cthalupa

Trigger warnings have been quite heavily researched at this point and at best they seem to have no positive impact to overcoming traumatic events and a some of the studies have shown them to be a negative.

Put 'scientific support for trigger warnings' in your favorite search engine and you'll find meta-analysis, RCTs, other types of studies, reviews, as well as discussions from the APS, other psychology and psychiatry related publications, etc.

This isn't to say removing trigger warnings is a replacement for actual guided therapy, exposure therapy or otherwise, but it doesn't seem like it would be a negative outcome for long term mental health and would be a benefit for anticipatory distress and potentially in combating avoidant behaviors (though not all studies universally found them to increase avoidant behaviors - just some)

This is a separate question than when it comes to general polite society and social expectations and what is and isn't considered a courtesy. The studies also aren't dealing with people that have just gone through the traumatic experience, so you could make a reasonable argument that exposure to something still fresh could have a very different impact.

The problem is they are explicitly arguing that all of our best science is that trigger warnings are counter productive for getting better. Just a quick google search of 'scientific support for trigger warnings' will get you all sorts of meta analysis, RCT results, etc. on this. At best they don't seem to actually do anything, and at worst, they actively impede your ability to get better.

That doesn't mean it's a matter of willpower, but it does suggest that avoiding your triggers or trying to use trigger warnings to prepare you for dealing with them provides no benefit. Your use of the word avoid pretty much sums up the core problem here - on a personal enjoyment of day to day life level, avoiding your triggers makes perfect sense. On the long term healing and not being traumatized by them level, you don't want to do that. (Edit: This isn't to say try taking exposure therapy into your own hands and just surround yourself with the stuff. None of this is a replacement for guided therapy. But specifically going out of your way to avoid these things is 'avoidant behavior' and is pretty much universally recognized as being a bad thing when it comes to dealing with PTSD etc.)

That being said, I believe everyone should be able to disclaim what they want and that people can choose how they approach their own self-care, even if it isn't supported by the science.

Today's game can be just as much roll-playing, it highly depends on the group. One of the things that drove me back to B/X and ADD was the sheer number of min-max players and rise(!) of murder hobos in 5e vs. even 3e/3.5/pf1

Most of the early old-school stuff was way too deadly for players to be murder hobos or try to solve everything with combat - if you went into Caverns of Thracia at level 2 as a murder hobo you're just going to die over and over and over again. It'll be endless TPKs. Right now I'm two years into DM'ing an Arden Vuul campaign, running a mix of OSE (Streamlined B/X) and OSRIC (ADD 1e) rules, and it's really only the past 6 months or so that my players have felt comfortable engaging in regular combat - before then they might have spent a whole session or two trying to stack up every advantage they could because they never wanted to be in a fair fight.

And from my experience with a whole lot of OSR play over the past 6-7 years is that this is the sort of feel most OSR players are after. They're not wanting to play late ADD 2e, Dragonlance era, where the shift to the more heroic play started happening - they want to have to think and outsmart things. Faction interaction was also huge in the more sandbox environments, and that was where most of the roleplaying occurred then, and occurs now in the games I run. The players RP a bit with each other, but not as much.

Modern D&D is a kitchen sink approach that tries to solve every possible playstyle, and that makes it popular and reasonably good at most anything people want to do with it. But I don't know that there's any facet of it that it does as well as other systems.

> Mac Mini M2, Sequoia.

It's Tahoe specific

https://news.ycombinator.com/item?id=47670995

I'm pretty certain I've run into this a couple of times now since upgrading to Tahoe last year and had been wondering what the deal was. Had never thought to check the uptime and make note of it, but I basically never shut down my laptop.

> But they are ineffective outside clinical trial setting for treating obesity.

This is one of the wildest claims I have ever seen on this website.

Would you claim insulin is ineffective outside of clinical trials for treating type 1 diabetes because people have to keep injecting it?

We have no specific reason to believe there are concerns with GLP-1s for cancer or anything else, beyond the mildest signal in rodent studies around thyroids.

