Most of weight loss actually happens in the kitchen, not the gym. A candy bar is roughly equivalent to a 20 minute run, in terms of Calories. Weight loss drugs surpress appetite urges. Even if you got super fit on the drug, without long term habit changes, most people are likely to put back on the weight quickly. Somewhat counter intuitively, fat people tend to have strong muscles to move all their mass around. My understanding with these drugs is that they artificially inhibit cravings, reducing the urge to eat, thus effectively stimulating weight loss. As soon as the drug stops being administered, the cravings return (and thus the weight) regardless of how fit you are.

Just as an anecdote, I used to not understand how people got so fat. Just eat less lol? I’ve been a little light for my size pretty much my whole life, so I didn’t quite understand. In fact, if it were up to me I probably wouldn’t eat at all. So the concept of being overweight was foreign to me and I assumed that fat people must be lazy/weak/whatever. As I got older and a little more in tune with my body, I noticed what sugar cravings are really like. And my god, when that part of the brain complains, it gets front and center stage. I specifically remember trying hard to resist reaching for a soda for like an hour. I conceded and drank one. I couldn’t focus otherwise. Then I realized that there are people (typically easily spotted) that live every day of their life like this. And I get that the brain is hardwired for gluttony- I will literally never eat enough food in my life- so it’s a rather natural thing to want Calories. I’m lucky that I’ve got a passable relationship with food. I feel for those who struggle with it. I’m also glad that there is a stop-gap in drugs like ozempic that help effectively curtail eating, today. I’m also hopeful that the drugs of tomorrow will be even safer and more effective than we have now and that the systemic sources of obesity in society erode away. I think the future is only getting brighter (and lighter) for the millions struggling with their weight.