Obesity and Ozempic and more (4 Viewers)

[Terminalxylem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

 

[Terminalxylem]

I’m assuming the podcast is more nuanced, but saying that some people just can’t exercise or diet and would rather take a pill is an awful take. They are designed for where tried diet and exercise and they are not enough. My wife has been trying to get her weight down for years — she goes to orange theory around 4-5 times per week, eats pretty much the same as me (though with less alcohol), but she has not been able to get her weight down despite that (by comparison, I’m a pretty slim guy at around 155). Doctor recommended Ozempic to her, but was not seeing any impact. Doctor switched her over to Monjauro to see if that could produce different results.

It’s not like taking the pill, so can lose weight while sitting around eating Cheetos all day.

How heavy is she? Societal pressure tells women they should look skeletal. If she’s otherwise healthy and weighs, say 160, due to her genetics, that’s healthy.

I’m not going to post her weight here, but she is significantly heavier than me and it has caused some medical issues.

Fair enough. And I’m not shaming her in any way. Just pointing out that the body shaming, especially for women, is disgusting. My daughter’s best friend is a big girl. 6’ curvy but not fat. She thinks she’s some sort creature from another planet. She’s pretty. She’s healthy and she thinks she should lose weight. It’s sad. Her mom is on ozempic for the sole purpose to lose weight. She’s not fat either. Maybe 5-8 165#

While I don’t condone body shaming, I actually think cultural acceptance of overweight and obesity is a big part of the problem. We no longer have any idea what constitutes a healthy weight.

 

[Murph]

But then it goes back to the practical reality of it. If someone is going to continue eating too much and poorly and won't exercise, is it better to give them Ozempic if they can't solve the problem on their own?

I think it may be.

This is pretty much where I land (though we'll need to see long term what it does to the gut microbiome and other downstream consequences).

My issue with Ozempic isn't use of the drug itself, but how screwed up the incentives are in our health care system. Why will insurance (and the American taxpayers) cover an expensive drug you basically have to take for life (or else the weight comes back). But they won't cover a gym membership (sure maybe a rebate if you fill out 15 forms). To say nothing of how American food is pretty much poisoning us....

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

 

[Mitchie]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

 

[johnnycakes]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

 

[Terminalxylem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

Believe me, I'm all for healthy diet and exercise.

But it isn't binary decision, as failure to maintain a healthy weight is almost certainly more harmful than compromising with pharmacologic weight management. For many, it's also probably worse than bariatric surgery.

I rank the available options as 1. Healthy weight achieved by diet and exercise. 2. Healthy weight achieved using medically approved interventions (meds > surgery). 3. Staying obese. And even if ideal weight cannot be attained, it's typically better for an obese person to lose some weight, by just about any means possible.

I find this argument akin to preaching abstinence to avoid teenage pregnancy and STI. Sure, it's possible, and should work for anyone with a little discipline. But the reality is, humans aren't perfect. I'd rather promote sexual education, pass out a few condoms, and make oral contraception readily available, than rigidly reject harm reduction, in favor of behavioral perfection.

 

[massraider]

I won’t necessarily say a disease but you are way shortchanging folks with obesity and eating problems. I don’t think you would do the same to a drug or alcohol addict. Nobody tells the drug addict to just have willpower.

No, but they do tell them to STOP TAKING DRUGS, don't they? Isn't that the final goal??

 

[AAABatteries]

I won’t necessarily say a disease but you are way shortchanging folks with obesity and eating problems. I don’t think you would do the same to a drug or alcohol addict. Nobody tells the drug addict to just have willpower.

No, but they do tell them to STOP TAKING DRUGS, don't they? Isn't that the final goal??

What ends up being tricky in this conversation is nobody tells a drug addict to just have a little or has them over for a party and puts out drugs for everyone. But that’s exactly what happens with sugar.

The goal should be to have these people be as healthy as they can be. For many, that will include taking this drug.

