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Ozempic Settles the Obesity Debate: It’s Biology over Willpower

14 points by shaburn 3y ago

mydriasis 3y ago
Roughly two out of three U.S. adults are overweight or obese (69 percent) and one out of three are obese (36 percent). In 2008, men in Western and Central Europe had higher rates of obesity than men in Eastern Europe (20 to 25 percent, versus 15 to 20 percent). What biological predisposition accounts for a 40+% difference? https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends-original/obesity-rates-worldwide/ https://www.hsph.harvard.edu/obesity-prevention-source/obesi...
- anovikov 3y ago
  It's simply availability of food on a systematic basis. That "set weight" tends to grow if not checked.
- brodouevencode 3y ago
  The availability of food, the quality of food, and the culture surrounding it all.
  - deprecative 3y ago
    And the availability of including health benefiting activities into our daily tasks. If we have to drive anywhere that is time, we may otherwise have been able to use walking to and from a place - work, lunch, grocery stores. It's not merely a food thing but I think a lot of folks like that answer because we don't have to contend that we've completely ruined day-to-day society.
- WorldMaker 3y ago
  The most basic answer is "science doesn't know". Biological doesn't just mean "intrinsic" like genetics or other factors. The important thing is that it probably isn't "willpower", unless you expect US and Europe to have such different cultures that there would be some "willpower problem" you could point. There are lots of easy sounding answers that other commenters have offered. There are lots of complex theories that need more scientific testing. A lot of testing hasn't been done simply because a lot of scientists stopped at the Occam's Razor of "it's just a willpower problem" and stopped questioning anything beyond that. Maybe the results of Ozempic here open up more scientists to questioning whatever is going on. Overall, there's no "smoking gun" yet, to my knowledge. Just lots of questions. I find the blog "Slime Mold Time Mold" an interesting read on this subject. It's definitely one to take with a huge grain of salt, and there are those that don't trust it at all, but it offers a number of investigations into potential theories (and correlations in the data worth checking for causation) involving all sorts of things from chemical contaminations and pollutants (such as PFAS and lead) and other environmental factors. That blog doesn't have any strong, useful conclusion either, beyond that it probably isn't "willpower" at fault, but it offers some food for thought at what variables science may be overlooking with respect to the overweight/obesity "epidemic".
  - WorldMaker 3y ago
    One of my favorite partially debunked theories is that it is a carbon sequestration instinct among mammals in a time of climate change and excess atmospheric CO2. There is an interesting correlation among a diverse range of mammals in North America towards overweight/obesity, it isn't just impacting humans. Part of why it is "easily debunked" with various razors is that most of the species involved are human-adjacent and you can't eliminate bioavailability of foods in a human environment as a culprit. But it is still a fascinating enough correlation and another thing that adds to the pile of "it is probably more than 'willpower'". Again, I don't think this theory explains everything, I just find it a fun thought exercise to ask more questions about what is going on.
anovikov 3y ago
I bet there is now a massive battle for who manages to break through the "Wegovy wall" and unlock appetite back, among the food processers...
- brodouevencode 3y ago
  I don't know that it's appetite per se. My understanding of how semaglutides work is that they slow the emptying of the stomach, persisting the "full" feeling. (Someone please correct me if I'm wrong here.)
  - polski-g 3y ago
    That doesn't sound right, because semaglutides also work to reduce one's addiction to heroine and nail-biting. Its literally a willpower drug: https://www.theatlantic.com/health/archive/2023/05/ozempic-addictive-behavior-drinking-smoking/674098/ https://www.theatlantic.com/health/archive/2023/05/ozempic-a...
  - Bluescreenbuddy 3y ago
    Yes. By targeting the GLP-1 receptor in the brain, it helps regulate appetite and slows down stomach emptying.
    - toomuchtodo 3y ago
      Hopefully gene therapy is a lasting fix vs ongoing drug protocols. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124282/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124282/
mutant_glofish 3y ago
The distinction isn't as clear as the headline suggests. Willpower itself is also biologic, in many senses. Including the sense that it has a large genetic component contributing to it. [1] [1]: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1649790 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1649790
archo 3y ago
https://archive.is/zBqMa https://archive.is/zBqMa
PeterStuer 3y ago
I'm sure human's "biology" has changed over the last 50 years. Those skinny doufusses from the 70's with their intake restriction diets had it all wrong. /s Let's face it. You've been hacked by big agrofood, and if you consume less they will up their game.
- deprecative 3y ago
  Over the last 50 years American food has become far more calorically dense. Sugar is in everything we eat. When a food is made fat-free they load it with sugar. Add to that the car-dependent nature of our infrastructure, the sedentary nature of most jobs worth doing (because money), and you end up exactly where we are. Everyone is gaining weight. Sure it's still calories in and calories out but that is the mechanism you have to look at the whole system.
- anovikov 3y ago
  True. Question now is, who has more cash - big pharma or argi giants.
  - morgango 3y ago
    In this case, don't they both win? Agriculture companies create calorie dense foods and then we need pharma to keep us from dying.

