11 ms·

The problem with this (and all diet plans/drugs) is the lifestyle that led to problem in the first place. If you do not change your lifestyle, for real and not

by Alupis 2y ago

The problem with this (and all diet plans/drugs) is the lifestyle that led to problem in the first place. If you do not change your lifestyle, for real and not just superficially, then you will relapse with a vengeance. That is to say, be careful with using a drug as a crutch. Sure, it can artificially make you much more interested in not consuming so many calories and/or perhaps being more active than before - but you have to continue that lifestyle after stopping the drug. Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss?

JamesBarney 2y ago
>If you do not change your lifestyle, for real and not just superficially, then you will relapse with a vengeance. Longterm glp-1 agonist research doesn't agree with this. > but you have to continue that lifestyle after stopping the drug. Why stop the drug? >Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss? A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic.
- Alupis 2y ago
  > Why stop the drug? Why would you want to continue using a drug for the rest of your life? > Longterm glp-1 agonist research doesn't agree with this. Please explain. If you stop using the drug, because you've achieved your goals, what stops you from relapsing other than your own personal habits and lifestyle? > A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic. Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years.
  - JamesBarney 2y ago
    > Why would you want to continue using a drug for the rest of your life? It's better than being obese. This is true of most drugs for chronic conditions. very few of them are curative, almost all of them treat the condition. > Longterm glp-1 agonist research doesn't agree with this. Sorry I wasn't clear, I meant with continued treatment you don't rebound. > Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years. They might have negative side effects but obesity has very large negative side effects. I would be incredibly surprised if any of these drugs that have been used in diabetes treatment for a long time have anywhere close to the negative side effects of obesity.
    - Alupis 2y ago
      [flagged]
      - catlikesshrimp 2y ago
        False. (All) People crave for food. Some people have stronger craving than others. In healthy people you call it "hunger". In obese people it is more like an addiction. Do you know people can be addictes to sex and to work, too? If you insist on the choice argument, the only way an addict can stop consuming is locking himself in a room and throwing away the key. Other than that, much help is needed, many changes are needed, and even chemicals are needed. "Choice" is victim blaming
        gooosle 2y ago
        All you're saying is the it's harder to make some choices depending on situation. They are still 100% choices. Choices don't have to be trivially easy.
      - JamesBarney 2y ago
        How much less likely do you think someone with high self control is to not be obese? 12%. Which shows that your intuitions about obesity and the causes are probably wrong. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717171/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717171/
- data_spy 2y ago
  The research says you gain the weight back: "For the two in every five patients who discontinue the treatments within a year, according to a 2024 JAMA study, this means that they are likely to rebound to their original weight with less muscle and a higher body fat percentage." The other issue is the muscle loss on being on these drugs as "Clinical data shows that 25 per cent of weight loss from Eli Lilly’s shot resulted from a reduction in lean body mass, including muscle, while 40 per cent of Novo Nordisk’s jab was due to a drop in lean body mass." Via https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2dea9 https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2d...
  - JamesBarney 2y ago
    Sorry I meant with continued use of the treatment you don't regain the weight. I agree if you stop taking the medication your weight will rebound.
    - Alupis 2y ago
      Right, so we doom some portion of the population to forever take a pill from big pharma? How is that acceptable with anyone? The goal should be to use Ozempic until you are in a better place to manage things yourself. The goal should not be to get people hooked on Ozempic for their entire lives. Perhaps Ozempic prescriptions should come with prescribed exercise with check-in and monitoring, or something.
      - rootusrootus 2y ago
        > doom some portion of the population to forever take a pill from big pharma That is temporary. The effects are real. The fact that you don't think big pharma should profit handsomely for making it happen is not the only alternative. Before too long semaglutide, as one example, will be out of patent and available as a generic. It won't cost a thousand bucks a month to big pharma, it'll be practically free. Cheap enough that most insurance plans will likely subsidize it all the way to zero out-of-pocket cost just because the ROI is so good.
      - 2y ago
- lizardlena 2y ago
  > A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. Ozempic is only fighting symptoms of that, not the root of the problem which is the stigma around weightgain, being a big person, just fatphobia being extremly generalized and a lot of shame surrounding weight. While it's amazing for people who have medical conditions making them gain a lot of weight, just saying that they should take ozempic will not change people gaining too much weight. It's not anything like high cholesterol or high blood sugar in most cases.
  - JamesBarney 2y ago
