Weight-Loss Surgery Down 25% as Anti-Obesity Drug Use Soars (harvard.edu) 159
A new study examining a large sample of privately insured patients with obesity found that use of drugs such as Ozempic and Wegovy as anti-obesity medications more than doubled from 2022 to 2023. During that same period, there was a 25.6% decrease in patients undergoing metabolic bariatric surgery to treat obesity. From a report: The study, by researchers at Brigham and Women's Hospital, in collaboration with researchers at Harvard T.H. Chan School of Public Health and the Brown School of Public Health, is published in JAMA Network Open. "Our study provides one of the first national estimates of the decline in utilization of bariatric metabolic surgery among privately insured patients corresponding to the rising use of blockbuster GLP-1 RA drugs," said senior author Thomas C. Tsai, a metabolic bariatric surgeon at Brigham and Women's Hospital.
Using a national sample of medical insurance claims data from more than 17 million privately insured adults, the researchers identified patients with a diagnosis of obesity without diabetes in 2022-2023. The study found a sharp increase in the share of patients who received glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, during the study period, with GLP-1 RA use increasing 132.6% from the last six months of 2022 to the last six months of 2023 (from 1.89 to 4.41 patients per 1,000 patients).
Meanwhile, there was a 25.6% decrease in use of bariatric metabolic surgery during the same period (from 0.22 to 0.16 patients per 1,000 patients). Among the sample of patients with obesity, 94.7% received neither form of treatment during the study period (while 5% received GLP-1 RAs and 0.3% received surgery). Compared to patients who were prescribed GLP-1 RAs, patients who underwent surgery tended to be more medically complex.
Using a national sample of medical insurance claims data from more than 17 million privately insured adults, the researchers identified patients with a diagnosis of obesity without diabetes in 2022-2023. The study found a sharp increase in the share of patients who received glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, during the study period, with GLP-1 RA use increasing 132.6% from the last six months of 2022 to the last six months of 2023 (from 1.89 to 4.41 patients per 1,000 patients).
Meanwhile, there was a 25.6% decrease in use of bariatric metabolic surgery during the same period (from 0.22 to 0.16 patients per 1,000 patients). Among the sample of patients with obesity, 94.7% received neither form of treatment during the study period (while 5% received GLP-1 RAs and 0.3% received surgery). Compared to patients who were prescribed GLP-1 RAs, patients who underwent surgery tended to be more medically complex.
Most people get no treatment (Score:3)
“Metabolic bariatric surgery and GLP-1 RAs are both effective interventions for patients with obesity, yet less than 6 percent of patients in our study received either form of treatment.”
Understandable in a way. The drugs are expensive and can have serious side effects. The average cost of bariatric surgery ranges between $17,000 and $26,000, but it reportedly is relatively safe and often results in significant weight loss.
https://www.saintalphonsus.org... [saintalphonsus.org]
Re: (Score:1)
Re: (Score:2)
>> weight can come back over time
Very true, you have to keep taking the expensive weight loss drugs that have side effects but the bariatric surgery is a one-time thing.
Obesity is another form of mental illness (Score:2, Insightful)
When you're eating enough to be fat enough it is having a serious negative effect on your life and you're not willing to reduce your food intake... That's a mental issue. A behavior you can't manage to change.
Drugs and surgery are temporary corrections of the symptom, if you don't deal with the problem - wanting and consuming too much food - you're going to need more drugs or surgery, or you're going to get fat again.
Re:Obesity is another form of mental illness (Score:4, Insightful)
Over 2/3rds of Americans are overweight or obese. That seems to rule out mental problems, because what is a normal mental state is defined by the behaviour of the majority. Few people believe in little green men so that's a delusion, but a lot of people believe an omnipotent being controls their life and responds to flattery, so that's perfectly normal.
Would you also say that people who are addicted to tobacco products also have a "mental issue"? It's not an unreasonable comparison. Food companies are strongly motivated to create products that are addictive, and then use every means they can to induce you to buy them.
Re: (Score:1)
If you have the capacity to change your behavior and you're suffering because you won't... It's a mental issue no matter how common it is. This can be heavily influenced by your environment and culture, but the truth is that if you WANT to be healthier, it's not impossible to do so without and easy/quick fix solution. You can even eat healthier in addition to eating less, and save money while doing so.
