[SamoyedFurFluff]

> I think for the majority of people diet and exercise is enough

As far as I understand it, in the wild for the majority of the people there’s very little evidence that obese people can diet and exercise themselves to a healthy weight. It just statistically doesn’t happen very often. For whatever reason, they need the hormone regulating drugs.

[ejb999]

They can, they just don’t want it enough to make the necessary sacrifice. I agree it doesn’t happen much, but that isn’t because it can’t work, it does for almost everyone that can make permanent change in their diet and lifestyle, most people just want the easy way out.

[AlisdairO]

Why shouldn't they want the easy way out? I was obese twenty years ago, and lost the weight via diet and exercise. Keeping that weight off is the single hardest thing I have ever done, and a battle I still have to consciously fight every single day. Why should it be that difficult? So that I can pass some kind of purity test?

The fact is that the food we eat has evolved over time, and is too hard to resist overconsuming for a large fraction of our population. If we can create more addictive food, why not create antidotes? If we could easily treat alcohol addiction with a pill, would we tell alcoholics to just apply willpower instead?

[sigilis]

I’ve seen figures that show that 98% of overweight people cannot lose and maintain weight loss. For obese people, the numbers are horrifyingly worse:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539812/

If at best only one in fifty can do such a thing, when the entire world is screaming at them to do so then you must re evaluate your position that it’s about just making some changes and having it all work out. Becoming a normal weight is just not something that you can expect for most currently obese people to achieve. The facts were have seen do not support the idea that it’s something that people can knuckle down and do in the majority of cases.

Whether the causes are biological, social, or whatever it’s something that we have not been able to even slow down as a society yet. The article mentions the abject failure of decades of efforts from doctors, government and individuals that have lead only to greater rates of obesity.

Even these drugs won’t be enough, given the best results in studies only show something like a 20% loss after more than a year. For many obese people, that leaves them still obese but $15k poorer if their insurance doesn’t cover the drug.

If you managed to lose a bunch of weight, congrats. But the experience is not generalizable, unfortunately. It’s really not for lack of effort on anyone’s part.

[nyokodo]

> the best results in studies only show something like a 20% loss after more than a year

The health benefits of losing that amount are enormous. In fact, they may get ~80% of the health benefits of a healthy fat percentage. Their blood pressure will plummet, their salt intake will drop, they’ll eat less sugar but more lean protein (it’s common to crave it). Because of this their blood work will improve and they’ll be at significantly lower risk of diabetes and heart disease etc. Don’t let perfect be the enemy of the waaaay better!

[belltaco]

You can say the same thing about sex and contraceptives. It's probably way easier to abstain from sex than food. Yet no one is blamed for taking 'the easy way out' and using contraceptives instead. Why the double standard?

[SamoyedFurFluff]

I mean quite literally something is wrong with obese people that statistically they cannot “want it enough”, like an addiction. The fact that obese people suddenly are able to “want it enough” when they take a hormone regulating drug points to this imo. It’s unhelpful to simplify this into a will thing, because it just doesn’t make sense that fat people love eating so much they’re totally cool with losing their feet to diabetes. That’s clearly something deeply wrong with the fat person, in the way that something is clearly wrong with a hoarded out house, or a homeless gambler.

[skepticATX]

I have to agree.

I don’t think that being obese is a moral failing at all. But caloric deficit does result in weight loss.

Anyways, there are plenty of other benefits that come from exercise and a healthy diet, besides weight loss. Hopefully these drugs can be used as part of a more holistic improvement in lifestyle, and not as a sole treatment.

[orwin]

I was clinically obese (32 BMI when I checked, I think it could have been higher). The hunger when on calorie restrictions was debilitating, making it impossible to work in the afternoons.

The thing that helped was a complete, week-long fast (I had 13 weeks of PTO per year so sacrifing 2 wasn't a huge deal then), that I prepared with my family (lot of them are either doctors or PT). The second day was worse than when I dislocated my ankle, except in my whole body, without the adrenalin/shock to help with the pain. The pain came in waves. Once that passed I was mostly fine, and the third day until the last I was mostly functioning (I tired easily, and couldn't work or really exercise, but I was mostly fine and could go out and walk).