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

 

[AAABatteries]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

If we came up with a pill that helps alcoholics not drink would you call that the lazy way out? I wouldn’t - anything to keep them from drinking.

 

[johnnycakes]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

OK, I get that. What I don't get is all the doctors prescribing Ozempic and Mounjaro strictly for weight-loss in patients who are not diagnosed with T2D. For the morbidly obese, like I said above, there is Wegovy and Zepbound, which are FDA-Approved for weight loss.

 

[Don Quixote]

Yeah, I’m going to stay out of this thread before I get banned.

 

[Terminalxylem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

OK, I get that. What I don't get is all the doctors prescribing Ozempic and Mounjaro strictly for weight-loss in patients who are not diagnosed with T2D. For the morbidly obese, like I said above, there is Wegovy and Zepbound, which are FDA-Approved for weight loss.

They're gaming the system, as the same meds labelled for diabetes are often cheaper.

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

Believe me, I'm all for healthy diet and exercise.

But it isn't binary decision, as failure to maintain a healthy weight is almost certainly more harmful than compromising with pharmacologic weight management. For many, it's also probably worse than bariatric surgery.

I rank the available options as 1. Healthy weight achieved by diet and exercise. 2. Healthy weight achieved using medically approved interventions. 3. Staying obese. And even if ideal weight cannot be attained, it's typically better for an obese person to lose some weight, by just about any means possible.

I find this argument akin to preaching abstinence to avoid teenage pregnancy and STI. Sure, it's possible, and should work for anyone with a little discipline. But the reality is, humans aren't perfect. I'd rather promote sexual education, pass out a few condoms, and make oral contraception readily available, than rigidly reject harm reduction, in favor of behavioral perfection.

Look I think for people that have a serious morbid obesity issue using the drug is a good way to jump start them and then hopefully they can “adopt” the lifestyle change that is absolutely needed to have a longer healthier life. Because the drug is temporary. And long term use could have unintended consequences.

 

[johnnycakes]

Yeah, I’m going to stay out of this thread before I get banned.

C'mon, chief, you only live once. Throw caution to the wind and speak your piece!

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

OK, I get that. What I don't get is all the doctors prescribing Ozempic and Mounjaro strictly for weight-loss in patients who are not diagnosed with T2D. For the morbidly obese, like I said above, there is Wegovy and Zepbound, which are FDA-Approved for weight loss.

My point exactly.

 

[Don Quixote]

Yeah, I’m going to stay out of this thread before I get banned.

C'mon, chief, you only live once. Throw caution to the wind and speak your piece!

The Summer Grooves thread is too important.

I do wish posters who refer to those who use for weight loss as lazy would stop generalizing in that manner, but I will leave it as politely as I can in that manner.

 

[Terminalxylem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

Believe me, I'm all for healthy diet and exercise.

But it isn't binary decision, as failure to maintain a healthy weight is almost certainly more harmful than compromising with pharmacologic weight management. For many, it's also probably worse than bariatric surgery.

I rank the available options as 1. Healthy weight achieved by diet and exercise. 2. Healthy weight achieved using medically approved interventions. 3. Staying obese. And even if ideal weight cannot be attained, it's typically better for an obese person to lose some weight, by just about any means possible.

I find this argument akin to preaching abstinence to avoid teenage pregnancy and STI. Sure, it's possible, and should work for anyone with a little discipline. But the reality is, humans aren't perfect. I'd rather promote sexual education, pass out a few condoms, and make oral contraception readily available, than rigidly reject harm reduction, in favor of behavioral perfection.

Look I think for people that have a serious morbid obesity issue using the drug is a good way to jump start them and then hopefully they can “adopt” the lifestyle change that is absolutely needed to have a longer healthier life. Because the drug is temporary. And long term use could have unintended consequences.

I'm not advocating everyone take these meds indefinitely, but I'm also not discounting the possibility some might, for fear of unforeseen consequences.

We know the long term consequences of obesity, and the rate lifestyle modification fails. At some point, we have to be willing to compromise, and I think we're waaaay past that point.

