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I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production)

I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).

ceejayoz 3mo ago
> things you can fix on your own (diet + exercise) We have decades of research showing this is more in the "excess acid production" realm of things.
- applfanboysbgon 3mo ago
  We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
  - ceejayoz 3mo ago
    > We also know there's a replication crisis in psychology and medicine… It seems unlikely to extend to bariatric surgery outcomes. > This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. This idea that Americans are genetically pre-ordained to lack willpower seems like fanciful thinking.
    - applfanboysbgon 3mo ago
      Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
      - ceejayoz 3mo ago
        > That's why they could stop being fat, if only they chose to. This seems like one of those "replication crisis" claims. > That's why they could stop being fat, if only they chose to. So they're pre-ordained not to? I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be. > You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one. What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
        applfanboysbgon 3mo ago
        > So they're pre-ordained not to? No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control. > What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting? Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
        cflewis 3mo ago
        Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
      - ksenzee 3mo ago
        What evidence do you have that it is a cultural shift, rather than, say, a chemical in the environment that wasn't there before, or a difference in the food supply?
        faangguyindia 3mo ago
        Are food options today not more calorie-dense than they were back in time? More easily accessible? Calories have become increasingly cheap and dense to come by. You've lots of processed food being engineered to be highly palatable and calorie dense at an industrial scale. Plus, cars and all "comforts" eating into your physical activities?
  - thereisnospork 3mo ago
    >This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug. I fail to see the need for additional analysis or consideration? Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
    - applfanboysbgon 3mo ago
      > I fail to see the need for additional analysis or consideration? Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
      - ceejayoz 3mo ago
        > especially if there are unforeseen longterm side effects GLP-1s have been used widely for 20+ years now.
      - dghlsakjg 3mo ago
        Look up what percentage of people take statins long term at some point in their life. For people in certain age brackets it's more than the 40% of people taking GLP-1s that you are so concerned with. Why don't they just lower their cholesterol via other means? Look up what percentage of people take antidepressants. Why don't they just try being happy? Look up what percentage of people regularly take OTC pain killers, Benadryl, etc. Why don't they just tough it out? You are only picking on GLP-1s which happen to treat obesity among other illnesses. All of the other medications I listed are treating conditions with non-pharmaceutical interventions, but you haven't stated a problem with a huge percentage of the population using them. If your problem is with chronic medication use, this isn't the one to pick on. It is insanely effective. > not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be. What makes you think that these people haven't tried other options. What makes you think this is the default option, and not a later option? Do you think they are unaware of diet and exercise? Do you think that they choose to be fat? Do you think that people that can get PHDs doing world changing science, climb mountains, run Fortune 500 companies, hell - run marathons, are just too undisciplined or stupid to lose weight?
habinero 3mo ago
Why? They both get you to the same place, and one is vastly more likely to work. I don't get the weird moralizing around this.
crooked-v 3mo ago
I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
- saberience 3mo ago
  [flagged]
  - SpaceNugget 3mo ago
    They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
    - crooked-v 3mo ago
      My meaning was more that indulging in that hunger would result in me just eating an exorbitant number of calories, way past anything it would be reasonable to burn off without spending 4 hours a day every day in the gym... but you're completely right that even if I did spend that time in the gym it wouldn't help with the calories-in-calories-out equation, because it would just make me more hungry.
  - Aaargh20318 3mo ago
    The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn. You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake. Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.

I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).

ceejayoz 3mo ago

> things you can fix on your own (diet + exercise) We have decades of research showing this is more in the "excess acid production" realm of things.

applfanboysbgon 3mo ago
We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
- ceejayoz 3mo ago
  > We also know there's a replication crisis in psychology and medicine… It seems unlikely to extend to bariatric surgery outcomes. > This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. This idea that Americans are genetically pre-ordained to lack willpower seems like fanciful thinking.
  - applfanboysbgon 3mo ago
    Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
    - ceejayoz 3mo ago
      > That's why they could stop being fat, if only they chose to. This seems like one of those "replication crisis" claims. > That's why they could stop being fat, if only they chose to. So they're pre-ordained not to? I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be. > You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one. What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
      - applfanboysbgon 3mo ago
        > So they're pre-ordained not to? No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control. > What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting? Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
        cflewis 3mo ago
        Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
    - ksenzee 3mo ago
      What evidence do you have that it is a cultural shift, rather than, say, a chemical in the environment that wasn't there before, or a difference in the food supply?
      - faangguyindia 3mo ago
        Are food options today not more calorie-dense than they were back in time? More easily accessible? Calories have become increasingly cheap and dense to come by. You've lots of processed food being engineered to be highly palatable and calorie dense at an industrial scale. Plus, cars and all "comforts" eating into your physical activities?
- thereisnospork 3mo ago
  >This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug. I fail to see the need for additional analysis or consideration? Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
  - applfanboysbgon 3mo ago
    > I fail to see the need for additional analysis or consideration? Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
    - ceejayoz 3mo ago
      > especially if there are unforeseen longterm side effects GLP-1s have been used widely for 20+ years now.
    - dghlsakjg 3mo ago
      Look up what percentage of people take statins long term at some point in their life. For people in certain age brackets it's more than the 40% of people taking GLP-1s that you are so concerned with. Why don't they just lower their cholesterol via other means? Look up what percentage of people take antidepressants. Why don't they just try being happy? Look up what percentage of people regularly take OTC pain killers, Benadryl, etc. Why don't they just tough it out? You are only picking on GLP-1s which happen to treat obesity among other illnesses. All of the other medications I listed are treating conditions with non-pharmaceutical interventions, but you haven't stated a problem with a huge percentage of the population using them. If your problem is with chronic medication use, this isn't the one to pick on. It is insanely effective. > not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be. What makes you think that these people haven't tried other options. What makes you think this is the default option, and not a later option? Do you think they are unaware of diet and exercise? Do you think that they choose to be fat? Do you think that people that can get PHDs doing world changing science, climb mountains, run Fortune 500 companies, hell - run marathons, are just too undisciplined or stupid to lose weight?

habinero 3mo ago

Why? They both get you to the same place, and one is vastly more likely to work. I don't get the weird moralizing around this.

crooked-v 3mo ago

I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.

saberience 3mo ago
[flagged]
- SpaceNugget 3mo ago
  They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
  - crooked-v 3mo ago
    My meaning was more that indulging in that hunger would result in me just eating an exorbitant number of calories, way past anything it would be reasonable to burn off without spending 4 hours a day every day in the gym... but you're completely right that even if I did spend that time in the gym it wouldn't help with the calories-in-calories-out equation, because it would just make me more hungry.
- Aaargh20318 3mo ago
  The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn. You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake. Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.