I started Tirzepatide 3-4 weeks ago. (Mostly as an experiment to understand the hype around GLP's... I don't have diabetes and only very slightly overweight at 20% body fat). Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month:
- Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat.
- No more feelings of hunger. At all. This is somewhat depressing. Eating is no longer enjoyable and feels like a chore. I woke up hungry for the first time in a while a couple days ago and was excited - jumped out of bed and ran to eat something just for the pure joy of it. I've only felt that a few times in the past few weeks, compared to every day off the drug.
- I completely stopped drinking. Have you ever been to a bar after eating a big meal at a restaurant, and had trouble drinking because you were too full from your meal? That's how I feel all the time. 1 or 2 beers and it becomes uncomfortable to have anymore.
- Normally I go grocery shopping and within 3-4 days, all the "good stuff" (snacks) I bought are eaten. Now, since I stopped snacking and eating much less, groceries simply last way longer. <-- $$ saved in groceries significantly offsets the monthly price of the medication
- My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).
- Haven't noticed anything regarding impulse control outside of food. No anecdata to share on that point...
After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice (choosing not to take the drug).
The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day).
I'm the kind of person that used to be able to order just about anything on a restaurant menu and clean my plate completely. Now I simply can't do that. It's actually kind of embarrassing being at a restaurant with friends and being completely uninterested in the food.
I’m not going to lie all this sounds like heaven to me.
I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons.
My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it.
If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better
I'm a few months into this drug as well, and I have to say, it doesn't offer control. What it offers is a lack of cravings & appetite. That is different, remarkably so.
Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective?
I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.
I've been on them for over a year now. I was 320lbs at my peak. I'm down to 247 as of today. I have about another 27 pounds to lose, and then I think I'll be where my doctor wants me.
Here's my experience (n=1):
* Zepbound is better than Wegovy. Wegovy has more side effects than Zepbound. Also the Zepbound pen is better than Wegovy.
* If you're worried about needles, don't be. The injection feels more like a rubber band snapping at the skin. And you'll get used to it.
* I typically have moody days maybe 2 or 3 days after I inject. I attribute that to blood sugar changes.
* Food tastes differently to me now. Food I used to really like can sometimes now just be okay. I don't like french fries so much anymore like I used to (they're good, but not what I remember). The huge bowl of chips I got from the Mexican restaurants don't taste as good anymore. Potatoes aren't really as attractive anymore. I prefer protein.
* I had constipation, which is a side effect. There was a stool softener I took from costco that helped. Eventually that went away.
* I got a bike for exercise. It's nice in that I feel like I actually go places rather than sitting on a Peloton. I also get fresh air. I had to find something I wanted to do, and I hate walking frankly.
* As I lost weight my alcohol tolerance dropped, but it's to be expected but still surprising when one beer hits you harder than it used to.
Maybe some tips:
* Nausea might a be a side effect, more so with Wegovy than Zepbound according to my doctor. So I guess plan to take it easy if you can.
* Your relationship with food will change, so be prepared mentally for that. Food used to make you happy maybe, and now it won't. So figure out what activities and interests that make you happy which don't involve food.
* Sugar is the one thing that can still ruin your progress. So be careful with desserts/candies/sweets/sugared sodas/etc.
* There's some debate about whether diet sodas spike your insulin levels or not. I would recommend going to black coffee to get your caffeine if you haven't already, and black coffee will also help to stimulate your bowels as well. That said, diet sodas are still better than sugared sodas.
I'm a major snacker in my 40s, have been most of my adult life. When I don't have my daughter I would fill myself up with cookies, cereal, and chocolate candy. I've been a few months off of all of that shit, accidentally didn't really plan it, I just haven't had any cravings whatsoever. I'm sure it could come back easily but it's not here and I don't miss it. I've lost a lot of fat. I'm not just eating fruit and vegetables, but I'm finding meals alone are enough.
I've heard similar accounts and it sounds pretty wild. I'm not overweight and don't take anything but I do enjoy food. It would be horrible to me to lose the enjoyment of such a primal pleasure. If the choice is between being overweight and giving up the pleasure of eating altogether, I can imagine plenty of gourmands who would rather carry the extra weight for the physical and social pleasures of food. I've heard anecdotal reports of people losing their enjoyment of food permanently, even when discontinuing the drug. Canot confirm but that would be a high cost to pay, imho.
I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.
I resonate with your comment about appetite loss. It is surprising how much it has affected my happiness, to have this few times a day pleasure taken away.
A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on.
The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.
Maybe, Norovirus affected GIP and GLP-1 hormones. This could be a new research avenue for weight loss. GIP and GLP-1 are product of the research about the Gila monster lizard, which eats three or four times a year and survives.
I'm curious -- do you have any brain fog? Are you able to exercise? When you exercise, do you wind up eating more, i.e. the caloric amount that you exercised?
I've never had any psychological difficulty with losing weight. I don't care if I'm hungry.
But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves.
I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?
Your muscle repair would come primarily from protein.
I used to train quite intensely and this protocol worked for me (timings matter):
- 45 mins before workout: small bowl of oatmeal with milk
- 30-0 mins before workout start: 1 liter of water pre-hydration
- During workout: 1/2 liter of water per half hour of intense cardio training, less so for resistance
- Straight after workout: double black espresso coffee (high caffeine)
- Hit sauna for extensive slow cool-down, drinking one sports drink (sugars and electrolytes)
- hour later: full meal of mainly lean protein
Never had issues with muscle pains or "fog".
If you go really deep beyond your usual sustain, feeling physically exhausted and needing rest afterwards is normal. Eating your way through it is not the way to go.
No brain fog. I walk at a very brisk pace ~6 miles a day. My calories are far less than before I started. I have to be very careful to have enough protein. When I exert myself, the recovery period is the same time as before.