It takes some effort. Culturally, we're not that big on effort. Most people pretend - taking up a new
Re: (Score:2)
Consider that these medications are not cheap, and a hefty chunk of change every week is a pretty big motivator. Between that, the people fat shaming them, the desire to look conventionally attractive, the health problems obesity causes, the daily inconveniences, the rising cost of food, you would have to assume that the majority of Americans are extremely lazy and willing to put up with a hell of a lot just to avoid your easy and effective solution.
A more likely explanation is that it is in fact far harder
Re: (Score:2)
You are getting fat because you are eating more than your body requires to sustain itself. Or you're staying fat because you are eating enough to sustain your body at that mass.
It's not as simple as that. In the first place, you can be on a ketogenic diet in which you eat a diet fairly high in protein, VERY high in fat, and with small or negligible carb content. You might be consuming 3,000 calories a day, and you will still lose weight; and you'll keep it off, as long as you avoid those carbs - especially the simple ones, and most especially the refined ones. I'm not saying carbs are unimportant, as some of them are our only sources of vital minerals, vitamins, and other compoun
Re: (Score:2)
That's a lot of text just to clarify to 'eat too much of digestible food'.
Re: (Score:2)
That's a lot of text just to clarify to 'eat too much of digestible food'.
So protein and fat aren't digestible? Good to know! You should publish a paper to that effect - I'm sure the entire scientific community will hail your wisdom and insight.
Re: (Score:1)
That seems to rule out mental problems, because what is a normal mental state is defined by the behaviour of the majority.
Does it? The number of obese Americans has tripled in the last 60 years https://usafacts.org/articles/... [usafacts.org] which pretty much means there's a mental issue at some level here for a lot of people regardless of whatever "normal" is. Everyone knows eating lots of sweet treats will put pounds on, everyone knows fast food will too. The choice to continue heavily consuming such items despite being able to physically see the negative effects on one's health (the expanding belly) is a mental one.
And sure, things like
Re: (Score:3)
So your theory is that more than 2/3rds of Americans have developed mental problems, as opposed to the far more likely hypothesis that foods and eating habits have changed dramatically over the last 60 years?
Re: (Score:2)
Maybe its just the kind of food people are being fed.
"The rising obesity epidemic in the U.S., as well as related chronic diseases, are correlated with a rise in ultra-processed food consumption. The foods most associated with weight gain include potato chips, sugar sweetened beverages, sweets and desserts, refined grains, red meats, and processed meats"
https://smhs.gwu.edu/news/proc... [gwu.edu]
Re:Obesity is another form of mental illness (Score:5, Insightful)
Would you also say that people who are addicted to tobacco products also have a "mental issue"? It's not an unreasonable comparison. Food companies are strongly motivated to create products that are addictive, and then use every means they can to induce you to buy them.
When my overweight wife would get hungry, she had exactly the same symptoms as when I would be in withdrawal from nicotine.
Re: (Score:2)
I heard the same thing from a friend, and I'm ashamed to say I didn't believe them at the time.
Re:Obesity is another form of mental illness (Score:5, Insightful)
Re: (Score:2)
Over 2/3rds of Americans are overweight or obese. That seems to rule out mental problems, because what is a normal mental state is defined by the behaviour of the majority.
When you arbitrarily draw a line around a group of people you can define "normal" to mean anything you want it to. Actual figures when you don't play games with statistics show 16% of adults in the world are obese, so no it's not normal. Oh but that's all starving kids in Africa right? Okay lets draw the line but do so somewhere comparable. 17% of adults in the EU are obese. Why do they not need to medicate, and who isn't normal now?
Re: (Score:2)
It's not just the food companies, it has permeated the whole culture. I'm currently in the US for a short trip and eating out a lot, and one thing I'm looking forward to, when I get back home, is fresh vegetables not drowned in some kind of fat (I do like fat, but there's the issue of proportion). When I have ordered a side of "fresh vegetables" I have regretted it. Don't even get me started on what passes as salad here. I'm sure it's different in different states or regions, however I have seen a few at th
Re:Obesity is another form of mental illness (Score:4, Interesting)
I dunno about you, but I eat a lot of real food--things that used to be plants and animals. I'm grateful to be in a position to be able to do that. So would I reduce my food intake without altering my appetite? Maybe someone that eats like crap could say "one fewer bag of crisps per day", but what would I say? One less spoon of chicken and black beans? 25% less olive oil in the hummus? Eat smaller fruit? Unless your food comes from cans and boxes, you can't just eat less. You can do something more nuanced, like alter your appetite, learn to detect fullness earlier, or be hungrier.
