[chpatrick]

But it still doesn't sound like a sustainable lifetime solution.

I think it makes great sense if you're badly out of shape, you fix it, and then you can maintain a healthy weight. But going on ozempic every few years sounds really bad.

[kelseyfrog]

"Sounds really bad" is orthogonal to "is really bad".

There's a heuristic that goes, "Shortcuts will catch up to people eventually," but I'm ok with letting the evidence bear that out.

[jart]

Yeah that's the kind of folk wisdom that causes people with psychiatric conditions to stop taking their medications. It's very ignorant and harmful.

[chpatrick]

I don't think that's a fair analogy. Psychiatric medications don't have a non-pharmacological alternative in many cases. You can't just consciously do something and not be depressed or schizophrenic any more.

However, putting food in your mouth is a completely conscious decision. If people have problems with controlling that then I think that's what should be treated, instead of medicating your body to react to food differently. I think a future where we turn to drugs on an ongoing basis to compensate our unhealthy lifestyles is pretty dystopic.

Again, if someone is obese and struggles to lose weight I think Ozempic sounds like a great way to get on the road to health. I just don't think you should take it for the rest of your life instead of changing your lifestyle.

[jart]

What you call dystopia, I call paradise. Evolution didn't give us bodies that are adapted to life in modern technological society. The better technology gets, the more unnatural the world gets for our bodies. People who are unfit to live won't die, because technology breaks the evolutionary process. Since we know that technology is better, the only way we can keep having it and thrive is by using more technology to hack our bodies so they're adapted for existence in the modern world.

[chpatrick]

I don't see it that way. Obesity is caused by deteriorating diets and lack of exercise. I don't think the solution is to keep the poor diet and lack of movement and treat only the resulting obesity. That's WALL-E, not paradise.

Many things get better with time and progress but I don't think our current lifestyles are some kind of evolutionary peak.

[kelseyfrog]

What do you think the ultimate causes of poor diet and lack of movement are?

All other things considered, how important is it that proximate or ultimate causes of obesity are addressed?

[criddell]

> doesn’t sound like a sustainable lifetime solution

Would you same the same thing about insulin or statins or even caffeine? Why couldn’t something like Ozempic be something you take long term?

[chpatrick]

Because it has many bad side effects and it's only treating the symptom, when the real problem is eating too much? Should we keep medicating people for damage that they're continuing to do to themselves willingly?

With regards to caffeine, as a doctor would you prescribe lifetime energy drinks to people who intentionally don't sleep enough?

Insulin is totally different because if you're diabetic and you don't take it, you die. There's no cure for diabetes, so there's no other option but to take it for the rest of your life.

But if you've lost weight (either with ozempic or not), it's possible to not be obese again, you're totally in control of what you put in your mouth. It feels really weird to me to keep medicating people forever when there are well understood ways to manage your weight.

I think it's probably a great solution to help people who have lost control of their weight and need to get back on track. But using it to compensate for an unhealthy lifestyle going forward just seems like bad health policy.

[kergonath]

The way it is done, people take them for the rest of their lives. It is not something you are supposed to get only for a while, it is not a cure in that sense. It’s still miles better than the alternative, which is staying obese.