Obesity and Ozempic and more (4 Viewers)

[ConstruxBoy]

They are surprised when I tell them my goal is improving my VO2 to 41+ (I am 58).

Fascinating how Attia is having an effect on how people view health.

Attia? Is he the carnivior diet guy? Uhm, no, I do not prescribe into limiting diet to only certain food groups.

I guess VO2 is not an indicator of cardio vascular health? What would be a good indicator? Please let me know so I can be better informed.

If you get a chance read Outlive. It's like #3 among all books right now. Attia argues in part of that book that VO2 max is the best indicator of overall health (as defined by all causes reduction in mortality) and he backs that up with a ton of studies. His big logic gate there is that one should aim at as high a VO2 as one can achieve so one has headroom as we age to be able to do the things we want to do - VO2 naturally decreases as we get older, so the higher we maintain it the better our overall health will be. Makes all the sense in the world.

You're the first person I've seen that called out VO2 Max as a primary goal, which is pretty atypical. It's a great thing to aim for, though, for sure.

I have the book but haven't read yet.

What's the easiest most practical way to test VO2?

Easiest way, though not quite as precise, is to use your watch (apple for example)) that has this calculation embedded into it. If you really want a precise number, going to the Dr and doing the treadmill test would be the thing to do. I just use my Apple watch knowing it isn't exact but testing has shown it to be close.

I will have to read the book Outlive as recommended by @Sand. I always thought Attia was the carnivore diet guy but will look into more. Rhonda Patrick is good too (her YouTube channel).

How do I do this on my Apple Watch? My gym does it withe mask and treadmill and what not. But I don’t feel like giving them $250 or whatever they’re charging.

I have an Apple watch 7 (I think, maybe an 8). It takes all of your metrics and loads it into the Apple Health app on your phone. The Apple Health app is where you will see the calculated VO2. Not 100% but close enough IMO.

Found it. Cool. It has me around 34. Thanks

Just checked mine and I'm a little over 33. Is that good?

 

[DA RAIDERS]

They are surprised when I tell them my goal is improving my VO2 to 41+ (I am 58).

Fascinating how Attia is having an effect on how people view health.

Attia? Is he the carnivior diet guy? Uhm, no, I do not prescribe into limiting diet to only certain food groups.

I guess VO2 is not an indicator of cardio vascular health? What would be a good indicator? Please let me know so I can be better informed.

If you get a chance read Outlive. It's like #3 among all books right now. Attia argues in part of that book that VO2 max is the best indicator of overall health (as defined by all causes reduction in mortality) and he backs that up with a ton of studies. His big logic gate there is that one should aim at as high a VO2 as one can achieve so one has headroom as we age to be able to do the things we want to do - VO2 naturally decreases as we get older, so the higher we maintain it the better our overall health will be. Makes all the sense in the world.

You're the first person I've seen that called out VO2 Max as a primary goal, which is pretty atypical. It's a great thing to aim for, though, for sure.

I have the book but haven't read yet.

What's the easiest most practical way to test VO2?

Easiest way, though not quite as precise, is to use your watch (apple for example)) that has this calculation embedded into it. If you really want a precise number, going to the Dr and doing the treadmill test would be the thing to do. I just use my Apple watch knowing it isn't exact but testing has shown it to be close.

I will have to read the book Outlive as recommended by @Sand. I always thought Attia was the carnivore diet guy but will look into more. Rhonda Patrick is good too (her YouTube channel).

How do I do this on my Apple Watch? My gym does it withe mask and treadmill and what not. But I don’t feel like giving them $250 or whatever they’re charging.

I have an Apple watch 7 (I think, maybe an 8). It takes all of your metrics and loads it into the Apple Health app on your phone. The Apple Health app is where you will see the calculated VO2. Not 100% but close enough IMO.

Found it. Cool. It has me around 34. Thanks

I found it in the app but the data is from 5 years ago. How does it get updated?

No clue. I don’t know if mine is updated. It has day/wee/month/6mo/year.

 

[DA RAIDERS]

They are surprised when I tell them my goal is improving my VO2 to 41+ (I am 58).

Fascinating how Attia is having an effect on how people view health.

