3 ms·

Isn't GLP-1 creating a "feel-good" starvation? Patching the receptors telling the brain one is not hungry and then just letting the body starve happily, leading

by storus 7mo ago

Isn't GLP-1 creating a "feel-good" starvation? Patching the receptors telling the brain one is not hungry and then just letting the body starve happily, leading to significant muscle loss and aged face? Contrary to e.g. water fast where the body switches to 100% ketosis that can run as long as there is any fat in the body and one supplements electrolytes (Mg/K/P/HCO3) and vitamins (predominantly B1/B2/B3), leading to a much more healthy appearance?

mrtesthah 7mo ago
There is nothing inherent in your description that would support your implied claim about facial aging.
- storus 7mo ago
  "Emerging research suggests GLP‑1 receptors are present on adipocytes and fibroblasts. Some animal studies indicate that GLP‑1 agonism may promote lipolysis in subcutaneous fat more aggressively than in visceral fat, leading to disproportionate loss of facial fat. It also may affect collagen synthesis or skin architecture, though human data are still evolving."
rootusrootus 7mo ago
GLP1s do not themselves cause any worse muscle loss than you would experience if you lost the weight by watching calories the old fashioned way. "Ozempic face" is almost certainly an artifact of people who spent their life significantly overweight having somewhat looser skin than they would if they had maintained a low weight throughout their life. Also, not everyone gets the face effect, not by a long shot.
- gedy 7mo ago
  Yeah exactly, what people call Ozempic Face is often just wrinkles. I look a bit older now that I lost 40 lbs, but much healthier shape. Fat does fill in your face some
  - deleted 7mo ago
    [deleted]
- storus 7mo ago
  Not really, Ozempic face is the same face as one gets when starved of food for a longer period of time from low caloric diet that contains carbs. Ketosis on the other hand doesn't cause this unless one has almost no fat left as it doesn't switch body to the starvation mode. There are two modes the human body operates normally - insulin-driven, active when carbs are in the food, and ketone-driven, active when there is a lot of fat storage and no food intake, or food has no carbs. Insulin-driven operation switches to starvation when food intake has caloric deficit but still enough carbs for insulin to be triggered; ketones on the other hand lead to zero insulin activity and pure fat burning; starvation is only activated when humans reach around 4% body fat while in ketosis.
  - cthalupa 7mo ago
    This is a bunch of pseudoscience. "Starvation mode" as people talk about it is generally nonsense - the exceedingly low bodyfat you mention for keto is the same place you would see it in a non-keto diet when we talk about actual starvation mode and not whatever you're talking about with a non-ketogenic diet. The only real difference when it comes to the biology here is that fat mobilization into glucose is significantly slower and less efficient, which keeps your blood sugar levels more constant, which results in fewer post-meal food cravings. Which isn't nothing, but it's not muscle sparing in and of itself. We have plenty of studies here. Keto diets are not better for sparing lbm. https://pubmed.ncbi.nlm.nih.gov/38934469/ https://pubmed.ncbi.nlm.nih.gov/38934469/ In fact, if you already have significant muscle mass, it might be worse. Glycogen is hugely important when doing resistance training, and keto significantly impacts your glycogen stores. People perform worse with their resistance training on keto than regular diets. https://pmc.ncbi.nlm.nih.gov/articles/PMC9244428/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9244428/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8469041/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8469041/
    - storus 7mo ago
      I suspect you have no idea that your body has two independent energetic circuits - one driven by insulin and glucose, the other driver by ketones. Just please dump this to any decent LLm to give you ELI5. Muscles obviously need glucose for their best performance which is why strength training is not recommended during ketosis; OTOH ketosis is naturally muscle-sparing.
cthalupa 7mo ago
Muscle loss is determined by your protein intake, muscle stimulus, and rate of weight loss. Plenty of people start lifting for the first time (or after having stopped for extended periods of time) when going on GLP-1s and actually put on muscle mass. It might result in more loss of buccal fat than otherwise but even that is not definitive. Activating the receptors is not the same as burning fat - there are GLP-1 receptors all over your body in all sorts of organs. If you activate them in your brain you're not burning your brain for energy.
- warmedcookie 7mo ago
  n=1, been lifting weights for 25 years and lost 40 lbs on Zepbound and counting. I can still do my routines easily with no issues. My muscles look slightly smaller I think, but maybe that's the fat around them that's been diminished.

