5 ms·

From my understanding GLP-1 agonists can actually modulate the reward pathway reducing people's appetite for toxic diets. We're not socially caught up yet to t

From my understanding GLP-1 agonists can actually modulate the reward pathway reducing people's appetite for toxic diets. We're not socially caught up yet to this information. I suspect there are folks who believe that regardless of similar outcome (reduction of toxic diet), that changing diet without medication is superior to those who change their behavior through pharmacological intervention. It's like the pre-1990s view on depression or anxiety - chemical intervention is a moral weakness.

andrewmcwatters 2y ago
You can literally do the same thing by eating a healthy diet for 2-4 weeks.
- hombre_fatal 2y ago
  That's a trivial claim about any medication that changes behavior. You can achieve the same thing that the medication does by "just" having different behavior.
  - SV_BubbleTime 2y ago
    Have you considered that maybe it is an evolutionary trait that it is hard to do certain things? That the people who can expend the effort and discipline, perhaps have a better configuration than those that can’t or don’t?
    - hombre_fatal 2y ago
      Sure. People say the same thing about ADHD. The question is how a trait fares in the modern world. Maybe a trait was useful to an ancestor but not to you today trying to navigate a calorie rich world of convenience. Just like a trait useful to a nomadic hunter might work against you when you're expected to sit at a desk job if you want to make the money necessary to fulfill your ambitions. It may very well be the case that we end up medicating away traits that were useful at some point in our lineage but not today. I just don't see how it matters much beyond the thought exercise.
      - SV_BubbleTime 2y ago
        I don’t think that’s a great comparison. Have you wondered why ADHD has exploded? Have you not realized how many people at hacker news are on SSRIs? Watch this comment, you will.
    - filoleg 2y ago
      The exact same argument can be applied to literally any medical issue, and it is a pointless one. Someone has an elevated risk of skin cancer due to their genetics? Probably an evolutionary trait that it is more likely for some people to get skin cancer within their lifetime. That doesn’t mean that using sunscreen and providing those people with related medical care (if the need arises) is some crime against nature and will end up hurting evolutionary prospects of the human race.
      - ben_w 2y ago
        > Someone has an elevated risk of skin cancer due to their genetics? Probably an evolutionary trait that it is more likely for some people to get skin cancer within their lifetime. More than probably, it's called "being white". (And we evolved that for more vitamin D?)
    - vundercind 2y ago
      Weird that the ones skinnier foreigners with a “better configuration” get genetically altered (I guess) to a worse configuration when they move to the US, then.
      - SV_BubbleTime 2y ago
        IDK what you mean, but if it isn’t clear to anyone that our food is poison, it should be. My complaint is getting addicted to pharma because we’re addicted to toxic food.
        vundercind 2y ago
        My point is that skinny populations don’t seem to be skinnier than the US population due to greater genetically-backed willpower (better “configuration”). At least, if it’s a factor, it’s overwhelmed by other factors, it seems.
        fragmede 2y ago
        hilariously, the toxic food companies are worried that ozemic will kill their profits. Maybe the pharma industry can fight the food industry conglomerates. https://www.bloomberg.com/news/articles/2023-10-07/ozempic-for-weight-loss-is-disrupting-companies-business-model https://www.bloomberg.com/news/articles/2023-10-07/ozempic-f... https://www.wsj.com/business/ozempic-impact-snack-food-companies-9eec87e5 https://www.wsj.com/business/ozempic-impact-snack-food-compa... https://www.washingtonpost.com/business/2023/10/09/ozempic-weight-loss-drugs-impact/ https://www.washingtonpost.com/business/2023/10/09/ozempic-w... https://www.cnn.com/2023/10/05/investing/ozempic-food-companies/index.html https://www.cnn.com/2023/10/05/investing/ozempic-food-compan...
  - andrewmcwatters 2y ago
    [flagged]
    - yohannparis 2y ago
      Could you provide some of those papers? I'm interested on what you are saying, but I am not able to find what you are mentioning using the link you provided.
      - andrewmcwatters 2y ago
        site:ncbi.nlm.nih.gov ghrelin, reward It goes on and on and on. In lab mice, it has been shown you can alter production in as little as 10 days. Human hormone production has similar turn around times.
    - rfrey 2y ago
      I eat almost zero processed foods and very little sugar - mostly from fruit. I shop exclusively on the perimeter of the grocery store and eat at a restaurant maybe once a month, with all my meals cooked at home. I try my best to limit portions. I have been overweight my entire life. I have successfully lost weight with up to eight months of calorie restriction, so my willpower is just fine, thank you. I have always gained it back, and you calling me out for some kind of moral turpitude is not helpful. Your "eat like an adult" finger waggling is condescending, and claiming anyone who thinks obesity is more complex than "just eat better food, bro" is anti-intellectual and anti-science is just insulting - and not particularly "pro science" either.
      - andrewmcwatters 2y ago
