10 ms·

The Ozempic Plateau

34 points by crescit_eundo 3y ago

crescit_eundo 3y ago
https://archive.is/nKnCU https://archive.is/nKnCU
immibis 3y ago
[flagged]
- dang 3y ago
  Could you please stop posting unsubstantive comments and flamebait? We had to ask you this just recently. Eventually we have to ban such accounts, because this is not what this site is for, and destroys what it is for. In terms of sites that have produced bad articles in the past: that's true of all major sites. On HN we go by article quality, not site quality: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&sort=byDate&type=comment&query=%22article%20quality%22%20%22site%20quality%22%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so....
  - immibis 3y ago
    > We had to ask you this just recently. Not sure what you're talking about.
    - dang 3y ago
      https://news.ycombinator.com/item?id=38466550 https://news.ycombinator.com/item?id=38466550
      - immibis 3y ago
        If one disliked comment every 50 days is enough to justify a permanent ban for you, then go for it - I don't really care.
        dang 3y ago
        I don't want to ban you! I just want to hopefully persuade you not to break HN's rules. Not because it's any sort of moral issue but because the default tendency on the internet is for discussion to degrade, and we're hoping to stave that off (https://hn.algolia.com/?dateRange=all&page=0&prefix=true&query=stave%20off%20by%3Adang&sort=byDate&type=comment https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...). The HN guidelines are designed to discourage the sorts of comment that accelerate that decay, and to encourage the sorts of comment that impede it.
Wowfunhappy 3y ago
Something I've been wondering: > [When you loose weight], your body looks for ways to conserve energy. Your muscles work more efficiently, for example, Ard says, so walking that normally burned 100 calories might now burn only 90. By making you want to eat more and burning fewer calories, your body is eventually able to slow weight loss down to zero. How exactly is your body able to accomplish the same task with less energy? What are you giving up? Do you become tired more easily, or wear out your muscles more quickly? Or does loosing weight just turn you into a more efficient super-human (albeit perhaps not in a way you would like)? Would it be desirable for, say, an ultra-marathon runner (who I assume needs to consume as little energy as possible) to spend a year gaining and then loosing a bunch of weight, to make their body more efficient?
- plasticchris 3y ago
  There's the obvious - you are now lighter and so less work is being done to move your body.
- throwup238 3y ago
  > How exactly is your body able to accomplish the same task with less energy? Mitochondrial uncoupling proteins [1]. They control how much energy gets converted to ATP in the mitochondria and how much is lost as waste heat. As you enter a caloric deficit, UCP1 is downregulated and the mitochondria adapt to lose less energy to heat. [1] https://en.wikipedia.org/wiki/Uncoupling_protein https://en.wikipedia.org/wiki/Uncoupling_protein
  - RobotToaster 3y ago
    It's a real shame that uncouplers like DNP have such bad side effects, from a theoretical standpoint they are perfect.
  - paulmd 3y ago
    the funny thing is people (including on HN) have spent years arguing that the human body is a blast calorimeter and that everyone absorbs the same amount of energy from the same amount of food and therefore CICO is the only thing that matters or can help. and oh look here's the protein which controls how much you absorb from it. CICO is the only actionable advice for an individual (at least in the absence of such drugs) but there are still major questions about things like endocrine disruptors etc. The rise of obesity is far too broad-spectrum (even in feral cat colonies or lab rat populations that shouldn't be affected) to really be attributable to just "people have desk jobs". Lots of people have desk jobs all over the world and obesity is not evenly distributed, and the story has always been that "exercise doesn't matter, what you eat controls your weight" so things like biking vs driving should have a relatively small effect. But people wanted to turn it into a moral hazard, and they did. Fat people have always been a socially-acceptable target to punch down on. "I'm actually helping them, you see".
neonate 3y ago
https://web.archive.org/web/20240121073821/https://www.theatlantic.com/health/archive/2024/01/why-you-will-stop-losing-weight-ozempic/677148/ https://web.archive.org/web/20240121073821/https://www.theat...
ravenstine 3y ago
