8 ms·

The ‘next Ozempic’ became a social media sensation. Then everything changed

40 points by bryan0 4y ago

debacle 4y ago
As someone with serious thyroid issues, I'm sidelined from both of the recent fad medications. Have to do it the old fashioned way (which is a slog).
raincom 4y ago
https://news.ycombinator.com/item?id=34909270 https://news.ycombinator.com/item?id=34909270 Similar discussion above:
- natdempk 4y ago
  This is basically a dupe of that one, same article.
rs_rs_rs_rs_rs 4y ago
What if I told you there's a way to lose weight that actually puts money into your pocket?
- credit_guy 4y ago
  Tell us more.
- geraldwhen 4y ago
  If any doctor prescribed eating less or eating the same and increasing daily activity, a patient would leave and get a new doctor for hurt feelings.
  - maxbond 4y ago
    The "caloric imbalance" theory of obesity is exploded, obesity is complex and not well understood, and related to the endocrine system, microbiome, etc. This is kind of like telling people they wouldn't need antidepressants if they smiled more.
    - dabbledash 4y ago
      When you say this do you mean "we have to look for the underlying causes of calorie imbalance" or do you mean "the human body is capable of materializing mass out of nothing"? I can't imagine someone saying "the gravity theory of plane crashes is exploded" even though when we look at how to prevent plane crashes we look at other causes.
      - argella 4y ago
        "When you say this do you mean "we have to look for the underlying causes of calorie imbalance" or do you mean "the human body is capable of materializing mass out of nothing"?" when you say this, you reveal your ignorance of the biology that makes it far more challenging for some people to "eat less" than others, and that changes their metabolism to combat the weight loss if they do happen to "eat less" for some time.
      - Aloha 4y ago
        BMR varies hugely by person, its not even a minor difference for some. Yes, calorie imbalance is a thing, but you can be a 300 lb person who eats 2750 calories a day, also be a 200 lb person who eats 2750 calories a day, with each performing a similar amount of exercise. While calories in/calories out will help anyone lose weight, for some, even with the advantage of math - its still much harder, sometimes an order of magnitude harder. I've done this before, and I lose around 100 lbs, and I've kept off about 60 of it - but for the entire two years, I had a gnawing, burning pit of hunger whenever I was away. It never stops, and I never stopped being hungry. I just did my best to ignore it. On top of that, look how many social occasions revolve around food, to stick to any essentially effective diet requires refraining in those situations. That's even harder. "oh, everyone is going for fast food after the thing, I guess I can just have some water? okay, I guess that's okay" because one fast food meal exceeds your calorie goal for the entire day. Now you tell me, how easy is it to eat less if you never felt satiated, never stopped being hungry? My point here, is while calorie counting and exercise works, there is clearly more going on than just that.
        lancesells 4y ago
- issa 4y ago
  Can it be done while making $5000 per week online?
- theragra 4y ago
  I'd say you had never been fat
  - deleted 4y ago
    [deleted]
  - rs_rs_rs_rs_rs 4y ago
    Yes, I have never been a glutinous imbecile.
    - argella 4y ago
      there it is, the real reason for your moronic refusal to acknowledge the complexity of obesity. if it's just a matter of willpower alone, you get to get a nice little sense of superiority and an ego boost. everyone else is just stupid and lazy.
      - rs_rs_rs_rs_rs 4y ago
