My manfriend is on ozempic and he always complains about how it makes him alternate between constipation and diahrrea. So it was funny to me to see it become a meme.
It's an important discussion. We should all be aiming to do better. Instead we're just lowering the standards for everything.
Only the morbidly obese should be using these drugs to get down to a healthy enough (overweight) level to lose the rest with sensible discipline, healthy/less eating (mostly this), and exercise (less this, but important for the mind, strength and cardio).
Discipline and basic understanding of nutrition and fitness are important life skills. At some point everybody should be developing them. If people can't be arsed doing that and we give easy shortcuts for everything in life, what's the point in being alive?
This argument comes up time and time again because it's common sense, yet people always seem to want to ignore it because deep down they are being lazy and undisciplined.
Nah man. I'm overweight and despite trying everything I possibly can for most of my adult life, I still can't win. I do everything you're supposed to do but it's just not possible to maintain long-term. It's a constant struggle. You don't have discipline. It's just easier for you. That's all. I still won't use this drug but don't try to tell me I failed because of a lack of effort, understanding, exercise, "discipline", etc.
> don't try to tell me I failed because of a lack of effort, understanding, exercise, "discipline", etc.
Not to be _too_ rude here, but clearly you missed the mark on at least one of those things. If you're burning more energy than you're consuming, it's impossible to not lose weight. Maybe you underestimated how many calories you were consuming, overestimated how many calories you were burning, didn't do it often enough, didn't do it for a long enough period of time, had a few too many "cheat days", or some combination thereof.
The missing piece is that the body does not burn a constant amount of energy, and often the body's response to calorie restriction is to reduce the amount of energy used. [1]
Play the weight-loss game with your body, and you'll find the goalposts get moved.
> and often the body's response to calorie restriction is to reduce the amount of energy used.
Presumably the point at which it's VERY difficult to expend more calories than you're consuming is something of an equilibrium point, or healthy weight. I find it hard to believe that if you're still 100 pounds overweight after having lost say 20 pounds that it's nigh-impossible to find more "fat to trim" in the caloric intake, for example.
I count my calories accurately. The problem is keeping consumption that low in the long term. It's not sustainable. Your body does everything to fight you and it only gets harder the further you go.
Only if you misunderstood what I said. Your body will determine how much "discipline" you have. Will power doesn't come from some external magical place. It'll be adjusted by your body as necessary to make sure losing weight is hard as possible for you.
For more than half of my life, I was quite skinny. I was not exhibiting any particularly strong willpower or self control. I never had to put forth any effort in not being fat. It was not a struggle, it was not a challenge, and it was not because I lacked a behavioral problem. Well into my 20s I had zero issue controlling my weight - though saying controlling my weight here is kind of a misnomer, since I put no thought or effort into it. If anything, when I was trying to get into powerlifting, I struggled to eat enough - I constantly felt sick trying to reach my calorie and protein targets.
Then circumstances changed. I swapped to an overnight job for more money. I started cooking less because of the hours, and eating more fast food. I stopped lifting weights because powerlifting was less interesting to me. My weight crept up little by little for years and years until I was overweight. And I realized my relationship with food had changed - ignoring physical hunger was still easy, but I was still constantly thinking about food. Slightly bored? Let's eat something. Work stressing me out? Grab some more food. Have a few minutes respite from everything? Eating sounds good. Eventually I was past overweight and into obese.
I managed to lose 30lb or so a few times, close to 50lb once. I could maintain it for a bit. But I was having to expend huge amounts of mental energy to do it - something I had never had to do before I had gotten fat in the first place. The second I had to prioritize other things in my life, for whatever reason, I no longer had the energy to spend so much time trying to push down all of the noise in my mind about food.
vs. just a decade prior, never really thinking about food at all. Is it possible for anyone to lose weight? Sure. Bodies aren't magic. Energy has to come from somewhere, and lower your calories a sufficient amount and you will lose weight. But for many people the amount of willpower and effort required is just massively different. The years of skinny me would not have lasted nearly as long as they did if I had the same level of food noise then that I do now.
No, it's not a "behavioral problem." Your phrasing is disgusting. The research is perfectly clear on why it's extrenely difficult to lose weight. There's no need for speculation.
You just haven't got there yet. You haven't failed.
It really just comes down to eating less and healthier. Some people have metabolic differences either side, but they don't amount to a great deal.
Weight loss drugs suppressing your appetite literally shows this to be true. You just need to do it yourself without the drug. Eventually you'd want to come off the drug, right? When that happens, you would need to do just this.
Every time I've heard somebody say they've tried everything, they usually haven't. It's not a failing, it's an opportunity to keep trying and get it right.
> Eventually you'd want to come off the drug, right? When that happens, you would need to do just this.
I've made enough changes to my lifestyle that I am confident I could come off the drug and maintain the lost weight. I've added weight lifting with the prospect of bodybuilding as a hobby. I'm likely going to need to take time off just to get enough calories in during periods when I am trying to add muscle because I won't want to eat enough otherwise.
But I'm not actually looking forward to that, because the list of positive effects from these medications that are independent of weight loss is quite long. I expect that short of any major detrimental side effect suddenly rearing it's head or gene editing or some other superior thing appearing, I'll be on these for life, regardless of weight.
