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[parent] [thread] 38 comments
1. jmward+(OP)[view] [source] 2025-12-21 20:36:46
Other medications become lifelong medications but without this level of scrutiny. I am 100% in favor of finding a more permanent treatment, but switching blood pressure meds, and cholesterol meds, and other daily meds for a single once a week med is a massive improvement, especially since the all source mortality data keeps rolling in showing the efficacy here is orders of magnitude better than all the other medications out there. A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.
replies(6): >>3roden+O1 >>AaronA+s4 >>paulpa+u7 >>pupppe+Fr >>nradov+qy >>xorcis+Hx1
2. 3roden+O1[view] [source] 2025-12-21 20:49:27
>>jmward+(OP)
I don’t think that’s a fair assessment. I’m all for life-long drugs that help with weight loss, I don’t view it as a moral failing. That said, it is easy to see why so many people are concerned about these drugs: people taking them can look terrible (“ozempic face”). Gaunt, sick, hollowed out, look at people like Sharon Osbourne, that’s the public face of these drugs. And so when people are committing to life-long use of these drugs, it is being viewed with the very visible side effects in mind, and that is concerning to a lot of people after these drugs seemingly appeared overnight.
replies(1): >>hamand+P2
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3. hamand+P2[view] [source] [discussion] 2025-12-21 20:56:42
>>3roden+O1
"Ozempic face" is actually just "unhealthy rapid weight loss face". Ozempic makes it easier to starve yourself, but that isn't how it's supposed to be used.
replies(3): >>yellow+d5 >>manmal+g6 >>tartor+N6
4. AaronA+s4[view] [source] 2025-12-21 21:06:16
>>jmward+(OP)
But it is factually true that it’s a matter of willpower, no amount of reframing it is going to change that.

It’s not like others like myself, currently on a cut cycle, don’t experience hunger. The idea that we are just “lucky” ignores all the willpower and discipline we fight through to do it ourselves.

I’ve eaten about 800 calories today and it is 4pm. Just finished 90 minutes on the indoor bike. My stomach feels hungry. I experience that and just sit with it. That is the difference.

replies(11): >>afavou+f6 >>manmal+U6 >>XorNot+H8 >>3roden+na >>toomuc+wc >>busyan+6p >>DamnIn+Zz >>seba_d+FQ >>thefz+8Y >>shadow+u32 >>array_+My2
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5. yellow+d5[view] [source] [discussion] 2025-12-21 21:09:25
>>hamand+P2
Many of the fly by night digital proscribes just jack the dosage to show rapid gains. Coupled with people lying on BMI to get a script is a bad combination and why it’s so obvious.
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6. afavou+f6[view] [source] [discussion] 2025-12-21 21:16:13
>>AaronA+s4
How can you say that with any certainty, though? How do you know that hunger hits you in the exact same way it does another person? That overcoming it requires the exact same amount of willpower in all people?
replies(1): >>AaronA+Z6
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7. manmal+g6[view] [source] [discussion] 2025-12-21 21:16:22
>>hamand+P2
It’s also accelerated muscle loss, even heart tissue. I‘m not saying it’s not worth it, but this should be kept on the radar for sure.
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8. tartor+N6[view] [source] [discussion] 2025-12-21 21:18:55
>>hamand+P2
Taking Ozempic also drops a lot of muscular mass and that ozempic face look totally makes sense.

There's no free lunch or wonder drug. While it's effective at weight loss it has a lot of unwanted side effects. And when stopping the drug the weight gain comes back so not sure if it's worth it.

replies(1): >>array_+5y2
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9. manmal+U6[view] [source] [discussion] 2025-12-21 21:19:23
>>AaronA+s4
Congrats, your metabolism (FAO, gluconeogenesis, insulin sensitivity, …) works well. Don’t assume that’s the case for everyone, because it’s well researched that this is highly individual.
replies(3): >>AaronA+c7 >>paulpa+F7 >>thefz+jY
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10. AaronA+Z6[view] [source] [discussion] 2025-12-21 21:19:54
>>afavou+f6
My hunger feels 8 trillion times worse than an obese person’s. Since I am making the claim, everyone else has to affirm it now.
replies(1): >>afavou+R9
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11. AaronA+c7[view] [source] [discussion] 2025-12-21 21:21:08
>>manmal+U6
You know nothing about my metabolism.
replies(1): >>manmal+A7
12. paulpa+u7[view] [source] 2025-12-21 21:22:45
>>jmward+(OP)
A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.

