5 ms·

The main difference between GLP-1 agonists and telling people to eat less/better is that one works and one doesn't.

by kelseyfrog 2y ago

akira2501 2y ago
Obesity rates are not consistent across the world or time. Neither work. They just hide symptoms of the larger problem.
- toomuchtodo 2y ago
  The problem is the human existing in a modern environment that is hostile to it. GLP-1s enable the human to more effectively operate in said environment. It patches malfunctioning reward centers (addiction and food compulsion), it reduces overall inflammation, it provide cardiovascular protective properties. As kubectl_h mentions [1], the future is better understanding and fine tuning the mechanisms responsible. I think gene therapy is the end goal (permanent fix vs chronic maintenance with GLP-1s), but others have indicated in previous threads that might not be possible. We need more information and research. This is only the beginning of the "Aha!" moment (The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That's funny...” —Isaac Asimov). [1] https://news.ycombinator.com/item?id=41989101 https://news.ycombinator.com/item?id=41989101
  - akira2501 2y ago
    > in a modern environment that is hostile to it. Our ancient environment was hostile as well. > It patches malfunctioning reward centers It has an impact on them. It does not "patch" them. This is not a rational way to describe any drug. > it reduces overall inflammation It can inhibit certain inflammatory pathways. > it provide cardiovascular protective properties. It reduces the number of cardiovascular events. Whether that number is normal to begin with is not considered here. > We need more information and research. You certainly do.
    - toomuchtodo 2y ago
      You're free to your opinion (legit, no snark intended), the market will deliver to the demand. The cost benefit ratio is obvious, even accounting for potential side effects at scale. https://www.axios.com/2024/01/18/ozempic-wegovy-weight-loss-drugs-states-map https://www.axios.com/2024/01/18/ozempic-wegovy-weight-loss-... https://www.axios.com/2024/01/19/weight-loss-drugs-america-obesity-diabetes-risks https://www.axios.com/2024/01/19/weight-loss-drugs-america-o... https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... https://www.jpmorgan.com/insights/global-research/current-events/obesity-drugs https://www.jpmorgan.com/insights/global-research/current-ev... Edit: I simply do not understand the hostility towards this simple intervention, my apologies.
      - akira2501 2y ago
        > You're free to your opinion Oh. Thank you. That's very generous. I assumed we started from that position but apparently not. > the market will deliver to the demand. Yes, because our healthcare market is perfect, and we should acquiesce to it's demands. The same could be said of opioid pain killers. > The cost benefit ratio is obvious Which entities cost benefit ratio, exactly? The patients? Are you _sure_ you have data which allows you to say that? > even accounting for potential side effects at scale. You're free to your opinion. The market will repeat history.
    - Teever 2y ago
      You seem hostile to this possible solution. Can you explain why?
- derektank 2y ago
  Obesity rates aren't consistent because access to cheap calories is not consistent across the globe. I don't mean to be glib, there are certainly other factors, but as a first order approximation obesity rates of a region or country are going to be proportional to how easy calories are to access, followed by how satiating those calories are
  - astrange 2y ago
    Japan and Colorado have just as much access to cheap calories as Louisiana, but notably less obesity. Also, obesity rates have increased faster than access to calories has; it's a surprisingly recent problem.
    - derektank 2y ago
      Even in the eighties, household spending on food was nearly 50% higher relative to overall consumption than today.[0] Japanese households today actually spend 16%(!) of their household income on food, compared to only 7% in the US.[1] Obviously there are multiple factors, as I said I think the relative satiety of food also plays a role. US food spending has been more or less static over the last two decades while obesity rates have continued to climb so cost can't explain everything (though as an aside, I do think lower costs probably take some time to have an effect). But even if there are multiple factors at play, cost really should not be discounted as a huge driver, especially if we're taking a public health approach to addressing the problem. If we just attribute obesity to individual moral failings, as some are wont to do, I think we're really doing a disservice to ourselves [0] https://www.cepr.net/in-the-good-old-days-one-fourth-of-income-went-to-food/ https://www.cepr.net/in-the-good-old-days-one-fourth-of-inco... [1] https://www.cia.gov/the-world-factbook/field/average-household-expenditures/ https://www.cia.gov/the-world-factbook/field/average-househo...
- kelseyfrog 2y ago
  This is like saying that driving doesn't work because people still walk and the real problem is transportation. It simply doesn't matter. It's not an argument.
  - akira2501 2y ago
    I'm pointing out the problems of considering this a valid on term "solution." It's simply not. You need a plan to eventually be rid of this compromise. That GLP-1 has benefits is good. That we could possibly rearrange our food system so we don't need it anymore is better. You can acknowledge both without hurting _anyone_. You entirely lack an argument.