We do not have robust clinical data for things like BPC-157 but we do have strong preclinical data and an understanding of the mechanisms in play.

I use BPC-157/TB-500/Ghk-CU/KPV - so I'm certainly OK taking the risks. But those mechanisms mentioned before? The same things we're counting on for healing and inflammation reduction are the same things that we know can cause an increase in tumor growth rate and chance of metastasizing. VEGF/VEGFR2 expression are even suppression targets for some cancer therapies.

Are there powerful and useful medications out there, available today, that we both don't have good scientific data on and are free enough of serious side effects? For sure! Is everything out there that, though? No. Some things that work will have too serious of a side effect profile to be feasible. Some things won't work at all, despite however much anecdata is out there.

As for the general idea... I agree there's no law that says a medicine with a strong positive effect must also have strong side effects. And we have plenty that don't - statins, particularly the latest generation, like pitavastatin, are effectively side effect free for the hugely overwhelming majority of people and have great lipid lowering effects. Even older ones showed extremely minimal incidents of things like muscle pain - a vanishingly small number of people relative to the total amount on the medications report muscle pain, and when investigated, quite a lot of even that ends up being unrelated to the statins. Yet the narrative persists that make it sound like anyone on statins is going to have their muscles ache 24/7

It is still wildly popular.

But it is wildly less popular than it was and demand is well below what they built out supply to meet. Even without the tariffs the industry was going to have a major contraction and the tariffs have made it even worse.

Bardstown literally has their production line workers doing yardwork and other random tasks to keep them on payroll while not running production.

I believe that was the point being made.

I generally agree that Americans tend to downplay the impact of Russia in WW2 but there is zero chance Russia would have won the war without the US. Even Lend-Lease going away would have resulted in a loss. Both Stalin and Kruschev agreed there.

The British Commonwealth was the biggest factor in Africa, but it's questionable how quickly they could have won out and taken the Suez without the Americans coming in late in 42, which was critical for both vital supplies like oil and also invading Italy. Japan was already getting bogged down with China and even Burma so they wouldn't have suddenly been free to do much in the European theater but just getting Italy out of the fight and forcing Germany to replace their divisions elsewhere. Italy exiting the war removed 30+ divisions between the Balkans and France, while another 70 Axis divisions were being held down by Allied forces in the Mediterranean during D-Day, with there being 33 Axis divisions in Normandy for D-Day itself. A lack of US involvement also likely means that Germany is able to hold Caucasus for longer (and take more of the oil fields), solving a sizable portion of their oil shortage issues.

With Lend-Lease but no active participation in the war from a military deployment standpoint, the UK and USSR do likely eventually win but at much greater cost and not without risk of losing. Without Lend-Lease it is highly possible that the Axis wins, at least in the European theater. Japan had kind of set themselves up to lose from the start no matter what the US did.

That's the official line.

The reality is offeason testing is incredibly rare in general and people always seem to have an uncanny ability to be hopping on a plane to another country right before WADA shows up at their home.

Neil Armstrong dealt with drugs with different half lives than AAS, but he still could have been tested at times where they would still be in his system... yet how long did he get away with it? While being tested far far far more frequently than, say, an MLB player.

You'll notice more a decent chunk of the MLB players that get popped get popped for PCT drugs at the end of the offseason - ran their cycle too long, decided to PCT instead of just go cold turkey, and next thing you know, Profar is getting popped for hcg and Severino for enclo.

Your body doesn't enter starvation mode until you are in the 4-6% body fat range no matter what your diet is.

I linked 3 reviews/analysis of a large group of studies.

Your study also doesn't argue what you think it argues.

> A total of 33 studies were analyzed, revealing no significant differences between the KD and other diets in muscle mass

But fundamentally it is not a meta-analysis of people on weight-loss diets, it is a meta-analysis of people on keto. Look at the included studies - nearly half of them were on athletes. They weren't tried to lose weight - they were just eating keto. No one is saying that maintaining on keto is going to cause muscle loss.