> With every one kilogram you lose, your appetite goes up above baseline by 90 or so calories per day If that were the case, it doesn't seem to apply to me. When I was on a fat-loss journey, I had gone from ~102 kg down to 72.5 kg, which I stayed around for several years. That's a difference in 29.5 kg. 29.5 * 90 = 2,655 kCal Not that I didn't get very hungry at times, but I'm failing to wrap my head around what this guy was saying. If it's true, then either my daily energy expenditure would be more than twice what it currently is (which I've measured through respiratory gas analysis), or I'm hungrier than I know and I'm just shitting out all those extra "calories" that I'm not turning into fat mass. > Ard says, so walking that normally burned 100 calories might now burn only 90. By making you want to eat more and burning fewer calories, your body is eventually able to slow weight loss down to zero. The problem here is in believing that the level of perceived hunger has a linear relation to "calories" burned which, if we are going to be accurate, describes a unit of heat. The body doesn't directly delegate heat because photons have no mass. All the body cares about having different kinds of mass in the optimal places at the current time. Just because you feel more hungry than usual doesn't mean that your body demands to burn X number of calories. Because there's more in play than just energy-in-energy-out, in order to overcome those plateaus, you have to either alter the fuel mixture to optimize for hormone levels, or you have to eat such little mass that it can't make up for all of the mass that your body loses otherwise. This isn't even counting the psychology behind hunger, and how people can think they are hungry with relatively low ghrelin levels because they are relying on food for psychological comfort.
- devmor 3y ago
  Yeah that sounds like nonsense to me too. I’ve lost about 100lbs in the past 15 months and my appetite hasn’t really changed at all. I do get hungrier on gym days, but that’s to be expected since I’m expending more energy. In fact, I recently discussed calorie intake with my trainer, who is extremely fit and about the same height as me - our BMR is nearly identical.
moritzwarhier 3y ago
Sorry but this drug really sounds like straight from Margaret Atwood's "Oryx and Crake" dystopia. It has already arrived here, and physicians are eager to offer it (medical insurance covers it from BMI>30 onwards). Long-term "patient relationships", I guess. The physician I went to until recently always employs 10-20 different doctors, most of them straight from university. And the truth is, they do a terribly bad job at treating diseases like Influenza, diabetes, or generally advising people with common health conditions. I might be wrong, because obesity really is a terrible lethal health problem, from a certain level upwards it's straight up similar to hard drug addiction (e.g. crack). But if this is the solution.. oh my. How about offering people rewarding opportunities for exercise that don't cost a fortune (if you live in a traffic-ridden district, who wants to "go for a walk" really?) How about educating people more vigorously about food addiction? No fret towards anyone who feels these drugs help them, but for me, it just reminds me how glad I am to have come off SSRIs. The pharmaceutical industry never had any kind of "don't be evil" facade, and they act like it.
- HDThoreaun 3y ago
  Telling overweight people to eat less or exercise more does not work. There have been countless studies and they all agree. Obesity is clearly a complex subject, but from what I understand some people just experience reality differently in that they're constantly thinking about food. One way it was explained to me is "telling overweight people to eat less is like telling someone to set their thermostat to 40 in the winter to save on their gas bill". It's possible, but extremely uncomfortable and not a realistic solution for most. At the end of the day heart disease is still the number one killer in this country and reducing obesity is the solution to that problem. With the government paying for the healthcare of a significant portion of the population I think its clear that we need to be pushing these drugs hard, for both the life saving and economic saving aspects.
  - fatherzine 3y ago
    possible, but uncomfortable -- nailed it. life is not supposed to be 100% comfortable. traditional spiritual practices bake in periods of discomfort for a reason.
fatherzine 3y ago
1. sedentarism + unhealthy diet 2. magic pill 3. ??? 4. profit!
- thefz 3y ago
  Magic pill so you don't have to change anything about your lifestyle. It's close to zero effort.
  - devilkin 3y ago
    And when you stop taking it you go back to your old weight. Win for everyone except for the person using Ozempic.
  - fatherzine 3y ago
    children are taught to eat with a spoon. to tie their shoelaces. to read. to write. to play sports. to play an instrument. to dance. to perform a job. it takes effort, but the rewards are worth it, primarily for the children themselves. same with weight control via exercise and diet. it's learnable, and teachable. we can do much better, while being neither judgmental, nor defeatist.
    - thefz 3y ago
      I am being neither.
gist 3y ago
This is one of a series of articles intended to downplay the benefits of weight loss drugs even to the point of being fostered by those in industries most impacted by weight loss drugs (the traditional weight loss industrial complex).
- RobotToaster 3y ago
  Probably the insurance companies not wanting to cover them as well.
smileysteve 3y ago