Attia? Is he the carnivior diet guy? Uhm, no, I do not prescribe into limiting diet to only certain food groups.

I guess VO2 is not an indicator of cardio vascular health? What would be a good indicator? Please let me know so I can be better informed.

If you get a chance read Outlive. It's like #3 among all books right now. Attia argues in part of that book that VO2 max is the best indicator of overall health (as defined by all causes reduction in mortality) and he backs that up with a ton of studies. His big logic gate there is that one should aim at as high a VO2 as one can achieve so one has headroom as we age to be able to do the things we want to do - VO2 naturally decreases as we get older, so the higher we maintain it the better our overall health will be. Makes all the sense in the world.

You're the first person I've seen that called out VO2 Max as a primary goal, which is pretty atypical. It's a great thing to aim for, though, for sure.

I have the book but haven't read yet.

What's the easiest most practical way to test VO2?

Easiest way, though not quite as precise, is to use your watch (apple for example)) that has this calculation embedded into it. If you really want a precise number, going to the Dr and doing the treadmill test would be the thing to do. I just use my Apple watch knowing it isn't exact but testing has shown it to be close.

I will have to read the book Outlive as recommended by @Sand. I always thought Attia was the carnivore diet guy but will look into more. Rhonda Patrick is good too (her YouTube channel).

How do I do this on my Apple Watch? My gym does it withe mask and treadmill and what not. But I don’t feel like giving them $250 or whatever they’re charging.

I have an Apple watch 7 (I think, maybe an 8). It takes all of your metrics and loads it into the Apple Health app on your phone. The Apple Health app is where you will see the calculated VO2. Not 100% but close enough IMO.

Found it. Cool. It has me around 34. Thanks

Just checked mine and I'm a little over 33. Is that good?

It says the same for me.

 

[Sand]

Just checked mine and I'm a little over 33. Is that good?

About the median for a 50 year old guy.

A Good VO2max Charts by: Age, Gender, Sport and Athlete Fitness

What is a good VO2max score? Discover comprehensive VO2max charts by age, gender, and sport. Understand what a good VO2max score is and how it compares with elite athletes.

inscyd.com

 

[DA RAIDERS]

Just checked mine and I'm a little over 33. Is that good?

About the median for a 50 year old guy.

A Good VO2max Charts by: Age, Gender, Sport and Athlete Fitness

What is a good VO2max score? Discover comprehensive VO2max charts by age, gender, and sport. Understand what a good VO2max score is and how it compares with elite athletes.

inscyd.com

Median! Where’s that damn epo?

 

[ConstruxBoy]

Just checked mine and I'm a little over 33. Is that good?

About the median for a 50 year old guy.

A Good VO2max Charts by: Age, Gender, Sport and Athlete Fitness

What is a good VO2max score? Discover comprehensive VO2max charts by age, gender, and sport. Understand what a good VO2max score is and how it compares with elite athletes.

inscyd.com

Happy to be average at this point, lol

 

[3C's]

My VO2 is 34 at (almost) 61yo so I'm doing pretty good. Even though I'm "obese" according to BMI. ()

 

[Joe Bryant]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

 

[Joe Bryant]

And part of why this podcast was so interesting is the guy being interviewed, Johann Hari has written extensively that he believes anti depressant medicines are prescribed too frequently when one might find the cure without medicine. (Friends, community, activities etc)

That's part of what he wrestled with he said, Something to the effect, "Am I hypocrite for suggesting people might cure some mental health issues without resorting to drugs but here I am using a drug to cure my obesity?"

I thought it was a fair and honest thought process for him. And us.

 

[Doug B]

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

I would argue that there is some risk with relying merely on "eating and exercising differently" -- namely, that they aren't sufficiently "automatic" (since almost all people who go this route are continually fighting their bodies) and thus don't pan out.

A solution that only works for people with one-in-a-million control over their psychophysical faculties isn't much of a solution at all.

 

[culdeus]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

There is risk in losing weight. Exercise is not without risk as an obese person. It is why many favor a very low level of exercise until well down the road of calorie restrictions.

