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Obesity and Ozempic and more (4 Viewers)

Sustained weight loss is really hard for Americans but not for other cultures??

Yeah, not buying it.

Better diet, more exercise. Americans are lazy and fat.
With few exceptions, obesity is a problem in much of the developed world.

Yeah, the idea of lazy American's as it pertains to obesity is really lazy humans. We are basically the top major world power but just about everybody on the planet is overweight (by BMI) save several African nations and the far East.


Thanks. Why do most people think US is 36% and Japan, a very developed country, is 4%?

Cultural differences. And probably genetic differences as well.

Thanks. Can you elaborate? What specific cultural or genetic differences?
Well, I'm not yet inclined to back this up with any studies just yet. But I can tell you that in China, for example, food has been in short supply for centuries, resulting in people who don't grow as tall or as fat as in Western society. And I have to think this has been built into their genetics to this day. Maybe in the form of foods they prefer. But I strongly feel there is a genetic component to obesity.
 
It’s not that they’re doing something that we’re not. What they are ingesting is better and healthier than what most Americans are ingesting. The US food industry has a monetary agenda to stock holders and fat cats to produce the cheapest possible product. that is as addictive as possible. and has the longest possible shelf life. There are genetics in play, but the easiest place to start is that the food they eat is healthier.

Same question as to @Doug B If the difference is that Japanese people eat healthier food, why are only 4% of Japanese folks unable to eat healthy food but 36% of Americans are unable to eat healthy food?
 
Well, I'm not yet inclined to back this up with any studies just yet. But I can tell you that in China, for example, food has been in short supply for centuries, resulting in people who don't grow as tall or as fat as in Western society. And I have to think this has been built into their genetics to this day. Maybe in the form of foods they prefer. But I strongly feel there is a genetic component to obesity.

As @IvanKaramazov said above, America's obesity epidemic is a relatively new thing. I'm no geneticist, but it's my understanding our genetics don't change that rapidly over 50 years. Yet our obesity rates have.
 
Well, I'm not yet inclined to back this up with any studies just yet. But I can tell you that in China, for example, food has been in short supply for centuries, resulting in people who don't grow as tall or as fat as in Western society. And I have to think this has been built into their genetics to this day. Maybe in the form of foods they prefer. But I strongly feel there is a genetic component to obesity.

As @IvanKaramazov said above, America's obesity epidemic is a relatively new thing. I'm no geneticist, but it's my understanding our genetics don't change that rapidly over 50 years. Yet our obesity rates have.
Not over 50 years, I will agree.... how about over 1,000 years??? Or even more??
 
This fits in here. So is the selection of this woman as Miss Alabama a exhibition of acceptance or as noted in this thread a promotion of an unhealthy lifestyle as acceptable/desirable?


Is she really beauty and grace?
 
Then there's this study, which basically says it's inconclusive as to genetics. But to me, it's not inconclusive at all. I think the Chinese, for example, have a genetic preference for vegetables and other low-fat foods because of the historic scarcity of other foods going back millenia.

 
This fits in here. So is the selection of this woman as Miss Alabama a exhibition of acceptance or as noted in this thread a promotion of an unhealthy lifestyle as acceptable/desirable?


Is she really beauty and grace?
What's this all about? More cushion for the pushin'?
 
Not over 50 years, I will agree.... how about over 1,000 years??? Or even more??

Not sure over 1000 years.

But what I'm saying is in this particular situation of obesity, the outcome has changed dramatically over 50 years. And because I don't think genetics change that fast, it leads me to believe the change is not caused by genetics. (Said by someone who knows next to nothing about genetics ;) )
 
And to be clear, I don't have any real point of view on this.

I'm mostly trying to understand the why on this. In particular, why countries like Japan have been able to do something we have not been able to do,.
 
What's this all about? More cushion for the pushin'?
That goes without saying. The question was is her promotion as a "beauty contest winner" an affirmation of an obviously profoundly unhealthy lifestyle or just a consequence of a society with more acceptance of beauty standards?
 
And to be clear, I don't have any real point of view on this.

I'm mostly trying to understand the why on this. In particular, why countries like Japan have been able to do something we have not been able to do,.
Just culture, Joe. The standard fare in Japan is pretty lean protein.

And it helps they didn't have an FDA **** up nutrition guidelines for 50 years.
 
What's this all about? More cushion for the pushin'?
That goes without saying. The question was is her promotion as a "beauty contest winner" a promotion of an obviously profoundly unhealthy lifestyle?
I think it's, at a minimum, turning a blind eye to an unhealthy lifestyle. I have no idea whatsoever what else this chick might have had going for her. But any judges sure as heck forgave the "blimp factor".
 
