[phil21]

Being skinny does not, but being morbidly obese absolutely is a strong correlation to the point of it being a rounding error. Medical conditions that cause it are extremely rare.

For better or worse, as a formerly morbidly obese person I can say society doesn’t really care why - they absolutely take you less seriously overall regardless of the underlying reasons.

[anon291]

> as a formerly morbidly obese person

Congratulations!

[cameronh90]

I would suggest that you're overstating the certainty of your view. At least in how it relates to rekenaut's point.

Purely focussing on people who are fat because they eat too much (which includes myself, albeit also now formerly morbidly obese thanks to Mounjaro):

(1) The studies find a statistically strong correlation, but that doesn't mean everyone who is morbidly obese has poor self control. The raw data still tends to show a big overlap of obese people with good self control and thin people with poor self control - so it's not reasonable to say anyone in that group is just a rounding error.

(2) The way that food self-control is usually measured is, for example, delayed gratification testing with food. It's not surprising that an obese person will do worse at this, but it doesn't necessarily mean the issue is self-control. It could be that their experience of hunger is stronger than the person who is able to exercise more restraint, so even if they're exercising the same level of self-restraint, they're going to give in sooner. It'd be like saying someone who can hold a plank for longer has more determination. There's a bit of that obviously, but then there's also (much more importantly) how fit and muscular you are.

(3) Self-control itself can be, and often is, a medical issue. Obviously there's ADHD/Autism/depression/thyroid issues/so on. which affect your mind in the general sense, but many common drugs including antidepressants, antipsychotics, antihistamines, etc. are also well known for causing obesity. Science still doesn't know why, exactly, they cause weight gain, other than it's through increased caloric intake - but not clear what drives it.

(4) This one is more speculative, but when I started taking Mounjaro, my general self-control increased. This is quite a common reported side effect. There's no evidence (yet?) that it directly affects your brain in any way that would affect self-control, but nevertheless it seems to for many. Separately, we know that being hungry seems to reduce your general self-control. It doesn't seem like a huge leap of logic to think that maybe the reason Mounjaro is having such powerful psychological effects on people is actually because being hungry is quite a powerful general non-specific motivator -- in which case, the studies testing calorie consumption against general measures of self-control might be producing a correct result but have the cause and effect the wrong way round.

Cards on the table, I'd say the proximal cause for why I'm fat is because I am less to resist food than the average person. However, my general self-control seems to be pretty much fine, and I only got fat after I started taking antidepressants for anxiety. Impulsive would be one of the last words anyone would use to describe me - it's just isolated to food as far as I can tell. Prior to Mounjaro, I was just thinking about eating pretty much all the time. While I'm eating, I'd be thinking about what I'm going to eat next. I was never NOT hungry.

[throwaway2037]

    > when I started taking Mounjaro, my general self-control increased. This is quite a common reported side effect.

Wow, this is fascinating. I write that without sarcasm; I really mean it. I put this in the same (unproven) category as when middle-aged men start to do weight lifting (nothing too crazy), it "magically" cures many mental health issues, such as anxiety and depression. (The number of anecdotes I have heard with this pattern boggles my mind.)

Do you think part of your improved self-control is just feeling better about yourself? Allow me to extrapolate a bit here: If you are depressed, it is "easy" to throw away self-control and eat, eat, eat. Might the reverse also be true? If you are less depressed, it is easier to harness your self-control and eat less? It seems very plausible to me, but nearly impossible to prove the mechanism, except to observe it with a careful study.

Further, I am curious to hear more about the positive effects on your life after your self-control increased. Example: Are you doing better in relationships, or better at work... or the sun shines brighter in your life now... or what? These kinds of HN posts with high quality, first hand anecdata are some of my favourites.

[anon291]

I am not the commenter above. However, depression and lack of discipline/self-control form a negative feedback loop. Lack of discipline causes you to be depressed, which causes you to have less discipline. A lot of practices that seemed 'strict' to us that cultures would practice in the past are socially evolved ways to re-instill discipline via social shame. For example, the fasting days in the liturgical calendar. While you may have become undisciplined personally, when there's a fasting day that comes around every week, or an especially important one that comes by every year, you might decide to make a change.

For me personally, as a Catholic, I was able to kick my bad dietary habits during Lent. I wouldn't have been able to do it otherwise. The social pressure of having to abide by my rules helped me very much, and this was possible because my parents were 'strict' about Lent with us.

Ignoring the spiritual aspect completely, I think these practices are insanely useful which is why every culture has them. But we've thrown them out the window for some reason.

[phil21]

Very late reply, but as someone who lost a lot of weight on Mounjaro and has so far (2 years after the fact or so) kept it off via lifestyle changes this is how I see it as well.

When you are constantly trying something and failing at it, you get into negative feedback loops. At least I do. Why even try? Then you get into depressive behavior and other such toxic lifestyle issues that effect far more than your physical health and appearance.

Tirzepatide was simply a tool that let me engage in self control and better behavior towards food while I learned what will and will not work for me long term. Call it a crutch, cheating, whatever - I don't care. All those are absolutely true in some sense. It gave me space to dial in consistency and habits when it came to eating and exercise.

After not stepping foot in a gym my entire life I now make zero excuses and show up 3 days a week rain, shine, depression, anxiety, lack of time time, whatever. Zero excuses. Same goes for eating and diet. I know where my weaknesses lie now, and simply don't put myself in a position to fail very often.

This in turn let me realize (well, remember!) that yeah, I can accomplish incredibly hard things if I put my mind to it. I knew this logically as I'm an extremely accomplished person (in my own mind at least!) - but now it's felt at a more emotional and subjective level. I used this feedback loop and am applying it to other areas of my life. It's all about consistency and good habits for me.

There isn't any rocket science or magic behind it. It's just a positive feedback loop replacing a negative one, and that pushing outwards to other areas of my life. It's still incredibly hard work, same with losing weight was even with the chemical help.

It's also why upthread I said that morbid obesity is a strong correlation to lack of self control. There are many reasons for not having self control, and I honestly think humans really don't have it in the sense most like to think about it. I don't see it as a moral issue as most do, so I can offend folks by saying so without meaning it that way. It's just habits and consistency and putting yourself in the right environment. Very difficult to do when surrounded by the negative forces modern society tosses you in by default, and it's zero surprise to me or indication of a moral failing when so many simply go with the default option. I sure did! It's also very easy to focus on one area of your life at the exclusion of the rest - starting and running a successful company gives you a million excuses to not worry about your health or weight, but it's still toxic to you in the end regardless of other successes in life.

[throwaway2037]

This is a great reply. Thank you to share your first hand account.

    > Tirzepatide was simply a tool that let me engage in self control and better behavior towards food while I learned what will and will not work for me long term.

For others, I needed to Google "Tirzepatide". The trade name is Mounjaro (or Zepbound).

    > Call it a crutch, cheating, whatever - I don't care.

No need for that. You have my full support. Whatever works for you is good.