5 ms·

I’m all for it. Initial results seem very promising, especially for those struggling to get to their target weights. I was initially skeptical of it especially

by xyst 3y ago

I’m all for it. Initial results seem very promising, especially for those struggling to get to their target weights. I was initially skeptical of it especially given the massive marketing push for off label usage (reminded me of fentanyl/oxy or certain amphetamines for weight loss). Personally, just adjusting lifestyle (reducing intake of sugary and artificially sweetened foods; exercise; and intermittent fasting) over a sustained period of time (3-4 months) helped me drop 40 lbs. OTC supplements like vitamin d, and omega fish oil added to regimen (as recommended by doctor).

temp0826 3y ago
It's very effective for sure. But I also think it's ripe for abuse. I've seen healthy people on it to lose only 10 lb instead of making slight changes. I don't think we know enough about its long term effects and how damaging it can be to be on severe calorie restriction for some periods of time. It's like an induced eating disorder in a way and I wonder about the psychological changes that accompany it.
- jstummbillig 3y ago
  We should stop thinking of this complex in terms of "abuse" and "slight changes". We suck to varying degrees and obesity is obviously a societal issue. We need help. We should keep looking for better options, we can and should always keep an eye on potential consequences down the line — and we can always elongate that line — but the very real, proven consequences of being overweight/having high blood pressure can be calculated like those that are attached to burning coal and they are worth tackling without prejudice, within the guidelines of what good science deems safe. Anything we can do to help with cardiovascular issues needs to be explored. Doing otherwise would simply be immoral and irresponsible. We have tried eating salads and going for quick walks. It's always great when that's enough to change one person for the better. When it's not, we should help with empathy. Currently, there simply is no clearer, quicker path to doing more than these drugs, on a societal level.
  - VS1999 3y ago
    I'm going to be skeptical of putting millions of on a new drug, permanently, to mask some underlying issue in society. Is there any evidence that people can be weaned off this after losing weight? Or is it expected to be permanent? This was not an issue in the past and whatever the root cause is, it's never going to be treated if we can just drug everyone into acting like they used to.
    - jstummbillig 3y ago
      You fix the immediate problems where you can. You buy time. You find better solutions down the line. When a person is dead, you can't find a better solution. It's "masking" the issue as much as chemotherapy is "masking" the issue. People are dying. We have tried appeals to salads and quick walks. Unless you got anything up your sleeve, I recommend we stick to the ol' "keep more people alive with the best stuff we currently got" plan, until information pops up, that makes this look like the morally worse option. But in that regard preventing death is fairly hard to beat as a baseline.
      - squigz 3y ago
        > We have tried appeals to salads and quick walks. This bit made me laugh, as if public health initiatives have been taken remotely seriously by the past few decades. It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication. Did that happen with tobacco? Alcohol?
        jstummbillig 3y ago
        > It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication. It's a hyperbole, meaning to say: The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach. What makes it fairly obvious to me is that despite clear and long standing conflicting beauty ideals, the massive societal advantages beauty affords, and an industry build around weight loss (not even drugs, stuff like Weight Watchers), people still struggle. If you have good insight into why informing about tobacco worked to the degree it did (although lung cancer is still the leading cause of cancer death) other than claiming vague un-seriousness, I am all ears. Otherwise I have a hard time understanding this as an information problem.
- prepend 3y ago
  How is that abuse? Obviously meds don’t work for everyone, but the aim is to have population level effects.
  - evantbyrne 3y ago
