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Comment by vineyardmike | Hacker News Reader

If people are obese, they’re not getting the right hunger signals anyways. Obesity is heavily tied to longevity. GLP1s cause muscle loss because when you lose weight, some of your caloric deficit will be supplemented by your muscles.

The article suggests that non-weight loss side effects of GLP1s are also worth considering taking the medication for. If you’re maintaining a healthy weight, while taking the drug, you shouldn’t experience the muscle atrophy.

Also, muscle size isn’t tied to longevity, usable muscle and a certain strength and physical ability is tied to longevity. Muscle size is a convenient proxy. Also cardiovascular ability in a related way. You basically just need to be able to move and carry things and act in your environment in a responsible way at an old age so you don’t fall or hurt yourself.

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I came here to basically say this.

People who tout the dangers of glp1 - and there ARE risks! - are also ignoring the "what did you do instead of a glp1" and the answer is.... remain overweight, which has many risks!

Yes glp1 might increase the risk of a certain kind of cancer. But guess what, it also reduces the risks of many other cancers tied to obesity!

It's hard for me to take hand-wringing over glp1s seriously. Appeals to "JUST do x" are lost in the "just" - hello if people could just do intermittent fasting, or eat less calories, well then there would be less obesity. The obesity epidemic is literally a rebuttal to any of these arguments.

Your points are just reforcing my initial point. Old paradigms of nutrition have clearly failed. If we could acknowledge that we could move forward and be open to very promosing alternative paradigms.

Which currently are not studied enough, to create clear nutritional guidelines for the public.

Gpl1 and those paradigms work through the same mechanisms action (autophagy, ketones, reducing food intake).

If there is acute problem with health such as (morbidly)obesity then gpl-1 could be a great intervention.

But its not long term solution, nutrition and a healthy relationship with food and lifestyle is.

Muscles are very important for health, but let's not go into that. For muscle size I linked to meta study about muscle size and all cause mortality (longevity)

> Conclusions: Low SMI(skeletal muscle mass Index) was significantly associated with the increased risk of all-cause mortality.

https://pubmed.ncbi.nlm.nih.gov/37285331/

> Old paradigms of nutrition have clearly failed. If we could acknowledge that we could move forward and be open to very promosing alternative paradigms.

> Which currently are not studied enough, to create clear nutritional guidelines for the public.

We have very clear, very obvious nutritional guidelines for the public, and we have lots of research on the healthy food to eat. The TLDR guidelines that would have a positive impact on most people is "eat less". Doesn't seem to work, and it's not an informational problem.

(1) its not long term solution, nutrition and a healthy relationship with food and lifestyle is.

The reality is that plenty of people will just never have this. Some people are "weak" or "genetically predisposed" or "addicted" or "impoverished" or any other number of things that people use to explain poor diet. No amount of nutritional guidelines will fix this. That's just the (unfortunate) reality. Now what do we do?

(2) GLP-1 medication (according to the article) have other benefits beyond nutrition, eg addiction, Alzheimer's, kidney health, etc. These benefits could be very real (some are still being studied). If they turn out real, how does our relationship with the drug change, how that its not just a replacement for a "healthy relationship with food and lifestyle"?

You've mentioned muscle being a proxy for health. Do you consider going to the gym and working out to be a "long term solution"? Why is spending an hour a day performing an artificial activity (lifting weights) generally considered a healthy lifestyle, but taking safe preventative medication not considered part of a healthy lifestyle?

(Generally) society considers vaccines to be safe and healthy, and we recommend them for everyone from a young age. They're obviously quite artificial, and they trick our body by stimulating certain biological pathways artificially.

What is different about certain medication like GLP1 meds that keep us from considering it part of a safe, healthy lifestyle?

The health benefits of eating less and fasting such as autophagy, ketones occurs with or without gpl1. That is how gpl1 is healthy, because eating less and fasting is healthy.

You don't have to go to the gym to activate and stimulate muscles. But our bodies are made for daily usage of muscles.

We always had downtrodden, poor, weak people, in any society. But in the 1970's they were not obese.

We dont take daily vaccins they are a intervention. Gpl1 could be intervention for obesity patients.

The danger of long term usage of gpl1 is that our bodies emerged ecosystems that we don't understand yet. By reducing hunger signals that their motivate a person to get nutrition such as protein, vitamins and minerals, etc Leads to malnutrition, muscle loss and other diseases.

Your point is that there is no problem with current paradigm of nutrition while at the same time promoting a agent that stops the addictive nature of our current nutritional paradigm.

If you use gpl-1, And it works for you that is great and we should be grateful that gpl-1 is available. My only advice would be, to lift weights or callisthenics to keep your muscle size and strength. And to explore other nutritional paradigms that can help you maintain the weight loss without gpl-1.

> That is how gpl1 is healthy, because eating less and fasting is healthy.

These medications do so much more than this. First, they have all sorts of direct metabolic benefits beyond just eating less, and secondly, studies are linking them to non-metabolic benefits too.

You don’t have to go to the gym to stimulate your bodies, but most people require it because they won’t do it naturally in their life. You don’t need GLP1s to regulate your metabolism, but it seems most people aren’t doing it naturally in their life.

In 1970s, people died of hunger. We’re also not in the 70s and won’t be going back. Our society has a surplus of unhealthy food and an uneven distribution of healthy food. The food is engineered in labs to be addictive. Our society doesn’t make room for regular physical exercise. So many things wrong, and until we start regulating the food industry, the best we can do is correct mistakes.

I’m also not sure there is any real evidence that the GLP1s are causing malnutrition because of “hunger signals”. But ensuring proper nutrition of vitamins and micronutrients is not that hard to monitor.

I’ve never used a GLP1 antagonist. I’m not one to brag to strangers on the internet, but I view myself as rather healthy and athletic. It’s a lot of work, it’s not that fun, it takes a lot of time. I just don’t believe that the only right way to be healthy is waste an hour in the gym every morning and do “hard work”. If there was a CrossFit pill, I’d be here supporting that too.

Some things (working out, vaccines) are basically just a net-good on the health of society. Why isn’t it possible that this is included in that list?

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