        In 8 months of losing 2 pounds a week, you would have lost roughly 64 pounds. You could have been losing more than that which is common on diets where added sugar is removed. But you're talking to someone who has worked with people with class 3 obesity and has seen the weight successfully stay off. You're omitting details. You simply didn't change your eating habits. Statistically, this detail you shared is also overwhelmingly the documented reason why people fail to keep off weight. Almost entirely, people who reside in higher classes of obesity have no idea what their relative consumption habits are in comparison to those with lower BMIs. This may come as a surprise to you, but most other countries where obesity is not a problem, most sugar consumption is also from fruit and these peoples' diets _don't_ contain anywhere near the amount of added sugar an American diet does. This isn't a special thing to point out, you just think it is because you have no other frame of reference.
- Chernobog 2y ago
  Not to argue for or against Ozempic, but there is a difference between what motivated individuals can achieve on their own, and what one can expect of the general population.
- mock-possum 2y ago
  Do you have the time to seek out and keep healthy food? Can you afford it? Do you have the executive function and impulse control etc to bring to bear the necessary self discipline? You’re making some pretty casual assumptions about people’s abilities.
- vundercind 2y ago
  Studies show nothing but high-touch interventions by specialists actually works for losing weight and keeping it off for a study cohort (i.e. might represent a population-level solution). These are impractically expensive and still less effective than one might expect. Researchers seem to be eager about the promise of supplementing the very-best programs they’ve been able to find… with GLP-1 agonists. Because that might finally make them really effective. That’s how bad the entire body of all other solutions we’ve looked at is.
- outworlder 2y ago
  > You can literally do the same thing by eating a healthy diet for 2-4 weeks. You have been downvoted, but that's true(and supported by evidence and science). Statistically, what most people have is sugar addiction. Simple carbs in general completely mess up your hunger hormones. The problem is that most people don't know what a healthy diet is. The food pyramid isn't it. Drinking a bunch of juice isn't it. Cereal is candy. They try "eating healthy", fail (not realizing what they are eating isn't healthy at all) and give up.
- cthalupa 2y ago
  If all it took to get the same feeling of GLP-1 agonists was success at the diet for 2-4 weeks, I would have a lot less experience being successful at diets for 2-4 weeks. A whole lot less.
mrweasel 2y ago
> GLP-1 agonists can actually modulate the reward pathway reducing people's appetite for toxic diets. There are also studies out showing that people just up their sugar intake, so I think the results on how it affects peoples diet is still pending. From what I've seen, people are eating less, but more of it is junk food and sugar. I can absolutely see why people would want to be able to just take a drug and start losing weight, it's hard. My concern is that it takes more than a low body weight to be healthy. You still need exercise, and while that's not an effective weight-lose solution, it is something that most would add when trying to lose weight, and now they're missing out on that part. Arguably exercise is more important than your weight.
- kelseyfrog 2y ago
  > Arguably exercise is more important than your weight I'm curious to hear the argument
  - mrweasel 2y ago
    Exercise strengths your cardiovascular system, immune system, improves bone strength, builds muscle (which helps you as you age, preventing the risk of falling and fall related injury), improves mental health, reduces stress. If your in good physical shape, it's less of an issue if you carry around a little extra fat. You can still be in bad health, even if your weight is spot on, but it's rare that you exercise a lot, but is overall unhealthy.
    - kelseyfrog 2y ago
      In terms of tangible outcomes, it helps you live longer or something compared to weight loss? greater reported life satisfaction? Or is this more of a personal value?
akira2501 2y ago
> chemical intervention is a moral weakness. As a default it is. And that's what it became. We stopped trying any other methods. Come in the door, have a set of symptoms that check all the boxes, walk out in 30 minutes with a prescription, doctor's office gets a bonus. Institutional psychiatric treatment is drugs first actual treatment later. This is a _social_ problem. It should be discussed and addressed as such. You should not attempt to pervert this concern into an _individual_ issue in an effort to invoke a needless moral defense.
- crooked-v 2y ago
  > As a default it is. Why?
  - akira2501 2y ago
    Are chemical interventions designed with the best outcomes for the patient or the best outcomes for society? I suspect it's the latter. It's cheap and if you're lucky it's effective. When it goes bad it can ruin lives and families. As a _default_ it's a moral weakness. Is this a solvable problem? Yes, but it's monumental, encompassing everything from the way we structure our civil society and work life from the forms of food and entertainment that we incidentally or directly subsidize. We accidentally built something gross. It moves really fast, though.
    - kelseyfrog 2y ago
      Just some notes. This would be a lot easy to take this seriously if it wasn't seeped in moral purity. It is rhetorically unappetizing. Re-wording it so that you say your end goal was better outcomes for people and restructuring society to achieve that is a noble goal. It's easier for people to want to agree with than being a moral policeman.
- triceratops 2y ago
  If it's a social problem then the non-pharmaceutical cure is obviously not white-knuckling a diet and exercise regimen individually. It needs a holistic, society-level solution. More time off work, less car-dependent suburbs, more bike lanes and subsidies for bikes, more agricultural subsidies for healthy food and less for corn. Realistically we aren't going to get those things.

