The Physicians Are Healing Themselves, with Ozempic
nytimes.com
nytimes.com
My guess is that it's the amount of sugar, salt, and fat in Western food.
If it works for them and has 0 negative health effect, good for them, but philosophically it opens up a lot of questions
No one is saying that being overweight is healthy. Most of those social campaigns were saying that we shouldn’t shame people for their body.
Also, plenty of studies have shown that weight control isn’t as simple as self control. Different people have different bodies that react differently, and plenty of people have other conditions that limit their ability to control weight.
Gaining weight is easy, and losing it is hard. The body evolved to treat a caloric deficit as literally painful. And losing significant weight requires months or years of deficit, which is months or years of pain. That’s tough to overcome with “a little bit of hard work and self control”.
Anecdotally, I’m a perfect example of this. I used to be a runner, and thin. Then I got sick, and my BMI doubled in months. It’s taken at least a year to undo months of illness. I can’t imagine what someone with chronic illness, or even more weight must go through. I live in a city and walk instead of drive, but not everyone has that lifestyle and it’s not a easy thing to change (“why don’t you just move a long way away to an expensive place and sell your car”). Of course, you should not require someone to do everything just right on paper for their views to be valid. Plenty of people struggle with the motivation, time, or finances to make healthy decisions, and those people are real and should be supported too.
It’s been studied and proven ad nauseam that food can be addictive and that addictions aren’t a matter of “self control” the way people want it to be.
Uh...
https://www.uchicagomedicine.org/forefront/health-and-wellne...
> Yes, you can be overweight and metabolically healthy. At the same time, we know that obesity is a disease that affects the body in many different ways. Thirteen types of cancer and 200 other health conditions are related to obesity.
> Those numbers [weight on the scale] directly correlate to life expectancy.
Also note, metabolic health doesn't mean "will live a happy and long life with good statistical outcomes for other areas". It mostly means things like "you're not anemic, not diabetic, you have acceptable cholesterol, etc." it doesn't mean "your knees will be fine as you age" nor does it mean "you are at a similar likelihood to develop cancer as someone who is not overweight". It's a pretty narrow definition that's focused on the hyper-immediate.
I stopped taking tirzepatide in September after losing 60lbs. Except for a blip at Christmas I am eating the same things and same amounts that I was during the weight loss with glp1 and I am steadily putting on weight, there is definitely something else going on and yet for the 20+ previous years where I've struggled to lose weight I've been told that I'm just not counting calories right.
As you said the first time I felt really full was on these drugs, and the lack of food noise - which is slowly returning but not as quickly as I thought - was wonderous.
On the other hand, studies have shown that almost nobody can count calories right, so it's probably useless to try and rely on outside of basic order-of-magnitude kind of things.
Perhaps they're just depressed and obesity is part of a vicious cycle of seeking comfort in food and feeling bad about themselves afterwards?
Every one of the BMI 40+ people that I've met had unresolved issues. Sometimes it makes them say things which are difficult to understand from a healthy person's point of view.
It is amusing in some way that that doesn't get as much press as all the weight loss and prettification.
(1) https://www.drugs.com/sfx/ozempic-side-effects.html scroll down to serious side effects and note it leaves a very serious side effect https://www.drugs.com/medical-answers/ozempic-cause-muscle-l...
Another part of me wonders if all the ozempic headlines I've seen over the past few months are just an incredibly effective and well orchestrated ad campaign.
Ask your doctor, you may be suffering from acute advertisement-induced judgment impairment.
After years of talking about the overweight epidemic, there's now medication that solves it. It's impossible not to talk about, whether your angle is "too good to be true" or "amazing step forward for humanity" It's ripe journalism bait and if a journalist decides to investigate they are going to write an article. Even if they don't find anything of value.
That said, as someone who prefers to stay fit the hard way (exercise, sleep and balanced diet) I would never take a drug to stay in shape or for that matter anything else that could be mitigated by lifestyle changes. About 11 years ago I was prescribed hypertension medication, I never went to the pharmacy to pick them up, instead I reduced my weight, started meditation and improved my cardio exercises and my hypertension is under control now. I know eventually I might need the drug (hereditary) but I will delay it as much as humanly possible.
To each their own I guess.
Not everyone can control their health issues through lifestyle changes alone. I successfully controlled hypertension with an hour a day of running but that's just not sustainable and I barely controlled it anyway. As I reached 50, my genetics and age caught up with me. My father and all my siblings take drugs for hypertension and now I do too.