    Fighting the symptoms of what? Taking ozempic will definitely keep people from gaining weight and will help them lose weight.
  - Eisenstein 2y ago
    A few questions: Can you qualify what you consider to be a 'symptom' vs a 'condition'? Is high cholesterol a symptom of something, or a condition itself? What about high blood sugar? Would you say that acid reflux is a symptom or a condition? Is a person that takes Prilosec daily to treat bad reflux treating the symptoms and not the underlying condition? What about people using asthma inhalers, or epipens: symptom or condition? Are people allowed to use the medicines if their underlying conditions are not being treated?
  - fortran77 2y ago
    > While it's amazing for people who have medical conditions making them gain a lot of weight, You mean matter is created out of thin air because of a "medical condition" and not by eating too much food?
- justinclift 2y ago
  > ... if they have high blood sugar we give them diabetes. That sounds like a hell of a treatment plan. o_O
  - bregma 2y ago
    It doesn't work. I keep trying to get off the diabetes and I just relapse after a few weeks. It doesn't help that my body tries to hide the glucose everywhere, like attached to hemoglobin or in my liver in the form of glycogen so it can share a hit with me first thing every morning. Nope, not going back to the doctor that gave me diabetes. That was a mistake.
perching_aix 2y ago
Sounds like it directly affects their lifestyle though? Being less drawn to addictions, and thus less engaged in related activities, is a pretty big lifestyle change.
- Alupis 2y ago
  > Being less drawn to addictions, and thus less engaged in related activities, is a pretty big lifestyle change While on the drug. Will those changes remain if the user stops using the drug?
  - Someone1234 2y ago
    What is the core of your point? That these drugs, that extend life, and reduce associated illnesses should be ignored or not used, because instead people can die sooner in some attempt to cure themselves the "correct" way? A corpse cannot learn healthy lifestyle habits. A living person who lost weight the immoral way or whatever you're trying to say, can of course.
    - Alupis 2y ago
      The point is you still need to develop a lifestyle that is healthy. The drug isn't a miracle, it's a band aid. If you do not change your lifestyle, and you discontinue using this drug, you will relapse. This is the same issue many people face when they diet as well, so it is nothing new. The point of my saying this is to point that out, because a lot of people in this thread seem to think it is totally ok to be on an Ozempic prescription for your entire life. That's horrifying for so many reasons. Others seem to think you take Ozempic until you're "cured" then you just live happily ever after. That's hardly going to be the case for many people who have struggled with weight for their entire lives.
      - rixed 2y ago
        I think we hear you, we should all take more care about bad lifestyle, everybody should exercise regularly and eat healthy food. But to be fair nobody has promoted a bad lifestyle, or said that, given there is this new drug let's care even less. At the contrary, given the testimonies it sounds like the drug helps people to adopt better habits, no?
Someone1234 2y ago
> Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss? Have alcoholics using Naltrexone? Or opioid addicts using Methadone, or smokers using nicotine gum/patches? See I'm bringing this up to point out the obvious double standard, people suffering from food addiction (i.e. literally the high from food) or binge-eating disorder, who finally have an effective treatment, are treated like it isn't addiction or illness, but a "lifestyle," but if you said this stuff about any other addiction people would call you out and be horrified. For people mildy overweight or accidentally obese, it is a wildly different illness for people with lifetime problems who have lost/regained weight tens of times and likely know more about nutrition than most healthy-weight people ever will.
- Alupis 2y ago
  This is bunk. An actual chemical addiction is not the same as feeling an urge to drink 8 cans of coke a day, or being unable to not buy a bag of chips at the gas station.
  - ben_w 2y ago
    Is it, though? Your entire body and brain is a complex and messy chemical reaction. The opening sentence of the wikipedia article on addiction currently reads: "Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences." The page then lists "eating or food addiction" as examples, with food addiction being its own entire page.
    - Alupis 2y ago
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      - deleted 2y ago
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      - 2y ago
jrockway 2y ago
I don't think you expect to stop taking the drug. It's a for-life kind of thing. If a prescription for "lifestyle changes" were a drug, it would be one of the least effective drugs ever made. I read something directed at medical professionals that are skeptical of the GLP-1 receptor agonists and it asks, if you prescribe a drug and your patient refuses to take it, why would you keep prescribing that drug? Of course not. That's what lifestyle changes are, and the landscape has changed so that there are alternatives. (My employer is heavy on the "lifestyle changes" angle. They will not pay for GLP-1s, but they will send you a newsletter about losing weight if you want. Guess who's losing the weight.)
metabagel 2y ago
