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So, I don't think exercise is going to have the effect that people are looking for. I have a BMI of a little less than 30 and exercise an hour every day. Like

So, I don't think exercise is going to have the effect that people are looking for. I have a BMI of a little less than 30 and exercise an hour every day. Like not an aspiration to exercise, documented evidence of doing an hour every day no matter what. I have lost approximately no weight on this program (but I do enjoy it greatly!). I'm definitely planning on asking my doctor about these drugs, because lowering the internal setpoint for "I need to eat or I'm going to smash something" would be highly valuable to my health. I think what can be hard to understand with disorders of the mind is that you can't really empathize with them if you don't have them. The reality is that there is a lot of documentation that people aren't just suffering from a lack of willpower; they simply don't have it in them to change because of how their brain is wired. Asking people to be less hungry is like asking them to jump over the Empire State Building. You can ask all you want. It's not going to happen. It's literally impossible. The approach for approximately the last 10,000 years of human history is to say "well these people are defective, get them out of here". Only now are we starting to develop treatment options, which can help people live what you and I consider a normal life. I don't think that's some sort of scam from Big Pharma. While they're making a lot of money, people are living measurably better lives. That's the economy. You spend money to get something in return.

onlyrealcuzzo 3y ago
~50% of Americans are morbidly obese - which is a relatively recent phenomenon. Why have people for thousands of years and still in many other countries not had this constant insatiable hunger that you speak of? The American lifestyle leads to a ~50% morbidly obese rate - not human nature. Morbidly obese rates throughout all human history were <10% until pretty recently.
- HDThoreaun 3y ago
  > Why have people for thousands of years and still in many other countries not had this constant insatiable hunger that you speak of? What makes you think they didn't? Maybe they just didnt have enough food to satisfy themselves and were constantly uncomfortably hungry.
  - onlyrealcuzzo 3y ago
    So ~30% of people in Europe are constantly starving compared to Americans? Europeans can, generally, afford to eat.
    - SJC_Hacker 3y ago
      Europeans have better public transit and more walkable/bikable cities. The portions at restaraunts are also more reasonable. Not the 1500 calorie abominations (half the calorie budget for an active man) you get in the US
    - tpmoney 3y ago
      European obesity rates are also on the rise. the US might have gotten there first, but lets not pretend that we're alone on this hill.
- jrockway 3y ago
  Yeah, I mean, we're not resource constrained anymore. It's easy to not gain weight when there are literally no calories available. You also don't contribute much to the economy and you're miserable all the time. Certainly the wide availability of food, most of it not particularly healthy, isn't helping much. Jobs where you sit in front of a computer all day aren't helping much. But I think it's impossible to give those things up at this point.
- hn_throwaway_99 3y ago
  Because for thousands of years people had to worry more about starving than overeating. And America may have gotten their first, but obesity rates are skyrocketing in nearly the entire Western (and many parts of the Eastern) world. I wholeheartedly agree with you that obesity is a modern problem, but if your solution is somehow "we should redesign all American cities so you can bike to work so we can all be like the Netherlands" or "we should all grow our own food", well, that's not really a solution.
- ThrowawayR2 3y ago
  It takes only moment to search on Google to find many, many news articles indicating that obesity is rising quickly in Europe, Asia, and the rest of the world.
- red-iron-pine 3y ago
  until the last ~100 years or so people regularly starved or died of famine & drought. if they could have been fat, they would have, but they couldn't get enough to eat to stay alive.
elevatedastalt 3y ago
270 word comment about trying to lose weight and you didn't mention anything about diet. I know people hate trite phrases like "You can't outrun a bad diet" or "The best weightloss exercise is a fork-putdown", but what do you say to people when they literally don't consider diet as a relevant part of weight management and instead focus entirely on exercise?
- jrockway 3y ago
  Personally I'm not doing too well on the whole diet thing. I'm well aware of the importance and make grand plans. Then I get really hungry and like eat a pound of noodles or something. I literally can't sleep if I'm hungry at bedtime, I will lay awake all night! Given that I have to go to work the next morning or won't be able to afford things like "shelter", I usually opt to try and get some sleep. Having been on the other side of these brain problems, I understand your skepticism. I have many apparently-normal friends that, once a month or so, disappear off the face of the planet and eventually they come back and they're like "I thought everyone hated me so I stopped going to work and talking to my friends". My honest thought is "WTF" but I offer them reassurances that that's not true at all and everyone likes them. Then they're OK for another month. Meanwhile behind the scenes, they're seeing a psychiatrist and a therapist every couple weeks, and the fact that they're around at all, ever, is because of this work with their doctors. You have to accept that people's brains are wired differently, often in harmful ways, and that there are treatment options available. It's totally alien to me to be too unhappy to get out of bed. But it does happen to people, the data says it. So I believe the data and try to be supportive. I really think not sticking to a diet is the same sort of problem.
SJC_Hacker 3y ago
Bodybuilders will always say, you lose weight in the kitchen, not the gym. Exercise is for building muscle, and other benefits like cardiovascular health. Depending on how intense the exercise is and other factors (your weight being a major one) you might burn 300-800 calories for an hour of exercise. A few cookies/donuts will destroy that in no time.
smileysteve 3y ago
We need to go beyond education; the FDA should start demanding reductions in non nutritional and fructose sweetened foods; Ultra filtered milk is an example where we have the means to double protein, convert lactose to sucrose - and has an extensive shelf life; but educating on why one milk is different than the other is extremely difficult. "Enriched" white bread is an example where wheat bread has less sugar, more protein, more fiber. Different brands of rice has different fiber contents too; the store brand had 1g of fiber and 1g of protein, but the premium store brand had 5g of fiber and 3g of protein. And cereal too; Cheerios had 2 fewer carbs, 2g more protein and 2g more fiber than the store brand of whole wheat cereal. (that's a roughly 20% difference)
carom 3y ago
Exercise is generally part of a weight loss plan but diet (e.g. cutting out carbs, sugar, not drinking calories, intermittent fasting, etc.) will be the biggest contributor. Running for an hour burns a surprisingly small amount of calories.

