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Comment by Extropy_ | Hacker News Reader

To me at least, celebrating individuals using drugs that support an unhealthy lifestyle does not appear like a positive for society at large. I thought medicine was about aiding people to become healthy, not providing quick fixes to common problems. Why is this being celebrated?

EDIT: I do not mean to say Ozempic is useless or dangerous, only that celebrating it as a solution to the problem of obesity is. It is certainly a tool that helps people. I don't think it should be relied on continously. People need to live healthy lives to be healthy. I am not perfect, no one is. Losing weight is hard.

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They don't support an unhealthy lifestyle any more than a miracle pill that stopped a harmful drug addiction would. Would you oppose its release since it's not actually "natural" to use medicine to stop your addiction, when you should instead use pure willpower? This simply doesn't make sense.

We live in a world of enormous abundance, exacerbated by companies min-maxing foods to have the most addictive properties humanly possible, at cheap prices.

I realize obesity is a major problem, but so is neuroticism about health, weight, and diet. I agree with the nagging feeling that using a drug to address hunger is likely to have negative consequences for some people.

EDIT: obsession -> neuroticism

> I realize obesity is a major problem, but so is obsession about health and weight.

The scales of the two problems are not even remotely comparable.

I don't think this is true at all. Peoples' obsession with solving obesity as a cure-all for human health deserves pushback. There's also a concerning degree of moralizing it that has no place in our culture but has taken firm root.

In 1990, no US state had more than 20% obesity. In 2018, no US state had less than 20% obesity.

[0]: https://obesity.procon.org/us-obesity-levels-by-state/ and https://stateofchildhoodobesity.org/data-by-policy/

Obesity has been linked to a huge number of health harms and they've been known for decades.

[1]: https://www.who.int/news-room/questions-and-answers/item/obe... and https://www.niddk.nih.gov/health-information/weight-manageme...

I think you may be right that there's room for nuance about obesity, especially moralization about it, but you simply cannot deny that it's a huge problem in the US

> I think you may be right that there's room for nuance about obesity, especially moralization about it, but you simply cannot deny that it's a huge problem in the US

Of course not. I just don't like how most conversations about health get subsumed into the much less productive conversation about how destructive obesity is.

I mean obesity slowly kills you. It's no different than being an alcoholic or a smoker. There's really no healthy way to be those things, the thing itself is destructive.

The reality is, to me, obesity is born of addiction. Which is why ozempic is exciting. Because it's not a solution that relies on moralizing or fatphobia or shaming.

I don't oppose the use of this drug or its release. People should be allowed to do what they will. I see harm in celebrating the drug as a cure to obesity. Of course, certain diseases may make it easier for you to gain weight. Though obesity is not like cancer, it is a condition brought on by unhealthy behaviours

I think you're overestimating your knowledge of what causes obesity.

Think I generally agree with your sentiment, but my understanding of how Ozempic works is that it kills your appetite. The "unhealthy lifestyle" you're referring to is one of overeating. Ozempic doesn't support a person to continue overeating, it removes the desire to overeat. From that perspective it is aiding people to become healthy.

Sure, yes it is aiding people to become healthy in that sense. Is it healthy to rely on drugs to change your thought and behaviour patterns? I definitely see this drug as a useful tool when combined with a plan to not continue using it for the rest of your life. I see relying on this drug continuously as a problem, thinking "oh, there's no need to try and change my behaviours on my own, this drug will do it for me."

> Is it healthy to rely on drugs to change your thought and behaviour patterns?

That is the same question people were asking about Prozac thirty years ago, with the same concern about continuing to use a drug for the rest of one's life. The idea may sound scary, but in practice people make a simple calculation: so long as the drug continues to make your life better, why wouldn't you continue taking it?

If a drug has zero side effects, than it is obviously healthy.

Ozempic has side effects, so we cna do a cost benefit analysis to argue that the various benefits of not being obese outweigh its problems. We clearly see many people are unable to loose weight without it, given nearly 50% of people are at an unhealthy weight, thus its likley a net positive.

Effects or side effects, using a drug changes things. It is not easy to suggest that someone is unable to lose weight, except for clearly disabled people

42.8% of US adults are obese. Not overweight, obese. They will die years earlier form this, suffer many health problems, etc.

Until Ozempic, the US obesity rate has literally never declined since it started rising.

Thus people clearly are not loosing weight. What do you propose instead? Nothing else is working

I propose plans that involve the temporary use of medical tools like Ozempic that involve also changing your behaviour and living a healthier lifestyle, especially after losing weight

> involve also changing your behaviour and living a healthier lifestyle

Ah, so the same thing that has repeatedly been tried and failed every time everywhere around the world for the last 50 years. Yeah, let's just keep on giving that a go.

