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Comment by lez | Hacker News Reader

The game hasn't changed a bit in my opinion.

People want miracle pills rather than educate themselves about how the body works, reducing toxic content in foods, healing underlying infections, taking care about minerals and vitamins, take on habit to do sports regularly, have good sleep, etc.

I prefer digging down to the root cause more than suppressing symptoms.

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There is more to weight gain than lack of willpower. The conscious mind is very little of the problem. The people in the study had all the same opportunity and advice, yet the ones who took the medication lost significantly more weight. What else do you need as proof that it’s not just education and choosing the right thing to do? If that were the case, why wouldn’t both groups show similar improvement?

> There is more to weight gain than lack of willpower.

Is there? The study you quoted suggests the opposite. The drug doesn't directly cause fat to melt off. The fat is lost by eating less. Why is the control group eating more? lack of....

Hold your breath for 3 minutes. This should be doable, with sufficient willpower. Freedivers can go much much longer. You didn't succeed?

Shame on you and your lack of willpower!

Biological urges are powerful, don't be so quick to judge.

No one should be expected to go from eating in an unhealthy fashion to a healthy one, just as one would not learn to hold one's breath for three minutes right away. But there are those who try and get better, and there are those who try and don't, and there are some people who simply don't try. This drug is good for the second group. But is bad for the third, the people who will use this to continue eating badly, just with the consequences less visible. And I think it could also be bad for the first: by hiding the immediate effects of bad habits, it removes the encouragement to get better. The concern that this may allow people to maintain bad diets but not see the effects in the short term is a valid one.

> Why is the control group eating more?

Because they aren't taking an appetite suppressing drug. It's easier to not eat when you aren't hungry, so it's easier to lose weight with the same amount of willpower compared to people that aren't taking an appetite suppressing drug. Willpower has no part in the study, it doesn't "suggest the opposite".

Willpower is exactly why they eat more. They feel a pang of hunger in their grossly stretched out stomach and can't resist eating.

The drug does not remove fat. It removes the feeling of hunger. Assume both groups have little willpower (they are fat after all). The control group feels hunger and continues satisfying that hunger with food as they have no will power. The group with suppressed hunger from the drug also have no willpower, but since they feel no hunger they eat normal amounts.

So we agree that there is more to weight gain than lack of willpower then. It wouldn't be a stretch to then imagine that not all people feel hunger the same (as hormones usually vary from people to people), and thus that for some people, it takes less willpower to maintain a healthy weight.

honestly who cares? it's not a competition. most people eat when they are hungry and stop when they're not hungry anymore. for me this results in being at the lower end of the ideal weight range for a person my size. it takes no willpower at all; I don't even think about it until I read a thread like this. other people, for whatever reason, have an appetite that is out of proportion with what their body needs. why not just let them solve their problem however they see fit? if a drug is part of their weight loss regimen, so be it.

Poverty is solved by earning more money. BAM I just won the war on poverty.

Crime is solved by just not commiting crimes. BAM I just solved crime.

Drug problems is solved by just doing less drugs. BAM I just won the drug war.

You should read "The Hungry Brain" [0]. It's by a neuroscientist, who explains the deep ways that the appetite mechanism is wired into just about every area of our brain, making "willpower" very hard to sustain. As just one example, prisoners placed on a forced starvation diet became obsessed with cooking implements. It also provides strong evidence that physiological mechanisms (not conscious choices) are behind appetite differences and fat mass variations in the population.

[0] https://www.amazon.com/Hungry-Brain-Outsmarting-Instincts-Ov...

If the drug is granting people willpower, then it really is miraculous.

I for one think changing human nature is harder than creating an appetite suppressing drug, and indeed it seems we arrived on the latter earlier. So if it works it works, right?

I think it is better for humans to be able to control themselves than be controlled by pills.

It is my choice to use drugs to assist in achieving my life goals. I've been doing it without drugs for a decade now and it's fucking hard and I don't appreciate assholes who imply otherwise.

By that logic shouldn't we be able to take steroid, or at least HGH, and other performance enhancing drugs that are less dangerous than steroids? Lots of people do less crazy amounts and don't have problems. Plenty of people have lived full lives after juicing, possibly even better lives. I'm not saying either way, just food for thought. If we banned something because you might get cancer alcohol, cigs, and junk food would be banned too.

I'm not shaming you or anyone for taking drugs, not at all. I think drugs can be great and can do great things for a lot of people. I take certain drugs myself on occasion.

What I am trying to say is that someone might not be able to control their appetite, but they do have at least some control over the food they put in their body. I think that education on nutrition can go a much longer way for overall human health than appetite pills.

Having lost over 150lbs and kept most of it off for about a decade, I disagree. Knowledge about nutrition[0] is insufficient. The only reason I was able to do this at all was that I was in a very low-stress period of my life at the start and after that I have had to put a whole lot of effort into not ballooning up again, to the extent that my behavior patterns were described as an eating disorder.

I am hardly unique in this. I would argue that to lose and keep off this kind of weight without chemical assistance (good fucking luck getting a doctor to help there) pretty much necessitates the development of an eating disorder. It takes over a significant portion of your life and is no fucking fun at all.

Give me an apatite pill any day.

[0] this is without even mentioning how difficult it is to find information on nutrition that isn't complete bullshit pushed by people selling fads.

Although a bit preachy, I partially agree with Your comet. If semaglutide mimics a hormone produced in our gut, what microbes produce the hormone and what can be done to encourage them?

That being said, as a person who struggles with weight I can attest to how much better my life was before gaining the weight and being obese compounds the problem in a sort of vicious circle. I'm ashamed of my body so don't participate in fun healthy activities like swimming and dancing, my weight makes it risky to run or skate due to my ankles and knees being strained.

I used to be thin and thought along the same lines of your comment but when I gained the weight I also gained empathy and perspective.

"Toxin" is a weasel word (https://rationalwiki.org/wiki/Weasel_word); be more specific.

>reducing toxic content in foods

can you elaborate on this? The terms toxic/toxins have been so overused when it comes to diet and alternative medicine that it's basically meaningless.

> People want miracle pills rather than educate themselves about...

Yeah, of course we do!

And that is perfectly rational.

That's like telling a depressed person they shouldn't be depressed.

> If you're homeless, why don't you just buy a house?

Do you know people who regularly consume toxic content in food and survive?

lots of foods have toxins in them. usually it's not enough to matter. do you put nutmeg in your alfredo sauce?

Being overweight/obese might be (and might not be) a side-effect of the things you list, but it also that causes its own further side-effects and is worth dealing with in its own right.

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