4 ms·

I was not talking about your personal experience. You may have actually benefitted from the main intended pharmacological effects of this drug, since it appears

I was not talking about your personal experience. You may have actually benefitted from the main intended pharmacological effects of this drug, since it appears to be affecting your metabolism (your "body holds onto weight" comment suggests that). This is a diabetes drug, remember. The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food. Our societal-level response is to treat it with a drug rather than helping people who really do have significant willpower problems overcoming their lack of discipline. There are hugely beneficial approaches that rely on CBT, for example, but are relatively controversial because of "weightism" concerns.

borski 2y ago
> The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food. Citation needed. This is the main assumption you are making that I, and others, vehemently disagree with. The implication is that this is the first time people have suddenly decided they don’t like being obese. That’s absurd. The people on these medications have tried everything. Talk to literally any obesity doctor and ask them about their patients. This assumption is the problem. Nothing about the meds is easy. It just makes it possible for people to change when they couldn’t before. I don’t know why people feel a need to argue against that. > Our societal-level response is to treat it with a drug rather than helping people who really do have significant willpower problems overcoming their lack of discipline. There are hugely beneficial approaches that rely on CBT, for example, but are relatively controversial because of "weightism" concerns. Sure, and I don’t disagree. And I’m all for people doing that too. If it works, great! On average, it doesn’t, for the vast majority of people, though it does work for some, and that’s great. I agree it’s a preferable approach. But if it worked for most people, it would have worked. But if it doesn’t work? Previously, people just accepted that they were going to be obese and miserable, and that it was their fault, which led to depression, etc., further making it “impossible” to ever fix. So if there is a medication that helps people change their lifestyle to get healthy, and also appears to be extremely effective, and has a good safety profile… that’s bad?
- pclmulqdq 2y ago
  > The people on these medications have tried everything. Talk to literally any obesity doctor and ask them about their patients. Citation needed on this one. Almost all the obese people I know have never seen a specialist doctor about it, so I assume your anecdata have selection bias. The people who see obesity doctors are the ones who have tried everything. Not the average obese person. I don't personally mind if you or anyone who really needs it and gets prescribed the thing by a specialist takes Ozempic. I don't think any drug use, be it Ozempic, abortion pills, or estrogen, should be stigmatized for the individuals taking it. I do think it's a sign of a societal ill that a large majority of the people taking Ozempic are not in that situation.
  - borski 2y ago
    > Citation needed on this one. Almost all the obese people I know have never seen a specialist doctor about it, so I assume your anecdata have selection bias. You sure? Nearly every single one I know has seen their primary about it every time they go in and if the primary referred them to a specialist they went. What they don’t do, though, is talk about it. Have you asked them? > I don't personally mind if you or anyone who really needs it and gets prescribed the thing by a specialist takes Ozempic. I don't think any drug use, be it Ozempic, abortion pills, or estrogen, should be stigmatized for the individuals taking it. Great, agreed. > I do think it's a sign of a societal ill that a large majority of the people taking Ozempic are not in that situation. I don’t think it’s true that “a large majority” of the people taking it are just handed the pills for fun, to lose a few pounds. Your assumption about to whom they are prescribed is my whole issue, as it assumes they don’t need it to lose weight and can “just eat right and work out,” and that is not true. People who are obese don’t like being obese. They aren’t that way because they don’t care. They aren’t that way because they are lazy. (On average)
CydeWeys 2y ago
> This is a diabetes drug, remember. No, Wegovy and Zepbound are not diabetes drugs. They are weight loss drugs. > ... but problems with controlling themselves around food. Problems that Wegovy and Zepbound solve for most people taking them, when no other solution worked for those people. > There are hugely beneficial approaches that rely on CBT, CBT is much more expensive, time-intensive, and less effective for weight loss than GLP-1 drugs. It also scales incredibly poorly, as you need a huge number of therapists. There are roughly a hundred million obese Americans. We can make enough drugs to treat all them, but can we make and pay for several million therapists to perform CBT on all of them, all for less efficacy than the GLP-1 agonists? Fat chance.
- borski 2y ago
  > No, Wegovy and Zepbound are not diabetes drugs. They are weight loss drugs. Moreover… who cares? Viagra was a failed angina treatment. Valium was originally a dye So?
  - CydeWeys 2y ago
    Exactly! For many drugs it's essentially a funny accident of history that they were originally discovered while attempting to cure something completely unrelated to what is now their primary usage.
alan-hn 2y ago
>The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food Quite frankly this is an incredibly absurd statement. Do you realize that our brains entirely control our behavior? An issue with self control is a brain issue, and very well may be an endocrine issue. Are you an endocrinologist?

