[samaltmanfried]

I find something really gross and dystopian about the idea of Ozempic. Developing the willpower to resist short-term gratification, and the ability to make long-term decisions about your diet and health are some of the most important ingredients to living a good life. The idea of letting a drug do the thinking for you because you just can't trust yourself really horrifies me.

[orwin]

You just don't understand how food addiction works. Going from 34 BMI to 28 (I'm at 26 now) was the hardest thing I ever done, and I had money, great friends, a great family and a doctor that followed me twice a month.

Willpower is not a muscle, it's a well that fill doing what you enjoy, and clear when used. During my diet, my work ethic was at the bottom, and I couldn't force myself to go out meet new people.

Now that I have a healthier weight and stopped dieting hard (I'm still constantly hungry, but now it's my life), I'm a great coworker, I met a lot of people, made life-changing decisions and I have a lot of willpower left to do all the little things right. If I had a drug that helped me control my appetite at the time, i would have taken it.

[titanomachy]

> Willpower is not a muscle, it's a well that fill doing what you enjoy, and clear when used.

I won't negate your experience, since this is such a personal thing, and it's not like we have a rigorous scientific understanding of these things. But to me, willpower does feel like a trainable thing. Doing hard things seems to make me better at doing other hard things. Limiting my TV makes me less likely to compulsively eat later. Working out hard makes me less likely to lie in bed scrolling on my phone. Doing hard coursework makes me more focused at work.

The caveat is that these changes seem to happen pretty gradually, and the gains can be lost pretty easily, just like with muscle.

But being in a perpetual caloric deficit can be pretty rough and can definitely sap your energy. Glad you found your way to a healthier weight.

[stavros]

It's different per thing. Yes, working out gives me energy (even though I hate it and am bored out of my mind doing it), but going hungry or resisting food isn't the same kind of thing. If I had a bad day at work, I'll usually go "fuck it" and eat a pizza. If I've gone hungry all day because I'm eating what I should, I'll be cranky and not as much fun.

I can definitely relate with the GP, even though your comment is relatable too. They're just different mechanisms, or they apply differently to different people.

[titanomachy]

Tangential to the discussion, but I'd encourage you to not give up trying to find a form of exercise that you don't find boring. It makes it much easier to get adequate exercise. Also, not having to spend time doing things you hate is nice.

For example, personally I find lifting in the gym or running on the treadmill to be quite boring. I like biking and running outside, especially on trails. A lot of people enjoy group classes like crossfit or yoga, since the social reinforcement can make it psychologically a lot easier.

Καλή τύχη.

[stavros]

Yeah, I (try to) cycle and play tennis, but due to some circumstances both are less frequent than I'd like. You need to lift weights too, though, to build and maintain muscle, so there's no getting out of that. I'll definitely need to do more cardio, though.

Thanks!

[Funes-]

How have fat people gotten thinner without those meds up until now, then? Was their addiction not as strong as yours, as you seem to imply? They just didn't "understand"? Look, I went from being an absolute fucking fatass to 8% body fat out of willpower alone when I was 17. It took a lot, namely destroying every bad habit I upheld for years regarding food and exercise, but I wanted to do it bad enough, so I did. It was a really extreme and sudden change of mindset, like a flip of a switch, actually, because I had enough of the bullying and lack of self confidence. One day I just got mad enough and changed my whole life.

[AlisdairO]

> How have fat people gotten thinner without those meds up until now, then?

Mostly, they haven't. You and I are outliers.

The population-level data tells us that overweight people are mostly unable to control their weight in the face of modern food. That being the case, it doesn't seem unreasonable to look for alternative solutions to the failed option of just telling people to eat less.

edit: regarding strength of addiction - I mean, of course, isn't it profoundly obvious that different people will have different strengths of addiction? I can drink without the slightest inclination to excess, while others are broken alcoholics. My grandfather didn't have the slightest interest in food beyond the calories needed to survive, while I have to fight every day to eat well.

[titanomachy]

Exactly, regarding strengths of addiction. I don't feel morally superior about not being an alcoholic... it's pretty clear that my experience of alcohol is just wildly different from some of my friends. I enjoy alcohol fine, but I never feel like I'm exercising willpower when I choose to stop after 1-2 drinks.

[Funes-]

>edit: regarding strength of addiction...

It's profoundly obvious you're missing the point, and conflating somehow having a low degree of addiction to something with not being addicted at all to it. Your example about alcohol clumsily compares people addicted to it with people who obviously don't have a problem with it. We were talking, instead, about people, like myself, who had some degree of addiction to food, and still found it in themselves to overcome that shit. So it's two groups of people: addicts who beat their addiction, and addicts that didn't; not addicts and non-addicts, like you explained. Your examples, as you can see, are totally irrelevant and miss the point completely.

