The ‘next Ozempic’ became a social media sensation. Then everything changed

I suspect its a mix of regulatory and practical limits.

The delivery mechanism on the pens for Mounjaro are.. highly complex spring loaded devices. On top of that, you have the whole License Raj around pharma manufacturing - we only scaled as fast during COVID with the vaccine because some of the rules were functionally waived.

Get the message out there and keep up the good work of caring for your body and your health

In cases of severe harm to multitudes, like the Sacklers, the regulatory regime should strip the perpetrators of all their wealth and income even unto the seventh generation and the fourth degree of relatedness, and salt the earth of all their lands and possessions.

Scale back proportionately from there.

"When you say this do you mean "we have to look for the underlying causes of calorie imbalance" or do you mean "the human body is capable of materializing mass out of nothing"?"

when you say this, you reveal your ignorance of the biology that makes it far more challenging for some people to "eat less" than others, and that changes their metabolism to combat the weight loss if they do happen to "eat less" for some time.

BMR varies hugely by person, its not even a minor difference for some.

Yes, calorie imbalance is a thing, but you can be a 300 lb person who eats 2750 calories a day, also be a 200 lb person who eats 2750 calories a day, with each performing a similar amount of exercise.

While calories in/calories out will help anyone lose weight, for some, even with the advantage of math - its still much harder, sometimes an order of magnitude harder.

I've done this before, and I lose around 100 lbs, and I've kept off about 60 of it - but for the entire two years, I had a gnawing, burning pit of hunger whenever I was away. It never stops, and I never stopped being hungry. I just did my best to ignore it.

On top of that, look how many social occasions revolve around food, to stick to any essentially effective diet requires refraining in those situations. That's even harder. "oh, everyone is going for fast food after the thing, I guess I can just have some water? okay, I guess that's okay" because one fast food meal exceeds your calorie goal for the entire day.

Now you tell me, how easy is it to eat less if you never felt satiated, never stopped being hungry?

My point here, is while calorie counting and exercise works, there is clearly more going on than just that.

I think this is bad faith, but I'll put it like this: There's tribes out there that walk 5+km/day or whatever to get food, but their base calorie consumption isn't significantly higher than a sedentary American even with all their walking. There's something definitely weird going on in the human body in which it can modulate its own calorie burn and I don't think science has gotten that yet. Telling a fatty to eat less might be simple, but if the fat person's body fights them every time it might be helpful to trying to figure out how to make the body stop fighting weight loss.

The human body has a lot of latitude and how it stores & taps it's reserves. You could eat less than than you expend & lose muscle mass instead of fat, for example.

So yes, humans are a thermodynamic system, but that isn't a model that explains the dynamics of what your body does with it's tissues. It's more complex than that.

It's kind of like saying, "a CPU is just a resistive heater." There's a way in which this is true and it's a useful perspective for designing a cooling system. But it's a useless model to give to someone asking for advice in debugging race conditions, because you've erased the complexity their problems arise from.

Additionally there's a moralizing component where people erase this complexity in order to blame people for their medical problems and frame it as an issue of irresponsibility.

No one has ever said, "aircraft crashes are caused by gravity, and the moral failing of pilots not to understand this most basic principle. Imagine spending so much money on flight school when all you need to do is watch stuff fall, that's all you need to know." There is no gravity theory of airplane accidents in the same way there is a caloric imbalance theory of obesity.

Consider also that airplanes are "simple"[1], well understood, engineered systems which are centrally coordinated, and that bodies are complex, evolved systems, containing autonomous components, many of which are very poorly understood. Aircraft are engineered for consistency, with faulty or expired components swapped out, whereas humans vary dramatically, not only between each other, but over the course of their lives. Other people have very different bodies & experiences than you do; it can be night and day.

I came to understand this when speaking to a friend with executive dysfunction. I kept telling them they were beating themselves up or undermining themselves when they told me about limitations they experienced. Eventually they snapped at me and described their day to day in detail, and I realized their mind as a different place with different demons than mine, and that there were things I could do easily that they struggled with, and things I struggled with that were an ordeal for them. (They're a very smart and capable person who has abilities I do not, and of course I have demons and struggles they do not have as well.) I meant well but what I was doing was really undercutting and devaluing their lived experience, trying to comfort and bolster instead of understand.

[1] In the sense that they are not "complex systems" https://en.wikipedia.org/wiki/Complex_system (obviously aircraft are complex in a general sense)

>just eat less

Yes. Just do it.

>refusal to acknowledge the complexity of obesity

It is never an obese person's fault for stuffing themselves, it's always something else. In this thread it's the big bad pharma corps that don't give away for free diabetes drugs to people that don't have diabetes.

I wish you all the best, when you realize the problem is your lack of willpower maybe you'll lose weight and not gain it back.

>social environments practically require them to eat muffins, cakes, sweet desserts

Most people will let you slide on gorging if you simply say "Doctor's orders". HIIT means sprinting hard 3 times twice a week. Just about anybody can do it.