybody to know, if you are allergic to ozempic you should not take ozempic.

Aren't those warnings the stupidest things? Also "If you are allergic to the ingredients in this medication do not take this medication", after which the commercial proceeds to not list the ingredients.

 

[Terminalxylem]

Just want everybody to know, if you are allergic to ozempic you should not take ozempic.

Aren't those warnings the stupidest things? Also "If you are allergic to the ingredients in this medication do not take this medication", after which the commercial proceeds to not list the ingredients.

Yep, same goes for the disclaimers in the electronic medical record.

I always assumed that stuff serves no purpose, but for the lawyers out there, do disclaimers on prescribed medications provide any legal protection, and to whom?

 

[Sparky Polastri]

https://www.pbs.org/show/shot-in-the-arm/

 

[Idiot Boxer]

Just want everybody to know, if you are allergic to ozempic you should not take ozempic.

Aren't those warnings the stupidest things? Also "If you are allergic to the ingredients in this medication do not take this medication", after which the commercial proceeds to not list the ingredients.

Yep, same goes for the disclaimers in the electronic medical record.

I always assumed that stuff serves no purpose, but for the lawyers out there, do disclaimers on prescribed medications provide any legal protection, and to whom?

I've not done any research on this, but usually ridiculous warnings such as these don't materialize out of thin air, they're the result of a bad ruling or something that raises the eyebrows of the lawyers. Somewhere out there, someone has sued a doctor and/or drug company because they took a drug they were allergic to and, (it would seem predictably) had a negative outcome and blamed the doctor/drug company for not warning them to not take something they're allergic to.

You would think its common sense, but as they say. Common sense isn't common.

 

[Terminalxylem]

Just want everybody to know, if you are allergic to ozempic you should not take ozempic.

Aren't those warnings the stupidest things? Also "If you are allergic to the ingredients in this medication do not take this medication", after which the commercial proceeds to not list the ingredients.

Yep, same goes for the disclaimers in the electronic medical record.

I always assumed that stuff serves no purpose, but for the lawyers out there, do disclaimers on prescribed medications provide any legal protection, and to whom?

I've not done any research on this, but usually ridiculous warnings such as these don't materialize out of thin air, they're the result of a bad ruling or something that raises the eyebrows of the lawyers. Somewhere out there, someone has sued a doctor and/or drug company because they took a drug they were allergic to and, (it would seem predictably) had a negative outcome and blamed the doctor/drug company for not warning them to not take something they're allergic to.

You would think its common sense, but as they say. Common sense isn't common.

I’m sure. Still, seems like pretty flimsy legal protection, as every prescription you receive has instructions with major warnings, and potentially the package insert, which includes a more extensive list.

And every commercial advises you to “talk to your doctor” anyway.

 

[The Longtime Lurker]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

 

[Mister CIA]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

Doctor Mike seems pretty solid. He has a fantastic social media game and a very large following on youtube (14 million) and he seems to be fighting the same good fight as Term.

I've mostly cut bait on ones you mentioned, especially with their podcast format. Way too much jargon which reduces me to the role of prospector, discarding 98% of the conversation as I try to extract nuggets of information. It's exhausting.

 

[The Longtime Lurker]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

Doctor Mike seems pretty solid. He has a fantastic social media game and a very large following on youtube (14 million) and he seems to be fighting the same good fight as Term.

I've mostly cut bait on ones you mentioned, especially with their podcast format. Way too much jargon which reduces me to the role of prospector, discarding 98% of the conversation as I try to extract nuggets of information. It's exhausting.

Haven't heard of Dr Mike, but will check him out.

I'm not sure about Attia, but Rhonda Patrick has a website that goes deeper into a lot of her podcasts and cites studies to highlight the important points. I don't care for hour plus podcasts either, but find the breakdowns interesting.

 

[Max Power]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

I stumbled on to Peter Attia when I was researching some longevity advice for my ailing father. His focus on functional strength and stability was very useful to us. I bought my dad a couple 24lb kettlebells and we did farmers walks a couple times a day. Added in some body weight squats and some real improvement was made in the short term. My dad saw some physical improvements and that lead to a more optimistic outlook. Ultimately the cancer became too much.

I have no idea what Attia's positions are on everything. The nature of social media personality probably lends itself to overextending on medical advice, but to me that isn't a reason to discount everything a person puts out there and call them a grifter or suggest everything they say is baseless.

 

[Mister CIA]

To be clear, there is Doctor Mike, and then there is Dr. Mike.

- YouTube

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

youtu.be

 

[Max Power]

To be clear, there is Doctor Mike, and then there is Dr. Mike.