Calorie restrictions done with macro deprivation (keto) and without Dr supervision can cause other issues.

Simply reducing calories raises hormones that fight such reduction. We have drugs that counter this for smoking (and lead to suicide btw) and alcohol. Gotta ask why this narrative is so strong that you just gotta put the fork down?

 

[DA RAIDERS]

Anyone know how tall Hari is? I’m checking him out and it seems he was just over 200# at his heaviest. The way he throws around how obese he was, I expecting 300+ pounds.

 

[Joe Bryant]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

There is risk in losing weight. Exercise is not without risk as an obese person. It is why many favor a very low level of exercise until well down the road of calorie restrictions.

Calorie restrictions done with macro deprivation (keto) and without Dr supervision can cause other issues.

Simply reducing calories raises hormones that fight such reduction. We have drugs that counter this for smoking (and lead to suicide btw) and alcohol. Gotta ask why this narrative is so strong that you just gotta put the fork down?

I'm sure there are some risks to anything. I don't think many people reasonably assign significant risk to slowly losing weight naturally. Although I'm sure some may disagree.

For "Gotta ask why this narrative is so strong" no idea you mean is "so strong"? I don't believe reasonably attempting to lose weight by eating healthier and exercising is a hot take opinion.

 

[culdeus]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

There is risk in losing weight. Exercise is not without risk as an obese person. It is why many favor a very low level of exercise until well down the road of calorie restrictions.

Calorie restrictions done with macro deprivation (keto) and without Dr supervision can cause other issues.

Simply reducing calories raises hormones that fight such reduction. We have drugs that counter this for smoking (and lead to suicide btw) and alcohol. Gotta ask why this narrative is so strong that you just gotta put the fork down?

I'm sure there are some risks to anything. I don't think many people reasonably assign significant risk to slowly losing weight naturally. Although I'm sure some may disagree.

For "Gotta ask why this narrative is so strong" no idea you mean is "so strong"? I don't believe reasonably attempting to lose weight by eating healthier and exercising is a hot take opinion.

The narrative that cutting out other addictive behavior is not a cold turkey item exclusively, where food intake is.

Nobody fought Nicorette when it came out. For example.

 

[Joe Bryant]

The narrative that cutting out other addictive behavior is not a cold turkey item exclusively, where food intake is.

Nobody fought Nicorette when it came out. For example.

I don't see anyone with a strong narrative on anything in particular.

I said the risk factors for a medicine seem different when there is a more natural alternative possible.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

Nicorette is a good example. If Nicorette has potential side effects (I know nothing about Nicorette) I'm sure people would reasonably weigh the side effects vs stopping smoking without any drugs. Would you not?

 

[Doug B]

I'm sure people would reasonably weigh the side effects

To me, "reasonably" is doing A LOT of work here.

 

[Joe Bryant]

I'm sure people would reasonably weigh the side effects

To me, "reasonably" is doing A LOT of work here.

How so exactly?

 

[Ministry of Pain]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

"So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk."

 

[Terminalxylem]

My Dr told me I am his only patient that he can remember being able to pull this off, lol. Especially at my age - 58 years old.

To me, these kind of accounts make the necessity of this class of drugs all the more firmly-grounded. What good is a medical solution if hardly anyone can take advantage of it?

"Here, this pill has a 0.001% cure rate. Yes, yes, that other one has a 95% cure rate, but you have to take the 0.001% pill for a few years first."

Yep. More than anything else, these types of dilemmas reflect fundamental deficiencies in math, and estimating risk.

 

[Joe Bryant]

Yep. More than anything else, these types of dilemmas reflect fundamental deficiencies in math, and estimating risk.

Can you elaborate on exactly what you mean? And "these types of dilemmas". On the surface, that sounds pretty condescending and dismissive of potential risks but I'm sure that's not how you meant it.

 

[Terminalxylem]

Ozempic is probably a net plus to society. We're a lazy unhealthy culture and these extreme weight loss options are realistically some of the only ways Americans will get on board to losing weight.

Less obesity would lead to less of a burden on our medical system = Good thing for everyone else.

I'm sure these drugs are dangerous as well, but if you aren't going to follow a healthy weight loss plan, you own the risks.

