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To tell people to choose between a pill and death without discussing the underlying cause of the problem _is_ the problem. Ethics and morality used to be a cor

To tell people to choose between a pill and death without discussing the underlying cause of the problem _is_ the problem. Ethics and morality used to be a cornerstone of medicine.

BLKNSLVR 5y ago
I'm sure the original comment is merely a summation of the conversation rather than its entirety. The point I get from the above, is that it doesn't matter how, why, what, when of the conversation, recommendation, reasons, root causes, treatments, lifestyle changes - they's goin' stay the course, right over the cliff.
cm2012 5y ago
Research shows that nothing doctors recommend has any effect on weight loss except bariatric surgery. This has been shown over and over again in every study. Doctor moralizing is pointless, people know they are supposed to be eating right. Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people. 1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453 http://www.ncbi.nlm.nih.gov/pubmed/1580453) 2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full http://ajcn.nutrition.org/content/74/5/579.full) 3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/ https://fatfu.wordpress.com/2008/01/24/weight-watchers/) 4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope- http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data. 5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/) Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.
- ellyagg 5y ago
  The problem with studies like these is you only need to know one person who contradicts the claim to know that it's false as an absolute. And I know several. It more points to the limitations of studies like these than it does an incontrovertible fact. Some people who are highly internally motivated can lose weight and keep it off.
  - NineStarPoint 5y ago
    Ignoring the possibility that people have different physiologies that react to these things differently: We’re not dealing with machines, we’re dealing with humans. If only 5% of people are capable of following the advice then we need to find a better method. It could be any number of things that need to be changed, but just telling people to do x and y the way we currently are clearly isn’t working.
- rdmirza 5y ago
  This is no longer true. The GLP1s have proven to have excellent efficacy for weight loss (and cardiovascular mortality in diabetics). Their numbers approach bariatric surgery (>10% body weight in the obese). People keep the weight off too. Here's one study showing 5kg on average weight loss at 5 years according to this study: https://www.mdpi.com/1660-4601/17/1/207/pdf https://www.mdpi.com/1660-4601/17/1/207/pdf
- boublepop 5y ago
  There are products and studies now with Liraglutide and semaglutide, which show consistent and maintainable weight loss, but neither has been on the market for 5 years yet afaik, and the longest study only ran for 2 yearsit seems. Though it seems likely sustainable results from a 2 year study will hold for 5 years. https://www.europeanpharmaceuticalreview.com/news/165203/wegovy-demonstrates-sustained-weight-loss-in-two-year-obesity-study/ https://www.europeanpharmaceuticalreview.com/news/165203/weg...
- eyeball 5y ago
  It would be nice if there were a drug to counteract the changes that make it so hard to keep weight off. Losing it is easy. I’ve lost 100lbs five times in my life. It’s fucked.
joelbondurant 5y ago
[dead]
hermes8329 5y ago
I am facing taking the mountain of pills or die situation right now. I know what the underlying cause was but in reality it is irrelevant to anything now. The event happened and now i deal with the fallout. The cause was not predictable due to lifestyle or anything else. It was simply like being struck by lightening. So why do i care about the cause again? I dont. it was a non reversible event

To tell people to choose between a pill and death without discussing the underlying cause of the problem _is_ the problem. Ethics and morality used to be a cornerstone of medicine.

BLKNSLVR 5y ago

I'm sure the original comment is merely a summation of the conversation rather than its entirety. The point I get from the above, is that it doesn't matter how, why, what, when of the conversation, recommendation, reasons, root causes, treatments, lifestyle changes - they's goin' stay the course, right over the cliff.

cm2012 5y ago

Research shows that nothing doctors recommend has any effect on weight loss except bariatric surgery. This has been shown over and over again in every study. Doctor moralizing is pointless, people know they are supposed to be eating right. Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people. 1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453 http://www.ncbi.nlm.nih.gov/pubmed/1580453) 2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full http://ajcn.nutrition.org/content/74/5/579.full) 3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/ https://fatfu.wordpress.com/2008/01/24/weight-watchers/) 4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope- http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data. 5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/) Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.

ellyagg 5y ago
The problem with studies like these is you only need to know one person who contradicts the claim to know that it's false as an absolute. And I know several. It more points to the limitations of studies like these than it does an incontrovertible fact. Some people who are highly internally motivated can lose weight and keep it off.
- NineStarPoint 5y ago
  Ignoring the possibility that people have different physiologies that react to these things differently: We’re not dealing with machines, we’re dealing with humans. If only 5% of people are capable of following the advice then we need to find a better method. It could be any number of things that need to be changed, but just telling people to do x and y the way we currently are clearly isn’t working.
rdmirza 5y ago
This is no longer true. The GLP1s have proven to have excellent efficacy for weight loss (and cardiovascular mortality in diabetics). Their numbers approach bariatric surgery (>10% body weight in the obese). People keep the weight off too. Here's one study showing 5kg on average weight loss at 5 years according to this study: https://www.mdpi.com/1660-4601/17/1/207/pdf https://www.mdpi.com/1660-4601/17/1/207/pdf
boublepop 5y ago
There are products and studies now with Liraglutide and semaglutide, which show consistent and maintainable weight loss, but neither has been on the market for 5 years yet afaik, and the longest study only ran for 2 yearsit seems. Though it seems likely sustainable results from a 2 year study will hold for 5 years. https://www.europeanpharmaceuticalreview.com/news/165203/wegovy-demonstrates-sustained-weight-loss-in-two-year-obesity-study/ https://www.europeanpharmaceuticalreview.com/news/165203/weg...
eyeball 5y ago
It would be nice if there were a drug to counteract the changes that make it so hard to keep weight off. Losing it is easy. I’ve lost 100lbs five times in my life. It’s fucked.

joelbondurant 5y ago

[dead]

hermes8329 5y ago

I am facing taking the mountain of pills or die situation right now. I know what the underlying cause was but in reality it is irrelevant to anything now. The event happened and now i deal with the fallout. The cause was not predictable due to lifestyle or anything else. It was simply like being struck by lightening. So why do i care about the cause again? I dont. it was a non reversible event