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I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me fo

I'm also on one of these drugs (Tirzepatide) and have been for a few months. The first time I remember knowing I was fat was when a babysitter made fun of me for it at age 6. I've been fat ever since and I'm in my late 30s now. I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every time, I've gained the weight back. At the beginning of 2022, I was the heaviest I've ever been. I've accomplished very hard things in my life, including those that take sustained effort. Sufficient willpower isn't a problem for me in general. I honestly only ever hear "it's easy, just eat less and move more" from people that have never actually been fat. "I did it and I lost 15 pounds, no big deal!" and the like. 15 pounds is easy for me to temporarily lose too. I've done it enough times I should know ;) I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. On this drug, I finally know what people are talking about. I still like food, and I still get hungry. But it doesn't dominate my thoughts. I eat, and don't feel like eating again for hours. I eat something that I'd normally easily eat all of like a big burrito or whatever, and I feel quite full halfway through with no desire to finish. I'm steadily losing weight, with none of the usual preoccupation with hunger, ascetic adherence to a strict calorie plan, etc. But above all, I feel like I must be experiencing what most thin people experience all the time. I'll be perfectly happy to take the drug for the rest of my life, though I do hope affordability improves. As for side effects: I've had some heartburn, but none of the other commonly reported side effects.

ilyt 4y ago
What finally got me on right way on controlling hunger was just getting used to eating once a day and dropping a lot of the quick-burning foods that made me go hungry quicker. Not necessarily going super healthy but stuff like eating less bread/pasta and more say baked potatoes so still nice tasty food that doesn't get me into diet sadness mood, just shifting away from carbs Also figuring out when I'm "brain hungry" (brain is bored and wants to munch on something/get reward for hard day at work) and when I'm "body hungry" (body actually wants some energy and is slowing down, fingers/feet getting colder etc.).
- jasonwatkinspdx 4y ago
  Yeah, I've never struggled with weight the way other comments in this thread have, but I made similar changes when I was younger and they've been one of the best things I've done. I have one largish meal a day, with one smaller or a snack, and focus on low GI foods but in a mild way. When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately.
  - ilyt 4y ago
    Yeah when I tried the "eat a bunch of small meals during the day" way I felt like some constantly munching pasture animal and also had to plan for all that. And any social plans threw a wrench in it, as getting used to frequent meals also made me go brain hungry quicker. Now getting some frozen pizza for dinner coz I'm lazy/don't have time no longer ruins diet pace for this week > When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately. Anything with a bunch of milk works well for me for quashing hunger. Weirdly enough I usually feel more hungry in the evening than morning next day (at the very least for first 1-2 hours)
- petesergeant 4y ago
  I've done all of these things. I've essentially been on a diet since I was 17. I am not (especially) fat, but the amount of mental and emotional energy I burn on not being fat is huge. It is a daily struggle. Like one of the parent posts, I've achieved a number of other hard things in my life that took sustained effort and willpower. I can easily eat 7-8,000 calories in a day, and there's no amount of stairmaster can fix that. I've also previously taken modafinil, and had situations where I've had caffeine having been caffeine-free for a while, and the appetite-suppression properties have me thinking "this is what normal people must feel like". I cannot wait until these drugs become available in the country I mostly live in.
altcognito 4y ago
I have gerd, and was like, I was wondering if this would make it easier for me to eat small amounts and not have as much heartburn... then I read this: > As for side effects: I've had some heartburn, but none of the other commonly reported side effects. And I looked up the less side effects, it is a laundry list of gerd symptoms. I can confirm, these symptoms will help you lose weight, but I mean that tounge in cheek, I hope this drug helps a lot of people but doesn't have much in the way of side effects.
- windpower 4y ago
  The heartburn has been quite minor, and only at night. Tums has been plenty for controlling it. (But I don't have GERD.) The heartburn itself is definitely not the cause of the weight loss for me, haha. But intuitively it does make sense, because one of the primary effects of the drug is slowing down gastric emptying, so it causing heartburn isn't exactly surprising.
- sarchertech 4y ago
  I just read through the side effect information. Gerd was reported in 5% of Wegovy users compared to 3% in the placebo arm. It’s a risk but it’s not a huge risk. Nausea especially in the first few weeks was more common, but it was only bad enough to cause <2% of people to discontinue the trial.
