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by scarmig 1264 days ago
> It’s so hard to eat healthy, I honestly cannot fathom how people do it.

When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body needs); now, a slice is more than sufficient and satiety lasts well into the next morning.

GLP-1 agonists makes eating healthy trivial and automatic, instead of a dieting state where you're thinking about food literally constantly throughout the day for months or years on end.

Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

3 comments

> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

Where does this line of thinking stop?

Is everything pre-determined by genetics?

Is everyone who is smarter than me, just actually lucky that their dopamine system works correctly, and mine doesn't, and hasn't since I was a very young kid?

I'm sure this response will get down voted but its an honest question. This line of thinking that everything is genetically pre-determined seems both accurate and somewhat depressing.

It means that if I'm skinny and can't gain weight, I need to take steroids and lift. Or if I'm fat, I should take a GLP-1 agonist. If I'm underperforming in my career or school, I should take adderal or similar pharma solutions.

What role does good old fashioned hard work and discipline have in this day and age?

Instead of thinking in terms of "everything", "everyone", etc, it may help to think in terms of bell curves and outliers on that curve.

Would you be willing to believe that, out of 7+ billions people in the world, there is at least one person whose brain is set up to constantly hammer them with feelings of hunger? (I'm not sure how a basic proposition like this could be rejected, since the chemicals and processes that govern hunger are something that science actually has some understanding of, and we also know that basically anything can go haywire.)

Next: if you can believe that one person is such an outlier, can you believe that hundreds are? Thousands? Millions? Whatever size that group is, it seems like a possible answer to your worry of when these lines of thinking stop. Perhaps some outlying group of people do actually need something more than "good old fashioned hard work and discipline", especially considering that thousands of years of people repeating such sentiments hasn't solved quite a lot of problems (beyond just obesity).

> there is at least one person whose brain is set up to constantly hammer them with feelings of hunger

Not only was there a fascinating example of this the unfortunate man was documented by a doctor of the era.

https://en.wikipedia.org/wiki/Tarrare

> Next: if you can believe that one person is such an outlier, can you believe that hundreds are? Thousands? Millions?

Yes, those people exist as outliers. But a population-level outlier theory doesn't explain why obesity is growing in the population.

ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

Obesity is similar. This feeling of hunger is thrown out of whack often not by genetic but by lifestyle. I’m lucky enough that I haven’t felt it all my life, but I have felt it during multiple phases of my life; i know exactly how eating the wrong kinds of food can teach your body to eat more than it needs and to adapt to that new number.

Our environment sucks ass.

> ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

I think this might be a misunderstanding. Rates of ADHD may be higher but I think it's more likely we have an environment which now challenges people with ADHD more than in the past.

The advent of electrical lighting did not cause an increase in pattern-reactive epilepsy, it just created conditions in which pattern-reactive epilepsy were more likely to be triggered. I believe now is the same.

If increased stress and the demand for 8 hours of uninterrupted mentally challenging work exacerbates ADHD, why wouldn't increased food availability - especially high density ones - exacerbate obesity in those with a a satiety loop defect.

If you eat until you are no longer physically capable of eating more it sure matters if you ate vegetables or pastries.

same thing we now have an environment that challenges our starvation signals in ways our ancestors never had to deal with. They never had an ever present source of dense calory food.
> ADHD used to be only a tiny amount of outliers and is growing, thanks to the lifestyle we lead.

That's speculative I believe. Last I checked, I think they chalked this up to better diagnosis.

I've had the same experience and I agree. It's deeply ingrained but it's not hardwired so it can be changed, it just requires going against the grain in almost every area of your life in order to avoid being impacted by the modern food environment (in America at least).
You make a sound argument, but it doesn't explain, why in one country 1% of the people are in this situation, and in another country 30%.
Given that those countries have massively different foods available, massively different environments available, require people to spend massively different amount of physical effort during the day, it would not be that shocking.
The statistical/genetic view of obesity and observed weight gain in general, which is useful in its descriptiveness, fails to explain, behaviorally, why people 30-40-50 years ago-I was young in one of those decades-were much less likely to be not only obese but also overweight. And while it is true that much more high-calorie food is available today than back then, a lot of butter was used, pasta and bread were widely consumed, and if one wanted to be fat, one could easily become fat.