When you're eating enough to be fat enough it is having a serious negative effect on your life and you're not willing to reduce your food intake... That's a mental issue.
Food for thought: if you eat 1% too much, you will gain over two pounds per year.
No not really (Score:2)
This is before we get into all the gut bacteria problems many of wh
Re: No not really (Score:2)
Nobody makes fun of you because you're fat, they make fun of you because you're such a simpleton. Being fat is just the cherry on top.
Obesity Drugs = I lack responsibility * (Score:3, Insightful)
Okay, how many people are on these drugs, but take no real responsibility? I can name a handful of people, all women, who are on Ozempic, who DO NOT NEED IT. What do I mean, when I say they don't need it? All the people I'm thinking of have the same few points in common:
1. They have terrible diets.
2. They've all tried the fad diets, including Keto (which is for intractable epilepsy in kids, who "normal" meds don't work for).
3. They're very stationary, and their active outputs aren't useful.
4. This is important, they don't take responsibility!
Fad dieting, is NOT a method for weight loss, if you move between Keto (which you should NEVER do), Fasting (starvation), FOD MAP (which is nonsense on overdrive), and all the others, you're asking for your body to react negatively. If you eat pasta 4x a week, you're not going to lose weight. If you mix random shakes full of nuts, powders, and fruits, chances are, you're not going to lose weight because, you don't really know what's in the mess you're drinking. Stabilize your diet, so your body knows what to expect, look at what people eat who have low-fat levels, body builders and strongmen. Notice how they share the same diet, protein + simple carbs, and then just copy it adjusting for your body weight.
Once you have a real diet, that is balanced, then get to the gym, and or get active! You need to be moving, so move weights around, have some cardio, and make sure you're meaningfully and usefully active. If you sit at a desk for 8 hours a day, 5 days a week, you can't be shocked when you put on the pounds, so honestly, get a standing / sitting desk, get a little treadmill and walk while you work. Also, go to the gym, 3x a week, and try to get into some sports if you can, which can be substituted for the gym.
If you're done those things for a year or two, and you're still gaining weight, then you might actually have a problem, but, doctors today are prescribing Ozempic because after trying Keto 4 times, and FOD MAP for 1 week, after sitting on your ass for 80 hours, you had a cry session that you're a cow, and it's not your fault your fat, it's societies. All the people I'm thinking of, could get active, get a better diet, and stop making excuses, and they would be in better overall health for it. They would ALL get mad at me for saying this, while also trying to eat 10kg of pasta for dinner, covered in thick sugary sauce, with a side salad covered in equal amount of sugar dressing, then insisting I'm not a woman, so I can't understand, then laying down because "Oh, I just don't feel well."
Re: (Score:3)
Human beings evolved when the food supply was unreliable. Plants and animals had not been bread to be larger and higher in fat, or pumped full of hormones.
Modern foods are produced by people who have a vested interested in selling you as many calories as possible. The US, where this problem is the worst, also has very low food standards compared to other developed nations. Life now doesn't give people much time to prepare or even seek out healthy food.
It's not the case that people today lack the willpower a
Re:Obesity Drugs = I lack responsibility * (Score:4, Interesting)
Again, I need to stress this, I've seen all of them, sit down to LARGE pasta dinners, covered with sugary sauce, with salads that are covered in equally sugary sauce, and then lecture me that the oatmeal I'm eating is bad for me, before I head off to gym. You won't burn off a pasta dinner, unless you're doing balls to the wall, hardcore mode. People think they can eat absolute junk, and the gym will fix that because they did 10 minutes on the StairMaster.
Re: (Score:2)
Around here meat is quite expensive relative to other foods, and farmers markets and butchers tend to be higher priced than supermarkets.
Pasta is cheap and very easy to prepare.
Re: (Score:2)
Yes, it's cheap, and easy, but you can't consume crap, and then at the same time whine about your inability to control your weight. The people I'm referring to are all well off, so groceries are not a burden, but, on the other hand, I know someone whose has a burden paying for the basics. He actually has a legit medical reason to need something like Ozempic, but on some sad notes:
1. Can't afford it (our family offered to cover it for him).
2. Can't get
Re: (Score:2)
On the other hand, someone could live a health lifestyle, never smoke a day in their life, and still get lung cancer, the difference is the second person has every ri
Re: (Score:2)
1. They have terrible diets.
2. They've all tried the fad diets, including Keto (which is for intractable epilepsy in kids, who "normal" meds don't work for).
