[Analemma_]

Around the internet you can find tons of people griping about GLP-1s, saying "diet and exercise make you lose weight, they have to, the First Law of Thermodynamics, etc. etc. How come doctors don't prescribe those?". And the answer is "diet and exercise are not a cure, they are a proposed treatment plan with a dismal success rate". To treat something as medicine, we want it to work in the real world of fallible humans, not in the imaginary world of perfect regime adherence that internet commenters dream up when they want to get snarky.

It's exactly the same thing here: exercise is not a "cure" for depression, it is a treatment plan that has good odds of success if stuck to, and it is frequently not stuck to. Turns out that depressed people are even less likely than the median person to stick to an exercise plan, and the median person is already pretty fucking bad. So the field gravitates to treatments which are achievable even if imperfect.

The article goes into this not at all, it just closes with some blather about supervised programs and gym access, which is like yelling louder at a fat person to "eat less, dammit!". Good luck with that treatment, I'll take the drugs which work.

[WalterBright]

When I took up jogging, I had to force myself to. After a year of that, I suddenly realized I was looking forward to running and began to enjoy it.

I had taken up jogging before, but never stuck with it for very long.

I had an operation a couple years ago, and the surgeon told me I could not jog for six weeks. It was hard to wait that long :-)

[Forgeties79]

A lot of us are concerned about more than objecting to GLP-1’s. They’re pretty aggressive as a “treatment” used for weight loss, TONS of people are on it, it’s aggressively marketed in ways that seem rather backwards with what we’ve learned about how to talk about bodies and weight, and we are already seeing concerning GI issues emerging from prolonged usage - which is a given unless someone makes a lifestyle change, which as you said is not a great assumption.

[rootusrootus]

> we are already seeing concerning GI issues emerging from prolonged usage

Could you elaborate? I have been looking for a scientific discussion on that topic and coming up with not much.

[Forgeties79]

Here are some hits from a search for “studies on GI problems associated with GLP1's.” I have not read them start to finish but it’s a starting point for you to do your own searches off of. I used Kagi, for reference.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10213739/

https://www.mayoclinicproceedings.org/article/S0025-6196(25)...

https://www.ncbi.nlm.nih.gov/books/NBK551568/

https://pmc.ncbi.nlm.nih.gov/articles/PMC9821052/

https://www.nature.com/articles/s41366-025-01859-6

[rootusrootus]

Ah, okay, I was thinking you might have run across something more recent. The latest science seems to be going mostly in the opposite direction, saying that with additional data it looks like early concerns about things like pancreatitis (and worse, cancer) were overblown. If there are some newly identified adverse reactions I'm always interested to learn more about them.

[Forgeties79]

I don’t know what exactly this is but it rubs me the wrong way. You say you’re curious and can’t find anything, but then you dismiss all the stuff I linked in minutes as if no valid literature exists yet and you already have a formed opinion. It doesn’t seem like you’re particularly curious and it feels like my time is being wasted by a lack of transparency.

[rootusrootus]

Sorry, wasn't trying to offend. I skimmed the links, and the majority of what I saw was observations that nausea, constipation, and diarrhea remained fairly common side effects even after having been on the medication for a while. That seems pretty mild [0]. I saw a couple mentions of pancreatitis, which is something that seems mostly debunked by now.

The really interesting one out of those was the first one, which showed an actual physical side effect. In rats, not humans, with disclaimers about how hard it is to replicate in humans. I will keep an eye out for more mentions of that effect, for certain.

[0] Okay, I wanted to say more about the nausea thing, because I suppose this might be a controversial hot take ;-). I think the physical punishment dished out by the medication is the only reason many people see continued success. They could eliminate the side effects by eating less, but that was always the problem. If they lower the dose the side effects go away, but without the punishing side effects they start to gain weight.

Or maybe it's just my own demons talking. Can't tell you how many times I've asked myself why I was eating something in spite of knowing it was the wrong answer, that I was not hungry, etc. If I could answer that with reliably action, I wouldn't take tirzepatide. People may look down on me for being unable to tame those demons, but oh well, I do what works for me. I do want to be on the lookout for long term problems that me outweigh the massive improvement in my health that came with losing 100 pounds, however.

> It doesn’t seem like you’re particularly curious and it feels like my time is being wasted by a lack of transparency.

Sorry, I probably just misread your comment as the usual "hey you lazy fat fuckers why don't you just eat less instead of cheat with a pill" moralizing that crops up in these discussions. I don't really think those links you provided a lot of ammunition disproving that, at least not to me.