11 ms·

Not sarcasm: I'm sure it would be frustrating to see so much scientific and commercial effort going into treating TIID pharmacologically when you believe the so

by sctb 2y ago

Not sarcasm: I'm sure it would be frustrating to see so much scientific and commercial effort going into treating TIID pharmacologically when you believe the solution is trivial. But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful.

jasonpeacock 2y ago
100% agree, it's a modern cultural problem. We look for drug and technology solutions because "doing the right thing" is hard.
- baq 2y ago
  GLP-1 drugs don’t make you burn fat, they make you eat healthy (or healthier, at least). That’s why they’re so amazingly effective and the reason why is even more amazing - they hack your reward subsystem.
  - nradov 2y ago
    GLP-1 drugs seem to increase resting heart rate. I suspect that also increases total daily energy expenditure, although I don't know that we have reliable data on that yet.
    - rootusrootus 2y ago
      That can happen, but is not universal. My resting heart rate has been dropping (probably in lock step with my weight), it has not risen one bit since I started taking tirzepatide. And my heart rate variability has been trending up, not down. Why do you suspect it changes energy expenditure?
- mapt 2y ago
  When you say "it's a modern cultural problem", do you mean, as most people appear to mean, "This is not a social problem worth solving, these people deserve it for their moral failings, and their death is a useful example for the rest of us"? Most people don't actually say it out loud, but this is all directly implied by the "personal responsibility" retort that is wildly popular among people who don't actually suffer from a given malady, in response to attempts to address it collectively.
  - s1artibartfast 2y ago
    not OP, but I agree it is modern cultural problem and a personal responsibility problem. However, I dont agree with your supposition following from that. I think that obesity is a symptom of a cultural problem worth solving, not an individual moral failing, and there are better ways to learn than death. There are lots of things in our culture that result in physical and mental sickness. It is good to treat the symptoms, but we should also pay attention to the cause. Culture operates both at the individual and collective level. One can not exist without the other. One can not change without changing the other. Personal beliefs and actions shape collective culture, and culture shapes personal beliefs.
    - rootusrootus 2y ago
      Biologically, obesity could be seen as a win. It is the natural consequence of the human body's strategy for finding enough sustenance to drive that big brain over an evolutionary timeline that was mostly dominated by scarcity. We like to call it a disease because we want to live longer. But all of the consequences happen after most humans have procreated, so there is no evolutionary pressure[0] to change it. [0] Yes, I understand evolution isn't quite that simple
      - nradov 2y ago
        Obesity reduces fertility for both sexes. This is one of the factors behind declining birth rates.
        consteval 2y ago
        Our bodies and responses were "designed" for such a system where obesity is impossible. The mechanisms that power obesity are vital for the survival of the human race. The agriculture revolution only happened 10,000 years ago. This is all very new to us.
        nradov 2y ago
- soganess 2y ago
  Friendly fwiw: Your parent clearly does not think it is a "modern cultural problem": > "when _you_ believe the solution is trivial" (emphasis mine) They were trying to start a polite dialogue with you by displaying that they could see things from your purview. Probably with the hope of building common-ground that would, in turn, invite you to maybe see the other side: > "But you could also consider..." Perhaps reconsider their olive branch?
- Spooky23 2y ago
  We have government policy that reshaped American agriculture 70 years ago to lower the cost curve for food. That was accomplished by industrialization of food production. That drives Americans to eat the way they do. Travel to Italy or France and the difference is shocking — both in terms of the look of the people and the quality of the food.
  - s1artibartfast 2y ago
    There are also very relevant cultural differences between the French and Americans. It is not just the food on the shelves, or price, but healthy attitudes and behavior around eating and life in general. The average American is 50% richer than the average French, and have access to everything they need to eat like one if they choose. In fact, much of the difference is the French choosing not to eat - both in terms of frequency and quantity. Healthy food attitudes can absolutely be learned and taught. If you see a 200lb 10 year old, the difference between them and their classmates isn't the contents of the supermarket. Its what is going on at home, the actions of their parents, and what they are learning. I say this not to blame or pass judgement, but to demonstrate that induvial behavior and actions matter.
meiraleal 2y ago
> But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful. As programmers, we usually prefer to remove code to fix a bug than adding patches on top of buggy code. Let's not pretend that the same logic does not apply here. That's clearly double unhealthy behavior and will bring unintended consequences. Which might be better than the current predicament but still let's not pretend this is not a "monkeypatch".
- consteval 2y ago
  > That's clearly double unhealthy behavior and will bring unintended consequences Consider: GPL-1 inhibitors are actually root-cause solutions, and diet/exercise are not root cause solutions. That's because the cause of obesity is not eating. The cause of obesity is a propensity to overeat. The cause begins in your brain and automatic responses, not on the table or the gym. That's why you and I can eat, be satisfied, and not be obese. Diet/exercise doesn't address the root cause. It fixes the symptom - obesity. But those people are still addicts, and if they fall off then they're off and will become obese again, much like an alcoholic. This diet "rubber banding" is extremely common. Ozempic and others address the root cause, by lowering the desire or propensity to eat, perhaps closer to that of someone with a normal brain and normal regulation.
  - meiraleal 2y ago
    > That's why you and I can eat, be satisfied, and not be obese. Who said so?! I have been obese (clinically, BMI) multiple times. And all the time I got back to overweight then normal weight by exercising and eating less (than what I wanted! Because eating until I feel like exploding is so good). > Consider: GPL-1 inhibitors are actually root-cause solutions, and diet/exercise are not root cause solutions. False. Overeating is caused by lack of movement and bad diet. There is no point in discuss the rest starting from a completely wrong point.
    - consteval 2y ago
      > Overeating is caused by lack of movement and bad diet Is this some kind of joke? A bad diet doesn't cause overeating - overeating IS the bad diet. Also not moving doesn't cause overeating, because how could it? What, I sit down and suddenly a burrito appears in my hands? The cause of overeating is a propensity to overconsume, i.e. you have an addiction. Diet and exercise address the SYMPTOMS, but not the ROOT CAUSE. You STILL have an addiction. In the exact same way someone who is sober is STILL an alcoholic. Because drinking alcohol is not actually the root cause of alcoholism. The root cause is an addiction to alcohol. You can't get rid of the addiction, but you can treat the symptoms - by never drinking, by being sober. But you did not address the root cause. By my logical analysis, I conclude GLP-1 inhibitors better address the root cause than diet and exercise. To further strengthen my point, you've more or less admitted this by pointed out you've been obese "multiple times". If you had addressed the root cause this would be impossible! But you did not address the root cause but merely the symptoms via diet and exercise. You still had the addiction, so when you slipped you became obese again. This cannot happen while taking a GLP-1 inhibitor because you no longer have the extreme desire to eat. Even when you lost weight, you still had the extreme desire to eat.

