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Comment by Night_Thastus | Hacker News Reader

Source on "majority"? It seems like for the vast majority of people it's the opposite - they just eat too much and what they eat isn't helping. (Soda/sugar waters, chips, fatty meat, etc)

If they lack the motivation or determination to see through a diet, that's on them. The resources to count calories are there, it's not nearly as hard as it would have been 20 years ago.

Now, some people genuinely have some form of disease or unusual case where medication is 100% needed and no lifestyle change would help - and those people should get whatever treatment best suits them.

But 36% of the US (obese) is not an unusual edge case, some rare genetic disorder or disease.

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What I meant was a doctor telling a patient to "make lifestyle changes" an then expecting actual change doesn't work for the majority of people.

Do I have hard data on this? No.

Oh. You're not saying lifestyle choices are ineffective, you're saying telling people to make those changes is ineffective.

Yes, that I would completely agree on.

I think you’re actually not very well informed despite being confident of your position. The body attempts to maintain stasis at a given weight. “Lifestyle choices” as a solution are essentially a constant uphill fight against your body and its signals. High probability of failure, because there is no point at which your body stops telling you to eat more to reach the weight it thinks you should be.

I think now that we actually have a solution, we can stop saying this “lifestyle choices” junk. The reality is people rarely have a true choice.

You're absolutely right on all of those points. You have to eat less for a long enough period of time where the body adapts to that new, lower amount of calories. Then it becomes easier to maintain. But at the start it's really rough. Constantly feeling hungry isn't fun.

But just because it's hard doesn't mean it's not doable. For the vast majority of people it is doable without any form of medication. It will be slow and uncomfortable, but doable.

I think that a prescription should be a last-resort option for people who genuinely have a condition that makes a traditional method not possible. There's a variety of reasons for that, from monetary ones to health concerns about being on something like these medications long-term.

The majority of the population is overweight and more than a third are obese, with the numbers of both on a steady upward climb for decades.

Traditional methods are already out there and this health crisis is just getting worse each year. The average person is clearly not having success with them, and saying "if they just try harder" or putting some different spin on them hasn't done a thing to fix the trajectory of this problem in the past 30 years, so I can pretty confidently say that there is zero chance they will somehow solve this societal problem in the future.

Being significantly overweight has immense health consequences and imposes huge costs on both the individual and society. I think it's incredibly, incredibly unlikely that the costs or health risks of this medication are higher than the well-documented costs of people continuing to be significantly overweight.

And FWIW: I say this as a thin person with no trouble with my own weight.

As someone who hasn't struggled with weight I don't understand this sentiment. I'd love to eat way more than I already do and I'm constantly hungry.

Sure it's hard but if I ate till I couldn't regularly I'd end up several thousand calories over what my body needs for maintenance.

> As someone who hasn't struggled with weight I don't understand this sentiment. I'd love to eat way more than I already do and I'm constantly hungry.

Struggling successfully is struggling.

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