- YouTube

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

youtu.be

lol, I've listened to Israetel before and knew immediately they had to be talking about a different Dr. Mike.

 

[The Longtime Lurker]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

I stumbled on to Peter Attia when I was researching some longevity advice for my ailing father. His focus on functional strength and stability was very useful to us. I bought my dad a couple 24lb kettlebells and we did farmers walks a couple times a day. Added in some body weight squats and some real improvement was made in the short term. My dad saw some physical improvements and that lead to a more optimistic outlook. Ultimately the cancer became too much.

I have no idea what Attia's positions are on everything. The nature of social media personality probably lends itself to overextending on medical advice, but to me that isn't a reason to discount everything a person puts out there and call them a grifter or suggest everything they say is baseless.

I agree. I've found both Peter Attia and Rhonda Patrick to be the best of the "internet gurus" as far as quality of information, citations, and guests they speak to. Ofcourse they have sponsors that can seem to conflict with some of what they say, but i don't think it's a deal breaker for me if they want to sell AG1 or venison jerky before a podcast if the information provided is otherwise reasonable.

 

[Terminalxylem]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

All those guys provide valuable information, and it’s entirely possible they’re ahead of the curve in some instances.

I just don’t like when their advice becomes gospel for those who haven’t bothered to scrutinize the literature, nor when they sidestep viewpoints which conflict/show limitations to their approach.

Lastly, I don’t think I’ve heard any of them talk about the dangers of over testing, or unnecessary supplements.

 

[Terminalxylem]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

Full disclosure: I also looked into Lp(a) and apoB after reading Attia’s book. But I reviewed European and US standards for stratifying vascular risk first.

As it turns out, Euro guidelines suggest measuring Lp(a) and apoB once as an adult. This differs from US guidance, which offer no recommendation when to check them, if ever, although they acknowledge both are “risk enhancing factors” to personalize cardiovascular risk.*

There’s probably a good reason for this, as current treatment options for elevated Lp(a) are limited (though this is changing). ApoB is harder to dismiss, as there is data it provides a better gestalt of artery-clogging dyslipidemia than LDL (“bad cholesterol”) alone. Moreover, elevated apoB, even in concert with “normal” LDL, has implications for more aggressive lifestyle and medical management of vascular risk.

That said, neither test changed anything for me, and I’ll argue doctors should be recommending consistent exercise and heart-healthy diet regardless. If my apoB were through the roof, I guess I’d consider more testing (coronary calcium score and/or CT angiography), along with starting medication, as I’m already doing all the behavior stuff.

What percentage of those “doing their own research” would take the extra steps I did before testing, and does it matter?

*US guidelines are being updated, and should be released soon. I suspect they’ll make more firm recommendations on these tests, and others.

ETA I’ll guess neither would change your management either @The Longtime Lurker, as you’d opt for a trial (indefinite?) lifestyle modification regardless of the results.

 

[Terminalxylem]

To be clear, there is Doctor Mike, and then there is Dr. Mike.

- YouTube

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

youtu.be

Hadn’t heard of him, but he seems reasonable.

I watched this interview with Eric Topol, which reviews longevity research, its limitations, and problems with some of the podcast “gurus” who’ve become de facto authorities on the subject.

 

[The Longtime Lurker]

Huberman convo was interesting. How about people like Rhonda Patrick and Peter Attia? Is there anyone on the socials worth taking serious or is it all pseudoscience and baseless claims? I've taken information from both of the latter and found it ahead of curve compared to my doctor in some cases, ApoB and LP(a) testing for example. I was able to ask questions about that testing and get it earlier than i would have otherwise.

Full disclosure: I also looked into Lp(a) and apoB after reading Attia’s book. But I reviewed European and US standards for stratifying vascular risk first.

As it turns out, Euro guidelines suggest measuring Lp(a) and apoB once as an adult. This differs from US guidance, which offer no recommendation when to check them, if ever, although they acknowledge both are “risk enhancing factors” to personalize cardiovascular risk.*

There’s probably a good reason for this, as current treatment options for elevated Lp(a) are limited (though this is changing). ApoB is harder to dismiss, as there is data it provides a better gestalt of artery-clogging dyslipidemia than LDL (“bad cholesterol”) alone. Moreover, elevated apoB, even in concert with “normal” LDL, has implications for more aggressive lifestyle and medical management of vascular risk.

That said, neither test changed anything for me, and I’ll argue doctors should be recommending consistent exercise and heart-healthy diet regardless. If my apoB were through the roof, I guess I’d consider more testing (coronary calcium score and/or CT angiography), along with starting medication, as I’m already doing all the behavior stuff.

