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Comment by farceSpherule | Hacker News Reader

A lot of people fail to realize that eating healthy and exercising is not enough for a lot of people who fight with their weight their entire lives.

Ozempic and Wegovy are game changes and have real, tangible health benefits.

One person told me, "No matter how much I eat or exercise, I have been 'hungry' my entire life. That ended when I started taking these drugs."

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> One person told me, "No matter how much I eat or exercise, I have been 'hungry' my entire life. That ended when I started taking these drugs."

I would change this to "No matter how much I eat, I have been hungry my entire life", because that's what my experience is.

I'm nearly always hungry. Doesn't matter what I eat or how much of it. High protein, high fiber, moderate fat, low carb, all the steps people say cures hunger, and I'm still hungry. 20 oz steak and a massive portion of broccoli, and I'll still get munchies an hour later. And before someone says "You're probably actually thirsty, but making the common mistake of thinking it's hunger", no, that's not it. I'm drinking plenty of water. My urine is almost clear.

People say things like "If you're hungry between meals, just eat a handful of nuts!", and I don't know if I want to laugh or cry, because I'll eat a handful, then another, and another, next thing I know, I've eaten literally 1,000 calories and I'M STILL FUCKING HUNGRY.

And so I get incredibly angry whenever someone says something like "omg these fatties have to take drugs because they don't know how to stop eating" as if everyone has the same experiences as them.

No, my hunger sensor is miscalibrated. Some of ya'll might go out to lunch and end up eating a large meal and not end up hungry for dinner and skip it. I'll go out to lunch, eat the large meal, and end up hungry 2 hours later. If I get the smaller meal, I'll leave the restaurant still being hungry.

I even tried keto. I did it for 9 months and went from 270 to 205 lbs, but even after 9 months, my hunger was not recalibrated. I was still hungry after every meal. After 9 months, I ran out of willpower. Gave into the hunger again. Slowly came back to 245 lbs and stayed there.

I wish I could try Ozempic. Maybe it would fix me. But I'm not diabetic, so my doc won't give it to me.

Ozempic (or better, Zepbound) will solve that problem. I feel just like you, have had a similar experience, and I'm taking tirzepatide (Zepbound, basically) now.

Ignore the haters. Focus on what will make you successful.

> my doc won't give it to me

Get another one. You can have more than one. Go to one biased in favor of selling you the drug, if that is what works. It is your health. Your doc is not your mom, he is your advisor, it is your body and your choice what to take.

Compounded semaglutide is relatively inexpensive. And over time the brand name stuff will start to come down because they are being undercut by the compounds. Zepbound, for example, is now available direct to consumer for $550/month (5mg, and not an autopen so you can easily split the dose to make it last longer if that still works for you). Still pretty expensive, but for a life changing drug it is worth it. I also expect the price will continue to drop, probably quite a lot in the upcoming years.

> I wish I could try Ozempic. Maybe it would fix me. But I'm not diabetic, so my doc won't give it to me.

Wegovy (which is the same drug, with a different name) is licensed for weight loss, if you fulfill certain criteria:

adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, or dyslipidemia) [0]

[0] https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/21...

I gained about 50 pounds the past decade and the past year I’ve been trying to lose it.

I weighed myself at the beginning: 205 lbs

I started running 30 minutes per day (heartrate training targeting about 140-150), every day, for 10 months. I kept my diet the same as before (though with a protein bar after the run). Weighed myself every week or two, always within a couple pounds of 205.

In March I ramped up my runs to 45 minutes per day with better interval planning. Still 205. I injured my ankle in May: 205. I’ve been busy and haven’t gotten back into running yet, just weighed myself, and after months of no activity: 205

Weight loss is hard. It is possible to put in a pretty strenuous amount of effort and willpower and see exactly zero results.

What do you eat? I bet $10 either it's calorie-counted standard high carb diet or something that is low in protein and fats.

The physiology of dieting, and avoiding hunger, is pretty well understood at this point. Just don't ask your GP or they'll just tell you to stop eating red meat and eat more cereals as the "solution".

Eh, in a clinical setting only eating "good food" works fine.

In the real world this is not what people experience. Especially those that experience mental food noise.

Imagine there is a donut in a box at work. It's free, you can have it at any point. It's junk food, it's bad for you, it's not part of your diet and you don't want it. I mean you ate a high fiber food and protein earlier, you shouldn't be hungry at all. Now imagine there's an additional voice in your head that just slips in "Ok, finish that page your on and go pick up that donut". How long can you resist it? You probably won't even notice it since it's the normal stream of thought you have. At some point you'll end up with that donut in your hand.

Now take a GLP-1. The voice gets silenced. If you smoke or drink you'll notice that you don't really want to do that either.

Not the OP but I have tried to reduce my sugar intake, I'm walking more than before, and I still basically gain half a pound every year. I'd lose some weight for a few days, and gain it all back on the one day I'm a bad boy. It seems like there's an internal dial that decides what my weight is supposed to be, no matter how much I fight it. And the dial adds half a pound every year. I guess the dial is my metabolism as I age.

You need to reduce your calorie intake. The exercise isn't enough to have a significant impact.

There are a couple things missing from routine. That protein bar is sabotaging your run. Those things are filled with sugar. You need to do 2 things. Change what your eating and do intermittent fasting to jump start your metabolism.

Just doing more exercise doesn't actually help much with losing weight, as it turns out. The human body will optimize around even intense exercise to reduce calorie burn to a homeostatically stable level. The exercise will still make you healthier (and have some marginal extra calorie burn from e.g. extra muscle mass), but you'll only lose serious weight if you also reduce what you eat.

