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Comment by armchairhacker | Hacker News Reader

Why don’t governments pay for free GLPs for everyone overweight? They overrepay for themselves by reducing medical care.

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It's much more effective to address the obesity problem on the front end.

We have fast food and junk food advertising targeting kids. Kids are driven to school instead of walking or biking. School lunches are optimized to be cheap not nutritious. Pediatricians have to tap dance around weight. When the Obama Administration tried to push for healthier lunches there was pushback from the right over government bad, from industry over higher costs, and from school districts over costs. Healthier food for kids could not win a durable political coalition!

Why not both? Because we’ve been “addressing on the front end” for a while without results. Making places walkable and getting (especially already obese) kids onto healthy food are things we should be doing, but need more support and take longer than a drug, which admittedly has side effects but seems healthier than waiting.

And Obama’s healthier lunches received pushback because they had some stupid requirements, like reducing salt intake, and poor implementation: maybe not Obama’s fault, but should’ve been addressed, IME students were forced to take a fruit or vegetable they would just throw away, and sometimes the “fruit” were these gross bananas that were simultaneously green and brown/mushy. They also received pushback from kids themselves and their parents.

> We have fast food and junk food advertising targeting kids.

The government is also heavily subsidizing corn, which made corn syrup the cheapest sweetener.

> It's much more effective to address the obesity problem on the front end.

Is it? GLPs cost literally pennies to manufacture in bulk. The government could easily justify a trillion to just buy the rights and give it away for free and still come out ahead on healthcare cost savings.

Everything your suggesting sounds like a lot of work by comparison.

GLPs require some good dietician advice to be given and followed to be effective, otherwise you are just trading off obesity for an eating disorder. You really have to do both, provide the high protein + high fiber food alternatives and the GLP to make cheating less likely.

Have you taken them? Because I see this “you still need virtue^Wdiscipline” refrain a lot, but it doesn’t match my experience or that of many others I know who use GLP-1s.

For me, I lost 50 lbs not exercising and not actively managing my diet. I felt better and all my biomarkers got better (blood pressure, cholesterol, etc.). Later, I started to exercise and cleaned up my diet because I wanted to. Healthy food just tastes better now, and moving my body is satisfying rather than tiring. They are the closest thing to magic I’ve ever experienced.

I'm talking from direct experience here. Although I'm over 50 (years, not lbs) so that definitely can make my experience different from yours (assuming you are younger, but that's just an assumption, my health/body could also be different).

Also, constipation and muscle loss are real issues. Protein and exercise will help with muscle loss (well, I haven't really started weight training yet, just aerobic), but you need to up your water and fiber intake or you could be in for a very hard time. I'm glad that this didn't happen to you, and that you didn't have to take an emergency trip to the drug store to figure out what an enema was (and how to use it, ouch).

I'm in the same age range. Never had those issues (with GLP-1s, anyway) and I'm sorry to hear you did. Fiber is good regardless :)

On each ramp I had constipation issues, but they seem to have mellowed as I got used to the dose. The dietician has been really useful, I recommend that anyone who wants to get started with this look into a video consult (no need to attend in person), insurances generally cover the dietician faster than they will your GLP dosage, and they are good at providing solutions to balance out your diet long term if you can't figure it out on your own.

That's not even vaguely true a low dose is effective enough at reducing hungry enough to get slow and steady weight loss and require zero planning or effort on the users part.

The only time you need a dietician is if you want a high enough dose you barely want to eat at all.

I can't imagine the military wants a fighting force dependent on a consistent supply of GLP-1s to the front lines.

Because the political will doesn't exist. Because being fat is portrayed as a moral failing. Because the Protestant work ethic's[1] virtue of self-discipline extended to health and eating. I guess it's kinda strange to carry the mantle of the protestants without being protestant one's self, yet it happens.

1. https://www.researchgate.net/publication/249628161_The_moral...

Kind of hard to feel sorry for the richest country in the world when they refuse to spend enough money to take care of their people enough to even meet basic national security standards.

Taking care of them was historically about calorie and nutrientmaxxing. Subsidized calories have worked too well, worldwide, and there's no response to it within the current Overton window.

Being fat is a moral failing though? It’s also not portrayed that way, see the entire body positivity/healthy at every size movement.

What do you think that was in response to?

Half the country being fat and not wanting to take responsibility?

Right. Fat acceptance was created in response to the sentiment that you're expressing - that it is a moral failing (responsibility).

Taking responsibility for the tremendous surge in highly-calorific, ultra-processed food over the last forty years or so?

And these calories are in the water supply? No, the fat people choose to buy and eat that food. I'm on a 700C deficit right now, it's not very fun, but it works because I have the discipline to not order a pizza.

It can be, but so can existing as an ordinary citizen and not devoting your life to activism, abstaining from everything but the most sustainable resources. Some people lose or maintain weight with zero effort, while some have significantly lower TDEEs and experience actual Minnesota-starvation effects, so I disagree. At least make the moral failing not doing the basics, like planned meals with whole foods and some amount of exercise, so it’s fair.

Anyways regardless, morality is irrelevant here. The rest of society would be better off if these people lost weight, and I doubt forcing them would go well, but voluntary GLPs would.

Hell, let's just reduce the Medicare eligibility age (alllll the way down) so everyone can afford the care they need or would benefit from.

Medicare is currently something like 14% of the budget and covers 20% of the population.

The least healthiest 20% of the population. Old people use much more medical care.

Personal healthcare spending is estimated to have been 4.5T in 2024. [1] Total revenue was 4.9T that year. [2]

[1] https://nchsdata.cdc.gov/dqs?topic=personal-healthcare-spend...

[2] https://en.wikipedia.org/wiki/2024_United_States_federal_bud...

to be fair if everyone was paying 10-20k less in private healthcare thorough their employer you could tax that amount

Ironically that GLP-1 blocker prescription would potentially make you ineligible. You have to take that pill for the rest of your life, and the military generally doesn't want to deploy combat troops dependent on a consistent supply of non-life saving medications.

There is no value for a government in long-term thinking, if the electorate only votes on short term issues.

This may be true, but I think the electorate would go fucking bananas for free GLP-1s.

Why only GLP? Same logic can be applied to all preventive care

True, but GLPs in particular are obvious.

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