Comment by insane_dreamer | Hacker News Reader

Comment by insane_dreamer | Hacker News Reader

Without discounting the cases that are genetic or as a result of some other illness, for whom such a pill is a godsend, most obesity is due to lifestyle and especially all the processed foods (not to mention soda!) that Americans eat and drink.

I'd rather my taxes go to preventing obesity in the first place then paying for a pill that helps relieve its symptoms (but does not fix the underlying cause), is expensive, and has side effects. Make it harder to life an unhealthy lifestyle, just as we've made it a lot harder to smoke over the past 40 years. Start by taxing sodas and processed foods for one and use the money to subsidize healthier foods and prevention of "food deserts" in lower income areas (given that obesity is highly correlated with low income which is highly correlated with unhealthy diet -- it's hard to stay healthy when all you have nearby are corner stores stuffed with Frito Lay and Coke.

To me it's another example of how we really have our priorities backwards.

> Make it harder to life an unhealthy lifestyle

Well, and that's exactly what these drugs do: they either make you uninterested in processed foods or make you ill if you consume them. Considering how many people's dietary habits are formed in childhood, and considering how many people learn dietary habits from their parents, I could see GLP-1 agonists having a generational effect where the children of people who take them never get hooked on bad food to begin with.

Although for what it's worth, you're absolutely right about food deserts and income, I sadly just don't see those things getting tackled head-on unless political winds in the US shift dramatically. On the other hand, making junk food less profitable to its creators might actually force some change, as backwards as that is.

They dont focus on processed foods do they? I thought it was just overall food consumption reduction by making you feel full.

That’s my understanding as well.

They do make you feel full, but it seems like they also change how you digest food that's too fatty/oily/etc. I've heard some rough stories about people who ate certain foods on Ozempic and very much regretted it.

> making junk food less profitable

That’s probably the only long term solution our hyper-capitalistic society

It’s not that there are no other interventions for obesity, it’s just that this is the cheapest and most effective.

If taxing sodas had the effect of reducing body weight by 1/3, then I’d be all for it.

But behavioral interventions are really hard to stick. The reason ozempic is taking off is that it works given the systemic issues we have.

It’s the equivalent of saying people shouldn’t take anti-depressant meds because we can just change systemic factors they cause depression.

We can do both, but it’s not like we’d discourage food deserts instead of ozempic. We need to do both. And cynically, I think ozempic will work to reduce obesity.

> It’s the equivalent of saying people shouldn’t take anti-depressant meds because we can just change systemic factors they cause depression.

Fair point, but the systemic factors that cause depression are much more diverse, harder to identify, and much more difficult to rectify. (Also, I would argue that we have become a highly over-medicated society.)

Edit: Also, we did successfully change social behavior when it comes to smoking (younger people don't realize just how prevalent smoking was in 60s and 70s, perhaps as prevalent as drinking Coke and being overweight is today), though it did take massive class-action law suits. Maybe that's what it will take, though smoking -> lung cancer was perhaps a particularly easy link to prove.

Realistically, none of those things have happened in a way that puts a dent in ever climbing obesity rates. I think it’s time we celebrate the pharmaceuticals and pay up. This is one of those times where technology might solve a social problem.

None of those things have happened to any significant degree period. There is a reason why obesity has skyrocketed in only 50 years and it’s not genetic. It’s of our own making. And yet instead of focusing on prevention we’re focused on symptom relief which granted is much more profitable if you’re Big Pharma ;). One of the reasons why healthcare costs so much in the US for everyone is because of the unhealthy lifestyle choices that people make either out of necessity (low income, cheapest option) or addiction (stuff yourself now, pay later).

I guess what I’m saying is if those preventative things were talking about, have not been implemented in the decades that they’ve been known about, I’m pessimistic thet they ever will be implemented.

a discouraging but fair assessment

> To me it's another example of how we really have our priorities backwards.

Not if your priority is to maximize shareholder value

My point exactly

Identify a cheaper way of getting people to change lifestyle that is actually possible to get agreement on and that actually works, and you'd be showered with money.

Trying to get support for changes to what food is available etc. may well be better in the long term, but in the short term you're doing the equivalent of asking a bunch of addicts (me included) to voluntarily vote to banish our dealers.

Many of us will, but the measures will remain weak enough that we'll still find ways of satisfying the addictions anyway.

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