        >refusal to acknowledge the complexity of obesity It is never an obese person's fault for stuffing themselves, it's always something else. In this thread it's the big bad pharma corps that don't give away for free diabetes drugs to people that don't have diabetes. I wish you all the best, when you realize the problem is your lack of willpower maybe you'll lose weight and not gain it back.
        theragra 4y ago
        How it is different from anything else? If willpower is all you need, why do you have lack of willpower to be kind and compassionate?
Groxx 4y ago
T2D diagnosis is labeled as something awful a few times in the article, e.g. >If Kay wanted to continue to lose weight, live pain-free, and stave off a dreaded diabetes diagnosis... Not having anyone close with diabetes, so I'm quite unfamiliar with that landscape: why is being diagnosed with type-2 "dreaded"? If it's a valid diagnosis, and it would solve many of your problems, it feels like a fairly obvious choice... I'm sure there are social stigmas around it, but is that all? Or are there some severe insurance implications or something?
- ryeights 4y ago
  I interpreted that to mean that she is pre-diabetic and will soon develop diabetes without the assistance of the drug to alter her eating habits.
  - Groxx 4y ago
    Surely that would have been true three months ago as well? $25/month is absurdly affordable for preventing that and that'd have been a truly awesome option... but unless it has increased her diabetes symptoms, she has likely been close to but resisting that diagnosis for years. Or is it more that they're worried about developing "full" type-2 in a few years if nothing else changes? But if that's the case, trying to get diagnosed with it ASAP seems like a reasonable route, not dreading it. --- Edit: correction, ignore the below. Rogers here is a diagnosed diabetic who had to stop using it due to shortages. --- >Due to shortages, Rogers had to stop taking Mounjaro for three weeks. “I was a wreck over it and full of despair,” said the 58-year-old. “I gained several pounds back, but I was surprised at how badly I felt when my [blood glucose] numbers got out of control again. It was a wakeup call to me to realize how sick diabetes makes you.” Tbh that sounds like resisting diagnosis, not worrying about a future health decline.
    - deleted 4y ago
      [deleted]
- woodruffw 4y ago
  I think you're distinguishing between having T2D and being diagnosed with it, when the article is using the latter as an idiom for the former. The implication is that she doesn't currently have T2D.
yieldcrv 4y ago
why are diabetics getting insurance denials? they are the population approved for using this drug for now
- runnerup 4y ago
  Usually insurance companies create a list of drug tiers based on cost-effectiveness. Mounjaro is super expensive, so a lot of insurance companies won't cover it.
NegativeLatency 4y ago
“The first one’s free” as they say If we’re not going to nationalize drug manufacturers, they should at least be regulated (competently, as to avoid regulatory capture), but I have little faith in the government to be able to do so effectively.
- gruez 4y ago
  >they should at least be regulated (competently, as to avoid regulatory capture) You mean the current regulations that fine drug makers for promoting off label use, of which handing out coupons arguably constitutes? https://en.wikipedia.org/wiki/Pfizer#Legal_issues https://en.wikipedia.org/wiki/Pfizer#Legal_issues
  - tuatoru 4y ago
    That regulatory regime is clearly not competent, as your example is a long-time repeat offender.
    - gruez 4y ago
      So we want them to be more competent, so they can regulate harder... so that they won't try promoting off label uses? Isn't that what they're already doing by limiting how you can use the coupons?
      - tuatoru 4y ago
        In cases of severe harm to multitudes, like the Sacklers, the regulatory regime should strip the perpetrators of all their wealth and income even unto the seventh generation and the fourth degree of relatedness, and salt the earth of all their lands and possessions. Scale back proportionately from there.