My thought is the beauty pageant stuff is sort of a distraction. Same with the heavier than normal SI Swim Suit models.

What people see as beauty is personal. Maybe it's thin, maybe not thin. Blonde, Brunette etc. Those are all personal and subjective.

For me, dealing with the objective BMI and health is a better angle.
 
Being near a healthy BMI is one of the consequences of living in Japanese society right now.

Can you unpack that?

Why is being near a healthy BMI one of the consequences of living in Japanese society right now?
I don’t have time to reply at length, but briefly - as I had written about upthread - it’s sociology-cultural conditions. Yes, I know that’s broad — but it’s not a one-factor magic-bullet kind of thing. The socio-cultural conditions that promote health BMI are legion and all-pervasive in Japan.

One big thing that is different in Japanese culture is a much lesser societal expectation of privacy, and a greater acceptance of personal constraint from those in power. See the article below and pay attention to the section about the “Metebo law” in Japan. Aside from that, the article explains a lot - but not nearly everything. - that accounts for Japan’s low obesity rate.

 
And to be clear, I don't have any real point of view on this.

I'm mostly trying to understand the why on this. In particular, why countries like Japan have been able to do something we have not been able to do,.

To me it's obviously cultural.

Americans have accepted being obese/overweight more than the Japanese.

Americans also have poor life decisions like less exercise and terrible foods.

Americans have less discipline.

I see a lot of FBGs trying to make excuses for Americans in this thread, very few of those excuses hold water IMHO particularly for those Americans that can afford to eat healthy which is the vast majority of Americans. Also, last time I checked, it's completely free to take a walk or go on a jog.

The lack of personal accountability of Americans when it comes to weight gain is a small part of a larger epidemic in the country when it comes to personal accountability for all facets of life, not just personal health.
 
I agree that for the most part, Japan’s low obesity rate is not genetics. Some, but only a small factor.

Second- and third-generation Asian Americans are considerably more obese than their first-generation relatives — but less so than people with long roots in the U.S.
 
I don’t have time to reply at length, but briefly - as I had written about upthread - it’s sociology-cultural conditions. Yes, I know that’s broad — but it’s not a one-factor magic-bullet kind of thing. The socio-cultural conditions that promote health BMI are legion and all-pervasive in Japan.

What doesn't add up for me is reading things like that makes it sound like people "in a culture" have no choice. LIke they are predestined to obesity.

It seems some think they are locked into unchangeable behaviours and they have no ability to break free of the chains of the culture.

When what we're talking about is eating healthier. It's not like people are in prison and being force fed a diet they despise.

It seems like some people think Americans are unable to break out of our culture and eat more healthy and exercise better. Like we're destined to accept the fate of our culture with no ability to do anything about it.

That's what I'm struggling with.
 
Understood.

What I'm struggling with is the idea that just because it exists, it must be consumed.

To me that is a perfect illustration of the accountability epidemic in our country.

"It's McDonald's fault that people are obese." Last time I checked nearly every grocery store in the country sells apples and broccoli.

And even McDonalds has a salad on the menu.
 
Some factors we haven’t discussed that likely also contribute to the high rate of obesity in US vs other developed countries :

Car culture/suburbanization/lack of good public transit in USA as compared to Japan and EU.

Lack of a unified food culture and wholesale buy-in with convenience (and thus processing) as a major factor in our food choices.

Aggressive marketing of said processed foods, especially towards our youngest and most impressionable, often in concert with a public education system that allows said marketing in its confines (while also providing inadequate - and arguably inaccurate - nutritional education). Compare Japanese and French school lunches to those served in US schools.

And lastly (and this may be controversial) though we’ve talked a bit about American female beauty standards becoming more accommodative of unhealthy weights, this seems to me to be a more recent trend. I’d argue that media messaging on male overweight and obesity has long been very accepting. How many sitcom families of the aughts featured overweight/obese male leads with thin, beautiful wives? We have two of America’s leading pasttimes - the NFL and WWE prominently feature men at obviously unhealthy weights. I think it adds up to that bigger bodtype being normative. I know in my practice the overweight/obese women seem to have more insight into their weight being an issue than do the men.
 
It’s not that they’re doing something that we’re not. What they are ingesting is better and healthier than what most Americans are ingesting. The US food industry has a monetary agenda to stock holders and fat cats to produce the cheapest possible product. that is as addictive as possible. and has the longest possible shelf life. There are genetics in play, but the easiest place to start is that the food they eat is healthier.