Similarly, my wife, who I've known since we were teenagers, fought her weight as long as we've been together. No amount of weight watchers, calorie counting, eating well and exercise allowed her to maintain a healthy weight. It's also exhausting being hungry all the time and fighting against your increasing weight. About two years ago she started Wagovy for legitimate health reasons. It's changed her life. She still exercises, eats well, and counts calories. What the Wagovy has enabled is for it not to be a constant battle with herself. She's not hungry all the time now maintaining a healthy weight.
Unless you've really fought these battles, you don't know what other people are going through.
On one hand I couple probably benefit from it. I'm about 80-100lbs over where I'd like to be but I recently lost 50lb (so I was 130-150lbs away before) without any drugs (and I have lost weight in the past successfully and kept it off until I got lazy). I think it comes from a combo of "If I don't need to rely on something I'd rather not" and "It feels like cheating". Digging into both those ideas comes up rather... empty. Neither are great reasons and so I keep mulling over "should I try it?".
The only thing I'm fairly certain on is this: These are not meant to be "forever drugs" but many people will/do treat them as such. My understanding (which could be flawed) is this is a "3-12mo"-type thing. I really don't know how many people are using Ozempic and friends as "This is going to help me get on track" and "Look at this magical drug that makes me lose weight", I fear it's largely the second group.
running 8 km (or 5 miles) a day, you can lose 1 kg in 2 weeks. 110km/kg or 0.11 km/g or 110 m/$ or 0.9 cent per meter.
In fact it is one of the insidious things that gaining weight forms a vicious feedback loop.
Also, often enough when people start exercising to lose weight they overcompensate by eating more and getting even more weight.
Finally, the "diet and exercise" advice is clearly misleading as paid for by the sugar council. For almost everybody, our weight is dominated by what we consume. Some people can get out of this by exercising a lot, multiple hours a day, without getting injured or overcompensating, but that is not enough people to matter compared to the diet pushed on people.
The first step to making America healthy again would be to criminalize adding sugar to food-like substances
> Many overweight people simply cannot run that far even if they wanted to.
If that is what their doctor says.
https://thewiredrunner.com/running-when-you-are-overweight-h...
> In fact it is one of the insidious things that gaining weight forms a vicious feedback loop.
You get enormous muscles form all that weight and burn a lot more.
> Also, often enough when people start exercising to lose weight they overcompensate by eating more and getting even more weight.
Don't worry about it. The goal is health. You should eat more or you get sluggish, weak, fail to recover, get injuries and quit.
> Finally, the "diet and exercise" advice is clearly misleading as paid for by the sugar council. For almost everybody, our weight is dominated by what we consume.
Agreed, it's a pretty dumb abstraction.
The funny thing tho is that at some point in the training the lack of consumption becomes a problem. Some marathon runners and some bodybuilders require 4500 kcal per day. Long before that people are trying to eat uncomfortable amounts of food. Good food of course, not random trash.
Fat people already have enormous muscles and a trained digestive system. Switching to jacked isn't far away. If you grab a random 90 kg fit guy from the gym and put a 50 kg backpack on him his "running" wont be anywhere near that of a 140 kg couch potato.
https://www.youtube.com/shorts/94xlCEJaVeg
Ill message him and ask him to run... haha....
> Some people can get out of this by exercising a lot, multiple hours a day, without getting injured or overcompensating, but that is not enough people to matter compared to the diet pushed on people.
I actually think that if you go all out on the exercise bike for 8-15 seconds and do a single 1r max deadlift per day people will be very surprised what happens. It is dramatically more than not doing anything. No cheating, it has to be all out on the bike and if you can lift it twice put more weight on it. Put the bar and the bike in the middle of the living room as an internal conversation piece.
I think one will find that the internal protest starts around 10 seconds per day not hours.
Getting to these 8 km is a rough journey for someone who is overweight and their food intake is the first reason for their problems. Lack of sport is rather the effect.
It is like saying that simply building the CERN accelerator will give you a PhD.
Also, running (rather, jogging) isn’t terrible aerobically taxing, if you can’t keep up a convo, you’re running too hard.
Once you’re used to running, it’s an insanely efficient way to create a calorie deficit. Not the most glamorous exercise, but cheap, easy, requires no significant equipment and most all, incredibly time efficient.
1 kg worth of body fat is about 7700 kcal or 7.7 kcal per gram. One m&m is about 3 kcal, if you run 35 meters for each m&m you can eat the whole bag :) You don't have to eat the whole bag.
If you gradually build up to 8 km/day it isn't very likely to kill you. 1000 dollar/month however... If 110 km in two weeks takes more than 2 hours/day you aren't really jogging. 28 hours in two weeks is $35.72 per hour.