You also seem to imply that the degree to which you're addicted to something is the sole factor determining whether you will overcome your addiction or not, leaving your own will out of the equation. It should be logically self-evident that the fact that somebody beat their addiction says close to nothing about its "strength". One could have many physiological and psychological predispositions to food adiction and still beat it, while somebody with just a fraction of such problems could live a miserable life and never do away with it.

[AlisdairO]

Me> different people will have different strengths of addiction

You> It's profoundly obvious you're missing the point, and conflating somehow having a low degree of addiction to something with not being addicted at all to it

Suggest applying some of that willpower towards paying attention to what you're reading.

> You also seem to imply that the degree to which you're addicted to something is the sole factor determining whether you will overcome your addiction or not

I don't imply anything of the sort. Willpower is one variable, level of addiction is another. What I do imply is that without deeper observation of a person's life, and the other areas in which they might demonstrate willpower, you can't make strong conclusions about their lacking willpower based simply on their weight.

Based on all I know about you (or you about me), we could each be people of tremendous willpower who overcame titanic odds to beat our food addiction, or we could simply be people who really quite like food who tried hard and overcame our mild predisposition.

[titanomachy]

the guy you're replying to also lost weight without the drugs... he says he would have taken them if they'd been available.

[timewizard]

> You just don't understand how food addiction works.

Would you concede that some foods are more addictive than others? Doesn't this suggest other remedies like food regulations, at the very least, should be deployed in concert with seeming "miracle drugs" like GLP-1 agonists?

[orwin]

You have multiple type of food addiction. Most are hormones dependent. For some people, it's linked with insulin, and they will crave carbs, and probably modern diet doesn't help.

Mine is linked to grahlin, I'm just always hungry. Painfully so too (at least it used to be). Do you have a friend who doesn't like to eat, sometimes forget to, and only do so to avoid hypoglycemia? I'm the opposite, I produce too much grahlin, too fast. The weird part is that the more you eat/fatten, the more your hormone production increase.

My solution was regular, multiple days fast. Not calorie reduction (which was slightly painful, and very hard to follow), but full on fast, where the first two days are impossibly painful, but then your body start to ignore grahlin, and the last 3-5 are pretty much OK (hypoglycemia is an issue though, I did it with a doctor). And of course, more fibers in the diet (reducing milk-based products and meat helped).

[SpicyLemonZest]

Can't speak for the original commenter, but I would not concede that, because experiencing semaglutide has convinced me it's not true. The feeling I can now clearly recognize as something like "food addiction" disappeared uniformly for everything from Brussels sprouts to donuts.

[djur]

Yeah, my fridge has been virtually empty of ultra-processed foods for years. Mounjaro silenced the little voice saying "hey, why not go dig into the leftovers?", and when I do find myself grabbing a late-night snack (because my glucose monitor says I need one), I find it much easier to eat a little scoop of yogurt rather than wiping out most of the chicken I cooked for my lunches that week. I have to remind myself to finish things off before they go bad, now.

[AlisdairO]

Respectfully, have you ever had anything in your life that you have struggled desperately with, and needed help? Anything at all that might give you a little empathy on the topic?

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. Doing so causes me a great deal of pain and frustration, and I know that I'm someone who is right on the edge of not being able to control my weight. 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? Why would we want people to suffer like that?

[firesteelrain]

I took compounded Mounjaro for two months. It was like a jolt to the system and got me back on track. I learned how to eat better and alter what I eat plus tracking it. Started walking and going to the gym. Started with 7k steps and now easily over 12k a day on average. I don’t drink soda and if I do it js Coke Zero, Pepsi Zero or Diet Coke. We just don’t buy it. I didn’t know about maximizing my protein and fiber.

It wasn’t short term at all like you say. Something was seriously wrong.

It’s everything though - if it was that easy to just start doing it then people would.

I needed a jolt and impetus to get better. I was depressed, worryful, everything.

I have lost 40 lb. I went from 255 to 229 with the assistance of Mounjaro. I stopped taking it but kept up with the regimen. I am now down to 214.

Some people who take it don’t do it right, they still eat crap and so those are the people who rebound or think they need to go up to 15. I was taking 2.5 then 5 when I stopped.

Yea it is willpower and discipline. Being on the medicine as an assistant along with a lot of research spurred by the community such as maximizing protein, fiber and water intake to become satiated was all that did it with exercise.

[foxyv]

Consider the fact that, if a drug can make you skinny, perhaps a drug can also make you fat. Or, even your own body can make you fat. Sometimes, what we think are our choices, have more to do with our biology and environment.

Just like you can't will yourself to be healthy if you are sick with the Flu. Some people can't just will themselves to be skinny. This is why we have drugs and treatments, because our bodies are not perfect machines that work the way we want them to.