If I knew those drug existed, I think I couldn't have passed that second day, and taken those instead.

[paulpauper]

Even if they can, the easy way out is sometimes better anyway. Not everytign has to be a struggle if it does not need to be.

[amazingman]

What a cruel usage of the term "just". None of us is lucky enough to want what we should want in every important facet of our lives. If you "just" wanted something enough to make "the necessary sacrifice", then you were lucky.

[jncfhnb]

Yeah but shut up.

Talking about things that are feasibly solved with willpower as if they should be achievable because people ought to be able to willpower their way through any plausible challenge is just bullshit. The world is full of people who are so eager to say that they did it ergo everyone else is just being lazy. But just… shut up. Everyone has different circumstances. Things that are very mentally hard are very mentally hard and we don’t need to pretend otherwise. It’s complete bullshit and moral high grounding. It’s not helpful in the slightest. It’s not an easy way out. It’s a way out.

[hombre_fatal]

Also we’ve stacked our whole culture against health and nutrition. Just compare 7/11 in the US vs Japan. This goes far deeper than saying everyone just needs to pull a small easy lever in their life. To come back from the brink in the US you have to win the fight every second of the day forever and inoculate yourself against a world poised against you.

[spaceprison]

100%. after a lifetime of being overweight I found the will to make diet changes and ended up losing about 90lbs. The thing that's missed in these 'it's just calories in, calories out and will power' types of comments is that the commitment required to accomplish the weight loss is nothing compared to life consuming commitment required to maintain the loss over multiple years.

After 5 years of vigilance the mental and social toll was just too much and I gradually let down my guard within about 3 years I was up 50+lbs.

So now 10 years on it's corner cutting because there's a medical intervention that can help or just weakness because I can't find the will to do it to myself and people around me all over again?

Not helpful.

[SamPatt]

1 in 50 obese people being able to escape obesity on their own is still tens or hundreds of thousands of people.

Telling people who've lost weight through willpower to just shut up is rude and unhelpful.

I lost 90 lbs through diet and exercise. When I say that others could do what I did - which is true for many - I often get people asking me for advice, which I give. What's wrong with that?

[amazingman]

Telling people who couldn't muster the sustained willpower to lose weight through diet and exercise that they "just didn't want it enough" is rude and unhelpful. It's a little bit like telling bereaved parents they didn't pray hard enough for their deity to save the child. I'm happy for you, and hopefully the advice you're giving isn't some form of willpower woo-woo. The hard truth is that you were lucky; none of us can truly account for why we did or did not succeed at a practically achievable long-term goal. If the other 49 obese people had the capability to will themselves to health, they would have done so.

[jncfhnb]

Your advice is shit that’s what’s wrong. Your situation is not the same as others. Everyone knows what you’re saying. You’re not giving useful info saying “power through it”. You’re bragging.

So good job. But shut up. Whatever rudeness you feel from me saying shut up is FAR less rude and unhelpful than the poor people you’re telling to “power through it” who are certain that they cannot. Because you are implicitly calling them weak. And that’s fucked up.

Because for the third time, it might be MUCH harder for them to lose weight than you.

[SamPatt]

You admit you don't know what advice I'm giving, yet you insist it's me just telling them to power through it and my motivations are as a braggart.

You can't see how presumptuous and rude this is? And how weak you are presuming all of these people are? Treating them as if they have no agency and they cannot handle hearing someone else's life experience.

While I don't doubt for many people it would be harder to lose weight than it was for me, you also have no idea how hard it was for me to lose weight. So what? Other people like me exist.

I lost weight by listening to other people who lost weight and learning from their experience, and I'm available to do the same for others. Why you think this is "fucked up" and demand I shut up is just bizarre.

[jncfhnb]

I have no issue telling you where to shove your unsolicited advice. Especially when the advice is suggesting people, who have almost certainly tried suffering through to suffer through it in the context of looking at an alternative that works for people that have struggled with the approach you’re injecting here.

If people want your advice on diet and exercise they can ask for it. Otherwise, I trust they know it’s an option

[hackernewds]

the word "can" doing a lot of heavy lifting here. from a practical vs theoretical standpoint