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Obesity in America is an undeclared national emergency. POTUS should invoke the Defense Production Act to nationalize the production of generic tirzepatide at

• fileeditview 2y ago
  The idea that a drug is the answer to an overly obese population seems absolutely bonkers to me.
  • shiroiushi 2y ago
    The healthier answer simply isn't feasible, unfortunately: it means bulldozing the suburbs, confiscating most cars and handing out bicycles in exchange, and building new, walkable cities and forcing Americans to live in them. Also needed would be strict regulations on food quality, and banning some ingredients. The drug may be a band-aid solution, but if it actually works for making people lose weight, it's better than telling them to eat better and get more exercise and then being shocked when they don't.
    • lostlogin 2y ago
      Your first paragraph sounds amazing.
      • berkes 2y ago
        Indeed. I'd dig one deeper and look at the reasons why it's "not feasible" and the change that first. If people propose "national emergency" as a solution, clearly such options should be on the table.
        • shiroiushi 2y ago
          It's not feasible for various reasons, but they mostly boil down to "political will". There's two main causes I see: food/nutrition, and lifestyle (i.e. not enough exercise, and using cars, which is caused by urban design). There simply isn't enough political will to make any significant change on either of these fronts. Don't forget, the US is almost certainly going to elect Trump for a 2nd term, so obviously there isn't going to be any positive change in either nutrition or urban design for quite some time.
          • berkes 2y ago
            So, basically the US electorate chooses to be obese? If so, the underlying question is: why do they choose this? I can think of several reasons, but to me the most obvious cause is "runaway capitalism", where a few big corporations lobby and market and (mis)inform, to make people think this is what they want, just so they can sell more cars, sugar, processed (high marging) foods and so on. Not to make this an anti-capitalist rant, to be clear. Just that I'm fairly sure we're seeing a clear limitation of "free markets", where people simply aren't the rational homo-economicus that many promised we'd be.
            • shiroiushi 2y ago
              There's tons of healthy food options available to consumers these days, even in regular supermarkets. They all have "organic" food aisles now. Some Americans have become more conscious of this and have adjusted their diets. (Of course, there's also some companies trying to profit off this unfairly, like advertising "gluten free" on foods that would never contain gluten anyway, and also pushing gluten-free foods as "healthier" when there's really no evidence for that, they're healthier of course for people with a gluten allergy or sensitivity but that doesn't extend to everyone.) In a democratic society, it's the people's responsibility to be educated about issues, so they can vote accordingly. Most Americans are making conscious choices to eat bad foods, not exercise, live in suburbs with car-dependent lifestyles, etc. They could move to inner cities and/or push locally for more density and anti-car measures, but they don't, outside of a few select places. Instead, a large chunk of American society "educates" itself about conspiracy theories and the "importance" of guns and religion, and votes accordingly, and what you get is the society you see now.
    • goodpoint 2y ago
      No need for that drama. Building walkable cities is not only perfectly possible and cheap, but most US cities were very walkable 100 years ago.
      • shiroiushi 2y ago
        Building walkable cities (at large scale) in the US is impossible. Not because of physics or resources, but because of politics and American voters' preferences. Sure, there's a small portion of the electorate that wants this, but they're a minority and not powerful enough to get real change outside of a few localities.
      • falcolas 2y ago
        100 years ago the US had ~76m inhabitants - a fifth of what we have today - plus horses and buggies were used broadly throughout the country. The streets in our older cities weren't born from nothing but aether when cars were invented.
    • khazhoux 2y ago
      It’s not the cars and it’s not the walking. Ignore the unique cities like LA and NYC, and daily suburban life is the same in Santa Clara or Little Rock or St. Louis or Charlotte. But some cities are full of morbidly obese people, while some (e.g. Bay Area, where you drive everywhere) have basically none of it.
      • HideousKojima 2y ago
        Also exercise really doesn't burn as many calories as people think. You usually need to work out as much as a pro athlete or olympian to burn a noticeable amount of calories from exercise. The reality is that a lot of Americans just eat too much.
        • loeg 2y ago
          That's why the drug helps. It reduces the overeating. And it's a relatively simple, relatively easy policy lever, unlike every other proposal.
        • khazhoux 2y ago
          Eat and drink! Beer, coke, more beer, more coke.
        • shiroiushi 2y ago
          Exercise changes your metabolism so you burn more calories no matter what you're doing.
    • thefz 2y ago
      Walking is not the only option. One can easily commute by car and once home, jog around, bike, swim... Once the demand is solid, there will be supply for bike lanes, pedestrian paths...
