3 ms·

I read the abstract, intro and conclusion (paper reviewers often read less!). I'd say if anything the paper supports my assessment, particularly this bit: > fo

I read the abstract, intro and conclusion (paper reviewers often read less!). I'd say if anything the paper supports my assessment, particularly this bit: > for all practical purposes, “a calorie is a calorie” when it comes to body fat and energy expenditure differences between controlled isocaloric diets varying in the ratio of carbohydrate to fat So, calories in calories out. All you have to do is not ingest them. And if you do, who made that choice? The rest of the paper seems to be talking about factors such as "the obesogenic environment" which completely factor out the agency of the individual. It's like saying it's not your fault that you are an alcoholic or gambling addict because supermarkets sell alcohol and there are bookies just around the corner. I understand what you mean by "who cares". I get that these drugs are a net positive good because they greatly reduce harm with minimal effort. That's great, but it's ultimately like administering narcan to an opioid addict. No one argues narcan is bad (it's proven and effective at preventing OD deaths), but also no one argues it is a solution to the addiction (you cant shoot up as much as you want and take narcan if things go unwell). Obesity of course is not as destructive (to a single individual) as an opioid addiction, but the fact that you regain the weight as soon as you stop taking ozempic etc shows that it's a bandaid.

klausa 3y ago
Why do you think it’s like narcan; instead of comparing it to, say, methadone?
arcticbull 3y ago
> So, calories in calories out. All you have to do is not ingest them. That is not at all a conclusion you can draw from the link I provided. This is the conclusion I would draw. > > In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake. Weight loss is accompanied by persistent endocrine adaptations that increase appetite and decrease satiety thereby resisting continued weight loss and conspiring against long-term weight maintenance. But it just feels better to blame the individual. > That's great, but it's ultimately like administering narcan to an opioid addict. No one argues narcan is bad (it's proven and effective at preventing OD deaths), but also no one argues it is a solution to the addiction (you cant shoot up as much as you want and take narcan if things go unwell). But that's not how it works at all. It would be like taking a drug that makes you find opioids unappealing, and stopping you from shooting up in the first place. Honestly you're basically making the case that any chronic condition isn't worth treating because it'll come back if you stop taking the treatment. And that chronic conditions are actually moral failings. > Obesity of course is not as destructive (to a single individual) as an opioid addiction, but the fact that you regain the weight as soon as you stop taking ozempic etc shows that it's a bandaid. I'm not sure that's not true. The leading causes of death in the US are heart disease (#1), cancer (#2), stroke (#5) and diabetes (#8) and kidney disease (#10). These are all diseases you are at risk of due to obesity. Opioid overdoses don't even make the list. In fact 15% of prescription opioid use is itself due to obesity. [1] Obesity is responsible for ~380,000 deaths in the US per year vs about 80,000 opioid deaths. [1] So buddy if this was narcan for obesity (it's not) you should be pretty bullish on it. [1] https://journals.lww.com/pain/fulltext/2019/10000/the_contribution_of_obesity_to_prescription_opioid.10.aspx https://journals.lww.com/pain/fulltext/2019/10000/the_contri...

klausa 3y ago

Why do you think it’s like narcan; instead of comparing it to, say, methadone?

arcticbull 3y ago

> So, calories in calories out. All you have to do is not ingest them. That is not at all a conclusion you can draw from the link I provided. This is the conclusion I would draw. > > In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake. Weight loss is accompanied by persistent endocrine adaptations that increase appetite and decrease satiety thereby resisting continued weight loss and conspiring against long-term weight maintenance. But it just feels better to blame the individual. > That's great, but it's ultimately like administering narcan to an opioid addict. No one argues narcan is bad (it's proven and effective at preventing OD deaths), but also no one argues it is a solution to the addiction (you cant shoot up as much as you want and take narcan if things go unwell). But that's not how it works at all. It would be like taking a drug that makes you find opioids unappealing, and stopping you from shooting up in the first place. Honestly you're basically making the case that any chronic condition isn't worth treating because it'll come back if you stop taking the treatment. And that chronic conditions are actually moral failings. > Obesity of course is not as destructive (to a single individual) as an opioid addiction, but the fact that you regain the weight as soon as you stop taking ozempic etc shows that it's a bandaid. I'm not sure that's not true. The leading causes of death in the US are heart disease (#1), cancer (#2), stroke (#5) and diabetes (#8) and kidney disease (#10). These are all diseases you are at risk of due to obesity. Opioid overdoses don't even make the list. In fact 15% of prescription opioid use is itself due to obesity. [1] Obesity is responsible for ~380,000 deaths in the US per year vs about 80,000 opioid deaths. [1] So buddy if this was narcan for obesity (it's not) you should be pretty bullish on it. [1] https://journals.lww.com/pain/fulltext/2019/10000/the_contribution_of_obesity_to_prescription_opioid.10.aspx https://journals.lww.com/pain/fulltext/2019/10000/the_contri...