> The problem with this (and all diet plans/drugs) is the lifestyle that led to problem in the first place. I don't think we fully know what led to the problem in the first place. I think it's a complex interaction between the types of foods we eat, and which are more affordable, our gut microbiome, and the amount and frequency of exercise which we are able to fit into our day. We have some pretty good ideas that reducing intake of high glycemic foods, safely reducing overall calorie intake, and getting regular exercise will help. However, it's the bad food which many families can most afford. Many people find it difficult to make time for exercise, since they are pretty exhausted from making a living. The foods which are bad for us tend to make us feel good in the short term. When a person has become obese, it is harder to start exercising, and it's harder to find exercises which don't hurt their feet, joints, back, or other parts of their body. Ideally, we would all have copious time to exercise, and healthy food would be abundant and affordable. But, that's generally not the case for most people. And some people seem to be genetically predisposed to gain weight.
- sirsinsalot 2y ago
  If you compare the typical American diet and ingredients to the rest of the world, the answer is clear. The problem is most Americans (where the obesity crisis is worst) don't know their country's businesses are selling them rubbish and their government is subsidising it.
cam_l 2y ago
I figure for some people it will work as a crutch and for some it will work as a prosthetic. I guess that depends on whether you need to take some weight off and allow yourself to heal, or if you are actually missing that appendage. Metaphorically.
nwienert 2y ago
> you will relapse with a vengeance You say this - but not from experience (correct me if I'm wrong and you have taken a GLP-1 agonist). I say this because as someone who has taken it, I found one of the craziest parts is how they do seem to help you set better habits, and those habits do stick, and it's not like some fake thing. For example MJ helped me do the following: entirely stopped late night snacking, stopped craving sweets, stop smoking weed. And it doesn't come back when I go off, even after months. I wasn't especially overweight when I went on (maybe 20lbs), I did it for the incredible immune system benefit which seem to heal my immune disorder, but I was stunned at the results outside of it. I get that people hate the idea of something that helps you be better without having to "put in work", but in the weirdest and best way possible, it seems to do that, at least in part.
- coffeebeqn 2y ago
  > people hate the idea of something that helps you be better without having to "put in work" This is kind of an incredible reaction many people seem to have. Isn’t this just a net positive? Even if someone feels like gatekeeping good health, ozempic is only giving you maybe 60% of the benefits of a healthy diet and regular exercise. It’s not taking anything away from people who put in the effort
  - golol 2y ago
    "Everything comes at a cost" as a meme is really deeply integrated in our culture. Since thousands of years probably.
homebrewer 2y ago
Yeah, no. Speaking of "personal discipline" makes it obvious you have never seriously dealt with addicts. Solving it long term is basically impossible for some of us; pretty sure because of how our brains are wired at the physical level. I know all the (popular) science, I discussed it with a good doctor whom I personally know, I know you're supposed to change your habits long-term (and how you're supposed to do it), and I recently lost 15 kgs of weight for the fourth time in my life. The longest time I managed to maintain healthy weight was maybe 3-4 years. If Ozempic (or whatever) actually solves this, I'm ready to go on it for the rest of my life. I also live in a "vodka belt" and know several alcoholics who tried very hard to maintain their "personal discipline". It's impossible for most of them -- almost all relapse in a few years' time.
- zero-sharp 2y ago
  I'm one of those people who has repeatedly lost weight by managing food intake. I'm talking about losing over 30 pounds, more than once. It might have been three times. Oh yea and I've kept it off for close to a decade now. I didn't use drugs. At times I used a food scale to manage portions. At times I literally just microwaved broccoli for a snack/meal. I still do it periodically if I'm feeling self-conscious. Does it suck? Yep. Have you guys ever tried those things? I mention this because I feel like you need somebody who has gone through the experience to actually have credibility in the conversation, to tell you that personal discipline is a real thing that can achieve results. I think it's ridiculous how quickly you dismissed the parent post.
  - mrcrumb1 2y ago
    At what point are you willing to concede that it might not be feasible for someone that isn't you? If it were 10% harder do you think you would have stuck through it? 50% harder? The numbers say the proportion of people who are successful is very small and there are sure a lot of people who are trying Edit: I'll add that I've successfully shed 100lbs through discipline before. With the life I currently as caretaker for my son I don't nearly as much room in my life for the mental overhead that sort of change in diet required me in the past.
cthalupa 2y ago
I'm someone that has spent many years of my life eating well and exercising regularly, including weightlifting. I'm also someone who has spent the past decade doing neither of those things, with one attempt in the middle to correct my behavior interrupted by a knee injury. I'm currently on tirzepatide and have also started to resume exercise, and I'm enjoying it like I did when I was younger - I expect I'll be able to go off of it when I get to my goal weight. But at the same time, there's not any real reason that people would need to go off the drugs, outside of cost. So far we don't see any adverse reactions in the vast majority of people. Some people have reactions from rapid weight loss - gallstones, hair loss, etc. but these are also risks in crash diets, etc. We accept that people will need lifelong medication (often with worse side effects) for other illnesses that have less risk to all cause mortality, etc., than obesity. Why would we be unwilling to do it for obesity? The fact of the matter is that despite the risks and downsides of obesity being well known in America, 42% of American adults are obese. No amount of education or knowledge that has gotten us on the whole to eat better or exercise more. Plainly, being on these GLP1 medications is preferable to being obese based on all current knowledge.