No brain fog, but in my experience it does impact exercise (similar to any other caloric deficit). Both maximal efforts (e.g., heavy barbell squats) and endurance (hours on the bike).
Awesome stuff. Envious, here (NL) its impossible to get a prescription.
For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early.
Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.
Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.
I tried, I got some results but it meant that my entire body’s digestive system felt like it stopped working. Constipation, nausea at the drop of a hat, finding I’d have to take a fast acting prescription anti nausea multiple times a day. I’m not that overweight, and I felt like my body was getting far less healthy and like I was starving myself. This is on the lowest starter dose, too! It just… yeah, it works as I’d expect an extreme appetite suppressant would.
This was me. I’ve been on them for four years and actually gained fifty pounds
The drug keeps me from binge eating, which is huge, but if I take enough to actually lose weight then I have weekly bouts of food poisoning because the sugars in my gut start to ferment. An entire day sitting on the toilet while holding a bucket because it’s coming out both ends.
> My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).
Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items.
I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places.
People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.
I am 8 months in, you do develop a tolerance over time to the drug (and why you need to increase the dosage progressively). I have gone up slower than the prescibed steps but still, this drug is to help doing diets, I don't think it would work as a long term medication. And as far as I can tell, when you get off the drug or have become tolerant to the current dosage, it is easy to gain back some weight if you are not careful. So the point being I don't think it will suppress completely obesity, but it will certainly help people make a time limited effort to go down to a lower weight.
Some doctor advised a protocol: stay on GLP-1 for 3 months, then take metformin for a month or two; then repeat the cycle. I have to dig out the source for this.
I’ve been on it for over 2 years now. Yes you plateau, and if you go off of it (as I had periodically), you will regain weight. Hoping my weight loss resumes now that I’m back to the maximum dosage for a few weeks. As it’s 5pm and I just ate for the first time today, I can confidently confirm that my appetite is well suppressed.
Interesting, what is the end game then if you need to be on the drug to keep the weight off but you also develop resistance to it over time?
I wonder how the body reacts after being on the drug for years at a time and then you cut it off, are the cravings stronger than before you started the drug?
Yes well your PCP / pharmacist should not have prescribed you an appetite suppressant when you have below average body fat %. The effects are very worth it for people weighing them against heart disease and mobility issues. It's not a Faustian bargain, it's all right on the tin. When you stop taking it the effects go away. If you want to be indulgent and it fits your lifestyle you can reversibly make that decision. The power to make that decision is difficult to overstate.
After using them, I think GLP-1’s will eventually be rebranded as a weight management / weight maintenance drug rather than a weight loss drug in order to appeal to the masses.
It’s a very interesting feeling to feel like you’re in full control of what you eat, not influenced by random cravings or hunger.
In my case I’m planning to only stay on it another month or 2 to drop 10lbs. I can easily see people cycling on/off this drug throughout the year to keep weight in check while removing will power from the equation completely. It’s quite remarkable.
Why is it only appropriate for people with heart disease / mobility issues but not for someone who is merely overweight? This feels like finger-wagging for the sake of finger-wagging.
I assume GP isn't a woman, why do you think 20% is normal for men. The point is that there are no side effects and there is no reason to stop taking it, especially if it saves him money.
Are you just using average as weasel words here? I get my best pump and generally have the best workout sessions at ~10-12%, which is easily maintainable for me, but definitely not for most people, having a drug that makes it effortless for most people is a GOOD thing. People shouldn't have to suffer to get to <15% if they aren't born with good genetics?
And what about strength athletes who want to build up a large runway? Now literally all of them can get down to ~7% no problem, and have no problems on the way up either.
> Yes well your PCP / pharmacist should not have prescribed you an appetite suppressant when you have below average body fat %.
Why do you think this? I agree that people who have associated risk factors should be prioritized, but if there's enough for everyone why wouldn't we give it to anyone who wants it?
You shouldn't have to ask permission from a PCP / pharmacist in the first place. Who are you to decide whether side effects are worth it for anybody but yourself?
I can't speak to their choice of taking the drug, but it's wild how warped people's perceptions are now of what constitutes "healthy" and "fat" thanks to the obesity epidemic. People remark on how George Costanza on Seinfeld was once considered fat (because he was), or how Homer's scale-tipping 300 lbs. in the King-Size Homer episode of The Simpsons was considered comically obese (because it was). Never mind the fact that people almost always underestimate how fat they actually are and are almost always disappointed by their DEXA scans. Even if the OP's estimate is correct that they're just a little north of 20% BF (as a man), they're still overweight, and specifically overfat, and probably look soft and doughy.
It's weird that I've never been overweight and you describe basically how I normally feel.
I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult).
Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry.
If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.
I've been on tirzepatide for 8 weeks (2.5mg then 5mg) and have a very similar conclusion as you. I started off at 160kg 8 weeks ago and now I'm down to 145kg. No other change in my lifestyle except eating radically less. Two 500-calorie-ish meals a day and some fruit as a snack, that's about it.
For decades I've struggled with diets but tirzepatide is the only thing that's made me stick with it. Will power alone wasn't enough, but with tirzepatide I'm very confident I'll get down to a under 100kg for the first time since I was a teenager, within a few months.
> The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day).
But the late night trip to McD's always makes you feel like shit the next day, it's just that we then forget and do it again. (Same with drinking).
> Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat.
This is the largest of several reasons I hesitate to try it for myself. I am a very big guy (I would be about 184lbs if I had 0% bodyfat at my current musculature level). From the experiences I hear, I would not only struggle to have enough energy to do any kind of rigorous exercise, but struggle to consume the amount of protein I require to even maintain my current muscle mass.