Same question as to @Doug B If the difference is that Japanese people eat healthier food, why are only 4% of Japanese folks unable to eat healthy food but 36% of Americans are unable to eat healthy food?
I don’t think I understand your question.

I’ll give it a go though.

1). The food in the US is rife with HFCS, preservatives, transfats, all the wrong oils, etc
2) The marketing for said food is top notch
3). It’s much more available to the masses.
4). America is a microwave society. We must have it now! And as easily as possible! Some describe this as lazy.
5). Mental and physical health are a higher priority in Japan
6). Fat shaming is real in Japan.
7). Genetically the US is mostly descended from a bigger group of people(bigger doesn’t mean obese)

:shrug:
 
It's not like people are in prison and being force fed a diet they despise.
You’re right. It’s not like that. The motivations are actually reversed. Americans aren’t being force fed a diet they despise. Instead, socio-cultural conditions make an unhealthy diet the appealing, desired default.

But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.
 
I don’t think I understand your question.

I’ll give it a go though.

1). The food in the US is rife with HFCS, preservatives, transfats, all the wrong oils, etc
2) The marketing for said food is top notch
3). It’s much more available to the masses.
4). America is a microwave society. We must have it now! And as easily as possible! Some describe this as lazy.
5). Mental and physical health are a higher priority in Japan
6). Fat shaming is real in Japan.
7). Genetically the US is mostly descended from a bigger group of people(bigger doesn’t mean obese)

:shrug:

to add to Raiders post.

1. Personal Decision
2. Personal Decision
3. Personal Decision
4. Personal Decision
5. Pesonal Decision
6. Country's Decision
 
"easiest" maybe for many but absolutely not for everyone but yes it is simplest. Simplest not always being the best or most effective.

I am on Ozempic currently. At my heaviest, I was 344 lbs (dated April 5th, 2023). My health was deteriorating. Obesity caused, was a major contributing factor, or made ailments I was dealing with worst. The list goes bad back, bad knee, gout, kidney stones, low testosterone, sleep apnea, high BP.... that is all I can remember right now but I feel like I am forgetting something.

My weight largely came from being an extremely active kid with sports and just being a kid. I was talking to my best friend growing up and we were going over a typical day for us which our kids didn't believe.... we would ride our bikes from one place to another (a couple of miles easily) and then often go play basketball from after school until the light went off in the park many times. It was not uncommon for us to play 6 hours of basketball a day. Of course, we didn't always play basketball but during the day we were usually out doing something... swimming, playing football, baseball, or whatever else we decided that day. Sure, we played our fair share of video games (Super Tecmo Bowl seasons between three of us friends was a favorite) but that was usually at night when we couldn't be outside. That activity burned a lot of calories on a daily basis which meant that I was very use to eating ridiculous quantities of food and the constant activity plus the hyper active metabolism of youth... I had a very lean, athletic build... maybe even a little on the skinny side. Habits are a powerful thing and hard to break. As I got older, my activity dropped but my eating habits didn't change as much as they should have in response. I mean, as an adult, you typically can not play 30 something hours of basketball a week on average and that means ordering 5 things from Taco Bell for one meal should not be your norm as well. Over the years, I gained a little more weight and a little more weight. Back, knee and ankle problems (later finding out the ankle issues were actually gout attacks) made being active at even a normal adult level hard to do consistently and if you are not consistent at something it is hard to keep doing it... at least for me.

I tried various ways of losing weight. Most of which had minimal success. A few years back, just pre-covid (funny how pre/post covid is such a defining moment in our life timelines now) I had went to a weight lose doctor. He put me on a diet using meal replacement shakes/bars and then a low carb meal for dinner. I got back into the gym and was getting to make it a habit. I dropped 70 lbs during this time. There were some other things that the doctor gave or prescribed to me.... testosterone shots, a vitamin b plus other stuff shot, a pill to take during the day that was supposed to help you focus away from food... I think it is used for ADHD kids too, and a pill to take a night as the ADHD kind of gave you an energy boost similar to having a good amount of caffeine. It was going well and I was well on my way to my target weight but then I really started having issues with my ankles at a frequency and intensity that increased extremely (later diagnosed as gout) and even worse.... I had my first kidney stone attack. Wow... if you have never had them then thank God for it. The pain level of that was on a level nothing in my life could compare to... any of various sports injuries, car accidents, gout, anything. Going to Doctors to address the gout and kidney stones along the process you get a list of food to avoid, limit or that is good. Basically my entire diet of food was on the avoid or limit for the two lists. Obviously, I need to make changes. I went to the weight loss Doctor and then we had a conference call with him and the 'head Doctor' of the clinic chain they had. The head Doctor said to me, word for word... "do you want to have pain or do you want to die?" in response to me asking for us to change things up. I did not like that answer at all. That was the last time I went there. This was prob about mid November and so I decided, I will just get through the holidays, try to limit what I am eating, keep going to the gym and then figure out what to do next with a different program or whatever. Well.... as I said, that was pre-covid so it was that Jan that things started happening and soon everything was shut down. I stopped the gym and reverted to old habits. I gained all the weight back plus.

