The Problematic Arrival of Anti-Obesity Drugs

ThatRobGuy · Jan 25, 2023

Handmaid for Jesus said:
The body needs fat. But transfats are deadly. Sugar is what causes fatty liver disease, not fat.We see obese children today more because of being fed sugary cereals, (don't get me started on that.),candy, and soft drinks and juice boxes.

The body needs a lot of things...some of things people give their bodies in excess.

For instance: While we need fats, but we don't need to eat 3 eggs & 4 strips of bacon for breakfast, and a 20oz porterhouse steak cooked in butter for dinner to satisfy that need.

We're omnivores, but being "omnivorous" is a more complex concept than being an obligate herbivore or obligate carnivore as the ideal meat-to-plant ratio for various omnivorous species can differ drastically.

Chimps and Grizzly Bears are both omnivorous, but the well-suited ratios are very different among the two species. With regards to the ratios, I would dare say, human are much closer to chimps, but many eat as if they're closer to grizzly bears.

Nithavela · Jan 25, 2023

I think that "willpower" is overrated. The best way to get rid of a bad habit like snacking is to remove the ability to easily do that habit. The best way to lose weight is not to have unhealthy food lying around.

Also, I switched from normal sodas to diet sodas at the end of my 20s, and it helped me maintain my weight and then lose some instead of gaining weight. Didn't change any other part of my habits. So I think that diet sodas making you fat is an untruth.

ThatRobGuy · Jan 25, 2023

Nithavela said:
I think that "willpower" is overrated. The best way to get rid of a bad habit like snacking is to remove the ability to easily do that habit. The best way to lose weight is not to have unhealthy food lying around.

That still, in and of itself, involves some measure willpower. People are picking out their groceries when they go to the store. Opting to not the buy the cookies when walking by that store aisle is still an individual decision. (and apparently one a lot of people have trouble with)

By making the choice to say "I'm not gonna buy that, even though I could if I wanted to", you still exercised willpower.

Nithavela · Jan 25, 2023

ThatRobGuy said:
That still, in and of itself, involves some measure willpower. People are picking out their groceries when they go to the store. Opting to not the buy the cookies when walking by that store aisle is still an individual decision. (and apparently one a lot of people have trouble with)

By making the choice to say "I'm not gonna buy that, even though I could if I wanted to", you still exercised willpower.

You need less willpower than having the snacks in a bowl in your living room, though.

And you can decrease that need of willpower further by, for example, shopping with someone else who stops you from buying stuff you don't want to buy.

Humans essentially have a finite amount of "willpower". Once it runs out, they just do the thing they're inclined to do and then feel bad about it.

Desk trauma · Jan 25, 2023

ThatRobGuy said:
The Problematic Arrival of Anti-Obesity Drugs

Fat activists say they’re tools of coercion. Celebrities are taking them to get slim. Is this really the road people want to go down?

www.wired.com

The success—and mushrooming popularity—of these drugs brings us to a crossroads. We can make bigger bodies smaller with them, but does that mean we should? They promise to help people whose weight poses a health risk. And by shedding more light on what drives obesity, they could also chip away at harmful stereotypes that being overweight is simply a personal failing. At the same time, framing fatness as a disease to be done away with could lead to even greater stigma—as well as turbocharging society’s obsession with thinness.

The activists fear that fat people may feel pressured to take these medications in order to access the same rights as their non-fat counterparts, rather than out of any desire to improve their health. “Is it really about health improvement when a person is experiencing daily weight stigma and feeling shamed and blamed and is looking for a solution to decrease the influence of that in their life?” says Sarah Nutter, a psychologist at the University of Victoria in Canada who specializes in weight stigma and body image.

To go through life in a fat body means you are less likely to be hired for a job and will be paid less than non-fat people. The effects of weight discrimination—which can include poorer medical treatment, loneliness, psychological distress, and increased stress—may actually be cutting short the lives of fat people.

Deciding whether to take the drugs becomes a “devil’s choice,” says Osborn. “Assert that I have the right to be as I am right now—or exchange that right for significantly more rights and privileges in the culture.” The fat acceptance movement instead pushes for fat people to be afforded the same rights as everybody else, regardless of size.

Based on the tone of the article, it would seem as if there are people wanting it both ways here.