I do have issues with overeating and the prospect of a drug that prevents me from consuming too many calories is attractive, but the side effects sound counterintuitive to any kind of natural fitness.
I’ve been hyper aware of the muscle loss caveats and I think it’s the most important thing to know when starting the drug.
You really need to prioritize protein intake and make sure your calorie deficit isn’t extreme.
Losing too much weight too quickly, with or without the help of a drug, can be very unhealthy.
I drink 4 protein shakes a day (160g total) in addition to regular food. If it weren’t for the protein shakes I definitely would be protein deficient.
You’re 100% spot on with decreased energy at the gym. I’ve had to pull back 4x weekly cardio to 1-2x weekly. Then again, anyone who’s in a calorie deficit has lower energy. It’s not a unique phenomenon of the drug, just a side effect of weight loss.
If it makes you feel better, this class of drugs has been part of bodybuilding cutting stacks for a while now. It makes the process much easier and as long as you're diligent about your shakes, no big deal.
I’m somewhat the same. I need to be active for other health reasons (physical therapy, etc) and not eating enough saps my ability to push forward physically.
I don't have a published study to back this up, but in my 10 < n < 100 experience, the alcohol suppression effect is limited to occasional-to-moderate drinkers.
Giving a GLP-1 to a heavy drinker/alcoholic results in a skinny alcoholic.
Given that the overwhelming majority of alcohol is consumed by heavy+ drinkers this isn't the gamechanger people think it is.
I'm a heavy drinker (1.5 bottles of wine a day -or the equivalent- everyday, for at least 5 years). I started a GLP-1 at 2.5mg two weeks ago after the most recent study was released[1].
In just the two weeks at that low dose it's been quite effective.
In fact the only reason I'm replying to your comment is because instead of being a bottle deep in front of the TV at this point in the evening I got bored after one glass and decided to noddle around on the internets.
Ask any heavy drinker/alcoholic and they will tell you that one doesn't just have 'one' drink and then move on with something else. One is always too much, and never enough. Now it feels like enough.
Does it have any impact on focus or motivation to get work done, do hobbies or recreational activities, engage in human relationships, sex, intellectual curiosity, etc.?
It would be fascinating and almost too good to be true if we found a way to suppress only largely harmful (in our current environment) urges but leave the good ones intact.
Something like that becoming widely available could change the world, and mostly for the better. It would refocus our entire economy on much more constructive pursuits instead of gambling, addiction, and pandering to transient urges.
I've never had any lack of focus or motivation to get anything done since I started Tz.
I did have some energy loss, especially at first, but I assume that was because my body was struggling to cope with a lack of carbs. However, after a couple of weeks that for the most part disappeared.
This sounds like my whole life, I've always been trim and have never understood the joy people get from food. Facinating to see there's a drug that recreates that physiology.
Two years ago I was some 7-8kg beyond my target weight range. I started calorie cutting, and filling myself with salads etc before each meal. Also added some more changes like taking longer times to eat. I used to, and sadly back to it, eat in a flash. Initially it was hard so increased a bit and then a bit and then in a few days it was stabilised at a calorie intake point which was still significantly below my normal need. And in next few days it dropped further. So next 3-4 months when I was watching calories and trying to keep in check - I didn't have to worry about eating less calories, but I had to worry about taking sufficient calories. Because surprisingly I stopped feeling hungary even eating lesser calories.
I am talking about being okay in 900-1000 while my normal need was ~2500 and nutritionist had suggested to target around 2000 for first few weeks then bring it down to 15-1600 and then slowly bring it up near normal as weight settled. But by the end of 2nd week or 3rd I was struggling to finish 900-1000. I used to kinda force eat.
There was no medication involved in any way (not for this purpose; not for anything else).
It depends. The 5mg, 10mg, and 15mg were the doses tested and recommended as maintence doses. The 2.5mg is meant as a starter to reduce side effects but since most people don't see results with it the recommendation is that you only take it for 4 weeks. The 7.5mg and 12.5mg doses are meant as transitional doses but you can stay on them longer than 4 weeks.
Some doctors will go by the Lilly recommendations but I think more are allowing people to stay on the lowest dose providing benefits. That leaves your health insurance as the only other obstacle.
I was one of the rare people that saw results with 2.5mg but by the end of that first month I had plateaued. After 3 months at 5.0mg I've plateaued again and will probably move up to 7.5mg in the near future and stay on it as long as I can.
Some people like to go back to 2.5mg as their maintence dose after reaching their weight loss goals.
Yes, up to 15 mg. Maintenance levels at 5, 10, and 15. If you cannot tolerate a maintenance level you can still get it, but insurance will not cover it ($1000/mo rather than $15/mo.) This is not an unreasonable situation.
The inbetween doses are just used for titration. They were not studied as long term doses like the maintenance doses. It’s stupid, and you can get exceptions if you are persistent. I preferred 7.5 mg over 10 mg for example.
Ozempic has been in use for diabetic patients for at least a decade if you want to look at the research of its long term results in that population - which is fairly large to constitute a good sample sizing.
I am much more daring in my will to experiment but I do agree.
Keto, fasting and also breaking the "foodie" culture that eating and going out to eat becomes a hobby.
I didn't order/dine in at all from a restaurant in 2024. It is much easier to not over eat the boring keto meals I make myself. My "cheating" is eating basmati or jasmine rice with a stir fry instead of cauliflower rice.
There is actually not enough known side effects for me to take GLP-1s. They are either complete miracle drugs or side effects we don't currently understand haven't come out in the wash yet.
We have a pretty good track record when a new powerful medication like this is introduces of doing things quite wrong. There are probably risk mitigation strategies we will learn in the coming decades that we simply can't know right now. Otherwise, these are basically free lunch miracle drugs. That seems an easy short.