What percentage of those “doing their own research” would take the extra steps I did before testing, and does it matter?

*US guidelines are being updated, and should be released soon. I suspect they’ll make more firm recommendations on these tests, and others.

ETA I’ll guess neither would change your management either @The Longtime Lurker, as you’d opt for a trial (indefinite?) lifestyle modification regardless of the results.

What percentage do extra research beyond what they're told on a podcast and does it matter is a good question.

I like to think of these "gurus" more like food for thought. They present ideas that are often worth taking a closer look and that means not just taking their word for it, but looking at the studies cited, guidelines in other populations, asking your own doctor. I don't think i would take advice beyond diet, exercise, and some easy safe (imo) modification recommendations without trying to get a more complete picture. Zone 2 vs HIIT, Mediterranean vs high protein i don't feel is much of a risk. Methylene blue vs BPC157 and I'm not going to just start taking something without my doctor signing off.

I'm health conscious and always have been, so i find their conversations and ideas interesting. Sometimes what they discuss is helpful. Huberman's attention to sleep hygiene is helpful. I'm not taking any sleep supplements he recommends, but i think circadian rhythm is super important and often overlooked. Attia we discussed with cholesterol testing. Patrick covers a lot of research related to dementia and as someone with an increased risk (family history. Apoe4 heterozygous) even though I'm not doing anything other than the usual prevention/delay recommendations my doctor suggested i still like to see new/evolving research.

It does take a critical eye to know what's theoretical and what's practical, but if you can do that they offer interesting content and discussion. I'm sure i fall for some of the woo, but i don't think all of it is bad or dangerous (sauna, morning sun, cold plunge, creatine dosage, timed eating) at the same time good habits can be reinforced as they'll push basics aswell (hydration, exercise, quality sleep, controlling cholesterol, diet)

Those tests didn't change anything for you and they didn't change anything for me either (as a side note i had to pay out of pocket for both as insurance wouldn't cover either nor would it have covered the subsequent CAC if apoB was high. I think that's changed in the case of apoB). Like you I'm checking off the basics and so far that's been enough, but they could be important for someone else. I guess for me I'm comfortable listening/reading content from gurus because i find their discussions interesting and informative, but at the same time I'm not rushing out to eat 200g of protein, start up methylene blue, or challenge my doctor beyond asking about something i might find interesting, or wanting to try lifestyle first.

I still think you're reading me wrong though. I want food, movement, and lifestyle to be my medicine whenever possible and outside of a totally unexpected health issue I've been lucky that it's been enough. If in the future that's no longer the case I'm open to medical/pharmaceutical intervention, but currently i don't want that to be my first or only option. At some point I'm sure I'll face the fact that lifestyle isn't enough and that's ok, but as of today my health is good with the basics.

 

[Terminalxylem]

I want food, movement, and lifestyle to be my medicine whenever possible

This should be the default position your doctor takes for most chronic disease management. The problem is, there are many, many false claims supported by “research” that fall under the lifestyle umbrella, including almost the entirety of the nutraceutical industry. On top of that, we now have a bunch of unsubstantiated testing and technology being advocated by internet experts, as alternatives to conventional medical care.

So medication becomes a last ditch effort, after time has passed and the underlying disease may have progressed. I’ve seen this repeatedly with cancer patients, for example, though you could argue our collective approach to weight management is another area lifestyle modification isn’t working. And it gets even messier with public health interventions, where individual benefit usually isn’t immediately apparent.

So how do you decide when enough is enough, and acquiesce to the meds?

Also, I’d be curious what you, Joe, or anyone else thinks about the interview I linked above, in contrast to podcasts like Huberman’s? It’s about longevity science, though it touches on issues posed by individuals doing their own “research”.

 

[The Longtime Lurker]

though you could argue our collective approach to weight management is another area lifestyle modification isn’t working.

I can't wrap my head around this. I understand that there's people with medical conditions that no amount of lifestyle can overcome, but for the average person lifestyle likely led to being overweight, so the fact that lifestyle can't undo it as a general rule is very surprising. I linked an article* in the fat to fit thread that points the finger at the developed world and it's ultraprocessed diet since the same level of activity in the developing world doesn't result in our level of obesity. My interpretation of that is its less physiological and more psychological since a pivot and commitment to a less processed diet might produce the desired outcome. Ofcourse a lifetime of bad habits is pretty hard to overcome. Does that matter? Probably not. Results are results, but my belief for myself is that my good habits are just as good as bad habits with medical intervention.