by storus 7mo ago

mrtesthah 7mo ago

There is nothing inherent in your description that would support your implied claim about facial aging.

storus 7mo ago
"Emerging research suggests GLP‑1 receptors are present on adipocytes and fibroblasts. Some animal studies indicate that GLP‑1 agonism may promote lipolysis in subcutaneous fat more aggressively than in visceral fat, leading to disproportionate loss of facial fat. It also may affect collagen synthesis or skin architecture, though human data are still evolving."

rootusrootus 7mo ago

GLP1s do not themselves cause any worse muscle loss than you would experience if you lost the weight by watching calories the old fashioned way. "Ozempic face" is almost certainly an artifact of people who spent their life significantly overweight having somewhat looser skin than they would if they had maintained a low weight throughout their life. Also, not everyone gets the face effect, not by a long shot.

gedy 7mo ago
Yeah exactly, what people call Ozempic Face is often just wrinkles. I look a bit older now that I lost 40 lbs, but much healthier shape. Fat does fill in your face some
- deleted 7mo ago
  [deleted]
storus 7mo ago
Not really, Ozempic face is the same face as one gets when starved of food for a longer period of time from low caloric diet that contains carbs. Ketosis on the other hand doesn't cause this unless one has almost no fat left as it doesn't switch body to the starvation mode. There are two modes the human body operates normally - insulin-driven, active when carbs are in the food, and ketone-driven, active when there is a lot of fat storage and no food intake, or food has no carbs. Insulin-driven operation switches to starvation when food intake has caloric deficit but still enough carbs for insulin to be triggered; ketones on the other hand lead to zero insulin activity and pure fat burning; starvation is only activated when humans reach around 4% body fat while in ketosis.
- cthalupa 7mo ago
  This is a bunch of pseudoscience. "Starvation mode" as people talk about it is generally nonsense - the exceedingly low bodyfat you mention for keto is the same place you would see it in a non-keto diet when we talk about actual starvation mode and not whatever you're talking about with a non-ketogenic diet. The only real difference when it comes to the biology here is that fat mobilization into glucose is significantly slower and less efficient, which keeps your blood sugar levels more constant, which results in fewer post-meal food cravings. Which isn't nothing, but it's not muscle sparing in and of itself. We have plenty of studies here. Keto diets are not better for sparing lbm. https://pubmed.ncbi.nlm.nih.gov/38934469/ https://pubmed.ncbi.nlm.nih.gov/38934469/ In fact, if you already have significant muscle mass, it might be worse. Glycogen is hugely important when doing resistance training, and keto significantly impacts your glycogen stores. People perform worse with their resistance training on keto than regular diets. https://pmc.ncbi.nlm.nih.gov/articles/PMC9244428/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9244428/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8469041/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8469041/
  - storus 7mo ago
    I suspect you have no idea that your body has two independent energetic circuits - one driven by insulin and glucose, the other driver by ketones. Just please dump this to any decent LLm to give you ELI5. Muscles obviously need glucose for their best performance which is why strength training is not recommended during ketosis; OTOH ketosis is naturally muscle-sparing.

cthalupa 7mo ago

Muscle loss is determined by your protein intake, muscle stimulus, and rate of weight loss. Plenty of people start lifting for the first time (or after having stopped for extended periods of time) when going on GLP-1s and actually put on muscle mass. It might result in more loss of buccal fat than otherwise but even that is not definitive. Activating the receptors is not the same as burning fat - there are GLP-1 receptors all over your body in all sorts of organs. If you activate them in your brain you're not burning your brain for energy.

warmedcookie 7mo ago
n=1, been lifting weights for 25 years and lost 40 lbs on Zepbound and counting. I can still do my routines easily with no issues. My muscles look slightly smaller I think, but maybe that's the fat around them that's been diminished.