- icambron 4y ago
  One of the likely factors in my gerd issues is being about 20 lbs overweight, so I wonder how this balances out.
relaxing 4y ago
> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. This is what all the common advice doesn’t address. The only thing that has helped for me in the past was an SNRI (sibutramine) that was later withdrawn from the market. Then all the weight came back.
- lumb63 4y ago
  Common advice does address this. A lot of dieting has been, in my experience, finding ways to make less food make me fuller, or to think less about being full. For example, intermittent fasting is a great way to do both.
Izkata 4y ago
> I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. There's something similar here I've noticed while testing myself in the past: At least for me, it seems like hunger occurs when the stomach empties by a certain percent of its last maximum. No matter if I barely eat anything, or eat until max capacity, hunger starts after my stomach empties a bit further, but it doesn't take until I'm actually empty (tested by the size of the following meal), and the hunger tends to end after reaching the last maximum. To use some made-up numbers to demonstrate, it's like I can bounce back and forth between 60% full and 90% full or 20% and 30% full, and once I've gone a cycle or two on either of those, the low ends of 60% and 20% make me feel equally hungry and the high ends of 90% and 30% equally full, but I've digested more when the baseline is on the higher end. It can be difficult pushing from the higher range to the lower range though, have to ignore/squelch the hunger long enough to reach it.
loeg 4y ago
> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I have a similar experience.
danielvaughn 4y ago
I was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.” It’s so hard to eat healthy, I honestly cannot fathom how people do it.
- scarmig 4y ago
  > It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body needs); now, a slice is more than sufficient and satiety lasts well into the next morning. GLP-1 agonists makes eating healthy trivial and automatic, instead of a dieting state where you're thinking about food literally constantly throughout the day for months or years on end. Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.
  - rubicon33 4y ago
    > Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit. Where does this line of thinking stop? Is everything pre-determined by genetics? Is everyone who is smarter than me, just actually lucky that their dopamine system works correctly, and mine doesn't, and hasn't since I was a very young kid? I'm sure this response will get down voted but its an honest question. This line of thinking that everything is genetically pre-determined seems both accurate and somewhat depressing. It means that if I'm skinny and can't gain weight, I need to take steroids and lift. Or if I'm fat, I should take a GLP-1 agonist. If I'm underperforming in my career or school, I should take adderal or similar pharma solutions. What role does good old fashioned hard work and discipline have in this day and age?
auganov 4y ago
> The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I feel exactly the way you do, and yes, I was fat, lost it in one go and never gained it back. I try to keep my BMI around 18, never went over 20 since losing weight. It's been around 15 years now. I still have the exact same unlimited appetite I have always had. If you put food I like in front of me, I'm going to eat it. I don't do anything special. I eat the same foods I always have, just less of them. Got really good at counting and never get more food than I need. The trick is to not put yourself in a situation where you have to stop eating in the first place. It's hard to just stop eating something you want to eat. Not that hard to stop yourself from going to the store again or ordering more (especially when other people are around). I feel like most people never get serious enough about counting, try to eat stuff they don't enjoy, waste effort on exercise or let other people interfere.
- fortran77 4y ago
  [flagged]
  - SamPatt 4y ago
    Counting calories correctly is really hard. I've lost 90 lbs, achieved a healthy body weight, and kept it off for years, but I keep trying to lose just 10 more pounds. I only make progress when I'm religious about calorie counting, including weighing every meal or needing to do precise food prep beforehand. That's such a pain in the ass that I inevitably fail and keep returning to my body's new average weight. I think you're right about truly obese people. They're eating so many calories that they would lose weight if they could manage a better diet. For people who aren't obese, the same principle may apply, but it's now a matter of much tighter margins and much greater precision, and it's remarkably difficult. Natural bodybuilders seem to manage their weight with precision, so it's not impossible with knowledge and effort. But I suspect very few people are capable of managing that if they tend towards obesity to begin with.
notacoward 4y ago