Back about a year ago, it was obvious things were at a point that action had to be taken. I went to my primary doctor, an Endocrinologist and dietician. The first Endocrinologist I saw basically wanted to put me on Wegovy but my insurance did not cover it. My AC1 level was knocking on the door of 'pre-diabetes' so he said he would put in a prescription for Ozempic and maybe they would cover it. Since my wife had her own health issues- it didn't matter as we had met our family deductible and basically everything is free. I went on Ozempic. It worked a lot that first week but then kind of wore off and subsequent injections seemed to be less and less effective even with the higher doses as prescribed so then I stopped really using it. Working with the Dietician, we worked on several different ways of doing essentially doing what you said to do.... eat less calories and she even had me get back on myfitnesspal (I had used it before when I was losing the weight in the low carb diet). Between the Ozempic and trying to limit calories, I did lose about 5 pounds but kept ending up in a failed attempts and it was very frustrating.

After a while, I made an appointment with my primary Doctor. I basically felt defeated. I could not figure out how to lose weight. I kept trying but would break down. My will power wasn't strong enough and that made me get really down on myself.... like I am mentally weak and lesser of a man because of that. One thing I really was against was doing any sort of surgery but that appointment was all about starting that process. I just felt like I was a failure and needed it. Because of our insurance situation, I knew if I was going to get the surgery that I needed to do it this year so that it would not cost me anything whether it was covered or not the next year it would cost more money which we are still recovering financially from my wife's health issues.

continued...
 
In the consultation, my primary, who I love to death as a Doctor.... he listens to you patiently, he takes time to think and consider, he works with you to figure out how to help.... thankfully he has a lot of openings versus other Doctors because all the things I love about him take time and I know that if my appointment is 2pm he will be running late and I won't see him until like 3:30 or something. We discussed the various attempts to lose weight before. I went over the various ways I tried and failed. I told him that one of the biggest reasons the low carb diet worked for me was that I struggle with evening cravings. That was when my will power would break down and my diets would go to hell. The reason the low carb diet worked was when I had those cravings, I could go to town on some pistachios, cashews, or broccoli and humus as my normal go to's and still be in the parameters of my diet. (however all of those were high on the do not eat lists for gout and kidney stones). It was these cravings that broke me down. It made all diets other than that low carb one fail. I needed to be very careful with the low carb diet to keep my Uric Acid low (causes Gout) and avoiding kidney stones. My Doctor listened, considered for a time and then said that there was a drug that is often given to recovering alcoholics and drug addicts that helps might help with cravings. The drug is Contrave. He prescribed it to me and I started taking it. There was an immediate change. I read up more on Contrave and as indicated, it basically is a drug that helps with addiction. This not only was helpful but it really made me understand me more. It really made me realize that it wasn't just will power lacking but there was an actual real life addiction. Even though I grew up going to AA meetings (literally, my mother is a recovering alcoholic and would take me to her meetings when I was little) and my brother struggled with drug addiction- I never really understood addiction. I never had an issue with alcohol use and avoided drugs all my life. But this overwhelming 'craving' that I chalked up to me being weak willed and lesser of a man was really an addiction. It made me more understanding of other addictions people struggle with and allowed me peace with myself as I didn't just suck at will power but had this addiction.

The Contrave along with the Ozempic have been a huge help to me as I continue to work on losing weight. As of June 3rd, I have lost 40 pounds from my heaviest. Almost half of that being since April 24th when I started on Contrave along with the Ozempic. I don't know if my insurance will cover Contrave after this year but I do know that the Ozempic is not and that each prescription is $950ish for a 5 week supply. I have another 6 months to use this to help me get more weight off. Once that is done, Ozempic will be done for me and maybe Contrave. Even with Contrave, I can't take it forever and will eventually need to go off from it. My hope and what I am working towards is creating new habits and mindset that will help me maintain weight after I have lost it and no longer have the use of these drugs.