andrewmcwatters 2y ago

You can literally do the same thing by eating a healthy diet for 2-4 weeks.

hombre_fatal 2y ago
That's a trivial claim about any medication that changes behavior. You can achieve the same thing that the medication does by "just" having different behavior.
- SV_BubbleTime 2y ago
  Have you considered that maybe it is an evolutionary trait that it is hard to do certain things? That the people who can expend the effort and discipline, perhaps have a better configuration than those that can’t or don’t?
  - hombre_fatal 2y ago
    Sure. People say the same thing about ADHD. The question is how a trait fares in the modern world. Maybe a trait was useful to an ancestor but not to you today trying to navigate a calorie rich world of convenience. Just like a trait useful to a nomadic hunter might work against you when you're expected to sit at a desk job if you want to make the money necessary to fulfill your ambitions. It may very well be the case that we end up medicating away traits that were useful at some point in our lineage but not today. I just don't see how it matters much beyond the thought exercise.
    - SV_BubbleTime 2y ago
      I don’t think that’s a great comparison. Have you wondered why ADHD has exploded? Have you not realized how many people at hacker news are on SSRIs? Watch this comment, you will.
  - filoleg 2y ago
    The exact same argument can be applied to literally any medical issue, and it is a pointless one. Someone has an elevated risk of skin cancer due to their genetics? Probably an evolutionary trait that it is more likely for some people to get skin cancer within their lifetime. That doesn’t mean that using sunscreen and providing those people with related medical care (if the need arises) is some crime against nature and will end up hurting evolutionary prospects of the human race.
    - ben_w 2y ago
      > Someone has an elevated risk of skin cancer due to their genetics? Probably an evolutionary trait that it is more likely for some people to get skin cancer within their lifetime. More than probably, it's called "being white". (And we evolved that for more vitamin D?)
  - vundercind 2y ago
    Weird that the ones skinnier foreigners with a “better configuration” get genetically altered (I guess) to a worse configuration when they move to the US, then.
    - SV_BubbleTime 2y ago
      IDK what you mean, but if it isn’t clear to anyone that our food is poison, it should be. My complaint is getting addicted to pharma because we’re addicted to toxic food.
      - vundercind 2y ago
        My point is that skinny populations don’t seem to be skinnier than the US population due to greater genetically-backed willpower (better “configuration”). At least, if it’s a factor, it’s overwhelmed by other factors, it seems.
      - fragmede 2y ago
        hilariously, the toxic food companies are worried that ozemic will kill their profits. Maybe the pharma industry can fight the food industry conglomerates. https://www.bloomberg.com/news/articles/2023-10-07/ozempic-for-weight-loss-is-disrupting-companies-business-model https://www.bloomberg.com/news/articles/2023-10-07/ozempic-f... https://www.wsj.com/business/ozempic-impact-snack-food-companies-9eec87e5 https://www.wsj.com/business/ozempic-impact-snack-food-compa... https://www.washingtonpost.com/business/2023/10/09/ozempic-weight-loss-drugs-impact/ https://www.washingtonpost.com/business/2023/10/09/ozempic-w... https://www.cnn.com/2023/10/05/investing/ozempic-food-companies/index.html https://www.cnn.com/2023/10/05/investing/ozempic-food-compan...
- andrewmcwatters 2y ago
  [flagged]
  - yohannparis 2y ago
    Could you provide some of those papers? I'm interested on what you are saying, but I am not able to find what you are mentioning using the link you provided.
