[sfn42]

This is a load of bullshit man. Even the article you linked describes lying to his friends' parents to get a second dinner, being unable to have just one cookie etc.

The only way to get fat is to eat too much and anyone who really eats too much will get fat. There's a huge amount of people who simply lie or are ignorant about their food intake. Fat people falsely claiming they hardly eat anything but can't lose weight etc. Of course you lose weight if you don't eat. Your body can't create energy from nothing. Without energy you die.

[mmooss]

That's not actually what the evidence says, overwhelmingly.

[sfn42]

Share to share any of it?

[mmooss]

Always a fair request. I don't know it well enough or have time at the moment, but afaik it's the medical consensus:

Obesity is a disease, (mostly) not a result of behavior. Eating less and/or more activity doesn't cure people; iirc bodies adjust to retain the same amount of fat, etc. under the new conditions.

[indecisive_user]

Then how does ozempic, whose primary mechanism of action is to decrease appetite, work for obese people?

Yes, your body will compensate somewhat for caloric deficit, and yes, when you gain enough fat mass your adipocytes will divide, creating more/stronger hunger signals that encourage weight gain moreso than someone who was never obese.

But your body is not magic. If you feed it a sufficiently low amount of calories, it has to break down energy stores, e.g. fat, to make up the difference in energy requirements.

[mmooss]

> Then how does ozempic, whose primary mechanism of action is to decrease appetite, work for obese people?

That is a very interesting question.

> your body is not magic.

But it is a complex, highly adaptable system. The simplistic formula of calorie input = output is highly misleading.

> If you feed it a sufficiently low amount of calories

Sure, if you starve yourself, you'll start transitioning to dust pretty soon.

[indecisive_user]

Somewhere between obese and dust you'll eventually hit a healthy weight.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2495396/

[onefootincode]

It is a disease as in “your metabolism is slow” so you need to cut food even more. It is a disease as “you have problem with controlling your impulses and therefore crave food”

Psychological diseases are not better or worse from psychical/metabolic ones. They are real, and for some of them we have or we develop medicine.

Nobody is claiming that obesity can’t be a result of a disease, but under the hood it always ends up as: calories surplus is stored as fat.

[sfn42]

Slow metabolism is a bit of a myth. By that I mean that it's not strictly wrong to say someone has a slow metabolism, but metabolism is an expression of your activity level so what you're really saying is the person is sedentary. If the person starts being more active their metabolism will necessarily increase.

So, slow metabolism is not a disease, it's not a genetic disorder, it is simply a result of the fact that someone is spending too much time on the couch.

I think this gets lost a lot when people talk about "slow metabolism", they turn it into this thing they're just helpless to influence, like they're just cursed with a slow metabolism and that's that. It's not like that at all, which is why I don't like the term. It just hides the reality of the situation.

[mmooss]

What is all that based on?

[sfn42]

I don't know where you get your science man but I'm about 100% sure what you just said is completely false. Not even remotely controversial just flat out wrong.

[mmooss]

What I said is commonplace if you look around.

[sfn42]

Yeah, beliefs commonly held by people who would rather make excuses than improve their lives.

[accidentallfact]

Let's say there is a new discovery tomorrow - there is a virus that lives in your mitochondria, and makes them unable to produce energy. We can make a vaccine against it, and nobody will ever get fat.

Would you be against the vaccine?

[sfn42]

Why would I be against that? I'm not against ozempic either.

I'm just against people who throw their hands in the air, say "my fatness is a disease" and continue eating 4000 calories a day while hardly moving at all. And just to be clear I'm not against the fatness - if you want to be fat that's fine, I don't care. It's your life. And if you want to say it's a mental disorder that's fine too, addiction is real and I know first hand that it's hard to resist good food and get off the couch.