- CydeWeys 2y ago
  > The fact of the matter is that despite the risks and downsides of obesity being well known in America, 42% of American adults are obese. It's down to 40% and dropping now, thanks essentially solely to GLP1 agonists! This will, no lie, save our country trillions of dollars in increased years of quality of life (and thus productivity) and reduced healthcare costs.
slothtrop 2y ago
Yes, what's true and often understated about weight-loss is that people usually do lose weight when they decide to, but gain it back. Aside from lifestyle, metabolic adaptation is one factor. Since metabolism is lower, increasing calorie intake too quickly leads to weight-gain, and metabolism remains worse than it was before.
monkeycantype 2y ago
The genetics of hunger are fascinating, people literally feel very different levels of hunger. My family are mostly all quite fit and healthy, but this is because exercise and dieting are a cultural obsession in my family to an un-mentally healthy extent, because as I understand through conversation with others We feel an unusually high level of hunger, I can be full to bursting and hunger does not stop. I tried semaglutide, it was the first time I can recall ever feeling the absence of hunger. To think that my family and I are likely nowhere near the top of the hunger spectrum astonishes and horrified me
sheepscreek 2y ago
As someone very close to an Ozempic user, I can tell that you have no idea what you’re talking about. Would we consider insulin a crutch? Think of this as something in the same league. At least that is the case for a good chunk of the target audience.
mitjam 2y ago
It seems to be more like an orthosis than a crutch as it helps the body to get back into a healthy state instead of replacing it‘s functionality.
skywhopper 2y ago
Did you even read the top level comment here where the person addresses this? Anyway, this sort of moralizing is incredibly inhelpful. Very few people are obese because they lack “discipline”. Certainly they are no less disciplined than most non-obese folks in the world. All sorts of factors play into obesity that have nothing to do with “discipline”: genetics, gut microbiome, local environment, food availability, mental health, physical disease. There’s some small percentage of people for whom “discipline” is enough, but when people talk like you are with the implicit assumption that all fat people are lazy and immoral due to lack of “discipline”, you only reinforce the misinformation about the causes of obesity and make it harder to address novel causes with novel treatments.
legacynl 2y ago
Well that's the whole point of the novelty of this drug. This drug somehow effects our emotional resilience and/or the strength of our response to emotional decisions and/or the way our brain weighs different options regarding to long-term planing. Basically instead of your suggestion of not treating drugs as a crutch, and trying hard to restructure your life; this drug basically does exactly that. It gives you the decision making of a person that already did fight the addiction and restructured his life. The only thing then is for the person to actually restructure his life by living his newly well-decisioned life for a while. That's why it is sometimes bad advice to tell people not to use medicine as a 'crutch'. Just like actual crutches, they actually are meant to be able to temporarily support a person. If somebody needs a 'crutch' they should fully use it, especially if it can help them ultimately solve the need for the crutch. I get what you're trying to say with the crutch thing, but personally this kind of attitude prevented me from considering medication much earlier. Even though we all feel deep in our hearts that standing by yourself is better than relying on some crutch, nobody cares, and nobody is going to give you any bonuspoints if you make it to your death without any help. If any type of medication or treatment can help you, for the love of all that is good, use it.
nunez 2y ago
So I was, also, a firm believer of the "gotta fix your lifestyle" school of thought regarding weight management until I was introduced to the Maintenance Phase podcast (hosted by Aubrey Gordon and Michael Hobbes). This podcast, and Aubrey's book "What We Don't Talk About When We Talk About Fat," opened my eyes to the fact that many people are just _born_ hungrier than others. The body will weigh what the body wants to weigh, no matter how many fad diets or drugs you throw at it. Unfortunately, those whose bodies that don't conform to our modern, eugenicized definition of "healthy" and don't particularly care for working out at all times are dealt a lifelong sentence of social ostracizing, "have you tried this diet" and "calories in, calories out," mostly against their will. To wit: I can easily scarf down 3000+ calories per day. EASILY. I also know people who struggle to eat 2000 calories per day. I've seen this dynamic with kids in the same family as well. I'm not saying that it's impossible to make healthier choices. Everyone can benefit from a balanced diet and more exercise. I'm saying that some people will naturally be heavier than others, and that should be okay.

