7 ms·

Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. (From that perspect

Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. (From that perspective:)a miracle cure that allows someone to stop being fat is like an indulgence (in the Roman Catholic sense). It’s a cheat, a shortcut that allows the unworthy to reach a state they do not deserve. My opinion is to wait long enough to validate there are no long term harms, but beyond that, yeah, adjust the priors, it could be a modern aspirin.

NoMoreNicksLeft 1y ago
>My opinion is to wait long enough to validate there are no long term harms, What's your threshold on that? How many years is "long enough"? Trying to calibrate my own sense of risk.
- dexwiz 1y ago
  Not OP but 10-15 years for most drugs. Took about a decade for the general consensus around Oxy to change.
  - 2OEH8eoCRo0 1y ago
    Haven't these been out for a very long time, just not for weight loss? A quick Wikipedia search shows Exenatide was FDA approved in 2005 for diabetes.
    - mapontosevenths 1y ago
      Ozempic itself has been in use for almost a decade now (originally approved for type 2 diabetes in 2017). Many millions of people have taken it, without much in the way of serious complication. Exenatide had been in use since about 2005, and by 2019 had more than a million people on it. Some of those patients have literally been on it for 20 years. It does have a worse side-effect profile than Ozempic (or the more modern GLP-1's like zepbound), but even then the benefits outweigh the risk for those diabetics. Today it is hard to argue the benefits of modern GLP-1s don't outweigh their risks. They've been extensively tested, the class of drug has been around for decades, and they are used by many millions of people. I personally lost 120 pounds on Zepbound in a little less than a year. It's been life changing, and anyone who thinks I might be less healthy now is very clearly wrong. Literally every aspect of my life has been greatly improved.
- gryn 1y ago
  I'm a late adopter to most things. my estimate would bigger than others and I would put it at 30-50years. I take smoking as a cautionary tale, in the beginning it was pushed as not just a recreational thing but a healthy activity that bring benefits with papers published to sing praises about it. my parents were even nudged by their teachers/doctors/etc when they were young to try smoking. now we all know that smoking is beyond bad and all that early "research" was just people paid off by big companies to promote it.
  - daedrdev 1y ago
    I think a lot of people share similar concerns, but the benefits of a successfully therapy are so extreme it would take quite a lot to derail ozempic. People easily gain 5 or more years of lifespan by not being obese, avoid myriad related health conditions, and are truly much better off. It would take a lot to reduce someone's life expectancy by a comparable amount and we haven't seen that much besides gastrointestinal issues. We performed the surgical options like stomach reduction before this which come with serious danger for comparison
    - radiofreeeuropa 1y ago
      Under-discussed benefit: being able to have all your clothes actually fit at the same time (no wardrobe scattered between your "skinny" weight and your "fat" weight and rarely being in the right place for more than a handful of pieces to fit entirely correctly) so you can spend up a little on nicer clothes without worrying you'll only be able to wear them part of the time. Worst case, you start to pack on a little too much and they start getting tight, you increase the dose or go back on the drugs for a week or three (or just do it the old fashioned way—hey, it works some of the time, temporarily) and ta-da, right back where you want to be—you're not going to pack on weight and find yourself unable to lose, so buying "skinny clothes" isn't mortgaged against your future success at forcing yourself to eat less.
  - krisoft 1y ago
    > I take smoking as a cautionary tale, in the beginning it was pushed as not just a recreational thing but a healthy activity While i agree the gist of what you are saying, also important to mention that humans started cultivating tobaco when mamoths still roamed the Earth. There was indeed a concentrated pro-smoking publicity campaign by tobaco manufacturers in the 1930s, but it was hardly “in the beginning” of our tobaco use.
- bradleyjg 1y ago
  There’s two sides to that coin. Obesity has known long term harms. So what we are looking for in a deal breaker can’t be a small but statistically significant increase in some cancer or other. We’d need something as bad as smoking to outweigh the benefits.
stronglikedan 1y ago
> Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. As an American with a sister with thyroid issues, I can say that is absolutely not true for the majority of Americans. People are mostly sympathetic to those who are not obvious slobs.
- drowsspa 1y ago
  People are mostly sympathetic when it's physical issues. Psychological issues are treated as diseases of the soul that you only need God or willpower or whatever to fix. And most fat people are fat because of the incentives in our society, but admitting that also goes against certain political ideologies...
  - jfim 1y ago
    What are the incentives for people to be fat, out of curiosity? Do you mean farm subsidies for corn, for example?
    - const_cast 1y ago
      At a low level, yes, corn, but at a high level: more consumption = more money. Everyone benefits from you being fat. Your doctors, your car manufacturer, food manufacturers, everyone. Except maybe health insurance. But they're not hurt too too much.
      - deleted 1y ago
        [deleted]
      - XorNot 1y ago
        There is no doctor on Earth who goes to work and thinks "thank god for fat people or I wouldn't have a business". There's plenty of doctors and surgeons who wish there were less fat people, because they enormously complicate doing surgery on and managing in hospitals.
cm2187 1y ago
And also the idea that it is "easy" to lose weight is completely out of touch. If it was there wouldn't be millions of people trying hard, spending money on trying and failing for decades, and entire businesses addressing that. RFK Jr's "let them eat less" is paradoxically the modern version of "let them eat cake"!
- kulahan 1y ago
  I think many people confuse simple with easy. It IS simple to reduce your weight. There are like, two things you need to do. It is, however, VERY hard to actually do those things.
  - morkalork 1y ago
    Even then, limiting calorie intake isn't all that difficult; there's a reason why intermittent fasting took off and so many people were getting results from it.
    - nosignono 1y ago
      It is that difficult, otherwise everyone would do it.
    - tsol 1y ago
      Not necessarily. Some people respond well too intermittent fasting but not everyone. Some people respond to keto but not everyone. And just because you respond doesn't mean it's gonna take you to where you need to be. I've always been skinny but for some reason I've gained weight recently. Even with keto, intermittent fasting, tirzeptide, and workouts twice a week I have only lost 5 lbs in months. When I was skinny and forgot to eat, I would feel a little crappy but still could function. Now I begin to feel incredibly depressed, I can't sleep nor focus. This solidified it to me that there's a circuit in your brain that controls feeding and if it's out of whack it'll punish you until you eat. Dieting takes months and no one can go that long without sleep. So it's still a practical problem, its just hard to see if your system is well calibrated.
naravara 1y ago
The weight loss mechanism largely just comes from suppressing appetite though, so it still lines up with the penance for sin narrative. It’s not that different from wearing a hair-shirt and whipping yourself if you find yourself having lustful thoughts. Only instead of a whip you just feel kind of uncomfortable and nauseous if you eat too much.
- cheald 1y ago
  That's true of semaglutide, but newer peptides like tirzepatide (a dual-agonist) and retatrutide (a triple agonist) have additional effects like improving insulin sensitivity, and simultaneously slowing the release of glucagon and activating glucagon receptors, which directly increases fat oxidation and thermogenesis.
- radiofreeeuropa 1y ago
  I'd describe the effects as basically the opposite of self-torture. Self-torture is dieting/fasting without the drugs. With them, it's great. No afternoon light-headedness and difficulty concentrating, no hunger pangs, no "hangry" effect, no cravings you have to keep suppressing. Just smooth sailing. (though experiences do seem to vary—as do dosage levels)
thaumasiotes 1y ago
> Gluttony or overeating are not the sin, but being fat. This is a strange thing to say. If you do something normal, and you end up in a normal state, why would that be a moral failing? There's no such thing as "overeating". Different people eat different amounts. The same person eats different amounts at different times. > (From that perspective:)a miracle cure that allows someone to stop being fat is like an indulgence (in the Roman Catholic sense). It’s a cheat, a shortcut that allows the unworthy to reach a state they do not deserve. This is incoherent. If you believe that being fat is a sin, but that the things you do that make you fat are not sins, then a miracle cure that makes you thin removes the only sin you were committing. You can't be unworthy if you're not fat. In order for a miracle cure to be "cheating", it is necessary that the sin is in the behavior and not the result.