> If people can't be arsed doing that and we give easy shortcuts for everything in life, what's the point in being alive?
Embrace the shortcuts. Life's too short not to.
What's that Plato quote about writing?
If men learn this, it will implant forgetfulness in their souls. They will cease to exercise memory because they rely on that which is written, calling things to remembrance no longer from within themselves, but by means of external marks.
What you have discovered is a recipe not for memory, but for reminder. And it is no true wisdom that you offer your disciples, but only the semblance of wisdom, for by telling them of many things without teaching them you will make them seem to know much while for the most part they know nothing.
And yet, here were are, conversing at all only because of writing.
The truth is that we designed a system in which a majority of people cannot thrive and in which a lot of people end up developing problems like obesity or being labeled as ADHD. Now the same system designed a cure, one that you have to pay for and take for years if not for life, just so that you can rewire your perfectly normal brain to fit in the very imperfect mold of what the system needs
Taking antidepressant won't fix your depressing environment
Taking sleeping pills won't fix your sleep depriving routine
Taking ozempic won't fix your stressful job that materialized into an compulsive eating
The extreme vast majority of people have perfectly normal bodies/hormones/&c. but are evolving in unhealthy environments, you're merely fixing the last link of the chain, if you stop there, like a lot of people do when they're being advertised magic pills, you're setting up yourself for failure. The fact that all of these lifestyle disease increased 100 folds in the last 50 years should be a clear sign that the problem isn't the human body/brain, but whatever the fuck we're collectively agreeing to take part in.
Also the fact that plato was wrong about one piece of progress 2000 years ago doesn't mean every new thing since then was a net positive for humanity. You could have used the same argument for decades about asbestos, leaded paint, leaded gas, freon, &c. and yet here we are...
know what makes it easier to fix/change your environment? when you aren't obese and everything in life is so much harder.
Guess what? you can both take ozempic AND fix the problems that caused the need to self-medicate with food (for example). In fact, I would be willing to bet that we see research coming out in the next couple years that shows people who lose weight with GLP-1's then go on to make better lifestyle choices because they confer many benefits that are much more obvious and attainable when you aren't obese and just fighting to get around in daily life.
It's a two-way issue - having some problems result in you being obese, but being obese also creates problems, makes them worse, and harder to address. Mental health issues for example can both cause obesity and be caused by obesity - if you aren't obese anymore then your mental health improves and you can then go onto address other issues you might not have been able to otherwise.
Lastly, you talk about "the system" as if that's not a two way relationship. People who have unhealthy habits they have trouble controlling create demand for services and products that are unhealthy - but if you have less people with unhealthy habits then that demand reduces and so do those unhealthy supplies.
I went from about 265lbs down to 160lbs at my lowest. I crashed it as quickly as I could over the course of about 4-5 months, because that’s how my brain works. Single goals with a hard metric to optimize.
During that I forced myself to start walking. 6k steps a day to begin with, ramping up to 20k steps a day at my peak. Not optional and no exceptions for any reasons. If it was 11:30pm and I was at 9k for the day, I got out of bed and walked until I hit my 20k goal.
Very difficult at first but eventually it just became a new habit. Having a dog that demands at least 5 miles of walks a day helped a lot!
After I dropped the weight I knew my strength was now an issue. Zero way to drop over 100lbs that quickly without losing muscle mass. So I started going to the gym towards the last couple months of that. I literally just sat in the hottub or did some really lazy laps in the pool since I enjoy that. The point was forcing myself to go on my scheduled “gym days”.
After I got out of severe calorie deficit territory I got a personal trainer twice a week to force myself to go with some social and financial pressure, and slowly learned how to do weight training. This was terrifying to me due to social anxiety, so I left it as my last item to work on.
I’m now back to 200lbs or so, but with an estimated 12% body fat composition. Roughly where I want to be, and just short of some “fun” strength goals like hitting a certain bench or squat target and staying there.
So far after over a year of being largely off the GLP-1s these habits have stuck. They still are not easy, but knowing how much impact they have just on my mental health when I am consistent with them keeps it going. Plus I made a few new unexpected friends along the way who give light social pressure to keep the gains coming.
My path is certainly not for everyone, but there would have been zero way for me to accomplish it and stick to it without the weight loss drugs. I’m now 44 years old, and a few of my friends have commented that this is the most unexpected thing they have seen me accomplish - and I like to think I’ve accomplished quite a bit throughout my life so far. A complete 180 from how I approached my physical health in the past, and the drugs gave me the performance enhancement for my diet that I needed to get over the hump.
> The truth is that we designed a system in which a majority of people cannot thrive and in which a lot of people end up developing problems like obesity or being labeled as ADHD.
We designed — if you can call this "design" — a system where most people are not the literal property of their feudal lords and most of them do not need to worry about literally starving to death.
Our genomes don't know we're not at constant risk of starving, they're not universally adapted to abundance. Heck, our genes are barely adapted to milk[0] or cooked food[1].