    - andrewmcwatters 2y ago
      site:ncbi.nlm.nih.gov ghrelin, reward It goes on and on and on. In lab mice, it has been shown you can alter production in as little as 10 days. Human hormone production has similar turn around times.
  - rfrey 2y ago
    I eat almost zero processed foods and very little sugar - mostly from fruit. I shop exclusively on the perimeter of the grocery store and eat at a restaurant maybe once a month, with all my meals cooked at home. I try my best to limit portions. I have been overweight my entire life. I have successfully lost weight with up to eight months of calorie restriction, so my willpower is just fine, thank you. I have always gained it back, and you calling me out for some kind of moral turpitude is not helpful. Your "eat like an adult" finger waggling is condescending, and claiming anyone who thinks obesity is more complex than "just eat better food, bro" is anti-intellectual and anti-science is just insulting - and not particularly "pro science" either.
    - andrewmcwatters 2y ago
      In 8 months of losing 2 pounds a week, you would have lost roughly 64 pounds. You could have been losing more than that which is common on diets where added sugar is removed. But you're talking to someone who has worked with people with class 3 obesity and has seen the weight successfully stay off. You're omitting details. You simply didn't change your eating habits. Statistically, this detail you shared is also overwhelmingly the documented reason why people fail to keep off weight. Almost entirely, people who reside in higher classes of obesity have no idea what their relative consumption habits are in comparison to those with lower BMIs. This may come as a surprise to you, but most other countries where obesity is not a problem, most sugar consumption is also from fruit and these peoples' diets _don't_ contain anywhere near the amount of added sugar an American diet does. This isn't a special thing to point out, you just think it is because you have no other frame of reference.
Chernobog 2y ago
Not to argue for or against Ozempic, but there is a difference between what motivated individuals can achieve on their own, and what one can expect of the general population.
mock-possum 2y ago
Do you have the time to seek out and keep healthy food? Can you afford it? Do you have the executive function and impulse control etc to bring to bear the necessary self discipline? You’re making some pretty casual assumptions about people’s abilities.
vundercind 2y ago
Studies show nothing but high-touch interventions by specialists actually works for losing weight and keeping it off for a study cohort (i.e. might represent a population-level solution). These are impractically expensive and still less effective than one might expect. Researchers seem to be eager about the promise of supplementing the very-best programs they’ve been able to find… with GLP-1 agonists. Because that might finally make them really effective. That’s how bad the entire body of all other solutions we’ve looked at is.
outworlder 2y ago
> You can literally do the same thing by eating a healthy diet for 2-4 weeks. You have been downvoted, but that's true(and supported by evidence and science). Statistically, what most people have is sugar addiction. Simple carbs in general completely mess up your hunger hormones. The problem is that most people don't know what a healthy diet is. The food pyramid isn't it. Drinking a bunch of juice isn't it. Cereal is candy. They try "eating healthy", fail (not realizing what they are eating isn't healthy at all) and give up.
cthalupa 2y ago
If all it took to get the same feeling of GLP-1 agonists was success at the diet for 2-4 weeks, I would have a lot less experience being successful at diets for 2-4 weeks. A whole lot less.