- frumper 1y ago
  Everyone defines normal differently and people are quite good at judging those that are not their normal.
  - thaumasiotes 1y ago
    Did you mean to respond to someone else?
falcor84 1y ago
I'm not a Catholic, but wasn't the idea of an indulgence that God intentionally allowed an alternative path to redemption, such that if you buy an indulgence, you are (at least by their definition) worthy and deserving? I always thought of this as essentially the same idea as with Civ allowing you different paths to victory.
- swat535 1y ago
  Yes indulgences mean something different in Catholicism, they remit the "temporal effects" of Sin ie its spiritual consequences but don't "forgive" it like "Sacrament of Reconciliation" would.. I think that parent is perhaps confusing it with the sin of Gluttony.
- noah_buddy 1y ago
  My point was that many people view ozempic and other drugs like Martin Luther viewed buying an indulgence: a cheat for the undeserving.
  - j2bax 1y ago
    I thought Martin Luther's issue was more with the organization selling indulgences than the undeserving buying them. He preached justification by faith alone. Not some org selling justification.
- kjkjadksj 1y ago
  The idea was for the bishop to pocket money and wave a wand and say “saved” after someone with means did something morally embarrassing. It was a racket and also a useful PR tool.
Aurornis 1y ago
> Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. I feel like I've seen and heard more of the opposite: The trend is to avoiding anything that might make someone feel blame for arriving in their situation. With obesity the trend is to blame some combination of "our food supply", trending science topics like microplastics or the microbiome, and genetics. I've heard countless people explain to me that dieting doesn't work for them. It's not hard to find people claiming they ate <1000 calories per day and still gained weight. Even Eliezer Yudkowsky, a figurehead of the "rationalist" movement, has written about "metabolic disprivilege" and claimed that his genetics do not allow him to lose weight through dieting. This thinking runs deep. What's interesting about GLP-1 inhibitors is that they modulate the intake portion of the diet, which shatters these previous notions that some people had "metabolic disprivilege" and simply could not lose weight by reducing caloric intake. They just make it easier to reduce food intake.
- nxobject 1y ago
  > I feel like I've seen and heard more of the opposite: The trend is to avoiding anything that might make someone feel blame for arriving in their situation. > I've heard countless people explain to me that dieting doesn't work for them. I think you're being a tad reductive – "dieting right now doesn't work for me for reasons I can't control" and "reducing calorie intake will help me reduce weight" aren't necessary contradictory, and don't imply "I'm going to attribute it all to biology/blame it on something general". Anyway, let me assert the opposite: as a partner of a nutritionist who's talked (with anonymity) about her clients, the majority of the people she's worked with, who struggle with sustainably reducing calorie intake over the course of years, come to dieting with that logic, and _then_ struggle against specific barriers, and _then_ blame themselves. (A recent example: "because of my work schedule I don't get enough sleep, which leads to weight gain and time only for frozen food – on top of my predispositions".) In that case, GLP-1 inhibitors as an intervention _complements_ the way her clients think about dieting.
  - Aurornis 1y ago
    > and _then_ blame themselves. I was responding to a comment about Americans blaming others, not dieters blaming themselves. The concept of "blame" isn't really helpful anyway. The problem I frequently see is that blame becomes something to be avoided, which turns into a game of externalizing the source of the problem, which makes people think the problem is out of their hands. A similar pattern happens in addiction and addiction counseling, where well-meaning friends and family try to soften the blow by telling the person that the addiction was not their fault, it was the result of their circumstances or bad influences. Addiction counselors have to undo this thinking and find a way to gently get the person to take some ownership of their role in arriving at the problem, which is the first step to having some control over correcting it. For nutrition, when people convince themselves that they have a hidden metabolic disadvantage that makes caloric restriction not work for them, they're more likely to give up than anything.