by Alupis 2y ago

JamesBarney 2y ago

>If you do not change your lifestyle, for real and not just superficially, then you will relapse with a vengeance. Longterm glp-1 agonist research doesn't agree with this. > but you have to continue that lifestyle after stopping the drug. Why stop the drug? >Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss? A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic.

Alupis 2y ago
> Why stop the drug? Why would you want to continue using a drug for the rest of your life? > Longterm glp-1 agonist research doesn't agree with this. Please explain. If you stop using the drug, because you've achieved your goals, what stops you from relapsing other than your own personal habits and lifestyle? > A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic. Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years.
- JamesBarney 2y ago
  > Why would you want to continue using a drug for the rest of your life? It's better than being obese. This is true of most drugs for chronic conditions. very few of them are curative, almost all of them treat the condition. > Longterm glp-1 agonist research doesn't agree with this. Sorry I wasn't clear, I meant with continued treatment you don't rebound. > Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years. They might have negative side effects but obesity has very large negative side effects. I would be incredibly surprised if any of these drugs that have been used in diabetes treatment for a long time have anywhere close to the negative side effects of obesity.
  - Alupis 2y ago
    [flagged]
    - catlikesshrimp 2y ago
      False. (All) People crave for food. Some people have stronger craving than others. In healthy people you call it "hunger". In obese people it is more like an addiction. Do you know people can be addictes to sex and to work, too? If you insist on the choice argument, the only way an addict can stop consuming is locking himself in a room and throwing away the key. Other than that, much help is needed, many changes are needed, and even chemicals are needed. "Choice" is victim blaming
      - gooosle 2y ago
        All you're saying is the it's harder to make some choices depending on situation. They are still 100% choices. Choices don't have to be trivially easy.
    - JamesBarney 2y ago
      How much less likely do you think someone with high self control is to not be obese? 12%. Which shows that your intuitions about obesity and the causes are probably wrong. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717171/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717171/
data_spy 2y ago
The research says you gain the weight back: "For the two in every five patients who discontinue the treatments within a year, according to a 2024 JAMA study, this means that they are likely to rebound to their original weight with less muscle and a higher body fat percentage." The other issue is the muscle loss on being on these drugs as "Clinical data shows that 25 per cent of weight loss from Eli Lilly’s shot resulted from a reduction in lean body mass, including muscle, while 40 per cent of Novo Nordisk’s jab was due to a drop in lean body mass." Via https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2dea9 https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2d...
- JamesBarney 2y ago
  Sorry I meant with continued use of the treatment you don't regain the weight. I agree if you stop taking the medication your weight will rebound.
  - Alupis 2y ago
    Right, so we doom some portion of the population to forever take a pill from big pharma? How is that acceptable with anyone? The goal should be to use Ozempic until you are in a better place to manage things yourself. The goal should not be to get people hooked on Ozempic for their entire lives. Perhaps Ozempic prescriptions should come with prescribed exercise with check-in and monitoring, or something.
    - rootusrootus 2y ago
      > doom some portion of the population to forever take a pill from big pharma That is temporary. The effects are real. The fact that you don't think big pharma should profit handsomely for making it happen is not the only alternative. Before too long semaglutide, as one example, will be out of patent and available as a generic. It won't cost a thousand bucks a month to big pharma, it'll be practically free. Cheap enough that most insurance plans will likely subsidize it all the way to zero out-of-pocket cost just because the ROI is so good.
    - 2y ago
lizardlena 2y ago
> A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. Ozempic is only fighting symptoms of that, not the root of the problem which is the stigma around weightgain, being a big person, just fatphobia being extremly generalized and a lot of shame surrounding weight. While it's amazing for people who have medical conditions making them gain a lot of weight, just saying that they should take ozempic will not change people gaining too much weight. It's not anything like high cholesterol or high blood sugar in most cases.
- JamesBarney 2y ago
  Fighting the symptoms of what? Taking ozempic will definitely keep people from gaining weight and will help them lose weight.
- Eisenstein 2y ago
  A few questions: Can you qualify what you consider to be a 'symptom' vs a 'condition'? Is high cholesterol a symptom of something, or a condition itself? What about high blood sugar? Would you say that acid reflux is a symptom or a condition? Is a person that takes Prilosec daily to treat bad reflux treating the symptoms and not the underlying condition? What about people using asthma inhalers, or epipens: symptom or condition? Are people allowed to use the medicines if their underlying conditions are not being treated?
- fortran77 2y ago
  > While it's amazing for people who have medical conditions making them gain a lot of weight, You mean matter is created out of thin air because of a "medical condition" and not by eating too much food?
justinclift 2y ago
> ... if they have high blood sugar we give them diabetes. That sounds like a hell of a treatment plan. o_O
- bregma 2y ago
  It doesn't work. I keep trying to get off the diabetes and I just relapse after a few weeks. It doesn't help that my body tries to hide the glucose everywhere, like attached to hemoglobin or in my liver in the form of glycogen so it can share a hit with me first thing every morning. Nope, not going back to the doctor that gave me diabetes. That was a mistake.