- argella 4y ago
  how would nationalizing the drug manufactures help in this particular situation? glp1 shortages.
Aloha 4y ago
I'm on Mounjaro and was on Ozempic before that - the supply issues for both have been a serious impact on my health. The thing about these meds is, if you miss weekly dose (by more than about 3-4 days), you are essentially going back to the beginning, and your blood sugar will be unstable for 3-4 weeks as you adapt again to the medication. You only see the real benefits from it after being on it continuously for more than a month, but so far, I've not been able to get a consistent supply for more than a month at a time since.. summer I'd guess. Its been really frustrating for me, and has caused me negative health effects. So while I get, yes, you should lose weight - and this drug does that (and has a whole bunch of other positive health effects), the idea of this going to someone who might only be 30-40 lbs overweight who does not have T2D, infuriates me. Without it, even on insulin, even fasting, my liver pumps out glucose constantly, I can fast for close to 24 hours before my blood sugar falls off enough to start to be low.
- colechristensen 4y ago
  I would be more mad at the sources of the supply problems not being aggressively dealt with than the medicine available going to the “wrong” patients.
  - Aloha 4y ago
    I have some grief with the supply issues, but there are some pretty obvious logistics limits to how fast you can scale up production, and I suspect with mounjaro the main limiter is the delivery mechanism (its special).
    - peteforde 4y ago
      As someone who spends a lot of idle time wondering why these companies don't ramp up production as quickly as possible, I would be genuinely excited to hear your thoughts on what these limits are. It seems like there are so many billions of dollars in nearly-pure profit to be made, so why is it not a problem that can be solved by throwing money at it?
      - 4y ago
runnerup 4y ago
Huge gray market for this stuff. I detailed this in an earlier discussion of the same compounds[0]. It's awful that people like Kay would be forced to non-FDA approved versions with a "mystery-meat" theme to them, but they can be had for $10-90/month, which is a huge improvement over the $1,000/month they're staring at now. 0: https://news.ycombinator.com/item?id=34228157 https://news.ycombinator.com/item?id=34228157
- raincom 4y ago
  Is it hard for compounding pharmacies to good quality semaglutide/tirzapitide from peptides bought wholesale from China, since you are familiar with this process? Can some generic manufacturers in India make this stuff?
ali7388 4y ago
You can get the same effects from waterfast, even save money on food. It is really the worst of America, either pay fortune for medication, or nationalize healthcare (with socialism...). There is no middle ground.
- iwanttocomment 4y ago
  Surely there are no side effects that people might experience by, uh, not eating at all.
nsenifty 4y ago
I also see ads for Metformin as a "longevity" and "weight loss" drug. I worry for my mom and other diabetic members of my family potentially not being able to get it if it goes viral like this.
- RobotToaster 4y ago
  Metformin is generic, and much simpler to manufacture. These shortages mostly happened because of a patent monopoly.
- Alex3917 4y ago
  Metformin is suspected to act like a mitochondrial complex I inhibitor, at least under certain conditions. If so, there may be a risk of it causing progressive supranuclear palsy if taken in high doses or long term. If you have diabetes the risk is probably worth it, but if you’re already healthy then taking it for longevity reasons seems more dubious. It wouldn’t surprise me if in a couple decades some non-trivial percentage of the folks using it for longevity end up with PSP, which is a fatal and untraceable disease.
