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There's anecdotes, and there's science. Individually, there's (previously) been nothing better to suggest than "try harder (and, maybe, smarter)". Statistical
by radiofreeeuropa 1y ago
There's anecdotes, and there's science.
Individually, there's (previously) been nothing better to suggest than "try harder (and, maybe, smarter)".
Statistically it was almost useless, but it's the best we had. It's not bad advice exactly, it's just extremely unlikely to work for long-term, sustained weight loss.
It also very much appears to be the case that weight gain and loss are heavily influenced by environmental factors. Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that. It'd be kinda weird if we expected "just try harder" to work very well when that's evidently not the mechanism by which skinny countries are skinny. Alternatively, if it is willpower doing it, we're just adding a step, because then it appears that environment strongly influences willpower, instead, since the same observations hold.
Sure, sometimes it works for individuals. In fact, it often works temporarily, causing a yo-yo effect. It can work for long periods (many years without a slip) but that's rare.
If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No, it won't, it's amazingly ineffective, even very expensive high-touch interventions involving multiple experts aimed at weight loss and lifestyle change and such are wildly less effective than "inject GLP-1 agonists" or "move somewhere skinnier".
- throwawaylaptop 1y ago[flagged]
- radiofreeeuropa 1y agoRun a study of your approach and show good results over a cohort for 2+ years and you'll make an entire sub-field of medical scientists very happy. [EDIT] It's not that your approach can't work, it's that if (for example) people had as hard a time following the directions for condoms as they do following diet & workout plans, we'd never allow condoms to be sold as contraceptives, they'd not even be close to being OK to promote as useful for that purpose. It wouldn't matter if a few people could follow the directions and it worked 100% of the time for them.
- throwawaylaptop 1y ago[flagged]
- op00to 1y agoYou’re a fool. “Pull out” does not protect against pregnancy or STDs. Pre-ejaculate can have viable sperm in it.
- throwawaylaptop 1y ago[flagged]
- bluGill 1y agoYou reduce the odds. It is good for those who want kids but not 20 - which is likely the result with nothing at all. does nothing about stds though.
- backscratches 1y agopre ejaculate contains zero sperm if you havent fully ejaculated previously. there is no mechanism for sperm to be released during preejaculation.
- vidarh 1y ago[dead]
- komali2 1y agoPull out method is a less viable method of preventing pregnancy, and especially less viable at preventing STDs. However, it's still considered a contraceptive strategy. https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method/how-effective-is-withdrawal-method-pulling-out https://www.plannedparenthood.org/learn/birth-control/withdr... For every 100 people who use pull out method perfectly, within a year, 4 will get pregnant. Since not everyone does a great job doing it, in reality 22 get pregnant every year. Here's a great overview page: https://www.plannedparenthood.org/learn/birth-control https://www.plannedparenthood.org/learn/birth-control in summary, condoms are 87% effective at preventing pregnancy, and withdrawal is 78% effective. For a going-steady couple that isn't worried about STDs, keeps an emergency contraceptive ('morning after pill') ready for oopsie mistakes, and live in a country that grants women bodily autonomy (or have discussed and accepted that a mistake might lead to a child), pullout is a perfectly valid contraceptive mechanism. There are better, but considering that basically every method except a condom/internal condom can cause extreme discomfort or bad side effects to the woman in the relationship, I think it's totally fine to choose pull-out.
- op00to 1y ago[flagged]
- aydyn 1y agoMaybe dont take it personally bro. Unless your identity is tied to posting on HN.
- throwawaylaptop 1y agoI've been on here for 10+ years I think at this point. New throwaway, named throwaway to not even lie, every few months. I tweet with Paul G every now and then positively, because I'm nicer on there. But sorry you dont think I provide value.
- maest 1y agoFor someone as clever as you, I'm sure it's obvious why using a throwaway greatly diminishes the value of what you're saying. To spell it out for you: there is value to having some notion of persistent identity even on pseudonymous forums. Anyone can use a throwaway and say anything - and valiantly admitting you're using a throwaway doesn't change this fact.
- unethical_ban 1y agoIt should not be surprising as to why someone would be suspicious in 2025, if someone is insulting anyone who got success from a drug by saying "my dad's dirt worked for him" and then complaining about declining quality on the forums. Use throwaway identity, pay the price. I'm glad your dad is healthy and yes, carbs cause issues.
- rockemsockem 1y agoI find that almost all doctors give useless advice. On multiple occasions I've been advised that there was nothing wrong but they can run a scan "if I insist" and then bam, the exact problem I expected shows up clear as day. They're morons for the most part.
- throwawaylaptop 1y ago[flagged]
- homefree 1y agoIt’s like any other field, most suck and it requires effort to find the smart ones.
- rockemsockem 1y agoYep, 100%. It just feels worse with doctors imo because it feels like the culture treats them like some monolith of skill and wisdom.
