[rs_rs_rs_rs_rs]

>Obesity is being changed from a willpower problem to a chronic disease that is treatable

It's absolutely a willpower problem. These medications won't fix that for you. You stop taking them and you will gain weight again.

[belltaco]

All forms of contraception are also solving a "willpower problem". Food is even more of a basic need compared to sex, so evolution has it made it so that it's really hard to eat less.

[bb88]

Hunger is caused by not enough glucagen-like peptides (GLP-1, etc) being distributed to the brain from the gut. Obesity is not so much a food "addiction" as it is the body's failure to properly regulate it's own fullness.

I've heard this called "food noise" by those who are obese. GLP-1 agonists reduce the so called food noise -- that's all it does.

In that light your argument is like trying to tell schizophrenics, "Hey, stop hearing those voices in your head!" I think we tried that for over a century.

[intothemild]

I can speak to the food noise.

I hit my 30's, and became a dad, I lost my ability to run as much as I did. Now a decade later that's changed. But in that time I gained a lot of weight. I started running again. I'm a distance type of runner so I'm talking 6-15km a day, 6-7 days a week.

With that out of the way. After doing that for 6 months I was wondering WHY am I not losing weight? Like basically nothing. I counted every calorie, kept myself in a caloric deficit, used a TDEE spreadsheet to keep readjusting my daily caloric needs. Nothing was working.

Went to the doctor, he did blood work, it was all pretty much normal for someone obese. He asked me how hungry I am. I said I'm constantly hungry and it's just willpower alone that keeps me from eating, unless I had a drink, so I usually refused to drink.

I was put on Ozempic/Wegovy.

Pretty much two weeks later, I stopped thinking about food. Gone. Just gone. Before I would wake, and I'd be planning every meal.. when, what. How much, etc. If anything got in the way of a meal, I would be super irate. I was counting down seconds... Every single thought in my head was food.

Now gone.

I sometimes forget to eat.

So yeah. Food noise is real, and it suuuucks.

Side note: the weight loss helped my running a lot! And the weight loss seems to have stalled... But I don't care. I'm just happy to have this extra energy from not thinking about food every second of every day. :)

[lifty]

Fully agree with you. I think the unknown that still remains is why that noise is created. It must be related to modern food processing, besides the abundance of food.

[bb88]

I don't necessarily agree with that premise it's modern food processing.

The evolutionary human condition was primarily hunger. Animals fought over food. Humans fought, went to war over it. Nature has been that way for millions of years.

So now only in the past 100 years food has become abundant. Do you expect our evolution to change with it to be that quick too? That's really only 4 or 5 generations.

One data point here. In the 1700's, 1800's the rich were the ones that were fat, because they were the ones that had the abundance.

[lifty]

That doesn’t explain the discrepancy between USA and other regions of the world where obesity rates are much lower but food is equally abundant.

[nathanyz]

The amount of willpower required to maintain differs from person to person. So yes you can willpower your way to a healthy weight, but the amount of mental energy required is going to vary significantly between people. The drug proves it as it basically flips people with a high willpower requirement to feel more in the normal range where it is easier to eat less.

[aantix]

We commonly accept that are large ranges of inner experience.

Different levels of anxiety, depression, focus, pain, sexuality. All that we can manipulate with medication, to bring within a range we find suitable.

So why can't ones inner experience of hunger be vastly different from someone else?

[aantix]

Long-term success numbers on 10-year weight loss are abysmal. Everyone gains it back.

Eating right, exercising, taking this medication - if you stop any of these, yes, you will gain back weight.

[intothemild]

I'm on Wegovy, I'm told it will be for 2 years max... Then I'm weaned off it. My biggest fear is when I come off, the hunger and food noise returns.

I would happily continue to be on this med for the rest of my life, side effects and all.

[aantix]

What's their reasoning for "2 years max"?