* https://www.msn.com/en-us/health/other/ar-AA1IDR4o

But to your point, something like cancer and I'm not taking a wait and see approach. I'll seek out the best care i can find and follow the recommendations to the letter immediately. I feel like there's some amount of common sense involved in when you take a wait and see approach and when you need to act immediately. Common sense isn't so common though.

So how do you decide when enough is enough, and acquiesce to the meds?

Anything major and I'm first in line for medical intervention, surgery, pills, injections, whatever it takes. I'm not trying to be Steve Jobs and take a holistic approach to cancer.

I don't think we're all that different in when we would seek care outside of lifestyle. Like you I check all the boxes i can with lifestyle. Like you i don't really take many supplements (i do take creatine, vit d, fish oil). Like you i know my numbers and have them reviewed by a doctor. And like you at my last physical i had zero red flags. Correct me if I'm wrong here, but that's what I've gathered from our conversations.

So how do i know when it's time for meds? When the above no longer applies, or is no longer enough. My example with statins applies here. My cholesterol was high, i took 5 months and made dietary changes, upon retesting the levels were acceptable. If there was no change i would go on meds. My BP is borderline, but acceptable. If/when it gets high i won't hesitate to go on meds.

Also, I’d be curious what you, Joe, or anyone else thinks about the interview I linked above, in contrast to podcasts like Huberman’s?

I'll give this a watch and respond. I understand the limitations and contradictions the gurus present, but it's worth hearing the bear case from another professional.

I was raised in a very health conscious family so good habits were ingrained early. The last decade or so I've moved to a primarily plant based whole food Mediterranean diet. I lift 3 days a week, low weight high rep. I both walk 2 miles and mountain bike 7-10mi most days with a longer 15-20mi ride on the weekend. I pay attention to my hydration and practice good sleep hygiene. There's very little wiggle room for vast improvement in my lifestyle. I just want to bring that up as I'm not sitting around pounding doritos and cranking cigarettes expecting Peter Attia to fix me with supplements so i don't have to take meds.

I'm super competitive, mostly with myself at this point. For a time i ran full and half marathons, skate ski epics in winter, ultra endurance mtb events and I'm looking for those 1-2% improvements where i can get them. If morning sun, sauna, breath work, broccoli sprouts can do that i consider it a win and if they don't i can't see any downside outside of wasting my time.

 

[Joe Bryant]

Side thought. How an obviously accomplished and demonstrably competent person transforms from MD or Stanford PhD to "Internet Guru" the moment they become popular or make money with their expertise is interesting.

 

[Joe Bryant]

I want food, movement, and lifestyle to be my medicine whenever possible and outside of a totally unexpected health issue I've been lucky that it's been enough. If in the future that's no longer the case I'm open to medical/pharmaceutical intervention, but currently i don't want that to be my first or only option. At some point I'm sure I'll face the fact that lifestyle isn't enough and that's ok, but as of today my health is good with the basics.

I think this is where lots of people are. And lots of people "did their own research" to get to land at this spot.

It's trying first to change diet or lifestyle before seeking pharmaceutical solutions.

In talking with my MD friend, it seems lots of people don't want this. They have a problem, and just want the pharmaceutical solution to their problem instead of more "natural" solutions like better diet and movement. Obviously, lots of doctors will suggest that and that seems proper. When the "Internet Gurus" suggest it, (even when they're MDs or PhDs) it seems to land different.

I think it also gets back a little to the "Food is medicine" idea that will get eyerolls from some. But makes perfect sense to me.

We seem to fully understand caring for a pet in how and what we feed it, and what excercise it gets is crucial. What goes into something determines the state of that thing. Yet with our own bodies, sometimes it seems we don't think that way.

 

[djmich]

though you could argue our collective approach to weight management is another area lifestyle modification isn’t working.

I can't wrap my head around this. I understand that there's people with medical conditions that no amount of lifestyle can overcome, but for the average person lifestyle likely led to being overweight, so the fact that lifestyle can't undo it as a general rule is very surprising. I linked an article* in the fat to fit thread that points the finger at the developed world and it's ultraprocessed diet since the same level of activity in the developing world doesn't result in our level of obesity. My interpretation of that is its less physiological and more psychological since a pivot and commitment to a less processed diet might produce the desired outcome. Ofcourse a lifetime of bad habits is pretty hard to overcome. Does that matter? Probably not. Results are results, but my belief for myself is that my good habits are just as good as bad habits with medical intervention.

* https://www.msn.com/en-us/health/other/ar-AA1IDR4o

But to your point, something like cancer and I'm not taking a wait and see approach. I'll seek out the best care i can find and follow the recommendations to the letter immediately. I feel like there's some amount of common sense involved in when you take a wait and see approach and when you need to act immediately. Common sense isn't so common though.