How do you feel about drugs prescribed for mental health (Prozac, Zoloft, etc.)? Why do you feel differently (if you do feel differently)?

It depends on the person. Major depressive disorder is an inexplicable depression that is not brought on by the circumstances of your life, I think SSRIs are a suitable treatment for that. I think that it's important to consider all factors of a persons life when deciding whether or not they should be prescribed medication that suppresses ALL emotion, not just negative emotion. Positive constructive therapy to help people better their lives ought to be considered in cases that may not necessarily be a disordered condition (i.e., they have a shitty life and need to be a better person to themself and others to be happy and feel good about themself)

This medicine literally aids people to become healthy. They will gain years of life from the lost weight.

Their lifestyle changes to be healthier by eating less, which many are unable to do without help because the human body has millions of years of baked in evolution demanding we overeat if able

My father has used ozempic. He hails it as a wonder drug, yet he does little to nothing to change his behaviours because he can rely on this crutch. I see that as concerning

Weird, this drug chemically changes behaviour, so how can his behaviour stay the same?

It's been reported to reduce cravings related to food, alcohol, and cigarettes, you are saying your father while on the drug consumes the same?

Or is it that he uses it for a while, then lapses, repeat ad naseum?

If it's the second scenario, that's personal responsibility, not much to do there really, he has been given all the tools to improve but chooses not to, and that will catch up to him, no matter ozempic usage.

This is what I'm saying: personal responsibility. Celebrating this drug as a magic solution to obesity is not right. It is a tool, not a fix

It is sold as a tool, not a fix. If you've found it to be otherwise you should report it to the FDA.

Did you actually see it being sold in the way you're describing, or are you just extrapolating from social media rot?

I dont really think an ancedote is a good argument. We have studies showing many people eat less on ozempic and loose substantial amounts of weight, and its main effect is not even the weight loss but reducing heart problems and fixing blood sugar in diabetes patients

He lost substantial amounts of weight. He sees it as a solution to his problem of being overweight and does nothing to change his lifestyle. I'm concerned that celebrating this drug as a simple solution to Obesity sends that message to other people as well

EDIT: celebrating Ozempic as a simple solution to obesity is literally what I'm referencing my Dad doing

You should keep in mind that you’re disapproving of your father’s lifestyle choices and his choices were not determined by the drug.

Many people make different choices on those drugs. Eg once they’ve lost some weight and it’s easier to move, they move more and the sedentary lifestyle changes. Similarly, I’ve seen antidepressants used to get enough functioning and control back that the chain of causes and effects can start to be addressed and intervened in.

Is he not eating less? If it's reducing appetite that seems like the biggest change of behavior you'd want, right?

You're suggesting that appetite is the cause of obesity. I don't agree with that notion. Repeatedly giving into your "appetite" will reinforce overeating

Its being celebrated because it is an amazing development? I think I can agree that, ideally, people will bootstrap healthy lifestyles and not need the aide long term. I don't know how you could justify that as a reason not to be glad the aide exists, though?

> support an unhealthy lifestyle

Do people not know what Ozempic does?

Ozempic doesn't make you sit around, eat like a pig and you lose weight. That's not what it does.

Ozempic makes you eat less, curbing overconsumption. People on Ozempic are also much more likely to exercise. It does not "support an unhealthy lifestyle". It literally does the opposite.

> People need to live healthy lives to be healthy

Okay, Ozempic helps people live healthy lives. Just like having a personal trainer helps people live healthy lives.

Would you say having a personal trainer is "supporting an unhealthy lifestyle"? Of course you wouldn't.

I've struggled with weight my entire life (I'm in my forties). Back in 2019, I lost 80 pounds. I carefully regulated my calorie intake to 1,800 per day. I discovered I have an absolutely terrible sense of portion size, and absolutely never feel "full" or satiated. I also made it a point to close all three Activity rings on my Apple Watch every day. I felt better, I had more energy, and I was able to enjoy more things in my day-to-day life. Even with all of those positives, a series of difficult life events during the first year of COVID took me out of my routine, and I haven't been able to bounce back. I would like to try a GLP-1 to see if it could give me a boost in the right direction again. I have no interest in being on it, or any medication, forever.

Thankfully, I've never been addicted to anything other than food. I never liked alcohol, nor did I get any positive feeling from it. So, I don't drink. I've never been enticed by drugs, so I've never used them. I went to Atlantic City once, but have never gambled another day in my life. Being spared from these other addictions isn't a matter of my amazing willpower. I'm simply not drawn to those addictions. Nor do I think that people who battle those addictions simply have a lack of willpower. I believe it's much deeper than that.

