Comment by hn_throwaway_99 | Hacker News Reader

Comment by hn_throwaway_99 | Hacker News Reader

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hn_throwaway_99

Sorry, but I couldn't disagree more. We have certainly tried the "diet and exercise" mantra for generations at this point, and they simply do not work for society at large (obviously they can work for individuals). I have 0 belief that "educating people more vigorously about food addiction" would do anything to lower obesity rates. Knowledge is not the problem.

I wholeheartedly agree that the obesity epidemic is a consequence of modern society: it's easy for the average person to go a whole day with nearly no physical activity, and our foods are calorie dense (not to mention literally designed to addict with fat, sugar and salt) and nutrient poor. But loads of people who have, basically for the first time in their lives, lost weight with semaglutide realistically have no other options.

Do I like that we need to cure one problem with modern society with another drug which has side effects of its own? No. But rather that than condemning people to obesity, which has enormous physical and mental health costs.

I don't understand why we're acting like preventing obesity for society at large is an unsolved problem. Looking at Japan with an obesity rate of 3%, it's clearly possible.

Who's pretending it's unsolvable? The comment was merely pointing out that the current strategy in the US is not working.

Whatever Japan's strategy is, I can guarantee it is not the type of lifestyle that is convenient in the US, and it's not making pleas for changes away from the current dominant lifestyle.

I can't even get my city to allow basic Japanese style housing, or the type of housing that was commonly built a century ago, with daily needs within convenient walking distance and without threat of massive trucks and SUVs running me over. It's not even legal to build a neighborhood that would fit the Japanese lifestyle in the vast majority of the US.

Perhaps that daily amount of activity is the difference in obesity, perhaps not, but following a typical American diet and the allowed types of transportation is clearly not helping us.

Because I don't think it's a realistic solution to say, for example, that in the lifetime of anyone currently alive that we're going to get, say, Dallas, TX to have the built environment and food preferences of Japan.

I said directly in my comment "I wholeheartedly agree that the obesity epidemic is a consequence of modern society". And I'm all for making cities more walkable, for example, and making it easier for people to get healthier foods. But I don't think these are realistic options for making a dent in obesity in America any time soon.

How is it a solved problem? Did Japan have some sort of campaign that shifted their entire culture from a fat one to a skinny one that we can replicate?

If not, are you suggesting you know how to do that? The problem isn't knowing what an individual needs to do. It's knowing how to get an entire country from where we are currently to that point desired point.

prevention is different from treating.

What works to keep skinny people skinny won't necessarily make fat people skinny.

That's why some people think things like Ozempic are necessary to deal with obesity in America.

At least we can all agree that knowledge is not the problem. :(

For better or worse. Some of the comments in this thread seem extremely disconnected from reality.

You're presenting a false dichotomy. Endocrine health is just one example of where doctors ought to investigate before more extreme interventions like these weight loss drugs.

The false dichotomy is to believe that these new drugs are the more extreme interventions.

Many people who go on semaglutide were on the road to bariatric surgery before these drugs were widely available. Bariatric surgery is a major surgery, with not insignificant rates of complications. I guarantee nearly everyone who gets this surgery considers it a last resort. Yet now, most physicians believe these new drugs will essentially put bariatric surgeons out of business.

I'd be all for any options with fewer side effects, but handwavy "endocrine health" doesn't cut it, again for the society at large.

I think it's great if we have a treatment for obesity, but can we maybe actually certify & test it for that purpose first instead of this off-label thing it seems to be?

But they have, right? Wegovy works really well. Ozempic is off label for weight loss only in the sense that it is the semaglutide drug that is marketed for diabetes and that it therefore isn't sold at the same high dose as Wegovy.

We did. Its called Wegovy.

Many drugs are prescribed in ways that take advantages of their side effects. Indeed, many drugs are designed for one purpose but perform a second purpose much better.

It’s clear that these drugs cause weight loss (in everyone) so I’m not sure what further certification and testing might show

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