Honestly not sure how I feel about people being able to be absolute gluttons then just take a pill and have no consequences. I can't imagine a move to healthier eating or lifestyle afterwards.
You cannot be a glutton on this class of drugs. They make you not want to eat, and that’s how weight loss is achieved.
Think back to a time when you had a gastroenteritis. There is a period after vomiting where you are fine pain wise, but have a mental opposition to eating. That’s the sensory feedback these drugs give to your HPA axis.
I would speculate yes, but Im not an expert.
GLP-1 seems to be the primary signal of “nutrient in the gut”.
What happens when you mechanically overwhelm your gut? You throw up. What happen when you have gastroenteritis? You want to get everything out of your gut.
Similarly, gastric bypass surgery directly affects GLP-1 secretion (increasing it), which has the effect of causing people to not want to eat/ feel nausea with much lower nutrient intake.
Prebiotic fiber while fasting feeds gut bacteria so you won’t feel overwhelming hunger. Electrolytes/mineral-salt stop “fasting headaches.” With prebiotics and drinking tea my stomach doesn’t even growl while fasting, and I’m more productive. Most people just need to try and they’ll find it’s easier than they thought.
If it works for you OK - but I'm not a fan of dairy or red meat. I'm very close to my ideal weight anyway with my current diet and intermittent fasting. (I do two 36 hour fasts per week if trying to lose weight)
If instead you choose to be your own doctor, research the best approach you think might work and take responsibility for your health, then you have a good chance of succeeding. People can't be told what to do, they have to discover it.
In terms of policy, gastric bypass appears to be the sanest policy. Relatively safe, effective, some types are reversible and cheaper than a lifetime of GLP1 agonists.
We need more research into what is driving the obesity epidemic at the brain level. Or if there even is an obesity epidemic vs. humans didn’t evolve with Costco like food availability.
If someone eats 100% keto, that might not be a problem. But the average Joe is going to think "hey I've heard about this keto thing, that means I should eat more steak and butter". Ultimately this translates to a mixed high saturated fat + carbohydrate diet which is the worst of all worlds.
Have not tried it yet, but it's on the list (https://exfatloss.substack.com/p/hypotheses)
But yea the diet as listed is keto AF. I test 1.7-2.7mmol/L most of the time when on it.
I mean could the drug counteract that or is there a limit?
Guess we'll find out.