    • TaylorAlexander 2y ago
      I very strongly disagree. Fixing our food, transit, and social systems is absolutely worth it. There are very simple measures we can take like offering a subsidy for e-bikes like we do for electric cars that would get more people outside. Taking measures to make more healthy food more accessible to people who need it would absolutely be worth it. Cities all over the country are already assessing which roads can be converted from four lane stroads to two lane streets with protected bike lanes on either side. We can provide federal funds to encourage more of this. Weight isn’t even the only problem with our culture. Being stuck in cars and eating unhealthy food also affects rates of heart disease and depression. Making those people lose body fat might help with those factors, but I suspect it would do so less than actually making healthier food options more accessible. For those that really feel medication is their best choice, when we have made sure other options are available, we should also offer free medical care to all people. But that should not be the primary solution to this problem for most people!
      • shiroiushi 2y ago
        The "simple measures" you name are things that require political will, and America doesn't have it. That's why these things are infeasible: American voters have to want them, and have to elect people who will enact them. They're not going to do that, outside of a few select municipalities (where obesity probably isn't a big problem anyway, because the people there are wealthy and educated). Even worse, America is almost certainly going to elect Trump for a 2nd term; the country is swinging conservative, so these "simple measures" you name definitely aren't happening any time soon. Look at NYC for instance: the Democratic state governor just scrapped their congestion charge program, so living in blue states and electing Democrats isn't any kind of guarantee of positive change either.
        • TaylorAlexander 2y ago
          Honestly most of the stuff I mentioned is pretty in line with Bidens infrastructure plan which did actually pass! But even if you say my proposal is pure political fantasy, so is giving everyone ozempic. If we’re actually going to dream of fantasy proposals, “give everyone drugs to mask one symptom of our many problems” seems to me an impoverished fantasy.
  • caseyy 2y ago
    This idea is the natural conclusion of interventionist medicine culture where preventative measures and working the root causes are both disliked. It has been shown, for example, that statins prevent much of the heart disease that kills middle-aged people, but this medication needs to be taken for decades before. And yet in many countries, although it is a known fact and statins are safe, doctors don’t prescribe it until people have heart failure and it won’t help much anyways. Our approach to pain management has also shifted a lot in the last 2-4 decades. Managing pain was about finding the root cause and treating it. Now its about hiding the symptoms with paracetamol and ibuprofen. Exercise is a known and very effective treatment for obesity. Many cultures in the East accept it and group exercises in public are common. We in the West also know the science, but more often than appropriate make fun of Asians exercising in the parks every morning. Then we medicate for all the symptoms of diseases that obesity brings. Doctors do not even prescribe exercise to most obese people. That is a prescription which is very effective with $0 monthly costs. The goal is not quality of life. It is not to prevent disease, or to holistically treat it. The goal is to do interventions to prevent death. And maybe that’s more liberal in a way — people can live their lives more consequence-free, enjoy unhealthy habits, and know that some % will be bailed out of their coffins just before things get bad enough. Ozempic is such a bail-out. Yes, Ozempic is an effective drug in reversing obesity. It is a great drug. It will give people back many years of their lives that would have been lost to obesity. Maybe it is even as effective as good exercise habits, which cost $0 and have about 0 side-effects. It is definitely not a better option than exercise for most of the population. But if it’s the only option possible in our healthcare culture, then it is still very valuable. It just won’t end the obesity epidemic. A health culture that only prevents death simply does not concern itself with improving the quality of life. Unfortunately, we are also quite proud to have such a dysfunctional culture.
    • logicchains 2y ago
      Statins don't prevent "much of the heart disease", they have a modest effect of reducing mortality by around 1%: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790055 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
      • 2y ago
  • Teever 2y ago
    Do you genuinely believe that obese Americans can just walk this problem off? That isn't how things work.
    • blitzar 2y ago
      That is exactly how things work. They are not just "big boned" or genetically predisposed to being 500lbs.
      • Teever 2y ago
        Describe as you see it the process and ideal timeline that sees every 500lb and under American lose weight and regain the health benefit that comes from it. Do you support the use of statins and diabetes medications in this population for this process or do you consider that cheating as well?
  • gnulinux996 2y ago
    Why address the root cause and destroy a market when you can make a new one by selling a cure?
  • thefz 2y ago
    Same. Not for this forum, however. The general consensus seems to be that obesity is not lifestyle related, those affected can't do anything about it, and the only option is taking a drug (that has other severe side effects imo). Caloric restriction and exercise of course do not work because thermodynamics are subjective.