For a long time, some have suggested that obesity is out of a person's control and can't be prevented or corrected through lifestyle choices alone, some have even gone further and categorized it as a mental disorder or brain disease. (including one of the doctors selected to run the new dietary guidelines committee)

Now they've introduced medicines that seem to address some of that without relying solely on the person's own will power (which you'd think would be considered a big win), and they're seemingly taking issue with that out of fear that "fat people may feel pressured to take the new drugs". It would seem as if certain folks are unwilling to entertain any plan other than "pretend it's okay to be 100+ pounds overweight, and have everyone else put on blinders and pretend people can be healthy at any size" and "everyone else has to accept me just the way I am and no changes of any kind should be required on my part"

It's a perfect storm of the bad Ideas that hold sway in the US trying to quash something that could greatly improve the lives of many. Par for the course.

At least we don't have such prejudices against controlling diabetes and hypertension.

dqhall · Jan 25, 2023

ThatRobGuy said:
The problem with the (for lack of a better term) "fad diets" (although plant based eating has been around long enough that it's not a recent fad like some of the others, and I think data shows that there are some definite advantages to it) is that they'll all have fairly good results in the short term if the person is starting from a really bad place, and when people see some short term results with something, they tend to think of it as "this must be the perfect diet, look how quickly I dropped 40 pounds!"

If a person is 350+ lbs, and was eating pizza & fast food 4 nights a week, and was washing down every meal with 30oz of Pepsi...

They could do a vegan, vegetarian, keto, paleo, Atkins, Mediterranean, Intermittent Fasting, Carnivore, or 'South Beach' diet, and sticking to any of them for 3-4 months is going to lead to some weight loss and the person feeling better...because in comparison to what they were eating, they'll be taking in fewer calories and/or less processed junk.

Much like if a person was smoking 2 packs a day and drinking 6 beers a day...if they switched to a half pack and 2 beers, they're likely going to cough less, lose some weight, sleep better, have more energy, etc...than they did before. However, that wouldn't necessarily be evidence that "half pack + 2 beers" is a good long term strategy.

From a purely biological sense, we're pretty close to chimps...we're closer to chimps, than chimps are to gorillas. If you look a what chimps eat in nature...it's an omnivorous diet of about a 95:5 ratio of plants:animal-foods. Our small intestine is a little longer and our large intestine is a little shorter (which means we'd be a little better geared for fats and proteins, they'd be little better geared for plant/plant roughage. So my hunch is that if stuck to whole foods, and kept the plant:animal food ration to about a 80:20, we'd probably be in pretty good shape.

People on the Atkins Diet died at a faster rate than others.

I think Tom Brady of the Tampa Bay Bucs eats an 80% plant, 20% lean meat diet. He is the world’s greatest quarterback. He made it to the NFL playoffs at age 45.

Tom Brady’s diet and wellness routine: 8 rules to staying healthy

The 44-year-old NFL legend is coming out of his retirement – here’s everything you need to know about the wellness tips he follows to stay healthy and fit

www.scmp.com

I am about 6’ tall. The most I ever weighed was in the 190’s. I decided to lower my weight to the 180’s. Later I hurt my back and lost muscle mass until my weight was in the 170’s. About 6 years ago I watched Joel Fuhrman on PBS. I bought his book and tried a low-fat vegan diet. My weight is in the 160’s. I can eat some fish or meat these days, usually less than 4 oz a day.

A low sodium diet may help lower blood pressure. You need some salt to live. It is a common preservative that a person can get too much of.

ThatRobGuy · Jan 25, 2023

Desk trauma said:
It's a perfect storm of the bad Ideas that hold sway in the US trying to quash something that could greatly improve the lives of many. Par for the course.

At least we don't have such prejudices against controlling diabetes and hypertension.

I think it's a symptom of the cultural mandate that dictates that "any difference, whether it be unhealthy or benign, that could subject one to superficial discrimination in any form, has to be celebrated and rebranded as a good thing or symbol of empowerment in order to be adequately progressive"

Since obese people are subject to forms of superficial discrimination, it puts them in a quasi-victim class. Therefore, some entities feel compelled to rebrand it and talk about it in the same vein as if it were like the other differences that resulted in superficial discrimination.

Desk trauma · Jan 25, 2023

ThatRobGuy said:
I think it's a symptom of the cultural mandate that dictates that "any difference, whether it be unhealthy or benign, that could subject one to superficial discrimination in any form, has to be celebrated and rebranded as a good thing or symbol of empowerment in order to be adequately progressive"

Also the distain for the "easy way out" moral hazard coming from the other side, for want of a better term. I mentioned hypertension and diabetes, I should have specified type two, as they are for the most part analogous to obesity in that most of time they result from poor health choices with most people capable of getting them under control to the point of not needing medication via some rather severe non-pharmaceutical measures. Yet we don't have any real push back on the first step for treating both conditions being medication with some more mild behavior changes.