All of this to say.... I didn't listen to the podcast (I am not much of a listener but may give it a try later) but I KNOW it is a band-aid. But just like a real band-aid, which is something extra that helps you heal a cut but you eventually take it off and move on.... it helps. I needed this help. I couldn't just cut my calories. That was an impossible task for me. I agreed with a lot of people who think "well, you just have to cut calories and if you can't it is because you are weak.... buck up cupcake!" and after failing to buck up again and again, I thought that really said a lot about me as a person, none of which is good. I will use this band aid for another 6 months and hopefully made all the progress I am striving for and then I will need to transition away and either lose more or maintain weight based on a healthy diet and physical activity. Without the Contrave and Ozempic, I would be 20 pounds heavier than I am now without any doubt in my mind. Give me the band aid.

Sorry- I know that was a lot but I thought it was highly relevant to the discussion.
 
But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.

I disagree.

The vast majority of Americans have the opportunity to prioritize health thanks to the amazing country that the United States is.

Unfortunately, many Americans make poor health decisions.
 
What I'm struggling with is the idea that just because it exists, it must be consumed.
“Finish your plate! Your mother worked hard on dinner!”

“You’re not throwing perfectly good food away!”

“Make sure and try some of everything. Yes, even Aunt Mabel’s potato salad!”

“You’re too skinny! You can have more lasagna . And I won’t take no for an answer!”

Take a set of cultural expectations, integrate them into your psyche, than begin to generalize them to other situations. You won’t need to be prodded externally to eat beyond 80% fullness anymore.

And again — still just another small part of the picture.
 
What I'm struggling with is the idea that just because it exists, it must be consumed.
“Finish your plate! Your mother worked hard on dinner!”

“You’re not throwing perfectly good food away!”

“Make sure and try some of everything. Yes, even Aunt Mabel’s potato salad!”

“You’re too skinny! You can have more lasagna . And I won’t take no for an answer!”

Take a set of cultural expectations, integrate them into your psyche, than begin to generalize them to other situations. You won’t need to be prodded externally to eat beyond 80% fullness anymore.

And again — still just another small part of the picture.
This is a huge struggle for me as well.

I hate wasting things. I have three kids (13, 10 and 8) that it seems like their life's mission is to waste things. So, I am in the habit of eating the left overs.... whether it is off the plate of my kids or whatever food my wife makes and then eat that for the next day. Now, because the amount of food I eat is so much lower there is a whole lot of food that isn't being eaten and it going to waste. It drives me crazy but then I have to remind myself that being fat is a bigger problem but it is a struggle that I deal with.

I believe this is from the Greatest Gen.... they lived through the Depression and then World War II. Either there was no money for food and then everything was rationed during war. You have to think how that will shape your thinking and how you approach food. That scarcity then carried over to the Boomers and the Boomers taught many of us Gen X those same things you listed.... "Finish your dinner, there are kids in China that are starving" or "don't waste food!" etc.
 
I don’t have time to reply at length, but briefly - as I had written about upthread - it’s sociology-cultural conditions. Yes, I know that’s broad — but it’s not a one-factor magic-bullet kind of thing. The socio-cultural conditions that promote health BMI are legion and all-pervasive in Japan.

What doesn't add up for me is reading things like that makes it sound like people "in a culture" have no choice. LIke they are predestined to obesity.

It seems some think they are locked into unchangeable behaviours and they have no ability to break free of the chains of the culture.

When what we're talking about is eating healthier. It's not like people are in prison and being force fed a diet they despise.

It seems like some people think Americans are unable to break out of our culture and eat more healthy and exercise better. Like we're destined to accept the fate of our culture with no ability to do anything about it.

That's what I'm struggling with.
It’s inertia. Once you’re headed one way, it’s hard to change it up.

Is it easier to get something from a fast food joint, or make a quick egg white scramble at home? If you’re already doing the former, it might be considered a PIA to make food every morning. Dishes/time/effort. And that doesn’t factor in the addictive properties of the McMuffin or whatever.

Apply that to every meal. Every day. Forever. What’s easier?

choose your hard. I’ll make the majority of my food thanks.
 
But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.

I know you're sincere and thoughtful, but I think I disagree.

I don't think it's that complicated.

1. Educate people that lots of the food available is crap. Educate people that they need to move around. (That one feels like it's complete)
2. The people who understand there's lots of crap available instead choose the healthier options to eat.
3. The people who understand you need to move and take 10,000 steps a day do it.

I fully admit I may be naive. But I don't think it's that complicated.