3. They're very stationary, and their active outputs aren't useful.
4. This is important, they don't take responsibility!
Point 2:
If talk to any serious nutritionist or doctor, they will not recommend a keto diet, they'll wave you off that idea with vigor. The entire concept behind th
Statistically, obesity is... (Score:5, Insightful)
...less curable than cancer.
Most people who lose weight with dieting gain it all back and more.
Some believe it's simple and insult those who fail to achieve healthy weight.
It's not simple!
Weight loss surgery is a crude and awful approach. The new drugs are a tiny bit better, but still are not the solution. This is a hard problem. We need research, not hate and insults
Re: (Score:2)
...less curable than cancer.
Of course it is. If you can have a diet that has fewer calories than you burn and yet not lose weight before lack of nutrients causes problems, what does that tell you about the food that is being eaten?
Our food is engineered to make us as fat as possible. It is extraordinarily difficult to get all the nutrients that are needed and not gain fat simultaneously.
I do NOT have an issue with weight, so you can try to say that I am just a slovenly person who is unable to control their appetite so everything I sa
I lost 110lbs on Mounjaro (Zepbound) Last Year (Score:2)
I was over weight for 20 years (classic yo-yo dieter. I could lose, but it always came back. I put on 40lbs during the two years I ran marathons)
What is really cool? I turned 12 people on to the same drug. Combined we
Poor messaging (Score:2)
I'm not saying that these medications don't have a place, particularly for folks in extreme cases you need a jump start, but the idea that one would have to take these medications for the rest of their lives is awful. I think the part that's missing from the "balanced diet and exercise" message is that it is definitely not a "get thin quick" plan. Healthy weight loss is between 0.5-1lb per week. That means following those "balanced" routines takes a lot of time, and killing yourself in the gym for two we
Long term effects of Semaglutide (Score:2)
how can they AFFORD IT? (Score:2)
Or.... (Score:2)
We could just eat healthier?
Not a very accurate sample (Score:2)
I don't think the data in the paper is a very accurate representation of the true population. Many insurance plans explicitly exclude bariatric surgery from their covered services, and I'd be surprised if those same plans don't exclude weight loss drugs as well.
Re:How about (Score:5, Insightful)
so it begins
we've had the fat shamers, now they will transition to being ozempic shamers because you are just miserable fucks who hate everyone because you hate yourselves. find a new easy target i guess eh
Re: (Score:2)
Trans people exist. But they've already moved on to immigrants.
Re: (Score:2)
so it begins
we've had the fat shamers, now they will transition to being ozempic shamers because you are just miserable fucks who hate everyone because you hate yourselves. find a new easy target i guess eh
I've always found the shamers to be a bit weird.
Their life is so devoid of achievement that the only thing they have to feel good about is the fact they haven't put on an excessive amount of weight.
I disagree with shaming in general, but if we should shame anything in our society it's being an idiot.
Re: (Score:2)
Re:How about (Score:5, Interesting)
For people that need to lose a little weight*, calorie counting is a myth--in the sense that nobody can count the calories in their food with a high degree of accuracy, unless they subsist on stuff that came out of factories and doesn't belong in their body anyway.
Everybody* actually just relies on their appetites to tell them how much to eat. If I wake up hungry in the night, that's my appetite giving me a stern correction. If I wake up hungry in the morning, my appetite is telling me I did a good job. If I can't stomach the though of breakfast, my appetite is getting rid of a few extra calories for me.
Is this not an accurate description of having a body? Where does math come into it? Is there any way I could alter the balance between exercise and calories without either getting more intimate with hunger or altering my appetite? I think people* that talk about counting calories are either pretending or mistaken.
* If someone's appetite is so far off as to be useless as a guide, then even inaccurate calorie counting would be a useful map of the territory.
Re: (Score:2, Interesting)
Re: (Score:2)
Re: (Score:2)
Re: (Score:3)
True, and weight loss surgery more or less provides feedback when your stomach is full, at a smaller size.
Ozempic and its friends (I was calling it 'liquid gastric bypass' 7 years ago, essentially does the same thing by slowing the process of emptying the stomach. Which also is why the acid reflux happens.