I agree that celebrating a medication as a cure-all solution is problematic. But, I don't think that's what most people think about GLP-1s. I think most most people simply want, and deserve, a little help in a difficult and complex world.

I guess it's because some of us aren't as perfect as you.

If humans stopped eating sugar we wouldn't need most dentists. Should we stop celebrating dental advances?

Dentists will tell you to eat less sugar. The company that manufactures ozempic will tell you that you don't have to do anything but use our drug

They do not tell you that. You are wrong.

From their FAQ: "Ozempic® is a medicine for adults with type 2 diabetes that, along with diet and exercise, may improve blood sugar. While not for weight loss, Ozempic® may help you lose some weight."

They literally never tell you that. I'm so fucking sick of people just making shit up about medicine and doctors in general!

"Oh they'll all tell you you don't need to do anything just takes this pill and then the pill fixes you hurr durr!" Okay nobody says that. Nobody has ever said that. You made that up, everyone who says that makes that up.

If you go to the doctor and you smoke the first thing out of their mouth is "quit smoking". If you're obese they're gonna DRILL "lifestyle changes" into your skull.

Where the fuck is this absolute delusion that "big pharma just gives pills!!1!" coming from? This has literally never been how medicine works.

< Where the fuck is this absolute delusion that "big pharma just gives pills!!1!" coming from?

The way this is phrased is a little rude, but hey it's the internet.

I'm actually curious where this idea comes from as well. I hear it all the time, but have never experienced anything close to it in all of my years on the planet. Is it some kind of political trope? Something that used to be true that older people haven't realized changed a long time ago? Does it come from 70's sitcoms?

It's certainly never happened to me with any of the doctors I've ever seen, met, or worked with, and I have decades of experience in healthcare adjacent fields. All of the doctors I've known actually really cared about their patients and would often complain that the patient just wanted pills and weren't more compliant when it came to things like diet, exercise, and quitting their vices.

> I thought medicine was about aiding people to become healthy

This is exactly what this medication does. I don't understand what confusion there is - this medication undoes the damage that a poor lifestyle choice creates, then gives the user to choose again.

Not how it works. Ozempic seems to shift processes in the body that divert you from the unhealthy lifestyle

It’s only unhealthy if the drug isn’t used.

Imagine if there were a button on your head that when you pushed it all alcohol in you blood would be cleared out with no negative effect on your liver. In that case, heavy drinking would NO LONGER BE an unhealthy lifestyle. Kids would be able to drink alcohol with no problems.

Why is this being celebrated?

Call me cynical, but maybe because Big Pharma has the deepest pockets and is one of the largest (if not the largest) spender on advertising out there.

Or maybe its because the majority of the population will loose years of life from being overweight or obese

What I’m afraid of is that this just ends in an arms race of ever unhealthier lifestyles versus medication to counter-balance that. These aren’t wonder drugs. People just need to stop eating garbage food, and too much of it. And the government should pass laws to facilitate that to counter lobbyists

This is a drug that literally turns off the part of your brain that craves overeating. Governments can’t legislate against human nature, as much as the nanny state wants to. We fixed food production without fixing the scarcity mindset that got us here. Now we’ve fixed that too.

It's a pretty dangerous mindset to imagine you're "fixing" a problem rather than "treating" a symptom.

Obesity is the main cause of myriad health problems. It is both treating a symptom, and fixing a problem. On average, somekne imwho is obese will love a much healthier life that is years longer than it would be without the drug. If that isn't an amazing outcome for medicine, than what is? Everyone dies, so all medicine treats symptoms at some level

Sure, but none of us know what the impact this drug will have on a societal level yet. Saying we've "fixed" anything is ridiculous.

>"People just need to stop eating garbage food, and too much of it."

Easier said than done. However for the vast majority of the people taking these drugs, these drugs enable them to finally do that.

But this drug is basically mind controlling people to live healthier. Its not countering an unhealthy lifestyle, it improving their current lifestyle

Its weird that people are celebrating the fact that our lifestyle and food supply is so bastardized that it's causing people to become unhealthy to the point where they need a lifelong drug to overcome it. I get why the manufacturers and big pharma likes it, but it seems that it's also celebrated by many individuals, like you see in this and other HN threads.

This drug is a symptom of a sick culture, and not cause to celebrate. I don't at all blame the individuals that have this prescribed to them for taking it, but it just seems like a technochratic solution addressing superficial symptoms of a much larger problem.