I'm pretty sure keto has not been extensively studied for anything but the management of epilepsy in children that do not respond to medication. So tbh this is an odd comparison.
The above describes me but it is the consequence of my behaviors/habits. Being a workaholic, I learned long ago to ignore the leash that pulls me to the refrigerator. It seems by brain no longer sends me a "you need to eat" signal similar to the way free divers can become oblivious to the "you need to breath" signal.
I wonder if with time, you can learn from this drug, form the helpful habits/behaviors and then stop taking it.
I understand that on population level we can't just tell everyone "get on a diet", but when talking to you in particular, why couldn't you... just get on a diet?
Personally, I love food. I can't live without stuffing candy in my mouth. But I also have a tendency to get fat, so I weight myself every day, and based on that I either have a diet day or a cheat day. Moreover, I do a lot of physical exercise every day. The idea of having to depend on a drug to live is scary to me.
Having said the above, I'm sure that one day we'll create a drug that makes life of majority of population better, and we'll be able to administer it to everyone without major consequences.
> That late night trip to McDonalds will have you feeling like shit the next day
I've never had this reaction to fast food before. I only eat mcdonalds every few months and yea it's not the highest quality food, but I don't think there's anything in it to make you sick any more than other burger places have. I imagine you'd have to have restricted fast-food nutrition for quite some time before you feel a difference.
I'd like to see a study comparing people who ate mcdonalds who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic, or how much of the craving for mcdonalds is rooted in feeling like crap in the first place.
(Granted, I've never had an issue with maintaining my appetite before, in fact I have issues keeping weight on, so I might have a fundamentally different relationship with food.)
The way I read it, i think the original commenter would usually agree with you, but the effect of the drug turns the post-fast food / treat satiation from joy to pain.
>> That late night trip to Mcs will have you feeling like crap the next day
> I've never had this reaction to fast food before.
I do. Because of it, I eat fastfood when I'm willing to pay that price, ~5x/decade.
> I'd like to see a study comparing people who ate mcs who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic.
The notion that our psychology could be holding us back from fastfood completeness is one that never occurred to me. I like how novel it is.
I was in the overeating column (4000+ calories a day, no sugar drinks) and going into month 3 I am fighting to hit 1500 every day except the day before shot day and shot day. YMMV of course, but it is very effective for me so far.
> Eating is no longer enjoyable and feels like a chore
I used to view eating as a chore and it was great. Then (no joke) I got into tech and everywhere I work they have fancy food or frequent team lunches or something of that nature.
The effects seemed to wane slightly for me, but it vastly changed my relationship with food. I was raised in a family with plenty of food, but food was used as a weapon of manipulation and thus I was taught to eat as much as I can else it might be taken away. With Zepbound I now eat appropriate portions. Can’t really stand more than a single beer. I don’t mind being at a restaurant and not really eating. I’ll have a bite of this or that and be happy.
My shits, however, have been glorious since starting the drug. Truly pleasant steamers that rocket right out.
Be careful with all this. At one point I had gone 72 hours without eating or drinking anything and one beer by the pool had me on the floor. I keep hydrated these days but sometimes it’s an effort.
Atkins-ish diet caused the same thing for me with a car accident back in the 90's. Sudden uptake of carbs with the alcohol resulted in lost memory of over 13 hours, a '68 De Ville convertible that got totaled and 2 months spent with a wired jaw.
Interesting, this sounds like my normal state. I cope by only eating tasty calorie-dense meals and snacks, never skipping meals or snacks, and weight lifting to increase my appetite. Otherwise I become significantly underweight.
One thing this comment ignores is the very non-zero chance, which increases with dose and time on the drug, of developing gastropwresis. Gastropwresis will ruin your life to the point where you may never be hale to eat normal solid food ever again.
> being overweight will be a choice (choosing not to take the drug)
This may be an ignorant take and if it is I apologize, but isn't it a choice anyway? A calorie deficit and minimal exercise will have you cutting body fat. Or am I missing something here?
People aren’t computers. Eating fixation and compulsion empirically override the more rational mind in millions of people. One of the effects of these drugs is making eating a more “impersonal” or “detached” kind of decision, so it feels like a real choice rather than something that you think you have a say in but really the more base instincts will override.
There is a segment of people where GLP-1 medications just don't work, 68% stop within a year, and dosing keeps on escalating up and up. It will help a lot of people, but it is not going to be the panacea early results show.
Since you are not terribly overweight you could reach a healthy weight with relatively minor lifestyle and diet adjustments. Isn’t this preferable to the side effects (some probably unknown) involved in these drugs? Genuine question.
Depends. I tried Ozempic and felt fine but every time I bumped up the dose I’d feel a vague feeling of dread, until I got to the max dosage then I didn’t lose any weight but also felt like I was going to die at any moment. It was bad. I discontinued usage then immediately went back to 300 pounds from 260.
Zepbound/Mounjaro on the other hand has been fantastic. I just noticed I was hurting my muscles a lot and realized it was because I was losing muscle mass. I started taking protein shakes and that seems to have fixed it. Wish I’d realize it sooner as I’ve hurt my hip joint and can’t ride my bike which was primarily how I was exercising, so I need to go to physical therapy. I’m on 10mg and frozen at 260, have an appointment to go to the next dosage on Monday. Hopeful I’ll keep losing weight and get down to around 200.
> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month
... what? Get a better medical provider, you can stay on 2.5mg as long as it's effective. Your hunger will come back. Going up every month is poor practice if you have hunger-suppressing effects, whatever the manufacturer says: speak to an endocrinologist who's experienced with prescribing it instead. The first couple of weeks I had no appetite, but I stayed on 2.5mg for three months and had a healthy appetite by the end, and continued to take it slow. Lost about 1kg a week, and enjoyed my food just fine.