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

Believe me, I'm all for healthy diet and exercise.

But it isn't binary decision, as failure to maintain a healthy weight is almost certainly more harmful than compromising with pharmacologic weight management. For many, it's also probably worse than bariatric surgery.

I rank the available options as 1. Healthy weight achieved by diet and exercise. 2. Healthy weight achieved using medically approved interventions. 3. Staying obese. And even if ideal weight cannot be attained, it's typically better for an obese person to lose some weight, by just about any means possible.

I find this argument akin to preaching abstinence to avoid teenage pregnancy and STI. Sure, it's possible, and should work for anyone with a little discipline. But the reality is, humans aren't perfect. I'd rather promote sexual education, pass out a few condoms, and make oral contraception readily available, than rigidly reject harm reduction, in favor of behavioral perfection.

Look I think for people that have a serious morbid obesity issue using the drug is a good way to jump start them and then hopefully they can “adopt” the lifestyle change that is absolutely needed to have a longer healthier life. Because the drug is temporary. And long term use could have unintended consequences.

I'm not advocating everyone take these meds indefinitely, but I'm also not discounting the possibility some might, for fear of unforeseen consequences.

We know the long term consequences of obesity, and the rate lifestyle modification fails. At some point, we have to be willing to compromise, and I think we're waaaay past that point.

It’s too bad. But you are
Probably right.

It’s an epidemic.

 

[AAABatteries]

Yeah, I’m going to stay out of this thread before I get banned.

C'mon, chief, you only live once. Throw caution to the wind and speak your piece!

The Summer Grooves thread is too important.

I do wish posters who refer to those who use for weight loss as lazy would stop generalizing in that manner, but I will leave it as politely as I can in that manner.

Don’t let people who don’t know what they are talking about get you banned.

 

[massraider]

What ends up being tricky in this conversation is nobody tells a drug addict to just have a little or has them over for a party and puts out drugs for everyone. \

Yes, they do.
And alcoholics can face it every time they go out to dinner.

Their goal is still to stop.

People are heroes if they stop their friends from taking drugs or drinking alcohol. Not too many heroes out there making their friends eat healthy.

Why is that?

 

[Todem]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

If we came up with a pill that helps alcoholics not drink would you call that the lazy way out? I wouldn’t - anything to keep them from drinking.

I am not trying to be argumentative.

People can do whatever the heck they want.

Freewill is a good thing.

 

[AAABatteries]

What ends up being tricky in this conversation is nobody tells a drug addict to just have a little or has them over for a party and puts out drugs for everyone. \

Yes, they do.
And alcoholics can face it every time they go out to dinner.

Their goal is still to stop.

People are heroes if they stop their friends from taking drugs or drinking alcohol. Not too many heroes out there making their friends eat healthy.

Why is that?

I do think people put out a bunch of alcohol at parties but my experience is that doesn’t happen with known alcoholics but maybe I’m wrong. I have an uncle who is an alcoholic and we would never serve alcohol around him.

 

[Terminalxylem]

Podcast was decent. Some of his medical commentary was overstated (eg. estimating the majority of population will take weight loss drugs, when less than 2/3 of us take all prescription medications combined; risks of diabetes, including how much it shortens lifespan), but overall good summary, with a couple issues I hadn’t considered.

The end about Japan was really interesting. I’ve come under fire complimenting their culture on this forum, but suffice it to say, they’re waaaaay different than Americans. So I doubt the things they’re doing would fly here. And the measures they’re taking are effectively preventative: we’ve already got an obesity problem that needs our immediate attention, long before any policy changes can be implemented.

 

[Pip's Invitation]

Without even listening, of course it’s a band aid.

The American microwave society wants everything NOW. And easily as possible. Have a health problem? Here’s a pill, no need to change what you’re doing/not doing. Eat and drink away!

Yes, I don't think many would disagree it's a band-aid.

The question is, do you participate with the band-aid?

If it can cut down diabetes and a ton of other health issues connected to obesity, is it worth it?