  • nicomeemes 2y ago
    Why? It works and is (so far as we can tell, except for a few exceptions like thyroid cancer) completely safe. It would have immediate results. Sure, it would be better to fix the root causes. But we are so far from being in a position where that is feasible.
• Lionga 2y ago
  Just the murican way instead of doing sport or having a better diet to improve health, lets fucking give everyone a million pills and injections.
  • littlestymaar 2y ago
    Sport is not the answer either though, stopping the junk food industry from mass poisoning the population is.
    • robertlagrant 2y ago
      The problem lies with the people who created the junk food industry.
• berkes 2y ago
  This reply is so "American" I find it hard to believe it's not satire. The, IMO, logical solution would be to change the underlying problem. Maybe even through some "national emergency". Force the food industry to change, help people to make healthy decisions, punish/rewards etc. But no: let's put everyone on medication. I could imagine the latter to be a legitimate option if a country's people have some genetic trait that makes obesity harder to fight. But I don't believe that's the case in the US.
  • mft_ 2y ago
    I fundamentally agree with you. However, I’m struggling to imagine how centralised actions would work. e.g.: * Food and food ingredients are probably part of the problem, yet lots of people in America also manage to not be obese. There are some low-hanging fruit (eg high fructose corn syrup and saturated fats), but how far to go and where to stop? Also, this would generate a huge fight with those industries affected. * We could create economic incentives or disincentives, but give there’re links between obesity and lower socioeconomic status, this would hit poor people harder and potentially exacerbate inequality. * Education also seems like a rational response, but agreeing the ‘truth’ to educate people with would be a difficult fight! As in, the ‘Standard American Diet’ pyramid taught for generations and supported by “experts” is arguably a very bad diet to teach people to follow, yet misaligned incentives and economic influences meant that it persisted for generations. If that dogma was changed, where to go: low carb, vs. plant-based, vs. calorie counting, vs. paleo/primal, vs. intermittent fasting…? And ultimately, as we saw during the pandemic, large groups of people are able to be stubborn and make scientifically bad decisions, especially in this world of ever-more polarised politics. You really think the anti-maskers will cope well with centralised (“communist”) meddling with their freedoms around food and drink?
    • idoubtit 2y ago
      > However, I’m struggling to imagine how centralised actions would work. Don't imagine, just have a look at what is happening in other countries. Overlooking the world outside of the USA is also very "American". Chile has the same problem with obesity. Some national policies where introduced, including mandatory information on food packages and a sugar tax. Of course, it did not magically solve the problem, but the obesity pandemic is decelerating, and the sales of unhealthy food have dropped, especially for children. Other countries have introduced similar rules for mandatory package labels. In this domain, Mexico and Canada are ahead of the USA.
• a-french-anon 2y ago
  Just make them fully pay for the consequences of their lack of willpower. An elegant, simple to apply and moral solution.
  • consp 2y ago
    > their lack of willpower Which is almost never the problem. Socioeconomic status mostly is. By claiming it's willpower you are going for the "poor people are lazy" cow manure.
    • robertlagrant 2y ago
      I don't think this is obviously true, if it is true. You're the one equating money with obesity. You shouldn't do that and then instantly deride the previous person for doing it. They didn't.
      • throwawayqqq11 2y ago
        So, socioeconomic status vs personality traits it is? How does personality develop? Is it somehow inherent to sub-humans or a product of ones environment? Of course its a socioeconomic factor. If you try to argue against this one, you have essentially only the other option left and derserve to be ripped apart in the comments. Others have asked for the root cause before, here is my grand take: better education <- fair taxation <- social mobility <- wealth distribution <- matured laicists and a healthy democracy. I tried to put capitalism in there but it just lingers all over it. That socialist take is also my broad explanaition why other developed countries habe better health metrics. Guess what happens when you argue against this one :)
        • robertlagrant 2y ago
          > Guess what happens when you argue against this one :) I'll assume you'll either accidentally or deliberately find a way to box what I'm saying into a much narrower confine, which you will then threaten to beat the straw out of. Given it's happened twice now. > Of course its a socioeconomic factor. If you try to argue against this one, you have essentially only the other option left and derserve to be ripped apart in the comments. What is the other option?
• bitwize 2y ago
  You'd get a lot farther, for cheaper, by declaring cane sugar and HFCS as Schedule I drugs.
  • happymellon 2y ago
    But the war on drugs failed and everyone will be on illegal sugar!