trhway 1y ago
>My opinion is to wait long enough to validate there are no long term harms, but beyond that, yeah, adjust the priors, it could be a modern aspirin. it can be more than aspirin. Such an effect on glucose should, among other things, be affecting cancer, probably in a very positive way.
throwawaylaptop 1y ago
You can be gluttonous and still thin. I eat 2 lbs of ground beef a day, with tons of cheese on it. For breakfast I have 6-8 eggs, with cheese. I have my morning coffee with heavy whipping cream. For desert, I whip up some of the heaving whipping cream and have it with frozen berries thawed out. It drives gfs nuts but they're too anti fat to try it.
- Aurornis 1y ago
  Eggs have about 60 calories each. Cooking 2lbs of ground beef could yield a little over 1500 calories (Source https://www.uhhospitals.org/health-information/health-and-wellness-library/article/nutritionfacts-v1/beef-ground-80-lean-meat--20-fat-loaf-cooked-baked-1-loaf--yield https://www.uhhospitals.org/health-information/health-and-we... ) A tablespoon of heavy whipping cream is 50 calories. There's nothing incompatible with what you wrote and a 2500 calorie diet. This confuses a lot of people who associate certain foods with becoming fat, or think that eating fat makes you fat. It's entirely possible to eat what you described and maintain a neutral weight. There isn’t any real secret to this: This combination of foods leads to you eating a calorically neutral amount every day. That’s a horrifying amount of saturated fat per day, though. This is an extreme risk for heart disease.
  - throwawaylaptop 1y ago
    I agree of course. Only note is when I say coffee with heavy cream, I mean like half a cup of it into espresso to make a cream latte. And over a cup whipped for desert. But I'm also 6'4". When I ate the standard American diet I was about 40 lbs heavier than I am now.
  - buu700 1y ago
    That’s a horrifying amount of saturated fat per day, though. This is an extreme risk for heart disease. I keep hearing this, yet after 13 years of keto my cholesterol is still 100. Being fat is much higher-risk than eating fat. I'm all for obese people taking Ozempic if they really need it, as well as thoroughly studying its long-term benefits and risks, but the fact that we're at the point of considering medical intervention as the population-wide solution to obesity is an abject failure of policy. Looking at our nutritional guidelines, you'd think everyone in America was an extreme athlete. All we have to do is: 1. Take something like the food pyramid, and put vegetables on the bottom, put fat/dairy/coconut and protein/meat/eggs/soy/mycelium in the next level up, put fruit in the next level up, and put starches and sugars on top. In other words: eat real food, mostly plants, without extreme high-carb macros, and treat fruits as dessert. Reverse the failed policy of demonizing saturated fat, and make this the official dietary recommendations for at least a generation. 2. Provide an incentive structure to use lower-GI ingredients in food products. For example, largely replace sugar with inulin fiber sweetened with stevia and/or monk fruit, and largely replace flour with alternatives made from blends of flax, wheat gluten, and resistant starch; no one will notice the difference. Stop letting Cheerios of all things market itself as "heart healthy", at least with its current formulation. In this world, people would eat way more veggies because they'd grow up with parents and restaurants preparing them properly (with saturated fat and salt). Even for those who didn't, high fiber fortification of UPFs would provide a reasonable backstop. The low-fat/low-salt era's reframing of healthy food as "bland" is a crime against humanity. For any fat people we still have after that, sure, put them all on Ozempic. It just shouldn't be the expected default that unmedicated people are fat while the medical establishment shrugs its shoulders and doubles down on half a century of empirically bad advice.
glp1guide 1y ago
I agree with this take but want to add that once everyone is doing it, these opinions will change drastically and everyone will pretend like they were never against it. Another interesting question is where do people go from there? What is the next signal of virtue, I wonder.
bjackman 1y ago
There's also a horseshoe effect here. At the other end are people who advocate for fat acceptance and see the GLP-1 drugs as another source of pressure to be thin. (Not everyone can take semaglutide etc without unpleasant side effects).