So how do you decide when enough is enough, and acquiesce to the meds?

Anything major and I'm first in line for medical intervention, surgery, pills, injections, whatever it takes. I'm not trying to be Steve Jobs and take a holistic approach to cancer.

I don't think we're all that different in when we would seek care outside of lifestyle. Like you I check all the boxes i can with lifestyle. Like you i don't really take many supplements (i do take creatine, vit d, fish oil). Like you i know my numbers and have them reviewed by a doctor. And like you at my last physical i had zero red flags. Correct me if I'm wrong here, but that's what I've gathered from our conversations.

So how do i know when it's time for meds? When the above no longer applies, or is no longer enough. My example with statins applies here. My cholesterol was high, i took 5 months and made dietary changes, upon retesting the levels were acceptable. If there was no change i would go on meds. My BP is borderline, but acceptable. If/when it gets high i won't hesitate to go on meds.

Also, I’d be curious what you, Joe, or anyone else thinks about the interview I linked above, in contrast to podcasts like Huberman’s?

I'll give this a watch and respond. I understand the limitations and contradictions the gurus present, but it's worth hearing the bear case from another professional.

I was raised in a very health conscious family so good habits were ingrained early. The last decade or so I've moved to a primarily plant based whole food Mediterranean diet. I lift 3 days a week, low weight high rep. I both walk 2 miles and mountain bike 7-10mi most days with a longer 15-20mi ride on the weekend. I pay attention to my hydration and practice good sleep hygiene. There's very little wiggle room for vast improvement in my lifestyle. I just want to bring that up as I'm not sitting around pounding doritos and cranking cigarettes expecting Peter Attia to fix me with supplements so i don't have to take meds.

I'm super competitive, mostly with myself at this point. For a time i ran full and half marathons, skate ski epics in winter, ultra endurance mtb events and I'm looking for those 1-2% improvements where i can get them. If morning sun, sauna, breath work, broccoli sprouts can do that i consider it a win and if they don't i can't see any downside outside of wasting my time.

Largely where I’m at as well, good post.

 

[DA RAIDERS]

I’ll speak to a conversation I had with @Terminalxylem specifically about weight loss and weight loss drugs.

I know that through diet and exercise one can maintain their weight. I’m willing to die on that hill. But in an in-depth conversation with term, he presented me with the facts that I already knew, but dismissed. I was/am fairly unyielding and arrogant in my opinion that diet and exercise alone will do the trick. I’m also very anti pharma. However… Most people fail. Look around. How many fit people do you see? I’m 56. How many fit 56 year olds do you see? I’m more fit than most dudes my age..I work out. I’m very active. To be even healthier, I could still lose 10 lbs. term was quite blunt about that. 5’10” 185# for reference.

Term pointed the massive failure rate. What really struck me from his point of view was how many times people say they’re going to change their habits. And they just don’t. Again, look around. Most people don’t want to put in the work. He also went over all of the other benefits of weight loss. Which are NUMEROUS. I’ve softened my stance and see how for most people (sad to say) the pharma route will be the most effective and beneficial.

I’ve never met a Dr that didn’t espouse a healthier life style. I think most are tired of hearing how the patient is going to change their habits. I’m know the patients are full of good intentions. It just doesn’t translate most of the time.

 

[Joe Bryant]

I think it's interesting that the obesity rates in the US are 10x what they are in Japan. This article talks about some reasons why. https://www.npr.org/2023/08/03/1191792973/why-its-easier-to-make-healthy-food-choices-in-japan

I understand the sentiment of just giving up and acknowledging people won't / can't lose weight without pharmaceutical help. Seems odd Japan is able to do it.

Aside from Japan or other countries, I also think it's interesting that just in the US, our obesity rates have more than tripled since the 1960s. https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

 

[Dinsy Ejotuz]

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

+1

I'd love to see us invest in public infrastructure and restructure society to encourage walking; deeply educate kids on the importance of nutrition by making school lunches from scratch with fresh food every day, have the kids serve each other, and treat school lunchtime as a communal ritual that teaches what healthy food and portion control looks like; maybe even run an anti-smoking-style public service campaign on the proven dangers of industrialized junk food and other highly processed foods (especially meat).

(the things pointed to in the article as the causes of Japan's lower weight)

But then I look at what's happening today around vaccines, and I figure we better just go ahead and prescribe the drugs. Because IMO literally every one of those things is impossible in America, 2025.

