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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

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.
    - Attummm 2y ago
      IF is not well understood, nor explained. So in that aspect we agree completely. A few years ago people would call you mad for fasting, and now we have drug that allows people to life the fasting lifestyle. And if there is a medical reason I'm not making the argument against. I'm making the argument that it's a intervention and that healyhy nutrition, healthy relationship with food will is the long-term solution. And order todo that we would need to explore other nutritional paradigms than the current one. Edit: - Fasting lifestyle, like omad(eat once a day) removes the feeling of hunger and thoughts about food, until it's the moment to eat.
      - stavros 2y ago
        > So in that aspect we agree completely. A few years ago people would call you mad for fasting, and now we have drug that allows people to life the fasting lifestyle. It's nothing like the fasting lifestyle, it just quiets the food noise. > I'm making the argument that it's a intervention and that healyhy nutrition, healthy relationship with food will is the long-term solution. That's like saying "I'm making the argument that diabetes medication is an intervention, and that producing healthy amounts of insulin is the long-term solution". Yeah, it's all well and good, except it doesn't work. You can yell at people for not <insert favorite reason here>, but, at the end of the day, people have tried diet, they've struggled with it, and it's failed. No matter how much yelling you do, they won't stop. It's like trying to talk a meth addict out of their addiction.
        bb88 2y ago
        Doctors have long said, "Diet and Exercise", but they couldn't really address the pain aspect of hunger until the last few years. And hunger is painful. Hunger is something that is left to the patient to cope with -- usually badly. Sure there could be support groups and exercise groups, but nobody is going to be there in your bed when you're trying to fall asleep with hunger pains.
- sangnoir 2y ago
  Depending on ones metabolism, IF with no caloric deficit doesn't guarantee weight loss.
  - bb88 2y ago
    Right and caloric deficit is just diet.
- schnebbau 2y ago
  You don't lose weight when IF if you eat your maintenance calories during the period you're not fasting.
RachelF 2y ago
A GLP-1 drug trial 12 years ago by a major pharma company was stopped because of increased suicide risk (2 in 10,000) among the cohort. We will see what happens long term the second time around.
- chpatrick 2y ago
  It's not even the second time around now, liraglutide was approved a decade ago.
- phonon 2y ago
  "Compared with those prescribed lifestyle intervention for obesity, adolescents prescribed either liraglutide (Saxenda; Novo Nordisk) or semaglutide (Wegovy; Novo Nordisk) had a 33% lower risk of suicidality over 12 months of follow-up after controlling for potential baseline confounders."[1] [1]https://www.tctmd.com/news/defying-earlier-glp-1-data-study-teens-sees-possible-mental-health-gains https://www.tctmd.com/news/defying-earlier-glp-1-data-study-...
vineyardmike 2y ago
If people are obese, they’re not getting the right hunger signals anyways. Obesity is heavily tied to longevity. GLP1s cause muscle loss because when you lose weight, some of your caloric deficit will be supplemented by your muscles. The article suggests that non-weight loss side effects of GLP1s are also worth considering taking the medication for. If you’re maintaining a healthy weight, while taking the drug, you shouldn’t experience the muscle atrophy. Also, muscle size isn’t tied to longevity, usable muscle and a certain strength and physical ability is tied to longevity. Muscle size is a convenient proxy. Also cardiovascular ability in a related way. You basically just need to be able to move and carry things and act in your environment in a responsible way at an old age so you don’t fall or hurt yourself.
- ryanobjc 2y ago
  I came here to basically say this. People who tout the dangers of glp1 - and there ARE risks! - are also ignoring the "what did you do instead of a glp1" and the answer is.... remain overweight, which has many risks! Yes glp1 might increase the risk of a certain kind of cancer. But guess what, it also reduces the risks of many other cancers tied to obesity! It's hard for me to take hand-wringing over glp1s seriously. Appeals to "JUST do x" are lost in the "just" - hello if people could just do intermittent fasting, or eat less calories, well then there would be less obesity. The obesity epidemic is literally a rebuttal to any of these arguments.
- Attummm 2y ago
  Your points are just reforcing my initial point. Old paradigms of nutrition have clearly failed. If we could acknowledge that we could move forward and be open to very promosing alternative paradigms. Which currently are not studied enough, to create clear nutritional guidelines for the public. Gpl1 and those paradigms work through the same mechanisms action (autophagy, ketones, reducing food intake). If there is acute problem with health such as (morbidly)obesity then gpl-1 could be a great intervention. But its not long term solution, nutrition and a healthy relationship with food and lifestyle is. Muscles are very important for health, but let's not go into that. For muscle size I linked to meta study about muscle size and all cause mortality (longevity) > Conclusions: Low SMI(skeletal muscle mass Index) was significantly associated with the increased risk of all-cause mortality. https://pubmed.ncbi.nlm.nih.gov/37285331/ https://pubmed.ncbi.nlm.nih.gov/37285331/
illiac786 2y ago
On one side, sure GPL-1 may have side effects, maybe bad ones. On the other hand, overweight in the sense of excessive adipose tissue, correlates with a huge number of very bad health problems (both mental and physiological), with an abundance of proof around causality for many of these. I’m thinking, whatever negative side effects we find for GPL-1 in the future, they will have to be pretty massive to offset all these benefits.

