[9x39]

If they were a normal weight they would not have been prescribed the drug. The underlying issue is they're overweight because they eat too much. Anything more is speculation.

There is usually no free lunch when it comes to pharma, and extrapolating long term or lifetime dependence as being equivalent to short term interventions is an unsupported leap.

[MPSimmons]

Oh hi, I'm a heart attack survivor who had GLP-1 prescribed by my cardiologist for its heart-protecting benefits. I told my cardiologist that I wasn't losing weight as fast as I thought I would, and he said, quote, "I don't care about you losing weight. That's not why I prescribed you this."

So I'm not sure your first sentence is universally accurate.

[Aaargh20318]

That’s the problem with these new weight loss drugs. Ultimately they work by reducing food intake.

For many people food is one of the few things in life that gives them some form of joy. I won’t ever take any drug that will take that away from me. Life is depressing enough as is.

What we need is a weight loss drug that lets you eat unlimited amounts of food, preferably even suppressing the feeling of fullness, without gaining weight.

[wincy]

I’m on the max dosage of Zepbound and ate an entire six course meal at a Michelin star restaurant last year. It was an incredible experience. I just don’t eat an entire frozen pizza by myself, or box of zebra cakes where I’d then wake up with horrifying heartburn at three in the morning anymore. My life is so much better and my relationship with food is still totally fine. Sure I’ll have a treat sometime, but I’m not finding myself hungry at 11pm driving to the store to buy a box of them because I feel like I’m starving. I was well on the path to becoming diabetic and it felt like something I could barely control. When I’d try to diet I’d wake up shaking from night time blood sugar drops. All that hell is gone now.

[dotcoma]

> For many people food is one of the few things in life that gives them some form of joy.

This is the problem to be addressed, not hoping for a miracle drug that will let you chuck down 5,000 calories a day and be healthy, imho.

[MPSimmons]

It doesn't take away joy. It does cause me to be slapped in the face with the "full" feeling while I am in the middle of eating, which is like 15 minutes earlier than I used to get it. I don't overeat anymore because I would be literally miserable if I did. It would be like force-feeding myself. But before I get that full feeling, food is excellent.

[SubiculumCode]

Have you taken this drug? Because they don't reduce my enjoyment of food. Quite the opposite; I enjoy it more...its just that I get full feeling much quicker, and am less likely to go graze in the kitchen. But enjoy? No, I enjoy my food quite a bit.

[toast0]

Maybe there's something that you can take to simulate IBS...

I'm pretty sure when food goes right through me that I'm not getting any of those calories. Otoh, I have some idea of what types of foods (and how much) will trigger and the foreknowledge of that certainly reduces the joy of eating some foods I otherwise enjoy.

I still have trouble with calorie balance, but although I enjoy many kinds of ice cream, I have no problem going into an ice cream shop with friends and not ordering anything, even if I'm hungry. A 'single' scoop is way beyond my limit, and if I order a scoop, I won't order a scoop, take two bites and toss the rest, I'll eat the whole thing, so it's not worth it.

When I was doing bike commuting with real hills, I could eat anything, but now I work from home and can't convince myself to put that much time in the saddle just to eat whatever.

[JumpCrisscross]

> that will take that away from me

They don’t stop eating, just overeating. Getting joy from food is different from self medicating with overconsumption. (For the record, I love food. I also don’t have an issue maintaining a healthy weight and physique.)

[cflewis]

This is it.

I am on GLP-1 (Zepbound). I have done Weight Watchers multiple times. I'd lose the weight for a little bit, then it would come back. The reason was _I was hungry all the time_. It's not sustainable. As someone else in WW told me: "The easy bit is losing the weight. The hard part is continuing to eat that way your whole life."

It's simply a faulty hunger sensor in my body. It was not what I was eating, simply how much.

GLP-1s fix the sensor. It's really simple. Nothing else to it.

I still enjoy food (although my palette has turned away from anything greasy, which is for the better anyway), but I can finally understand why someone would eat half a plate of something and say "I'm good" and actually mean it rather than trying to diet/starve themselves.