I haven’t seen anything specific on this, but at least with tobacco use I’ve seen studies showing that on average (over a lifetime) they are less costly in terms of medical spending than their non smoking counterparts. I questioned why, and then found it’s because they don’t live as long (on average). Their entire medical spending (making up the numbers here, but you get the point) generally ends around age 72 when their non smoking counterpart's ends at age 85. Those extra 13 years (end of life) tend to be the most costly - and are generally covered in that age range by Medicare.

The same would be true of Social Security. If more people are living longer (that would be the outcome of less obesity), that would be a further strain on it, too.

Again, haven’t seen any specific studies in regards to obesity, but I do t see how it would be any different than tobacco in these type situations.

That is some interesting food for thought (no pun). Probably exposes some bias in my thinking. I saw the immediate reward potential and didn't factor in what the second or third order affect might be.

Again, I haven’t seen any studies on it regarding obesity, but have with tobacco use. I hate to phrase it in these terms - but social programs like Medicare (possibly Medicaid), and social security all need folks passing in their 50s and early 60s to remain financially solvent long term.

And those are just the social safety net type things - we’d also need to consider hospital capacity/strain with more elderly people in the system a few decades down the line. Additional long term care facility need as well, which will only increase those costs.

Not saying it won’t be a net possible to society or not, but these are additional factors that should be considered.

For the individual, those considerations are irrelevant. And for healthcare providers, it would be unethical to consider withholding treatment, for fear of people living longer.

But yes, insurers and healthcare infrastructure would suffer, if we treated the biggest contributor to premature death in this country.

 

[Doug B]

I'm sure people would reasonably weigh the side effects

To me, "reasonably" is doing A LOT of work here.

How so exactly?

I think it's common for people to unreasonably weigh the side effects. Or what Terminalxylem has written on this page.

 

[Joe Bryant]

For the individual, those considerations are irrelevant.

What considerations?

 

[Joe Bryant]

I think it's common for people to unreasonably weigh the side effects. Or what Terminalxylem has written on this page.

Ok. When I talk about my opinions, I'd prefer to be reasonable about it. Not sure if that means it has to do A LOT of work. But I think reasonable is better.

 

[Joe Bryant]

As far as determining or weighing risk, maybe I'm giving way too much credit to people but I think giving them the facts on accurate data regarding the risks and and benefits letting the person and their doctor work to a conclusion is a good thing.

As I mentioned earlier, I have two close friends who weighed those things and chose to lose significant weight with Ozempic. Seems like the right decision to me.

But the dismissive "People worried risks reflect fundamental deficiencies in math" seems off. At least to me. Your mileage may vary of course.

 

[Doug B]

I think it's common for people to unreasonably weigh the side effects. Or what Terminalxylem has written on this page.

Ok. When I talk about my opinions, I'd prefer to be reasonable about it. Not sure if that means it has to do A LOT of work. But I think reasonable is better.

I took it that you were speaking generally -- and not about yourself personally -- when you wrote "I'm sure people would reasonably weigh the side effects".

To be clear, I was speaking generally -- and not about any individual -- when I wrote "I think it's common for people to unreasonably weigh the side effects."

 

[Doug B]

s far as determining or weighing risk, maybe I'm giving way too much credit to people but I think giving them the facts on accurate data regarding the risks and and benefits letting the person and their doctor work to a conclusion is a good thing.

Agreed on the bolded -- it is a good thing. I believe the bolded is rare on the ground -- going double for the part in red. I believe more people make more decisions based on (a) impressions, things they heard about, people they know, friend-of-a-friend accounts, and so forth, as opposed to (b) facts on accurate data.

 

[Terminalxylem]

Not saying it doesn't warrant a risk:benefit analysis, but people tend to overestimate potential downside of the unknown, especially when it involves putting an "unnatural" substance in one's body.

There's a 3rd element in this though with some illnesses.

Obviously, I'm not a doctor like some here so I don't mean to be obvious. But this seems important.

This isn't like a great many medicines where a non-pharmaceutical choice exists that has a reasonable chance of curing the problem.