> people that have never actually been fat. "I did it and I lost 15 pounds Also people who have never had an older metabolism. It's different. I was also skinny despite eating a ton and hardly exercising when I was 25. Everyone I know over about 30 can identify when their metabolism suddenly changed. Diet (and to a lesser extent exercise) advice from those who haven't hit their own wall yet is worthless for those who have. Those people need to stop over-generalizing their (limited) experience as universal truth.
- stavros 4y ago
  I'm 40 and I can't pinpoint when my metabolism changed. I can pinpoint exactly when I moved in with my girlfriend, who cooks delicious food, instead of me ordering a salad a day as my main meal, but my metabolism itself seems to have hardly changed at all.
- Auracle 4y ago
  A recent study found basically no change in metabolism from the age of 20-60: https://www.bbc.com/news/health-58186710 https://www.bbc.com/news/health-58186710 People usually just start packing on a few pounds a year (or more) in their 20s and it adds up.
ashwagary 4y ago
>I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I hear people following a carnivore diet have had success in dealing with this satiety issue. The only things you can eat with this diet are butter (or ghee), beef, and salt. There is a claim that nutrient difficiency causes the scenario you are describing. Your body is being deprived of what it really needs with your current diet and requires more consumption to continue its search for a particular set of nutrients. The carnivore diet is not a silver bullet but worth a try. I will also mention it is high protien, high fat, and zero carb which has been shown to result in massive weight loss in relatively short periods of time (counterintuitive, I know).
- xvilka 4y ago
  > high protien, high fat, and zero carb Basically a keto diet, of course it works due to ketosis.
  - Sparkyte 4y ago
    I think the problem with Ketosis is that people are too busy trying to eat a lot of fats. You just need healthy fats, protein and vegetables.
    - jononomo 4y ago
      You don't need vegetables.
  - jononomo 4y ago
    A carnivore diet is not necessarily a ketogenic diet, although it is a zero-carb diet. If you eat enough protein then your body will make glucose from it and keep you out of ketosis. But I agree that a diet of only red meat is absolutely ideal no matter which angle you look at it from.
heavyset_go 4y ago
> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I had this exact same experience when I was prescribed a drug that, as a side effect, blocked receptors in parts of the brain responsible for signalling satiety from food. I went from having trouble eating enough food to maintain a healthy weight, and just not being hungry, to suddenly being unable to feel full at all. It was like I always had room for more, no matter how much I ate. And I was constantly hungry, felt like I was starving 24/7 and would ruminate about food so much that it impacted my ability to sleep or concentrate. My brain was obsessed with preventing me from "starving" and it ultimately dissolved the illusion of willpower that I thought I had. No longer take that drug, but it was an eye opening experience. I didn't know that was a thing people could experience, as someone who was always skinny. It really drove home that we are products of our biology and made me more empathetic with those who struggle with food.
- onionisafruit 4y ago
  I know what you mean. My doctor prescribed Naltrexone. The first day I took it I ate half my dinner and felt full for the first time in my life. As a middle-aged man I had never had that feeling before. Previously I assumed what people meant by feeling full is that you felt like you literally can't eat anymore. Unfortunately that stopped working for me after a few months. Hopefully this one will work better.
  - heavyset_go 4y ago
    If that doesn't work out, I think they make a combination drug of naltrexone/bupropion if the naltrexone worked for you originally. The latter drug activates parts of the brain that are responsible for emesis and it works well with the reward blocking effects of naltrexone. Good luck either way.
    - 4y ago
ericmcer 4y ago
Does your appetite not adjust to your intake? I did a “dirty bulk” while working at Trader Joe’s in my 20s. At the beginning I could barely eat one frozen mac and cheese. A month of heavy eating later and I could easily finish 2 and still feel hungry. Im older now so I don’t eat like that anymore, but it is still very noticeable to me how easily I get full when I am dieting hard.
SpeedilyDamage 4y ago
[flagged]
- HealthNeed 4y ago
  I think you are missing the point. People are not skinny because they "intellectually" know something. Nor are people fat because they are stupid, sometimes sure, but the societal trend towards obesity is not caused by ignorance. Read the article.
  - SpeedilyDamage 4y ago
    People absolutely are skinny because they intellectually know something, but the word “intellectually” doesn’t mean smart/stupid, it means “apply critical thinking to a situation” as opposed to allowing your animal brain to keep control. To put it another way, system 1 will eat until its full, system 2 knows what a calorie is, and at least vaguely understands how many calories are in what you just ate against what you need to survive. Skinny people are not smarter, they’ve either never had an impulse to eat more in the first place, or are able to react to the impulse with the part of the brain that reasons.