    - deleted 2y ago
      [deleted]
    - pixl97 2y ago
      >That we could possibly rearrange our food system so we don't need it anymore is better. Ya so you want to change a system that involves millions of selfish actors and corporations looking to profit and that have entrenched themselves, and are protected by freedom of association versus a choice between a doctor and a patient. I can tell you which one will be more successful.
    - kaibee 2y ago
      > It's simply not. You need a plan to eventually be rid of this compromise. because..? > That we could possibly rearrange our food system so we don't need it anymore is better. Will this be before or after we fix capitalism/finish building communism?
    - kelseyfrog 2y ago
      This is a textbook case of letting better stand in the way of good. I'd love to re-imagine our food of food production and consumption, but it sounds like you're arguing that because food production and consumption is a better solution, we shouldn't be promoting GLP-1 agonists. Sorry, but one is exists in reality and the other exists in our imaginations. When we let our imaginations take precedence over reality, we live in a fantasy and the consequence is that we get neither. Effectively this argues for neither, and that's a bad deal for everyone.
- jmward01 2y ago
  'problem' is a loaded word. The data is coming in saying that this class of drugs provides potentially massive benefits. If I get a lot of benefit but didn't fully address the root 'problem', I still get a lot of benefit.
  - akira2501 2y ago
    As long as the supply chain correctly functions for the entire time you plan on being on the drug.
    - prepend 2y ago
      Yes, obviously. As long as the drug is available and the earth exists, etc etc Therapies are contingent on being available. That’s uniform. What’s unique about glp-1s is that they are very effective in weight loss and many other things. As compared to alternatives that aren’t.
    - pixl97 2y ago
      One, going off GLP-1 for all I know doesn't have bad side effects, other than going back to your bad diet. If we are back at the point of supply chain issues that interrupt GLP-1 for any significant amount of time you're starting to look at issues like we had during covid that are going to have all kinds of other effects. From my understanding getting the pre-compounded components isn't that difficult, and that India and China are making versions of it now.
- drowsspa 2y ago
  Obesity rates consistently increase as people get more access to calories.
  - smith7018 2y ago
    Yes, but that’s an incomplete view on the obesity epidemic in the West, imo. It’s not just that there’s “more access to calories,” it’s that access to healthy foods is getting more difficult for a large portion of the population. People working multiple jobs don’t have time to cook a complete, nutritious meal. Also, due to our ever-increasing wealth inequality, it’s harder for people to afford healthy food. A whole chicken, a vegetable, and a starch will always cost more than getting something at Wendy’s. Similarly, a jar of jelly is cheaper and lasts longer than a box of strawberries.
    - drowsspa 2y ago
      I'm Brazilian, but whether you consider Latin America western or western-adjacent, here healthy food is definitely not cheaper than processed food at all. Yet, you can see populations and regions dropping from food insecurity directly into obesity as soon as people do have access to more food. The time argument might be relevant, but even then, most Brazilians do have cheap and easy access to a very healthy lunch in restaurants or to-go meals, purchased or prepared, with rice, beans, meat, salad... The breakfast is probably bread, but I'd say most people don't eat a lot of that in the morning. Getting proper nutrition at night will probably be problematic, but it's also a smaller window... But, like I said, processed food is quite expensive here. For instance, a 1 kg of chicken breast goes by less than a third the price of a McDonald's combo. A pack of cookies or snacks will be like double the price of a 1 kg of bananas...
      - smith7018 2y ago
        I can only speak for my culture so thank you for the perspective and insights on yours. Just checked and it seems like bananas are 27.5% cheaper in Brazil than America. Chicken fillets are a shocking 71% cheaper! I'm sure I'm not taking a lot of things into account here like the average income levels, but still, that's crazy.
- SpicyLemonZest 2y ago
  I don't understand your point. Many common medications - ibuprofen, albuterol, insulin injections - function entirely by hiding symptoms of an underlying problem. If the symptoms being hidden are worse than the side effects of the medication, what's the concern?
  - bigstrat2003 2y ago
    Solving symptoms and not root causes is how you get band-aid fixes that wind up being inadequate to the task in the end. I would've thought everyone here would be aware of the danger of treating symptoms rather than the underlying issues, given it's such a common pitfall in the computer field.
    - moron4hire 2y ago
      I think if you reflect on the purpose of a bandaid a little bit, you would come to understand why your own analogy is bad.
    - SpicyLemonZest 2y ago