Calorie counting is essentially useless. Adjust the foods you eat and activity level to suit, but counting calories is not how to do it. There are ocnfounding factors that throw the count off anyway. L
Re: (Score:3)
Everybody* actually just relies on their appetites to tell them how much to eat.
* If someone's appetite is so far off as to be useless as a guide, then even inaccurate calorie counting would be a useful map of the territory.
This is the ideal, to rely on hunger signals to control for intake. However, close to nobody actually does this. Aside from the emotional motivations for eating, there is also a significant delay from initial food intake to feeling satiated. In those minutes, is very easy to overeat. No one tries a few bites and waits 10 to 15 minutes to test satiety before eating more.
Re: (Score:3)
But it's worse than that. Even if YOU could count calories, your body can't. There's no hormonal pathway or other mechanism that correlates to "calories". Your body responds to simple heuristics like the vagus nerve, insulin levels, leptin, and seratonin and all kinds of environmental cues...basically you are made of nerves and hormones, not a machine with gears an
Re: (Score:2)
Is this not an accurate description of having a body?
well, you answered yourself with:
* If someone's appetite is so far off as to be useless as a guide, then even inaccurate calorie counting would be a useful map of the territory.
"someone with appetite so far off" would be about 47% of current us adult population according to the cdc. that's not and exception, the main reason for that is letting hunger drive eating habits.
hunger won't tell you anything about your current nutritional state except that you haven't eaten for a while, and even at that it's not very precise. it's just a drive to seek food that evolved when food was scarce and required effort. that worked well enough even through the agric
Re: (Score:2)
hunger won't tell you anything about your current nutritional state except that you haven't eaten for a while, and even at that it's not very precise
Maybe yours won't. Mine seems super precise. Yes, it is miscalibrated to the extent that I slowly gain weight (like everybody in my ethnic/regional group). But on a shorter time scale, if I have an excessive dinner, I want to delay my next meal and my appetite is smaller for all meals the next day. The human set-point seems close to perfect when things are going well. But I've noticed if something is off, for example eating junk food or regularly eating a lot before bed, the system has no obvious change but
Re: (Score:2)
Maybe yours won't. Mine seems super precise. Yes, it is miscalibrated to the extent that I slowly gain weight
so your hunger is super precise but somehow miscalibrated, so it really isn't and leads to obesity if not counter balanced by external factors. clear. that's what i said.
yet you complain that calories can't be counted accurately enough, so people doing that are either "pretending or mistaken" and should (i guess) just listen to their hunger instead. this is nonsense, and doing that is exactly what got them in trouble in the first place. calorie counting is one of many tools that might help them getting out
Re: (Score:2)
hunger doesn't know about your caloric balance, nor the vitamins, aminoacids or minerals present in your body... hunger is just drive to feed, it isn't any form of sensible feedback about your nutritional or energetic state at any given time, let alone "precise".
Your body doesn't ramp up hunger after increased metabolic expenditure? Your body doesn't crave salt or protein if you haven't eaten enough of that lately? Your increased or decreased eating today doesn't influence your hunger tomorrow? I don't think my metabolism is particularly gifted, but you seem not to inhabit the same kind of body as I do.
P.s., I don't enjoy your tone enough to engage in a long conversation with you. I'll just leave this here. And I found it with neutral terms, not a confirmation bias
Re: (Score:2)
https://pmc.ncbi.nlm.nih.gov/a... [nih.gov]
that study doesn't rule out calorie restriction (and implied counting) as a way to reduce weight at all, it rather suggests it shouldn't be the only strategy (which i implied aswell, twice), reckons that it is a useful tool for diet configuration (as i did) and that more research is necessary, and then proceeds to literally make my point:
There is evidence of physiological mechanisms that monitor intake, although Western society often ensures that they are overwhelmed and obesity develops.
besides, those mechanisms aren't really well understood and there isn't really much conclusive evidence. you might be reading too much into your bodily sensations. alas, th
Re: (Score:2)
> In some people, all calories are stored as fat regardless of how little they eat.
That can't happen because there's continuous energy consumption from something. That the hunger signals are wrong and misguided in some people is a certainty though.
> two people eating the same diet may not experience the same changes to their body's mass.
thats the calories out
Re: (Score:2)
Yeah, I think the people who are saying there's no value in it are falling into the old trap of letting the perfect be the enemy of the good.
In my own personal experience: As long as I log everything (including spur-of-the-moment snacks), I find my calorie input is very predictive of my weight trends.