    - strken 4y ago
      I think executive function might be a better way to understand obesity, rather than Kahneman's system 1 and system 2 thinking. Inhibitory control in particular seems more relevant[0]. Applying critical thinking (as opposed to applying inhibitory control) is only useful against obesity insofar as you can make changes to your lifestyle and diet. Lots of people know what a calorie is yet still fail to lose weight, because intellectually understanding something doesn't mean you can do it. [0] https://www.sciencedirect.com/science/article/abs/pii/S0149763415301779 https://www.sciencedirect.com/science/article/abs/pii/S01497...
      - SpeedilyDamage 4y ago
        Making changes to your lifestyle and diet is still the best, most reliable way to lose weight; this article’s science is far from conclusive or “production ready”, as engineers would say.
ccvannorman 4y ago
> I still like food, and I still get hungry. But it doesn't dominate my thoughts. This is how I feel as a default, I am a perpetually skinny person. Thank you for putting this into words from your perspective in such a crisp way. I wish everyone would have the same (non dominating) relationship with food as a normal occurance (and not some immense mountain to continually climb.)
jononomo 4y ago
Please try eating only liver, eggs, and ribeye steaks and drinking only water. You can absolutely stuff yourself on this diet and you will nevertheless get in shape. It breaks my heart that people have such an upside down idea about what healthy food is -- people think they should avoid red meat and eat fruits and vegetables and "heart healthy grains" when in fact the only thing they should eat is red meat. It is a tragedy almost beyond description -- there are millions of people in your situation who have been thwarted in their weightless journeys at every turn because we've been getting the wrong information about what food is healthy for us to eat. In addition to losing weight, you will also completely eliminate heartburn. Just try it.
- jvyduna 4y ago
  I did this and lost 18% of my body weight (BMI 36 to 29) after reading Gary Taubes. It works. The resulting blood chemistry worried my doctor. Worse, it’s excruciatingly boring. The 60th serving of fatty steak is no longer delicious. I lusted for a crouton. Even onions are a cheat in a glycemic load regime. When I was single, strategies like having no sugar, alcohol, or refined carbs in the house were practical, but living with a family and especially with young kids, they really aren’t. I regained it all and more. I’ve made follow-on efforts and had several +/- 30lb swings. I started tirzepatide three months ago. I echo what others have said above: I never understood satiety before this. Keeping keto takes excruciating willpower in comparison. I now know what it feels like to eat 3/4 of a normal dinner with balanced macros and not think about food till lunchtime the next day. There’s a big difference between maintaining constant vigilance against desire and having none.
  - arcticbull 4y ago
    > There’s a big difference between maintaining constant vigilance against desire and having none. This is exactly the case I make for fasting to those who ask why I like it. Nothing to count. It's super effective, much easier than people assume, and very quick. Also gives you a ton of energy and focus. Glad you found something that works!
- ghostbrainalpha 4y ago
kweingar 4y ago
If you don’t mind sharing, we’re you prescribed tirzepatide for type 2 diabetes, or was this an off-label prescription for weight loss?
anovikov 4y ago
How much weight did you end up losing on that stuff?
vineyardmike 4y ago
> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I’ve had a weirdly similar experience due to wildly different histories. When I was a kid I was on medication that f’ed with my appetite so I literally never learned what hunger was as a kid. As an adult and long off the medication, I just eat and don’t understand the signals my body produces. When I was younger, I had a healthy and active body and didn’t notice my diet was bad until first I graduated and took a desk job then it accelerated with Covid when I became sedentary and snacks were constantly available. I put on weight very quickly.
paul7986 4y ago
Just curious in regards to saying you never really feel full ..have you ever counted daily calories you consumed on average?
adriang133 4y ago
I was fat/overweight all my life until I was about 24. I had enough of it and I went from ~94kg to about 85kg quite quickly (through calorie deficit), then over 1-2 years I went to a low of about 72kg. I am about 75-76 now, and have been oscillating in the 72-77 range for the past 5 years or so. It still requires me to be mindful of how much I eat, which has become part of my daily life. I'm not very strict about it, I have days when I eat more and then I compensate by eating less. I think the mistake people make is they think they can go on a diet temporarily, then go back to the old eating habits and not get fat again. That is nonsense of course, which is why dieting doesn't work. Dieting implies something temporary and you need something permanent.
- wrp 4y ago
  I've heard from many sources that maintaining a weight level is harder than losing weight, and that has been my own experience.