    Maybe abuse is not the right term, but certainly not necessary to drop 10lbs. I workout pretty casually, and when I go on a cut I can lose 1lb/day. It wouldn't surprise me if an inactive person could lose that in a month. And the act of practicing self control would be beneficial. Maybe you are onto something with your comment about population-level effects though, I wouldn't know.
    - kdnvk 3y ago
      1lb/day isn’t sustainable at all, that would require a 3500 calorie deficit. You’re losing water weight.
      - evantbyrne 3y ago
        Sure some of the weight in those first ten days might have been water, but it stayed off. Possibly because my diet didn't immediately revert to pre-cut levels but it's hard to say given it didn't go back up and I wasn't exactly suffering. A 1000 calorie deficit over a month would still cut 8lbs. No problem for an overweight man who is likely eating well in excess of 3000 calories. The point is that major interventions aren't really necessary for that level of weight loss, and imo practicing the self-control needed to lose 10lbs should be beneficial to pretty much anyone. Let me put it this way: it should be way harder for a couch potato to train for a 5k run than to lose 10lbs on a cut.
        prepend 3y ago
        > The point is that major interventions aren't really necessary for that level of weight loss It’s about effective interventions. Obviously major interventions are needed as there is a huge amount of obese and overweight in the US and many other methods have been attempted. It’s not about theoretically possible (ie, a bodybuilder can do it) but effective population interventions that result in people successfully losing weight. Think about people going to medical school and becoming a doctor. It’s obviously possible but if you said the solution to income inequality was for everyone to go to medical school and be doctors that would not be a very effective intervention. Not being obese is not being wealthy. It’s simple what to do, but difficult to stick to a successful plan.
- dangus 3y ago
  I lost 40 pounds the classic way. Just better diet, eating less. And like the majority of people who lost weight, I gained it back. Why? I don’t know. My body just wants to eat more. I have to be constantly vigilant or else I’ll fall into my old habits of what my body demands that I eat. I’ll eat dinner and then still be hungry. I think you’re getting this backwards. I already have an eating disorder.
  - someotherperson 3y ago
    > I’ll eat dinner and then still be hungry I'd take the odds that you eat too fast. Slow down and carefully chew every single bite. Put the cutlery down in-between bites.
    - dangus 3y ago
      Thanks for the advice. It’s so helpful. Why didn’t I think of that? All the people who have never been fat have the best advice that us fatties totally appreciate and want to hear even when we never asked for it. In fact, it’s extra awesome when people bring up obvious advice when we don’t ask for it because fat people like me are actually less smart than you! So it’s really helpful to have a helping hand and I thank you for it. Thank you for downplaying a disease that almost half of the population has and for blaming it on me as an individual. Because obviously if half the country has the exact same ailment as me, it’s really a sign of the dangerous virality of the fast paced chewing lifestyle. Since most people who lost weight gain it back at some point statistically, it really makes logical sense that it’s all about how fast we are all chewing our food. All the celebrities and pundits on TV and in social media talk about how we need to chew our food faster, so it’s hard to escape that perverse influence.
      - Dove 3y ago
        I'm sorry to hear about your troubles. I have occasionally shared them. :( If you're interested, I do have a recommendation for you. For my money, Joel Greene is the best scientific thinker on the topic of diet and health, and his recent book "The Way" does a lot to replace frustration and confusion on the topic with sense and helpful advice. I recommend it if you've had success with a diet, and then regained the weight, and now nothing works - that's the exact problem he's focused on. Above and beyond whether you like his suggested solution, he does a lot to uncover mechanisms and explain the complexity of the problem. For what it's worth, I think your experience is completely normal. Nearly universal, even.

