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Comment by eganist | Hacker News Reader

Probably the latter, but "just eating less" is next to impossible for a non-trivial minority of people much the way "just stopping heroin" would be for someone battling addiction.

An aid to help clear the noise in the brain seems to be unsurprisingly useful, then, in achieving these outcomes.

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Sure, but Ozempic is not the only drug that suppresses appetite. So if the underlying benefits are from “just eating less,” then the study should also examine the effects of other pharmaceutical interventions that suppress appetite.

Funding tends to be a constraint with larger studies, and it's best to keep studies focused anyway — less confounding variables.

Here, I'll pontificate a bit. For instance, study 1 finds that Ozempic is associated with a reduced risk of X. Study 2 is now funded to see if the association can be experimentally reproduced to establish a causative relationship. Competing institution gets Study 3 funded to test competing drug Mounjaro, reaches same conclusion. Study 4 by another institution finds same conclusion with a drug that acts in an entirely different manner, Buproprion. Study 5 by yet another institution finds similar results with amphetamines. Study 6 is funded on the premise that there's an underlying mechanism that needs to be explored, gets funding to study caloric restriction, gets similar results. Meanwhile, study 2 finds a causative relationship between Ozempic and X, concluding experimentally that Ozempic achieves X by inducing calorie restriction, which concurs with study 6.

I'm oversimplifying. But you see where I'm going with this. Much easier to both control and fund the smaller studies than a giant one, and you develop more knowledge in the process.

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Also, I'm not an academic, so I could be wildly off base. Would appreciate a gut check by someone who actually does this for a living.

It's not the only drug that suppresses appetite, but GLP-1 agonists (Ozempic, Zepbound, etc) appear to work for a larger percentage of the population, and significantly outperform previous appetite suppressants.

There's also findings that suggest that it goes beyond simply suppressing appetite, but also manipulates the "reward" center in the brain. Individuals who take it to lose weight find that they have reduced desire to drink or smoke, suggesting it's less that they struggle with appetite and more the medicine helps overcome addictive behavior.

Nicotine suppresses appetite as well and that has been used by humans for thousands of years.

Sure, it's just not as good as Ozempic at doing that particular job.

That’s so silly, these drugs aren’t even anywhere near the same league of effectiveness. There’s plenty of fat people who take nicotine all day.

Hmmm...if as many people consumed semeglutide you would have examples of fat people in that population as well.

You certainly would, because not every case of obesity results from the same mechanisms. But just as with all the other what-about comments, this comment misses the point: this class of drug is wildly successful, and it's the most specific drug for this problem that's been developed so far

https://www.healthline.com/health-news/ozempic-glp-1-drugs-m...

Here's a good piece running through the failure modes in lay terms.

This is genuinely one of the stupidest conversations I’ve been involved in. If nicotine was as effective as Ozempic at appetite suppression then everyone would know about it, it would be commonly used in medicine to treat obesity and Ozempic would never have been created. I hope for your sake this is pedantry instead of ignorance.

> Ozempic is not the only drug that suppresses appetite

If there were a drug that is equally as effective with the same or fewer downsides, then it would've been just as popular for that use case already.

Someone else mentioned nicotine. There are still a lot of "unsuccessful" nicotine users compared to Ozempic.

Just to hammer the point home, imagine suggesting a cure for heroin addiction is to amputate the arms so they can't shoot up. Then look up what gastric bypass surgery is.

For some reason we don't take food addiction seriously at all. You can't walk anywhere without seeing a picture of a Big Muck or something. Heroin addicts don't have to see their vice everywhere they go. Even cigarette addicts don't.

"Just eating less" may be very difficult, psychologically, in the context of an otherwise stressful and distracting life. However, I find that if you are able to eliminate those issues and focus on your own health and diet -- a big "if", I will grant -- then it's actually not that hard, on its own. You get used to it.

That GLP-1 agonists are as successful as they are and appear to modulate the reward center of the brain (per the latest research on the same class of drugs and smoking/alcohol cessation) suggests that it's certainly not just a psychological matter.

That's why I made the heroin comparison. People underappreciate the addictive properties of refined sugars.

Edit: people also looked at the opiate angle too, apparently. https://pennstatehealthnews.org/2024/04/qa-can-weight-loss-d...

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