Can a person count calories with 100% accuracy? Of course not. But can a person count accurately enough to lose weight when the calorie counting is paired with some self discipline? Yes, of course! It's possibl
Re: (Score:2)
Perhaps. But I'll give him a pass because - hey, it's bacon.
Re: (Score:2)
I appreciate the rebuttal. I note however that the bulk of your calories are from processed foods. Those major calories which are not processed--the eggs, butter, and fruit--probably can't be measured with better than a 20% margin of error. That said, at least this approach seems like it would work on a macro scale (for someone that is trying for a strict deficit or someone whose appetite gives basically no indication of what they should eat).
If you are using this technique to maintain weight (precision), I
Re: (Score:3, Insightful)
If we were machines it would be simple, but we are not.
It has taken me so long to start losing weight because I was taught the wrong things in school, like the old food pyramid that was very carb heavy, didn't dive into refined grains vs whole grain etc.
Even with discipline and daily visits to the gym, I could just not get the weight down. Through trial and error, Searching so much information, I finally learned how to get the right amount of protein, fiber and not refined carbs, avoid sugar that boosts hun
Re: (Score:2)
Cooking your own food is definitely helpful. No processed foods, keep the sugar and salt way down. Makes a big difference.
Re: (Score:2)
Re: (Score:2)
Re: (Score:2)
We had a US food pyramid long before the 90s, I remember seeing it in schools and black and white films back in the 80s at least.
Re: (Score:2, Insightful)
In an otherwise healthy person with normal endocrine function and appropriate muscle mass - sure calories vs calories out, is going to be the driver.
However you have people that:
1) Have far less than normal muscle mass, which means they will NOT have normal metabolism no matter what. That might not be just because the are a couch potato, could well be the result of other disease or debilitating injury. Weight control from them should be part of treatment.
2) Abnormal endocrine function is a thing, sure type-
Re: (Score:2)
> So this all seams horrible but maybe we should ask some philosophical questions about how wrong it really is to offer healthy-bmi-the-easy-way as a subscription.
About as wrong as offering the healthy-blood-pressure-the-easy-way as a subscription. Or clean-water-on-top as a subscription.
And in truth, the collection of BP medications has saved many people from nasty diseases and poor health.
Re: (Score:2)
Yes, people have (often self-induced) problems, but that doesn't invalidate the equation that < excess energy in means < excess energy stored.
Actually, no, in humans, quite frequently, less excess energy on input results in less energy spent, and about the same amount of energy being stored.
Reducing your calorie excess will never result in weight loss or even a significant reduction in weight gain, realistically. The only way to lose weight is to consume massively fewer calories than you need, and even then, your metabolism tries to compensate for the reduction in available calories, resulting in lower calorie use, but because you can only reduc
Re: (Score:2)
You're half right and half wrong. It's not the spreading meals out that makes a difference, it's what is in those meals. You CAN'T use your fat stores when your insulin is high. Pretend there's a one lane road going into/out of your fat cells. You can't being adding and removing energy at the same time. If you're snacking on carbs throughout the day then you're constantly peaking your insulin levels.
I wasn't talking about eating carbs. I was talking about the fact that lipolysis, ketogenesis, gluconeogenesis, etc. turn fat and protein into carbohydrates and ketones over an extended period of time, which means you don't have an insulin spike. Your blood sugar remains stable, and this can reduce or reverse insulin resistance as well.
Regardless of how much energy is in your blood stream, if your insulin is high then it's moving energy from your blood and into fat cells. If your blood glucose levels drop too much you will be grabbing something to eat, most likely a carb heavy snack as that'll raise your levels the fastest.
If you're overweight, there's a decent chance your blood glucose level won't drop *too* much, nor your insulin levels. The only solution for that is to force yourself to a
Re:How about (Score:4, Insightful)
Sure, he could have sugar-coated it a little but the fact is that weight management is a matter of simple maths.
And drug addiction is just a simple matter of "stop taking the drugs", right?
If if was that easy, there'd be no fat people. You completely discount the power of cravings that the brain constantly bombards fat people with. In some cases it's quite literally like drug withdrawals where people are desperately Jonesing for that food. Their brain rewards them for eating more and encourages deception and self-delusion. You can draw a direct line between the junkie telling himself "I'll be fine; one more hit and I'll stop" and the fat guy telling himself "I'll be fine. One more pizza and I'll stop". When willpower goes up against the brain screaming "Give me more!", willpower usually loses in the long run.
