[radiofreeeuropa]

It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway.

Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes) or "find a miracle drug". Neither seemed likely. Turns out, decent odds we've managed the latter! Which was always the more likely of the two, but I still wouldn't have rated it as very likely.

[throwawaylaptop]

I helped my dad lose 50 lbs by finally, after 10 years, getting him to give up bread, sugar, potatoes. It took buying him 2 months of a bluetooth glucose monitor. Once he saw what certain foods do, he believed me finally. At 65 years old, healthier than I remember since he was 40 and I was a teen. It doesn't require some weird injection.

[radiofreeeuropa]

There's anecdotes, and there's science.

Individually, there's (previously) been nothing better to suggest than "try harder (and, maybe, smarter)".

Statistically it was almost useless, but it's the best we had. It's not bad advice exactly, it's just extremely unlikely to work for long-term, sustained weight loss.

It also very much appears to be the case that weight gain and loss are heavily influenced by environmental factors. Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that. It'd be kinda weird if we expected "just try harder" to work very well when that's evidently not the mechanism by which skinny countries are skinny. Alternatively, if it is willpower doing it, we're just adding a step, because then it appears that environment strongly influences willpower, instead, since the same observations hold.

Sure, sometimes it works for individuals. In fact, it often works temporarily, causing a yo-yo effect. It can work for long periods (many years without a slip) but that's rare.

If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No, it won't, it's amazingly ineffective, even very expensive high-touch interventions involving multiple experts aimed at weight loss and lifestyle change and such are wildly less effective than "inject GLP-1 agonists" or "move somewhere skinnier".

[eru]

> Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that.

Do we have data on that?

I guess you could look at natural experiments, like people who lost and won H1B lotteries, and see if only the ones actually making it to the US get fat?

[radiofreeeuropa]

Yes, it’s a google away.

[verisimi]

> There's anecdotes, and there's science.

> If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No

Are you an individual or a population though? Take off the telescopes (and data, and science), and look at the world through your own eyes.

No one needs (or can) to address the obesity crisis in the population. The only crises that can be solved are the ones individuals find in themselves.

[vidarh]

And odds are very firmly that you'll fail. That's what the science shows us.

[gmadsen]

having the understanding of the science and self motivated enough to make lifestyle changes already puts you a couple standard deviations out of the population average, such that I don't really think its helpful as a comparison or something to model after

[vidarh]

The science is clear that people who do make changes and achieve initial results are still overwhelmingly likely to fail at maintaining the results.

Lots of people successfully make changes and lose weight, but exceedingly few manage to keep it low over time.

[skeezyboy]

you are taking in more calories than you are burning off, for whatever reason. its that simple

[_345]

Then what should I do :(

[toomuchtodo]

Get a GLP-1 under the supervision of a doctor or other licensed medial provider.

[ykonstant]

As a chronically obese, non-diabetic individual, here in Greece it is impossible to convince a doctor to prescribe anything close to that :(

[everfrustrated]

I find this hard to believe. Wegovy is authorised for sale in the EU for weight loss (IE not Ozempic which is for diabetes. Yes I know it's the same drug). If you can't find someone to prescribe it, that's on you. Find a better doctor or pharmacist. In all seriousness, please do - obesity is no joke and taking ownership of this by at the very least finding a doctor who will support you might be one of the most important and life changing decisions you make.

[mghfreud]

Visit Turkey for a couple weeks. Rules are the same, but behavior is the opposite. Weekly dose of 1mg is sold over the counter for around 150$.

[ponector]

Hard to believe. Always can try the same kind of doctors who issue prescription for medical marijuana.

[siva7]

Get it simply over other legal channels instead of fighting with the stupidity of the local medical system.

[randomNumber7]

I think it's mainly the food that makes skinnier countries skinnier.

People in the US eat absolute shit. Even the bread is full with sugar.

Good for capitalism if you can feed that to the people and then give them an injection to be healthy again I guess.

[wonderwonder]

I think its great you helped your dad lose weight but what is your issue with others choosing a different path? The health benefits of losing weight are massive . Why is it important to you that they do it how you want them to do it? Study after study has sung the praises of GLP-1s.

It appears that your major issue is that you are simply angry people are taking a short cut. Which seems odd, why would it bother you how someone lost weight, why not just be happy for them?