perching_aix 2y ago

Sounds like it directly affects their lifestyle though? Being less drawn to addictions, and thus less engaged in related activities, is a pretty big lifestyle change.

Alupis 2y ago
> Being less drawn to addictions, and thus less engaged in related activities, is a pretty big lifestyle change While on the drug. Will those changes remain if the user stops using the drug?
- Someone1234 2y ago
  What is the core of your point? That these drugs, that extend life, and reduce associated illnesses should be ignored or not used, because instead people can die sooner in some attempt to cure themselves the "correct" way? A corpse cannot learn healthy lifestyle habits. A living person who lost weight the immoral way or whatever you're trying to say, can of course.
  - Alupis 2y ago
    The point is you still need to develop a lifestyle that is healthy. The drug isn't a miracle, it's a band aid. If you do not change your lifestyle, and you discontinue using this drug, you will relapse. This is the same issue many people face when they diet as well, so it is nothing new. The point of my saying this is to point that out, because a lot of people in this thread seem to think it is totally ok to be on an Ozempic prescription for your entire life. That's horrifying for so many reasons. Others seem to think you take Ozempic until you're "cured" then you just live happily ever after. That's hardly going to be the case for many people who have struggled with weight for their entire lives.
    - rixed 2y ago
      I think we hear you, we should all take more care about bad lifestyle, everybody should exercise regularly and eat healthy food. But to be fair nobody has promoted a bad lifestyle, or said that, given there is this new drug let's care even less. At the contrary, given the testimonies it sounds like the drug helps people to adopt better habits, no?

Someone1234 2y ago

> Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss? Have alcoholics using Naltrexone? Or opioid addicts using Methadone, or smokers using nicotine gum/patches? See I'm bringing this up to point out the obvious double standard, people suffering from food addiction (i.e. literally the high from food) or binge-eating disorder, who finally have an effective treatment, are treated like it isn't addiction or illness, but a "lifestyle," but if you said this stuff about any other addiction people would call you out and be horrified. For people mildy overweight or accidentally obese, it is a wildly different illness for people with lifetime problems who have lost/regained weight tens of times and likely know more about nutrition than most healthy-weight people ever will.

Alupis 2y ago
This is bunk. An actual chemical addiction is not the same as feeling an urge to drink 8 cans of coke a day, or being unable to not buy a bag of chips at the gas station.
- ben_w 2y ago
  Is it, though? Your entire body and brain is a complex and messy chemical reaction. The opening sentence of the wikipedia article on addiction currently reads: "Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences." The page then lists "eating or food addiction" as examples, with food addiction being its own entire page.
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jrockway 2y ago

I don't think you expect to stop taking the drug. It's a for-life kind of thing. If a prescription for "lifestyle changes" were a drug, it would be one of the least effective drugs ever made. I read something directed at medical professionals that are skeptical of the GLP-1 receptor agonists and it asks, if you prescribe a drug and your patient refuses to take it, why would you keep prescribing that drug? Of course not. That's what lifestyle changes are, and the landscape has changed so that there are alternatives. (My employer is heavy on the "lifestyle changes" angle. They will not pay for GLP-1s, but they will send you a newsletter about losing weight if you want. Guess who's losing the weight.)

metabagel 2y ago

> The problem with this (and all diet plans/drugs) is the lifestyle that led to problem in the first place. I don't think we fully know what led to the problem in the first place. I think it's a complex interaction between the types of foods we eat, and which are more affordable, our gut microbiome, and the amount and frequency of exercise which we are able to fit into our day. We have some pretty good ideas that reducing intake of high glycemic foods, safely reducing overall calorie intake, and getting regular exercise will help. However, it's the bad food which many families can most afford. Many people find it difficult to make time for exercise, since they are pretty exhausted from making a living. The foods which are bad for us tend to make us feel good in the short term. When a person has become obese, it is harder to start exercising, and it's harder to find exercises which don't hurt their feet, joints, back, or other parts of their body. Ideally, we would all have copious time to exercise, and healthy food would be abundant and affordable. But, that's generally not the case for most people. And some people seem to be genetically predisposed to gain weight.