14 points by shaburn 3y ago

Roughly two out of three U.S. adults are overweight or obese (69 percent) and one out of three are obese (36 percent). In 2008, men in Western and Central Europe had higher rates of obesity than men in Eastern Europe (20 to 25 percent, versus 15 to 20 percent). What biological predisposition accounts for a 40+% difference? https://www.hsph.harvard.edu/obesity-prevention-source/obesity-trends-original/obesity-rates-worldwide/ https://www.hsph.harvard.edu/obesity-prevention-source/obesi...

anovikov 3y ago
It's simply availability of food on a systematic basis. That "set weight" tends to grow if not checked.
brodouevencode 3y ago
The availability of food, the quality of food, and the culture surrounding it all.
- deprecative 3y ago
  And the availability of including health benefiting activities into our daily tasks. If we have to drive anywhere that is time, we may otherwise have been able to use walking to and from a place - work, lunch, grocery stores. It's not merely a food thing but I think a lot of folks like that answer because we don't have to contend that we've completely ruined day-to-day society.
WorldMaker 3y ago
The most basic answer is "science doesn't know". Biological doesn't just mean "intrinsic" like genetics or other factors. The important thing is that it probably isn't "willpower", unless you expect US and Europe to have such different cultures that there would be some "willpower problem" you could point. There are lots of easy sounding answers that other commenters have offered. There are lots of complex theories that need more scientific testing. A lot of testing hasn't been done simply because a lot of scientists stopped at the Occam's Razor of "it's just a willpower problem" and stopped questioning anything beyond that. Maybe the results of Ozempic here open up more scientists to questioning whatever is going on. Overall, there's no "smoking gun" yet, to my knowledge. Just lots of questions. I find the blog "Slime Mold Time Mold" an interesting read on this subject. It's definitely one to take with a huge grain of salt, and there are those that don't trust it at all, but it offers a number of investigations into potential theories (and correlations in the data worth checking for causation) involving all sorts of things from chemical contaminations and pollutants (such as PFAS and lead) and other environmental factors. That blog doesn't have any strong, useful conclusion either, beyond that it probably isn't "willpower" at fault, but it offers some food for thought at what variables science may be overlooking with respect to the overweight/obesity "epidemic".
- WorldMaker 3y ago
  One of my favorite partially debunked theories is that it is a carbon sequestration instinct among mammals in a time of climate change and excess atmospheric CO2. There is an interesting correlation among a diverse range of mammals in North America towards overweight/obesity, it isn't just impacting humans. Part of why it is "easily debunked" with various razors is that most of the species involved are human-adjacent and you can't eliminate bioavailability of foods in a human environment as a culprit. But it is still a fascinating enough correlation and another thing that adds to the pile of "it is probably more than 'willpower'". Again, I don't think this theory explains everything, I just find it a fun thought exercise to ask more questions about what is going on.

anovikov 3y ago

I bet there is now a massive battle for who manages to break through the "Wegovy wall" and unlock appetite back, among the food processers...

brodouevencode 3y ago
I don't know that it's appetite per se. My understanding of how semaglutides work is that they slow the emptying of the stomach, persisting the "full" feeling. (Someone please correct me if I'm wrong here.)
- polski-g 3y ago
  That doesn't sound right, because semaglutides also work to reduce one's addiction to heroine and nail-biting. Its literally a willpower drug: https://www.theatlantic.com/health/archive/2023/05/ozempic-addictive-behavior-drinking-smoking/674098/ https://www.theatlantic.com/health/archive/2023/05/ozempic-a...
- Bluescreenbuddy 3y ago
  Yes. By targeting the GLP-1 receptor in the brain, it helps regulate appetite and slows down stomach emptying.
  - toomuchtodo 3y ago
    Hopefully gene therapy is a lasting fix vs ongoing drug protocols. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124282/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124282/

mutant_glofish 3y ago

The distinction isn't as clear as the headline suggests. Willpower itself is also biologic, in many senses. Including the sense that it has a large genetic component contributing to it. [1] [1]: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1649790 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1649790

archo 3y ago

https://archive.is/zBqMa https://archive.is/zBqMa

PeterStuer 3y ago

I'm sure human's "biology" has changed over the last 50 years. Those skinny doufusses from the 70's with their intake restriction diets had it all wrong. /s Let's face it. You've been hacked by big agrofood, and if you consume less they will up their game.

deprecative 3y ago
Over the last 50 years American food has become far more calorically dense. Sugar is in everything we eat. When a food is made fat-free they load it with sugar. Add to that the car-dependent nature of our infrastructure, the sedentary nature of most jobs worth doing (because money), and you end up exactly where we are. Everyone is gaining weight. Sure it's still calories in and calories out but that is the mechanism you have to look at the whole system.
anovikov 3y ago
True. Question now is, who has more cash - big pharma or argi giants.
- morgango 3y ago
  In this case, don't they both win? Agriculture companies create calorie dense foods and then we need pharma to keep us from dying.