  - kurthr 4y ago
    It seems like Metformin has been used as treatment in some neurological diseases especially where diabetes is a known risk factor (eg Alzheimer's) . And while it has not been shown to be causal, it is correlated with development of palsy by meta-analysis of a large group of studies. https://drc.bmj.com/content/8/1/e001370 https://drc.bmj.com/content/8/1/e001370 https://www.mdpi.com/1424-8247/14/9/890 https://www.mdpi.com/1424-8247/14/9/890
flipgimble 4y ago
The sad state of affairs in modern medicine is that patients now need to be weary for scams like this where a multinational pharmaceutical conglomerate will pull a bait, addict and switch prices tactic. It leads to patients avoiding what could be the best medical advice in order to avoid predatory business tactics.
throwaway12245 4y ago
To anyone facing diabetes type II, consider non pharmaceutical approaches: diet and exercise. 1) Diet: Low carbohydrate diets are one technique: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437985/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437985/ "In this randomized, crossover intervention trial among adults with prediabetes or T2DM, the 12-week percentage change in HbA1c, the primary study outcome, improved significantly for participants on both diets" 2) Exercise: High intensity training and strength training improve blood measurements. https://pubmed.ncbi.nlm.nih.gov/30270019/ https://pubmed.ncbi.nlm.nih.gov/30270019/ "From a practical clinical perspective, the performance of [strength training] + [high intensity interval training] may be advised for additional benefits regarding insulin dosage reduction." In short, cut out the bread, deserts, pizza , lift some weights and do some sprints. Keep doing it. Pubmed is great resource. Search for terms like "clinical trial" "diabetes", "HIIT", "mediterranean diet", VFKD. [edit: I do want to emphasize the term "clinical trail". Diet and nutrition research has a lot of other types of research. Often the quality suffers. Clinical trials, and hopefully other clinical trials that verify earlier findings, are the best.] Getting on top of the situation early will save you a lot of grief ( and doctor's visits and paying for drugs).
- teucris 4y ago
  Low carb diets seem to be a key component of curbing metabolic syndrome, but it’s really never as simple as “diet and exercise…keep doing it”. For some bodies, the amount of diet and exercise needed to avoid metabolic diseases is so high that it impedes quality of life.
  - throwaway12245 4y ago
    > it’s really never as simple as “diet and exercise…keep doing it” I disagree with "never". I think most people can use diet and exercise to avoid and even reverse type 2 diabetes. An unpopular opinion hereabouts, but likely true.
    - tuatoru 4y ago
      The exercise part is possible in theory, but in practise not many people have lives in which they can do 4000 kcal of exercise daily, six days a week. 4000 kcal takes a long time. I have heard of a guy who became a security guard and walked around a town for 10 hours each night. Exercise took him from "severely obese" to just above "normal" BMI over the course of 18 months or so. The diet part is also possible in theory, but many people's family and social environments practically require them to eat muffins, cakes, sweet desserts, and other micronutrient-poor dishes. Refusal to take part gets them ostracized.
upsidesinclude 4y ago
"Jastreboff said. 'In order to continue to maintain the new re-regulated defended fat mass, and weight reduction, you have to continue taking the medication'..." Doctors like this are disgusting. Nothing about obesity is incurable for the vast majority of the obese. It is a lifestyle choice. Score one more for pharma and drugs that "require" lifetime use.