[JumpCrisscross]

My friends who have been on it can genuinely enjoy food more now. There is no guilt. The portions make restaurant budgets more manageable. And they’re trying more of the menu. They liked food before. I think they can genuinely love it now, and that’s really great to experience with them, even aside from the massive lifestyle benefits losing weight brings.

[cflewis]

Yes!

I was able to drink an Italian soda this week and not feel like "oh God I'm drinking my calories I'm going to be punished for this on the scales later".

[SubiculumCode]

So many misconceptions in these threads; your take is spot on and accurate.

[phil21]

I dunno. It’s not universal, but I have a newfound joy when it comes to food after being on a GLP-1 and losing about 100lbs.

Sure, I don’t get the instant giant dopamine spikes from binge eating $30 worth of Taco Bell or a couple large pizzas. Once in a while I do miss that, but I can still do it now that I’m a few years into the weight staying off. It’s just not worth how shit I feel the next couple days afterward.

But healthy Whole Foods? What was once kind of meh for me is now something I look forward to and explore. Both going out to foodie type spots, and cooking at home. Both gourmet and basic. Just tasting the nuances and everything in some well prepared veggies or whatnot is great and not something I used to appreciate.

I also don’t constantly feel like crap with stomach issues either. I suppose there is less “addictive” type vice enjoyment in my life in some way, but the tradeoff has been life changing. I certainly still get plenty of joy from many of my meals when I feel the need!

[wincy]

You and I are kindred souls here buddy, I haven’t had heartburn in months and it used to be an almost daily occurrence. When it does occur it’s fixed by one Tums. I’ve lost 120 pounds taking Zepbound. My life used to be Waking up and downing half a bottle of Pepto because my stomach was an acid volcano. Doctors telling me that it’s just the way my life is now, and to take PPIs. Eating a pizza in one sitting. Feeling the urge at 11pm to go get fast food after eating dinner because I was so hungry. Now if I get Taco Bell it’s like $8 and it still tastes good, but I tucked into cauliflower and Caesar dressing as a snack today instead.

Totally transformative.

[thereisnospork]

Nonsense, one not just as easily say they are overweight because they aren't taking enough GLP-1 agonists. A patient with scurvy is proscribed vitamin C - they might even need to take it for the rest of their lives to stay healthy.

Woe is them I guess for their chemical dependence.

[buck746]

One could even argue food is a lifetime chemical dependance. An assortment of chemicals really with the amino acids, lipids and sugars involved. People who are against these medications typically draw arbitrary lines for what treatments are "acceptable".

Until starting tirzepitide I always thought about food, now I don't. Had depressive issues since I was a teenager as well. I took Wellbutrin for 20 years and had an interruption in the last six weeks due to an insurance issue. Payed for the tirzepetide out of pocket, take that once a week, my depression is manageable without the Wellbutrin for the first time in my life. I'm still going thru depression, but that's due to my husbands death in early March. If I wasn't taking my weekly shot I would easily be morbidly obese and probably suicidal. The cost isn't an issue either, I would spend more on food that I'm not buying or eating each month than it costs to buy the medication.

Just because something might not be interesting to someone doesn't mean it has no value. I have no interest in sports, but that doesn't mean they shouldn't exist. I could argue they shouldn't be as prominent in society but that's a different argument.

If you have struggled with your weight, depression, have early warning signs of cardiac problems and a range of other conditions it can be worth considering semaglutide or terzepitide. As long as you stick to the lowest dose that's effective the side effects are minimal to non existent. Categorically dismissing these drugs is as silly as refusing pain meds because "god designed us to experience pain".

[9x39]

I think you dislike the personal responsibility angle, which is fine but separate from caloric intake being the source of obesity. The fat is stored energy from food, it would violate conservation of energy otherwise.

There's metabolism, food density, food availability, psychology, culture, economics, etc in play, but it's important not to lie to ourselves that the proximal cause of obesity isn't from over consumption.

[JumpCrisscross]

> dislike the personal responsibility angle

I dislike the rejection of evidence. These drugs solve a problem. Preaching personal responsibility does not. In that way it almost reminds me of drug prohibition and abstinence-only rhetoric.