 

[DA RAIDERS]

I think it's interesting that the obesity rates in the US are 10x what they are in Japan. This article talks about some reasons why. https://www.npr.org/2023/08/03/1191792973/why-its-easier-to-make-healthy-food-choices-in-japan

I understand the sentiment of just giving up and acknowledging people won't / can't lose weight without pharmaceutical help. Seems odd Japan is able to do it.

Aside from Japan or other countries, I also think it's interesting that just in the US, our obesity rates have more than tripled since the 1960s. https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

No one said to give up. Americans are lazy. We live in a microwave society, where we must have everything immediately. Most people just aren’t willing to put in the work. Be it for losing weight and keeping it off, to forcing the food manufacturing companies to make things in a healthier manor. Everything is POSSIBLE, but most don’t want to put in the work

 

[tommyGunZ]

Doesn't every doctor on earth believe that improving dietary and exercise habits would be beneficial to virtually every person's health and well being? Seems like Term and other Doctors who prescribe pharmaceuticals are responding to the reality of health care as it exists, while these diet/exercise podcast gurus state the obvious and wonder why everyone doesn't make healthy choices.

Seems clear that there are overarching structural issues that are leading to higher obesity rates, lower life expectancy rates, and people making poor choices. No one wants to be obese and unhealthy. As a society we don't want to make the investments and structural changes in public health that would result in the type of changes these gurus want. We say we want that, but we don't even want to pay for basic health care for everyone, much less the far more expensive costs related to fixing the obesity crisis.

 

[tommyGunZ]

I think it's interesting that the obesity rates in the US are 10x what they are in Japan. This article talks about some reasons why. https://www.npr.org/2023/08/03/1191792973/why-its-easier-to-make-healthy-food-choices-in-japan

I understand the sentiment of just giving up and acknowledging people won't / can't lose weight without pharmaceutical help. Seems odd Japan is able to do it.

Aside from Japan or other countries, I also think it's interesting that just in the US, our obesity rates have more than tripled since the 1960s. https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

No one said to give up. Americans are lazy. We live in a microwave society, where we must have everything immediately. Most people just aren’t willing to put in the work. Be it for losing weight and keeping it off, to forcing the food manufacturing companies to make things in a healthier manor. Everything is POSSIBLE, but most don’t want to put in the work

This, plus we don't want to pay for it.

 

[DA RAIDERS]

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

+1

I'd love to see us invest in public infrastructure and restructure society to encourage walking; deeply educate kids on the importance of nutrition by making school lunches from scratch with fresh food every day, have the kids serve each other, and treat school lunchtime as a communal ritual that teaches what healthy food and portion control looks like; maybe even run an anti-smoking-style public service campaign on the proven dangers of industrialized junk food and other highly processed foods (especially meat).

(the things pointed to in the article as the causes of Japan's lower weight)

But then I look at what's happening today around vaccines, and I figure we better just go ahead and prescribe the drugs. Because IMO literally every one of those things is impossible in America, 2025.

yep. The ¡my freedoms! People lose their minds when any kind of “rule” is suggested. That hurdle alone is impossible as our country stands now.

NYC did a misguided attempt to ban huge sugary drinks. It was terribly written and had weird exemptions and was struck down by the courts. however misguided, that’s the sort of thing that needs to happen.

 

[DA RAIDERS]

I think it's interesting that the obesity rates in the US are 10x what they are in Japan. This article talks about some reasons why. https://www.npr.org/2023/08/03/1191792973/why-its-easier-to-make-healthy-food-choices-in-japan

I understand the sentiment of just giving up and acknowledging people won't / can't lose weight without pharmaceutical help. Seems odd Japan is able to do it.

Aside from Japan or other countries, I also think it's interesting that just in the US, our obesity rates have more than tripled since the 1960s. https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

No one said to give up. Americans are lazy. We live in a microwave society, where we must have everything immediately. Most people just aren’t willing to put in the work. Be it for losing weight and keeping it off, to forcing the food manufacturing companies to make things in a healthier manor. Everything is POSSIBLE, but most don’t want to put in the work

This, plus we don't want to pay for it.

This times a million. Again, most don’t want to put in the work.

 

[KarmaPolice]

I think it's interesting that the obesity rates in the US are 10x what they are in Japan. This article talks about some reasons why. https://www.npr.org/2023/08/03/1191792973/why-its-easier-to-make-healthy-food-choices-in-japan

I understand the sentiment of just giving up and acknowledging people won't / can't lose weight without pharmaceutical help. Seems odd Japan is able to do it.

Aside from Japan or other countries, I also think it's interesting that just in the US, our obesity rates have more than tripled since the 1960s. https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

Their food is gross and they seem to smoke a lot too. Easier to stay skinny.