40 points by bryan0 4y ago

As someone with serious thyroid issues, I'm sidelined from both of the recent fad medications. Have to do it the old fashioned way (which is a slog).

raincom 4y ago

https://news.ycombinator.com/item?id=34909270 https://news.ycombinator.com/item?id=34909270 Similar discussion above:

natdempk 4y ago
This is basically a dupe of that one, same article.

rs_rs_rs_rs_rs 4y ago

What if I told you there's a way to lose weight that actually puts money into your pocket?

credit_guy 4y ago
Tell us more.
geraldwhen 4y ago
If any doctor prescribed eating less or eating the same and increasing daily activity, a patient would leave and get a new doctor for hurt feelings.
- maxbond 4y ago
  The "caloric imbalance" theory of obesity is exploded, obesity is complex and not well understood, and related to the endocrine system, microbiome, etc. This is kind of like telling people they wouldn't need antidepressants if they smiled more.
  - dabbledash 4y ago
    When you say this do you mean "we have to look for the underlying causes of calorie imbalance" or do you mean "the human body is capable of materializing mass out of nothing"? I can't imagine someone saying "the gravity theory of plane crashes is exploded" even though when we look at how to prevent plane crashes we look at other causes.
    - argella 4y ago
      "When you say this do you mean "we have to look for the underlying causes of calorie imbalance" or do you mean "the human body is capable of materializing mass out of nothing"?" when you say this, you reveal your ignorance of the biology that makes it far more challenging for some people to "eat less" than others, and that changes their metabolism to combat the weight loss if they do happen to "eat less" for some time.
    - Aloha 4y ago
      BMR varies hugely by person, its not even a minor difference for some. Yes, calorie imbalance is a thing, but you can be a 300 lb person who eats 2750 calories a day, also be a 200 lb person who eats 2750 calories a day, with each performing a similar amount of exercise. While calories in/calories out will help anyone lose weight, for some, even with the advantage of math - its still much harder, sometimes an order of magnitude harder. I've done this before, and I lose around 100 lbs, and I've kept off about 60 of it - but for the entire two years, I had a gnawing, burning pit of hunger whenever I was away. It never stops, and I never stopped being hungry. I just did my best to ignore it. On top of that, look how many social occasions revolve around food, to stick to any essentially effective diet requires refraining in those situations. That's even harder. "oh, everyone is going for fast food after the thing, I guess I can just have some water? okay, I guess that's okay" because one fast food meal exceeds your calorie goal for the entire day. Now you tell me, how easy is it to eat less if you never felt satiated, never stopped being hungry? My point here, is while calorie counting and exercise works, there is clearly more going on than just that.
      - lancesells 4y ago
issa 4y ago
Can it be done while making $5000 per week online?
theragra 4y ago
I'd say you had never been fat
- deleted 4y ago
  [deleted]
- rs_rs_rs_rs_rs 4y ago
  Yes, I have never been a glutinous imbecile.
  - argella 4y ago
    there it is, the real reason for your moronic refusal to acknowledge the complexity of obesity. if it's just a matter of willpower alone, you get to get a nice little sense of superiority and an ego boost. everyone else is just stupid and lazy.
    - rs_rs_rs_rs_rs 4y ago
      >refusal to acknowledge the complexity of obesity It is never an obese person's fault for stuffing themselves, it's always something else. In this thread it's the big bad pharma corps that don't give away for free diabetes drugs to people that don't have diabetes. I wish you all the best, when you realize the problem is your lack of willpower maybe you'll lose weight and not gain it back.
      - theragra 4y ago
        How it is different from anything else? If willpower is all you need, why do you have lack of willpower to be kind and compassionate?

Groxx 4y ago

T2D diagnosis is labeled as something awful a few times in the article, e.g. >If Kay wanted to continue to lose weight, live pain-free, and stave off a dreaded diabetes diagnosis... Not having anyone close with diabetes, so I'm quite unfamiliar with that landscape: why is being diagnosed with type-2 "dreaded"? If it's a valid diagnosis, and it would solve many of your problems, it feels like a fairly obvious choice... I'm sure there are social stigmas around it, but is that all? Or are there some severe insurance implications or something?

ryeights 4y ago
I interpreted that to mean that she is pre-diabetic and will soon develop diabetes without the assistance of the drug to alter her eating habits.
- Groxx 4y ago
  Surely that would have been true three months ago as well? $25/month is absurdly affordable for preventing that and that'd have been a truly awesome option... but unless it has increased her diabetes symptoms, she has likely been close to but resisting that diagnosis for years. Or is it more that they're worried about developing "full" type-2 in a few years if nothing else changes? But if that's the case, trying to get diagnosed with it ASAP seems like a reasonable route, not dreading it. --- Edit: correction, ignore the below. Rogers here is a diagnosed diabetic who had to stop using it due to shortages. --- >Due to shortages, Rogers had to stop taking Mounjaro for three weeks. “I was a wreck over it and full of despair,” said the 58-year-old. “I gained several pounds back, but I was surprised at how badly I felt when my [blood glucose] numbers got out of control again. It was a wakeup call to me to realize how sick diabetes makes you.” Tbh that sounds like resisting diagnosis, not worrying about a future health decline.
  - deleted 4y ago
    [deleted]
woodruffw 4y ago
I think you're distinguishing between having T2D and being diagnosed with it, when the article is using the latter as an idiom for the former. The implication is that she doesn't currently have T2D.

yieldcrv 4y ago

why are diabetics getting insurance denials? they are the population approved for using this drug for now

runnerup 4y ago
Usually insurance companies create a list of drug tiers based on cost-effectiveness. Mounjaro is super expensive, so a lot of insurance companies won't cover it.