onlyrealcuzzo 3y ago

~50% of Americans are morbidly obese - which is a relatively recent phenomenon. Why have people for thousands of years and still in many other countries not had this constant insatiable hunger that you speak of? The American lifestyle leads to a ~50% morbidly obese rate - not human nature. Morbidly obese rates throughout all human history were <10% until pretty recently.

HDThoreaun 3y ago
> Why have people for thousands of years and still in many other countries not had this constant insatiable hunger that you speak of? What makes you think they didn't? Maybe they just didnt have enough food to satisfy themselves and were constantly uncomfortably hungry.
- onlyrealcuzzo 3y ago
  So ~30% of people in Europe are constantly starving compared to Americans? Europeans can, generally, afford to eat.
  - SJC_Hacker 3y ago
    Europeans have better public transit and more walkable/bikable cities. The portions at restaraunts are also more reasonable. Not the 1500 calorie abominations (half the calorie budget for an active man) you get in the US
  - tpmoney 3y ago
    European obesity rates are also on the rise. the US might have gotten there first, but lets not pretend that we're alone on this hill.
jrockway 3y ago
Yeah, I mean, we're not resource constrained anymore. It's easy to not gain weight when there are literally no calories available. You also don't contribute much to the economy and you're miserable all the time. Certainly the wide availability of food, most of it not particularly healthy, isn't helping much. Jobs where you sit in front of a computer all day aren't helping much. But I think it's impossible to give those things up at this point.
hn_throwaway_99 3y ago
Because for thousands of years people had to worry more about starving than overeating. And America may have gotten their first, but obesity rates are skyrocketing in nearly the entire Western (and many parts of the Eastern) world. I wholeheartedly agree with you that obesity is a modern problem, but if your solution is somehow "we should redesign all American cities so you can bike to work so we can all be like the Netherlands" or "we should all grow our own food", well, that's not really a solution.
ThrowawayR2 3y ago
It takes only moment to search on Google to find many, many news articles indicating that obesity is rising quickly in Europe, Asia, and the rest of the world.
red-iron-pine 3y ago
until the last ~100 years or so people regularly starved or died of famine & drought. if they could have been fat, they would have, but they couldn't get enough to eat to stay alive.

elevatedastalt 3y ago

270 word comment about trying to lose weight and you didn't mention anything about diet. I know people hate trite phrases like "You can't outrun a bad diet" or "The best weightloss exercise is a fork-putdown", but what do you say to people when they literally don't consider diet as a relevant part of weight management and instead focus entirely on exercise?

jrockway 3y ago
Personally I'm not doing too well on the whole diet thing. I'm well aware of the importance and make grand plans. Then I get really hungry and like eat a pound of noodles or something. I literally can't sleep if I'm hungry at bedtime, I will lay awake all night! Given that I have to go to work the next morning or won't be able to afford things like "shelter", I usually opt to try and get some sleep. Having been on the other side of these brain problems, I understand your skepticism. I have many apparently-normal friends that, once a month or so, disappear off the face of the planet and eventually they come back and they're like "I thought everyone hated me so I stopped going to work and talking to my friends". My honest thought is "WTF" but I offer them reassurances that that's not true at all and everyone likes them. Then they're OK for another month. Meanwhile behind the scenes, they're seeing a psychiatrist and a therapist every couple weeks, and the fact that they're around at all, ever, is because of this work with their doctors. You have to accept that people's brains are wired differently, often in harmful ways, and that there are treatment options available. It's totally alien to me to be too unhappy to get out of bed. But it does happen to people, the data says it. So I believe the data and try to be supportive. I really think not sticking to a diet is the same sort of problem.

SJC_Hacker 3y ago

Bodybuilders will always say, you lose weight in the kitchen, not the gym. Exercise is for building muscle, and other benefits like cardiovascular health. Depending on how intense the exercise is and other factors (your weight being a major one) you might burn 300-800 calories for an hour of exercise. A few cookies/donuts will destroy that in no time.

smileysteve 3y ago

We need to go beyond education; the FDA should start demanding reductions in non nutritional and fructose sweetened foods; Ultra filtered milk is an example where we have the means to double protein, convert lactose to sucrose - and has an extensive shelf life; but educating on why one milk is different than the other is extremely difficult. "Enriched" white bread is an example where wheat bread has less sugar, more protein, more fiber. Different brands of rice has different fiber contents too; the store brand had 1g of fiber and 1g of protein, but the premium store brand had 5g of fiber and 3g of protein. And cereal too; Cheerios had 2 fewer carbs, 2g more protein and 2g more fiber than the store brand of whole wheat cereal. (that's a roughly 20% difference)

carom 3y ago

Exercise is generally part of a weight loss plan but diet (e.g. cutting out carbs, sugar, not drinking calories, intermittent fasting, etc.) will be the biggest contributor. Running for an hour burns a surprisingly small amount of calories.