[9x39]

The evidence of where their fat stores came from?

[JumpCrisscross]

> evidence of where their fat stores came from?

Yes. Specifically, how basal metabolism is not a consciously-controlled rate that modifies itself against diet and exercise to the point that in some people with serious metabolic syndrome it may be impossible for them to lose weight through diet and exercise without suffering nutritional shortfalls.

Also, the clinical evidence around what works for people losing weight and getting healthier and what doesn’t. Like, I get we have a powerful fast-food and sugary-drinks lobby in America, but wow is it wild seeing people get uppity about third parties’ private healthcare decisions like this.

[faangguyindia]

>Yes. Specifically, how basal metabolism is not a consciously-controlled rate that modifies itself against diet and exercise to the point that in some people with serious metabolic syndrome it may be impossible for them to lose weight through diet and exercise without suffering nutritional shortfalls.

The average person does not understand how weight loss works; many people do not know the concept of maintenance calories, and don't know how calorie surplus or deficit works.

Simply putting them on drugs for life isn't a solution. The average person does not have metabolic syndrome, yet the average person is increasingly becoming obese or perhaps already is obese in many countries.

[s1artibartfast]

Third party private healthcare decisions are almost non-existant in the US due to the payment systems. People are on the hook for the decisions of others either through their premium, taxes, or both. Of course, this is non-central and rarely the concern people present.

That said, 2026 US GLP-1 healthcare sales projections run between 60 and 100 billion [1]. it will be interesting to see if these miricle drugs can really provide that much benefit/offset that much cost.

For comparison, Medicare part D is ~150 billion in its entirety. https://evolvancemarketresearch.com/reports/glp-1-weight-los...

[phil21]

Who is lying? I was fat because I ate too much.

Why I ate too much is uninteresting to me. I also don’t have some moral hang up over it. Give me that easy button all day long so I can focus on shit in my life that actually matters.

If it makes someone feel better about themselves to believe in woo-woo science that violates the laws of physics and ascribe magical properties to GLPs, why do you care?

[faangguyindia]

>If it makes someone feel better about themselves to believe in woo-woo science that violates the laws of physics and ascribe magical properties to GLPs, why do you care?

Why we should not care about putting people on drug who do can benefit from making lifestyle changes, being less sedentary and leaning about maintenance calories and how calorie surplus and deficit works?

if there is no resistance, simply prescribing GLPs to average person may become a new normal.

[toast0]

We don't seem to care much about giving people access to caffeine, allergy pills, corrective lenses, and in many places alcohol and marijuana.

Why is it a problem if there's wider access to these drugs? So far, afaik, there's been no long term major adverse effects, and especially I've seen no reports of adverse effects that extend beyond use of the drug (as has been the case with previously popular weight loss drugs that could injure people's hearts).

We're 5 years since fda approval specifically for weight loss and 9 years since fda approval for type 2 diabetes. That's a pretty good amount of time to find serious problems, although certainly many withdrawn drugs were on the market for longer, ex wikipedia says Ranitidine was the biggest selling prescription drug in 1987, but was found to be problematic in 2019 (apparently a new formulation is available as of late 2025!)

Sure, there are other ways to work on weight, just like there are other ways to work on allergies and exercises some people say are effective for vision problems. But we don't force people to give up pets or move somewhere that has fewer triggering allergens, we let them take allergy pills; we let people use eyeglasses or contact lenses or have their eyeballs adjusted so they can see; etc. There's a tool that's effective for many people, why not use it?

[phil21]

> being less sedentary and leaning about maintenance calories and how calorie surplus and deficit works?

Because it's useless advice that doesn't work in practice. As witnessed by decades of failure, with the only thing turning the tide on the obesity epidemic on a population scale being GLP-1 drugs.

> if there is no resistance, simply prescribing GLPs to average person may become a new normal.

Probably not ideal, but until Western society decides to change from the ground up it's better than the alternative which showed literally nothing but failure. One is something that works, the other is something that will take multiple generations to correct.