mrweasel 2y ago

> GLP-1 agonists can actually modulate the reward pathway reducing people's appetite for toxic diets. There are also studies out showing that people just up their sugar intake, so I think the results on how it affects peoples diet is still pending. From what I've seen, people are eating less, but more of it is junk food and sugar. I can absolutely see why people would want to be able to just take a drug and start losing weight, it's hard. My concern is that it takes more than a low body weight to be healthy. You still need exercise, and while that's not an effective weight-lose solution, it is something that most would add when trying to lose weight, and now they're missing out on that part. Arguably exercise is more important than your weight.

kelseyfrog 2y ago
> Arguably exercise is more important than your weight I'm curious to hear the argument
- mrweasel 2y ago
  Exercise strengths your cardiovascular system, immune system, improves bone strength, builds muscle (which helps you as you age, preventing the risk of falling and fall related injury), improves mental health, reduces stress. If your in good physical shape, it's less of an issue if you carry around a little extra fat. You can still be in bad health, even if your weight is spot on, but it's rare that you exercise a lot, but is overall unhealthy.
  - kelseyfrog 2y ago
    In terms of tangible outcomes, it helps you live longer or something compared to weight loss? greater reported life satisfaction? Or is this more of a personal value?

akira2501 2y ago

> chemical intervention is a moral weakness. As a default it is. And that's what it became. We stopped trying any other methods. Come in the door, have a set of symptoms that check all the boxes, walk out in 30 minutes with a prescription, doctor's office gets a bonus. Institutional psychiatric treatment is drugs first actual treatment later. This is a _social_ problem. It should be discussed and addressed as such. You should not attempt to pervert this concern into an _individual_ issue in an effort to invoke a needless moral defense.

crooked-v 2y ago
> As a default it is. Why?
- akira2501 2y ago
  Are chemical interventions designed with the best outcomes for the patient or the best outcomes for society? I suspect it's the latter. It's cheap and if you're lucky it's effective. When it goes bad it can ruin lives and families. As a _default_ it's a moral weakness. Is this a solvable problem? Yes, but it's monumental, encompassing everything from the way we structure our civil society and work life from the forms of food and entertainment that we incidentally or directly subsidize. We accidentally built something gross. It moves really fast, though.
  - kelseyfrog 2y ago
    Just some notes. This would be a lot easy to take this seriously if it wasn't seeped in moral purity. It is rhetorically unappetizing. Re-wording it so that you say your end goal was better outcomes for people and restructuring society to achieve that is a noble goal. It's easier for people to want to agree with than being a moral policeman.
triceratops 2y ago
If it's a social problem then the non-pharmaceutical cure is obviously not white-knuckling a diet and exercise regimen individually. It needs a holistic, society-level solution. More time off work, less car-dependent suburbs, more bike lanes and subsidies for bikes, more agricultural subsidies for healthy food and less for corn. Realistically we aren't going to get those things.