That's an individualized decision one has to make with one's family and health care providers. So much of medicine is about figuring out where the risk/benefit line is for each patient, and this is no different.

What has changed in the last 10+ years is that obesity had been perceived by the medical community exclusively as the result of a patient's poor lifestyle choices and the lack of willpower to change them, but that is no longer the case. Obesity is now classified as a disease, and it is recognized that for some patients, it is at least in part a result of things they cannot control -- genetics, metabolism, eating disorders, etc. So, why shouldn't it be considered a target for pharmaceutical treatment like high blood pressure, high cholesterol, etc., are? Especially now that these new drugs make cardiometabolic issues better, as opposed to older weight-loss drugs that make them worse.

Someone who is young, wants to lose 10 pounds and has no other health conditions should not be taking these drugs. There are plenty of other ways to help them that have fewer side effects and less cost. But for people who have more severe obesity and other health conditions, these drugs may very well be the best solution for them; for many of them, only these drugs or bariatric surgery are going to get them where they need to be.

 

[eoMMan]

Interesting that there’s such strong takes here against a drug that’s helping a lot of people get healthier, even if there were other ways of those people getting healthier (more extreme diets, exercise, etc.). I wonder if there’s a similar opinion on other drugs that are helping people get healthier, such as cholesterol lowering drugs.

Or are you guys just unleashing because there’s no political forum to do it in?

 

[FairWarning]

Maybe the US should take a harder look at food additives that add to obesity.

 

[Terminalxylem]

Maybe the US should take a harder look at food additives that add to obesity.

Aside from added sugar, including high fructose corn syrup, to what are you referring?

 

[DA RAIDERS]

I’m assuming the podcast is more nuanced, but saying that some people just can’t exercise or diet and would rather take a pill is an awful take. They are designed for where tried diet and exercise and they are not enough. My wife has been trying to get her weight down for years — she goes to orange theory around 4-5 times per week, eats pretty much the same as me (though with less alcohol), but she has not been able to get her weight down despite that (by comparison, I’m a pretty slim guy at around 155). Doctor recommended Ozempic to her, but was not seeing any impact. Doctor switched her over to Monjauro to see if that could produce different results.

It’s not like taking the pill, so can lose weight while sitting around eating Cheetos all day.

How heavy is she? Societal pressure tells women they should look skeletal. If she’s otherwise healthy and weighs, say 160, due to her genetics, that’s healthy.

I’m not going to post her weight here, but she is significantly heavier than me and it has caused some medical issues.

Fair enough. And I’m not shaming her in any way. Just pointing out that the body shaming, especially for women, is disgusting. My daughter’s best friend is a big girl. 6’ curvy but not fat. She thinks she’s some sort creature from another planet. She’s pretty. She’s healthy and she thinks she should lose weight. It’s sad. Her mom is on ozempic for the sole purpose to lose weight. She’s not fat either. Maybe 5-8 165#

While I don’t condone body shaming, I actually think cultural acceptance of overweight and obesity is a big part of the problem. We no longer have any idea what constitutes a healthy weight.

I agree. It’s a double top secret reverse trick. Being fat has become normal in this country. It’s sad.

 

[DA RAIDERS]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

Should work.

But the practical reality is, most diet and exercise programs fail to achieve long-term weight loss. Now, we can certainly work on changing some of the underlying reasons for their nearly inevitable failure, though it’s an uphill battle on both the individual and societal level.

In the meantime, obesity-related morbidity and mortality marches on. Too bad finger wagging doesn’t burn many calories, I guess.

The reality is the person has to commit to a lifestyle change that is centered around moderate, consistent exercise and eating better and less.

It really is the only real long term solution.

Commitment.

But problem is that isn't working for a lot of people. Ideally a drug wouldn't be the solution but I don't see anything else changing anytime soon.

Agreed. Commitment = Willpower. And willpower does not work for many people in many different situations. For me Ozempic and Mounjaro have been absolute life-savers. And not just because I have lost some weight with them. They have knocked my A1C down to totally acceptable levels. Before Ozempic, my A1C tested as high as 8.6%. Now it's 5.5% to 5.7%.