NoMoreNicksLeft 1y ago

>My opinion is to wait long enough to validate there are no long term harms, What's your threshold on that? How many years is "long enough"? Trying to calibrate my own sense of risk.

dexwiz 1y ago
Not OP but 10-15 years for most drugs. Took about a decade for the general consensus around Oxy to change.
- 2OEH8eoCRo0 1y ago
  Haven't these been out for a very long time, just not for weight loss? A quick Wikipedia search shows Exenatide was FDA approved in 2005 for diabetes.
  - mapontosevenths 1y ago
    Ozempic itself has been in use for almost a decade now (originally approved for type 2 diabetes in 2017). Many millions of people have taken it, without much in the way of serious complication. Exenatide had been in use since about 2005, and by 2019 had more than a million people on it. Some of those patients have literally been on it for 20 years. It does have a worse side-effect profile than Ozempic (or the more modern GLP-1's like zepbound), but even then the benefits outweigh the risk for those diabetics. Today it is hard to argue the benefits of modern GLP-1s don't outweigh their risks. They've been extensively tested, the class of drug has been around for decades, and they are used by many millions of people. I personally lost 120 pounds on Zepbound in a little less than a year. It's been life changing, and anyone who thinks I might be less healthy now is very clearly wrong. Literally every aspect of my life has been greatly improved.
gryn 1y ago
I'm a late adopter to most things. my estimate would bigger than others and I would put it at 30-50years. I take smoking as a cautionary tale, in the beginning it was pushed as not just a recreational thing but a healthy activity that bring benefits with papers published to sing praises about it. my parents were even nudged by their teachers/doctors/etc when they were young to try smoking. now we all know that smoking is beyond bad and all that early "research" was just people paid off by big companies to promote it.
- daedrdev 1y ago
  I think a lot of people share similar concerns, but the benefits of a successfully therapy are so extreme it would take quite a lot to derail ozempic. People easily gain 5 or more years of lifespan by not being obese, avoid myriad related health conditions, and are truly much better off. It would take a lot to reduce someone's life expectancy by a comparable amount and we haven't seen that much besides gastrointestinal issues. We performed the surgical options like stomach reduction before this which come with serious danger for comparison
  - radiofreeeuropa 1y ago
    Under-discussed benefit: being able to have all your clothes actually fit at the same time (no wardrobe scattered between your "skinny" weight and your "fat" weight and rarely being in the right place for more than a handful of pieces to fit entirely correctly) so you can spend up a little on nicer clothes without worrying you'll only be able to wear them part of the time. Worst case, you start to pack on a little too much and they start getting tight, you increase the dose or go back on the drugs for a week or three (or just do it the old fashioned way—hey, it works some of the time, temporarily) and ta-da, right back where you want to be—you're not going to pack on weight and find yourself unable to lose, so buying "skinny clothes" isn't mortgaged against your future success at forcing yourself to eat less.
- krisoft 1y ago
  > I take smoking as a cautionary tale, in the beginning it was pushed as not just a recreational thing but a healthy activity While i agree the gist of what you are saying, also important to mention that humans started cultivating tobaco when mamoths still roamed the Earth. There was indeed a concentrated pro-smoking publicity campaign by tobaco manufacturers in the 1930s, but it was hardly “in the beginning” of our tobaco use.
bradleyjg 1y ago
There’s two sides to that coin. Obesity has known long term harms. So what we are looking for in a deal breaker can’t be a small but statistically significant increase in some cancer or other. We’d need something as bad as smoking to outweigh the benefits.

stronglikedan 1y ago

> Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. As an American with a sister with thyroid issues, I can say that is absolutely not true for the majority of Americans. People are mostly sympathetic to those who are not obvious slobs.

