10 ms·

> “The data show clear changes in food spending following adoption,” Hristakeva said. “After discontinuation, the effects become smaller and harder to distingui

by nemomarx 10mo ago

> “The data show clear changes in food spending following adoption,” Hristakeva said. “After discontinuation, the effects become smaller and harder to distinguish from pre-adoption spending patterns.” It's interesting that overall spending doesn't decrease that much in the end, although shifting from snacks to fruit is the kind of change health advocates have always wanted?

giuliomagnifico 10mo ago
After discontinuation of Ozempic, people start to gain the weight again (and buy again more food), that’s why the spending changes again.
- jacobthesnakob 10mo ago
  Which is no surprise to anybody with common sense, the data for discontinuing GLP-1s show exactly the intuitive outcome. Zero diet change, zero habit change for the vast majority of users. Weight loss is accomplished via biochemical tricks to eat less volume of calorie dense junk food, rather than diet substitution. When the artificial appetite suppression ends, volume of the same food increases again leading to weight yo-yo. Plus why start to exercise when you’ve got a magic weight loss drug? Don’t get me wrong, there are some people using these drugs to get out of a pit of inertia with weight and sedentary lifestyles. But it’s small. GLP-1 drugs will have most users hooked for life because they don’t have the discipline and motivation to maintain the weight loss without it. Cha-Ching!
  - rootusrootus 10mo ago
    > they don’t have the discipline and motivation to maintain the weight loss That argument has been tried for years and yet it fails nearly 100% of the time. Should we be trying something different than claiming it's a moral issue? Or is that too scientific?
    - jacobthesnakob 10mo ago
      Why do we need to try anything? This comes down to individualism versus collectivism. Besides, the logical consequence of the portion of my comment you highlighted is that the majority of GLP-1 patients will need to be on these drugs forever to maintain these benefits long-term. We have precisely one trial of 5+ years of patients taking liraglutide, and ~2 years for semaglutide. Some side effects and long-term consequences could be entirely unknown.
      - amanaplanacanal 10mo ago
        It's possible that there could be long term side effects that we don't know about, but given the number of people taking these drugs we would likely already have seen some indication of them. I guess we will find out!
      - astrange 10mo ago
        All the side effects I've seen of GLP-1s are positive, and we've had diabetes patients taking them for much longer than that. Anyway, it's fairly obvious that discipline is not a solution to weight loss, because weight gains a) happened in lab and pet animals on the same timescales they happened to humans and b) are reversed by moving to higher altitudes. So to be productive, you should be telling people to move to Colorado.
      - pixl97 10mo ago
        >This comes down to individualism versus collectivism. All fun and games until it costs every individual a massive amount.
    - zahlman 10mo ago
      > That argument has been tried for years and yet it fails nearly 100% of the time. No, it doesn't. Saying that people lack an ability is not the same as claiming that the problem is a simple matter of instilling that ability. > Should we be trying something different than claiming it's a moral issue? It also isn't the same as shaming people or making a moral issue out of it. > Or is that too scientific? The snark is uncalled for. "Science" doesn't require ignoring obviously true proximate causes in search of ultimate causes.
  - WheatMillington 10mo ago
    Weight gain/loss is not a matter of motivation and discipline.
    - phil21 10mo ago
      It absolutely can be. It was for me. Is it for everyone? Perhaps not. But to outright unequivocally say it's not is simply outright incorrect. It was absolutely motivation and discipline for me. One day I just decided enough was enough and I threw the proverbial kitchen sink at it. I am perhaps an outlier in that I'm not ashamed to say I was obese in the past because I simply lacked the motivation and desire to do the work to change it. It was easier and more comfortable being fat than in shape. I definitely agree telling an obese person to eat less and move more is about as useful as telling a depressed person to just stop being depressed. But lets not make outlandish claims either.
      - oarfish 10mo ago
        Great, your one of the few. Statistics are pretty clear that most people cannot willpower their way out of their food seeking behaviours. They are to a large extent not under your concious control. correcting satiety signaling on a chemical level more directly addresses the problem in those folks. yes, the food environment is the main problem, in a way, but only because it punishes having a certain set of chemical and lifestyle parameters and rewards others.
- FatherOfCurses 10mo ago
  People must be getting prescribed this medication in a vacuum without any corresponding nutritional guidance. I can't see any way of going back to my previous eating habits, mainly because I've really had my eyes opened to how mindless some of my eating was before.
  - SketchySeaBeast 10mo ago
    Just like any weight loss and gain, this is the sort of things that happens over years. You lose the weight, then five years later realize your weight has started creeping back up. Once you're heavy the battle never really ends.
  - kjkjadksj 10mo ago
    It is no surprise given the issue at hand. I mean it is people who failed at dieting and managing weight using the methods shouted from rooftops for a century or more now. Doctor could say whatever and its clearly in one ear out the other. A lot of these patients are taking it as a silver bullet, a quick fix. If you have to actively manage your diet anyhow while on the drug, the whole issue around diets and exercise the drug attempts to surmount, one wonders at the purpose of the drug.