Smoking causes lung cancer. I don't smoke, but if they found a cure for lung cancer I would celebrate that rather than griping about "personal responsibility" or whatever it is your grievance here is.

This thing objectively and subjectively improves the lives of the people you share this world with. If you have a problem with that it might be time to turn your gaze inward.

I'm upset that we just accept a society that requires a lifelong commitment to purchasing a drug as an appropriate answer, rather than looking at real causes of why people are so unhealthy. I don't think it's exclusively a matter of personal responsibility, rather a supply chain and incentive structure to produce sick people that need medication to be healthy. This is a band aid.

> rather than looking at real causes of why people are so unhealthy

I'll answer this one.

The human body is designed and built to eat as much as possible, as often as possible. The brain will prod, poke, and even force you to eat.

For all of human history and prehistory, this is incredibly advantageous. A greedy approach to food consumption allows lower risk of starvation, and fat reserves can be utilized to provide survival mechanisms when food is short.

For the first time in human history and prehistory, we have an abundance of food.

Some humans, a minority, are able to simply fight their biological urges or they may not even have those urges. If this were 10,000 years ago, they would surely be one of the first to die. Now, however, this is advantageous.

Every single part of our biology is in contradiction with modern society. It's not a shock that humans have a problem with obesity. If I gave my dog infinite kibble, I give him a month before he has killed himself.

We are not built for this.

I don’t buy this fatalistic attitude at all. Japan has an abundance of food as well, and Japanese humans are also human. Yet I don’t see nearly the same level of obesity here. The difference is entirely cultural, and yet you argue that we poor humans are destined to overeat. It’s not like the poor Japanese are suffering not to overeat every day of their tragic lives.

Instead the same measures that work here work in western countries as well. Free food at schools in the US and Europe has led to less obesity. Teaching cooking at school has led to less obesity. Teaching appreciation of the own physical self as a gift that one is responsible for rather than a burden has led to less obesity.

None of this requires throwing even more money at pharma to balance out the out-of-control American food industry (originating from the unscrupulous tobacco industry) which pays pharma to create more addictive foods. And yes, our bodies did not evolve to handle those ultra-processed foods laden with additives, but that is not normal food! Look up how the American food industry wreaked havoc in Latin America, leading to insane rates of obesity in mere years.

I don't think "big pharma" is creating more addictive foods, lol. I will say our food industry is fucked but what they're doing isn't magic.

Fast food is addictive because it contains high amounts of fats, sodium, and carbs. That's all there is to it.

I don't think that anything you said here is wrong, however I don't see how any of it is relevant either.

I mean, sure... We should fix all the everything, but we can also help the people who are dying right now while we do that. They aren't mutually exclusive.

Imagine rejecting a cure for cancer because it might encourage smokers to continue. That would just be silly.

ok, I get the difference between life 10k years ago and today. Why has obesity and diabetes in children roughly doubled since the 80s though?

Personally, I would guess less smoking. We're really good at replacing addictions with other addictions. Not so good at stopping addiction as a whole.

> This is a band aid

Yes, and like a band-aid it will help sick people heal. Which is a good thing, that should be celebrated.

I don't believe that I've ever heard anyone espouse the idea that nothing else in the patients life should change, or that the drugs alone are a complete answer. Although, that seems to be the counter position to your argument.

Everyone knows that fat people need to eat less and exercise more, including the fat people. These drugs help them do that. The drugs are advertised, sold, and prescribed that way and include advice to that effect in the informational pamphlets they come with in addition to usually including a lecture from your physician.

What else do you need before you can just be happy for people that are struggling a little less now?

I'm happy for that, I repeated that I don't blame the people that get it prescribed. And I was using the term band aid in the colloquial term, as in 'something that doesn't address the root issues'.

Obesity, diabetes, have all risen, especially in kids since the 90s, what changed, and what caused this? Are we still having the same causes, or because we can get a lifetime prescription to Ozempic and cover up the worse symptoms, we're ok with it? This is a massive red flag that something is wrong with this situation, not because some people are losing weight, but because some people are getting people sick and others are selling a cure at their expense. Encouraging another lifelong prescription is not addressing the causes and encouraging people to benefit off of making people sick.

I think you have a solid point here.

I can accept that there may be larger root causes left to address, as long as we can also be clear that these drugs are also a huge win for individual health while society works on those, possibly intractable, root causes.

It's obviously going to be faster to treat individuals than it is to change our entire societies relationship with food and how we produce it, and we shouldn't just let all the fat people die while we figure it out.

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