[seadan83]

The concern regarding a drug as a crutch is stil valid. Smokers/drinkers may deal with stress by smoking/drinking. After cessation, ways to deal with stress need to be learned from a new.

"Addiction" is ambiguous and a term almost better not used. "Addiction" may constitute chemical dependency but can also be largely a set of habits. A set of habits and lifestyle are pretty much the same thing.

[CydeWeys]

The problem is that calling it a "crutch" is already presupposing a negative judgment of it. Use a neutral word; e.g. it is a weight loss aid.

[tomrod]

Some things simply are negative, and masking behind a neutral word makes the neutral word perceived as negative over time.

Masking reality is not a good way to work within it nor modify it.

[CydeWeys]

Some things simply are negative, sure. I think we can all agree that murder is negative on the whole, for example.

But you are making a HUGE leap here in assuming that GLP1 agonists "simply are negative". You have not remotely supported this logical leap. All studies in fact have shown that GLP1 agonists are significantly positive: That they improve health, reduce obesity, reduce all-cause mortality, etc. You are denying observed reality across a large number of double blinded, objective clinical trials.

[collingreen]

I just keep following your comments down the page and giving you upvotes.

I think folks using drugs (or meditation or habits or diet or any other thing) to intentionally make their life better is amazing and should be celebrated.

If some things are easy for you but not others try to be grateful for yourself without having to be petty or wanting others to be worse off.

[tomrod]

To be clear, I don't think GLP1 agonists are "negative." I think the blend of environmental, food supply, and other factors that led many adults, in the US and elsewhere, to need obesity intervention is the negative. GLP1 agonists are an inherent crutch.

Much like if we geoengineered cloud seeding or similar light blocking and fail to reduce CO2, the treatment masks the cause and can lead to worse outcomes globally (even if some folks are better off - and I hope they are!).

[firecall]

I don’t agree they are a crutch.

However, if they are, then modern life is a sledge hammer that’s constantly breaking your legs.

Our (US, UK, Australia and so on) life styles and food chain have created this obesity problem.

We are now a sedentary population, and low-nutrient high-calorie food is being made readily available to stressed, tired, overworked, and economically challenged people. When you are stressed and tired, you don’t make the best choices!

These drugs are not so much a crutch as they are a rescue helicopter!

We still need education though.

These drugs might reduce hunger, but they won’t stop you from consuming junk-food. People are used to overeating, and a feeling full isn’t always what’s stopping them from eating!

So we do absolutely need to address the root of problem….

[CydeWeys]

Amazingly enough, the drugs do address the root of the problem. Snacking / junk food is less appealing on them.

[neuralRiot]

>These drugs are not so much a crutch as they are a rescue helicopter!

Yes, but once you’re rescued you hopefully try to avoid falling in the same situation that lead you to have to be rescued the first time. This should be a double approach solution, a short term (the drug) and a long term ( lifestyle changes) it can be done with the second only but personal commitment is required. Besides that we, as a society, are not accustomed to “subtractive solutions” they’re simply never considered or pushed by anyone because there’s no money on them. Money is in “creating solutions” not in “eliminating problems”

[cthalupa]

What's the explanation for why GLP1 medications are negative things? There are a very minor subset of people that have some medically significant adverse reactions, but it is VERY small. We don't have any evidence to my knowledge of any long term risks with being on it.

[blackeyeblitzar]

GI issues are fairly common and sometimes linger after stopping too. Loss of muscle mass is also common.

[cthalupa]

The GI issues tend to be minor. Unpleasant, but not exactly any more debilitating than a lactose intolerant person deciding that they really really wanted that extra large milkshake. Some people have it worse - but those, to my understanding, very much are in the minority.

Tirzepatide also has significantly fewer GI issues.

Muscle mass loss happens in any sort of weight loss where you don't eat enough protein and get enough exercise. There's no current evidence that when you control for calorie deficit, diet macros, level of exercise, bmr, etc., that people lose more muscle mass on GLP1 agonists to my knowledge.

[jart]

Is there any evidence those things aren't just side effects of eating less food?