If you have cancer and you're seeking a cure from a drug, the only reasonable choice is to take the medicine or don't take the medicine. There are not a lot of non-pharmaceutical cures. Same with a vaccine but we're not going to go there.

For obesity, some might reasonably say there is an alternative that does not involve pharmaceuticals and has virtually zero risk: eating and exercising differently.

So, the risk factors are a little different when there IS a non-pharmaceutical choice with virtually no risk.

I think this is the disconnect: weight loss + exercise doesn't work most of the time.

Whether you view it as a moral failure, lack of willpower, or slowing of metabolism, whatever the reason, about 80% of people regain weight within 1 year of losing it, and some studies suggest up to 95% do within 2 years. That's not a reasonable chance of success.

But if you believe weight loss + exercise is a solution for obesity, you probably should feel the same way about the treatment of high blood pressure, high cholesterol, diabetes, gout, etc., all of which respond to lifestyle modification. Are you as concerned about the pharmaceutical treatments for those diseases?

 

[Joe Bryant]

Are you as concerned about the pharmaceutical treatments for those diseases?

Of course.

I'd weigh out the side effects/risks against the benefits for any pharmaceutical and make a choice, Ideally with my doctor. Shouldn't everyone?

 

[Joe Bryant]

I think this is the disconnect: weight loss + exercise doesn't work most of the time.

Whether you view it as a moral failure, lack of willpower, or slowing of metabolism, whatever the reason, about 80% of people regain weight within 1 year of losing it, and some studies suggest up to 95% do within 2 years. That's not a reasonable chance of success.

What's your best guess then on:

Explaining why we as a nation are so much more obese now than we were?

Anecdotally, how does it make sense to look at pictures of people on the beach in the 60s compared to now?

How do countries like Japan have 5% obesity instead of 35% like we have?

 

[culdeus]

I think this is the disconnect: weight loss + exercise doesn't work most of the time.

Whether you view it as a moral failure, lack of willpower, or slowing of metabolism, whatever the reason, about 80% of people regain weight within 1 year of losing it, and some studies suggest up to 95% do within 2 years. That's not a reasonable chance of success.

What's your best guess then on:

Explaining why we as a nation are so much more obese now than we were?

Anecdotally, how does it make sense to look at pictures of people on the beach in the 60s compared to now?

How do countries like Japan have 5% obesity instead of 35% like we have?

Capitalism, mainly.

1. Develop an infrastructure with the capacity to ship huge quantities of goods long distances at low costs
2. Innovate ways to preserve, ship, store foods long distances out of season at times, across the planet.
3. By design or luck innovations in step 2) spurs demand by creating hunger.
4. Shift food demand by 3) or by marketing to foods that are very calorie dense with low satiety (alcohol)
5. Promote a narrative that fat shaming is not acceptable
6. Obscure longevity data increases from smoking cessation against all cause mortality from body fatness to promote a false lifestyle narrative of "healthy at any size"

Oh and phones and stuff like that.

 

[Terminalxylem]

Are you as concerned about the pharmaceutical treatments for those diseases?

Of course.

I'd weigh out the side effects/risks against the benefits for any pharmaceutical and make a choice, Ideally with my doctor. Shouldn't everyone?

Sure. But I haven’t seen this same level of judgement/scrutiny with every new diabetes/blood pressure/cholesterol medication.

To be fair, I haven’t searched, either, but I don’t think there are multiple threads about other medications, are there?

 

[Terminalxylem]

I think this is the disconnect: weight loss + exercise doesn't work most of the time.

Whether you view it as a moral failure, lack of willpower, or slowing of metabolism, whatever the reason, about 80% of people regain weight within 1 year of losing it, and some studies suggest up to 95% do within 2 years. That's not a reasonable chance of success.

What's your best guess then on:

Explaining why we as a nation are so much more obese now than we were?

Anecdotally, how does it make sense to look at pictures of people on the beach in the 60s compared to now?

How do countries like Japan have 5% obesity instead of 35% like we have?

Oh, it’s 100% behavioral - horrific diet and exercise habits.

Even though behavioral modification should be the cornerstone of weight loss, I don’t believe we should ignore viable pharmacologic options, if (nearly unvariably) first-line interventions fail.