That is a Gift Jar in Snowflake Gift Tube per hour!
https://www.mms.com/en-us/gifts/gift-jar-in-snowflake-gift-t...
The doctors are accomplished and astute.
ps: feel free to explain your downvotes
I am not diabetic and not insulin resistant so that totally helped.
My sleep apnea and IBS has been virtually eliminated altogether.
I do know other people who are on the medicine but haven't taken the proactive approaches like I did to properly track their food and incorporate exercise. So they'll never fully realize the weight loss benefits until that changes or they'll continue to take the GLP-1.
Former weight = 255 lb
Current weight = 212 lb
Goal weight = 185 lb
I have a secret that I use to keep myself healthy because I watched as most everyone else in my family struggled with obesity and its related health issues.
But your comment reminds me of the times I overhear the ladies in the office trash-talking another coworker who decided to lose weight and become healthier. I've honest to god heard morbidly obese coworkers try to justify their size and claim that they are in fact healthier than our skinny coworkers.
Whats your secret?
My secret is “self respect.”
That’s all I used.
Are you saying that overweight people lack self-respect?
It gets somewhat preachy to promote that one should practice delayed gratification instead of YOLO.
Your knees are significantly more likely to work well into old age if you’re active, but not constantly supporting excess weight. Talk to any orthopedic doctor and they will tell you weight loss makes your lower body joints much healthier in old age. Not to mention the natural increase in activity people experience when they are lighter and walking is less of a chore.
Having healthy lower body joints makes you much less of a fall risk.
Being less of a fall risk extends your lifespan quite a bit once you’re around 60-70.
Being overweight is one of the most objectively bad for you things out there, but it’s a shame we all share (75% of Americans are overweight and way even higher you look at people old enough to be doctors).
The entire point of this article is now that it is something treatable through medical science, people who understand the major health downsides of being overweight are treating themselves.
Yeah I don't buy it. The dude in the pic went from slightly chubby to thin as fuck, nothing prevented him from updating his diet, especially as a doctor
Of course the result overall is better, all I'm saying is that it's far from a magic pill if you keep everything else the same
https://www.niddk.nih.gov/health-information/weight-manageme...
Note that the list of diseases in that article includes every single one of the leading non-injury causes of death:
https://www.cdc.gov/nchs/products/databriefs/db355.htm
(partially excluding cancer, and excluding flu, which does have a higher mortality among obese patients)
Yeah, the same one that made them obese... if their normal appetite was fine they wouldn't have a problem to begin with
https://pubmed.ncbi.nlm.nih.gov/35441470/
> One year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss
> Findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health.
You need a complete change of mindset, of routine, of relationship with food, of relationship with your body. If you keep everything the same as soon as you stop the treatment it's game over. And if you manage to change all of these things you don't need the treatment to begin with. We treated my father in law, by explaining him about calories, exercise, &c. He lost 40kg in a few years and will never gain them back, because he isn't relying on any magic pills.
Check reddit, it's full of people stopping ozempic and telling how they gained it all back and couldn't stop
https://www.reddit.com/r/Ozempic/comments/15lgnnc/i_now_unde...
> My Endo halved my dose recently and I gained 10lbs in about 3 weeks on a half dose despite no changes in my food intake.
> About 10 days after my last dose, I suddenly became voracious. It was like my hunger came back with an insane vengeance and I physically couldn’t stop myself from overeating.
> I've been off Ozempic 2 weeks and yes the appetite came back
https://www.reddit.com/r/Ozempic/comments/1h49urx/weight_gai...
https://www.reddit.com/r/Ozempic/comments/1g1xa8l/rebound_we...
What the treatment does is enable me to change all of these things. I don't let food control me because I no longer get extremely cranky when I haven't eaten in 8 hours. I eat a balanced healthy diet because feeding my hunger no longer requires 1000 calories of carbs. I listen to my body because the voices saying "drink some water" and "get up and stretch" are no longer drowned out by a troll demanding that I go eat 3 cookies right this second.
Even if it were, many people would happily trade addiction for a dependency.
"Hey buddy, looks like you can use some help. I have a medicine here that can help you live longer with a better quality of life, and a boost to self-esteem but its gonna require a subscription."
Is it silly to think many people would not enter this non-binding agreement that can be stopped at any time?
> One year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss
> Findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health
I think diabetes doesn’t have a max treatment recommendation because most of the other interventions choices are also long term.
Yes, people will probably have to bounce on and off them, but that's not the same as a lifelong addiction.
Not sure what your beef is, they work, they're helping millions get healthier and live longer.
Was watching some comedy specials lately and looking into the crowd it’s quick to realise what a blessing these working weight loss drugs are for the US.