I have noticed much less moralizing over the issue now compared to 2-3 years ago. I think more people realize these drug are safe and effective and not 'taking the easy way out', but rather a treatment for a medical problem than just blaming laziness or gluttony.

replies(1): >>thefz+88
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13. manmal+A7[view] [source] [discussion] 2025-12-21 21:23:09
>>AaronA+c7
Well one of those has to work well or you would have fainted by now.
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14. paulpa+F7[view] [source] [discussion] 2025-12-21 21:23:55
>>manmal+U6
The ability to tolerate discomfort is probably as genetic/inante as metabolism.
replies(2): >>nradov+Fy >>xorcis+Ov1
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15. thefz+88[view] [source] [discussion] 2025-12-21 21:26:31
>>paulpa+u7
The article explains they they are not safe nor effective
replies(1): >>sergio+I41
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16. XorNot+H8[view] [source] [discussion] 2025-12-21 21:30:32
>>AaronA+s4
On the one hand I'm impressed but 800 is really super low. I was losing about a kilo a week at the peak of my diet eating double that.
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17. afavou+R9[view] [source] [discussion] 2025-12-21 21:38:07
>>AaronA+Z6
But you’re disproving your own point. Other people’s experiences aren’t knowable so you can’t say it’s just a willpower issue.
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18. 3roden+na[view] [source] [discussion] 2025-12-21 21:41:13
>>AaronA+s4
People are different. Using your own achievements as evidence of other’s failings isn’t useful, we are all different. I can fast for 23 hours a day, 365 days a year (omad) with ease, not because I have more willpower than my fat friends, but because I’m different. My fat friends are objectively stronger and more resilient than me in almost every aspect of life, yet by your measure, because hunger doesn’t bother me, I have more willpower than them? Willpower isn’t measured on outcomes.
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19. toomuc+wc[view] [source] [discussion] 2025-12-21 21:56:09
>>AaronA+s4
Willpower is just brain chemistry. Some are lucky, some are not.
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20. busyan+6p[view] [source] [discussion] 2025-12-21 23:29:07
>>AaronA+s4
What is your definition of willpower? What is it, mechanistically, that you have and others lack?
21. pupppe+Fr[view] [source] 2025-12-21 23:54:58
>>jmward+(OP)
But what if these weight loss drugs are making you hungrier than you ever would have been had you not started in the first place?
22. nradov+qy[view] [source] 2025-12-22 01:09:08
>>jmward+(OP)
I doubt that willpower or lack thereof is a significant factor. It's more a matter of habits and discipline. Willpower can allow you to resist temptation for a few hours but it's not sustainable.

I know several people who were formerly obese and have achieved sustained weight loss without drugs or surgery. The common factor seems to be that they "hit rock bottom", sort of like a drug addict, and decided to make permanent lifestyle changes in order to survive and stop letting down those who depended upon them. These lifestyle changes are often pretty drastic, and involve more than just eating less and exercising more.

If people want to take GLP-1 drugs and understand the risks then I have no problem with that and don't see it as a moral failing. But they might want to evaluate whether this is just masking the symptoms of some deeper mental health condition.

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23. nradov+Fy[view] [source] [discussion] 2025-12-22 01:12:54
>>paulpa+F7
Why would we think that? Tolerating discomfort seems to be a skill that anyone can develop with deliberate practice. Perhaps genetics imposes some upper limit, but just like in sports most people never put in the work necessary to even approach their genetic limit.

https://eastermichael.com/book/

It's winter in the Northern hemisphere right now. Try going for a walk tomorrow deliberately undressed to the point that you're deeply uncomfortable but not risking serious injury or death. Anyone can do this, and over time it makes tolerating other forms of discomfort easier.