I support the use of Ozempic for helping diabetics and the obese get back into the overweight range of bmi; Obesity often leads to pre-diabetes which leads to diabetes, which increases demand of insulin -- a much harder/expensive/riskier regimen to administer. It's a better option than a gastro surgery, typically better than extreme dieting. But, I'm also frustrated at the US food choices; Fast food, even sit down food is often devoid of fiber. Store brand cereals, grains are devoid of fiber unless you pay a premium. Ultra filtering milk doubles protein and halves sugar (by converting lactose to glucose) -- but it costs 8x as much. Why do we even sell "enriched" white bread when whole grain wheat bread has lower sugar, more protein, and more fiber? Margarine - with partially hydrogenated oils - but sold in stores and often at restaurants (waffle house).
- stephenitis 3y ago
  I have never heard of ultra filtering milk. Do any grocery store chains carry that?
  - smileysteve 3y ago
    Fairlife is the major brand at grocery stores and convenience stores; but there are now store brands as well.
curtis3389 3y ago
On the one hand, reducing obesity by 15-20% with a pill is pretty amazing. That certainly reduces negative outcomes and improves people's lives (and saves society money). On the other hand, pharmaceutical companies only care about money and the chemistry is pretty straight-forward. They will continue making new drugs, and they will certainly release a "newer and better" version when their patents run out. But, there will certainly be unintended consequences, and we still don't have a good understanding of the cause of the obesity epidemic.
- red-iron-pine 3y ago
  > and we still don't have a good understanding of the cause of the obesity epidemic. yes, we do. it's not rocket science. sedentary lifestyle + huge amounts of cheap calories, esp. cheap carbohydrates. the Japanese are much skinnier than the US because the eat ~1000 calories less than the US. much of Asia and the ME are skinnier due to poverty and climate -- easy to be thin when you live in a sauna. and they're rapidly catching up to the US; America just got there first, and hard.
devilkin 3y ago
Does this even work in the long run? When you stop using this drug, and you have not adjusted the way you eat/live... don't you just yoyo back up? I'd think so. Having been morbidly obese, i can say that being told to lose weight doesnt work. You have to want it, be dedicated to it, and have the mental support. For me it was exercise and changing your food patterns: more small things to keep you full longer. Not denying yourself anything, but everything - and i mean everything- was weighted, added to a calorie tracking app. Your max is your max. Want crisps? Sure, but that comes out of your food budget. It requires dedication that i find a lot of people are just not willing to put into it, and hence... the popularity of a drug like Ozempic. I've lost 70kg (154lbs) and it is nearly a decade in still a struggle, having been obese for 20ish years. But the health benefits alone make it worth it.
- p_l 3y ago
  Unfortunately different people can need really different takes on diet. "5 smaller regular portions during the day" is part of how I went from 100 to over 110kg and struggled to walk longer than 20 minutes. Getting back to walking fit required 10 days being fed minimal amounts to prevent collapse of digestive system with a tube through the nose. I still gained weight ultimately, but combined with exercise it allowed me to walk and even run for short distances. Spent years just trying to figure out what's wrong with endocrine system - still don't really know. One of the things led to being prescribed ozempic, not just for weight loss, but because of its function of lowering insulin levels.
- tpmoney 3y ago
  > When you stop using this drug, and you have not adjusted the way you eat/live... don't you just yoyo back up? I'd think so. Why does it matter? Do we worry that asthmatics will start havin asthma attacks again if they stop their medications? Do we worry that diabetics will struggle with insulin problems if they stop theirs? Do we worry that people with vision problems will suffer again if they stop using their eyewear? If someone has to take ozempic every day for the rest of their lives in order to maintain a healthy weight, why the heck do we think that’s worse than being obese every day for the rest of their lives? Why is it more noble that you “nearly a decade in” struggle every single day of your life to maintain a healthy weight? Wouldn’t it be better if you could both maintain a healthy weight and also stop struggling so much?
namingisharder 3y ago
As some others are saying here, just telling people to exercise more and eat less is not working. I exercise at a minimum of 35-45 minutes a day, and when I can get out in the warmer months sometimes as much as 90 minutes a day. While it does have its health benefits, it can just make me hungrier. And sure, I’ve tried eating less. But I find that leads to me being foggy headed, tired, and irritable. Which the leads to more stress too. And let me tell you as remote developer that is not a great way to live your life. And in the past when I’ve done all that I still plateau around fifteen pounds lost. And if I slip up any, well, I have to work that much harder to get back again. I’m not sure I’m ready to resort to medication yet, but I can definitely see the appeal.