ilyt 4y ago

What finally got me on right way on controlling hunger was just getting used to eating once a day and dropping a lot of the quick-burning foods that made me go hungry quicker. Not necessarily going super healthy but stuff like eating less bread/pasta and more say baked potatoes so still nice tasty food that doesn't get me into diet sadness mood, just shifting away from carbs Also figuring out when I'm "brain hungry" (brain is bored and wants to munch on something/get reward for hard day at work) and when I'm "body hungry" (body actually wants some energy and is slowing down, fingers/feet getting colder etc.).

jasonwatkinspdx 4y ago
Yeah, I've never struggled with weight the way other comments in this thread have, but I made similar changes when I was younger and they've been one of the best things I've done. I have one largish meal a day, with one smaller or a snack, and focus on low GI foods but in a mild way. When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately.
- ilyt 4y ago
  Yeah when I tried the "eat a bunch of small meals during the day" way I felt like some constantly munching pasture animal and also had to plan for all that. And any social plans threw a wrench in it, as getting used to frequent meals also made me go brain hungry quicker. Now getting some frozen pizza for dinner coz I'm lazy/don't have time no longer ruins diet pace for this week > When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately. Anything with a bunch of milk works well for me for quashing hunger. Weirdly enough I usually feel more hungry in the evening than morning next day (at the very least for first 1-2 hours)
petesergeant 4y ago
I've done all of these things. I've essentially been on a diet since I was 17. I am not (especially) fat, but the amount of mental and emotional energy I burn on not being fat is huge. It is a daily struggle. Like one of the parent posts, I've achieved a number of other hard things in my life that took sustained effort and willpower. I can easily eat 7-8,000 calories in a day, and there's no amount of stairmaster can fix that. I've also previously taken modafinil, and had situations where I've had caffeine having been caffeine-free for a while, and the appetite-suppression properties have me thinking "this is what normal people must feel like". I cannot wait until these drugs become available in the country I mostly live in.

altcognito 4y ago

I have gerd, and was like, I was wondering if this would make it easier for me to eat small amounts and not have as much heartburn... then I read this: > As for side effects: I've had some heartburn, but none of the other commonly reported side effects. And I looked up the less side effects, it is a laundry list of gerd symptoms. I can confirm, these symptoms will help you lose weight, but I mean that tounge in cheek, I hope this drug helps a lot of people but doesn't have much in the way of side effects.

windpower 4y ago
The heartburn has been quite minor, and only at night. Tums has been plenty for controlling it. (But I don't have GERD.) The heartburn itself is definitely not the cause of the weight loss for me, haha. But intuitively it does make sense, because one of the primary effects of the drug is slowing down gastric emptying, so it causing heartburn isn't exactly surprising.
sarchertech 4y ago
I just read through the side effect information. Gerd was reported in 5% of Wegovy users compared to 3% in the placebo arm. It’s a risk but it’s not a huge risk. Nausea especially in the first few weeks was more common, but it was only bad enough to cause <2% of people to discontinue the trial.
icambron 4y ago
One of the likely factors in my gerd issues is being about 20 lbs overweight, so I wonder how this balances out.

relaxing 4y ago

> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. This is what all the common advice doesn’t address. The only thing that has helped for me in the past was an SNRI (sibutramine) that was later withdrawn from the market. Then all the weight came back.

lumb63 4y ago
Common advice does address this. A lot of dieting has been, in my experience, finding ways to make less food make me fuller, or to think less about being full. For example, intermittent fasting is a great way to do both.

