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Comment by justinbaker84 | Hacker News Reader

This is exactly what happened to me. The clinic I went to recommended starting out with 1/10 the normal dose for the first month to make sure I would tolerate it. Then we would move up each month.

It worked so well I didn't want to move up so for month 2 I stuck with 1/10th the amount. During that month the effects wore off so I had to take more to get the same impact. I chose to just quit.

2 months after quiting I am 7 pounds fatter than I was when I started with the drug. I suspect that most people will need to keep taking more and more of it to get the same benefits they got from the recommended dose. I am really concerned this is going to lead to a bigger health crises than the one it purported to solve.

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> I am really concerned this is going to lead to a bigger health crises than the one it purported to solve.

A lot of diabetics taking it to regulate blood sugar (particular the feedback loop with insulin and hunger) have said it's changed their life... but for people who are merely overweight I think the benefits may not always be worth the side effects. IMO the correlation between weight and health is not as strong as people often assume.

Anecdotal, but if you looked at me and my partner, you'd probably assume I was the "healthier" one based on our respective body types. But they're strong, fit, and rarely get sick (knock on wood); meanwhile I'm a lifelong wimp with a host of autoimmune issues. I outsource all of the heavy lifting to them, literally—if the trash is too heavy for me to take to the dumpster, they get to do it instead :P

So to your point about health crises, yeah. It seems foolish to put my partner on a weight loss drug just so they could "look" healthier while nursing a bunch of unpleasant side effects that would make them far sicker than they were before.

Obesity is the number one cause of heart disease, which is the number one killer in this country. No, its health effects are not being overstated.

Sure, but that doesn't mean everyone who's overweight has high blood pressure and therefore should go on "shit your brains out" medication.

EDIT: Also, to my previous anecdote, despite being the skinny one compared to my partner, I actually do have several heart problems! (Thank you inflammatory diseases.) But you wouldn't guess that by looking at me, because weight is not a 1:1 indicator of health.

I think weight is the wrong thing to target for gauging health, but it is the thing that is in everyone's face and easy to see. Undernourishment is just a big of a problem as over-nourishment. Targeting the four horsemen(t2 diabetes, Alzheimer's, heart disease, cancer) is a better use of time and money, but they are relatively much harder to identify early.

> Undernourishment is just a big of a problem as over-nourishment.

Having been recently diagnosed with Crohn's I 100% agree. Getting skinnier during a bad flare makes people think I'm in better health, because I look a certain way that aligns with their expectations, but it really just means my gut isn't absorbing any nutrients. Turns out being at my lowest weight in years was a Very Bad Thing and not a sign I was doing anything right.

Which, again, is an interesting juxtaposition with my partner who weighs more than me but whose body functions correctly and whose biomarkers come back normal, unlike mine.

> Targeting the four horsemen(t2 diabetes, Alzheimer's, heart disease, cancer) is a better use of time and money, but they are relatively much harder to identify early.

All of these diseases have significant input from bad diet and metabolic disorder. Alzheimer's is considered a variation of t2d in some circles.

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