The Ozempic Plateau

34 points by crescit_eundo 3y ago

crescit_eundo 3y ago

https://archive.is/nKnCU https://archive.is/nKnCU

immibis 3y ago

[flagged]

dang 3y ago
Could you please stop posting unsubstantive comments and flamebait? We had to ask you this just recently. Eventually we have to ban such accounts, because this is not what this site is for, and destroys what it is for. In terms of sites that have produced bad articles in the past: that's true of all major sites. On HN we go by article quality, not site quality: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&sort=byDate&type=comment&query=%22article%20quality%22%20%22site%20quality%22%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so....
- immibis 3y ago
  > We had to ask you this just recently. Not sure what you're talking about.
  - dang 3y ago
    https://news.ycombinator.com/item?id=38466550 https://news.ycombinator.com/item?id=38466550
    - immibis 3y ago
      If one disliked comment every 50 days is enough to justify a permanent ban for you, then go for it - I don't really care.
      - dang 3y ago
        I don't want to ban you! I just want to hopefully persuade you not to break HN's rules. Not because it's any sort of moral issue but because the default tendency on the internet is for discussion to degrade, and we're hoping to stave that off (https://hn.algolia.com/?dateRange=all&page=0&prefix=true&query=stave%20off%20by%3Adang&sort=byDate&type=comment https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...). The HN guidelines are designed to discourage the sorts of comment that accelerate that decay, and to encourage the sorts of comment that impede it.

Wowfunhappy 3y ago

Something I've been wondering: > [When you loose weight], your body looks for ways to conserve energy. Your muscles work more efficiently, for example, Ard says, so walking that normally burned 100 calories might now burn only 90. By making you want to eat more and burning fewer calories, your body is eventually able to slow weight loss down to zero. How exactly is your body able to accomplish the same task with less energy? What are you giving up? Do you become tired more easily, or wear out your muscles more quickly? Or does loosing weight just turn you into a more efficient super-human (albeit perhaps not in a way you would like)? Would it be desirable for, say, an ultra-marathon runner (who I assume needs to consume as little energy as possible) to spend a year gaining and then loosing a bunch of weight, to make their body more efficient?

plasticchris 3y ago
There's the obvious - you are now lighter and so less work is being done to move your body.
throwup238 3y ago
> How exactly is your body able to accomplish the same task with less energy? Mitochondrial uncoupling proteins [1]. They control how much energy gets converted to ATP in the mitochondria and how much is lost as waste heat. As you enter a caloric deficit, UCP1 is downregulated and the mitochondria adapt to lose less energy to heat. [1] https://en.wikipedia.org/wiki/Uncoupling_protein https://en.wikipedia.org/wiki/Uncoupling_protein
- RobotToaster 3y ago
  It's a real shame that uncouplers like DNP have such bad side effects, from a theoretical standpoint they are perfect.
- paulmd 3y ago
  the funny thing is people (including on HN) have spent years arguing that the human body is a blast calorimeter and that everyone absorbs the same amount of energy from the same amount of food and therefore CICO is the only thing that matters or can help. and oh look here's the protein which controls how much you absorb from it. CICO is the only actionable advice for an individual (at least in the absence of such drugs) but there are still major questions about things like endocrine disruptors etc. The rise of obesity is far too broad-spectrum (even in feral cat colonies or lab rat populations that shouldn't be affected) to really be attributable to just "people have desk jobs". Lots of people have desk jobs all over the world and obesity is not evenly distributed, and the story has always been that "exercise doesn't matter, what you eat controls your weight" so things like biking vs driving should have a relatively small effect. But people wanted to turn it into a moral hazard, and they did. Fat people have always been a socially-acceptable target to punch down on. "I'm actually helping them, you see".

neonate 3y ago

https://web.archive.org/web/20240121073821/https://www.theatlantic.com/health/archive/2024/01/why-you-will-stop-losing-weight-ozempic/677148/ https://web.archive.org/web/20240121073821/https://www.theat...