[oatmeal_croc]

This. You'll need studies to prove that semaglutide causes muscle mass -so you need to have a group that loses weight using semaglutide and another group that loses weight without it and compare the muscle loss. I'm willing to bet you'll see similar numbers. If you don't exercise, you will lose muscle mass when reducing weight - which is why trainers recommend resistance training and higher than usual protein while cutting.

[phil21]

GI issues are almost always minor. Folks are used to zero discomfort in their lives so the social media reporting of such is wildly overdone.

Tirzepatide is being investigated as a therapy for IBS. Within two weeks of being on the drug I was able to start living a life not scheduled around being near a restroom. This was suggested as a potential side effect by my doctor before taking it for weight loss, due to the GIP component in the drug which slows down your digestive track.

It could be I’m eating less. However I have went on crash diets before with absolutely no change to my constant lifetime GI issues, and have eaten extremely clean the past half decade due to a partner who cooks amazing healthy meals that would exceed most definitions of the term.

I’ve long since reached my goal weight and target body composition- but I plan on sticking to a low dose of Tirzepatide for the rest of my life since it gave me my life back. No more popping Imodium every few hours on vacation while simultaneously fasting. Just a normal life these days. I can enjoy a breakfast if I feel like it without it ruining the rest of my morning. Heck, I can even eat shitty greasy food at the state fair with only mild discomfort most folks would have from such poor choices.

Every study (still limited in number) I’ve read more or less refutes all the social media hysteria. There is a whole lot of smoke but no fires yet to be seen. They may still be coming.

The things that are not wholesale misinformation seem to be the requirement to cease use many weeks before going into surgery, potentially needing to be on it for your whole life, and the side effect it currently has on your finances. Nothing else seems to hold up under scientific scrutiny yet.

Perhaps I will regret this decision in 20 years, but I’m willing to take that risk to have some of the best quality of life years I’ve had yet.

[Alupis]

> We don't have any evidence to my knowledge of any long term risks with being on it.

Nobody has yet been on these drugs for an entire lifetime - which is what is being advocated in this thread.

[cthalupa]

Sure. But what's the proposed mechanism? For many - not all, obviously - medications, we have an understanding of potential long term risks. Animal studies catch some of them, others we know are potentially risky even without animal studies, e.g. drugs that increase angiogenesis have a risk of increasing tumor growth.

But no one has proposed mechanisms for GLP1 peptides.

Meanwhile, we know obesity is one of the largest long term risks to health in existence, and one of the most prevalent.

[throwup238]

> But no one has proposed mechanisms for GLP1 peptides.

I'm worried about long term malnutrition leading to significant loss of muscle mass, osteoporosis, and other deficiencies that eventually lead to infirmity and brings forward the immobility death spiral much earlier in late age through weak muscles and bones. Most of the long term studies on GLP-1 agonists that I've reviewed have been on diabetic patients who already had to carefully control their diets and we still don't know what decades of poor diet on Ozempic will do.

For very obese people the tradeoff is still pretty damn good though.

[__blockcipher__]

One obvious risk would be blunting of longer term GLP-1 receptor activation. Imagine type 2 diabetes but for ghrelin.

To use an analogy amphetamines have a honeymoon period, and it feels like a lot of people on these weight loss drugs haven’t been on them long enough to get past the honeymoon period and see what the effects are after 10, 20, etc years

[rolisz]

Loss of muscle mass. Most folks on these drugs don't lose fat only, but a disproportionate amount of muscle too

[unethical_ban]

If someone has a broken leg, the word "crutch" isn't derogatory in the first place.

Cessation tools are not negative. Yes, root causes of abuse should be addressed, but aids are aids.

[CydeWeys]

    Crutch (n)
    a : a support typically fitting under the armpit for use by the disabled in walking
    b : a source or means of support or assistance that is relied on heavily or excessively

Use a is a neutral, non-judgmental, literal use of the word. Use b is clearly a pejorative, judgmental, metaphorical use of the word. The two are not the same.

[seadan83]

> relied on heavily or excessively

That _OR_ is doing a lot of work. I believe that 'or' makes the word not objectively pejorative. Context is important. A no-true-scotsman insinuation, or an insinuation that the crutch will never be removed does lack empathy and would seem pejorative to me.