      Again, I genuinely don't understand the point. There's a large and well-funded segment of the nutrition industry dedicated to solving the root causes - Weight Watchers alone has over a billion dollars in annual revenue. We just haven't invented a diet-based solution which works as well as GLP-1 agonists without requiring you to compromise on palatability and feel hungry all day. It'll be great if we do, although I don't know of any promising research avenues and I lean towards the hypothesis that the average human metabolism is simply tuned to mild obesity under conditions of widespread food availability.
      - UglyToad 2y ago
        The point, which seems to be routinely massively downvoted on here, is that both things can be true at once: - these drugs are good and a paradigm shift in the treatment of obesity (and have other benefits) - we must not lose sight of the need to address a thoroughly sick food industry that necessitate so many people needing to use these. Junk food advertising, lack of subsidies for fresh vegetables, HFCS, food deserts, etc. Chile is experimenting with banning junk food ads to children and is seeing some early behaviour changes. The point which people seem to be wilfully missing is that we can have both these drugs and advocate for cracking down on a food system that deliberately poisons everyone in society. Having everyone be on this drug because we shrug and say "free market innit" while big corps continue to feed us crap is not a solution, obviously.
Attummm 2y ago
That is because the advice around eating less is focused on old paradigms that have clearly failed. Those drugs let people experience intermittent fasting and fasting by reducing hunger and snacking. The danger of suppressing hunger signals is that hunger could've been a important que for nutritional needs. Muscle loss is severe danger of gpl-1, And muscle size is tied to longevity. So although promising it's not without danger. And there are other paradigms but those are not yet explored yet the underlying mechanisms work the same. Edit: Let's keep HN a place where discussion can be held without just kneejerk down voting. Edit2: great discussion thanks all.
- stavros 2y ago
  > Those drugs let people experience intermittent fasting and fasting by reducing hunger and snacking. This shows you haven't tried GLP-1s. I've been doing IF for ten years, doesn't stop me from being overweight. GLP-1s do.
  - Attummm 2y ago
    First of all congratulations with your succes, and not take away from that. But IF nor fasting is a silver bullet. Reducing food intake, and insuline while keeping hunger down is. Important aspect is keeping hunger down. And if your fasting/excersicsing you can experience the same. The discussion on weight unfortunately almost always focused on total weight. But we would like to retain our muscles, and reduce adipose tissue(fat). With gpl1 people are able to fast, stop snacking and reduce food intake because hunger signals are blocked. But a fasting lifestyle, which goes further then just IF. And a focus on nutrition(vitamins, minerals, quality sources) could the same. Furthermore the effects of lowering inflammation of gpl1 is only logical reduction in food intake/fasting will lead to autophagy. IF/Fasting and other new nutritional paradigms are still new and uncharted. It's not clear yet what the full effects are, and how to implement them correctly.
    - stavros 2y ago
      Yeah, but at the end of the day, it either works, or it doesn't. You can say "you're holding it wrong" all you want, but if it's easy to hold the thing wrong, it's the thing's fault. GLP-1s work for many more people than any other diet advice we've ever had.
thefz 2y ago
Eating less works, if taking a drug that makes you eat less, well, works.
- maxerickson 2y ago
  That's a bad read of what they said. They didn't say that eating less doesn't work, they said that telling people to eat less doesn't work. I am tempted to make a snide remark, but I suppose that won't do any good.
  - s1artibartfast 2y ago
    I think the post is as hostile to GLP-1 as you feel it is. Eating less works. Telling people to eat less and exercise self control doesn't work very often.
derbOac 2y ago
I'm fine with GPL-1 agonists, they seem great, not trying to argue against them. This is an age old problem in the obesity treatment and research community. It never seems to go away. It's come up with bariatric surgery, with other methods, and now GPL1- agonists. The issue for me is that "telling people to eat less" is sort of a strawman in some ways. It doesn't work. What does work, however, at least according to evidence I've seen, is giving people strategies for losing weight, therapy, support, and so forth. It doesn't work for everyone but it does for some. I would rather people try that first as it can be self-sustaining and doesn't require medication. I'm not opposed to the medication or people using it, in fact I think it's a good thing, but it seems a little dangerous to me to create a culture where people are just told "take this pill, pay lots of money for it, because nothing else will work" which is not actually true. I don't think we're at that point but it's easy for me to imagine.
- CooCooCaCha 2y ago
  It's tricky because losing weight can take a mental load off, it's just getting there that's hard. Once you get there you gain confidence, people treat you differently, doctors take you more seriously, exercise becomes easier (less weight to throw around and less strain on joints), etc.
ZYbCRq22HbJ2y7 2y ago
Except adherence to taking GLP-1 agonists isn't a given, especially with dosing regimens that are shorter than a week.