There are a bunch of articles out there about it, but Kurzgesagt has a decent pop-science summary: https://www.youtube.com/watch?v=vSSkDos2hzo

Its a pretty well known fact that exercise alone (unless you are doing extreme athlete training) is not going to change your weight without a change in diet.

You can get healthier with exercise, but not smaller. That is almost entirely based on diet.

Just think about it; your thirty minutes of running probably burned between 300-500 calories. That one protein bar probably has about 300 calories by itself.

And that's where the GLP-1 meds come in. You get physically sick from eating your current (oversized) meal size. You don't have cravings. You can lose weight using GLP-1 even if you don't exercise strenuously/daily. However you lost a lot more if you have a regimen.

If his weight is stable then his meal size is probably in the norm. That's the hard part of losing weight. Only a small sustained calorie excess will make you gain weight but you need a large sustain calorie deficit to lose it. And your brain and body will fight as hell against this.

> 300-500 calories

Put another way, up to a pound a week of weight loss, changing nothing about your diet.

Right, but the exercise made OP eat a protein bar, which has about as many calories as you were burning in exercise.

The exercise made OP eat a protein bar?

I feel like you just inadvertently explained why dieting is not the answer.

Speaking from experience, that assume that you are currently maintaining your weight. I think a lot of people are gaining weight slowly, so burning those calories actually just keeps you at your existing weight, not decreasing it.

It's also really hard to not overeat after working out, especially if you do something like swimming, which makes you just so hungry. The hunger reduction is I'd like to try ozempic. I am active (I swim 3-4k yards hard 2-3 times a week and surf once a week + walking generally), the hunger I have after swimming is so huge I just can't not eat something huge, even though I drink a ton of water and do all the other things people say to do to not get hungry.

I've been a lifetime swimmer, so I can relate. There's a reason a lot of swimmers and waterpolo players gain tons of weight as soon as they stop training.

Usually if you can fight through the "hunger" it'll calm down in its own after about an hour or so in my experience.

Thanks for sharing. It must be discouraging to see no results after pretty rigorously following the mantra of "just try harder".

Exercising won't work, weight loss happens in the kitchen.. You can do some moderate exercise of course but you should count calories and eat less (don't forget to recalculate your requirements as you lose weight!).

Running for 30 minutes is maybe 200-400 calories. If you trigger your body to eat more because of that or you are more lazy throughout the day because you’re tired after running, it’s a wash. Exercise is not the route to weight loss. It’s like 80-90% diet.

> It’s like 80-90% diet.

And if you diet, you lose weight temporarily and trigger your body to eat more because you're hungry. Your body doesn't want there to be a route to weight loss, so it blocks them pretty effectively.

what? this is entirely made up/false

a diet doesn't mean starving yourself, it means have balanced nutrition that doesn't rely on fast carbs, if you burn 2000cal a day for example you still eat 2000cal but not in sugar/fast carbs but adequete protein, fats, and high fiber/slow carbs; insulin resistance is the biggest reason people will feel that hunger right at the start but once your body starts gets used to the slower carbs that don't constantly spike your insulin the resistence goes down

a lot of time it seems like people absolutely don't track what they eat or sort of tell lies to themselves (this doesn't include people with illnesses that impacts their metabolism)

once you start doing a medium amount of working out, just going for 30min walks everyday, you will start to build some lean muscle which will increase your base metabolism and this is where the weight loss kicks in

Exercise by itself doesn't increase calorie burn all that much, it just strengthens your body in other ways. It's still very important, but to have a healthy weight you need to eat healthy (for most people this just translates to eating less) and diverse foods with good macro coverage.

You not changing your diet is the problem in this case, and that protein bar has so much sugar that by itself it's counteracting whatever effort the exercise had in the first place.

Also in my experience most people who say this kinda stuff (I train and eat healthy but can't lose weight!) actually don't eat healthy at all, because they simply don't know what that actually looks like.

It is enough, but there are people who dont have metal fortitude to eat healthy and just the right amount.

>eating healthy and exercising is not enough for a lot

That's because both these interventions when followed in the way they are commonly understood are near completely incorrect. I blame the govt/medical profession for this.

Other factors: again I blame govt/medical profession for this - example it's difficult to get unprocessed food unless one reads labels carefully. For example it is near impossible to get milk that is not fortified with vitamin D. As they say: the road to hell is paved with good intent.

Granted that even after doing everything right there will be some people who will be obese, but that would be the minority. Again the govt/medical profession is to blame - for example I've heard that infants/kids are now given around 30 vaccines. With so many variables that have changed in the environment it now becomes difficult to isolate what is causing the health issues that predispose people to a lifetime of ill health

Wait, what is wrong with Vitamin D?

Vitamin D produces short-term results, in the long run it is harmful.

I cannot find a good article on it at the moment but dig around and you should be able to find it. And yes I know people rave about vitamin D.

It doesn't exactly bode well for your argument when there's a wide body of evidence disagreeing with what you're saying, and you also cannot find the source of your claim.

There is some evidence to suggest that vitamin d supplementation can result in increased calcification of arteries:

https://pubmed.ncbi.nlm.nih.gov/26995293/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986531/ https://pubmed.ncbi.nlm.nih.gov/23109644/ https://pubmed.ncbi.nlm.nih.gov/21406296/

It's far from conclusive, but there is a mechanism of action that makes some sense, so it wouldn't be out of left field if it were the case.

There's also some evidence that vitamin k can be used to help balance out the risk:

https://pubmed.ncbi.nlm.nih.gov/19386744/ (More animal studies on K, too, but god knows how well those will translate to humans)

In general it's all in the "Potentially a thing, more research needed before we start a mass panic" bucket. I personally wouldn't go buy a bucket of "ULTRASUPPLEMENT 10000 IU VITAMIN D HORSE PILLS," though.

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