Though, an empathetic concern that the crutch will never be removed - is not necessarily pejorative IMO. Either way, the crutch is a tool to "healing." Context matters.

[collingreen]

Is this an argument that you should use crutch and everyone ever will always read it as version b?

It might be more good faith to just pick language that is more clear. The alternative feels a lot like pretending to be one thing while trying to make people think something else - it rings just like a bad faith "Im just asking questions"

[CydeWeys]

To be clear, version a is referring to literal (non-metaphorical) crutches, and is not the version being used here because GLP-1 agonists are not literal crutches. Version b is the only possible use of the word being used in this conversation, and is always pejorative. "Oh, you broke your foot, you're getting around on a crutch" = Always version A, literal, non-pejorative. "Oh, you're obese, you're using medicine as a crutch to cure it" = Always version B, metaphorical, pejorative. There's no confusion.

[seadan83]

I'm a bit confused. Would you mind clarifying whether you think using "crutch" is the more clear vocabulary, or whether alternative vocabulary would be more clear?

[borski]

The negative connotation of a crutch implies that you are past the point of needing it and should be standing on your own two feet. If a thing is not meant to be temporary, or if you'll never be able to perform a task as well without it as you could with it, then it's a tool rather than a crutch.

Thus, calling GLP-1 meds a “crutch” implies that they are unnecessary, and that the patient should be able to do it without medication, which then creates guilt and shame where there shouldn’t be any.

[fknorangesite]

> If someone has a broken leg, the word "crutch" isn't derogatory in the first place.

It is so profoundly disingenuous to pretend not to know what the word "crutch" means or what connotations it has in this context. Like, come on.

[ab5tract]

Is using glasses to see a crutch? Asking as someone who needs them as much as I need the prescribed-for-life medications I’ve been prescribed.

[seadan83]

Reflecting on this, I think that 'for-life' aspect is very key. A 'seeing aid' vs 'seeing crutch'. Crutches are usually meant to be temporary. A walking stick is the walking aid equivalent. Hence, for weight loss, is medication meant to be the life long solution? As a facilitator to move the needle for people - very helpful. The underlying question about lifestyle and habits never changing is where the life long crutch concern comes in.

[nswest23]

All these people are calling it a crutch are moralizing tongue clicking, holier than thou Calvinists who think you shouldn’t be able to be thin unless you bootstrapped yourself to thinness with your own blood sweat and tears, as though this viewpoint represents some abstract understanding of the world instead of merely a smug sense of self righteousness.

[seadan83]

Crutches allow broken legs to heal properly. It could be that some simply don't have that same strong negative connotation.

What is more, getting hung up on the wording is missing the larger point.

[buzzerbetrayed]

Crutch and “weight loss aid” aren’t synonymous at all. You can’t ask someone to use a word that has a less negative connotation if they mean completely different things. They intentionally said crutch because they’re specifically talking about people who use it as a crutch. Not people who just use it as a weight loss aid.

[golol]

What's wrong eith a medicine as a crutch? If you break your leg you use a damn crutch and that's good. If you suffer from an illness and we have a medicine that's worse than the illness and affordable - go for it. Phrasing it as a crutch suggests it is somehow only a temporary that prevents you from finding a "real" solution by changing your "lifestyle". It doesn't matter, only outcomes matter.

[names_are_hard]

Agreed. After I broke leg the physical therapist saw me walking without aids and said I should go back to using a cane and explained that I'll heal better and faster if I use help than if I don't. Made me realize that the expression "using x as a crutch" doesn't make sense if it's supposed to imply that x is an impediment to progress.

[cbsmith]

> The concern regarding a drug as a crutch is stil valid.

People with pacemakers can't get off of them either, but it doesn't have the same stigma. Diabetics often need regular insulin injections, but it doesn't have the same stigma. People with high-blood pressure often need regular medication, but it doesn't have the same stigma. It's mostly antidepressants and now Ozempic which have this stigma.

> A set of habits and lifestyle are pretty much the same thing.

I believe the DSM does not consider them "pretty much the same thing".

[namaria]

'Anew' is an adverb: learn anew.

'Learn from a new' is missing an object.