If the problem was all in poor impulse control and hunger felt differently by some people genetically predisposed to feel it (but >30 percent in some states in the U.S. feel it that way?), there would have been many more fat people in the 1970s, 1980s, and 1990s, when highly palatable food became available. And, I reiterate, those who wanted to or had no problem getting fat could certainly do so. In fact, there were (some) fat people even then.

One thing that has certainly changed over the decades is the social acceptance of obesity and being fat in general. In my country, which is not the United States, people are still asked what happened when they put on a few visible pounds or promise to start working on it before anyone says anything.

I recently visited Buenos Aires and the difference in weight between women and men compared to what I see in the United States/California was hard to believe. It was quite surprising to see so many women and men young and old in good shape, or at least at a good weight.

But in the United States (and other countries) being fat and terribly out of shape is personally and socially accepted. Let me take an opposing and politically incorrect position for a moment, strange as it may seem: if I had a kid who was overweight, I would firmly tell him or her that he or she must lose weight. Would that work? It's hard to say, but it's something I wouldn't accept lightly.

But it's like the differences we see in the way people dress, even though clothes are not part of a physiological process that is apparently easy to hijack. How is it that people show up dressed in a way that 30-40 years ago would have appeared offensive to others-I'm thinking of going to the supermarket in pajamas. Well, for one thing, that way of dressing and showing up in public has become accepted. People of my parents' generation would have been ashamed to show up in public in pajamas. Ashamed to show up in public in pajamas. But nowadays, whether one considers the loosening of dress codes as good or bad, it is socially accepted and becomes almost a need. In fact, for the younger generation, what was once considered normal (for most people), such as making phone calls or being groomed, is almost physiologically intolerable.

Lab animals kept on strict diets and routines for decades have been mysteriously gaining weight as well. (https://www.nature.com/articles/news.2010.628)

There's more than just social acceptance of obesity and pajamas in the grocery store at work.

Increased calorie consumption is the offender, there is little doubt about that. By carefully measuring food, one loses and gains weight accordingly (taking into account age, physical activity, etc.).

The social acceptability of being fat leads to psychologically easier consumption of calories. Personally, if it were not for the shame I would feel, I would eat 1 kg of ice cream every night. I have a great appetite, but also a great capacity for restraint.

The "mysterious weight gain" not explained by calories is, at this point, rather speculative.

> By carefully measuring food, one loses and gains weight accordingly (taking into account age, physical activity, etc.)

That was the problem. The lab animals have had their food careful measured for several decades with essentially the same food/lifestyle, but weight was being gained at a rate higher than other animal populations. Because it's unknown the "why" part is speculative, but they've got some interesting ideas. Changes in animal husbandry standards, endocrine-disrupting chemicals and infectious agents were considered as possible factors.

From the study:

"There are multiple conceivable explanations for these observations. Feral rats could be increasing in weight because of selective predation on smaller animals or because just as human real wealth and food consumption have increased in the United States, rats which presumably largely feed on our refuse, may also be essentially richer. But these factors cannot account for the findings in the laboratory animals that are on highly controlled diets, which have varied minimally over the last several decades." (https://royalsocietypublishing.org/doi/full/10.1098/rspb.201...)

I didn't say anything about genetics, though I wouldn't be surprised if that plays a part. Might be how you were raised. Might be simply your cumulative life path leaving you in a particular state. Might be toxins in the environment. It doesn't matter; in the existing present, people have wildly different responses to food and diet.

As for your actual question, it depends on the particular thing we're talking about. For obesity, we've tried telling people to do more hard work and discipline, and it's been a spectacular failure. Plenty of people who do work hard and have incredible discipline in other areas of their life fail when it comes to getting to a normal BMI. There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

This also is more common in our current society, for whatever reason (likely not genes, since we're close enough to our grandparents), than it was historically. This isn't some natural state of affairs we live in.

So, bring on the drugs! If there are ones that help other things with minimal side effects, bring them on too. Everyone wins, because we end up with a better, happier, more productive society.

> There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

Out of curiosity, what kind of food were you obsessing over, specifically? Why were you craving that kind of food, instead of, say, lettuce?

For me, it was primarily carbs. Not potato chips or anything particularly greasy, but things like tortillas, rice, noodles, bread, potatoes.

As to why, who knows. I'd be "starving" but have zero desire to eat lettuce, but then jump on the first chance I got to eat a couple cups of rice.

