5 ms·

“when lifestyle changes aren’t enough.” People don’t want to hear it, but we do nobody any favors by pretending this is more complicated than it is. It’s actua

“when lifestyle changes aren’t enough.” People don’t want to hear it, but we do nobody any favors by pretending this is more complicated than it is. It’s actually pretty simple. The solution is to adjust calories in vs calories out. Fast a few days a week. Cut out bread, sugar and other simple carbs. We don’t help alcoholics or opioid addicts by enabling them with statements like “when not getting drunk isn’t enough…” The pharma industry will enable addicts because it wants money. Fat people need love, though love, and a home without good tasting, or high calorie foods.

epgui 4y ago
> The pharma industry will enable addicts because it wants money. This is a little over-simplistic. The "pharma industry" is not a monolith, and is made up in large part by academics who love spending their time thinking about how to make the world better, and by doctors who have no conflict of interest, etc etc.
- 2devnull 4y ago
  It is an industry. It must therefore be optimized to maximize shareholder value, roi, revenue, etc… Gambling can be fun, and nothing wrong with casinos, but in the long run they are optimized for one thing. A casino that is not optimized for profit will disappear. Same is true for the healthcare industry. If a corporation is not optimized to make money they disappear. I think it’s valuable from a financial perspective to avoid casinos. I think it’s valuable from a health perspective to avoid drugs, to the extent possible. But, yes, casinos can be fun, and you can even profit from them if you play your cards right.
mshake2 4y ago
While I agree, you're right, nobody wants to hear it. There's no point telling people to have discipline, because discipline is not spread through strangers telling each other to have it. Someone either has the capacity to have discipline (instilled through upbringing or formative events), or they don't. These magic pills are for everyone who doesn't have discipline.
- 2devnull 4y ago
  Maybe. I was fat. I believed various things I heard parroted about, “starvation diets don’t work,” and “it’s not healthy to skip meals.” There are too many of these to list. I noticed skinny people tended to eat less and skip meals. I noticed bariatric surgery worked, for awhile. I tried fasting. I’m now quite healthy. Exercise doesn’t help lose weight, but it can be a better way to change your biochemistry than eating tasty food. People should be told these 2 simple things, and none of the other stuff that doesn’t really help. It’s simple. Eat less.
YellOh 4y ago
We actually do often recognize that "just stop having problems" isn't usually useful advice for people with drug addiction, too. Ex. naltrexone for alcohol addiction, methadone for opioid addiction, etc. "Just stop having problems" is usually easy to say as an outside observer, but generally when someone's reward circuit is hijacked by addiction, it takes something more effective to rewire it. Sometimes sheer willpower is enough to exit the cycle, but usually it takes outside changes (drugs, environmental changes, effective therapy) to loosen the grip of addiction.

epgui 4y ago

> The pharma industry will enable addicts because it wants money. This is a little over-simplistic. The "pharma industry" is not a monolith, and is made up in large part by academics who love spending their time thinking about how to make the world better, and by doctors who have no conflict of interest, etc etc.

2devnull 4y ago
It is an industry. It must therefore be optimized to maximize shareholder value, roi, revenue, etc… Gambling can be fun, and nothing wrong with casinos, but in the long run they are optimized for one thing. A casino that is not optimized for profit will disappear. Same is true for the healthcare industry. If a corporation is not optimized to make money they disappear. I think it’s valuable from a financial perspective to avoid casinos. I think it’s valuable from a health perspective to avoid drugs, to the extent possible. But, yes, casinos can be fun, and you can even profit from them if you play your cards right.

mshake2 4y ago

While I agree, you're right, nobody wants to hear it. There's no point telling people to have discipline, because discipline is not spread through strangers telling each other to have it. Someone either has the capacity to have discipline (instilled through upbringing or formative events), or they don't. These magic pills are for everyone who doesn't have discipline.

2devnull 4y ago
Maybe. I was fat. I believed various things I heard parroted about, “starvation diets don’t work,” and “it’s not healthy to skip meals.” There are too many of these to list. I noticed skinny people tended to eat less and skip meals. I noticed bariatric surgery worked, for awhile. I tried fasting. I’m now quite healthy. Exercise doesn’t help lose weight, but it can be a better way to change your biochemistry than eating tasty food. People should be told these 2 simple things, and none of the other stuff that doesn’t really help. It’s simple. Eat less.

YellOh 4y ago

We actually do often recognize that "just stop having problems" isn't usually useful advice for people with drug addiction, too. Ex. naltrexone for alcohol addiction, methadone for opioid addiction, etc. "Just stop having problems" is usually easy to say as an outside observer, but generally when someone's reward circuit is hijacked by addiction, it takes something more effective to rewire it. Sometimes sheer willpower is enough to exit the cycle, but usually it takes outside changes (drugs, environmental changes, effective therapy) to loosen the grip of addiction.