[hack1312]

> Diets also don’t stick when you discontinue them.

Yes, obviously. Which is why sustainable weight loss takes a commitment to making a change in lifestyle.

What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

[macintux]

At a large enough scale, being beholden to a drug is far more sustainable.

We’ve tried shaming people into being healthy. Amazingly enough, it doesn’t work very well.

[hack1312]

You claim shame was tried and was unsuccessful thus we should drug people. But what about the opposite of shame? Education, encouragement, non-judgementalism, and providing all other support required.

[nemomarx]

We've been doing that for a while too - it was Michelle Obama's whole thing, for example?

It could definitely use more support, but it doesn't do a ton if the structure of people's lives is being changed by other factors. (Car based commutes, long work hours, lack of exercise at their job, the cheapness of certain kinds of foods, food advertising.)

If we had a lot more political power to work on public health programs, maybe. But obesity rates are rising throughout the developed world regardless of local culture so there is a ton of work needed there.

[topgrain2]

The drug is more likely to work long-term. Diet & exercise, as a treatment plan, are distressingly ineffective.

Well-studied problem.

It makes more sense when you realize that something like sheer dieting/exercising willpower isn't why some populations are skinnier than others. Pick another country with a healthier-weight population, start placing some of them in the US, and they'll gain weight. Put them back, and it'll drop again.

If "just diet and exercise" (the advice, and individual effort to that effect) aren't what are keeping some populations skinnier, why would it cure a population with an obesity epidemic?

[hack1312]

So clearly it’s something to do with the difference in their lives in the USA, but your first response is to treat the symptom with drugs rather than look at their life holistically?

Just off the top of my head the food (portions, quality, etc) in the USA combined with how much people no longer can walk vs being required to drive are a huge contributor to weight gain of immigrants to the USA.

[nemomarx]

From the last time I looked at studies on basically any diet, I think prescribing people drugs for life probably lasts longer. Do you have any longitudinal studies of people making lifestyle changes for 10+ years to keep off weight?

[ajross]

> What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

That's some pretty... charged language. But even so: the drug, clearly. People take drugs reliably as a matter of empirical fact. People likewise emphatically don't "change their lifestyles" as a general rule. If they did we wouldn't be talking about this new drug, would we?

[hack1312]

It’s reality.

People take drugs if they can afford them; will GLP-1’s be available dirt-cheap to the masses or limited to those fortunate enough to have health insurance.