Well, simple carbs (which includes sugar) are highly addictive, so I can't say I'm surprised. Your brain was trying to get you your fix by convincing you that you were starving. In contrast, if you were truly starving you'd eat anything -- including lettuce ; )

So, maybe you already tried that, but there's a psychological/addiction angle that's seldom explored when it comes to simple carbs and obesity.

That said, if there's a drug that you can take that'll numb those cravings down to a healthy level, there's nothing wrong with that.

"Hard work and discipline" are multipliers for the output of an otherwise-balanced brain and body chemistry. But they're no substitute for fixing that balance when it is imbalanced.

An analogy: "hard work" is what your car's engine does when you throttle it up. But that "hard work" isn't going to take you very far — or even in the right direction — if the car's wheels aren't aligned and balanced equidistantly on the car's axle. This "imbalance" will mean that any power put into the system, just gets shunted into running you faster and faster in circles, and/or into "spinning your wheels" and "burning out."

Bringing the car into balance is an overriding concern. You won't get anywhere without first doing that, no matter how hard you push the engine. Once you've done that, though, then the amount of power you're pushing through the engine — your "hard work and discipline" – becomes relevant.

Let's say there were a drug that made people motivated to study hard and get a lot of work done. Would the successes people reaped from that be less useful to themselves and people around them, than those which other people reaped from being natively predisposed in that direction?
If your eyes got bad, would you get glasses?

My brain doesn't produce the same amount of dopamine as a non-ADHD human's brain. It's morally neutral to fix that with medication, same as it's morally neutral to wear glasses, imo.

Why are you more worried about "good old fashioned hard work and discipline" than taking a scientific and results-oriented approach to improve people's lives? Do you want to see people toil and suffer for its own sake?
Funnily enough one could argue that we're also biologically predisposed to apply certain moral judgements to the behaviour of other people and our own. After all, our environment of selection didn't include the ability to alter much of our body chemistry.
> Is everything pre-determined by genetics?

Well, much more is, than isn't, it seems. You may trim the sails, but life will provide you your wind direction... And in this case:

"As many as 400 genes have been shown to affect body weight in one way or another."

https://www.genomicseducation.hee.nhs.uk/blog/obesity-is-it-...

We’re products of our nature and environment. Belief in free will, virtue, etc. are useful beliefs, but they’re also just not true.
Free will is a product of our nature.
There is 0% chance that human genetics changed this much in the last 100 years (3-4 generations). Look at photos from 100 years ago, people were mostly thin.

So no, we’re not genetically predetermined to be hungry.

There’s something in our environment that’s messing with our circuits. Either some toxins (e.g. endocrine disrupters) or hyper palatable food (artificially engineered for max enjoyment and min satiety), or maybe something else.

But this doesn’t dismiss the idea that some people are genetically predisposed to be far hungrier. While true cheap and abundant calories facilitate obesity, that probably synergizes with people who have naturally voracious appetites. Someone in the pre-industrialized past wouldn’t have been able to binge on so much calorie dense food, but they may very well have felt gnawing hunger more strongly than their peers.
I don't think _everything_ comes down to genetics, but a lot of stuff does, including the attributes you mentioned here.
Genetics and microbiome are the biggest factors, but training, habits and environment (how accessible is that junk food?) also matters.
> Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

As someone who's always been thin and doesn't have a strong appetite, I couldn't agree more. I'm just enough outside the norm yo be able to recognize it.

There are times when I simply can't force myself to finish my food and it goes to waste, but the upside is that many people assume that people in my body fat range are somehow virtuous for not "overeating". That's not the case at all - I don't eat particularly healthy, don't have any particular exercise routine beyond walking, and I don't limit myself. I just get full quickly and have a metabolism that burns what I eat.

I applaud that self knowledge.

It's always hard to know others' experiences. I have a friend who genuinely tried to help me lose weight in college with the typical advice and a lot of support: he had the strategy of just eating until he was full and then stopping, and he just couldn't get why that didn't work for me. But when he hit his 30s, he suddenly started ballooning up and suddenly couldn't put his strategy into practice, to his great frustration. Did his willpower dry up overnight? Nope; something else changed to upregulate his appetite.

(I pointed him to semaglutide, and he's already halfway to returning to his college weight.)