ThatRobGuy · Jan 25, 2023

dqhall said:
People on the Atkins Diet died at a faster rate than others.

That's not surprising. Any omission diet is inherently going to lead to extremes in other areas of the diet. For instance, on Atkins & Keto, people have the mindset that carbs are the devil, so they only focus on that one macronutrient and nothing else, and end up throwing caution to the wind in other areas. If I had a nickel for every time someone who just started doing keto was espousing "this diet is great, you can eat all the <insert high fat meat> you want as long as you don't have any bread with it!"

dqhall said:
I think Tom Brady of the Tampa Bay Bucs eats an 80% plant, 20% lean meat diet. He is the world’s greatest quarterback. He made it to the NFL playoffs at age 45.

There's something reassuring about knowing that my 80:20 hunch (based on a human to chimp comparison) is substantiated by at least one top tier athlete lol. That's the way I eat as well...though, my gym regimen undoubtedly lacking compared to what he's probably doing.

dqhall said:
I am about 6’ tall. The most I ever weighed was in the 190’s. I decided to lower my weight to the 180’s. Later I hurt my back and lost muscle mass until my weight was in the 170’s. About 6 years ago I watched Joel Fuhrman on PBS. I bought his book and tried a low-fat vegan diet. My weight is in the 160’s. I can eat some fish or meat these days, usually less than 4 oz a day.

A low sodium diet may help lower blood pressure. You need some salt to live. It is a common preservative that a person can get too much of.

I'm currently 6' 2", 185-195 depending on the season (I always make an effort to lean out a little before beach season). I was as high as 235-240 at one point after I switched from a warehouse job to a computer programming job, but then decided it was time for a change when faced with the choice of "do I change my eating habits, or do I go back to the Kohl's for the 3rd time in 4 years to by bigger pants?"

In terms of the fad diets, the vegan diet does have the best long term results backing it (in terms of heart disease and cancer risks). I tried going plant-based for a while, but did have some issues with my B-12 levels getting too low (confirmed by blood tests) and making me feel crummy despite supplementation. However, some people do okay on a 100% plant based diet with B-12 and D-3 supplementation.

ThatRobGuy · Jan 25, 2023

Desk trauma said:
Also the distain for the "easy way out" moral hazard coming from the other side, for want of a better term. I mentioned hypertension and diabetes, I should have specified type two, as they are for the most part analogous to obesity in that most of time they result from poor health choices with most people capable of getting them under control to the point of not needing medication via some rather severe non-pharmaceutical measures. Yet we don't have any real push back on the first step for treating both conditions being medication with some more mild behavior changes.

You'd think that covid would've been a wakeup call that there are risks apart from "my knees hurt all the time after I turned 40" with regards to obesity. 78% of people hospitalized with it were obese.

It was the aspect that had the highest correlative overlap with poor outcomes when contracting covid (even more so than age), yet it was the one thing people weren't supposed to talk about. 78% percent of people hospitalized with it were obese, 42% were over 65. Yet people freely talked about the age risk factor, but most wouldn't touch on the obesity risk factor.

dqhall · Jan 25, 2023

ThatRobGuy said:
That's not surprising. Any omission diet is inherently going to lead to extremes in other areas of the diet. For instance, on Atkins & Keto, people have the mindset that carbs are the devil, so they only focus on that one macronutrient and nothing else, and end up throwing caution to the wind in other areas. If I had a nickel for every time someone who just started doing keto was espousing "this diet is great, you can eat all the <insert high fat meat> you want as long as you don't have any bread with it!"

There's something reassuring about knowing that my 80:20 hunch (based on a human to chimp comparison) is substantiated by at least one top tier athlete lol. That's the way I eat as well...though, my gym regimen undoubtedly lacking compared to what he's probably doing.

I'm currently 6' 2", 185-195 depending on the season (I always make an effort to lean out a little before beach season). I was as high as 235-240 at one point after I switched from a warehouse job to a computer programming job, but then decided it was time for a change when faced with the choice of "do I change my eating habits, or do I go back to the Kohl's for the 3rd time in 4 years to by bigger pants?"