The main difference between GLP-1 agonists and telling people to eat less/better is that one works and one doesn't.

akira2501 2y ago

Obesity rates are not consistent across the world or time. Neither work. They just hide symptoms of the larger problem.

toomuchtodo 2y ago
The problem is the human existing in a modern environment that is hostile to it. GLP-1s enable the human to more effectively operate in said environment. It patches malfunctioning reward centers (addiction and food compulsion), it reduces overall inflammation, it provide cardiovascular protective properties. As kubectl_h mentions [1], the future is better understanding and fine tuning the mechanisms responsible. I think gene therapy is the end goal (permanent fix vs chronic maintenance with GLP-1s), but others have indicated in previous threads that might not be possible. We need more information and research. This is only the beginning of the "Aha!" moment (The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That's funny...” —Isaac Asimov). [1] https://news.ycombinator.com/item?id=41989101 https://news.ycombinator.com/item?id=41989101
- akira2501 2y ago
  > in a modern environment that is hostile to it. Our ancient environment was hostile as well. > It patches malfunctioning reward centers It has an impact on them. It does not "patch" them. This is not a rational way to describe any drug. > it reduces overall inflammation It can inhibit certain inflammatory pathways. > it provide cardiovascular protective properties. It reduces the number of cardiovascular events. Whether that number is normal to begin with is not considered here. > We need more information and research. You certainly do.
  - toomuchtodo 2y ago
    You're free to your opinion (legit, no snark intended), the market will deliver to the demand. The cost benefit ratio is obvious, even accounting for potential side effects at scale. https://www.axios.com/2024/01/18/ozempic-wegovy-weight-loss-drugs-states-map https://www.axios.com/2024/01/18/ozempic-wegovy-weight-loss-... https://www.axios.com/2024/01/19/weight-loss-drugs-america-obesity-diabetes-risks https://www.axios.com/2024/01/19/weight-loss-drugs-america-o... https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... https://www.jpmorgan.com/insights/global-research/current-events/obesity-drugs https://www.jpmorgan.com/insights/global-research/current-ev... Edit: I simply do not understand the hostility towards this simple intervention, my apologies.
    - akira2501 2y ago
      > You're free to your opinion Oh. Thank you. That's very generous. I assumed we started from that position but apparently not. > the market will deliver to the demand. Yes, because our healthcare market is perfect, and we should acquiesce to it's demands. The same could be said of opioid pain killers. > The cost benefit ratio is obvious Which entities cost benefit ratio, exactly? The patients? Are you _sure_ you have data which allows you to say that? > even accounting for potential side effects at scale. You're free to your opinion. The market will repeat history.
  - Teever 2y ago
    You seem hostile to this possible solution. Can you explain why?
derektank 2y ago
Obesity rates aren't consistent because access to cheap calories is not consistent across the globe. I don't mean to be glib, there are certainly other factors, but as a first order approximation obesity rates of a region or country are going to be proportional to how easy calories are to access, followed by how satiating those calories are
- astrange 2y ago
  Japan and Colorado have just as much access to cheap calories as Louisiana, but notably less obesity. Also, obesity rates have increased faster than access to calories has; it's a surprisingly recent problem.
  - derektank 2y ago