I'm in a similar boat as you. COMPLETE opposite experience as other folks, to the point of pathology. I could not overeat to save my life. I cannot lift weights and expect any growth due to lack of caloric intake. When I try to exceed 2k calories in a day, I find myself so full I need to lie down and groan for an hour until things move and digest. Force any more down and I'll vomit. I cannot concentrate with a meal in my stomach, so I wake at 9, eat ~500cal at 1pm, and leave the rest til I'm done work at 8.

Sometimes I lose 15lbs when having a bout of constipation due to goddamn IBS.

Every person in my life, friend or foe or family or partner finds it clever and completely acceptable to tell me I'm "too skinny and need to eat more".

Others without my experience just don't get it. Glad these overweight folks have a tool to help them.

Since May, I have (very deliberately) put on ~16kg of mass, going from a BMI of 17.5 to 22.8. Started at around 2500kcal/day, currently at 3500kcal/day.

> I could not overeat to save my life

You are likely eating the wrong foods. It is _highly individual_ what kind of food can people eat in large caloric quantities. Start calorie tracking and experimenting more, you can figure this out. Some people do well with oatmeal (tastes like soggy sawdust to me), some with various nuts (peanut butter is a fitness industry staple), others make themselves milkshakes etc etc.

Progressive overload is key here, don't just expect to start eating 4000kcal/day, it is not going to happen (and would not be productive anyway).

> I cannot concentrate with a meal in my stomach

Same here. I feel like eating makes me lose about 10 IQ points, not great (though I am at a place in life where I can make this sacrifice). Maybe more sugar would be helpful here.

You may also find the /r/gainit subreddit englightening.

Thanks! Congrats on the 16kg.

I've been trying to eat more since I was 20 (am 34 now). It's been getting more difficult as I get older, especially with the onset of IBS a few years ago - now more foods and what used to be regular quantities cause my stomach to balloon.

All my experimentation has landed me on.. a mostly meat diet. Which I don't love (it's expensive, kills animals, impacts climate) but I can digest it more easily than vegetables or grains.

Oats are my everyday ~500cal first meal. If you find them unpalatable, try my recipe (it's literally my favorite thing to eat):

Combine in a jar night before and leave in fridge: 1/2 cup rolled oats, 1/2-1cup water/alt milk (amount depending on consistency you enjoy), half scoop flavorless protein powder, tbsp peanut butter, raisins, walnuts, pumpkin seeds, chia seeds, maybe 1/2 banana (if you need it to be a little sweeter).

I prepare mason jars with dry ingredients for the week, and add water to one or two every evening and put in fridge. Oat+raisin+pb combo tastes like my fav cliff bar. Banana + walnut are also amazing together.

I also recently got a vitamix and have been making vegetable smoothies midday to try and get more of them in my diet. I still cannot drink more than 500ml, else extreme fullness and bloating, but it's something. I'll add oats + avocado + protein powder to make it a meal with proper macros, but then I get to regular dinner time mostly full :)

Eating when full is a real bane for me. But there's bigger fish to fry in life, so I'll be a skinny guy.

I've known a few women with metabolism like yours. They actually had to work at keeping their body weight up. Their friends envied their slim figures, but it was a genuine health concern for them.
I'm sorry, but I'm a decently in shape person that tried semaglutide for reasons other than losing weight and I disagree.

While I'm sure we all are a bit different satiety wise (and I've found it greatly depends on how much I've been eating overall recently), your experience on the drug is not what the rest of us feel like all the time. It's unfortunately normal for our biology to basically want to shove calories down our mouths all the time. I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

The kind of "fullness" you get on semaglutide isn't natural. I've never felt like that my entire life. The closest thing would be after something like a Thanksgiving meal, but that's more of a "my stomach hurts" than "I really don't feel like I can put more in my stomach."

My sister in law is the skinniest, most in shape person I know. She's 35, has had 3 kids, and has abs, an ass she clearly worked for, etc. My wife (unfortunately) regularly compares herself to her and in this case also thinks like you, that it just comes naturally. She gave me her old phone so I could test some stuff on it as I don't have an Android phone handy. She didn't wipe it. MyFitnessPal was on there, and she was limiting herself to 1400 calories a day.

Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

And it needs to be said in case my wife ever finds this: she's also ridiculously hot and even though she can't see it has, at times, been skinnier than her sister.