sirsinsalot 2y ago
If you compare the typical American diet and ingredients to the rest of the world, the answer is clear. The problem is most Americans (where the obesity crisis is worst) don't know their country's businesses are selling them rubbish and their government is subsidising it.

cam_l 2y ago

I figure for some people it will work as a crutch and for some it will work as a prosthetic. I guess that depends on whether you need to take some weight off and allow yourself to heal, or if you are actually missing that appendage. Metaphorically.

nwienert 2y ago

> you will relapse with a vengeance You say this - but not from experience (correct me if I'm wrong and you have taken a GLP-1 agonist). I say this because as someone who has taken it, I found one of the craziest parts is how they do seem to help you set better habits, and those habits do stick, and it's not like some fake thing. For example MJ helped me do the following: entirely stopped late night snacking, stopped craving sweets, stop smoking weed. And it doesn't come back when I go off, even after months. I wasn't especially overweight when I went on (maybe 20lbs), I did it for the incredible immune system benefit which seem to heal my immune disorder, but I was stunned at the results outside of it. I get that people hate the idea of something that helps you be better without having to "put in work", but in the weirdest and best way possible, it seems to do that, at least in part.

coffeebeqn 2y ago
> people hate the idea of something that helps you be better without having to "put in work" This is kind of an incredible reaction many people seem to have. Isn’t this just a net positive? Even if someone feels like gatekeeping good health, ozempic is only giving you maybe 60% of the benefits of a healthy diet and regular exercise. It’s not taking anything away from people who put in the effort
- golol 2y ago
  "Everything comes at a cost" as a meme is really deeply integrated in our culture. Since thousands of years probably.

homebrewer 2y ago

Yeah, no. Speaking of "personal discipline" makes it obvious you have never seriously dealt with addicts. Solving it long term is basically impossible for some of us; pretty sure because of how our brains are wired at the physical level. I know all the (popular) science, I discussed it with a good doctor whom I personally know, I know you're supposed to change your habits long-term (and how you're supposed to do it), and I recently lost 15 kgs of weight for the fourth time in my life. The longest time I managed to maintain healthy weight was maybe 3-4 years. If Ozempic (or whatever) actually solves this, I'm ready to go on it for the rest of my life. I also live in a "vodka belt" and know several alcoholics who tried very hard to maintain their "personal discipline". It's impossible for most of them -- almost all relapse in a few years' time.

zero-sharp 2y ago
I'm one of those people who has repeatedly lost weight by managing food intake. I'm talking about losing over 30 pounds, more than once. It might have been three times. Oh yea and I've kept it off for close to a decade now. I didn't use drugs. At times I used a food scale to manage portions. At times I literally just microwaved broccoli for a snack/meal. I still do it periodically if I'm feeling self-conscious. Does it suck? Yep. Have you guys ever tried those things? I mention this because I feel like you need somebody who has gone through the experience to actually have credibility in the conversation, to tell you that personal discipline is a real thing that can achieve results. I think it's ridiculous how quickly you dismissed the parent post.
- mrcrumb1 2y ago
  At what point are you willing to concede that it might not be feasible for someone that isn't you? If it were 10% harder do you think you would have stuck through it? 50% harder? The numbers say the proportion of people who are successful is very small and there are sure a lot of people who are trying Edit: I'll add that I've successfully shed 100lbs through discipline before. With the life I currently as caretaker for my son I don't nearly as much room in my life for the mental overhead that sort of change in diet required me in the past.

cthalupa 2y ago

I'm someone that has spent many years of my life eating well and exercising regularly, including weightlifting. I'm also someone who has spent the past decade doing neither of those things, with one attempt in the middle to correct my behavior interrupted by a knee injury. I'm currently on tirzepatide and have also started to resume exercise, and I'm enjoying it like I did when I was younger - I expect I'll be able to go off of it when I get to my goal weight. But at the same time, there's not any real reason that people would need to go off the drugs, outside of cost. So far we don't see any adverse reactions in the vast majority of people. Some people have reactions from rapid weight loss - gallstones, hair loss, etc. but these are also risks in crash diets, etc. We accept that people will need lifelong medication (often with worse side effects) for other illnesses that have less risk to all cause mortality, etc., than obesity. Why would we be unwilling to do it for obesity? The fact of the matter is that despite the risks and downsides of obesity being well known in America, 42% of American adults are obese. No amount of education or knowledge that has gotten us on the whole to eat better or exercise more. Plainly, being on these GLP1 medications is preferable to being obese based on all current knowledge.