Humans have a space between Stimulus and Response. We can think.

I dog may not have the ability to weigh out choices and make the best one.

Humans do.

And I'm puzzled and discouraged why it seems we don't.
 
What I'm struggling with is the idea that just because it exists, it must be consumed.
“Finish your plate! Your mother worked hard on dinner!”

“You’re not throwing perfectly good food away!”

“Make sure and try some of everything. Yes, even Aunt Mabel’s potato salad!”

“You’re too skinny! You can have more lasagna . And I won’t take no for an answer!”

Take a set of cultural expectations, integrate them into your psyche, than begin to generalize them to other situations. You won’t need to be prodded externally to eat beyond 80% fullness anymore.

And again — still just another small part of the picture.

Sure. But nobody makes you do it.
 
What I'm struggling with is the idea that just because it exists, it must be consumed.
“Finish your plate! Your mother worked hard on dinner!”

“You’re not throwing perfectly good food away!”

“Make sure and try some of everything. Yes, even Aunt Mabel’s potato salad!”

“You’re too skinny! You can have more lasagna . And I won’t take no for an answer!”

Take a set of cultural expectations, integrate them into your psyche, than begin to generalize them to other situations. You won’t need to be prodded externally to eat beyond 80% fullness anymore.

And again — still just another small part of the picture.
"People in China are starving and you're just wasting food!"
Well send my food to them then.

My dad didn't appreciate my sense of humor.
 
I don’t have time to reply at length, but briefly - as I had written about upthread - it’s sociology-cultural conditions. Yes, I know that’s broad — but it’s not a one-factor magic-bullet kind of thing. The socio-cultural conditions that promote health BMI are legion and all-pervasive in Japan.

What doesn't add up for me is reading things like that makes it sound like people "in a culture" have no choice. LIke they are predestined to obesity.

It seems some think they are locked into unchangeable behaviours and they have no ability to break free of the chains of the culture.

When what we're talking about is eating healthier. It's not like people are in prison and being force fed a diet they despise.

It seems like some people think Americans are unable to break out of our culture and eat more healthy and exercise better. Like we're destined to accept the fate of our culture with no ability to do anything about it.

That's what I'm struggling with.
Advertising works.
 
But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.

I disagree.

The vast majority of Americans have the opportunity to prioritize health thanks to the amazing country that the United States is.

Unfortunately, many Americans make poor health decisions.
I disagree as well, though I see it as a matter of framing. You’re individualizing a general problem in American society. Individual solutions can’t be applied to 100 million people in American culture as currently constituted. We won’t stand for the necessary governmental intrusion that would be necessary. For starters.
 
In the consultation, my primary, who I love to death as a Doctor.... he listens to you patiently, he takes time to think and consider, he works with you to figure out how to help.... thankfully he has a lot of openings versus other Doctors because all the things I love about him take time and I know that if my appointment is 2pm he will be running late and I won't see him until like 3:30 or something. We discussed the various attempts to lose weight before. I went over the various ways I tried and failed. I told him that one of the biggest reasons the low carb diet worked for me was that I struggle with evening cravings. That was when my will power would break down and my diets would go to hell. The reason the low carb diet worked was when I had those cravings, I could go to town on some pistachios, cashews, or broccoli and humus as my normal go to's and still be in the parameters of my diet. (however all of those were high on the do not eat lists for gout and kidney stones). It was these cravings that broke me down. It made all diets other than that low carb one fail. I needed to be very careful with the low carb diet to keep my Uric Acid low (causes Gout) and avoiding kidney stones. My Doctor listened, considered for a time and then said that there was a drug that is often given to recovering alcoholics and drug addicts that helps might help with cravings. The drug is Contrave. He prescribed it to me and I started taking it. There was an immediate change. I read up more on Contrave and as indicated, it basically is a drug that helps with addiction. This not only was helpful but it really made me understand me more. It really made me realize that it wasn't just will power lacking but there was an actual real life addiction. Even though I grew up going to AA meetings (literally, my mother is a recovering alcoholic and would take me to her meetings when I was little) and my brother struggled with drug addiction- I never really understood addiction. I never had an issue with alcohol use and avoided drugs all my life. But this overwhelming 'craving' that I chalked up to me being weak willed and lesser of a man was really an addiction. It made me more understanding of other addictions people struggle with and allowed me peace with myself as I didn't just suck at will power but had this addiction.