Respectfully, you're in week 3, I think it's worth giving it a few months before you start sharing your experiences of it on the internet.
The much more common experience of this drug -- when you've been on it a little while and you've found a good dosage -- is you enjoy food, you have an appetite, you're just not ALWAYS thinking about food. There is enough anecdata in the many subreddits to constitute actual data about what a typical experience taking any of these things feels like.
> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month
Uh, you're allowed to stay there as long as you want. I was on 2.5 for two months and asked my Dr to up the dose, as progression kind of stalled in the second month. I've been hanging out around 3.5-4.5mg/week since then losing ~5 lb/month steadily.
Sounds like you're pretty sensitive to it, which is nice. You can lower the dose even further if you think it's too strong at 2.5mg/week.
If you don't cook, it is very easy to spend $1000+ on food in a month, especially if you live in a high cost of living area.
I'm single, live alone, work a lot, and earn a lot. Food delivery apps are hella expensive... but I still pay it quite frequently. Yes, I am ashamed, thanks for asking.
Is this person an expert of any kind? They throw around dozens of numbers without any sources. For example,
> 'A movie theater chain recently analyzed their user data and discovered that 72% of their profits came from concessions, primarily from impulse purchases made by people who swore they "wouldn't buy anything."'
This combination of non-descript source, precise numbers, and 'quotes' looks like the usual bullshit one reads in self-help books. I conducted a quick online search but couldn't find any direct source for this claim (although the number might be in the right ballpark).
This article also throws out a bunch of trends and then attributes them to Ozempic with no evidence.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces.
Maybe that's because malls have been struggling for years and are trying new tactics in response to that?
> Whole Foods is shifting from endcap promotions to subscription services.
So many industries are shifting to subscription services, because it's so lucrative. What evidence do we have that this is triggered by Ozempic patients??
When will I get downvote privileges on this site...
Yeah, I’m also having a lot of trouble finding sources for the specific claims they’re making (even, say, the NFL stadium redesign thing, which feels like it should be easy to find). And taking into account the AI-generated lead image, I’m a bit skeptical of all this.
>I would point out that it isn't unforeseen, given that genz don't drink, go out or do drugs to anywhere near the extent that millennials did at the same age
I certainly don’t think Simon is preparing for this massive economic shift; I think they’re reacting to an existing trend.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces. They're doing this because they recognize the writing on the wall.
Malls have been dying for years, and COVID felt like the nail in the coffin.
In October of 2023, when Walmart CEO told Bloomberg [0] that ozempic was partially responsible for sales declining, other shares including Coca-Cola [1] started to fall as well....
I think this is the appropriate response — it’s clear that lack of appetite control is driving purchases a nontrivial amount of the time for junk foods — companies that depend on that revenue have never really had a challenge until now
There are different classes of mall. In general those class A malls targeted at higher income stores and shoppers have been more resilient over the past decade than middle or lower. (Nordstrom vs Macy’s vs. Kmart)
It's straight up miserable to be in mclean/tysons between october and february. Truly it is america's asshole. And yes, people conspicuously consume more than ever. I think this is likely not true of most malls, though, the shopping culture here is just nuts.
There were a lot of different things happening but COVID certainly cut out some straggling malls.
In general this was a correction. The US ranked first in 2018 for retail sq ft per capita at 23. To put this in context, the next highest country, Canada, had 16 sq ft per person, and most developed countries sit around 3-4 sq ft per person. https://www.statista.com/statistics/1058852/retail-space-per...
> When companies like Google see their healthcare costs drop by $12,000 per employee annually and productivity increase by 25%, we observe a restructuring of corporate America that makes remote work a minor adjustment.
In my entire office, there's one overweight person that I know. Out of thousands of employees. There could be more, and other cities might be different, but you get the idea.
The author intentionally or mistakenly applies some numbers to whole populations.
Keep chaining impacts while eliminating small coefficients, your end result will be off by more than a few orders of magnitude.
EDIT: I need to be more clear about my point: My BigTech office does not represent my country stats: Canada has a 26% obesity and 36% overweight adult population. Just taking those numbers, applying them to all populations is wrong.
The analysis is wrong in other subtle but important ways as well. A 25% increase in performance of an allegedly low performing group of a company would not increase the overall company's efficency as much.
40% of Americans are obese and way more are merely overweight. Either your office is small, a huge fluke, weirdly selected or you're not observant enough.
6th option: They are overweight, but do not know, so they don't recognize what overweight looks like. But also, it's pretty easy to not look overweight if you're not obese. 30 pounds can be as little as a few waist sizes. I can gain and lose 15 pounds without looking like I changed at all.
Well, here in boulder, there are a lot of tech workers, and it is one of the thinnest cities in one of the thinnest states. Having said that, Colorado in 2025 despite being one of the thinnest states is still fatter than the fattest state in 1990.
Most of these studies use BMI which doesn't differentiate between muscle mass and fat. The number is likely much lower. Additionally, your numbers are off. I think you are looking at the number of people considered overweight, not obese. There were only three states in 2023 with an obesity rate over 40% [0]. The number usually hovers between 30 and 35%.
The population of a specific Google office could be two std deviations from the mean. My office area, SoHo NYC, has a dramatically lower obesity rate than the USA average. Maybe 10-20% of the population is overweight, let alone obese, and it’s mostly the service workers.
Obesity causes many health problems, but it's also a symptom - of our poor relationship with food, of the way American society is set up around instant gratification, of the predatory nature of food manufacturers.