drowsspa 1y ago
People are mostly sympathetic when it's physical issues. Psychological issues are treated as diseases of the soul that you only need God or willpower or whatever to fix. And most fat people are fat because of the incentives in our society, but admitting that also goes against certain political ideologies...
- jfim 1y ago
  What are the incentives for people to be fat, out of curiosity? Do you mean farm subsidies for corn, for example?
  - const_cast 1y ago
    At a low level, yes, corn, but at a high level: more consumption = more money. Everyone benefits from you being fat. Your doctors, your car manufacturer, food manufacturers, everyone. Except maybe health insurance. But they're not hurt too too much.
    - deleted 1y ago
      [deleted]
    - XorNot 1y ago
      There is no doctor on Earth who goes to work and thinks "thank god for fat people or I wouldn't have a business". There's plenty of doctors and surgeons who wish there were less fat people, because they enormously complicate doing surgery on and managing in hospitals.

cm2187 1y ago

And also the idea that it is "easy" to lose weight is completely out of touch. If it was there wouldn't be millions of people trying hard, spending money on trying and failing for decades, and entire businesses addressing that. RFK Jr's "let them eat less" is paradoxically the modern version of "let them eat cake"!

kulahan 1y ago
I think many people confuse simple with easy. It IS simple to reduce your weight. There are like, two things you need to do. It is, however, VERY hard to actually do those things.
- morkalork 1y ago
  Even then, limiting calorie intake isn't all that difficult; there's a reason why intermittent fasting took off and so many people were getting results from it.
  - nosignono 1y ago
    It is that difficult, otherwise everyone would do it.
  - tsol 1y ago
    Not necessarily. Some people respond well too intermittent fasting but not everyone. Some people respond to keto but not everyone. And just because you respond doesn't mean it's gonna take you to where you need to be. I've always been skinny but for some reason I've gained weight recently. Even with keto, intermittent fasting, tirzeptide, and workouts twice a week I have only lost 5 lbs in months. When I was skinny and forgot to eat, I would feel a little crappy but still could function. Now I begin to feel incredibly depressed, I can't sleep nor focus. This solidified it to me that there's a circuit in your brain that controls feeding and if it's out of whack it'll punish you until you eat. Dieting takes months and no one can go that long without sleep. So it's still a practical problem, its just hard to see if your system is well calibrated.

naravara 1y ago

The weight loss mechanism largely just comes from suppressing appetite though, so it still lines up with the penance for sin narrative. It’s not that different from wearing a hair-shirt and whipping yourself if you find yourself having lustful thoughts. Only instead of a whip you just feel kind of uncomfortable and nauseous if you eat too much.

cheald 1y ago
That's true of semaglutide, but newer peptides like tirzepatide (a dual-agonist) and retatrutide (a triple agonist) have additional effects like improving insulin sensitivity, and simultaneously slowing the release of glucagon and activating glucagon receptors, which directly increases fat oxidation and thermogenesis.
radiofreeeuropa 1y ago
I'd describe the effects as basically the opposite of self-torture. Self-torture is dieting/fasting without the drugs. With them, it's great. No afternoon light-headedness and difficulty concentrating, no hunger pangs, no "hangry" effect, no cravings you have to keep suppressing. Just smooth sailing. (though experiences do seem to vary—as do dosage levels)

thaumasiotes 1y ago

> Gluttony or overeating are not the sin, but being fat. This is a strange thing to say. If you do something normal, and you end up in a normal state, why would that be a moral failing? There's no such thing as "overeating". Different people eat different amounts. The same person eats different amounts at different times. > (From that perspective:)a miracle cure that allows someone to stop being fat is like an indulgence (in the Roman Catholic sense). It’s a cheat, a shortcut that allows the unworthy to reach a state they do not deserve. This is incoherent. If you believe that being fat is a sin, but that the things you do that make you fat are not sins, then a miracle cure that makes you thin removes the only sin you were committing. You can't be unworthy if you're not fat. In order for a miracle cure to be "cheating", it is necessary that the sin is in the behavior and not the result.