Re: (Score:2)
> All you'll do is make yourself addicted, dependent on expensive weight loss shots to make you feel a little bit better.
Does that apply to cholesterol and high blood pressure medications?
Realistically, they are much more efficacious than lifestyle changes, and most people have few serious side effects and it stacks upon personal behavior changes.
And healthy eating is much much easier according to those who are on the GLP-1As. Hunger drives are obviously strongly evolutionarily embedded to the beginning
Re: (Score:3)
Re: (Score:2)
People like him are the reason why I binge eat, drink, and smoke!
Re:How about (Score:4, Insightful)
As someone who's had weight loss surgery after a lifetime of being overweight, it's not nearly as simple as "moving your ass and not eating like a pig".
And weight loss surgery isn't a magic bullet, at all. I'd argue that in a lot of ways it is way harder than doing a traditional diet and exercise (Which you'll need to do anyways for the surgery to be a success). After a bypass you're going to face a lifetime of potential malnutrition, not being able to properly absorb nutrients and minerals, weird shit like sneezing uncontrollably if you eat too fast, not being able to eat certain basic things ever again (Any pork makes me feel sick for about a day now), and numerous other lifestyle changes that you'll have to make whether you want to or not.
There's a really good reason that my medical group required a 6 month class along with numerous appointments with psychologists (to make sure there weren't any underlying reasons for the obesity that hadn't been addressed), addiction specialists (to make sure the food addiction had as little chance as possible to transfer to another addiction) and social workers (to make sure I had a support system at home to help make this a success).
Even with all of that, my only regret is not doing this sooner. Stop being such a miserable asshole.
Re: (Score:2)
It sounds like a pretty rigorous regime, more so than I knew about. I don't think most people will do it.
But that would explain the preference for the drugs. One injection a week is relatively easy.
Re: (Score:2)
>> Many people get the surgery, lose some weight and then add it all back on
Do you have a cite? I don't see how a person could add all the weight back on when most of their stomach has been excised or bypassed. You just wouldn't be able to cram the food in there.
Re: How about (Score:2)
My father in law and his son both have had the surgery and it helped but they are both still over weight.
My wifeâ(TM)s best friend had the surgery and she has kept it off better.
You need a diet change too. You canâ(TM)t eat the same crap in crap quantities.
Fix the diet first and the surgery is almost always successful.
Re: (Score:2)
Re: (Score:2)
Re: (Score:3)
You don't just waltz into slashdot and call people fat and not expect to be modded down into oblivion.
Re: (Score:3, Informative)
"Ozempic does exactly NOTHING to your metabolism. It is, however, a powerful appetite suppressant. That's all."
All of this is wrong and you're a moron, if that's not already obvious to everyone after the stupid shit you just spewed.
"Eating less makes you loose weight. Who would have thought."
Everyone would have thought, and already did. The problem lies elsewhere, but you wouldn't know that because you've never experienced the problems others do.
Re: (Score:3)
The previous poster is correct. And semaglutide alters signaling which was damaged or ineffective.
And I'm 100% for it. Lots of diseases have improper signaling and altering energy metabolism is probably clinically risky. The hunger signaling is so deep in evolutionary history it's not possible to override in practice. Changing the setting also is safest--hunger signals are still there with their normal function just lowered in intensity.
People with the problem feel like they are eating 1200 calories eve
Re:Final nail in coffin for "broken metabolism" pp (Score:5, Interesting)
More than 2/3rds of Americans are overweight or obese, so while you might be correct that someone with enough willpower can lose weight, the reality today in that society is that most of them can't.
It's not like you haven't been berating them for decades either, so it's not like just listening to you is going to help. Where people have been forced to stick to 1200 calories, be it in controlled studies or on TV shows, while it does work in the short term they almost always put the weight back on. And that includes when they get extensive coaching to lead a healthier lifestyle afterwards.
Just telling people it isn't hard and all they need to do is stick to 1200 calories a day does not work. It makes you feel morally superior, but it doesn't help them lose weight permanently.
Ozempic works.
If it helps, look at it as a vaccination against predatory capitalists who bombard us with high calorie unhealthy food. You didn't think they were not trying to do everything they possibly can to make you eat more, did you?
Re:Final nail in coffin for "broken metabolism" pp (Score:5, Insightful)
In addition to being addicted to junk food, Americans are also addicted to treating large scale social issues as individual moral failure.