 

[KarmaPolice]

Seriously though, I think a ton has to come down to our sugar/carbs intake and ridiculously huge portion sizes we have.

 

[tommyGunZ]

When I see things like that, it makes me hesitant to just give up and say we're not able to do it without drugs.

+1

I'd love to see us invest in public infrastructure and restructure society to encourage walking; deeply educate kids on the importance of nutrition by making school lunches from scratch with fresh food every day, have the kids serve each other, and treat school lunchtime as a communal ritual that teaches what healthy food and portion control looks like; maybe even run an anti-smoking-style public service campaign on the proven dangers of industrialized junk food and other highly processed foods (especially meat).

(the things pointed to in the article as the causes of Japan's lower weight)

But then I look at what's happening today around vaccines, and I figure we better just go ahead and prescribe the drugs. Because IMO literally every one of those things is impossible in America, 2025.

yep. The ¡my freedoms! People lose their minds when any kind of “rule” is suggested. That hurdle alone is impossible as our country stands now.

NYC did a misguided attempt to ban huge sugary drinks. It was terribly written and had weird exemptions and was struck down by the courts. however misguided, that’s the sort of thing that needs to happen.

Philly did the same thing with soft drinks and they got killed for it. A recent effort to make school lunches healthier was demonized by a big portion of our society.

People don't want to make hard changes or pay for the changes we need. Until then, it's not the Doctors and big Pharma at fault in my opinion. It's our collective fault as a society for not prioritizing our health and well being.

 

[Joe Bryant]

much less the far more expensive costs related to fixing the obesity crisis.

I wonder what it would take or how expensive it would be to get us back to the obesity levels we had in the 60's?

Did we spend a lot of money on it back then?

 

[tommyGunZ]

much less the far more expensive costs related to fixing the obesity crisis.

I wonder what it would take or how expensive it would be to get us back to the obesity levels we had in the 60's?

Presumably without the food insecurity and hunger that contributed to those low rates?

It's a fascinating question, and reminds me of something I read a few years ago where someone commented on what a miracle of modern society a McDonald's cheeseburger is (all that protein for so cheap in a tasty form - billions of people on earth need that) while also pointing out how our over consumption of easy, cheap food was also killing so many of us.

 

[The Longtime Lurker]

much less the far more expensive costs related to fixing the obesity crisis.

I wonder what it would take or how expensive it would be to get us back to the obesity levels we had in the 60's?

Did we spend a lot of money on it back then?

I suspect there wasn't anywhere near the levels of ultraprocessed foods (defined as "industrial formulations of five or more ingredients" for instance). I linked an article earlier that contained a pretty fascinating study on populations that consume vs populations that don't consume them and what the obesity levels looked like. Eliminating those foods would seem to make the most sense as a starting point. It's a pretty big industry and Americans love their junk food, so I'm not sure what getting Joe Public to eat better would look like on a grand scale.

The more recent posts I've read are spot on imo. Doctors really have no choice in most cases but to prescribe medications. There's simply no appetite to do the work it takes to maintain much less correct health in the general population. People that do are outliers and not representative of a doctors normal patient load. It's unfortunate and i believe a casualty of our fast paced on-demand society as is mentioned by pretty much everybody else commenting. Until that changes medication probably is the only big picture solution.

 

[dgreen]

Our increase in suburban living and driving most places was around 1960. Urban living encourages walking. Not sure how big of a chunk of the increased obesity this accounts for, but I think it is a factor.

 

[DA RAIDERS]

much less the far more expensive costs related to fixing the obesity crisis.

I wonder what it would take or how expensive it would be to get us back to the obesity levels we had in the 60's?

Did we spend a lot of money on it back then?

It’s mindset more than money. It’s not more expensive to eat well. But it takes more effort. One has to make most of their own food. With quality ingredients. It all boils down to be willing to put in the work. Same with exercise.

The expensive part is changing how food is made. HFCS for example should be banned. Lobbyists will not let that happen as we stand now.

 

[Terminalxylem]

Side thought. How an obviously accomplished and demonstrably competent person transforms from MD or Stanford PhD to "Internet Guru" the moment they become popular or make money with their expertise is interesting.

I think it occurs when they abandon the scientific method, in favor of advocating unvalidated approaches to health, and cloud their clinical judgement with internet fame, and/or financial gain - the moment they monetize expertise which doesn’t exist.

None of this takes away from their accomplishments as a neuroscientist, PhD, or MD, and demonstrates additional skill as a businessperson.

