Hey, that was a UK study. A US study would yield completely different results!!
This mentality is overly simplified and ignores the significant medical component that obesity is a disease and an addiction. People who are obese know the choices they need to make and because they have a disease, cannot consistently make those choices. Letās stop villainizing fat people.
This.
Our government, even past ones, have not helped to eliminate addictive chemicals from foods. Wonāt even tell us that theyāre addictive.
I didnāt actually go into my doctor expecting to get a miracle weight loss drug - honestly, I didnāt know anything about it - what I actually did was join a Lifestyle Management program and thatās when I was told that diet and exercise alone will fail 95% of the time. 95%!! Think about that number - why even bother at that point?
Thereās clearly something else going on outside of āfat girl gets fat because she eats too much - and clearly she doesnāt want to changeā. What about people like me that have found out weāre not eating enough yet the weight still goes up?
1 Like
Problem with this, is that its really not that simple.
The problems with obesity start all the way back to when your mother had you in her womb. The food she ate then affected your physiological development as a child and adult. Then food they fed you from birth to about 5 years of age also affected your development. By the time you are 25 or so, your underlying physiology is pretty much set from a biological perspective, with those first 5 or so years being key.
If that food you had growing up was average to poor (in terms of nutrients and being too processed), you are very likely to be pre-disposed to obesity when you are older. You canāt beat biology in the long-run. Thats the unfortunate reality for many people and as posted, 95% of them fail at diets as their biology works against them.
Whats interesting about GLP-1 compounds is that they mask the underlying physiological limitations (its not just that they cut down food noise which means people it less calories, but they also alter key hormones that allow weight/fat loss to occurr), which then allows people in that sub-set to not be pre-disposed to obesity by altering their set point (the weight that the body believes is homestasis for you).
There is one big caveat though. Once off the drugs most regain a big % of their weight loss back, but this was only done on very obese sedentary people with no dietary modifications, or even resistance training. So I think the next big thing (in terms of pharma) will be around this area. How to lock-in those losses while maintaining the positive behaviors around food that were (hopefully) gained.
Food, in particular UPFs have been designed to be addictive. Diets fail 95% of the time just like they do with any other addictive substance where moderation is considered as part of the long term plan. A fundamental long term lifestyle change is needed.
Added this after re-reading article title and had already written my entire post
I canāt access the article on my work computer so just going off the headline and the thread title. I may have misinterpreted the study/article that Polymath linked. Was the study only offering individuals compensation for Option A? Or did the study do some kind of comparison of offering individuals compensation for Option A vs just going with Option B and seeing which they would prefer? My interpretation was the latter.
Original post, see above clarification
We have Option A (exercising more, eating healthier) that will yield an overall higher benefit to peopleās life and healthspans than Option B (GLP-1s). Technically thereās Option C (do nothing) but I think we can all agree that everyone would end up right where theyāre at or worse off.
Option A should not be viewed as a diet or a short-term fix, per Rii and The_Presidentās posts. 90+% of diets fail. I donāt doubt that. Polymath mentioned that people that go off GLP-1s regain most of the weight they lost while on the drug. Similar outcome when you stop doing both options. Option A is a lifestyle change and should be approached as such. Weāre not trying to cut weight for the next 4-weeks. Weāre trying to build habits that will benefit you for the next 4 decades. Build/maintain muscle. Lose fat. Improve your mood. Improve flexibility and mobility. These are all things that allow you to ālifeā better as you age. Itās going to take time. Itās not going to be easy. You might need to rewire how you approach eating and exercising (with or without the help of professionals). But the benefits of all this are so, so much more than Option B.
To me, Option B is reflective of instant gratification that we see everywhere in our society (social media, matching on dating apps, online streaming, etc). You see some pretty significant weight decreases fairly quickly, while on the drugs. Weight loss is obviously good but thatās not the whole story when it comes to overall health. You donāt see the additional benefits with Option B that you do with Option A unless you also incorporate some items (resistance training, cardio, yoga, etc) from Option A. Utilizing GLP-1s to springboard people in to a healthier lifestyle (Option A) could be incredibly powerful for the overall health of our population. Net positive, as I mentioned.
Of course there are situations where GLP-1s can be used to help individuals that have exhausted all other options and truly canāt lose weight. I feel those situations are more the exception than the rule though.
Of course there are costs (time and $$$) to both options but Iād argue the cost of Option A is far less than Option B in the long-term.