Re: (Score:1)
People are also somewhat resistant to the "nanny state" telling them what to do, protecting them from predatory businesses, or even giving them useful information like how many calories are in a particular item.
Re: (Score:3)
Okay, the US isn't perfect, but we definitely do this one.
Re: (Score:2)
Re: (Score:2, Insightful)
I know because I cook all my own meals. I spend about 3 hours a week putzing around grocery stores to get all the ingredients then I've got to get them home and put them away in my tiny ass little apartment fridge which requires a game of Tetris at the end of every trip. Then I've got to clean and prep the vegetables heat up all the pans on a crappy apartment
Re: (Score:2)
Interesting perspective, thanks.
I've got plenty of room to do all that but it hadn't occurred to me that many people will have a small living space that makes it much less practical. And if you do cook your own food you will want to do it in enough quantity to have leftovers for additional meals. That requires adequate refrigerator capacity, which may not be available.
I have to do multiple Grocery tripsq (Score:2)
The fridge isn't usually a problem since fridge food doesn't really keep. Though it can be a pain with all the vegetables since I'm a vegetarian. Meat being more calorically dense means it takes up less space for the same amount of food (calorie wise).
Cooking is also much harder with a tiny apartment kitchen. You're always shuffling pans & cooking equipment around.
Re: Final nail in coffin for "broken metabolism" p (Score:2)
Well there's your problem: All you think about is food and how to get more of it. You're basically a Soviet version of Homer Simpson if the Soviets actually had food in their grocery stores.
Re: (Score:2)
It is almost as if the entire economic model of the two income household is wrong. We should use policy to encourage one member of a domestic partnership to NOT work outside the home.
Re: Final nail in coffin for "broken metabolism" p (Score:2)
Re: (Score:2)
Just telling people it isn't hard and all they need to do is stick to 1200 calories a day does not work. It makes you feel morally superior, but it doesn't help them lose weight permanently.
Ozempic works.
Actually the fact Ozempic seems to be the only thing in America which works and the fact that other countries don't seem the need to rely on this makes me feel morally superior.
The Greatest Country on Earth seems to have a society that is unable to function without drugging itself. Or did I misread and the term "greatest" was referring to the mass of the people living in it...
Re: (Score:2)
Eating less makes you loose weight. Who would have thought.
Current understanding of how metabolic regulation makes this false on its face. Your body has a calorie consumption set point. If you ignore the signals and simply eat below the set point, your body will attempt to conserve energy in various ways. This includes moving less – you will subconsciously fidget less and become lazier generally, and cutting brain activity – you will literally think worse and become more sleepy and sluggish.
It is incredibly hard to beat biology once your body has reac
Re: (Score:3)
Think long and hard before taking Ozempic for weight loss if you're not Type II diabetic. I'm LADA, Agent Orange related and was having trouble with my blood sugar a few years ago, so my Diabetes Doctor suggested that I try Ozempic. It did help, slightly, but in three weeks I lost 17 pounds. Being that I was already underweight, I stopped it
Re: (Score:2)
Re: (Score:2)
It's difficult to take seriously someone who can't spell "lose."
Re: (Score:2)
It apparently persists in the gene pool because it helps people survive famine.
Re: (Score:3)
Hard disagree. Changes of that degree are rarely due to individual choices. What this really shows is that our society as a whole (led by those looking to make a buck) has made an awful lot of bad lifestyle choices, starting with building ourselves into a car-dependent culture.
Re: (Score:1)
Hard disagree. Changes of that degree are rarely due to individual choices.
Every person who sees their belly expanding and chooses to not make lifestyle changes to counter that effect is making an individual choice.
Re: (Score:2)
In the USA the grocery stores are full of prepared foods that are heavily dosed with sugar, fats, and salt. It tastes good. It comes in attractive packaging and it is advertised on TV. When I line up at the checkout counter I shake my head at what I see people buying.
"The rising obesity epidemic in the U.S., as well as related chronic diseases, are correlated with a rise in ultra-processed food consumption. The foods most associated with weight gain include potato chips, sugar sweetened beverages, sweets an
Re: Fat in the head (Score:2)
What do you mean "relatively"? Relative to what? Go talk to an actual endocrinologist, they understand the mechanism quite well. If they think you have the aptitude for it they'll even draw you a few diagrams.
Re: (Score:2)