NegativeLatency 4y ago

“The first one’s free” as they say If we’re not going to nationalize drug manufacturers, they should at least be regulated (competently, as to avoid regulatory capture), but I have little faith in the government to be able to do so effectively.

gruez 4y ago
>they should at least be regulated (competently, as to avoid regulatory capture) You mean the current regulations that fine drug makers for promoting off label use, of which handing out coupons arguably constitutes? https://en.wikipedia.org/wiki/Pfizer#Legal_issues https://en.wikipedia.org/wiki/Pfizer#Legal_issues
- tuatoru 4y ago
  That regulatory regime is clearly not competent, as your example is a long-time repeat offender.
  - gruez 4y ago
    So we want them to be more competent, so they can regulate harder... so that they won't try promoting off label uses? Isn't that what they're already doing by limiting how you can use the coupons?
    - tuatoru 4y ago
      In cases of severe harm to multitudes, like the Sacklers, the regulatory regime should strip the perpetrators of all their wealth and income even unto the seventh generation and the fourth degree of relatedness, and salt the earth of all their lands and possessions. Scale back proportionately from there.
argella 4y ago
how would nationalizing the drug manufactures help in this particular situation? glp1 shortages.

Aloha 4y ago

I'm on Mounjaro and was on Ozempic before that - the supply issues for both have been a serious impact on my health. The thing about these meds is, if you miss weekly dose (by more than about 3-4 days), you are essentially going back to the beginning, and your blood sugar will be unstable for 3-4 weeks as you adapt again to the medication. You only see the real benefits from it after being on it continuously for more than a month, but so far, I've not been able to get a consistent supply for more than a month at a time since.. summer I'd guess. Its been really frustrating for me, and has caused me negative health effects. So while I get, yes, you should lose weight - and this drug does that (and has a whole bunch of other positive health effects), the idea of this going to someone who might only be 30-40 lbs overweight who does not have T2D, infuriates me. Without it, even on insulin, even fasting, my liver pumps out glucose constantly, I can fast for close to 24 hours before my blood sugar falls off enough to start to be low.

colechristensen 4y ago
I would be more mad at the sources of the supply problems not being aggressively dealt with than the medicine available going to the “wrong” patients.
- Aloha 4y ago
  I have some grief with the supply issues, but there are some pretty obvious logistics limits to how fast you can scale up production, and I suspect with mounjaro the main limiter is the delivery mechanism (its special).
  - peteforde 4y ago
    As someone who spends a lot of idle time wondering why these companies don't ramp up production as quickly as possible, I would be genuinely excited to hear your thoughts on what these limits are. It seems like there are so many billions of dollars in nearly-pure profit to be made, so why is it not a problem that can be solved by throwing money at it?
    - 4y ago

runnerup 4y ago

Huge gray market for this stuff. I detailed this in an earlier discussion of the same compounds[0]. It's awful that people like Kay would be forced to non-FDA approved versions with a "mystery-meat" theme to them, but they can be had for $10-90/month, which is a huge improvement over the $1,000/month they're staring at now. 0: https://news.ycombinator.com/item?id=34228157 https://news.ycombinator.com/item?id=34228157

raincom 4y ago
Is it hard for compounding pharmacies to good quality semaglutide/tirzapitide from peptides bought wholesale from China, since you are familiar with this process? Can some generic manufacturers in India make this stuff?

ali7388 4y ago

You can get the same effects from waterfast, even save money on food. It is really the worst of America, either pay fortune for medication, or nationalize healthcare (with socialism...). There is no middle ground.

iwanttocomment 4y ago
Surely there are no side effects that people might experience by, uh, not eating at all.

nsenifty 4y ago

I also see ads for Metformin as a "longevity" and "weight loss" drug. I worry for my mom and other diabetic members of my family potentially not being able to get it if it goes viral like this.