>It's unfortunately normal for our biology to basically want to shove calories down our mouths all the time.

Not for me.

>I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

This is completely alien to my experience.

I eat until I get full, then I stop eating. I do not have any difficulty whatsoever maintaining a healthy weight. I don't think about calories at all. I have no idea how many calories or nutrients are in anything I eat; I've never paid attention to the that part of the label. It does not enter my mind for even a moment.

Sometimes I exercise regularly, sometimes I slip and get lazy for a while. Sometimes I eat a lot of fast food, sometimes I pull myself together and make better stuff at home. Throughout all this, my weight does not noticeably budge at all. I've been 20-22 BMI for my whole adult life.

>Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

I didn't work for it. It doesn't mean I'm a good and diligent person, it means I got lucky with my biochemistry and genetics. In another life, a different sperm would have met a different egg and I'd end up with different alleles and I'd end up fat.

It isn't fair that I'm living my life on diet easy-mode. If semaglutide can replicate this for people who aren't so genetically lucky, that's a fucking miracle.

I was like this for a long time, then I got older. That said, you seem to be following your body's instincts well, so good for you.
> I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more.

You give some thought to it every day, but do you think about it every minute? You could still eat more, but do you still have the same intrusive hunger to eat that you did before you started the nachos?

> Almost all of us work for it.

Your claim here seems to be that you work for it harder than people who have less success. But do you have any actual evidence of that?

Like, can you truthfully say that to keep your presumably healthy BMI you overcome nearly constant thoughts about how hungry you are? Can you eat an entire pizza and still be hungry except it's physically painful to eat?

People vary in their experiences of satiety. Many people do manage to be thin without constantly feeling hunger; that's what being on semaglutide does.

It's funny hearing people debate this topic on HN where the community skews heavily male. The vast majority of women have experienced both of these states of mind and in fact do so on a monthly basis. Three weeks out of the month I get hungry, I eat, I get full, and I don't feel hungry again or think about food at all for hours. You could put a cupcake in front of my face when I was full and I wouldn't even look at it. It requires zero effort to behave this way. Yet during that fourth week I get a constant gnawing feeling in my stomach that never goes away except in the first few minutes after eating something (usually simple carbs). I think about food nearly every minute of the day. Then one day it's like a switch flips and I'm back to having a perfectly normal appetite and satiety signals. It's an excellent lesson in how we're all at the mercy of our biology to some extent.
I’m a male with hormonal issues and I’ve also taken growth hormone peptides that make you ridiculously hungry. I’m no stranger to how hormones can affect our bodies. All I’m saying is that the type of satiety you get on semaglutide isn’t natural and I’ve never felt it before in my life.
Oh I definitely believe you on that. I haven't taken semaglutide myself but from what I've read it seems to increase satiety by slowing digestion, which is why it has nausea as a side effect, and I can't imagine that that's the same as the normal feeling of satiety you get from eating reasonable amounts. Did it make you less hungry in a sick way rather than a neutral way, maybe?
> Can you eat an entire pizza and still be hungry except it's physically painful to eat?

Same as the other poster, yes, but I can also still eat more without pain if it's a Large Domino's Pepperoni Pizza. If it's the Dominos "Deep Dish" though, that's my maximum. I can regularly put away a large Little Caesars pepperoni without trying, it's just a "normal meal".

The difference between me and people fatter than me is that after a large meal like this, my body stops "demanding" food for 1-2 days. Thats what keeps my weight in a +/- 3 lb range.

I know the difference because every once in a blue moon after I turned 30, my body's hunger signals will make me un-satiable. The experience of suddenly being unable to diet was jarring. I've managed to fix that somehow, thankfully. But it was very, very clear over several weeks that dieting was entirely beyond my control no matter how much willpower I had.

What semaglutide does is make the idea of putting more food in your stomach when it’s full…not nauseating, but something akin to that. It’s hard to describe. It almost feels like theres just no more room and the food will come back up. The main point I’m trying to get across is that (probably, sample size of 1) isn’t how healthy weight people feel.

And yes, I could easily eat more than one pizza. It’s a habit to simply stop at a few pieces, or more if I haven’t eaten much that day.

I’ve also taken growth hormone peptides that make you insatiably hungry. Literally insatiable - far beyond what I assume could be natural. I still usually limited myself. If I needed more I made popcorn or something and then went to bed hungry.

