4 ms·

A very small proportion of obesity is secondary to hypothyroidism which isn’t supplemented with synthroid/thyroid hormone, hypothalamic/pituitary axis dysfuncti

A very small proportion of obesity is secondary to hypothyroidism which isn’t supplemented with synthroid/thyroid hormone, hypothalamic/pituitary axis dysfunction, adrenal corticotroph, or exogenous corticosteroids. If viruses are blamed its going to be pseudoscience to sell pills. An accepted rule of nutrition/diet/physiology is that an excess of 3,500 calories will lead to a gain of 1lb of fat. The basal metabolic rate for an adult in the United States is 1,731 calories (numbers based on averages returned in google, 38.1 years old, 5’11, 181 lbs). So 1,731 calories for a sedentary person is really easy to surpass. If they surpass that by a few hundred calories a day then they’ll gain a pound every 10 days(ish). After ballooning up they can jump on the ozempic train and lose weight. Or just stay obese. If you don’t know anyone on ozempic then I’ll share - the weight loss appears mostly due to discomfort. Eating what they used to do becomes very uncomfortable due to abdominal pain/nausea and constipation. So they calorie restrict and they start to lose weight because they’re below their BMR.

galangalalgol 3y ago
Ozempic was also shown to modify BMR even after controlling for the change in body mass. It is doing something else in addition to aversion therapy. Probably several somethings else, not all of which we understand or would want. But again the calorie counting is an oversimplication as mentioned in other posts. Elegantly simple, and so attractive. Caloric restriction will always work in the absence of the endocrine issues you mention. And in the absence of other issues we haven't discovered or don't understand yet. The vast majority of hypothyroidism is due to autoimmune related inflammation (Hashimoto's). The normal cause for that is childbirth related immune response. But plenty of other autoimmune diseases are virally triggered, quite possibly even diabetes. Combining that with the way gut biome impacts appetite and processing efficiency, we can't just pretend telling people to eat less and better and exercise will matter no matter how hard we work on education. Ozempic is a bandaid that rich people will use and will slow down discovery of all the multitudes of ways modern life has conspired to cause obesity.

galangalalgol 3y ago

Ozempic was also shown to modify BMR even after controlling for the change in body mass. It is doing something else in addition to aversion therapy. Probably several somethings else, not all of which we understand or would want. But again the calorie counting is an oversimplication as mentioned in other posts. Elegantly simple, and so attractive. Caloric restriction will always work in the absence of the endocrine issues you mention. And in the absence of other issues we haven't discovered or don't understand yet. The vast majority of hypothyroidism is due to autoimmune related inflammation (Hashimoto's). The normal cause for that is childbirth related immune response. But plenty of other autoimmune diseases are virally triggered, quite possibly even diabetes. Combining that with the way gut biome impacts appetite and processing efficiency, we can't just pretend telling people to eat less and better and exercise will matter no matter how hard we work on education. Ozempic is a bandaid that rich people will use and will slow down discovery of all the multitudes of ways modern life has conspired to cause obesity.