  - sjw987 10mo ago
    You're in the faux enlightenment that everybody gets during weight loss. Everybody I've ever known losing weight starts discovering the wonders of healthy eating and nutrition as they lose weight, vowing never again to go back to their old habits. Then they slip further down the line and 1-2 years they're back to their original weight, plus some. Weight loss isn't the challenge. Maintaining it for the rest of your life is.
- SkyPuncher 10mo ago
  Processed foods are much cheaper per calorie than "healthy" options. GLP-1 helped me kick my cravings for junk food, but that just meant I was eating more of the "expensive" stuff. Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit.
  - zahlman 10mo ago
    > Processed foods are much cheaper per calorie than "healthy" options. > Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit. I won't bother with currency conversion because we're comparing ratios. 50 cents here gets a third of a 200g bag of generic brand potato chips, so 360 calories. Doritos are probably at least twice that expensive but whatever. (The generic-brand sandwich cookies that are my personal vice, are cheaper yet. There's so much variation within these vaguely-defined food categories that I can't take the comparison across categories seriously.) $1.50 gets probably a half dozen bananas here, at around a hundred calories per. Never mind the yogurt. (If you're buying fresh cut fruit you're simply doing it wrong.) So if you're purely comparing calorie counts and finding yourself on less-calorie-dense options then yeah there's a ratio but it's still not as bad as people think. But this is still fundamentally committing a fallacy equating "less calorie-dense" with "healthy". The same 360 calories from white rice cost me perhaps 15 or 20 cents (plus the time and energy to cook). I'm not big on brown rice but I'm sure I don't have to pay several times as much for it unless it's some fancy boutique thing. 360 calories from dried split legumes (packed with protein and fibre), similarly, are in the ballpark of 30 cents. Perhaps you don't "snack" on those things, but you get the point.
    - vorpalhex 10mo ago
      And this is the issue with these "healthy"/"processed" discussions. If you live off bananas and rice, you are not going to be healthy. You can get just as fat off plantains as you can doritos. Peanut butter (which is at least partially processed) can be a healthy part of your diet. It can also absolutely wreck it.
      - 10mo ago
spockz 10mo ago
Around here fruit is significantly more expensive than snacks. In fact, replacing the snacks with healthy food in our case increased spending. So it is awesome that these households managed to cut spendings.
- vidarh 10mo ago
  Yeah, I'm not on ozempic (though considering it, to get the last bit of the way to where I want to be and ensure I don't bounce back, which is frankly a lot harder than "just" the initial loss) but lost 20kg+ on diet changes, and the price of fruit and berries is shockingly high. But my dietary change still saved us a lot more from cutting takeaways alone...
- calpaterson 10mo ago
  > fruit is significantly more expensive than snacks This is a commonly repeated claim but it's usually not true. Fruit is, in fact, pretty cheap: In the US, bananas average $1.68/kilo: https://www.numbeo.com/cost-of-living/country_price_rankings?itemId=118 https://www.numbeo.com/cost-of-living/country_price_rankings... A kilo is usually ~6 bananas. So a banana costs maybe 28c on average. Find a cost-competitive ultra-processed snack for the calories and satiety that a banana provides. Healthy eating might not is cheap but junk food, specifically, is not usually a cost optimisation.
  - eru 10mo ago
    Well, some fruits are cheap. But there's plenty of expensive fruits that people might want to eat, too.
    - mrits 10mo ago
      There are plenty of expensive snacks.
  - zahlman 10mo ago
    > In the US, bananas average $1.68/kilo: That's definitely not something I expected to be cheaper in Canada than the US.
Ensorceled 10mo ago
> It's interesting that overall spending doesn't decrease that much in the end Only after discontinuation. GLP-1s should be considered chronic medication for most people.
- XorNot 10mo ago
  My brother was on it for a bit (and should go on it again) and the thing he noted was that it makes it easy to not eat but it gives you no useful habits to keep that up because it's so easy. Which makes sense. I still calorie count everything generally because I know I'll let myself creep portion sizes unchecked.
  - nemomarx 10mo ago
    I think durable habits there are just hard honestly. I was losing weight when I was very strict about calorie counting and lived with a roommate who was on the same diet, but when I moved out and stayed with family my habits and intuition about safe foods didn't last long and temptation got me again. It does make me think we're applying bandaids over some other issue with the available foods - it's hard to imagine that everyone 50 years ago was just much better about dieting and counting calories?
    - rootusrootus 10mo ago
      > it's hard to imagine that everyone 50 years ago was just much better about dieting and counting calories? Do we just have a lot more food available now? Not just bad food, but calories of all kinds? Combined with steadily automating nearly all of the hard work, I'm not surprised people get fatter these days than 50 years ago. I bet the average person today is actually much more aware of what healthy eating looks like, it's just that there aren't that many really physical jobs anymore and food is extremely cheap and plentiful for most.
      - buellerbueller 10mo ago
        Snacking (defined as between-meal eating) has had a massive uptrend (in the USA) since the 1970s: https://pmc.ncbi.nlm.nih.gov/articles/PMC10097271/#:~:text=Snacks%20are%20a%20staple%20of%20the%20American%20diet%2C%20accounting%20for,foods%20diminish%20overall%20diet%20quality. https://pmc.ncbi.nlm.nih.gov/articles/PMC10097271/#:~:text=S...