 

[Joe Bryant]

Sure. But I haven’t seen this same level of judgement/scrutiny with every new diabetes/blood pressure/cholesterol medication.

To be fair, I haven’t searched, either, but I don’t think there are multiple threads about other medications, are there?

Seems to me the obvious thing is to weigh out the side effects/risks against the benefits for any pharmaceutical and make a choice, Ideally with my doctor.

Honestly pretty surprised that's being questioned. Or how weighing that out is somehow flipped to "Judgement/scrutiny". Seems odd.

 

[Terminalxylem]

For the individual, those considerations are irrelevant.

What considerations?

How reducing obesity at the population level may overwhelm our healthcare system, and ultimately cost us (collectively) more than maintaining the status quo.

 

[Terminalxylem]

Sure. But I haven’t seen this same level of judgement/scrutiny with every new diabetes/blood pressure/cholesterol medication.

To be fair, I haven’t searched, either, but I don’t think there are multiple threads about other medications, are there?

Seems to me the obvious thing is to weigh out the side effects/risks against the benefits for any pharmaceutical and make a choice, Ideally with my doctor.

Honestly pretty surprised that's being questioned. Or how weighing that out is somehow flipped to "Judgement/scrutiny". Seems odd.

People are placing undue emphasis on potential risk of the meds, while downplaying the difficulty of behavioral modification.

And some have used terms like “lazy” and questioned people’s willpower. How is that not judgmental?

 

[Terminalxylem]

s far as determining or weighing risk, maybe I'm giving way too much credit to people but I think giving them the facts on accurate data regarding the risks and and benefits letting the person and their doctor work to a conclusion is a good thing.

Agreed on the bolded -- it is a good thing. I believe the bolded is rare on the ground -- going double for the part in red. I believe more people make more decisions based on (a) impressions, things they heard about, people they know, friend-of-a-friend accounts, and so forth, as opposed to (b) facts on accurate data.

Absolutely. Look at how many people have announced with certainty these drugs are harmful, with no data to support their assertions.

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss.

 

[WVU Alum]

I am all for medicine aided treatment for damn near everything. I also believe that a large majority of people with obesity issues have an addiction, whether to sugar directly or to the dopamine hit from satisfying the sugar/fat/salt cycle. Behavioral change is tough for people. I think this is because as a whole we are broken and a little lazy, but also addiction is not easily fixed by changing behaviors.

For about 10 years I was fat. I didn’t much care. Then some blood work made me care. I changed my eating habits. I have found that finding good food at the grocery store is tough because 80% of the stuff in there is ultra processed garbage, even the health food aisle. Hard to change habits when the food industry is actively trying to feed the addiction and finding creative ways to keep people hooked.

If drugs help, then prescribe them. I’m all for it. Disclaimer: I take no drugs, not even ibuprofen.

 

[Terminalxylem]

Anyone know how tall Hari is? I’m checking him out and it seems he was just over 200# at his heaviest. The way he throws around how obese he was, I expecting 300+ pounds.

Weighing 2 bills, he’d be obese at 5’ 9”

 

[Joe Bryant]

People are placing undue emphasis on potential risk of the meds, while downplaying the difficulty of behavioral modification.

I'd hope people would weigh the risks. Period.

Of course the risks they're weighing are potential. That's what a risk is. They haven't happened yet. That's why they're considering them.

 

[Joe Bryant]

How reducing obesity at the population level may overwhelm our healthcare system, and ultimately cost us (collectively) more than maintaining the status quo.

You dismiss people who want to weigh the risks of a medicine condescendingly telling them it "reflects fundamental deficiencies in math and estimating risk."

Yet you give consideration to the idea reducing obesity at the population level "may overwhelm our healthcare system, and ultimately cost us (collectively) more than maintaining the status quo."

Ok.

 

[massraider]

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss

Wait, what?

Diet and exercise don't work?

 

[3C's]

My VO2 is 34 at (almost) 61yo so I'm doing pretty good. Even though I'm "obese" according to BMI. ()

Correction, I'm now below "obese" and just "overweight", and my "love handles" are gone and my abs are making an appearance again. AKA, my continuing mocking of BMI as a reliable measurement of "health".