Though treating the symptom is undeniably good, it also lets the deeper problems that lead to it go unchecked, and my fear is that it will lead to novel problems down the line. How recreational drugs are being replaced by social media is a good example of this; less harm to the body, undeniably good, but still harmful to the mind, and enabling new industries to pop up and find new ways to exploit people.
To be clear my problems aren't with Ozempic, and I believe it should be researched further and, if safe (which seems to be the case), widely available. But the fact is that many nations are able to maintain healthy weight without drugs, and I think if we fail to continue asking why that is, the same societal patterns that led to self-destructive individual behavior in the first place will remain unaddressed.
I agree with everything you've written, and I think your thoughts about Ozempic are spot on.
In the US, though, I don't mean to be super pessimistic but the problems are now so ingrained that I don't really see them improving for at least several generations. Stuff like:
1. Basically everywhere except for a few notable cities are organized around the car. Even if you wanted to walk places in a lot of towns it's near impossible or dangerous due to the road architecture. Fixing this now that it's built is an enormous challenge. I'll be long dead and gone before even a dent is made in it.
2. For decades we've been going in the wrong direction, and I don't see that changing anytime soon. I'm often shocked and saddened by how, well, "thick" high schoolers are these days. Like when I was a kid, there were certainly "fat kids", but it really wasn't that common. And we had a joke that when people went to college they would gain the "freshman 15" due to the all-you-can-eat dining hall plans. To me it looks like the freshman 15 now starts for high school freshman. And while I don't have kids, I've also heard others say how childhood has drastically changed since I was a kid. So much "hanging out", which used to be a physical activity, is now just done on phones. Except for organized sports, kids these days get much less "ad hoc" physical activity. High school is usually the thinnest/most fit a lot of people will be in their lives, and so I think we've condemned a ton of kids to a lifetime of obesity and health problems.
I'm all for changing our structural issues, but I'll take an imperfect solution now over something I don't think will come to pass for decades.
The destructive behavior is overeating and this treatment eliminates the overeating. The problem is human beings are imperfect creatures. This drugs corrects the hormone imbalance that leads to overeating. It is fixing the actual problem.
The idea that medical treatment makes us weaker is genuinely harmful nonsense on the order of claiming vaccines make us sick, and you should seriously reconsider your position here.
Where did these hormone imbalances come from, when and why did they arise, why aren't they uniformly distributed across the globe? Answering these questions may lead to a root cause of obesity and obviate the need for medication altogether.
Do you have any concern that it's an over correction and leads to significant undereating? Which is also terrible for you. Genuine question for the record.
name some nations that maintain healthy weight without drugs? your dogma isn't supported by the data. obesity is a public health problem and it's not caused simply by junk food
Japan and South Korea. Much of southern Europe. It depends how you define healthy, but most of Europe has obesity rates below 20%. And that's just if you're counting rich countries.
The article posits that 80% of the top income quintile will be on this medication.
I have to ask, why? (I'm not in the US, I should add). Like, sure, is the average American overweight? Yes. Are 80% of the top 20% of earners? Seems pretty doubtful, plenty of the rich look to be in reasonable shape.
That statistic suggests that 80% of successful people have such poor impulse control that they end up seriously overweight or obese. And I say that as someone who likes a treat every couple of days, but exercises enough to maintain a fairly healthy weight.
Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
There are some signs that these drugs have effects beyond just apetite supression leading to weight loss. I recall reading something about them having a direct slowing effect on the metabolism, which increases longevity, among other benefits. I can foresee it being used like a supplement among those who can afford it.
> Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
This might be my biggest unknown with GLP1s, how does it affect people with reward system issues — it could dramatically worsen a procrastination problem if it dampen the will to reward seek.
Then again it has only seemed to do this for vices so far
Big food corporations profit from ultra-processed foods that manipulate our natural systems. They design products that override satiety signals using calculated combinations of sugar, fat and salt to activate brain dopamine pathways. Their priority is profit growth, not consumer health.
The consequences are significant health issues like obesity, diabetes and cardiovascular diseases. Healthcare systems struggle with preventable conditions while millions experience declining health and shorter lifespans. These corporations employ questionable strategies: marketing to children, lobbying against regulations, funding misleading research, and shifting responsibility to consumers.
Medications like Ozempic represent a threat to this model by reducing appetite and interrupting compulsive eating. Recent industry concerns about declining sales show how these medications could undermine their business approach. If consumers regain control over their eating habits, corporations may finally face consequences for practices that have profited from health problems for decades.
> Big food corporations profit from ultra-processed foods that manipulate our natural systems.
I've just never bought this.
Does grandma manipulate you when she adds sugar to her cherry pie? Does she manipulate you when she adds salt to her mashed potatoes?
Foods -- "ultra-processed" or not -- don't "manipulate" you. They literally just either taste better or taste worse. Grandma, and her grandma before her, used sugar, fat, and salt, and thank goodness they did. These are normal ingredients. It's not like they're nicotine or heroin or something.
I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
You're not being manipulated. You're just choosing to eat what you choose to eat based on what you like.
No matter how I look at it 60g of sugar in small bottle of coke is criminal. My wife bakes cakes for 10 people with less added sugar.
Junk food definitely is designed to abuse our natural instincts and needs, from packaging to ingredients. Go one year without processed food, you won't physically be able to drink coke or eat fastfood
Many foods and beverages include ingredients whose sole purpose is to hide how sweet it is because otherwise it would be unbearable in your mouth. Gives you a stronger high once it reaches your stomach though.
Do you go to grandma every day to eat calory packed food? Does grandma deploy dozens of scientists who design food so that it has an addicting effect? Dozens of marketing experts who confront you with images to consume the junk? Lobbyists who try to convince that sugar is not causing health problems? Your analogy does not work. These corporations are creating products that cause massive health issues that cost society billions.