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.
  - Attummm 2y ago
    IF is not well understood, nor explained. So in that aspect we agree completely. A few years ago people would call you mad for fasting, and now we have drug that allows people to life the fasting lifestyle. And if there is a medical reason I'm not making the argument against. I'm making the argument that it's a intervention and that healyhy nutrition, healthy relationship with food will is the long-term solution. And order todo that we would need to explore other nutritional paradigms than the current one. Edit: - Fasting lifestyle, like omad(eat once a day) removes the feeling of hunger and thoughts about food, until it's the moment to eat.
    - stavros 2y ago
      > So in that aspect we agree completely. A few years ago people would call you mad for fasting, and now we have drug that allows people to life the fasting lifestyle. It's nothing like the fasting lifestyle, it just quiets the food noise. > I'm making the argument that it's a intervention and that healyhy nutrition, healthy relationship with food will is the long-term solution. That's like saying "I'm making the argument that diabetes medication is an intervention, and that producing healthy amounts of insulin is the long-term solution". Yeah, it's all well and good, except it doesn't work. You can yell at people for not <insert favorite reason here>, but, at the end of the day, people have tried diet, they've struggled with it, and it's failed. No matter how much yelling you do, they won't stop. It's like trying to talk a meth addict out of their addiction.
      - bb88 2y ago
        Doctors have long said, "Diet and Exercise", but they couldn't really address the pain aspect of hunger until the last few years. And hunger is painful. Hunger is something that is left to the patient to cope with -- usually badly. Sure there could be support groups and exercise groups, but nobody is going to be there in your bed when you're trying to fall asleep with hunger pains.
sangnoir 2y ago
Depending on ones metabolism, IF with no caloric deficit doesn't guarantee weight loss.
- bb88 2y ago
  Right and caloric deficit is just diet.
schnebbau 2y ago
You don't lose weight when IF if you eat your maintenance calories during the period you're not fasting.

RachelF 2y ago

A GLP-1 drug trial 12 years ago by a major pharma company was stopped because of increased suicide risk (2 in 10,000) among the cohort. We will see what happens long term the second time around.

chpatrick 2y ago
It's not even the second time around now, liraglutide was approved a decade ago.
phonon 2y ago
"Compared with those prescribed lifestyle intervention for obesity, adolescents prescribed either liraglutide (Saxenda; Novo Nordisk) or semaglutide (Wegovy; Novo Nordisk) had a 33% lower risk of suicidality over 12 months of follow-up after controlling for potential baseline confounders."[1] [1]https://www.tctmd.com/news/defying-earlier-glp-1-data-study-teens-sees-possible-mental-health-gains https://www.tctmd.com/news/defying-earlier-glp-1-data-study-...

vineyardmike 2y ago

If people are obese, they’re not getting the right hunger signals anyways. Obesity is heavily tied to longevity. GLP1s cause muscle loss because when you lose weight, some of your caloric deficit will be supplemented by your muscles. The article suggests that non-weight loss side effects of GLP1s are also worth considering taking the medication for. If you’re maintaining a healthy weight, while taking the drug, you shouldn’t experience the muscle atrophy. Also, muscle size isn’t tied to longevity, usable muscle and a certain strength and physical ability is tied to longevity. Muscle size is a convenient proxy. Also cardiovascular ability in a related way. You basically just need to be able to move and carry things and act in your environment in a responsible way at an old age so you don’t fall or hurt yourself.

ryanobjc 2y ago
I came here to basically say this. People who tout the dangers of glp1 - and there ARE risks! - are also ignoring the "what did you do instead of a glp1" and the answer is.... remain overweight, which has many risks! Yes glp1 might increase the risk of a certain kind of cancer. But guess what, it also reduces the risks of many other cancers tied to obesity! It's hard for me to take hand-wringing over glp1s seriously. Appeals to "JUST do x" are lost in the "just" - hello if people could just do intermittent fasting, or eat less calories, well then there would be less obesity. The obesity epidemic is literally a rebuttal to any of these arguments.
Attummm 2y ago
Your points are just reforcing my initial point. Old paradigms of nutrition have clearly failed. If we could acknowledge that we could move forward and be open to very promosing alternative paradigms. Which currently are not studied enough, to create clear nutritional guidelines for the public. Gpl1 and those paradigms work through the same mechanisms action (autophagy, ketones, reducing food intake). If there is acute problem with health such as (morbidly)obesity then gpl-1 could be a great intervention. But its not long term solution, nutrition and a healthy relationship with food and lifestyle is. Muscles are very important for health, but let's not go into that. For muscle size I linked to meta study about muscle size and all cause mortality (longevity) > Conclusions: Low SMI(skeletal muscle mass Index) was significantly associated with the increased risk of all-cause mortality. https://pubmed.ncbi.nlm.nih.gov/37285331/ https://pubmed.ncbi.nlm.nih.gov/37285331/

illiac786 2y ago

On one side, sure GPL-1 may have side effects, maybe bad ones. On the other hand, overweight in the sense of excessive adipose tissue, correlates with a huge number of very bad health problems (both mental and physiological), with an abundance of proof around causality for many of these. I’m thinking, whatever negative side effects we find for GPL-1 in the future, they will have to be pretty massive to offset all these benefits.