frumper 1y ago
Everyone defines normal differently and people are quite good at judging those that are not their normal.
- thaumasiotes 1y ago
  Did you mean to respond to someone else?

falcor84 1y ago

I'm not a Catholic, but wasn't the idea of an indulgence that God intentionally allowed an alternative path to redemption, such that if you buy an indulgence, you are (at least by their definition) worthy and deserving? I always thought of this as essentially the same idea as with Civ allowing you different paths to victory.

swat535 1y ago
Yes indulgences mean something different in Catholicism, they remit the "temporal effects" of Sin ie its spiritual consequences but don't "forgive" it like "Sacrament of Reconciliation" would.. I think that parent is perhaps confusing it with the sin of Gluttony.
noah_buddy 1y ago
My point was that many people view ozempic and other drugs like Martin Luther viewed buying an indulgence: a cheat for the undeserving.
- j2bax 1y ago
  I thought Martin Luther's issue was more with the organization selling indulgences than the undeserving buying them. He preached justification by faith alone. Not some org selling justification.
kjkjadksj 1y ago
The idea was for the bishop to pocket money and wave a wand and say “saved” after someone with means did something morally embarrassing. It was a racket and also a useful PR tool.

Aurornis 1y ago

> Many people (will only speak to America), view being fat as a literal moral failing. Gluttony or overeating are not the sin, but being fat. I feel like I've seen and heard more of the opposite: The trend is to avoiding anything that might make someone feel blame for arriving in their situation. With obesity the trend is to blame some combination of "our food supply", trending science topics like microplastics or the microbiome, and genetics. I've heard countless people explain to me that dieting doesn't work for them. It's not hard to find people claiming they ate <1000 calories per day and still gained weight. Even Eliezer Yudkowsky, a figurehead of the "rationalist" movement, has written about "metabolic disprivilege" and claimed that his genetics do not allow him to lose weight through dieting. This thinking runs deep. What's interesting about GLP-1 inhibitors is that they modulate the intake portion of the diet, which shatters these previous notions that some people had "metabolic disprivilege" and simply could not lose weight by reducing caloric intake. They just make it easier to reduce food intake.

nxobject 1y ago
> I feel like I've seen and heard more of the opposite: The trend is to avoiding anything that might make someone feel blame for arriving in their situation. > I've heard countless people explain to me that dieting doesn't work for them. I think you're being a tad reductive – "dieting right now doesn't work for me for reasons I can't control" and "reducing calorie intake will help me reduce weight" aren't necessary contradictory, and don't imply "I'm going to attribute it all to biology/blame it on something general". Anyway, let me assert the opposite: as a partner of a nutritionist who's talked (with anonymity) about her clients, the majority of the people she's worked with, who struggle with sustainably reducing calorie intake over the course of years, come to dieting with that logic, and _then_ struggle against specific barriers, and _then_ blame themselves. (A recent example: "because of my work schedule I don't get enough sleep, which leads to weight gain and time only for frozen food – on top of my predispositions".) In that case, GLP-1 inhibitors as an intervention _complements_ the way her clients think about dieting.
- Aurornis 1y ago
  > and _then_ blame themselves. I was responding to a comment about Americans blaming others, not dieters blaming themselves. The concept of "blame" isn't really helpful anyway. The problem I frequently see is that blame becomes something to be avoided, which turns into a game of externalizing the source of the problem, which makes people think the problem is out of their hands. A similar pattern happens in addiction and addiction counseling, where well-meaning friends and family try to soften the blow by telling the person that the addiction was not their fault, it was the result of their circumstances or bad influences. Addiction counselors have to undo this thinking and find a way to gently get the person to take some ownership of their role in arriving at the problem, which is the first step to having some control over correcting it. For nutrition, when people convince themselves that they have a hidden metabolic disadvantage that makes caloric restriction not work for them, they're more likely to give up than anything.