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24. DamnIn+Zz[view] [source] [discussion] 2025-12-22 01:26:27
>>AaronA+s4
Oh, you can't reach the items on the higher grocery shelves no matter how hard you stretch? That's just a deficit of tall-power. I also experience items on high shelves. No, you shouldn't use a stepping stool to grab those items; just stretch more, and grow taller, like me! Look how good I am at being a bit taller than you! Your failure to be slightly taller is a character flaw, feel bad.
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25. seba_d+FQ[view] [source] [discussion] 2025-12-22 04:55:01
>>AaronA+s4
I don't think my ability to sit with hunger without fainting or experiencing massive headaches is due to my willpower. Fortunately, at least I'm not ignorant about it and don't write comments like yours.
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26. thefz+8Y[view] [source] [discussion] 2025-12-22 06:37:01
>>AaronA+s4
You can't make this point here without getting down voted to oblivion.

I know many ultra endurance runners and they are all in very good - healthy - shape. The only thing they all have in common is that they are very, very disciplined people.

replies(1): >>array_+Gz2
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27. thefz+jY[view] [source] [discussion] 2025-12-22 06:40:14
>>manmal+U6
Insulin sensitivity is made better or worse with diet alone
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28. sergio+I41[view] [source] [discussion] 2025-12-22 08:40:24
>>thefz+88
No. The article explains they do not cure the underlying issue, whatever it is. We have many such drugs, widely accepted as safe and effective.
replies(1): >>thefz+xa1
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29. thefz+xa1[view] [source] [discussion] 2025-12-22 09:45:15
>>sergio+I41
So they are not effective.
replies(1): >>array_+FA2
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30. xorcis+Ov1[view] [source] [discussion] 2025-12-22 13:34:12
>>paulpa+F7
Metabolism also isn't immutable. Ask anyone who became vegetarian for example.
31. xorcis+Hx1[view] [source] 2025-12-22 13:50:45
>>jmward+(OP)
> society views being fat as a moral failing

This is just as weak as a counter argument. If every argument that concludes that lifestyle changes are necessary, in most situations and for most patients, are just written off as some sort of moral high ground and not necessarily something to take seriously, then what do we have left?

Is there seriously no functional difference between healing a broken bone and getting someone to stop smoking? The only problem is just that we haven't found the right medication for the latter? Evidence of necessary lifestyle changes as part of some moral crusade?

The science is pretty clear on the subject and it is up there as one of the most well studied in medicine. Yes, anyone can stop smoking and anyone can gain or loose weight. Yes, lifestyle changes are the most imporant factor in a treatment being successful.

replies(1): >>array_+nx2
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32. shadow+u32[view] [source] [discussion] 2025-12-22 17:11:24
>>AaronA+s4
>I experience that and just sit with it. That is the difference.

Other people might have it worse and it might stay with them longer.

Could you keep it up if you were 10x as hungry as you are now for next 5 years?

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33. array_+nx2[view] [source] [discussion] 2025-12-22 19:35:40
>>xorcis+Hx1
There's a common misunderstanding that medication and lifestyle changes are two separate things, and we should do one or the other, with medication being the "easy way" out.

No. The way GLP-1 drugs work is by lifestyle changes. People on GLP-1 agonists will, on average, eat smaller portions, are more inclined to eat healthier food, and will even exercise more.

If you take GLP-1s and don't do the lifestyle changes, they don't work. So are these drugs useless? No. They make the lifestyle changes more attainable. In your smoking example, it's similar. We have cessation drugs, I know because I've used them. No, they don't magically make you stop smoking. But they do make it easier.

We need to rewrite how we view these drugs. They don't take away your power, your strength. No, they help you find it. You had the strength all along, but these are tools to help you exercise it.

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34. array_+5y2[view] [source] [discussion] 2025-12-22 19:38:43
>>tartor+N6
> Taking Ozempic also drops a lot of muscular mass and that ozempic face look totally makes sense.

No, it doesn't, weight loss does this. I've lost weight before via starving and even as a man, all my muscle went poof. If you look at someone like Ariana Grande, who clearly is anorexic, here arms are like sticks and here face looks tautly stretched over her bones.