    Even in the eighties, household spending on food was nearly 50% higher relative to overall consumption than today.[0] Japanese households today actually spend 16%(!) of their household income on food, compared to only 7% in the US.[1] Obviously there are multiple factors, as I said I think the relative satiety of food also plays a role. US food spending has been more or less static over the last two decades while obesity rates have continued to climb so cost can't explain everything (though as an aside, I do think lower costs probably take some time to have an effect). But even if there are multiple factors at play, cost really should not be discounted as a huge driver, especially if we're taking a public health approach to addressing the problem. If we just attribute obesity to individual moral failings, as some are wont to do, I think we're really doing a disservice to ourselves [0] https://www.cepr.net/in-the-good-old-days-one-fourth-of-income-went-to-food/ https://www.cepr.net/in-the-good-old-days-one-fourth-of-inco... [1] https://www.cia.gov/the-world-factbook/field/average-household-expenditures/ https://www.cia.gov/the-world-factbook/field/average-househo...
kelseyfrog 2y ago
This is like saying that driving doesn't work because people still walk and the real problem is transportation. It simply doesn't matter. It's not an argument.
- akira2501 2y ago
  I'm pointing out the problems of considering this a valid on term "solution." It's simply not. You need a plan to eventually be rid of this compromise. That GLP-1 has benefits is good. That we could possibly rearrange our food system so we don't need it anymore is better. You can acknowledge both without hurting _anyone_. You entirely lack an argument.
  - deleted 2y ago
    [deleted]
  - pixl97 2y ago
    >That we could possibly rearrange our food system so we don't need it anymore is better. Ya so you want to change a system that involves millions of selfish actors and corporations looking to profit and that have entrenched themselves, and are protected by freedom of association versus a choice between a doctor and a patient. I can tell you which one will be more successful.
  - kaibee 2y ago
    > It's simply not. You need a plan to eventually be rid of this compromise. because..? > That we could possibly rearrange our food system so we don't need it anymore is better. Will this be before or after we fix capitalism/finish building communism?
  - kelseyfrog 2y ago
    This is a textbook case of letting better stand in the way of good. I'd love to re-imagine our food of food production and consumption, but it sounds like you're arguing that because food production and consumption is a better solution, we shouldn't be promoting GLP-1 agonists. Sorry, but one is exists in reality and the other exists in our imaginations. When we let our imaginations take precedence over reality, we live in a fantasy and the consequence is that we get neither. Effectively this argues for neither, and that's a bad deal for everyone.
jmward01 2y ago
'problem' is a loaded word. The data is coming in saying that this class of drugs provides potentially massive benefits. If I get a lot of benefit but didn't fully address the root 'problem', I still get a lot of benefit.
- akira2501 2y ago
  As long as the supply chain correctly functions for the entire time you plan on being on the drug.
  - prepend 2y ago
    Yes, obviously. As long as the drug is available and the earth exists, etc etc Therapies are contingent on being available. That’s uniform. What’s unique about glp-1s is that they are very effective in weight loss and many other things. As compared to alternatives that aren’t.
  - pixl97 2y ago
    One, going off GLP-1 for all I know doesn't have bad side effects, other than going back to your bad diet. If we are back at the point of supply chain issues that interrupt GLP-1 for any significant amount of time you're starting to look at issues like we had during covid that are going to have all kinds of other effects. From my understanding getting the pre-compounded components isn't that difficult, and that India and China are making versions of it now.
drowsspa 2y ago
Obesity rates consistently increase as people get more access to calories.
- smith7018 2y ago