I got on GLP1s in January. I went from 6'1 240lb to 209lbs with defined abs benching 405lbs at 46 years old. I've worked out my entire life but never been lean like this. I like eating bread (steak, eggs, toast, ketchup and hot sauce is perhaps the single greatest breakfast in the history of the world. The toast is very important!) and potatoes are freaking incredible (mashed with Worcestershire sauce... bruv).

The bulk of my calories are protein but I generally eat what I want if I desire it. I just desire less of it. I had a roast beef sub from Jersey Mike's today with my kid, it was delicious. Their honey mustard is the bee's knees. I had a medium sub though and not a large.

The only change is now I essentially don't eat after 6pm. I just set that goal and the GLP-1 helped me keep it. The only side effects I have had is lower cholesterol and lower BP and that is while running 700mg of test. I'm going to hop on metformin next month after this cycle and target eliminating the fatty liver markers I have had for the last 20 years.

They work friend, they are good for you and they make people live happier healthier lives.

Embrace better living through chemistry.

[stavros]

I helped my dad lose 50 lbs by finally, after 10 years, getting him to give up bread, sugar, potatoes. It took buying him 2 months of Ozempic. Once he saw what stopping the cravings for certain foods can do, he believed me finally. At 65 years old, healthier than I remember since he was 40 and I was a teen. It doesn't require some weird bionic arm implant.

[throwawaylaptop]

Lol, a glucose monitor is a bionic arm implant (for $200 total), and an injection disrupting your entire hormone system is what then?

[stavros]

A ridiculous claim.

[siva7]

I would love to do the same for my dad but i have no idea how to get these stuff.

[42772827]

He could have lost all that weight and still had bread, sugar, and potatoes but instead he gave up what he clearly enjoyed. Now he gets to live out the rest of his life fighting cravings, telling himself he's not allowed to enjoy food. How utterly sad.

[throwawaylaptop]

Believe me, cutting out bread and sugar completely is 10x easier than some kind of lifelong moderation for a person that has struggled for it already for most of his life.

And he is extremely happy with his new sugar and bread free life of increased mobility, less pain, and much lower blood pressure. At 64, he's learning how to ride a dirtbike and doing pretty well at it.

[42772827]

The choice is no longer between "cutting out bread and sugar completely" and "some kind of lifelong moderation for a person that has struggled." The choice is now between "cutting out bread and sugar completely" and "removing the struggle to moderate bread and sugar."

You're clearly an advocate for your father making healthy choices. So why would you advocate against the use of a drug that makes that easier?

[nradov]

Why waste money and risk side effects for a drug that's not actually needed? Changing your habits is much easier.

[42772827]

If changing habits were much easier, then people wouldn't be using the drug to make it easier change their habits. They would just do it.

[homefree]

Obviously it’s not much easier or the drug wouldn’t be so valuable.

People make such a moral crusade of this - the drug works, people will take it. Behavior modification works in theory and fails for most in practice. Even for those that can make it work usually don’t hold out indefinitely.

[cthalupa]

This is such an absurd statement.

If changing your habits was much easier then we wouldn't need these medications and the world wouldn't keep getting fatter. People have known how to not be fat for a long time, yet the obesity rate has been rising worldwide, even in countries that have traditionally been skinny.

It's not like fat people on the whole are ignorant of how to become not-fat and never attempt to do so.

[ranger_danger]

If it's so easy why does the drug even exist? Why is it so popular? Why isn't everyone just changing their habits so easily like you say?

[sumeno]

As someone who in the past lost ~50lbs and has mostly kept it off for more than a decade this is just horse shit. It's incredibly hard even as someone who was only a bit overweight and not obese and it is still a struggle 15 years later, even more so than it was when I was younger

[Almondsetat]

Who are you to know what's going on inside his head? What an arrogant comment

[perching_aix]

> Now he gets to live out the rest of his life fighting cravings, telling himself he's not allowed to enjoy food. How utterly sad.

I don't understand what drives people to write such intentionally asinine comments. Do you get off on hurting others or something?

There were quite a few foods I let go of when I decided to drop weight. Can't say I miss them much, certainly not to the extent to say something like "wow, i can't enjoy food anymore" or "now i'm fighting cravings all the time!!". And I legitimately have no interest in reintegrating them into my diet.

Turns out, some kinds of food are just dumb to consume, and my enjoyment of them is legitimately secondary. To the extent that discovering how harmful they were, they became inherently less enjoyable, and it was well possible for the habits and the cravings to subside over time. You don't try to go hit a balance with crack addiction, why would you try to hit a balance consuming 5 bazillion calorie rubbish?