You should visit a food processing plant sometime. What they are doing with food is not what your grandma does when she cooks it from ingredients you can buy at the grocery store. And I bet your grandma doesn’t have a food chemistry lab to fine tune her recipes.
Similarly, fig trees don’t make Fig Newtons. They make figs.
Does grandma have a profit motive? Does grandma care about your wellbeing? Is grandma a vast conglomerate of strangers who couldn't give two flying fucks about you on a good day?
Is plain old sugar, animal fat, and salt unhealthy in large quantities? Of course, but eating grandma's mashed potatoes and cherry pie once a week will not materially affect your health. Meanwhile you pass 8 taco bells on your way home from her house, not to mention the 3 fast food ads you heard on youtube or the radio. Come on.
> Does grandma manipulate you when she adds sugar to her cherry pie?
Manipulation implies a purpose, so I’d say no. Does grandma have an ulterior motive? She adds sugar to express herself through the art of baking or does she need a favor?
> I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
Yeah it's anti-capitalist rants at every turn around here. Capitalism is the best system we have to make people happy in a fair way. It's not a system to teach people the benefits of moderation or charity. You're supposed to bring that to the table yourself. There's no economic system in the world that can fix character flaws.
I actually feel the opposite. Ozempic is a massive risk to health food companies. When people know they can eat whatever they want and not gain weight they'll only eat what tastes best. All mcdonalds no sweet green so to speak.
"Big food corporations" lol. You think every professional chef doesn't know the same tricks? There are basically 3 things that taste good. Fat, salt, and sugar.
GLP-1 drugs also manipulate our natural systems. It's not a panacea. There are early indications of increased suicidal ideation in cohorts that take this drug. Caveat emptor
Readit News
- Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat.
- No more feelings of hunger. At all. This is somewhat depressing. Eating is no longer enjoyable and feels like a chore. I woke up hungry for the first time in a while a couple days ago and was excited - jumped out of bed and ran to eat something just for the pure joy of it. I've only felt that a few times in the past few weeks, compared to every day off the drug.
- I completely stopped drinking. Have you ever been to a bar after eating a big meal at a restaurant, and had trouble drinking because you were too full from your meal? That's how I feel all the time. 1 or 2 beers and it becomes uncomfortable to have anymore.
- Normally I go grocery shopping and within 3-4 days, all the "good stuff" (snacks) I bought are eaten. Now, since I stopped snacking and eating much less, groceries simply last way longer. <-- $$ saved in groceries significantly offsets the monthly price of the medication
- My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).
- Haven't noticed anything regarding impulse control outside of food. No anecdata to share on that point...
After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice (choosing not to take the drug).
The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day).
I'm the kind of person that used to be able to order just about anything on a restaurant menu and clean my plate completely. Now I simply can't do that. It's actually kind of embarrassing being at a restaurant with friends and being completely uninterested in the food.
I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons.
My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it.
If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better
Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective?
I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.
Here's my experience (n=1):
* Zepbound is better than Wegovy. Wegovy has more side effects than Zepbound. Also the Zepbound pen is better than Wegovy.
* If you're worried about needles, don't be. The injection feels more like a rubber band snapping at the skin. And you'll get used to it.
* I typically have moody days maybe 2 or 3 days after I inject. I attribute that to blood sugar changes.
* Food tastes differently to me now. Food I used to really like can sometimes now just be okay. I don't like french fries so much anymore like I used to (they're good, but not what I remember). The huge bowl of chips I got from the Mexican restaurants don't taste as good anymore. Potatoes aren't really as attractive anymore. I prefer protein.
* I had constipation, which is a side effect. There was a stool softener I took from costco that helped. Eventually that went away.
* I got a bike for exercise. It's nice in that I feel like I actually go places rather than sitting on a Peloton. I also get fresh air. I had to find something I wanted to do, and I hate walking frankly.
* As I lost weight my alcohol tolerance dropped, but it's to be expected but still surprising when one beer hits you harder than it used to.
Maybe some tips:
* Nausea might a be a side effect, more so with Wegovy than Zepbound according to my doctor. So I guess plan to take it easy if you can.
* Your relationship with food will change, so be prepared mentally for that. Food used to make you happy maybe, and now it won't. So figure out what activities and interests that make you happy which don't involve food.
* Sugar is the one thing that can still ruin your progress. So be careful with desserts/candies/sweets/sugared sodas/etc.
* There's some debate about whether diet sodas spike your insulin levels or not. I would recommend going to black coffee to get your caffeine if you haven't already, and black coffee will also help to stimulate your bowels as well. That said, diet sodas are still better than sugared sodas.
I’ve seen cases where these sites are 5x cheaper than insurance
Your body has 2 separate engines that work completely differently
I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.
A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on.
The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.
I've never had any psychological difficulty with losing weight. I don't care if I'm hungry.
But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves.
I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?
This is crazy, I have the completely opposite effect. On keto + calorie restriction I feel much more alert and sharp.
- 45 mins before workout: small bowl of oatmeal with milk
- 30-0 mins before workout start: 1 liter of water pre-hydration
- During workout: 1/2 liter of water per half hour of intense cardio training, less so for resistance
- Straight after workout: double black espresso coffee (high caffeine)
- Hit sauna for extensive slow cool-down, drinking one sports drink (sugars and electrolytes)
- hour later: full meal of mainly lean protein
Never had issues with muscle pains or "fog".
If you go really deep beyond your usual sustain, feeling physically exhausted and needing rest afterwards is normal. Eating your way through it is not the way to go.
For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early.
Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.
Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.