giuliomagnifico 10mo ago

After discontinuation of Ozempic, people start to gain the weight again (and buy again more food), that’s why the spending changes again.

jacobthesnakob 10mo ago
Which is no surprise to anybody with common sense, the data for discontinuing GLP-1s show exactly the intuitive outcome. Zero diet change, zero habit change for the vast majority of users. Weight loss is accomplished via biochemical tricks to eat less volume of calorie dense junk food, rather than diet substitution. When the artificial appetite suppression ends, volume of the same food increases again leading to weight yo-yo. Plus why start to exercise when you’ve got a magic weight loss drug? Don’t get me wrong, there are some people using these drugs to get out of a pit of inertia with weight and sedentary lifestyles. But it’s small. GLP-1 drugs will have most users hooked for life because they don’t have the discipline and motivation to maintain the weight loss without it. Cha-Ching!
- rootusrootus 10mo ago
  > they don’t have the discipline and motivation to maintain the weight loss That argument has been tried for years and yet it fails nearly 100% of the time. Should we be trying something different than claiming it's a moral issue? Or is that too scientific?
  - jacobthesnakob 10mo ago
    Why do we need to try anything? This comes down to individualism versus collectivism. Besides, the logical consequence of the portion of my comment you highlighted is that the majority of GLP-1 patients will need to be on these drugs forever to maintain these benefits long-term. We have precisely one trial of 5+ years of patients taking liraglutide, and ~2 years for semaglutide. Some side effects and long-term consequences could be entirely unknown.
    - amanaplanacanal 10mo ago
      It's possible that there could be long term side effects that we don't know about, but given the number of people taking these drugs we would likely already have seen some indication of them. I guess we will find out!
    - astrange 10mo ago
      All the side effects I've seen of GLP-1s are positive, and we've had diabetes patients taking them for much longer than that. Anyway, it's fairly obvious that discipline is not a solution to weight loss, because weight gains a) happened in lab and pet animals on the same timescales they happened to humans and b) are reversed by moving to higher altitudes. So to be productive, you should be telling people to move to Colorado.
    - pixl97 10mo ago
      >This comes down to individualism versus collectivism. All fun and games until it costs every individual a massive amount.
  - zahlman 10mo ago
    > That argument has been tried for years and yet it fails nearly 100% of the time. No, it doesn't. Saying that people lack an ability is not the same as claiming that the problem is a simple matter of instilling that ability. > Should we be trying something different than claiming it's a moral issue? It also isn't the same as shaming people or making a moral issue out of it. > Or is that too scientific? The snark is uncalled for. "Science" doesn't require ignoring obviously true proximate causes in search of ultimate causes.
- WheatMillington 10mo ago
  Weight gain/loss is not a matter of motivation and discipline.
  - phil21 10mo ago
    It absolutely can be. It was for me. Is it for everyone? Perhaps not. But to outright unequivocally say it's not is simply outright incorrect. It was absolutely motivation and discipline for me. One day I just decided enough was enough and I threw the proverbial kitchen sink at it. I am perhaps an outlier in that I'm not ashamed to say I was obese in the past because I simply lacked the motivation and desire to do the work to change it. It was easier and more comfortable being fat than in shape. I definitely agree telling an obese person to eat less and move more is about as useful as telling a depressed person to just stop being depressed. But lets not make outlandish claims either.
    - oarfish 10mo ago