Personally, I prefer to focus on data, accept limitations in our knowledge base, and approach claims made by those who don’t with skepticism. There’s only so much time in the day; I prefer not spending it on multihour podcasts. And I don’t want businesspeople making health decisions, ever.

As the vast majority of us aren’t doing everything “right” healthwise, it makes sense to start with the basics, before entertaining whole body MRIs, batteries of blood tests, and handfuls of supplements, imo. Obviously YMMV: it’s your body, time and money. And some people may be able to do it all.

Now, is it possible these guys are ahead of the curve, and truly believe everything they’re selling? Maybe. Problem is, we’ll never know.

 

[djmich]

much less the far more expensive costs related to fixing the obesity crisis.

I wonder what it would take or how expensive it would be to get us back to the obesity levels we had in the 60's?

Did we spend a lot of money on it back then?

It’s mindset more than money. It’s not more expensive to eat well. But it takes more effort. One has to make most of their own food. With quality ingredients. It all boils down to be willing to put in the work. Same with exercise.

The expensive part is changing how food is made. HFCS for example should be banned. Lobbyists will not let that happen as we stand now.

That's it, work and willpower. We can blame the medical industry, supermarkets, producers, whoever...but like everything in the US it's always someone elses fault.

 

[Terminalxylem]

In talking with my MD friend, it seems lots of people don't want this. They have a problem, and just want the pharmaceutical solution to their problem instead of more "natural" solutions like better diet and movement. Obviously, lots of doctors will suggest that and that seems proper. When the "Internet Gurus" suggest it, (even when they're MDs or PhDs) it seems to land different.

It’s great you guys want to optimize diet and exercise. Every healthcare provider should encourage patients like you. And no one should dismiss advice along those lines.

What “lands different” is promoting venison jerky as a vehicle for consuming 50% more daily protein than has ever shown clinical benefit, and may actually cause harm. Especially when the person endorsing the jerky makes money from its sale, while simultaneously dismissing the utility of a Mediterranean diet.

I also object to equating “natural” with better. Raw milk is natural, for example, as are the deadly bacteria in it.

ETA Also not a fan of doing a bunch of exploratory tests for profit, then shirking responsibility for abnormal results to clinicians.

 

[Joe Bryant]

Our increase in suburban living and driving most places was around 1960. Urban living encourages walking. Not sure how big of a chunk of the increased obesity this accounts for, but I think it is a factor.

Makes sense it would be a factor. It just seems shocking to me the obesity rate has tripled since the 60's. Old pictures from that era obviously show small sample sizes but beach pictures from 50 years ago vs what we see today are wild.

And maybe we did spend tons more on food back then. Clearly, something is radically different. And it hasn't seemed to infect other modern countries like Japan the way it has us.

 

[Joe Bryant]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

 

[Joe Bryant]

Presumably without the food insecurity and hunger that contributed to those low rates?

Do you think food insecurity and hunger contribute to Japan's low obesity rates? If so, how important of a factor would you guess it is?

 

[DA RAIDERS]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

That’s not what term said at all

 

[Joe Bryant]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

That’s not what term said at all

He said

I also object to equating “natural” with better.

I disagree. Not in every case, but generally, I do equate "natural" with "better" for foods.

 

[Terminalxylem]

Seriously though, I think a ton has to come down to our sugar/carbs ultraprocessed food/sweetened beverage intake, ridiculously huge portion sizes, and lack of consistent physical activity we have.

FYP

 

[DA RAIDERS]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

That’s not what term said at all

He said

I also object to equating “natural” with better.

I disagree. Not in every case, but generally, I do equate "natural" with "better" for foods.

Context matters. He’s speaking to the podcast gurus. Not to all food production

 

[Alex P Keaton]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

That’s not what term said at all

He said

I also object to equating “natural” with better.

I disagree. Not in every case, but generally, I do equate "natural" with "better" for foods.

I tend to aim for minimally processed food. That isn’t always the same as “natural” food but I think you are basically saying something similar.

 

[KarmaPolice]

Seriously though, I think a ton has to come down to our sugar/carbs ultraprocessed food intake, ridiculously huge portion sizes, and lack of consistent physical activity we have.

FYP

Very fair fix.

 

[Terminalxylem]

I also object to equating “natural” with better.

No worries. We'll disagree there. Of course there are some things like raw milk that should be processed beyond the raw state to be safe. Same with raw honey for infants. I'm sure there are other things. But in general, I'll always lean to more natural and less processed foods.

I’m not saying (ultra)processed foods are good. They’re demonstrably terrible.

Just pointing out the appeal to nature fallacy, which is ubiquitous in the alternative medicine world.