The Contrave along with the Ozempic have been a huge help to me as I continue to work on losing weight. As of June 3rd, I have lost 40 pounds from my heaviest. Almost half of that being since April 24th when I started on Contrave along with the Ozempic. I don't know if my insurance will cover Contrave after this year but I do know that the Ozempic is not and that each prescription is $950ish for a 5 week supply. I have another 6 months to use this to help me get more weight off. Once that is done, Ozempic will be done for me and maybe Contrave. Even with Contrave, I can't take it forever and will eventually need to go off from it. My hope and what I am working towards is creating new habits and mindset that will help me maintain weight after I have lost it and no longer have the use of these drugs.

All of this to say.... I didn't listen to the podcast (I am not much of a listener but may give it a try later) but I KNOW it is a band-aid. But just like a real band-aid, which is something extra that helps you heal a cut but you eventually take it off and move on.... it helps. I needed this help. I couldn't just cut my calories. That was an impossible task for me. I agreed with a lot of people who think "well, you just have to cut calories and if you can't it is because you are weak.... buck up cupcake!" and after failing to buck up again and again, I thought that really said a lot about me as a person, none of which is good. I will use this band aid for another 6 months and hopefully made all the progress I am striving for and then I will need to transition away and either lose more or maintain weight based on a healthy diet and physical activity. Without the Contrave and Ozempic, I would be 20 pounds heavier than I am now without any doubt in my mind. Give me the band aid.

Sorry- I know that was a lot but I thought it was highly relevant to the discussion.
Huh. I had never heard of Contrave before you mentioned it and, at first, I thought it was something I should bring up to my PCP. But after reading all the warnings about suicidal thoughts, etc., I'm having second thoughts. I almost blew my brains out with a .357 Sig back in 2014. The police took all my guns and ammo and took my license to carry and everything. A complicating factor there was my cutting back on my prescribed anti-depressants because BCBS did not like the doctor who prescribed them and BCBS would not pay for it. Anyhow. I now steer clear of anything that would increase thoughts of suicide.
 
I disagree as well, though I see it as a matter of framing. You’re individualizing a general problem in American society. Individual solutions can’t be applied to 100 million people in American culture as currently constituted. We won’t stand for the necessary governmental intrusion that would be necessary. For starters.

Could the govt do more? Sure.

It is to blame for our obesity epidemic, not even remotely close IMHO. (for reasons previously stated)
 
Sure. But nobody makes you do it.
… you don’t need to be made to do it. That’s the point.

I think we’re less independent of our influences than you think we are. You said you were puzzled by people not making better choices. To me, the fact that people often make such choices make all kinds of sense.
 
I disagree as well, though I see it as a matter of framing. You’re individualizing a general problem in American society. Individual solutions can’t be applied to 100 million people in American culture as currently constituted.

Sure they can.

And for governmental regulations, people can make healthier decisions without the government's help. Plus they've already done some of that with school lunches and candy and stuff.

But the government isn't going to save us on this.
 
In the consultation, my primary, who I love to death as a Doctor.... he listens to you patiently, he takes time to think and consider, he works with you to figure out how to help.... thankfully he has a lot of openings versus other Doctors because all the things I love about him take time and I know that if my appointment is 2pm he will be running late and I won't see him until like 3:30 or something. We discussed the various attempts to lose weight before. I went over the various ways I tried and failed. I told him that one of the biggest reasons the low carb diet worked for me was that I struggle with evening cravings. That was when my will power would break down and my diets would go to hell. The reason the low carb diet worked was when I had those cravings, I could go to town on some pistachios, cashews, or broccoli and humus as my normal go to's and still be in the parameters of my diet. (however all of those were high on the do not eat lists for gout and kidney stones). It was these cravings that broke me down. It made all diets other than that low carb one fail. I needed to be very careful with the low carb diet to keep my Uric Acid low (causes Gout) and avoiding kidney stones. My Doctor listened, considered for a time and then said that there was a drug that is often given to recovering alcoholics and drug addicts that helps might help with cravings. The drug is Contrave. He prescribed it to me and I started taking it. There was an immediate change. I read up more on Contrave and as indicated, it basically is a drug that helps with addiction. This not only was helpful but it really made me understand me more. It really made me realize that it wasn't just will power lacking but there was an actual real life addiction. Even though I grew up going to AA meetings (literally, my mother is a recovering alcoholic and would take me to her meetings when I was little) and my brother struggled with drug addiction- I never really understood addiction. I never had an issue with alcohol use and avoided drugs all my life. But this overwhelming 'craving' that I chalked up to me being weak willed and lesser of a man was really an addiction. It made me more understanding of other addictions people struggle with and allowed me peace with myself as I didn't just suck at will power but had this addiction.