      Great, your one of the few. Statistics are pretty clear that most people cannot willpower their way out of their food seeking behaviours. They are to a large extent not under your concious control. correcting satiety signaling on a chemical level more directly addresses the problem in those folks. yes, the food environment is the main problem, in a way, but only because it punishes having a certain set of chemical and lifestyle parameters and rewards others.
FatherOfCurses 10mo ago
People must be getting prescribed this medication in a vacuum without any corresponding nutritional guidance. I can't see any way of going back to my previous eating habits, mainly because I've really had my eyes opened to how mindless some of my eating was before.
- SketchySeaBeast 10mo ago
  Just like any weight loss and gain, this is the sort of things that happens over years. You lose the weight, then five years later realize your weight has started creeping back up. Once you're heavy the battle never really ends.
- kjkjadksj 10mo ago
  It is no surprise given the issue at hand. I mean it is people who failed at dieting and managing weight using the methods shouted from rooftops for a century or more now. Doctor could say whatever and its clearly in one ear out the other. A lot of these patients are taking it as a silver bullet, a quick fix. If you have to actively manage your diet anyhow while on the drug, the whole issue around diets and exercise the drug attempts to surmount, one wonders at the purpose of the drug.
- sjw987 10mo ago
  You're in the faux enlightenment that everybody gets during weight loss. Everybody I've ever known losing weight starts discovering the wonders of healthy eating and nutrition as they lose weight, vowing never again to go back to their old habits. Then they slip further down the line and 1-2 years they're back to their original weight, plus some. Weight loss isn't the challenge. Maintaining it for the rest of your life is.
SkyPuncher 10mo ago
Processed foods are much cheaper per calorie than "healthy" options. GLP-1 helped me kick my cravings for junk food, but that just meant I was eating more of the "expensive" stuff. Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit.
- zahlman 10mo ago
  > Processed foods are much cheaper per calorie than "healthy" options. > Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit. I won't bother with currency conversion because we're comparing ratios. 50 cents here gets a third of a 200g bag of generic brand potato chips, so 360 calories. Doritos are probably at least twice that expensive but whatever. (The generic-brand sandwich cookies that are my personal vice, are cheaper yet. There's so much variation within these vaguely-defined food categories that I can't take the comparison across categories seriously.) $1.50 gets probably a half dozen bananas here, at around a hundred calories per. Never mind the yogurt. (If you're buying fresh cut fruit you're simply doing it wrong.) So if you're purely comparing calorie counts and finding yourself on less-calorie-dense options then yeah there's a ratio but it's still not as bad as people think. But this is still fundamentally committing a fallacy equating "less calorie-dense" with "healthy". The same 360 calories from white rice cost me perhaps 15 or 20 cents (plus the time and energy to cook). I'm not big on brown rice but I'm sure I don't have to pay several times as much for it unless it's some fancy boutique thing. 360 calories from dried split legumes (packed with protein and fibre), similarly, are in the ballpark of 30 cents. Perhaps you don't "snack" on those things, but you get the point.
  - vorpalhex 10mo ago
    And this is the issue with these "healthy"/"processed" discussions. If you live off bananas and rice, you are not going to be healthy. You can get just as fat off plantains as you can doritos. Peanut butter (which is at least partially processed) can be a healthy part of your diet. It can also absolutely wreck it.
    - 10mo ago