You needed it for medical purposes. I am speaking more To the people who don’t have diabetes and are simply taking the lazy way out to weight loss.

OK, I get that. What I don't get is all the doctors prescribing Ozempic and Mounjaro strictly for weight-loss in patients who are not diagnosed with T2D. For the morbidly obese, like I said above, there is Wegovy and Zepbound, which are FDA-Approved for weight loss.

Straight cash homey. Plain and simple.

 

[Oracle]

Podcast was decent. Some of his medical commentary was overstated (eg. estimating the majority of population will take weight loss drugs, when less than 2/3 of us take all prescription medications combined; risks of diabetes, including how much it shortens lifespan), but overall good summary, with a couple issues I hadn’t considered.

The end about Japan was really interesting. I’ve come under fire complimenting their culture on this forum, but suffice it to say, they’re waaaaay different than Americans. So I doubt the things they’re doing would fly here. And the measures they’re taking are effectively preventative: we’ve already got an obesity problem that needs our immediate attention, long before any policy changes can be implemented.

I think I’m the only person that has commented about the Japanese culture (maybe?). I find it hard to complement a culture that allows doctors to refuse to see patients with a high BMI. Discrimination is alive and well in Japan. Of all the people that need help, I would say those are the people. Furthermore, the Japanese reporting standards are skewed/odd. If you are not treating the people that need help, then there is no problem and that’s what is reported. If you walk around Japan, you will unfortunately see that the younger generations are moving towards the cusp of an obesity problem. I’m pretty sure it has everything to do with introducing the Western diet into Japanese culture as evidenced by the lines at KFC and Popeyes.

I do applaud the Japanese euthanasia/death with dignity laws. I wish the US would move more towards that mentality.

 

[Terminalxylem]

Podcast was decent. Some of his medical commentary was overstated (eg. estimating the majority of population will take weight loss drugs, when less than 2/3 of us take all prescription medications combined; risks of diabetes, including how much it shortens lifespan), but overall good summary, with a couple issues I hadn’t considered.

The end about Japan was really interesting. I’ve come under fire complimenting their culture on this forum, but suffice it to say, they’re waaaaay different than Americans. So I doubt the things they’re doing would fly here. And the measures they’re taking are effectively preventative: we’ve already got an obesity problem that needs our immediate attention, long before any policy changes can be implemented.

I think I’m the only person that has commented about the Japanese culture (maybe?). I find it hard to complement a culture that allows doctors to refuse to see patients with a high BMI. Discrimination is alive and well in Japan. Of all the people that need help, I would say those are the people. Furthermore, the Japanese reporting standards are skewed/odd. If you are not treating the people that need help, then there is no problem and that’s what is reported. If you walk around Japan, you will unfortunately see that the younger generations are moving towards the cusp of an obesity problem. I’m pretty sure it has everything to do with introducing the Western diet into Japanese culture as evidenced by the lines at KFC and Popeyes.

I do applaud the Japanese euthanasia/death with dignity laws. I wish the US would move more towards that mentality.

Not sure how common Japanese docs are refusing to see high BMI patients, though I expect it’s uncommon. That said, the same phenomenon occurs in the US, as some surgeons won’t operate/perform procedures on morbidly obese individuals.

 

[Oracle]

Podcast was decent. Some of his medical commentary was overstated (eg. estimating the majority of population will take weight loss drugs, when less than 2/3 of us take all prescription medications combined; risks of diabetes, including how much it shortens lifespan), but overall good summary, with a couple issues I hadn’t considered.

The end about Japan was really interesting. I’ve come under fire complimenting their culture on this forum, but suffice it to say, they’re waaaaay different than Americans. So I doubt the things they’re doing would fly here. And the measures they’re taking are effectively preventative: we’ve already got an obesity problem that needs our immediate attention, long before any policy changes can be implemented.