- deleted 1y ago[deleted]
- c4ptnjack 1y agoThe zeitgeist has pushed the idea carbs/grains and sugar are terrible over the last 40 years on and off, so that seems to say more about the medical industrial complex, than anything. That's fair, but if that message has been pushed so consistently, why didn't we see a real decrease in the consumption of those things and the associated weight loss?
- deleted 1y ago[deleted]
- ses1984 1y agoBecause carbs taste great.
- rkomorn 1y agoI can confirm.
- satyrun 1y agoIt is really more than just taste though. I am on a GLP-1 level calorie restricted diet right now without a GLP-1 and of course it is just miserable. I love eating a giant sandwich at night that is more calories than what I am eating all day now but it isn't the taste it is the brain chemical release. It is an addiction like any other addiction. I have never felt that same craving for chicken breast.
- ranger_danger 1y ago[flagged]
- sarchertech 1y agoDoctors don’t get paid for writing prescriptions. They don’t get kickbacks for writing prescriptions. A small subset of doctors are paid by pharmaceutical companies to run trials or provide expertise, but you can look that up since it’s publicly available information, and it’s not based on them prescribing you anything. At most a drug rep comes by and brings donuts or something to talk about their new drugs. Source wife is a doctor.
- _345 1y agoMy dad got box seats to a hockey game when I was a wee lad so theyll sometimes throw money at docs
- KPGv2 1y agoThanks to Obama and the Sunshine Act, this basically never happens anymore. https://www.mdlinx.com/article/a-physician-s-guide-to-acceptable-pharma-swag/lfc-3715 https://www.mdlinx.com/article/a-physician-s-guide-to-accept... Increased reporting requirements and a cap on the value of these gifts that is far too low for box seats. My wife's a physician, and I've seen these things change dramatically. Sometimes some food for the whole office will get dropped off. Or donuts. No one's getting box seats to a pro sports game anymore.
- HWR_14 1y agoThe rules changed around a decade ago to limit the amount of gifts a doctor could receive from pharmaceutical companies.
- Spooky23 1y agoHuh? Drug reps have scorecards for the doctors they call on and throw perks at the top performers or influencers. It also depends on the speciality - dermatologists working for price equity mills are almost evaluated like salespeople. Source: girlfriend is a rep.
- _345 1y agoThen what should I do :(
- toomuchtodo 1y agoGet a GLP-1 under the supervision of a doctor or other licensed medial provider.
- ykonstant 1y agoAs a chronically obese, non-diabetic individual, here in Greece it is impossible to convince a doctor to prescribe anything close to that :(
- siva7 1y agoGet it simply over other legal channels instead of fighting with the stupidity of the local medical system.
- mghfreud 1y agoVisit Turkey for a couple weeks. Rules are the same, but behavior is the opposite. Weekly dose of 1mg is sold over the counter for around 150$.
- jart 1y agoAnd it's thanks to that kind of dishonorable practice that $NVO has lost 64% of its value over the last year. This is how the world rewards the makers of the most successful and helpful drug in history.
- toomuchtodo 1y agoThey’ve been rewarded enough (~$14.65B USD net profit 2024), and are lucky they’re allowed to capture any further economic benefit from the sale of a simple compound (imho).
- verisimi 1y ago> There's anecdotes, and there's science. > If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No Are you an individual or a population though? Take off the telescopes (and data, and science), and look at the world through your own eyes. No one needs (or can) to address the obesity crisis in the population. The only crises that can be solved are the ones individuals find in themselves.
- vidarh 1y agoAnd odds are very firmly that you'll fail. That's what the science shows us.
- gmadsen 1y agohaving the understanding of the science and self motivated enough to make lifestyle changes already puts you a couple standard deviations out of the population average, such that I don't really think its helpful as a comparison or something to model after
- vidarh 1y agoThe science is clear that people who do make changes and achieve initial results are still overwhelmingly likely to fail at maintaining the results. Lots of people successfully make changes and lose weight, but exceedingly few manage to keep it low over time.
- gmadsen 1y agoyou are misunderstanding my point. There is a selection bias. Those with the reading comprehension and scientific aptitude to make a statement like "the science is clear" with accuracy and confidence is already exceedingly rare. My assertion is that the success of long term weight changes is not independent from that variable.
- 1y ago
- randomNumber7 1y agoI think it's mainly the food that makes skinnier countries skinnier. People in the US eat absolute shit. Even the bread is full with sugar. Good for capitalism if you can feed that to the people and then give them an injection to be healthy again I guess.
- eru 1y ago> Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that. Do we have data on that? I guess you could look at natural experiments, like people who lost and won H1B lotteries, and see if only the ones actually making it to the US get fat?
- radiofreeeuropa 1y agoYes, it’s a google away.
- skeezyboy 1y agoyou are taking in more calories than you are burning off, for whatever reason. its that simple