spockz 10mo ago

Around here fruit is significantly more expensive than snacks. In fact, replacing the snacks with healthy food in our case increased spending. So it is awesome that these households managed to cut spendings.

vidarh 10mo ago
Yeah, I'm not on ozempic (though considering it, to get the last bit of the way to where I want to be and ensure I don't bounce back, which is frankly a lot harder than "just" the initial loss) but lost 20kg+ on diet changes, and the price of fruit and berries is shockingly high. But my dietary change still saved us a lot more from cutting takeaways alone...
calpaterson 10mo ago
> fruit is significantly more expensive than snacks This is a commonly repeated claim but it's usually not true. Fruit is, in fact, pretty cheap: In the US, bananas average $1.68/kilo: https://www.numbeo.com/cost-of-living/country_price_rankings?itemId=118 https://www.numbeo.com/cost-of-living/country_price_rankings... A kilo is usually ~6 bananas. So a banana costs maybe 28c on average. Find a cost-competitive ultra-processed snack for the calories and satiety that a banana provides. Healthy eating might not is cheap but junk food, specifically, is not usually a cost optimisation.
- eru 10mo ago
  Well, some fruits are cheap. But there's plenty of expensive fruits that people might want to eat, too.
  - mrits 10mo ago
    There are plenty of expensive snacks.
- zahlman 10mo ago
  > In the US, bananas average $1.68/kilo: That's definitely not something I expected to be cheaper in Canada than the US.

Ensorceled 10mo ago

> It's interesting that overall spending doesn't decrease that much in the end Only after discontinuation. GLP-1s should be considered chronic medication for most people.

XorNot 10mo ago
My brother was on it for a bit (and should go on it again) and the thing he noted was that it makes it easy to not eat but it gives you no useful habits to keep that up because it's so easy. Which makes sense. I still calorie count everything generally because I know I'll let myself creep portion sizes unchecked.
- nemomarx 10mo ago
  I think durable habits there are just hard honestly. I was losing weight when I was very strict about calorie counting and lived with a roommate who was on the same diet, but when I moved out and stayed with family my habits and intuition about safe foods didn't last long and temptation got me again. It does make me think we're applying bandaids over some other issue with the available foods - it's hard to imagine that everyone 50 years ago was just much better about dieting and counting calories?
  - rootusrootus 10mo ago
    > it's hard to imagine that everyone 50 years ago was just much better about dieting and counting calories? Do we just have a lot more food available now? Not just bad food, but calories of all kinds? Combined with steadily automating nearly all of the hard work, I'm not surprised people get fatter these days than 50 years ago. I bet the average person today is actually much more aware of what healthy eating looks like, it's just that there aren't that many really physical jobs anymore and food is extremely cheap and plentiful for most.
    - buellerbueller 10mo ago
      Snacking (defined as between-meal eating) has had a massive uptrend (in the USA) since the 1970s: https://pmc.ncbi.nlm.nih.gov/articles/PMC10097271/#:~:text=Snacks%20are%20a%20staple%20of%20the%20American%20diet%2C%20accounting%20for,foods%20diminish%20overall%20diet%20quality. https://pmc.ncbi.nlm.nih.gov/articles/PMC10097271/#:~:text=S...