I had the thought there are gonna be some people on these drugs who will still find a way to have bad diets that keeps them fat and unhealthy. Since they have less appetite instead of a sandwich and a milkshake they will skip to the milkshake only.
GLP-1 looks increasingly like a miracle drug. We see problems of addiction and obesity skyrocketing across the developing world. It’s not cost free, but it’s a hell of a lot better than the majority of America, China and India becoming potatoes.
When vitamins were discovered, there was similar moralising about there being no free lunch. With the benefit of hindsight those concerns were misfounded. Perhaps Ozempic has terrible side effects that haven’t been noticed since 2005. Given that timeline, however, we can confidently say someone obese taking the drug is better off with it.
> never cures it
I have friends who took it, lost weight and then stopped. The rebound was real but nowhere close to what they lost. (The lifestyle changes also mostly stuck.) For all practical purposes, their fatness was cured.
> when probably 99% of cases could be reversed naturally
Scientifically unfounded.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400171/#:~:tex.... "Although treating type 2 diabetes complications is of utmost importance to protect organ damage, it is now increasingly recognized that even the more ambitious goal of diabetes remission may be possible [6]. Thus, while there is little doubt that healthy lifestyle habits are the cornerstone of prevention of type 2 diabetes, they could also be used as an effective treatment to even potentially reverse type 2 diabetes. In this regard, the interesting narrative review published by Hallberg SJ and colleagues [7] has summarized the evidence that type 2 diabetes reversal is possible with the use of three different approaches: bariatric surgery, low-calorie diets and carbohydrate restriction."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716578/ "Unlocking the Potential of Type 2 Diabetes Mellitus Remission"
Even the ADA had to finally acknowledge this is possible in a statement back in 2021: https://diabetes.org/newsroom/international-experts-outline-...
It's not such a crazy idea really - You consume so many carbohydrates that you overproduce insulin and become insensitive to it in a vicious cycle. The more you fast, stay in a ketogenic metabolic status, reduce carbs and/or go zero carb, compress your feeding windows the more insulin sensitive you become.
There is no such thing as an essential carbohydrate. Your body can maintain your glucose needs by converting proteins into glucose. Fat and proteins are essential. Glucose is not it can be produce by liver.
It’s absolutely possible. It’s unfounded that it even medically works for 99% of people, and that is while ignoring the obvious compliance problem.
> stay in a ketogenic metabolic status
Want to point out the naturalistic fallacy in assuming putting your body into an extreme condition for the long term is less harmful than a drug. (I say this as someone who intermittently fasts.)
> when probably 99% of cases could be reversed naturally.
What does that even mean? We aren't 'naturally' exposed to such calorie dense foods all the time and aren't 'naturally' supposed to be able to get any food with so little effort. What is natural about processed foods?
Source?
I agree. People did not need these drugs in the past but instead of fixing the social and economic structures which caused the obesity epidemic we tell people to take drugs to manage.
Oh, and take Adderall so you can focus. Again, nobody needed this in the past.
And Xanax to manage the anxiety people did not use to have either.
Feel unhappy and alone? They will make a pill for that too.
"Brave New World" turned out to be even more prophetic than "1984".
I'm not considering taking Ozempic nor am I aware of anyone who has, so I'm curious.
I think it makes great sense if you're badly out of shape, you fix it, and then you can maintain a healthy weight. But going on ozempic every few years sounds really bad.
There's a heuristic that goes, "Shortcuts will catch up to people eventually," but I'm ok with letting the evidence bear that out.
However, putting food in your mouth is a completely conscious decision. If people have problems with controlling that then I think that's what should be treated, instead of medicating your body to react to food differently. I think a future where we turn to drugs on an ongoing basis to compensate our unhealthy lifestyles is pretty dystopic.
Again, if someone is obese and struggles to lose weight I think Ozempic sounds like a great way to get on the road to health. I just don't think you should take it for the rest of your life instead of changing your lifestyle.
Many things get better with time and progress but I don't think our current lifestyles are some kind of evolutionary peak.
All other things considered, how important is it that proximate or ultimate causes of obesity are addressed?
Cheap and plentiful high-calorie food and you're not forced to move if you've got a desk job. That might be modern but that doesn't mean it's better.
Would you same the same thing about insulin or statins or even caffeine? Why couldn’t something like Ozempic be something you take long term?
With regards to caffeine, as a doctor would you prescribe lifetime energy drinks to people who intentionally don't sleep enough?
Insulin is totally different because if you're diabetic and you don't take it, you die. There's no cure for diabetes, so there's no other option but to take it for the rest of your life.
But if you've lost weight (either with ozempic or not), it's possible to not be obese again, you're totally in control of what you put in your mouth. It feels really weird to me to keep medicating people forever when there are well understood ways to manage your weight.
I think it's probably a great solution to help people who have lost control of their weight and need to get back on track. But using it to compensate for an unhealthy lifestyle going forward just seems like bad health policy.