Your confidence is the problem here - you're throwing around a bunch of words you don't understand and linking studies you didn't read.

Obviously the calories in are greater than the calories out if the diet doesn't work.

That's not the point.

The point is the vast majority of overweight and obese people try to diet and do not succeed in it.

The best part is that Ukraine wanted to sell us their anti-drone tech to us a year ago and Trump and co didn't see fit to pursue it.

Did they not know that the Shahed-136 has seen massive fucking use in Ukraine by Russia? Did they not think that Ukraine now being able to shoot like 75%+ of them down might be an indication that, if we are planning to start some stupid pointless war with the country that makes these drones, it might be a good idea to have that same capability?

Or did they think we have an infinite ammo cheat, and we can just launch an infinite number of missiles that cost millions of dollars to shoot down a drone that costs tens of thousands?

We had literally years of intelligence on the capabilities of these drones. The admin claims "We thought it was Zelensky being Zelensky. Self promotion" - but we know how successful their anti-drone capabilities are. We have the data! YOU JUST HAD TO TALK TO THE PEOPLE TO VERIFY IT. The sheer incompetence of these people is astounding.

Look, if Gordon Chang and Peter Zeihan continue to predict China will fall for long enough, someday they'll be right. Maybe. Probably.

Literal neo-nazis have existed within the administration at relatively high levels (and likely still do, though they've gotten better about not outright bragging about it like some of those dipshits). People at even higher levels talk about conversations with literal neo-nazis, how they listen to their podcasts, etc. I'm not using this in the "I think everyone that has even remotely fascist tendencies is a neo-nazi" manner, I am using it in the "No these people are literally self described neo-nazis" manner.

The reality of the USA post WW2 is one that is full of plenty of shame. It still might be the most harmless empire there ever was, but that's a relative statement - the US has done * a lot* of harm. Perhaps a lot of good, too. Maybe even more good than harm. But almost all of that harm was unnecessary. But the past is not the future, and the present shows us marching to a darker and darker future.

Better to raise the alarm now and stop that descent rather than letting it continue.

Diversity of views doesn't mean the tolerance of all views.

It is fine to be intolerant of intolerance.

I was really confused by this because I've spent about 6 months of my life in Tokyo and got very very very few disposable chopsticks at restaurants a tier above, like, shokken ramen shops.

But the internet informs me that the composite chopsticks that I am used to seeing went away during covid and now disposable wooden chopsticks are the norm.

> I suspect you have no idea that your body has two independent energetic circuits - one driven by insulin and glucose, the other driver by ketones.

I am fully aware - I have spent several years of my life following a ketogenic diet. None of that is relevant for "starvation mode" and insulin within that context. I was replying to your specific points - not providing an explanation on how ketosis works from end to end.

Unless you are claiming that your body just doesn't produce glucose/glycogen and insulin when in ketosis? Which would also be incorrect.

> Muscles obviously need glucose for their best performance which is why strength training is not recommended during ketosis;

Strength training should 100% still be done in ketosis/while following a ketogenic diet. It will be suboptimal compared to a regular training, but being in ketosis doesn't magically make resistance training optional if you want to be healthy.

> OTOH ketosis is naturally muscle-sparing.

It is not and the study links in my post show consistent data here. There might be an exception if you are an endurance athlete but that is based on far more limited data than the rest of the research. So... if you're a high level endurance athlete that is also somehow fat, keto might be a better option when it comes to sparing muscle, but for the rest of us, not the case.

I'm not knocking anyone meeting their goals without GLP-1s. It's obviously possible in absolute terms - people have been making great body transformations for as long as we've had fat people.

But everything you did, plenty of people try to do and fail at it. You are making it sound like this is all it takes and that it's easy. It might have been for you! But it might not be for other people.

The fact of the matter is the overwhelming majority of people that are obese and go on GLP-1s have tried other interventions before and failed at them. ~70% of all obese people have tried to lose weight in general, ~50% have recurring attempts, and while I don't have stats to back it up I am confident that the sort of people who are willing to go and inject themselves every week are the sort of people that have tried to lose weight in other ways.