This is just what happens when you starve your body of nutrients. Your muscles are some of the first to go because they're the least vital. Your organs and brain are much, much more important. Your body will have no issue taking your muscle away to give it to your organs. Regardless of ozempic.

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35. array_+My2[view] [source] [discussion] 2025-12-22 19:42:05
>>AaronA+s4
> But it is factually true that it’s a matter of willpower, no amount of reframing it is going to change that.

Okay... how?

You can't just make incredibly bold claims, say "it's a fact!" and then move on. No, you have to back them up otherwise you're just a bullshitter.

I don't know what other people, anyone else, is feeling. How do I know my hunger is their hunger?

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36. array_+Gz2[view] [source] [discussion] 2025-12-22 19:45:37
>>thefz+8Y
> I know many ultra endurance runners and they are all in very good - healthy - shape. The only thing they all have in common is that they are very, very disciplined people.

Right, but are you not seeing that this is orthogonal?

Meaning, is it that running MAKES YOU disciplined, or rather that people who are already predisposed to being disciplined are more likely to be runners? This says nothing about the genetic component of it.

And you would have to be born yesterday to truly think there is no genetic component. Even with alcoholism, we know it's hereditary. We know when it comes to compulsions there is a genetic component. This is not opinion, this is fact. We know this.

But specifically with food habits, you truly believe this is not the case? Do you not see how incredibly bold of a claim that is? How atypical, how surprising, that would be?

I'm not saying that some people are blessed and some are not. Everyone has the power to change their lives. But I AM saying that it's not the same for everyone. From the beginning, I have known some things come easier to some people. I thought this was common knowledge, a part of the human condition we were all aware of.

replies(1): >>thefz+hB5
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37. array_+FA2[view] [source] [discussion] 2025-12-22 19:48:55
>>thefz+xa1
Are you not listening or...?

I took chemotherapy for cancer treatment, and it was very effective. Chemo is not a root-cause solution. It's a shotgun solution, a hammer even. It just kills cells that look like cancer. It doesn't stop cells from being cancerous, or turn cancerous cells back into normal cells. It's also carcinogenic, meaning it actually causes cancer. I am now much more likely than the general population to develop another cancer.

But it also saved my life. We do not measure effectiveness of medicine by if you think it's morally just. Nobody cares what you think, actually. We measure it in the real world, by if it works.

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38. thefz+hB5[view] [source] [discussion] 2025-12-23 21:30:15
>>array_+Gz2
Ultimately the decision to put food or alcohol in your mouth is yours. I am tired of hearing of external factors, let's bring it back to the individual.
replies(1): >>array_+Qmd
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39. array_+Qmd[view] [source] [discussion] 2025-12-27 06:04:56
>>thefz+hB5
This view is held by many because it's incredibly simplistic and naive, while simultaneously allowing people to gain moral leverage. Meaning, if everything is in our control, then if we do good, we must be very good.

But it's just obviously not true. From the beginning, it is clear life is unfair. Children die from cancer. Are they losers? Should they have ate more veggies?

When everything happens for a reason, that has some unsavory side effects. This is all philosophical, but also real.

We are an amalgamation of what is in our control, and what is not. I could sit here and pat myself on the back for being skinny and attractive. Really, I could. But does that not seem, maybe, a bit pathetic?

I did have something to do with it, but it was not all me. I shouldn't take all the credit, and frankly I don't need it. Maybe some people do need it, in which case they should do other things to be proud of. There's no pride in being proud of something you did not achieve.

I think, for both you and me and for most things in life, the reality is that most things were given to us. Yes, we have achieved - off the shoulders of giants. Whether that be genetics, time, place, family.

From there, we have a few options on how to view the world:

- conclude that, since we've achieved nothing on our own, we must be losers, and kill ourselves.

- denounce the notion, and live in the delusion that we did do it all on our own. Essentially, lie at a fundamental level to boost our ego. Is there a lower low a person can sink to?

- embrace humility, and acknowledge that we are blessed and favored. Acknowledge that we do not know it all, and that our success is based off of practically infinite random things going right in our favor.

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