I think I’m the only person that has commented about the Japanese culture (maybe?). I find it hard to complement a culture that allows doctors to refuse to see patients with a high BMI. Discrimination is alive and well in Japan. Of all the people that need help, I would say those are the people. Furthermore, the Japanese reporting standards are skewed/odd. If you are not treating the people that need help, then there is no problem and that’s what is reported. If you walk around Japan, you will unfortunately see that the younger generations are moving towards the cusp of an obesity problem. I’m pretty sure it has everything to do with introducing the Western diet into Japanese culture as evidenced by the lines at KFC and Popeyes.

I do applaud the Japanese euthanasia/death with dignity laws. I wish the US would move more towards that mentality.

Not sure how common Japanese docs are refusing to see high BMI patients, though I expect it’s uncommon. That said, the same phenomenon occurs in the US, as some surgeons won’t operate/perform procedures on morbidly obese individuals.

This is from the Japan civilian medical advocacy group (Facebook) that is lobbying Congress right now. This is what is going on with the 110,000 military/dependants/civilians stationed in Japan and Japanese local nationals. Refusing to see high BMI patients (both US and Japanese) is common enough, that US civilians/military are asking the department of defense for adequate medical help on base.

DEAR COMMUNITY,

Military and civilian patients in Japan face alarming gaps in emergency care, making preventive care extremely important. Yet our trust in the quality of care we receive is dwindling due to dismissed concerns, long wait times, and staffing shortages. What happens when your care falls short?

Your stories reveal misdiagnoses, delayed treatments, and ignored test results:

ON BASE MISDIAGNOSIS: Cancer missed due to imaging and sample errors. Severe pneumonia dismissed as minor symptoms. Fractures reported as sprains, causing permanent damage.

OFF Base Limitations: Referral hurdles block off-base care. Even when you can be seen off base, issues include medication errors, BMI discrimination, and denied appointments.

Empowering Solutions:

CIVILIANS:

Seek FREE second opinions from major insurance providers. They can send your records to a major hospital in the states for another look.
Report denials of care and hardships - we track and report them anonymously to Congress and oversight bodies, fighting for more healthcare resources.
Reach out to state representatives - we can help you every step of the way with pre written letters and request a meeting on your behalf.

MILITARY:

You have the right to appointments within 28 days (faster if it’s urgent; 24 hours - 7 days). Contact your MTF Patient Advocacy program and say "my Access to Care standards are being violated". They can get you in quicker or have to refer you off base.
Tricare offers second opinion appointments with a different provider.
Tell us about denials of care and hardships. We get your stories to the top, anonymously.
Voice concerns at PFPC meetings and through ICE comments.
Resort to Joint Commission complaints (can be anonymous), IG reports (protected from retaliation), and legal action if needed.

YOUR VOICE MATTERS: Don't suffer in silence. Together, we can make a difference for everyone's access to medical care.

In Service,

Japan Civilian Medical Advocacy

 

[FairWarning]

Maybe the US should take a harder look at food additives that add to obesity.

Aside from added sugar, including high fructose corn syrup, to what are you referring?

Wouldn’t some of the genetic food processing add to the problem also? I could be off base on this. Other countries disallow itt.

 

[AAABatteries]

From the Google:

MSG, refined flour, high fructose corn syrup, and gluten.

MSG antagonizes the pancreas into pouring out more insulin and doctors call it a "hormonal cascade that makes you feel hungrier".

Refined flour causes your blood sugar levels to rise quickly, spiking your insulin before you crash.

Nutritionists say that refined sugar like high fructose corn syrup, which includes sodas, slows down the release of leptin, also known as the "I'm full" hormone.

The final toxic food ingredient, gluten, also called a gut-irritant, doesn't make your gut feel full..

—
Foods packed with added sugar, fat and salt trigger the brain's reward system, setting up a cycle of craving and addiction.

 

[bigbottom]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they attempt diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

Diet and exercise when done consistently will work almost all the time.

There is no magic bullet.

Eat less….move more.