ravenstine 3y ago

> With every one kilogram you lose, your appetite goes up above baseline by 90 or so calories per day If that were the case, it doesn't seem to apply to me. When I was on a fat-loss journey, I had gone from ~102 kg down to 72.5 kg, which I stayed around for several years. That's a difference in 29.5 kg. 29.5 * 90 = 2,655 kCal Not that I didn't get very hungry at times, but I'm failing to wrap my head around what this guy was saying. If it's true, then either my daily energy expenditure would be more than twice what it currently is (which I've measured through respiratory gas analysis), or I'm hungrier than I know and I'm just shitting out all those extra "calories" that I'm not turning into fat mass. > Ard says, so walking that normally burned 100 calories might now burn only 90. By making you want to eat more and burning fewer calories, your body is eventually able to slow weight loss down to zero. The problem here is in believing that the level of perceived hunger has a linear relation to "calories" burned which, if we are going to be accurate, describes a unit of heat. The body doesn't directly delegate heat because photons have no mass. All the body cares about having different kinds of mass in the optimal places at the current time. Just because you feel more hungry than usual doesn't mean that your body demands to burn X number of calories. Because there's more in play than just energy-in-energy-out, in order to overcome those plateaus, you have to either alter the fuel mixture to optimize for hormone levels, or you have to eat such little mass that it can't make up for all of the mass that your body loses otherwise. This isn't even counting the psychology behind hunger, and how people can think they are hungry with relatively low ghrelin levels because they are relying on food for psychological comfort.

devmor 3y ago
Yeah that sounds like nonsense to me too. I’ve lost about 100lbs in the past 15 months and my appetite hasn’t really changed at all. I do get hungrier on gym days, but that’s to be expected since I’m expending more energy. In fact, I recently discussed calorie intake with my trainer, who is extremely fit and about the same height as me - our BMR is nearly identical.

moritzwarhier 3y ago

Sorry but this drug really sounds like straight from Margaret Atwood's "Oryx and Crake" dystopia. It has already arrived here, and physicians are eager to offer it (medical insurance covers it from BMI>30 onwards). Long-term "patient relationships", I guess. The physician I went to until recently always employs 10-20 different doctors, most of them straight from university. And the truth is, they do a terribly bad job at treating diseases like Influenza, diabetes, or generally advising people with common health conditions. I might be wrong, because obesity really is a terrible lethal health problem, from a certain level upwards it's straight up similar to hard drug addiction (e.g. crack). But if this is the solution.. oh my. How about offering people rewarding opportunities for exercise that don't cost a fortune (if you live in a traffic-ridden district, who wants to "go for a walk" really?) How about educating people more vigorously about food addiction? No fret towards anyone who feels these drugs help them, but for me, it just reminds me how glad I am to have come off SSRIs. The pharmaceutical industry never had any kind of "don't be evil" facade, and they act like it.

HDThoreaun 3y ago
Telling overweight people to eat less or exercise more does not work. There have been countless studies and they all agree. Obesity is clearly a complex subject, but from what I understand some people just experience reality differently in that they're constantly thinking about food. One way it was explained to me is "telling overweight people to eat less is like telling someone to set their thermostat to 40 in the winter to save on their gas bill". It's possible, but extremely uncomfortable and not a realistic solution for most. At the end of the day heart disease is still the number one killer in this country and reducing obesity is the solution to that problem. With the government paying for the healthcare of a significant portion of the population I think its clear that we need to be pushing these drugs hard, for both the life saving and economic saving aspects.
- fatherzine 3y ago
  possible, but uncomfortable -- nailed it. life is not supposed to be 100% comfortable. traditional spiritual practices bake in periods of discomfort for a reason.

fatherzine 3y ago

1. sedentarism + unhealthy diet 2. magic pill 3. ??? 4. profit!

thefz 3y ago
Magic pill so you don't have to change anything about your lifestyle. It's close to zero effort.
- devilkin 3y ago
  And when you stop taking it you go back to your old weight. Win for everyone except for the person using Ozempic.
- fatherzine 3y ago
  children are taught to eat with a spoon. to tie their shoelaces. to read. to write. to play sports. to play an instrument. to dance. to perform a job. it takes effort, but the rewards are worth it, primarily for the children themselves. same with weight control via exercise and diet. it's learnable, and teachable. we can do much better, while being neither judgmental, nor defeatist.
  - thefz 3y ago
    I am being neither.

gist 3y ago

This is one of a series of articles intended to downplay the benefits of weight loss drugs even to the point of being fostered by those in industries most impacted by weight loss drugs (the traditional weight loss industrial complex).