by xyst 3y ago

temp0826 3y ago

It's very effective for sure. But I also think it's ripe for abuse. I've seen healthy people on it to lose only 10 lb instead of making slight changes. I don't think we know enough about its long term effects and how damaging it can be to be on severe calorie restriction for some periods of time. It's like an induced eating disorder in a way and I wonder about the psychological changes that accompany it.

jstummbillig 3y ago
We should stop thinking of this complex in terms of "abuse" and "slight changes". We suck to varying degrees and obesity is obviously a societal issue. We need help. We should keep looking for better options, we can and should always keep an eye on potential consequences down the line — and we can always elongate that line — but the very real, proven consequences of being overweight/having high blood pressure can be calculated like those that are attached to burning coal and they are worth tackling without prejudice, within the guidelines of what good science deems safe. Anything we can do to help with cardiovascular issues needs to be explored. Doing otherwise would simply be immoral and irresponsible. We have tried eating salads and going for quick walks. It's always great when that's enough to change one person for the better. When it's not, we should help with empathy. Currently, there simply is no clearer, quicker path to doing more than these drugs, on a societal level.
- VS1999 3y ago
  I'm going to be skeptical of putting millions of on a new drug, permanently, to mask some underlying issue in society. Is there any evidence that people can be weaned off this after losing weight? Or is it expected to be permanent? This was not an issue in the past and whatever the root cause is, it's never going to be treated if we can just drug everyone into acting like they used to.
  - jstummbillig 3y ago
    You fix the immediate problems where you can. You buy time. You find better solutions down the line. When a person is dead, you can't find a better solution. It's "masking" the issue as much as chemotherapy is "masking" the issue. People are dying. We have tried appeals to salads and quick walks. Unless you got anything up your sleeve, I recommend we stick to the ol' "keep more people alive with the best stuff we currently got" plan, until information pops up, that makes this look like the morally worse option. But in that regard preventing death is fairly hard to beat as a baseline.
    - squigz 3y ago
      > We have tried appeals to salads and quick walks. This bit made me laugh, as if public health initiatives have been taken remotely seriously by the past few decades. It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication. Did that happen with tobacco? Alcohol?
      - jstummbillig 3y ago
        > It seems quite a jump to go from "maybe try a a salad?" to putting millions of people on medication. It's a hyperbole, meaning to say: The problem is so frustratingly silly and solution is so obvious and simple — just eat a little less, move a little more — that I understand how hard it is to accept that it might just be the completely wrong approach. What makes it fairly obvious to me is that despite clear and long standing conflicting beauty ideals, the massive societal advantages beauty affords, and an industry build around weight loss (not even drugs, stuff like Weight Watchers), people still struggle. If you have good insight into why informing about tobacco worked to the degree it did (although lung cancer is still the leading cause of cancer death) other than claiming vague un-seriousness, I am all ears. Otherwise I have a hard time understanding this as an information problem.
prepend 3y ago
How is that abuse? Obviously meds don’t work for everyone, but the aim is to have population level effects.
- evantbyrne 3y ago
  Maybe abuse is not the right term, but certainly not necessary to drop 10lbs. I workout pretty casually, and when I go on a cut I can lose 1lb/day. It wouldn't surprise me if an inactive person could lose that in a month. And the act of practicing self control would be beneficial. Maybe you are onto something with your comment about population-level effects though, I wouldn't know.
  - kdnvk 3y ago
    1lb/day isn’t sustainable at all, that would require a 3500 calorie deficit. You’re losing water weight.
    - evantbyrne 3y ago
      Sure some of the weight in those first ten days might have been water, but it stayed off. Possibly because my diet didn't immediately revert to pre-cut levels but it's hard to say given it didn't go back up and I wasn't exactly suffering. A 1000 calorie deficit over a month would still cut 8lbs. No problem for an overweight man who is likely eating well in excess of 3000 calories. The point is that major interventions aren't really necessary for that level of weight loss, and imo practicing the self-control needed to lose 10lbs should be beneficial to pretty much anyone. Let me put it this way: it should be way harder for a couch potato to train for a 5k run than to lose 10lbs on a cut.
      - prepend 3y ago
        > The point is that major interventions aren't really necessary for that level of weight loss It’s about effective interventions. Obviously major interventions are needed as there is a huge amount of obese and overweight in the US and many other methods have been attempted. It’s not about theoretically possible (ie, a bodybuilder can do it) but effective population interventions that result in people successfully losing weight. Think about people going to medical school and becoming a doctor. It’s obviously possible but if you said the solution to income inequality was for everyone to go to medical school and be doctors that would not be a very effective intervention. Not being obese is not being wealthy. It’s simple what to do, but difficult to stick to a successful plan.
dangus 3y ago
I lost 40 pounds the classic way. Just better diet, eating less. And like the majority of people who lost weight, I gained it back. Why? I don’t know. My body just wants to eat more. I have to be constantly vigilant or else I’ll fall into my old habits of what my body demands that I eat. I’ll eat dinner and then still be hungry. I think you’re getting this backwards. I already have an eating disorder.
- someotherperson 3y ago
  > I’ll eat dinner and then still be hungry I'd take the odds that you eat too fast. Slow down and carefully chew every single bite. Put the cutlery down in-between bites.
  - dangus 3y ago
    Thanks for the advice. It’s so helpful. Why didn’t I think of that? All the people who have never been fat have the best advice that us fatties totally appreciate and want to hear even when we never asked for it. In fact, it’s extra awesome when people bring up obvious advice when we don’t ask for it because fat people like me are actually less smart than you! So it’s really helpful to have a helping hand and I thank you for it. Thank you for downplaying a disease that almost half of the population has and for blaming it on me as an individual. Because obviously if half the country has the exact same ailment as me, it’s really a sign of the dangerous virality of the fast paced chewing lifestyle. Since most people who lost weight gain it back at some point statistically, it really makes logical sense that it’s all about how fast we are all chewing our food. All the celebrities and pundits on TV and in social media talk about how we need to chew our food faster, so it’s hard to escape that perverse influence.
    - Dove 3y ago
      I'm sorry to hear about your troubles. I have occasionally shared them. :( If you're interested, I do have a recommendation for you. For my money, Joel Greene is the best scientific thinker on the topic of diet and health, and his recent book "The Way" does a lot to replace frustration and confusion on the topic with sense and helpful advice. I recommend it if you've had success with a diet, and then regained the weight, and now nothing works - that's the exact problem he's focused on. Above and beyond whether you like his suggested solution, he does a lot to uncover mechanisms and explain the complexity of the problem. For what it's worth, I think your experience is completely normal. Nearly universal, even.