In terms of the fad diets, the vegan diet does have the best long term results backing it (in terms of heart disease and cancer risks). I tried going plant-based for a while, but did have some issues with my B-12 levels getting too low (confirmed by blood tests) and making me feel crummy despite supplementation. However, some people do okay on a 100% plant based diet with B-12 and D-3 supplementation.

The Seventh Day Adventists are more likely to be vegan after the writings of Ellen G White. There is a large SDA community in Loma Linda, CA. They are more likely to live to be 100 than other communities.

Ana the Ist · Jan 26, 2023

ThatRobGuy said:
The Problematic Arrival of Anti-Obesity Drugs

Fat activists say they’re tools of coercion. Celebrities are taking them to get slim. Is this really the road people want to go down?

www.wired.com

The success—and mushrooming popularity—of these drugs brings us to a crossroads. We can make bigger bodies smaller with them, but does that mean we should? They promise to help people whose weight poses a health risk. And by shedding more light on what drives obesity, they could also chip away at harmful stereotypes that being overweight is simply a personal failing. At the same time, framing fatness as a disease to be done away with could lead to even greater stigma—as well as turbocharging society’s obsession with thinness.

The activists fear that fat people may feel pressured to take these medications in order to access the same rights as their non-fat counterparts, rather than out of any desire to improve their health. “Is it really about health improvement when a person is experiencing daily weight stigma and feeling shamed and blamed and is looking for a solution to decrease the influence of that in their life?” says Sarah Nutter, a psychologist at the University of Victoria in Canada who specializes in weight stigma and body image.

To go through life in a fat body means you are less likely to be hired for a job and will be paid less than non-fat people. The effects of weight discrimination—which can include poorer medical treatment, loneliness, psychological distress, and increased stress—may actually be cutting short the lives of fat people.

Deciding whether to take the drugs becomes a “devil’s choice,” says Osborn. “Assert that I have the right to be as I am right now—or exchange that right for significantly more rights and privileges in the culture.” The fat acceptance movement instead pushes for fat people to be afforded the same rights as everybody else, regardless of size.

Based on the tone of the article, it would seem as if there are people wanting it both ways here.

For a long time, some have suggested that obesity is out of a person's control and can't be prevented or corrected through lifestyle choices alone, some have even gone further and categorized it as a mental disorder or brain disease. (including one of the doctors selected to run the new dietary guidelines committee)

Now they've introduced medicines that seem to address some of that without relying solely on the person's own will power (which you'd think would be considered a big win), and they're seemingly taking issue with that out of fear that "fat people may feel pressured to take the new drugs". It would seem as if certain folks are unwilling to entertain any plan other than "pretend it's okay to be 100+ pounds overweight, and have everyone else put on blinders and pretend people can be healthy at any size" and "everyone else has to accept me just the way I am and no changes of any kind should be required on my part"

You know....the Unibomber predicted this.

timothyu · Jan 26, 2023

ThatRobGuy said:
Yet people freely talked about the age risk factor, but most wouldn't touch on the obesity risk factor.

How could they witthout putting the processed food system into question. Fortunately their anti-shaming campaign has protected them for now

timothyu · Jan 26, 2023

Good food, simple meals, cheap eats. A few veggies and 3 oz of meat a day for required muscle protein and we're good to go. Your gut will appreciate giving it what it was meant to digest. We only need one main meal early mid afternoon unless doing heavy labour.

https://www.youtube.com/@schnelllecker

ThatRobGuy · Jan 26, 2023

timothyu said:
How could they witthout putting the processed food system into question. Fortunately their anti-shaming campaign has protected them for now

I think food intake amounts in general should be the main factor being discussed instead of the processed vs. non-processed.

As, while it is possible to eat processed food and not become obese (you just have to be stricter with portion sizes, which I understand is tough for some people), it's nearly impossible for a sedentary person to eat a caloric surplus of 2000 calories over what they need without gaining weight.

If a person's disciplined enough with portioning, it's possible to eat a diet of nothing but processed stuff and maintain or lose weight, the person just won't be able to eat until they feel "full" every single meal like people are used to doing.

timothyu · Jan 26, 2023

ThatRobGuy said:
I think food intake amounts in general should be the main factor being discussed instead of the processed vs. non-processed.

Totally disagree. Both are food but only one is nourishment.