by sctb 2y ago

jasonpeacock 2y ago

100% agree, it's a modern cultural problem. We look for drug and technology solutions because "doing the right thing" is hard.

baq 2y ago
GLP-1 drugs don’t make you burn fat, they make you eat healthy (or healthier, at least). That’s why they’re so amazingly effective and the reason why is even more amazing - they hack your reward subsystem.
- nradov 2y ago
  GLP-1 drugs seem to increase resting heart rate. I suspect that also increases total daily energy expenditure, although I don't know that we have reliable data on that yet.
  - rootusrootus 2y ago
    That can happen, but is not universal. My resting heart rate has been dropping (probably in lock step with my weight), it has not risen one bit since I started taking tirzepatide. And my heart rate variability has been trending up, not down. Why do you suspect it changes energy expenditure?
mapt 2y ago
When you say "it's a modern cultural problem", do you mean, as most people appear to mean, "This is not a social problem worth solving, these people deserve it for their moral failings, and their death is a useful example for the rest of us"? Most people don't actually say it out loud, but this is all directly implied by the "personal responsibility" retort that is wildly popular among people who don't actually suffer from a given malady, in response to attempts to address it collectively.
- s1artibartfast 2y ago
  not OP, but I agree it is modern cultural problem and a personal responsibility problem. However, I dont agree with your supposition following from that. I think that obesity is a symptom of a cultural problem worth solving, not an individual moral failing, and there are better ways to learn than death. There are lots of things in our culture that result in physical and mental sickness. It is good to treat the symptoms, but we should also pay attention to the cause. Culture operates both at the individual and collective level. One can not exist without the other. One can not change without changing the other. Personal beliefs and actions shape collective culture, and culture shapes personal beliefs.
  - rootusrootus 2y ago
    Biologically, obesity could be seen as a win. It is the natural consequence of the human body's strategy for finding enough sustenance to drive that big brain over an evolutionary timeline that was mostly dominated by scarcity. We like to call it a disease because we want to live longer. But all of the consequences happen after most humans have procreated, so there is no evolutionary pressure[0] to change it. [0] Yes, I understand evolution isn't quite that simple
    - nradov 2y ago
      Obesity reduces fertility for both sexes. This is one of the factors behind declining birth rates.
      - consteval 2y ago
        Our bodies and responses were "designed" for such a system where obesity is impossible. The mechanisms that power obesity are vital for the survival of the human race. The agriculture revolution only happened 10,000 years ago. This is all very new to us.
        nradov 2y ago
soganess 2y ago
Friendly fwiw: Your parent clearly does not think it is a "modern cultural problem": > "when _you_ believe the solution is trivial" (emphasis mine) They were trying to start a polite dialogue with you by displaying that they could see things from your purview. Probably with the hope of building common-ground that would, in turn, invite you to maybe see the other side: > "But you could also consider..." Perhaps reconsider their olive branch?
Spooky23 2y ago
We have government policy that reshaped American agriculture 70 years ago to lower the cost curve for food. That was accomplished by industrialization of food production. That drives Americans to eat the way they do. Travel to Italy or France and the difference is shocking — both in terms of the look of the people and the quality of the food.
- s1artibartfast 2y ago
  There are also very relevant cultural differences between the French and Americans. It is not just the food on the shelves, or price, but healthy attitudes and behavior around eating and life in general. The average American is 50% richer than the average French, and have access to everything they need to eat like one if they choose. In fact, much of the difference is the French choosing not to eat - both in terms of frequency and quantity. Healthy food attitudes can absolutely be learned and taught. If you see a 200lb 10 year old, the difference between them and their classmates isn't the contents of the supermarket. Its what is going on at home, the actions of their parents, and what they are learning. I say this not to blame or pass judgement, but to demonstrate that induvial behavior and actions matter.