We don't know if our forebears had ADHD, but this not because they didn't, it's because approximately nobody in psychology wants to diagnose someone who isn't in the room with them — there's plenty of historical figures whose behaviour is compatible with such a diagnosis, which is a much weaker claim. Personally, I am suspicious of evolutionary psychology as being at risk of decorating "just-so" stories with just enough rigour to seem respectable, but even then one does need to make claims that at least add up, such as the ones behind this claim that it may have been an adaptation 50k years back: https://www.psychologytoday.com/us/blog/brain-curiosities/20...
> The fact that all of these lifestyle disease increased 100 folds in the last 50 years should be a clear sign that the problem isn't the human body/brain, but whatever the fuck we're collectively agreeing to take part in.
> You could have used the same argument for decades about asbestos, leaded paint, leaded gas, freon, &c. and yet here we are...
Mm. And despite all those errors, where we are is "living longer and healthier lives in greater comfort… unless you're American for some reason, you guys should look at what all the rest of us have been doing and copy us". Even a few of those examples, like asbestos, were direct improvements over the previous status quo of "perhaps my house/factory will burn down with me in it".
> and most of them do not need to worry about literally starving to death.
Yes, now the main causes of death are literal sloth and gluttony.
> living longer and healthier lives
Healthier ? 50% of people are basically disabled by the age of 40 because of obesity
You're conflating life expectancy at birth vs life expectancy, don't forget health-span expectancy either. The US life expectancy is going down, health span is going down in most of the west too:
Anyways, if your argument is that we should be glad that 70% of people are overweight/obese because people died earlier 300 years ago idk how many people you will convince...
Saying of employment and big companies "oh no totes the same as feudalism" from such superficial similarities is historically laughable. It's like saying that the Romans and the USA and Mussolini are all "the same thing" because of the iconography of the fasces.
> Yes, now the main causes of death are literal sloth and gluttony.
> You're conflating life expectancy at birth vs life expectancy, don't forget health-span expectancy either. The US life expectancy is going down, health span is going down in most of the west too:
Burden of disease
Disability-Adjusted Life Years (DALYs) per 100,000 individuals from all causes. DALYs measure the total burden of disease – both from years of life lost due to premature death and years lived with a disability. One DALY equals one lost year of healthy life.
Burden of disease goes down until the pandemic, only then goes up.
Even with pandemic making things worse, the USA was back at 1992 levels of health.
Specifically life expectancy: even in the USA, what you're seeing is the impact of the covid pandemic.
> Anyways, if your argument is that we should be glad that 70% of people are overweight/obese because people died earlier 300 years ago idk how many people you will convince...
And in any case, your previous argument was "Taking ozempic won't fix your stressful job that materialized into an compulsive eating", to which my snappy retort is: well, nothing else did that either, did it?
My real argument is: if you don't like the obesity epidemic, why are you opposed to people taking the magic weight loss treatment that actually works, and apparently has a whole bunch of surprising positive side effects such as the headline of this news story?
It's the solution, and you're complaining about the problem that it fixes as if it also causes it. Thinking of the asbestos example earlier, what you're arguing here is like saying "all fire-retardants must be bad because people are on fire a lot".
There's a time and place for shortcuts. Health and fitness shortcuts hold more to lose than they do to gain.
Sometimes the long way is better long term. A healthy attitude towards eating and fitness can, and usually does, elevate your life experience many times over. Taking a shortcut in these erases any personal development and learning experience you could get from finding a sport you love, changing your views on food.
A diatribe about Plato doesn't make the universal argument for taking shortcuts. Do you want the people building your home and infrastructure making shortcuts? Do you want doctors in training to shortcut their studies? Why work out and train longer when you can just take anabolic steroids? Why read (or watch films) if you can just skim the summaries on Wikipedia?
> Health and fitness shortcuts hold more to lose than they do to gain.
The entire history of medicine and sports science disagrees with you about that. It's all about knowing what the direct path to the goal is and not meandering around the metaphorical scenic route to those goals.
> Taking a shortcut in these erases any personal development and learning experience you could get from finding a sport you love
Or enable sports that were otherwise unobtainable.
> changing your views on food.
More likely that these drugs would do that. UK celebrity chef Jamie Oliver tried to promote healthy eating in schools by showing school kids how chicken nuggets were made. The kids were disgusted… and yet still wanted to eat them, much to Jamie Oliver's surprise.
> Do you want the people building your home and infrastructure making shortcuts?
I get the impression you're just conflating "shortcut" with "progress", based off of the original Plato example.
You clearly know what I was implying with many of the examples there and spun them into different directions. You don't want builders who take shortcuts building critical infrastructure to save time or hassle, nor do you want to be treated by a doctor who took shortcuts in their education and training.
If you want to become a professional athlete or sports person, tried and testing training methods, nutrition etc. aren't shortcuts. You still need to do those things consistently for years and years (much like staying in shape in general).
If somebody seriously wants to lose weight, they need to discipline themselves to eat better (and maybe supplement that with exercise). Just taking a shortcut weight loss jab without taking anything from it will just lead to the weight going back on (as in crash dieting), becoming an indefinite user of these drugs, or failing completely if the drugs ever become unavailable or develop long term side effects.