> Can you eat an entire pizza and still be hungry except it's physically painful to eat?

Yes. Except that it’s not physically painful not to eat (that would happen probably at 1 1/2 pizzas, but I almost never go there).

I’ve been feeling this way and limiting my food intake since teenage years (almost half my life). Sometimes more, other times less successfully (six pack to love handles, but never beyond that).

> I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication

If this was well and truly about the money you'd support it, because it's going to be cheaper than paying for long-term medical costs of obesity.

Yeah, and that's a definite bonus. It's the attitude I've read from people taking it that grinds my gears - when I read the semaglutide subreddit it was full of people saying "oh, so this is what skinny people feel like."

No, how you feel on the drug isn't how most of us skinny people feel. I'm probably somewhat uniquely qualified to make that distinction at the moment. The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat. It's one thing if you recognize it, but it's beyond annoying if you don't.

> The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat.

Someone could just as easily say that you've had access to a cheat your entire life and are now bitter other people have access to it. The fact that you have a stronger satiety response does not mean you are morally superior or are more entitled to a healthy life than others.

They could say that but they may very well be wrong. Obviously we can’t switch bodies and say, but I’m a non-diabetic person of a healthy weight that’s taken semaglutide. All I’m saying is the “full” you get when taking that drug was absolutely foreign to me.
> The rest of us have worked hard our entire lives to stay skinny [...]

Disagree.

I am skinny.

I spent almost no time thinking about it.

I eat whatever I want. If I overeat, my body feels bad... it tells me to stop.

After fasting 24 hours, my hunger turns off. I have no cravings. I am not eyeing chips and cookies with lust. I do not dream of roast chicken dinner.

Our human experiences of hunger and satiety differ more than I ever would have imagined.

Now should I look for a moral judgement? On me? On you?

I think I'll find something more positive to do with the rest of my day.

> Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

I don't really think this is a healthy way to look at it.

Yes every day is a struggle for most of us. I've been in the "healthy" BMI for a majority of my adult life, but only just barely. This requires constant effort and work for me. I assume that most "fit" people are similarly fixated on the quest to remain healthy.

But clearly, there's "something" that we have which makes it possible for us to succeed at this, which people who do not succeed lack. I don't begrudge them taking a shortcut, and I don't mind if they never understand my version of the struggle here, because I don't claim to understand theirs.

Fundamentally, we need to understand that our physiology has not evolved in a situation where we are both sedentary and have unlimited, good tasting food at our disposal, and any tools we have to make this situation easier should be embraced.

> she was limiting herself to 1400 calories a day

This is closer to disordered eating than healthy eating.

> The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat

Ah, the student loan forgiveness argument, and the pro-spanking argument: I suffered, so you should as well, because suffering is intrinsically moral and pleasure is bad.

> This is closer to disordered eating than healthy eating.

I believe she was losing what little weight she gained during pregnancy.

It’s not about suffering. Like I said, as long as you’re aware of it I don’t really care past the fact that I’m paying for it with my insurance premiums…but as someone else pointed out, it should be cheaper in the long run.

I'd be very careful with this kind of reasoning. We just do not know the insides of others peoples heads. How can you rule out that there are differences between peoples appetites?

Personally, I eat when I am hungry. My body typically generates hunger signals around the times I routinely eat. At other times I'm usually not hungry. Sometimes, I'll eat just for taste, but that is rare. I've had periods of time where I was trying to gain weight for fitness reasons and it was a real struggle. My natural state is to be skinny and it's quite hard for me to deviate from that. There a plenty of people like me and there are also plenty of people who tend to be overweight unless they actively fight it.

Clearly there are differences. There are extremes and their is a continuum between those extremes. You can exert some amount of willpower to change your position on the continuum, but the closer to the extremes you are, the harder it will be to arrive at a "normal" position.

And this is just inherent feelings of appetite. Some people may additionally be subconsciously eating to fill some kind of emotional hole or trauma. There is a lot going on and I wouldn't want to be too quick to judge.

Right, I’m sure there are extreme outliers on each side, but when half the population is fat it’s clearly not just that. The only point I was really getting at is that semaglutide doesn’t make you “feel like all those skinny people do and look how easy they’ve had it.”

Apart from people like you, perhaps. I also have a friend like that but he has pretty severe untreated ADD so I think that plays a part.