meiraleal 2y ago

> But you could also consider all of these developments as evidence that the prescription of "just eat healthy" isn't broadly useful. As programmers, we usually prefer to remove code to fix a bug than adding patches on top of buggy code. Let's not pretend that the same logic does not apply here. That's clearly double unhealthy behavior and will bring unintended consequences. Which might be better than the current predicament but still let's not pretend this is not a "monkeypatch".

consteval 2y ago
> That's clearly double unhealthy behavior and will bring unintended consequences Consider: GPL-1 inhibitors are actually root-cause solutions, and diet/exercise are not root cause solutions. That's because the cause of obesity is not eating. The cause of obesity is a propensity to overeat. The cause begins in your brain and automatic responses, not on the table or the gym. That's why you and I can eat, be satisfied, and not be obese. Diet/exercise doesn't address the root cause. It fixes the symptom - obesity. But those people are still addicts, and if they fall off then they're off and will become obese again, much like an alcoholic. This diet "rubber banding" is extremely common. Ozempic and others address the root cause, by lowering the desire or propensity to eat, perhaps closer to that of someone with a normal brain and normal regulation.
- meiraleal 2y ago
  > That's why you and I can eat, be satisfied, and not be obese. Who said so?! I have been obese (clinically, BMI) multiple times. And all the time I got back to overweight then normal weight by exercising and eating less (than what I wanted! Because eating until I feel like exploding is so good). > Consider: GPL-1 inhibitors are actually root-cause solutions, and diet/exercise are not root cause solutions. False. Overeating is caused by lack of movement and bad diet. There is no point in discuss the rest starting from a completely wrong point.
  - consteval 2y ago
    > Overeating is caused by lack of movement and bad diet Is this some kind of joke? A bad diet doesn't cause overeating - overeating IS the bad diet. Also not moving doesn't cause overeating, because how could it? What, I sit down and suddenly a burrito appears in my hands? The cause of overeating is a propensity to overconsume, i.e. you have an addiction. Diet and exercise address the SYMPTOMS, but not the ROOT CAUSE. You STILL have an addiction. In the exact same way someone who is sober is STILL an alcoholic. Because drinking alcohol is not actually the root cause of alcoholism. The root cause is an addiction to alcohol. You can't get rid of the addiction, but you can treat the symptoms - by never drinking, by being sober. But you did not address the root cause. By my logical analysis, I conclude GLP-1 inhibitors better address the root cause than diet and exercise. To further strengthen my point, you've more or less admitted this by pointed out you've been obese "multiple times". If you had addressed the root cause this would be impossible! But you did not address the root cause but merely the symptoms via diet and exercise. You still had the addiction, so when you slipped you became obese again. This cannot happen while taking a GLP-1 inhibitor because you no longer have the extreme desire to eat. Even when you lost weight, you still had the extreme desire to eat.