[pkaye]

> Consider the fact that, if a drug can make you skinny, perhaps a drug can also make you fat.

Yes that would be Prednisone. People call it the devils tic-tac. Its a wonder drug with terrible long term costs to your body especially at higher doses.

[djur]

Olanzapine, too. Gained 50 pounds on that stuff.

[foxyv]

Insulin injections as well. Also, just about every anti-depressant.

[timewizard]

> with our biology and environment.

Our biology hasn't changed much in recent years. Our environment has. So has our obesity levels. I mean, it's an "environment" that has "super size," as a default option.

[foxyv]

Also, smoking levels have decreased.

Edit: In addition, anti-depressant prescription has sky rocketed.

[JofArnold]

This is the kind of comment that can change a person's life. Really thoughtful. I'm going to quote it in future. Thanks.

[est31]

There is multiple effects fighting against people who want to lose weight:

* habits. often times, obese people use food as a stress response, as a reward, etc. this then makes them relapse.

* "target weight" of the body. there is a memory effect where once you have built up fat tissue, your body wants you to return to that weight. In other words, it's not just the first step that's hard, but all the steps thereafter. Relapse is easy.

* fat tissue makes you more hungry.

* environmental issues, like unwalkable cities, an entire industry putting chemicals into foods that make you addicted to them, its excessive marketing, missing availability of non-processed foods (large percentage of US population lives in food deserts), etc.

It's not just discipline of the individual holding them back.

[throw101010]

It's also unlike most addictions, you have to eat few times a day if you don't want to die... alcohol, drugs, gambling are not required to survive, eating is.

[crooked-v]

Telling everyone "just get better willpower" is about as useful on a societal level as looking at a disabled person at the bottom of a set of steep stairs and telling them that the struggle is good for them.

[jeroenhd]

I know it's an unpopular opinion, but I agree, at least partially. I think you're underestimating the "developing willpower" part, but I do think that helping people lose weight the themselves should be the solution, not chemicals.

These weight loss drugs are conditioning people to feel satisfied with less food in their stomachs, but only while they take the medication. If you don't put the same serious effort into improving your lifestyle, you're going to end up overeating again, gaining all that weight back, and probably going back on weight loss pills. Instead of solving the unhealthy dependency on food that most seriously overweight people struggle with, you're adding a dependency on medication.

Where I live, these drugs haven't even passed medical review for weight loss yet, they're purely prescribed for diabetics. That doesn't stop the illegal second hand market (taking drugs out of the hands of diabetics that are much better served with them) unfortunately.

In general, I do think weight loss drugs are better for society as a whole, as they save people from the ticking time bomb that is obesity, but I wish we could come up with a better solution.

[djur]

The best way to change your lifestyle is to change it, and GLP-1 agonists make it easier to change your lifestyle. In fact, they don't work at all if you don't. Someone who's unable to change their diet and exercise routines while taking a GLP-1 agonist wasn't going to be able to do it without the medication, either.

And this talk of "dependency on medication" is ridiculous. Lots of people take medication every day to live a better life, or they use medical devices like eyeglasses and hearing aids, etc. That's one of the blessings of modern society.

[tjpnz]

I do make good decisions and put in 10k steps everyday, which according to my stepcounter puts me in the top 5% for people my age. I've managed to slow my progression into the abyss; but I'm still going there.

Truth be told, my body can't effectively lose and maintain weight unless I'm eating a strict 1500 calories and replacing the walking with an hour long run each day. I know this because I've tried it and managed to maintain it for 6-months. It was a herculean effort and despite the results I paid a toll both physically and mentally. This isn't to say that the laws of thermodynamics don't apply to me; but my body will fight against them harder than most.

(I believe I would be a good candidate for these drugs. The only thing stopping me is the thought of having to be on them indefinitely.)

[steveklabnik]

Do you object to pencil and paper because people write down reminders because their memory isn't good enough to remember everything?

[loeg]

Ozempic helps many people make better long-term decisions about their diet than they would otherwise. Do you think no one without extraordinary willpower should be able to "live a good life?" The drug doesn't "do the thinking for you."

[plantwallshoe]

Would you be horrified at drug that made heroin addicts not want to do heroin anymore?

[paulpauper]

Just flip it around: what if there were a drug that made people fat? Is it an insufficient willpower issue then? Willpower works for some, but the drugs make it easier.

[latentcall]

I don’t understand why the USA doesn’t just ban processed foods? I know USA only cares about profit but come on. Other countries don’t eat like we do.

[djur]

Because there's no coherent regulatory framework to "ban processed foods", no country has ever done such a thing, and it would be political suicide to be the party that banned cheeseburgers, french fries, and Coca-Cola.

[amanaplanacanal]

Obesity is not just a USA problem.