Now that the drug has shown you what a more appropriate portion is, do you think you can manage that on your own without the drug?
I could take more caffeine to reduce my desire for food, but it is already too close to bedtime. I could try to focus on work (I am) but I keep getting intrusive thoughts about the fact that I could just get ice cream/cookies/chicken fingers/burrito/quesadilla/insert food here in just a few moments.
I wish I could take these drugs, unfortunately I cannot. Terrible side effects.
Strangely, after visiting Japan I found it quite easy to eat a healthy low calorie diet for about two weeks. Now I’m back to constant food noise, despite trying to stick to a Japanese-style diet (lots of fish and vegetables and fermented foods).
The people who say “just eat less” don’t understand what the actual problem is.
The issue with these things isn't that they don't work. It's that people attempt them and do not go all the way. They go on a little diet in some ways but fail to account for all their daily calories from stuff like beverages or snacks, maybe they aren't weighing their food either and just assuming a lot with what they are eating. They try and work out but it looks like walking on a treadmill or moving some 5lb weights around, far from running until lactic acid stops you or lifting to failure.
I think there is a lot of misjudgement of how intense a workout really is or how a diet should look like. And that feeds into this idea that it will not work.
But, you can't argue against thermodynamics. We don't make energy from nowhere. We are bound by the same laws of physics as anything else. If you can't lose weight with how you are eating, then the answer is obvious why that is the case: you are still eating too much given your activity level.
Multiple studies prove you wrong, IRL. Humans are not isolated test guinea pigs in a cage. It is simply not feasible to live one's life by a spreadsheet of accounting values.
> If you can't lose weight with how you are eating
The problem is people find it difficult to change how they eat.
This is largely an environmental problem - observe that obesity rates vary over time and location.
It's all the fructose in western diets. Tens of centuries of Europeans eating bountifully in the fall and then fasting through winter and spring evolved metabolic reactions that fructose means "pack on weight now because we'll be needing it"
People, on average, eat until they're no longer hungry. Problem is, there's only a loose relationship between your caloric needs and your hunger response. That's how you end up with underweight people who are trying to put on muscle saying they can't possibly eat any more and still can't put on weight, while having overweight people who eat twice as much as that guy and have to actively choose not eat more. Both people can make a conscious choice to disobey their signals, just like how you can choose to hold your hand to a hot stove. But it takes a lot of energy to keep up that willpower. Effective weightloss drugs solve that problem, by treating the actual problem: the hunger.
Speed of eating might also be an underrated factor in all this. Stretching out ones meals and slowing down the pace might lead to satiety triggers coming before the meal is done, whereas if one scarfs down the plate before that signal happens, well, one already scarfed down the plate and might be working into the next before those signals hit. This meta analysis suggests this is a possibility (1).
This would be true if not knowing what an appropriate portion size is was the one thing keeping most people from losing weight. If that was the case, traditional dieting would have a far better track record with long term weight loss.
And you mention exercise, that is an excellent point. Hunter gatherers might forage for 8 miles a day, while many peoples daily walking effort can be measured in a few dozen feet. Our bodies are built to be used. It is no surprise that when they are not, systems designed for a certain baseline load are no longer functioning as intended.
(they do they're fucking called glp-1s)
Australia's health organization did a meta study on people who had bariatric surgery. They found that every single one regained 70% of their original weight after five years, even though they were physically incapable of eating the way they did before.
This happened to my grandmother, she had a bypass in the 2000s, lost over a hundred pounds, and then regained it again and was back to her original weight when she passed in 2022. The woman couldn't eat more than 4 ounces per meal without throwing up.
I lost 40 pounds in 2017 from gastritis. I kept it off for three years, and then regained 50 pounds despite starting ozempic.