  Yes, but that’s an incomplete view on the obesity epidemic in the West, imo. It’s not just that there’s “more access to calories,” it’s that access to healthy foods is getting more difficult for a large portion of the population. People working multiple jobs don’t have time to cook a complete, nutritious meal. Also, due to our ever-increasing wealth inequality, it’s harder for people to afford healthy food. A whole chicken, a vegetable, and a starch will always cost more than getting something at Wendy’s. Similarly, a jar of jelly is cheaper and lasts longer than a box of strawberries.
  - drowsspa 2y ago
    I'm Brazilian, but whether you consider Latin America western or western-adjacent, here healthy food is definitely not cheaper than processed food at all. Yet, you can see populations and regions dropping from food insecurity directly into obesity as soon as people do have access to more food. The time argument might be relevant, but even then, most Brazilians do have cheap and easy access to a very healthy lunch in restaurants or to-go meals, purchased or prepared, with rice, beans, meat, salad... The breakfast is probably bread, but I'd say most people don't eat a lot of that in the morning. Getting proper nutrition at night will probably be problematic, but it's also a smaller window... But, like I said, processed food is quite expensive here. For instance, a 1 kg of chicken breast goes by less than a third the price of a McDonald's combo. A pack of cookies or snacks will be like double the price of a 1 kg of bananas...
    - smith7018 2y ago
      I can only speak for my culture so thank you for the perspective and insights on yours. Just checked and it seems like bananas are 27.5% cheaper in Brazil than America. Chicken fillets are a shocking 71% cheaper! I'm sure I'm not taking a lot of things into account here like the average income levels, but still, that's crazy.
SpicyLemonZest 2y ago
I don't understand your point. Many common medications - ibuprofen, albuterol, insulin injections - function entirely by hiding symptoms of an underlying problem. If the symptoms being hidden are worse than the side effects of the medication, what's the concern?
- bigstrat2003 2y ago
  Solving symptoms and not root causes is how you get band-aid fixes that wind up being inadequate to the task in the end. I would've thought everyone here would be aware of the danger of treating symptoms rather than the underlying issues, given it's such a common pitfall in the computer field.
  - moron4hire 2y ago
    I think if you reflect on the purpose of a bandaid a little bit, you would come to understand why your own analogy is bad.
  - SpicyLemonZest 2y ago
    Again, I genuinely don't understand the point. There's a large and well-funded segment of the nutrition industry dedicated to solving the root causes - Weight Watchers alone has over a billion dollars in annual revenue. We just haven't invented a diet-based solution which works as well as GLP-1 agonists without requiring you to compromise on palatability and feel hungry all day. It'll be great if we do, although I don't know of any promising research avenues and I lean towards the hypothesis that the average human metabolism is simply tuned to mild obesity under conditions of widespread food availability.
    - UglyToad 2y ago
      The point, which seems to be routinely massively downvoted on here, is that both things can be true at once: - these drugs are good and a paradigm shift in the treatment of obesity (and have other benefits) - we must not lose sight of the need to address a thoroughly sick food industry that necessitate so many people needing to use these. Junk food advertising, lack of subsidies for fresh vegetables, HFCS, food deserts, etc. Chile is experimenting with banning junk food ads to children and is seeing some early behaviour changes. The point which people seem to be wilfully missing is that we can have both these drugs and advocate for cracking down on a food system that deliberately poisons everyone in society. Having everyone be on this drug because we shrug and say "free market innit" while big corps continue to feed us crap is not a solution, obviously.