RobotToaster 3y ago
Probably the insurance companies not wanting to cover them as well.

smileysteve 3y ago

I support the use of Ozempic for helping diabetics and the obese get back into the overweight range of bmi; Obesity often leads to pre-diabetes which leads to diabetes, which increases demand of insulin -- a much harder/expensive/riskier regimen to administer. It's a better option than a gastro surgery, typically better than extreme dieting. But, I'm also frustrated at the US food choices; Fast food, even sit down food is often devoid of fiber. Store brand cereals, grains are devoid of fiber unless you pay a premium. Ultra filtering milk doubles protein and halves sugar (by converting lactose to glucose) -- but it costs 8x as much. Why do we even sell "enriched" white bread when whole grain wheat bread has lower sugar, more protein, and more fiber? Margarine - with partially hydrogenated oils - but sold in stores and often at restaurants (waffle house).

stephenitis 3y ago
I have never heard of ultra filtering milk. Do any grocery store chains carry that?
- smileysteve 3y ago
  Fairlife is the major brand at grocery stores and convenience stores; but there are now store brands as well.

curtis3389 3y ago

On the one hand, reducing obesity by 15-20% with a pill is pretty amazing. That certainly reduces negative outcomes and improves people's lives (and saves society money). On the other hand, pharmaceutical companies only care about money and the chemistry is pretty straight-forward. They will continue making new drugs, and they will certainly release a "newer and better" version when their patents run out. But, there will certainly be unintended consequences, and we still don't have a good understanding of the cause of the obesity epidemic.

red-iron-pine 3y ago
> and we still don't have a good understanding of the cause of the obesity epidemic. yes, we do. it's not rocket science. sedentary lifestyle + huge amounts of cheap calories, esp. cheap carbohydrates. the Japanese are much skinnier than the US because the eat ~1000 calories less than the US. much of Asia and the ME are skinnier due to poverty and climate -- easy to be thin when you live in a sauna. and they're rapidly catching up to the US; America just got there first, and hard.

devilkin 3y ago

Does this even work in the long run? When you stop using this drug, and you have not adjusted the way you eat/live... don't you just yoyo back up? I'd think so. Having been morbidly obese, i can say that being told to lose weight doesnt work. You have to want it, be dedicated to it, and have the mental support. For me it was exercise and changing your food patterns: more small things to keep you full longer. Not denying yourself anything, but everything - and i mean everything- was weighted, added to a calorie tracking app. Your max is your max. Want crisps? Sure, but that comes out of your food budget. It requires dedication that i find a lot of people are just not willing to put into it, and hence... the popularity of a drug like Ozempic. I've lost 70kg (154lbs) and it is nearly a decade in still a struggle, having been obese for 20ish years. But the health benefits alone make it worth it.

p_l 3y ago
Unfortunately different people can need really different takes on diet. "5 smaller regular portions during the day" is part of how I went from 100 to over 110kg and struggled to walk longer than 20 minutes. Getting back to walking fit required 10 days being fed minimal amounts to prevent collapse of digestive system with a tube through the nose. I still gained weight ultimately, but combined with exercise it allowed me to walk and even run for short distances. Spent years just trying to figure out what's wrong with endocrine system - still don't really know. One of the things led to being prescribed ozempic, not just for weight loss, but because of its function of lowering insulin levels.
tpmoney 3y ago
> When you stop using this drug, and you have not adjusted the way you eat/live... don't you just yoyo back up? I'd think so. Why does it matter? Do we worry that asthmatics will start havin asthma attacks again if they stop their medications? Do we worry that diabetics will struggle with insulin problems if they stop theirs? Do we worry that people with vision problems will suffer again if they stop using their eyewear? If someone has to take ozempic every day for the rest of their lives in order to maintain a healthy weight, why the heck do we think that’s worse than being obese every day for the rest of their lives? Why is it more noble that you “nearly a decade in” struggle every single day of your life to maintain a healthy weight? Wouldn’t it be better if you could both maintain a healthy weight and also stop struggling so much?

namingisharder 3y ago

As some others are saying here, just telling people to exercise more and eat less is not working. I exercise at a minimum of 35-45 minutes a day, and when I can get out in the warmer months sometimes as much as 90 minutes a day. While it does have its health benefits, it can just make me hungrier. And sure, I’ve tried eating less. But I find that leads to me being foggy headed, tired, and irritable. Which the leads to more stress too. And let me tell you as remote developer that is not a great way to live your life. And in the past when I’ve done all that I still plateau around fifteen pounds lost. And if I slip up any, well, I have to work that much harder to get back again. I’m not sure I’m ready to resort to medication yet, but I can definitely see the appeal.