Izkata 4y ago

> I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. There's something similar here I've noticed while testing myself in the past: At least for me, it seems like hunger occurs when the stomach empties by a certain percent of its last maximum. No matter if I barely eat anything, or eat until max capacity, hunger starts after my stomach empties a bit further, but it doesn't take until I'm actually empty (tested by the size of the following meal), and the hunger tends to end after reaching the last maximum. To use some made-up numbers to demonstrate, it's like I can bounce back and forth between 60% full and 90% full or 20% and 30% full, and once I've gone a cycle or two on either of those, the low ends of 60% and 20% make me feel equally hungry and the high ends of 90% and 30% equally full, but I've digested more when the baseline is on the higher end. It can be difficult pushing from the higher range to the lower range though, have to ignore/squelch the hunger long enough to reach it.

loeg 4y ago

danielvaughn 4y ago

I was just saying the exact same thing to my wife yesterday. We’re both trying to lose weight, for the millionth time in the 20 years we’ve been together. Exasperated, I just said “I don’t get it. I was an artist who had no technical background, and was able to teach myself computer science and now I’m a highly successful engineer. I did that. And yet I can’t lose 10 pounds to save my life.” It’s so hard to eat healthy, I honestly cannot fathom how people do it.

scarmig 4y ago
> It’s so hard to eat healthy, I honestly cannot fathom how people do it. When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body needs); now, a slice is more than sufficient and satiety lasts well into the next morning. GLP-1 agonists makes eating healthy trivial and automatic, instead of a dieting state where you're thinking about food literally constantly throughout the day for months or years on end. Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.
- rubicon33 4y ago
  > Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit. Where does this line of thinking stop? Is everything pre-determined by genetics? Is everyone who is smarter than me, just actually lucky that their dopamine system works correctly, and mine doesn't, and hasn't since I was a very young kid? I'm sure this response will get down voted but its an honest question. This line of thinking that everything is genetically pre-determined seems both accurate and somewhat depressing. It means that if I'm skinny and can't gain weight, I need to take steroids and lift. Or if I'm fat, I should take a GLP-1 agonist. If I'm underperforming in my career or school, I should take adderal or similar pharma solutions. What role does good old fashioned hard work and discipline have in this day and age?

auganov 4y ago

> The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I feel exactly the way you do, and yes, I was fat, lost it in one go and never gained it back. I try to keep my BMI around 18, never went over 20 since losing weight. It's been around 15 years now. I still have the exact same unlimited appetite I have always had. If you put food I like in front of me, I'm going to eat it. I don't do anything special. I eat the same foods I always have, just less of them. Got really good at counting and never get more food than I need. The trick is to not put yourself in a situation where you have to stop eating in the first place. It's hard to just stop eating something you want to eat. Not that hard to stop yourself from going to the store again or ordering more (especially when other people are around). I feel like most people never get serious enough about counting, try to eat stuff they don't enjoy, waste effort on exercise or let other people interfere.

fortran77 4y ago
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- SamPatt 4y ago
  Counting calories correctly is really hard. I've lost 90 lbs, achieved a healthy body weight, and kept it off for years, but I keep trying to lose just 10 more pounds. I only make progress when I'm religious about calorie counting, including weighing every meal or needing to do precise food prep beforehand. That's such a pain in the ass that I inevitably fail and keep returning to my body's new average weight. I think you're right about truly obese people. They're eating so many calories that they would lose weight if they could manage a better diet. For people who aren't obese, the same principle may apply, but it's now a matter of much tighter margins and much greater precision, and it's remarkably difficult. Natural bodybuilders seem to manage their weight with precision, so it's not impossible with knowledge and effort. But I suspect very few people are capable of managing that if they tend towards obesity to begin with.

notacoward 4y ago

> people that have never actually been fat. "I did it and I lost 15 pounds Also people who have never had an older metabolism. It's different. I was also skinny despite eating a ton and hardly exercising when I was 25. Everyone I know over about 30 can identify when their metabolism suddenly changed. Diet (and to a lesser extent exercise) advice from those who haven't hit their own wall yet is worthless for those who have. Those people need to stop over-generalizing their (limited) experience as universal truth.

