[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/

[mmooss]

That's a report on one person under direct medical supervision. The general consensus, afaik, is that starving yourself doesn't work, at least not more than short term - the weight comes right back.

[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]

Knowledge and understanding.

[mmooss]

So nothing.

[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.

[mmooss]

It's just baseless nonsense. Doctors and researchers say otherwise.

[sfn42]

And you still haven't found the time to show me any of them.

[mmooss]

Show us a basis for what you say.