> probably way harder to commit to.

A subcutaneous injection once a week is nothing. Dealing with constant food noise? I could maintain that if the rest of my life was stress free, and that's how I would drop 30lb. Once stress came back? So did the weight. Because for me, rearranging food doesn't matter if I still can't stop thinking about it even if I'm not actually hungry.

I'm on reta. It does barely anything to suppress my appetite - physical hunger has never been my issue. And I can easily eat however much I want - most days I am below 2k calories, but Saturday was an annual event with friends and I'm sure between food and alcohol I was probably at 5k calories for the day. But what reta does, is absolutely murders my food noise. I don't think about food constantly. I don't go eat because I got bored. The only thing I have to commit to for it is, once a week, put a needle on my injector pen, twist the dial to the right dosage, poke it into a spot where I still have subcutaneous fat, depress the twist top. Once a month I reconstitute a new vial.

Pretty much every adult fat person has attempted diet and exercise to resolve their weight issue.

Saying they should try this first at this point in the game is like having your support case escalated 5 times already and them saying "have you tried turning it off and on again"

This is a bunch of pseudoscience.

"Starvation mode" as people talk about it is generally nonsense - the exceedingly low bodyfat you mention for keto is the same place you would see it in a non-keto diet when we talk about actual starvation mode and not whatever you're talking about with a non-ketogenic diet.

The only real difference when it comes to the biology here is that fat mobilization into glucose is significantly slower and less efficient, which keeps your blood sugar levels more constant, which results in fewer post-meal food cravings. Which isn't nothing, but it's not muscle sparing in and of itself.

We have plenty of studies here. Keto diets are not better for sparing lbm.

https://pubmed.ncbi.nlm.nih.gov/38934469/

In fact, if you already have significant muscle mass, it might be worse. Glycogen is hugely important when doing resistance training, and keto significantly impacts your glycogen stores. People perform worse with their resistance training on keto than regular diets.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9244428/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8469041/

Muscle loss is determined by your protein intake, muscle stimulus, and rate of weight loss. Plenty of people start lifting for the first time (or after having stopped for extended periods of time) when going on GLP-1s and actually put on muscle mass.

It might result in more loss of buccal fat than otherwise but even that is not definitive. Activating the receptors is not the same as burning fat - there are GLP-1 receptors all over your body in all sorts of organs. If you activate them in your brain you're not burning your brain for energy.

> I'm saying that healthy habits are simply a matter of understanding.

Plenty of people have heard everything there is to hear on this, understand it, and still fail to implement it.

> I did not change my diet.

You plainly did. You do not lose weight without your diet changing.

> If anything I just added more variety with a specific intent and it worked.

This is changing your diet.

> Even just changing the order in which one eats things (fiber before sugary foods) can make a big difference

Changing your diet to eat more filling foods is a very frequently recommended thing, yes.

> Once I got the blood glucose under control all the strong cravings and eating mistakes basically went away on their own without my conscious effort.

My blood glucose has always been excellent. It did not stop me from having food noise and cravings.

It's always wild to me when I hear about how different the culture is between Osaka and Kyoto when they're so close.

> Now there’s something we agree on. If only we could agree that no one is stuffing cheeseburgers down people’s throat other than themselves. So close.

No one is saying that it is forced. What I am saying is that your sense of moral superiority for the fact you aren't is misplaced.

Let's give you an anecdote: Up until 18 or so, I was a stick. I went from being a stick to getting into powerlifting. I spent the first chunk of my 20s with a pretty great physique. Then as I had more and more responsibilities in life, I had less and less bandwidth to apply to things like cooking, exercise, etc. I slowly lost muscle mass. I slowly gained fat. I had never had food noise when I was skinny - I had never compulsively felt the need to eat, regardless of hunger. I had never had food just constantly occupy my brain. After my slow descent into obesity, something fundamental about my relationship with food had changed. When my stress was lower and I was skinny or later fit, staying that way was easy. It didn't require great mental fortitude, massive discipline, any of that. And when I got fat, it wasn't because I was craving food - it was because I had shit to do and couldn't take the time to cook. Or because I was going outwith friends or my SO and eating out was a huge part of my social life.