stavros 4y ago
I'm 40 and I can't pinpoint when my metabolism changed. I can pinpoint exactly when I moved in with my girlfriend, who cooks delicious food, instead of me ordering a salad a day as my main meal, but my metabolism itself seems to have hardly changed at all.
Auracle 4y ago
A recent study found basically no change in metabolism from the age of 20-60: https://www.bbc.com/news/health-58186710 https://www.bbc.com/news/health-58186710 People usually just start packing on a few pounds a year (or more) in their 20s and it adds up.

ashwagary 4y ago

>I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I hear people following a carnivore diet have had success in dealing with this satiety issue. The only things you can eat with this diet are butter (or ghee), beef, and salt. There is a claim that nutrient difficiency causes the scenario you are describing. Your body is being deprived of what it really needs with your current diet and requires more consumption to continue its search for a particular set of nutrients. The carnivore diet is not a silver bullet but worth a try. I will also mention it is high protien, high fat, and zero carb which has been shown to result in massive weight loss in relatively short periods of time (counterintuitive, I know).

xvilka 4y ago
> high protien, high fat, and zero carb Basically a keto diet, of course it works due to ketosis.
- Sparkyte 4y ago
  I think the problem with Ketosis is that people are too busy trying to eat a lot of fats. You just need healthy fats, protein and vegetables.
  - jononomo 4y ago
    You don't need vegetables.
- jononomo 4y ago
  A carnivore diet is not necessarily a ketogenic diet, although it is a zero-carb diet. If you eat enough protein then your body will make glucose from it and keep you out of ketosis. But I agree that a diet of only red meat is absolutely ideal no matter which angle you look at it from.

heavyset_go 4y ago

> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had. I had this exact same experience when I was prescribed a drug that, as a side effect, blocked receptors in parts of the brain responsible for signalling satiety from food. I went from having trouble eating enough food to maintain a healthy weight, and just not being hungry, to suddenly being unable to feel full at all. It was like I always had room for more, no matter how much I ate. And I was constantly hungry, felt like I was starving 24/7 and would ruminate about food so much that it impacted my ability to sleep or concentrate. My brain was obsessed with preventing me from "starving" and it ultimately dissolved the illusion of willpower that I thought I had. No longer take that drug, but it was an eye opening experience. I didn't know that was a thing people could experience, as someone who was always skinny. It really drove home that we are products of our biology and made me more empathetic with those who struggle with food.

onionisafruit 4y ago
I know what you mean. My doctor prescribed Naltrexone. The first day I took it I ate half my dinner and felt full for the first time in my life. As a middle-aged man I had never had that feeling before. Previously I assumed what people meant by feeling full is that you felt like you literally can't eat anymore. Unfortunately that stopped working for me after a few months. Hopefully this one will work better.
- heavyset_go 4y ago
  If that doesn't work out, I think they make a combination drug of naltrexone/bupropion if the naltrexone worked for you originally. The latter drug activates parts of the brain that are responsible for emesis and it works well with the reward blocking effects of naltrexone. Good luck either way.
  - 4y ago

ericmcer 4y ago

Does your appetite not adjust to your intake? I did a “dirty bulk” while working at Trader Joe’s in my 20s. At the beginning I could barely eat one frozen mac and cheese. A month of heavy eating later and I could easily finish 2 and still feel hungry. Im older now so I don’t eat like that anymore, but it is still very noticeable to me how easily I get full when I am dieting hard.

SpeedilyDamage 4y ago

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HealthNeed 4y ago
I think you are missing the point. People are not skinny because they "intellectually" know something. Nor are people fat because they are stupid, sometimes sure, but the societal trend towards obesity is not caused by ignorance. Read the article.
- SpeedilyDamage 4y ago
  People absolutely are skinny because they intellectually know something, but the word “intellectually” doesn’t mean smart/stupid, it means “apply critical thinking to a situation” as opposed to allowing your animal brain to keep control. To put it another way, system 1 will eat until its full, system 2 knows what a calorie is, and at least vaguely understands how many calories are in what you just ate against what you need to survive. Skinny people are not smarter, they’ve either never had an impulse to eat more in the first place, or are able to react to the impulse with the part of the brain that reasons.
  - strken 4y ago
    I think executive function might be a better way to understand obesity, rather than Kahneman's system 1 and system 2 thinking. Inhibitory control in particular seems more relevant[0]. Applying critical thinking (as opposed to applying inhibitory control) is only useful against obesity insofar as you can make changes to your lifestyle and diet. Lots of people know what a calorie is yet still fail to lose weight, because intellectually understanding something doesn't mean you can do it. [0] https://www.sciencedirect.com/science/article/abs/pii/S0149763415301779 https://www.sciencedirect.com/science/article/abs/pii/S01497...
    - SpeedilyDamage 4y ago
      Making changes to your lifestyle and diet is still the best, most reliable way to lose weight; this article’s science is far from conclusive or “production ready”, as engineers would say.