Just don't claim there's nothing to be done about it. There is. I and many people I know have successfully lost weight by eating less and moving more. I've also gained weight by eating too much and moving too little. Because that's literally how it works, for everyone in the entire world. Sure it's possible to have some disease or disorder that prevents you from gaining weight by preventing you from utilizing the calories in your food. Or parasites can steal your calories. But if you aren't eating, your body still needs energy. It can't just choose to not use energy, energy is required to live. Without energy the heart doesn't beat, the lungs don't breathe, the brain doesn't brain, the muscles don't work. It's not like the body's just wasting energy, it uses as much as it has to. It's a fine tuned machine. So it can't just use less - the only way to use less energy is to spend less by moving less. Maybe the body can reduce it slightly by adjusting organ activity and such, but not much.

This is why we breathe oxygen and exhale CO2. Oxygen is literally used to burn calories, CO2 is the product of that combustion. Just like in a fire. When you exert yourself the body is spending more energy so it needs more oxygen and produces more CO2, that's why we need to breathe faster and our heart beats faster to get the oxygen to where it's needed and get rid of all the CO2. When you relax, your pulse and breathing lowers because you're burning very little.

Now, with this understanding of basic body functions it's obvious that moving more and eating less is how you lose weight. There is no question about it, it's just clear as day and absolutely indisputable.

[accidentallfact]

All right. I guess you're right then, and the entire world is lying and everybody wants nothing else than to eat more.

[sfn42]

Entire world? Everybody? No, I think most people are completely aware of the link between overeating and overweight. If everyone around you agree that food intake and weight are entirely unrelated things then maybe you're just in some kind of echo chamber. Or maybe people just don't care enough to challenge your ideas. I don't know, but I do know for a fact that what I said earlier is true and that it is the overwhelming scientific consensus.

That's why common remedies for obesity are things like dieting, stomach reducing surgery to reduce capacity for food, and ozempic and similar drugs that reduce appetite. See how the common denominator here is less food? Diet for those who can do it that way, more drastic measures for those who struggle with self control. And of course all of these solutions work better when coupled with regular physical activity. Simply taking a daily walk for half an hour is a great way to burn some extra calories and get the heart pumping at least a little, this has many benefits beyond burning calories.

Trust me I know it's hard. I'm not in the shape I wish I was. It's a lot easier to order a pizza than go to the store, figure out what to make, buy ingredients and cook a heathy meal. And it's so nice just crushing half or more of a large pizza in one sitting. The amount of junk food i can eat before I feel full is way more than I should have. It's a lot easier to spend all day in front of the computer or on the couch than getting out and doing some exercise. It's hard to do the things I know I should do, when what I should do and what I want to do are so different. I know from experience that when you get going it's easier to keep it going but I've also fallen off the wagon a lot. And it's not like you just do it for a little while and you're good, it's a permanent lifestyle change. It takes months or years of dieting to get down to a normal weight, it's a huge task.

But if you don't even believe that this is the solution, which it unequivocally is by the way, then you're either going to waste your time and probably money on things that don't work or more likely just keep eating yourself into an early grave while telling yourself you're just unlucky.

And I think it's worth some negative social points for saying things that might upset some people on social media, if I can maybe influence someone to get their shit together and work towards a better life.

This isn't opinion, I am 100% sure about these things and I'm not paid to say them. I just want to help. Trust me, you can lose weight and eating less and moving more is the way to do it. Ozempic and similar drugs can help with that and there's no shame in using them. The only thing that matters is getting healthy.

Obesity is a deadly condition and it's miserable. Trust me I've been in great shape I know exactly what I'm missing. And I'm not even very overweight, I'm about 100kg and it's already miserable. I can't imagine what it must be like for someone to weigh 150+. Struggling to breathe, getting winded just from getting off the couch. It's no way to spend your limited time in this world.

Oh and I forgot to mention a cool fact in my previous comment: that CO2 you're breathing out - that is your fat. That's where your fat goes when you burn it, you literally breathe it out. And the carbs of course. Your body turns the food you eat into energy and CO2. Unless you eat too much, then it turns it into fat to store it for later.