Cutting out certain classes of foods from one's diet is absolutely possible and there's nothing necessarily wrong with it.

[ProfessorLayton]

Additionally, some of us give up foods for reasons other than weight loss. I have no weight issues today, nor have I personally struggled with it in the past, yet I also gave up stuff like drinking soda because diabetes runs in my family.

While I do miss it sometimes, I'm perfectly fine with sparkling water. Sure I'll have soda once in a while, but it's now officially a "treat", and not all that sad about it.

If I ever struggle with weight gain in the future, I see no reason to skip a tool that makes that much easier.

[42772827]

>There were quite a few foods I let go of when I decided to drop weight. Can't say I miss them much, certainly not to the extent to say something like "wow, i can't enjoy food anymore" or "now i'm fighting cravings all the time!!". And I legitimately have no interest in reintegrating them into my diet.

Your story has been told over and over and over. We get it. Congratulations. You win. You don't need GLP1s to sustain your weight loss. You don't experience food noise. You made all the right choices. Your brain and genetics are superior to the 30% of American adults who have been told to eat less and move more and still haven't managed to improve their health through weight loss.

Now that you've been properly congratulated for your superiority, are you interested at all in understanding the complex systems that prevent 100 million Americans from achieving the success you have? Like, any intellectual curiosity at all about a problem that causes untold suffering for almost one third of Americans? That costs literally billions in healthcare costs? About stress, anxiety, access to healthy foods, or the novel mechanisms by which a drug which was discovered through studying the venom of a Gila monster operates on the human gut and brain? Or are you only interested in re-telling the world how you don't have the problem that we're trying to solve?

[perching_aix]

I'm pretty okay with semaglutide and I understand its prospective benefits, both on a personal and societal level. My point was that the father of this person clearly has that oh-so-superior and elusive brain chemistry you suppose I have based on the account shared, so it was both immensely asinine to write what you did, as well as straight up false. That you could have went through all these other points without being an asshole about it, from the get-go. That there's a person on the other side of the screen too, and maybe, just maybe, they weren't meaning unwell, and didn't deserve a fucking brainwash about how they're actually torturing their loved one - you know, just like how people don't deserve one about how they can totally lose weight unassisted and are just being "weak willed" or whatever. That you escalated, and that thinking you're justified in doing so doesn't actually make it any fucking better.

[42772827]

You made the story about you, when nobody asked. Check the comment I responded to. You did exactly what people always seem to jump out of their seats to do when this drug is mentioned: crowd the conversation with anecdata about how you did it better.

[nradov]

I don't understand. What's sad about giving up junk carbs?

[42772827]

Bread, sugar and potatoes exist on a spectrum from highly processed/refined (truly problematic) to minimally processed whole food versions (nutritionally valuable). There's no reason to give up minimally processed whole food versions of these.

[imtringued]

There is no spectrum for me. I can't eat bread or sugar.

[nradov]

What a bizarre, illogical comment. Did you even read what @throwawaylaptop wrote above? While most of us can handle she carbs just fine, some people have to pretty much eliminate them (regardless of processing level) in order to lose fat.

[minznerjosh]

I find it odd you included potatoes in the list of foods to give up. Boiled potatoes in particular rank at the very top of the satiety index[1], meaning they keep you full longer with less calories than other food (likely due to a combo of high water and fiber content.) I recently lost a modest 10 lbs and mashed potatoes (even with some added butter and milk) were a staple of my diet—keeping me from feeling hungry even at a calorie deficit.

[1] https://pubmed.ncbi.nlm.nih.gov/7498104/

[op00to]

> some weird injection

What’s weird about it? Is insulin some weird injection? What about epinephrine?

[throwawaylaptop]

Yes, if you don't need it because there is a natural method that starts fixing your problem in the first week (like cutting all carbs does for being fat), then injecting insulin for your easily fixable problem would also be up there with injecting weird stuff into yourself.

[KPGv2]

> if you don't need it

It seems like a lot of people need something other than "don't eat bread" though.

[tuesdaynight]

Just scale that solution to millions of people and the comparison will be relevant.

[throwawaylaptop]

If you told millions of people that bread, sugar, pasta and bread are basically killing them, and to flat out stop eating them.. you probably would help people lose weight (and save many lives too).

My dad has finally understood that grains are for people that need help maintain weight or gaining weight.

No fat person should ever be eating them.