 

[Doug B]

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss

Wait, what?

Diet and exercise don't work?

At a level, they don't work. Not if "willpower" is the underpinning.

A group of doctors tells 1,000 obese patients to diet, exercise, and come in for monthly check-ups. After 24 months, 980 patients are at or above their starting BMI, 19 have lower BMI but are still obese, and one has turned themselves into a competitive triathlete.

A group of doctors tells 1,000 obese patients to take Ozempic and then come in for monthly check-ups. After 24 months, 800 are at at a healthy BMI, 199 have significantly lowered BMI but are still "overweight" on the charts, and one couldn't stay on Ozempic due to complications.

 

[Ministry of Pain]

I am all for medicine aided treatment for damn near everything. I also believe that a large majority of people with obesity issues have an addiction, whether to sugar directly or to the dopamine hit from satisfying the sugar/fat/salt cycle. Behavioral change is tough for people. I think this is because as a whole we are broken and a little lazy, but also addiction is not easily fixed by changing behaviors.

For about 10 years I was fat. I didn’t much care. Then some blood work made me care. I changed my eating habits. I have found that finding good food at the grocery store is tough because 80% of the stuff in there is ultra processed garbage, even the health food aisle. Hard to change habits when the food industry is actively trying to feed the addiction and finding creative ways to keep people hooked.

If drugs help, then prescribe them. I’m all for it. Disclaimer: I take no drugs, not even ibuprofen.

"Then some blood work made me care. I changed my eating habits.
I have found that finding good food at the grocery store is tough because 80% of the stuff in there is ultra processed garbage"


-I had my awakening a while back, it's hard to change habits but once you just stay along the walls in the grocery store and avoid most of the aisles you're good.
1 ingredient foods as I call them...oranges are oranges you don't have to read a label, apples are apples, chicken is chicken
Once you have to start reading multiple ingredients, usually time to set it back down.

-I'm not a Saint, I got done playing tennis last night and was craving a Home Run Inn and by gawd I bought one and cooked it up and ate maybe 1/4 of the entire thing.
I waste a lot of food but usually it's the processed kind and once I fill that void sorta speak I like to toss the rest of it away.

 

[Terminalxylem]

People are placing undue emphasis on potential risk of the meds, while downplaying the difficulty of behavioral modification.

I'd hope people would weigh the risks. Period.

Of course the risks they're weighing are potential. That's what a risk is. They haven't happened yet. That's why they're considering them.

I’d like them to weigh risks, too, based on the best objective data.

ETA Substitute potential with unsubstantiated.

 

[Terminalxylem]

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss

Wait, what?

Diet and exercise don't work?

Not sure if this is sarcastic, but unfortunately, diet and exercise seldom succeed in real world conditions.

 

[notoriousbill]

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss

Wait, what?

Diet and exercise don't work?

Not sure if this is sarcastic, but unfortunately, diet and exercise seldom succeed in real world conditions.

This is primarily due those that adopt diet and exercise don't fully adjust their lifestyle for the long term. They get to their desired goal and go back to the bad habits I am assuming, resulting in the viscous cycle of weight gain/loss....

 

[matttyl]

Meanwhile, we know obesity is pretty bad, and diet/exercise seldom accomplish long term weight loss

Wait, what?

Diet and exercise don't work?

Not sure if this is sarcastic, but unfortunately, diet and exercise seldom succeed in real world conditions.

Of course they do. For each and every person. You and me included. I’m not actively “dieting”, but I do “watch what I eat”. If I ate more chocolate, friend chicken, sodas and the like, I’d weigh more than I otherwise would. Yesterday I took my bike out for a ride on the trails with my kid. I weigh a bit less because I do that once or twice a week than I otherwise would. It’s all caloric input vs caloric output.

Even if you’re “overweight “ or “obese”, it would be even worse for that person if they had an even worse diet or were less active than they are.

 

[Joe Bryant]

unfortunately, diet and exercise seldom succeed in real world conditions.

Not sure if you see patients, but if you do see patients, do you tell them this?