The problem I have with the article is that people were literally paid to start with Option A, the one that yields higher benefits and builds those long-term habits and lifestyle changes from the get-go. For whatever reason, it wasnāt attractive to them. Maybe it was due to how they were being compensated, maybe it was due to how the study was structured, maybe it was due to something else. I donāt know. I just think itās sad when people are presented with a superior outcome and donāt pursue it.
Agreed that ultra-processed foods are incredibly delicious and incredibly not nutritious. Theyāre also cheap.
Itās going to take a not small amount of personal responsibility and government assistance to restructure how we approach food - from how itās prepared/made, to how it is regulated, to how we as consumers buy/eat it. Decades is probably too short a time horizon.
In the meantime, we as consumers can (re)educate ourselves and (re)define our understanding of health and nutrition. Thereās a lot of crap out there but I think weāre all analytical and capable enough to sift through most of the BS (with the help of professionals, if needed) and come to a better understanding of health and nutrition.
My main gripe was being presented with Option A vs Option B and choosing Option B. Not saying Option B is inherently bad or villainizing anyone.
I think you start to confuse the issue when you try to incorporate too much into the problem you are trying to solve. Instant gratification and broader lifestyle changes are separate issues from diet, but they may not have anything to do with the underlying issue of āfood addictionā if that is the real problem. GLP-1 solves food addiction, food noise, or whatever your favorite word is to describe it. Those other things tend to follow - there is less urge for instant gratification using food, and people will have more energy once their weight is in control. And those other things have always been problems throughout time. What is new, is our Frankenstein diets brought on by the food industry - that is well correlated with obesity rates (though technology is as well).
Is it your position that people who are fat are not disciplined enough to not be fat? Do you think fat people, for the most part, enjoy being fat and have never made an effort to lead a healthier lifestyle? Just trying to gauge your own experience with food addiction and weight management before writing off your opinion.
1 Like
TBPF, I think this is a bit harsh.
There is still an under-current in society where GLP-1s are viewed as cheating by the wider population.
Its a bit of a puritanical streak where people think you have to suffer and do it the hard way vs use the tools that you have at your disposal.
I see this in the UK a lot now. People even hide their GLP-1 use because they are afraid of the reaction from people when they lose weight.
There is also a bit of a personal component here where a lot of people do not like change. If you were the only obese/overweight person in the group of friends, and you then lost 40lbs to become thin in a short period of time, the rest of the group might have trouble adapating to the new you.
People are very weird about these sort of issues.
Iām on a glp-1, so yes Iāve heard all the responses about how Iām lazy and cheating and killing diabetics. Itās completely misinformed.
People who have never struggled with weight management often believe that their lack of fatness is proof of their virtue. Fat = moral failing, not fat = righteous. As if we all have the same struggles and are fighting the same battles (we are not).
I have no idea what this poster thinks about this and wonāt pretend to. But insinuating that fat people ought to just try harder aligns them with this camp and Iām not here for it.
1 Like
If it is done to win a contest, then sure.
If it is done to make walking easier, cuz 400 lbs., thatās not cheating. Thatās surviving.
If it is done to get jobs (acting, etc.), Iāll allow it (āsurvivingā again), but no one should be lying or bragging about their ādiet and exercise regimen.ā
Canāt hide their butt. Waitā¦ they can actually hide their butt better.
Let me know if you find mine. Itās gone.
Has GLP-1 induced anorexia become a problem? I came across someone at work who has become almost unrecognizable due to the weight loss. Like 3 months ago I thought they looked unhealthy thin but probably that was just a bit of what happens when you see someone the first time after weight lossā¦but ran into them again in the last week and it seems they kept going.
I noticed.
Donāt skip leg day.
Theoretically, it is possible. But would be fairly rare due to the prescribing guidelines.
Not sure about the US, but over here they will stop prescribing to you if your BMI goes under 19 (lowest that I have seen so far).
It is possible that person at work has also lost a lot of muscle over time so they look a lot worse when they get even thinner.
Iām not sure this means much given how opioids were handled. And Iām not really even sure if this person was on the drugs, just thought there may not be much to stop someone from taking this to far.
I dropped about 30 pounds in 6 months when i gave up booze and became more active. I think i was developing a bit of an unhealthy obsession with it for absolutely no rational reason. But Iām a guy, and Iāve had a few people comment, but they were mostly out of town work folks that would have only seen me before/ after. If i was a woman getting regular compliments/ support i think that could have been reinforcing things to a different level.
While I donāt think GLP-1s are in the same class of addictiveness as opioids, there are still risks of unscrupulous providers and straight-up illegal supply chains. Humans gonna human. So maybe rare as a %, but large as an absolute number. Just a guess.