[parineum]

If I told you billions of people eat bread, sugar and pasta and it wasn't "basically killing them" (whatever that means)...

It's strange to make the culprit of a modern epidemic foods that have been with us for millenia.

[randomNumber7]

Real bread contains no additional sugar and is not made with 100% white flour.

I know it's hard to believe in the US as today it even gets harder in Germany to find it.

The problem is eating shitty cheap mass produced food.

Same goes for "vegetable oil". Check out how it is made and you will probably respect olive oil more or some good ol butter.

Also it is possible to drink water. You don't need soda from dawn till dusk .

[throwawaylaptop]

Billions of people were not overweight when they ate those things. They did not eat them 3+ times a day.

I said in my other posts.. if someone needs help maintaining or gaining weight, eat those things.

If you are overweight, you should be eating ZERO of them.

"Basically killing them" means whatever the current obesity and type 2 diabetes epidemic means.

[sarchertech]

You don’t think people ate carbs 3 times a day in the past? The majority of humans for the majority of recorded history have eaten some kind of bread, rice, potatoes, porridge, or corn with the majority of their meals.

[esseph]

Hey, question, what's the most popular food across Asia?

[bluGill]

Ever look at the ingreadiants for bread? I sometimes bake my own sourdough bread, just flour and water (salt if I remember it).

[imtringued]

Modern wheat is a very modern invention. You have to be pretty gullible to believe that something that has only existed for 50 years has existed for millennia.

[Cthulhu_]

But millions of people are being told; "cutting carbs helps with losing weight" is, I dare to argue, commonly known.

> No fat person should ever be eating them.

This is absolutism and controlling. Carbs have their place in a balanced diet, but key emphasis on diet. Too much (like the US diet) isn't good, none at all isn't good either. Everything in moderation. I don't understand why dieting / weight loss conversations are always going into extremes and absolutes.

[komali2]

23% of PRC citizens are overweight or obese, compared to 73% of Americans. In the PRC, rice is typically had with every lunch and dinner, and sometimes breakfast as well. Plain old white rice, the worst kind from a glucose perspective.

[XorNot]

No but its a lot easier for people who've had trouble and gets results, which is all that matters.

[throwawaylaptop]

Heroine would also help them lose weight also. Maybe cocaine too, but I'm not sure. So it's not "all that matters".

What matters is, are the negative side effects and long term consequences better for you than the alternatives. One of them is "remaining fat". The other is "doing what other people have proven works.. cut all carbs".

[KPGv2]

You are showing your own ass with this ridiculous analogy. What are the negative effects of ozempic? Because the negative effects of heroin (not "heroine") and cocaine are well known and grossly outweigh "not being fat."

Is ozempic worse than being fat?

[Thlom]

From people I know that have used Ozempic/Wegovy, the side effects are basically that they get a bit nauseated a few hours after an injection. That's it.

[iwsk]

It took you 10 years to get him to give up bread, sugar, potatoes? This approach would be hard to scale.

[astrange]

> Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes)

Moving to higher elevations in the US causes people to become less fat, so you can do this by moving to Colorado.

https://journals.plos.org/plosone/article?id=10.1371/journal...

[lm28469]

It's not like we tried very hard... our whole system is designed around instant gratification, comfort, consumerism and low cost feel good food.

[mensetmanusman]

It does solve itself due to natural selection based on fertility rate effect of being obesity prone. Life finds a way.

[skeezyboy]

> It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway.

um, go out and exercise? compared to your ancestors from a century ago, you live a relative life of luxury. THIS IS WHY YOU ARE FAT. Too much food in, not enough burning calories. So simple. Im sure there are people who are clinically fat, broken metabolism, but there are tens of millions of obese in the USA alone, are they all metabollically disabled? I doubt it

[radiofreeeuropa]

Yep, overeating (and, to some degree, not enough moving around) is the reason. True.

But “just personally do better” doesn’t work very well when applied as a medical intervention (they have tried, and checked, over and over, a hundred different ways), even with lots of follow-up and monitoring, and it also doesn’t appear to be how other countries manage to be skinnier than the US. Between those two things, it really doesn’t look like a viable way to solve the obesity crisis—it doesn’t work when we try it, and it doesn’t seem to be what’s working anywhere else.

[desert_rue]

It has more to do with the American food supply than anything else. The obesity rate skyrocketed as we started to consume food-like substances instead of food.

Strip out all the signals that let the body know it has enough, and it is easier to overeat.