The drugs are a band aid and if the behavior change does not happen your doomed. There is no cure except diet and exercise. It’s a serious commitment to yourself to change your lifestyle and unwind your sugar addiction, fast food addiction…..it takes a commitment.

Those who are so morbidly obese should start with simple walking and get into a pool and move…..move your muscles in a non impact pool. And you gotta
really commit to strict diet.

My understanding is that with these drugs people are eating materially less. If so, behavior is indeed changing on that front at least.

 

[Joe Bryant]

To talk about the drug. Sorry to Steady and Joe from arguing a tangent.

I would be worried for those who take it. The unknown of longterm but I think we all know the longterm of obesity, high BP and diabetes. If I was in the position many of these folks are in then I would consider it.

The one thing they talk about on the pod is that it does have some track record. As mentioned above it's been prescribed for something like 18 years for diabetes.

So we have some track record. Not 50 years worth. But a decent bit.

He said the one thing the scientists found was an substantial (like 50%) increase in chance people would get thyroid cancer. And to be clear, not that 50% get cancer. That it increases THE CHANCE you'll get thyroid cancer. If that risk is 1% without the drug, it would now be 1.5%. Most people will take that chance to get the benefits from weight loss.

Another thing they talked about was how it's a "lifetime" drug. Hari said he stopped it for a little while and his appetite came roaring back.

So that's something to consider too.

 

[Joe Bryant]

Their goal is still to stop.

People are heroes if they stop their friends from taking drugs or drinking alcohol. Not too many heroes out there making their friends eat healthy.

Why is that?

That's an interesting question.

 

[Joe Bryant]

My understanding is that with these drugs people are eating materially less. If so, behavior is indeed changing on that front at least.

That's correct. Hari talks about how he went from eating a ton of fried chicken to one piece would fill him up. Was still eating the exact same unhealthy food. Just way less of it.

And of course, the right way is to change the type of food as well which he did.

He described it as amazing with how he could feel full eating very little. My two close friends experienced the exact same effect.

They consumed way less calories than they had been eating.

 

[massraider]

And of course, the right way is to change the type of food as well which he did.

And therein lies the rub.

Just a small little comment, but to me this is the (less fat) elephant in the room.

 

[culdeus]

Maybe the US should take a harder look at food additives that add to obesity.

Aside from added sugar, including high fructose corn syrup, to what are you referring?

Hyper palatable food requires more preservatives to extend shelf life. It isn't a A=B thing but limiting certain preservatives makes or eliminates a lot of the food people get hooked on. The US I imagine leads the consumption of this

 

[Joe Bryant]

Maybe the US should take a harder look at food additives that add to obesity.

Aside from added sugar, including high fructose corn syrup, to what are you referring?

Hyper palatable food requires more preservatives to extend shelf life. It isn't a A=B thing but limiting certain preservatives makes or eliminates a lot of the food people get hooked on. The US I imagine leads the consumption of this

Yes. Hari made the statement that the common denominator for obesity was places where pre-packaged "manufactured" food took over.

 

[Joe Bryant]

The podcast talked about something that seems incredible.

US obesity rate is like 40%
Japan's obesity rate is 4%

 

[Pip's Invitation]

To talk about the drug. Sorry to Steady and Joe from arguing a tangent.

I would be worried for those who take it. The unknown of longterm but I think we all know the longterm of obesity, high BP and diabetes. If I was in the position many of these folks are in then I would consider it.

The one thing they talk about on the pod is that it does have some track record. As mentioned above it's been prescribed for something like 18 years for diabetes.

So we have some track record. Not 50 years worth. But a decent bit.

He said the one thing the scientists found was an substantial (like 50%) increase in chance people would get thyroid cancer. And to be clear, not that 50% get cancer. That it increases THE CHANCE you'll get thyroid cancer. If that risk is 1% without the drug, it would now be 1.5%. Most people will take that chance to get the benefits from weight loss.

Another thing they talked about was how it's a "lifetime" drug. Hari said he stopped it for a little while and his appetite came roaring back.