Attummm 2y ago

That is because the advice around eating less is focused on old paradigms that have clearly failed. Those drugs let people experience intermittent fasting and fasting by reducing hunger and snacking. The danger of suppressing hunger signals is that hunger could've been a important que for nutritional needs. Muscle loss is severe danger of gpl-1, And muscle size is tied to longevity. So although promising it's not without danger. And there are other paradigms but those are not yet explored yet the underlying mechanisms work the same. Edit: Let's keep HN a place where discussion can be held without just kneejerk down voting. Edit2: great discussion thanks all.

stavros 2y ago
> Those drugs let people experience intermittent fasting and fasting by reducing hunger and snacking. This shows you haven't tried GLP-1s. I've been doing IF for ten years, doesn't stop me from being overweight. GLP-1s do.
- Attummm 2y ago
  First of all congratulations with your succes, and not take away from that. But IF nor fasting is a silver bullet. Reducing food intake, and insuline while keeping hunger down is. Important aspect is keeping hunger down. And if your fasting/excersicsing you can experience the same. The discussion on weight unfortunately almost always focused on total weight. But we would like to retain our muscles, and reduce adipose tissue(fat). With gpl1 people are able to fast, stop snacking and reduce food intake because hunger signals are blocked. But a fasting lifestyle, which goes further then just IF. And a focus on nutrition(vitamins, minerals, quality sources) could the same. Furthermore the effects of lowering inflammation of gpl1 is only logical reduction in food intake/fasting will lead to autophagy. IF/Fasting and other new nutritional paradigms are still new and uncharted. It's not clear yet what the full effects are, and how to implement them correctly.
  - stavros 2y ago
    Yeah, but at the end of the day, it either works, or it doesn't. You can say "you're holding it wrong" all you want, but if it's easy to hold the thing wrong, it's the thing's fault. GLP-1s work for many more people than any other diet advice we've ever had.

thefz 2y ago

Eating less works, if taking a drug that makes you eat less, well, works.

maxerickson 2y ago
That's a bad read of what they said. They didn't say that eating less doesn't work, they said that telling people to eat less doesn't work. I am tempted to make a snide remark, but I suppose that won't do any good.
- s1artibartfast 2y ago
  I think the post is as hostile to GLP-1 as you feel it is. Eating less works. Telling people to eat less and exercise self control doesn't work very often.

derbOac 2y ago

I'm fine with GPL-1 agonists, they seem great, not trying to argue against them. This is an age old problem in the obesity treatment and research community. It never seems to go away. It's come up with bariatric surgery, with other methods, and now GPL1- agonists. The issue for me is that "telling people to eat less" is sort of a strawman in some ways. It doesn't work. What does work, however, at least according to evidence I've seen, is giving people strategies for losing weight, therapy, support, and so forth. It doesn't work for everyone but it does for some. I would rather people try that first as it can be self-sustaining and doesn't require medication. I'm not opposed to the medication or people using it, in fact I think it's a good thing, but it seems a little dangerous to me to create a culture where people are just told "take this pill, pay lots of money for it, because nothing else will work" which is not actually true. I don't think we're at that point but it's easy for me to imagine.

CooCooCaCha 2y ago
It's tricky because losing weight can take a mental load off, it's just getting there that's hard. Once you get there you gain confidence, people treat you differently, doctors take you more seriously, exercise becomes easier (less weight to throw around and less strain on joints), etc.

ZYbCRq22HbJ2y7 2y ago

Except adherence to taking GLP-1 agonists isn't a given, especially with dosing regimens that are shorter than a week.