ccvannorman 4y ago

> I still like food, and I still get hungry. But it doesn't dominate my thoughts. This is how I feel as a default, I am a perpetually skinny person. Thank you for putting this into words from your perspective in such a crisp way. I wish everyone would have the same (non dominating) relationship with food as a normal occurance (and not some immense mountain to continually climb.)

jononomo 4y ago

Please try eating only liver, eggs, and ribeye steaks and drinking only water. You can absolutely stuff yourself on this diet and you will nevertheless get in shape. It breaks my heart that people have such an upside down idea about what healthy food is -- people think they should avoid red meat and eat fruits and vegetables and "heart healthy grains" when in fact the only thing they should eat is red meat. It is a tragedy almost beyond description -- there are millions of people in your situation who have been thwarted in their weightless journeys at every turn because we've been getting the wrong information about what food is healthy for us to eat. In addition to losing weight, you will also completely eliminate heartburn. Just try it.

jvyduna 4y ago
I did this and lost 18% of my body weight (BMI 36 to 29) after reading Gary Taubes. It works. The resulting blood chemistry worried my doctor. Worse, it’s excruciatingly boring. The 60th serving of fatty steak is no longer delicious. I lusted for a crouton. Even onions are a cheat in a glycemic load regime. When I was single, strategies like having no sugar, alcohol, or refined carbs in the house were practical, but living with a family and especially with young kids, they really aren’t. I regained it all and more. I’ve made follow-on efforts and had several +/- 30lb swings. I started tirzepatide three months ago. I echo what others have said above: I never understood satiety before this. Keeping keto takes excruciating willpower in comparison. I now know what it feels like to eat 3/4 of a normal dinner with balanced macros and not think about food till lunchtime the next day. There’s a big difference between maintaining constant vigilance against desire and having none.
- arcticbull 4y ago
  > There’s a big difference between maintaining constant vigilance against desire and having none. This is exactly the case I make for fasting to those who ask why I like it. Nothing to count. It's super effective, much easier than people assume, and very quick. Also gives you a ton of energy and focus. Glad you found something that works!
ghostbrainalpha 4y ago

kweingar 4y ago

If you don’t mind sharing, we’re you prescribed tirzepatide for type 2 diabetes, or was this an off-label prescription for weight loss?

anovikov 4y ago

How much weight did you end up losing on that stuff?

vineyardmike 4y ago

> I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I’ve had a weirdly similar experience due to wildly different histories. When I was a kid I was on medication that f’ed with my appetite so I literally never learned what hunger was as a kid. As an adult and long off the medication, I just eat and don’t understand the signals my body produces. When I was younger, I had a healthy and active body and didn’t notice my diet was bad until first I graduated and took a desk job then it accelerated with Covid when I became sedentary and snacks were constantly available. I put on weight very quickly.

paul7986 4y ago

Just curious in regards to saying you never really feel full ..have you ever counted daily calories you consumed on average?

adriang133 4y ago

I was fat/overweight all my life until I was about 24. I had enough of it and I went from ~94kg to about 85kg quite quickly (through calorie deficit), then over 1-2 years I went to a low of about 72kg. I am about 75-76 now, and have been oscillating in the 72-77 range for the past 5 years or so. It still requires me to be mindful of how much I eat, which has become part of my daily life. I'm not very strict about it, I have days when I eat more and then I compensate by eating less. I think the mistake people make is they think they can go on a diet temporarily, then go back to the old eating habits and not get fat again. That is nonsense of course, which is why dieting doesn't work. Dieting implies something temporary and you need something permanent.

wrp 4y ago
I've heard from many sources that maintaining a weight level is harder than losing weight, and that has been my own experience.