borski 2y ago

> The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food. Citation needed. This is the main assumption you are making that I, and others, vehemently disagree with. The implication is that this is the first time people have suddenly decided they don’t like being obese. That’s absurd. The people on these medications have tried everything. Talk to literally any obesity doctor and ask them about their patients. This assumption is the problem. Nothing about the meds is easy. It just makes it possible for people to change when they couldn’t before. I don’t know why people feel a need to argue against that. > Our societal-level response is to treat it with a drug rather than helping people who really do have significant willpower problems overcoming their lack of discipline. There are hugely beneficial approaches that rely on CBT, for example, but are relatively controversial because of "weightism" concerns. Sure, and I don’t disagree. And I’m all for people doing that too. If it works, great! On average, it doesn’t, for the vast majority of people, though it does work for some, and that’s great. I agree it’s a preferable approach. But if it worked for most people, it would have worked. But if it doesn’t work? Previously, people just accepted that they were going to be obese and miserable, and that it was their fault, which led to depression, etc., further making it “impossible” to ever fix. So if there is a medication that helps people change their lifestyle to get healthy, and also appears to be extremely effective, and has a good safety profile… that’s bad?

pclmulqdq 2y ago
> The people on these medications have tried everything. Talk to literally any obesity doctor and ask them about their patients. Citation needed on this one. Almost all the obese people I know have never seen a specialist doctor about it, so I assume your anecdata have selection bias. The people who see obesity doctors are the ones who have tried everything. Not the average obese person. I don't personally mind if you or anyone who really needs it and gets prescribed the thing by a specialist takes Ozempic. I don't think any drug use, be it Ozempic, abortion pills, or estrogen, should be stigmatized for the individuals taking it. I do think it's a sign of a societal ill that a large majority of the people taking Ozempic are not in that situation.
- borski 2y ago
  > Citation needed on this one. Almost all the obese people I know have never seen a specialist doctor about it, so I assume your anecdata have selection bias. You sure? Nearly every single one I know has seen their primary about it every time they go in and if the primary referred them to a specialist they went. What they don’t do, though, is talk about it. Have you asked them? > I don't personally mind if you or anyone who really needs it and gets prescribed the thing by a specialist takes Ozempic. I don't think any drug use, be it Ozempic, abortion pills, or estrogen, should be stigmatized for the individuals taking it. Great, agreed. > I do think it's a sign of a societal ill that a large majority of the people taking Ozempic are not in that situation. I don’t think it’s true that “a large majority” of the people taking it are just handed the pills for fun, to lose a few pounds. Your assumption about to whom they are prescribed is my whole issue, as it assumes they don’t need it to lose weight and can “just eat right and work out,” and that is not true. People who are obese don’t like being obese. They aren’t that way because they don’t care. They aren’t that way because they are lazy. (On average)

CydeWeys 2y ago

> This is a diabetes drug, remember. No, Wegovy and Zepbound are not diabetes drugs. They are weight loss drugs. > ... but problems with controlling themselves around food. Problems that Wegovy and Zepbound solve for most people taking them, when no other solution worked for those people. > There are hugely beneficial approaches that rely on CBT, CBT is much more expensive, time-intensive, and less effective for weight loss than GLP-1 drugs. It also scales incredibly poorly, as you need a huge number of therapists. There are roughly a hundred million obese Americans. We can make enough drugs to treat all them, but can we make and pay for several million therapists to perform CBT on all of them, all for less efficacy than the GLP-1 agonists? Fat chance.

borski 2y ago
> No, Wegovy and Zepbound are not diabetes drugs. They are weight loss drugs. Moreover… who cares? Viagra was a failed angina treatment. Valium was originally a dye So?
- CydeWeys 2y ago
  Exactly! For many drugs it's essentially a funny accident of history that they were originally discovered while attempting to cure something completely unrelated to what is now their primary usage.

alan-hn 2y ago

>The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food Quite frankly this is an incredibly absurd statement. Do you realize that our brains entirely control our behavior? An issue with self control is a brain issue, and very well may be an endocrine issue. Are you an endocrinologist?