The Contrave along with the Ozempic have been a huge help to me as I continue to work on losing weight. As of June 3rd, I have lost 40 pounds from my heaviest. Almost half of that being since April 24th when I started on Contrave along with the Ozempic. I don't know if my insurance will cover Contrave after this year but I do know that the Ozempic is not and that each prescription is $950ish for a 5 week supply. I have another 6 months to use this to help me get more weight off. Once that is done, Ozempic will be done for me and maybe Contrave. Even with Contrave, I can't take it forever and will eventually need to go off from it. My hope and what I am working towards is creating new habits and mindset that will help me maintain weight after I have lost it and no longer have the use of these drugs.

All of this to say.... I didn't listen to the podcast (I am not much of a listener but may give it a try later) but I KNOW it is a band-aid. But just like a real band-aid, which is something extra that helps you heal a cut but you eventually take it off and move on.... it helps. I needed this help. I couldn't just cut my calories. That was an impossible task for me. I agreed with a lot of people who think "well, you just have to cut calories and if you can't it is because you are weak.... buck up cupcake!" and after failing to buck up again and again, I thought that really said a lot about me as a person, none of which is good. I will use this band aid for another 6 months and hopefully made all the progress I am striving for and then I will need to transition away and either lose more or maintain weight based on a healthy diet and physical activity. Without the Contrave and Ozempic, I would be 20 pounds heavier than I am now without any doubt in my mind. Give me the band aid.

Sorry- I know that was a lot but I thought it was highly relevant to the discussion.
Huh. I had never heard of Contrave before you mentioned it and, at first, I thought it was something I should bring up to my PCP. But after reading all the warnings about suicidal thoughts, etc., I'm having second thoughts. I almost blew my brains out with a .357 Sig back in 2014. The police took all my guns and ammo and took my license to carry and everything. A complicating factor there was my cutting back on my prescribed anti-depressants because BCBS did not like the doctor who prescribed them and BCBS would not pay for it. Anyhow. I now steer clear of anything that would increase thoughts of suicide.
Yea, I had asked if there was any side effects and he said not really.... except for depression/thoughts of suicide, so if you have any changes in your mental state, let me know right away. I have not had any changes... if anything, I am happier because I know I am not just a weak willed wuss like I believed before and that I am making progress now.

Good call on avoiding it though since you have struggled with that in the past. The whole point of losing weight it longer life and better life.... suicide is exactly the opposite.
 
It is to blame for our obesity epidemic, not even remotely close IMHO. (for reasons previously stated)
The government is not to blame, right. But no one else is situated to employ a mass solution on an unwilling public.

I can promise you that 10s of millions of good personal decisions, turning on a dime just like that <snap> … that’s not happening.
 
But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.

I know you're sincere and thoughtful, but I think I disagree.

I don't think it's that complicated.

1. Educate people that lots of the food available is crap. Educate people that they need to move around. (That one feels like it's complete)
2. The people who understand there's lots of crap available instead choose the healthier options to eat.
3. The people who understand you need to move and take 10,000 steps a day do it.

I fully admit I may be naive. But I don't think it's that complicated.

Humans have a space between Stimulus and Response. We can think.

I dog may not have the ability to weigh out choices and make the best one.

Humans do.

And I'm puzzled and discouraged why it seems we don't.
I can say (as described in a lot more words in my other posts) that yes, it can be more complicated on an individual level and that also means it complicates things on a societal level as well. I don't think it is nearly as 'simple' as you think it is. You see it through your experience of "I just need to track my calories and limit how much I eat" and that is simple and it works but that isn't everyone's experience.
 
I disagree as well, though I see it as a matter of framing. You’re individualizing a general problem in American society. Individual solutions can’t be applied to 100 million people in American culture as currently constituted.

Sure they can.

And for governmental regulations, people can make healthier decisions without the government's help. Plus they've already done some of that with school lunches and candy and stuff.

But the government isn't going to save us on this.
The FDA is at the very least, complicit. Look into corn subsidies. It HUGE business.

is it possible to eat healthy. Of course. Is it easier to not eat healthily? Yep.
 
I can say (as described in a lot more words in my other posts) that yes, it can be more complicated on an individual level and that also means it complicates things on a societal level as well. I don't think it is nearly as 'simple' as you think it is. You see it through your experience of "I just need to track my calories and limit how much I eat" and that is simple and it works but that isn't everyone's experience.

I think everybody agrees it can get complicated on an individual level.

The disagreement in this thread appears to be at the societal level.
 

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