CydeWeys 2y ago
> The fact of the matter is that despite the risks and downsides of obesity being well known in America, 42% of American adults are obese. It's down to 40% and dropping now, thanks essentially solely to GLP1 agonists! This will, no lie, save our country trillions of dollars in increased years of quality of life (and thus productivity) and reduced healthcare costs.

slothtrop 2y ago

Yes, what's true and often understated about weight-loss is that people usually do lose weight when they decide to, but gain it back. Aside from lifestyle, metabolic adaptation is one factor. Since metabolism is lower, increasing calorie intake too quickly leads to weight-gain, and metabolism remains worse than it was before.

monkeycantype 2y ago

The genetics of hunger are fascinating, people literally feel very different levels of hunger. My family are mostly all quite fit and healthy, but this is because exercise and dieting are a cultural obsession in my family to an un-mentally healthy extent, because as I understand through conversation with others We feel an unusually high level of hunger, I can be full to bursting and hunger does not stop. I tried semaglutide, it was the first time I can recall ever feeling the absence of hunger. To think that my family and I are likely nowhere near the top of the hunger spectrum astonishes and horrified me

sheepscreek 2y ago

As someone very close to an Ozempic user, I can tell that you have no idea what you’re talking about. Would we consider insulin a crutch? Think of this as something in the same league. At least that is the case for a good chunk of the target audience.

mitjam 2y ago

It seems to be more like an orthosis than a crutch as it helps the body to get back into a healthy state instead of replacing it‘s functionality.

skywhopper 2y ago

Did you even read the top level comment here where the person addresses this? Anyway, this sort of moralizing is incredibly inhelpful. Very few people are obese because they lack “discipline”. Certainly they are no less disciplined than most non-obese folks in the world. All sorts of factors play into obesity that have nothing to do with “discipline”: genetics, gut microbiome, local environment, food availability, mental health, physical disease. There’s some small percentage of people for whom “discipline” is enough, but when people talk like you are with the implicit assumption that all fat people are lazy and immoral due to lack of “discipline”, you only reinforce the misinformation about the causes of obesity and make it harder to address novel causes with novel treatments.

legacynl 2y ago

Well that's the whole point of the novelty of this drug. This drug somehow effects our emotional resilience and/or the strength of our response to emotional decisions and/or the way our brain weighs different options regarding to long-term planing. Basically instead of your suggestion of not treating drugs as a crutch, and trying hard to restructure your life; this drug basically does exactly that. It gives you the decision making of a person that already did fight the addiction and restructured his life. The only thing then is for the person to actually restructure his life by living his newly well-decisioned life for a while. That's why it is sometimes bad advice to tell people not to use medicine as a 'crutch'. Just like actual crutches, they actually are meant to be able to temporarily support a person. If somebody needs a 'crutch' they should fully use it, especially if it can help them ultimately solve the need for the crutch. I get what you're trying to say with the crutch thing, but personally this kind of attitude prevented me from considering medication much earlier. Even though we all feel deep in our hearts that standing by yourself is better than relying on some crutch, nobody cares, and nobody is going to give you any bonuspoints if you make it to your death without any help. If any type of medication or treatment can help you, for the love of all that is good, use it.

nunez 2y ago

So I was, also, a firm believer of the "gotta fix your lifestyle" school of thought regarding weight management until I was introduced to the Maintenance Phase podcast (hosted by Aubrey Gordon and Michael Hobbes). This podcast, and Aubrey's book "What We Don't Talk About When We Talk About Fat," opened my eyes to the fact that many people are just _born_ hungrier than others. The body will weigh what the body wants to weigh, no matter how many fad diets or drugs you throw at it. Unfortunately, those whose bodies that don't conform to our modern, eugenicized definition of "healthy" and don't particularly care for working out at all times are dealt a lifelong sentence of social ostracizing, "have you tried this diet" and "calories in, calories out," mostly against their will. To wit: I can easily scarf down 3000+ calories per day. EASILY. I also know people who struggle to eat 2000 calories per day. I've seen this dynamic with kids in the same family as well. I'm not saying that it's impossible to make healthier choices. Everyone can benefit from a balanced diet and more exercise. I'm saying that some people will naturally be heavier than others, and that should be okay.