trhway 1y ago

>My opinion is to wait long enough to validate there are no long term harms, but beyond that, yeah, adjust the priors, it could be a modern aspirin. it can be more than aspirin. Such an effect on glucose should, among other things, be affecting cancer, probably in a very positive way.

throwawaylaptop 1y ago

You can be gluttonous and still thin. I eat 2 lbs of ground beef a day, with tons of cheese on it. For breakfast I have 6-8 eggs, with cheese. I have my morning coffee with heavy whipping cream. For desert, I whip up some of the heaving whipping cream and have it with frozen berries thawed out. It drives gfs nuts but they're too anti fat to try it.

Aurornis 1y ago
Eggs have about 60 calories each. Cooking 2lbs of ground beef could yield a little over 1500 calories (Source https://www.uhhospitals.org/health-information/health-and-wellness-library/article/nutritionfacts-v1/beef-ground-80-lean-meat--20-fat-loaf-cooked-baked-1-loaf--yield https://www.uhhospitals.org/health-information/health-and-we... ) A tablespoon of heavy whipping cream is 50 calories. There's nothing incompatible with what you wrote and a 2500 calorie diet. This confuses a lot of people who associate certain foods with becoming fat, or think that eating fat makes you fat. It's entirely possible to eat what you described and maintain a neutral weight. There isn’t any real secret to this: This combination of foods leads to you eating a calorically neutral amount every day. That’s a horrifying amount of saturated fat per day, though. This is an extreme risk for heart disease.
- throwawaylaptop 1y ago
  I agree of course. Only note is when I say coffee with heavy cream, I mean like half a cup of it into espresso to make a cream latte. And over a cup whipped for desert. But I'm also 6'4". When I ate the standard American diet I was about 40 lbs heavier than I am now.
- buu700 1y ago
  That’s a horrifying amount of saturated fat per day, though. This is an extreme risk for heart disease. I keep hearing this, yet after 13 years of keto my cholesterol is still 100. Being fat is much higher-risk than eating fat. I'm all for obese people taking Ozempic if they really need it, as well as thoroughly studying its long-term benefits and risks, but the fact that we're at the point of considering medical intervention as the population-wide solution to obesity is an abject failure of policy. Looking at our nutritional guidelines, you'd think everyone in America was an extreme athlete. All we have to do is: 1. Take something like the food pyramid, and put vegetables on the bottom, put fat/dairy/coconut and protein/meat/eggs/soy/mycelium in the next level up, put fruit in the next level up, and put starches and sugars on top. In other words: eat real food, mostly plants, without extreme high-carb macros, and treat fruits as dessert. Reverse the failed policy of demonizing saturated fat, and make this the official dietary recommendations for at least a generation. 2. Provide an incentive structure to use lower-GI ingredients in food products. For example, largely replace sugar with inulin fiber sweetened with stevia and/or monk fruit, and largely replace flour with alternatives made from blends of flax, wheat gluten, and resistant starch; no one will notice the difference. Stop letting Cheerios of all things market itself as "heart healthy", at least with its current formulation. In this world, people would eat way more veggies because they'd grow up with parents and restaurants preparing them properly (with saturated fat and salt). Even for those who didn't, high fiber fortification of UPFs would provide a reasonable backstop. The low-fat/low-salt era's reframing of healthy food as "bland" is a crime against humanity. For any fat people we still have after that, sure, put them all on Ozempic. It just shouldn't be the expected default that unmedicated people are fat while the medical establishment shrugs its shoulders and doubles down on half a century of empirically bad advice.

glp1guide 1y ago

I agree with this take but want to add that once everyone is doing it, these opinions will change drastically and everyone will pretend like they were never against it. Another interesting question is where do people go from there? What is the next signal of virtue, I wonder.

bjackman 1y ago

There's also a horseshoe effect here. At the other end are people who advocate for fat acceptance and see the GLP-1 drugs as another source of pressure to be thin. (Not everyone can take semaglutide etc without unpleasant side effects).