3 ms·

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

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 9mo 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 9mo 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 9mo 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 9mo 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 9mo ago
    >This comes down to individualism versus collectivism. All fun and games until it costs every individual a massive amount.
- zahlman 9mo 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.
  - pixl97 9mo ago
    >No, it doesn't If you owe the bank $100,000 that's your problem. If you owe the bank $10,000,000,000 that's the banks problem. Obesity is a 'bank problem' issue. When everyone around the globe is massively gaining weight, in every country on this planet that's not in a war or famine, this isn't a human willpower issue. Something has changed, and to ignore that is unscientific.
    - phil21 9mo ago
      All that has changed is the environment and lifestyle humans live in, and it's quite obvious discipline and willpower cannot overpower that environment on average. The change was far too rapid for anything else to be remotely the primary cause. If you put a past heroin addict locked in a room with unlimited heroin readily available, chances are likely 9 times out of 10 that person is going to partake eventually. Same goes for our food environment and way of life.
      - padjo 9mo ago
        We could stop companies spending billions shoving the heroin down people’s throats with advertising. But I guess selling them more drugs is a better solution.
        pixl97 9mo ago
        >We could stop companies spending billions You see, companies have a way of stopping that and it only costs millions. They pay off the politicians and the politicians say that companies have more freedoms than individuals.
- sjw987 9mo ago
  It's entirely discipline and motivation. Just because only a select few people carry it through and maintain it doesn't change that. Just very few people in this world are truly disciplined and self-motivated. You can see it all around you in one form or another:- overweight/obesity, alcohol consumption, smoking/vaping, people spending 5+ hours staring at glowing rectangles.
WheatMillington 9mo ago
Weight gain/loss is not a matter of motivation and discipline.
- phil21 9mo 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 9mo 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.

rootusrootus 9mo 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 9mo 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 9mo 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 9mo 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 9mo ago
  >This comes down to individualism versus collectivism. All fun and games until it costs every individual a massive amount.
zahlman 9mo 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.
- pixl97 9mo ago
  >No, it doesn't If you owe the bank $100,000 that's your problem. If you owe the bank $10,000,000,000 that's the banks problem. Obesity is a 'bank problem' issue. When everyone around the globe is massively gaining weight, in every country on this planet that's not in a war or famine, this isn't a human willpower issue. Something has changed, and to ignore that is unscientific.
  - phil21 9mo ago
    All that has changed is the environment and lifestyle humans live in, and it's quite obvious discipline and willpower cannot overpower that environment on average. The change was far too rapid for anything else to be remotely the primary cause. If you put a past heroin addict locked in a room with unlimited heroin readily available, chances are likely 9 times out of 10 that person is going to partake eventually. Same goes for our food environment and way of life.
    - padjo 9mo ago
      We could stop companies spending billions shoving the heroin down people’s throats with advertising. But I guess selling them more drugs is a better solution.
      - pixl97 9mo ago
        >We could stop companies spending billions You see, companies have a way of stopping that and it only costs millions. They pay off the politicians and the politicians say that companies have more freedoms than individuals.
sjw987 9mo ago
It's entirely discipline and motivation. Just because only a select few people carry it through and maintain it doesn't change that. Just very few people in this world are truly disciplined and self-motivated. You can see it all around you in one form or another:- overweight/obesity, alcohol consumption, smoking/vaping, people spending 5+ hours staring at glowing rectangles.

WheatMillington 9mo ago

Weight gain/loss is not a matter of motivation and discipline.

phil21 9mo 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 9mo 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.