3 ms·

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.

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.