So that's something to consider too.

The other thing about thyroid cancer is that it's got one of the highest success rates of detection and eradication. I'd be less wary of risk for that than something like risk for pancreatic cancer.

 

[Joe Bryant]

The podcast talked about something that seems incredible.

US obesity rate is like 40%
Japan's obesity rate is 4%

I don't know if it's accurate, but the podcast talked about some shocking stuff. Like Japanese companies having their employees regularly weigh in. And if they gained weight, they have to submit a plan for how they'll lose weight.

US would have a meltdown if we did that.

 

[DA RAIDERS]

Maybe the US should take a harder look at food additives that add to obesity.

Aside from added sugar, including high fructose corn syrup, to what are you referring?

Hyper palatable food requires more preservatives to extend shelf life. It isn't a A=B thing but limiting certain preservatives makes or eliminates a lot of the food people get hooked on. The US I imagine leads the consumption of this

Yes. Hari made the statement that the common denominator for obesity was places where pre-packaged "manufactured" food took over.

In other news, water is wet.

This is the disconnect that most have with food in the good ole USA. They don’t want to make hash browns themselves, they want to buy them in the frozen section. One can pick almost any food. Cookies? Too much of a PIA to make them, buy em. Even veggies. Canned or frozen is “easier”. All the packaged food comes with preservatives, sugars, HFCS and other things that you would never add at at home making things yourself. And the secret the pre packed food folks dont want you to know is that it’s not significantly cheaper to buy all the prepackaged stuff. It’s been very successfully marketed that way, but it’s not. It IS more “work” to make your food from scratch.

And the same goes for restaurants. In order to make the food taste better Add more fat salt and sugars. Usually.

 

[Joe Bryant]

In other news, water is wet.

I don't think it's that obvious. People ask the legit question, "Why when we look at pictures of beaches from the 60's that the people look entirely different than today?"

Mass manufactured food seems to be the answer.

Understanding that seems useful as some people can move back toward making food.

 

[Battersbox]

Every individual should certainly try behavioral modification in earnest, before subjecting themselves to a (potentially lifelong) medication.

But how long should they try diet/exercise alone, and not achieve their desired weight loss, before we consider alternative strategies?

What if your obesity makes exercise intolerable, from joint pain, trouble breathing, chest discomfort, etc.?

I understand the reluctance to take meds, but at the same time, it's highly unlikely these medications are more harmful than unmitigated obesity.

Hopefully, this doesn’t end up like covid vaccination, where people fear extremely unlikely side effects more than the more harmful diseases it prevents/treats.

I strongly agree with this if the goal is to get the weight to a “exercisable” level and then coming off of it but I think that will be unlikely.

Yeah the shots give people the false impression that they can just do this without changing their lifestyle.

Anyway good luck to people that are strictly using the shots to lose weight.

I certainly would never use this not knowing the long term side effects just to lose weight vs diet and exercise.

But to each his/her own.

I don't think you understand what these drugs do.

They don't make you lose weight on their own. If you take these shots and eat exactly as you always have and exercise the exact same amount, nothing would happen. They help you change your lifestyle, and then you lose weight (which is exactly what you're advocating for).

 

[DA RAIDERS]

In other news, water is wet.

I don't think it's that obvious. People ask the legit question, "Why when we look at pictures of beaches from the 60's that the people look entirely different than today?"

Mass manufactured food seems to be the answer.

Understanding that seems useful as some people can move back toward making food.

Respectfully, I disagree. That’s like saying people don’t know that fast food isn’t that good for you. It’s not as obvious, but I think people know that home made food is healthier.

Example: home made Mac and and cheese is better for you than that neon orange poison sold in a box. I’d say that people are aware but choose to look the other way for convenience, ease, they’re used to it, and they think it’s way cheaper. And they’ve trained their bodies to crave the junk which is tough to change. Which is one reason why these drugs are so popular for those looking to just lose some weight. No work involved.

It’s not easy to make changes.