When I looked at myself and decided I had to change, I though I just needed to stop doing those things. Stop going out, force myself to take the time to cook and let other things fall on the backburner, etc. Except now I thought about and craved food in a way I never had before. I went from thinking exactly the same as you to realizing 'Oh shit. This wasn't as simple as I thought it was.'

I lost weight plenty of times. Significant weight - not just a few lb, but 30+. Multiple times. And then I'd get busy at work, I'd have family members going through problems and need help, I'd have a rough patch with an SO - as soon as my mental bandwidth got divided, the weight loss stopped and regain started.

Even if an individual is just always able to resist, it's almost entirely based on their genetics. If you want to feel superior because of something you had no control over, I guess that's your perogative.

> Once the shame around disgusting fattening food has reached a critical mass the problem will solve it self.

I think shame is a useful human emotion. We evolved it for a reason. But we also know that it has limits and that once those are reached more shame on top, it becomes counter productive.

> Ironically the excuses you make for them only worsen the issue. If fat people and the food they ate were appropriate shamed they both would cease.

No. Fat people experience plenty of shame, and for a huge amount of them, it only worsens the problem. Once you shame a person too much - once you make it about them and not about the action - they start to feel that they are unable to make a change because they have less worth than those people that can, and often end up losing even more control in their relationship with food or whatever else they are being shamed about.

> FYI in Japan fat people are ruthlessly bullied. Fat people are rare. Food for thought, pun intended.

This is not universally true - it is highly regional, though the most populated portion of Japan is definitely an area where this is largely the case. But even in areas where this is not the case, they still have significantly lower obesity rates. Osaka and Hokkaido are significantly more laid back about it than the Tokyo area, for example, but they still have relatively flat obesity rates.

Basically every fat person in the developed world receives more than the maximum effective dose of shame over their body and it hasn't made them stop being fat.

They had stopped when the deal was in place.

They resumed after it went away, and had most of a decade to get the previous stuff out of mothballs and continue.

No one seriously suggests that Iran had continued working on their nuclear weapons program while the Obama deal was in place.

Edit: The IAEA had 24/7 access to the sites and constently verified they were abiding by the deal. Trump himself testified twice they were abiding by the deal. They had dismantled their heavy-water reactor and could not produce plutonium, had gotten rid of 97% of it's enriched uranium, turned off 2/3rds of their centrifuges, and was not producing weapons grade enriched uranium.

Under the deal they did not have any uranium enriched beyond 4%. After we withdrew, they had since been able to get up to 60% enriched.

I couldn't hit my macros on tirzepatide - couldn't get enough protein without feeling sick to my stomach. One of the reasons I swapped to reta.

(though as a general note for anyone reading, just getting enough protein isn't enough - you need muscle stimulus too. Getting enough protein will help reduce the amount lost but if you really want to stop it, you gotta do resistance training)

Why in the world do you think that taking a once a week injection requires even remotely similar levels of discipline to dealing with daily hunger and food noise? There's like, a dozen orders of magnitude in between. This is a silly argument.

> How do you explain correlations in obesity across cultures? Genetic superiority?

Every developed nation in the world except Japan has been seeing obesity and overweight rates rising at significant rates, including countries that have fairly similar cultures, such as Korea. You also see people move to America and stay in relatively isolated pockets of their culture and still gain weight.

So no. It's a matter of access to hyper palatable calorie dense food. The more of it around, the more likely people are to get fat. The fatter you get, the more of a feedback loop you end up in for a wide variety of known and relatively well understood mechanisms. GLP-1s help short circuit that feedback loop.

As best as I can tell, people are very attached to having achieved their body weight through whatever means they have determined are valid and derive self value from it, and believe that GLP-1s are cheating to achieve a result they worked harder for.