RobotToaster 4y ago
Metformin is generic, and much simpler to manufacture. These shortages mostly happened because of a patent monopoly.
Alex3917 4y ago
Metformin is suspected to act like a mitochondrial complex I inhibitor, at least under certain conditions. If so, there may be a risk of it causing progressive supranuclear palsy if taken in high doses or long term. If you have diabetes the risk is probably worth it, but if you’re already healthy then taking it for longevity reasons seems more dubious. It wouldn’t surprise me if in a couple decades some non-trivial percentage of the folks using it for longevity end up with PSP, which is a fatal and untraceable disease.
- kurthr 4y ago
  It seems like Metformin has been used as treatment in some neurological diseases especially where diabetes is a known risk factor (eg Alzheimer's) . And while it has not been shown to be causal, it is correlated with development of palsy by meta-analysis of a large group of studies. https://drc.bmj.com/content/8/1/e001370 https://drc.bmj.com/content/8/1/e001370 https://www.mdpi.com/1424-8247/14/9/890 https://www.mdpi.com/1424-8247/14/9/890

flipgimble 4y ago

The sad state of affairs in modern medicine is that patients now need to be weary for scams like this where a multinational pharmaceutical conglomerate will pull a bait, addict and switch prices tactic. It leads to patients avoiding what could be the best medical advice in order to avoid predatory business tactics.

throwaway12245 4y ago

To anyone facing diabetes type II, consider non pharmaceutical approaches: diet and exercise. 1) Diet: Low carbohydrate diets are one technique: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437985/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437985/ "In this randomized, crossover intervention trial among adults with prediabetes or T2DM, the 12-week percentage change in HbA1c, the primary study outcome, improved significantly for participants on both diets" 2) Exercise: High intensity training and strength training improve blood measurements. https://pubmed.ncbi.nlm.nih.gov/30270019/ https://pubmed.ncbi.nlm.nih.gov/30270019/ "From a practical clinical perspective, the performance of [strength training] + [high intensity interval training] may be advised for additional benefits regarding insulin dosage reduction." In short, cut out the bread, deserts, pizza , lift some weights and do some sprints. Keep doing it. Pubmed is great resource. Search for terms like "clinical trial" "diabetes", "HIIT", "mediterranean diet", VFKD. [edit: I do want to emphasize the term "clinical trail". Diet and nutrition research has a lot of other types of research. Often the quality suffers. Clinical trials, and hopefully other clinical trials that verify earlier findings, are the best.] Getting on top of the situation early will save you a lot of grief ( and doctor's visits and paying for drugs).

teucris 4y ago
Low carb diets seem to be a key component of curbing metabolic syndrome, but it’s really never as simple as “diet and exercise…keep doing it”. For some bodies, the amount of diet and exercise needed to avoid metabolic diseases is so high that it impedes quality of life.
- throwaway12245 4y ago
  > it’s really never as simple as “diet and exercise…keep doing it” I disagree with "never". I think most people can use diet and exercise to avoid and even reverse type 2 diabetes. An unpopular opinion hereabouts, but likely true.
  - tuatoru 4y ago
    The exercise part is possible in theory, but in practise not many people have lives in which they can do 4000 kcal of exercise daily, six days a week. 4000 kcal takes a long time. I have heard of a guy who became a security guard and walked around a town for 10 hours each night. Exercise took him from "severely obese" to just above "normal" BMI over the course of 18 months or so. The diet part is also possible in theory, but many people's family and social environments practically require them to eat muffins, cakes, sweet desserts, and other micronutrient-poor dishes. Refusal to take part gets them ostracized.

upsidesinclude 4y ago

"Jastreboff said. 'In order to continue to maintain the new re-regulated defended fat mass, and weight reduction, you have to continue taking the medication'..." Doctors like this are disgusting. Nothing about obesity is incurable for the vast majority of the obese. It is a lifestyle choice. Score one more for pharma and drugs that "require" lifetime use.