And as for an earlier comment about the majority of covid patients being obese.. the problem was not so much the weight (unless it had caused other organ problems) but the lack of a healthy immune system compliments of processed foods.

rturner76 · Jan 26, 2023

I had severe obesity and when I tried to lose weight at my highest weight, I went on a good high-protein diet and exercised every day and the weight just would not come off. I ended up having the gastric bypass because no matter what I did, I couldn't lose weight.

I have a feeling that once you get to a certain point, your system just turns everything to fat. It might be prudent for some people to try a medication before they go for a surgical option. The surgery did work for me to a point. I lost 200 pounds. But I am still overweight and my body just doesn't want to let go of that fat. Also, my lymphedema complicates things for weight loss because you hold on to so much fluid.

I took some pills that were for weight loss but it had some kind of amphetamine in it. It showed up in a drug test as amphetamine so I didn't want the strain on my heart. It would be a shame if these drugs were amphetamine-based.

ThatRobGuy · Jan 26, 2023

rturner76 said:
I had severe obesity and when I tried to lose weight at my highest weight, I went on a good high-protein diet and exercised every day and the weight just would not come off. I ended up having the gastric bypass because no matter what I did, I couldn't lose weight.

Perhaps I may be misunderstanding how the procedure accomplishes the end goal...

But isn't the main mechanism of how the gastric bypass works still heavily rooted in the concept artificial calorie restriction?

Per MayoClinic:
The physical change greatly reduces the size of your stomach and limits the amount of food that you can eat at one time. After eating a small amount of food, you will feel full very quickly and continue to feel full for several hours.

In many cases, couldn't that aspect be accomplished by calorie restriction in the diet? For instance, if post surgery a person feels full after 400 calories per meal, wouldn't the same thing be accomplished by the person just eating only 400 calories per meal in the first place? (I know, probably easier said than done)

If a person is lacking the will power at the dinner table, the gastric bypass ends up being only a temporary fix and they end up stretching out the smaller pouch of their stomach, and backslide into old habits. (which makes the studies showing that half of people regain weight after year 3, unsurprising)

ThatRobGuy · Jan 26, 2023

timothyu said:
Totally disagree. Both are food but only one is nourishment.

And as for an earlier comment about the majority of covid patients being obese.. the problem was not so much the weight (unless it had caused other organ problems) but the lack of a healthy immune system compliments of processed foods.

Are there any studies you can cite to accompany that assertion?

There are plenty of people who aren't obese who regularly eat processed foods, but didn't have the same linear correlation with hospitalization rates like weight does. Having a lot of excess weight, by it's very nature, puts a strain on the organs as the organs weren't intended to service a body of that size.

A study out of England showed a similar linear relationship:

Meanwhile, countries like South Korea (who also consume a lot of processed foods, but have much lower obesity rates) had much lower hospitalization/death rates than the US. Same is true of Finland and Belgium.

Now, there is the possibility that the processed food consumption of those countries "would have" caused the same high hospitalization rates, but their higher vaccine uptake rates counteracted a lot of what would've happened.

All in all, when looking at the countries consuming high amounts of processed foods that had much lower hospitalization rates than us, the two main aspects that differed were their lower BMIs and their higher vaccine uptake rates.

The same is true at the other end of the processed food consumption spectrum.

Countries like Italy and Romania only get ~15% of their calories from "ultra processed food". Yet had the same linear trends with regards to BMI and covid outcomes.

ThatRobGuy · Jan 26, 2023

Aaron112 said:
A relative had this done after months of research , and said at least in part it made her feel full quicker, so she ate less. I don't know if this is usual or not.

Remember penn and teller, the show on tv. He tried dozens of diets over a couple years as he was overweight and it affected his health quite a lot and obviously.

What worked for him ? Eating ONLY between noon and one pm. He lost weight over a few months and looks very very very much healthier and better.

Others numerously and variously have noted this 'intermittent fasting' works when nothing else will.

Also note, it may be best NOT to exercise. At least not until the strain of extra weight is no longer present.

Didn't Penn also incorporate "the potato hack" as it's called?

How Magician Penn Jillette Lost 100 Pounds on the Potato Diet

The famous illusionist performed a very out-there trick.

www.goodhousekeeping.com

Which, my understanding of that particular "hack" is that it's supposed to rewire your brain to think about the relationship with food differently and break people away from the "everything I eat has to taste amazing" mindset. (which I can imagine may have been even tougher in his situation given his economic status and living and working in a city where you're surrounded by good restaurants and have the funds to eat out as much as you want)

The Problematic Arrival of Anti-Obesity Drugs

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