Comment by sgwizdak | Hacker News Reader

Comment by sgwizdak | Hacker News Reader

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I started a GLP-1 in October. I've been eating healthy and exercising for a decade, but I was still in the obese category and blood sugar tests indicated I was at the edge of pre-diabetes. If I pushed hard on calorie reduction or exercise, I could gain 10-20% improvement, but it seemed like that would always reverse itself when I'd hit an injury or got sick. I'm hitting my mid-40s and decided it was time for a drastic change. I could have continued yo-yo dieting or opt for a solution that gets me to a healthy BMI within a year.

I gained a lot of weight during puberty, coupled with a less healthy diet in my youth. I suspect many folks are in the same boat - by the time they realize they need to eat/exercise, it's too late. Their metabolic system has been compromised by either diet, hormones, genetics, whatever.

In four months on a GLP-1, I've dropped about 18kg and since I coupled resistance training, I've increased on various strength parameters. The sudden reduction in weight has benefited my activity level substantially. There tends to be two classes of folks - those who need to stay on this drug forever and those who don't - I'm hoping in the end I fall into the don't, but I'm going to let the data from my continuous glucose monitor decide that.

I highly recommend the book "Ozempic Revolution" if you're considering the pros/cons of this path.

> it's too late. Their metabolic system has been compromised by either diet, hormones, genetics, whatever.

I do want to be clear to anyone reading: there is no "too late". One's system does not become somehow damaged at some cliff of weight and eating habits. It doesn't become irreparably meaningfully physically more difficult to lose weight. What can happen is a shift in many systems that effectively make one feel hungry all the time and psychologically react very strongly to those hunger cues, which makes people eat more. Outside rare circumstances, if you eat less, you will lose weight. I do have a lot of compassion for the psychological side of things being extremely difficult, though.

Sorry - I think there's complexity with insulin at play that you're overlooking. When I did caloric restriction, I was constantly battling hypoglycemic events that made me not want to exercise. I don't get that with the GLP-1s. In online discussions, people tend to conflate GLP-1 with appetite suppressants - but there's also insulin stabilization that occurs.

Exercise to the extent that obese people will do usually does not a very sizable impact on weight compared to the effect of proper diet, and weight loss is very achievable with zero exercise.

My dad was in a similar situation a couple months ago. He has been very obese for decades, which started after he stopped smoking. He does not eat fast food, has long ago cut out sugar and he favors whole foods in his diet. It was getting a shock blood sugar result and diabetes warning that pushed him to take Mounjaro (similar to Ozempic) that actually cut his weight down.

In his own words, what he noted as being the main contributor to his obesity was the moment to moment urges to just eat something (I empathize with that a lot - I'm also obese). Losing that desire made sticking to good portions and fixed calorie intake windows much easier. He has lost ~50kg of weight in the last year and now walks and bicycles around everywhere for hours every day.

I wish you luck!

Awesome, happy for your father!

Wdym you were eating healthy for a decade and still obese? How does that work. A diet where you eat to obesity isn't healthy.

And how did surpressing your hunger via GLP-1 drugs (a pure change to a more healthy diet for you) lead to big changes, if you apparently already had such a healthy diet.

Seems to me your diet was unhealthy for a decade and now isn't.

Think of it this way - once you're in a state of obesity, resolving that situation is quite difficult. Eating healthy may not be enough, particularly if there are other metabolic issues going on.

The imbalance of fat to muscle leads to insulin resistance. Insulin resistance gets in the way of weight loss. After a long time of trying other means, I decided to directly tackle the insulin resistance problem. And it's been the only thing that's worked.

Agreed, but thermodynamics (calorie in/out) still holds. If you actually eat healthy (say 2500 calories), you will lose weight if you're obese and need >3000 to maintain weight, period.

Sustaining that healthy diet is harder insulin resistance, agreed!

But you said you ate healthy for a decade. To me that's not eating obesity-maintenance level amounts of otherwise healthy foods, but rather eating healthy foods at a normal (say 2500 kcal daily) amount.

In other words, under your statement the behavioral impact of insulin resistance was already overcome, you were eating properly, and still didn't lose weight. And that's just not conform the science, which states that you lose weight even with high insulin resistance, as long as you're eating healthy (i.e. in a caloric deficit vis-a-vis obesity level maintenance).

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