The rate is over 1% which isn’t a lot nor is it nothing https://jamanetwork.com/journals/jama/fullarticle/2810542
The drug keeps me from binge eating, which is huge, but if I take enough to actually lose weight then I have weekly bouts of food poisoning because the sugars in my gut start to ferment. An entire day sitting on the toilet while holding a bucket because it’s coming out both ends.
I'm curious if daily oral doses which are smaller will solve a bunch of these problems at once, while also mitigating the supply-chain problems.
Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items.
I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places.
People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.
(I heard this somewhere on the internet, about the Frappucino.)
It seems like there is a lot of disagreement on this very basic point. Surely there must be data from the decade or so it was prescribed for diabetes.
I wonder how the body reacts after being on the drug for years at a time and then you cut it off, are the cravings stronger than before you started the drug?
It’s a very interesting feeling to feel like you’re in full control of what you eat, not influenced by random cravings or hunger.
In my case I’m planning to only stay on it another month or 2 to drop 10lbs. I can easily see people cycling on/off this drug throughout the year to keep weight in check while removing will power from the equation completely. It’s quite remarkable.
Are you just using average as weasel words here? I get my best pump and generally have the best workout sessions at ~10-12%, which is easily maintainable for me, but definitely not for most people, having a drug that makes it effortless for most people is a GOOD thing. People shouldn't have to suffer to get to <15% if they aren't born with good genetics?
And what about strength athletes who want to build up a large runway? Now literally all of them can get down to ~7% no problem, and have no problems on the way up either.
Why do you think this? I agree that people who have associated risk factors should be prioritized, but if there's enough for everyone why wouldn't we give it to anyone who wants it?
I can't speak to their choice of taking the drug, but it's wild how warped people's perceptions are now of what constitutes "healthy" and "fat" thanks to the obesity epidemic. People remark on how George Costanza on Seinfeld was once considered fat (because he was), or how Homer's scale-tipping 300 lbs. in the King-Size Homer episode of The Simpsons was considered comically obese (because it was). Never mind the fact that people almost always underestimate how fat they actually are and are almost always disappointed by their DEXA scans. Even if the OP's estimate is correct that they're just a little north of 20% BF (as a man), they're still overweight, and specifically overfat, and probably look soft and doughy.
I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult).
Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry.
If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.
For decades I've struggled with diets but tirzepatide is the only thing that's made me stick with it. Will power alone wasn't enough, but with tirzepatide I'm very confident I'll get down to a under 100kg for the first time since I was a teenager, within a few months.
But the late night trip to McD's always makes you feel like shit the next day, it's just that we then forget and do it again. (Same with drinking).
This is the largest of several reasons I hesitate to try it for myself. I am a very big guy (I would be about 184lbs if I had 0% bodyfat at my current musculature level). From the experiences I hear, I would not only struggle to have enough energy to do any kind of rigorous exercise, but struggle to consume the amount of protein I require to even maintain my current muscle mass.
I do have issues with overeating and the prospect of a drug that prevents me from consuming too many calories is attractive, but the side effects sound counterintuitive to any kind of natural fitness.
You really need to prioritize protein intake and make sure your calorie deficit isn’t extreme.
Losing too much weight too quickly, with or without the help of a drug, can be very unhealthy.
I drink 4 protein shakes a day (160g total) in addition to regular food. If it weren’t for the protein shakes I definitely would be protein deficient.
You’re 100% spot on with decreased energy at the gym. I’ve had to pull back 4x weekly cardio to 1-2x weekly. Then again, anyone who’s in a calorie deficit has lower energy. It’s not a unique phenomenon of the drug, just a side effect of weight loss.
Giving a GLP-1 to a heavy drinker/alcoholic results in a skinny alcoholic.
Given that the overwhelming majority of alcohol is consumed by heavy+ drinkers this isn't the gamechanger people think it is.
In just the two weeks at that low dose it's been quite effective.
In fact the only reason I'm replying to your comment is because instead of being a bottle deep in front of the TV at this point in the evening I got bored after one glass and decided to noddle around on the internets.
Ask any heavy drinker/alcoholic and they will tell you that one doesn't just have 'one' drink and then move on with something else. One is always too much, and never enough. Now it feels like enough.
Happy the share more if you like :)
1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
It would be fascinating and almost too good to be true if we found a way to suppress only largely harmful (in our current environment) urges but leave the good ones intact.
Something like that becoming widely available could change the world, and mostly for the better. It would refocus our entire economy on much more constructive pursuits instead of gambling, addiction, and pandering to transient urges.
I did have some energy loss, especially at first, but I assume that was because my body was struggling to cope with a lack of carbs. However, after a couple of weeks that for the most part disappeared.
I am talking about being okay in 900-1000 while my normal need was ~2500 and nutritionist had suggested to target around 2000 for first few weeks then bring it down to 15-1600 and then slowly bring it up near normal as weight settled. But by the end of 2nd week or 3rd I was struggling to finish 900-1000. I used to kinda force eat.
There was no medication involved in any way (not for this purpose; not for anything else).
So they are going to force you onto a higher dose?!
Some doctors will go by the Lilly recommendations but I think more are allowing people to stay on the lowest dose providing benefits. That leaves your health insurance as the only other obstacle.
There is a chart at https://zepbound.lilly.com/hcp/dosage
I was one of the rare people that saw results with 2.5mg but by the end of that first month I had plateaued. After 3 months at 5.0mg I've plateaued again and will probably move up to 7.5mg in the near future and stay on it as long as I can.
Some people like to go back to 2.5mg as their maintence dose after reaching their weight loss goals.
https://www.goodrx.com/zepbound/dosage
Keto + intermittent fasting are my magic pill right now and have been for some years.
Keto, fasting and also breaking the "foodie" culture that eating and going out to eat becomes a hobby.
I didn't order/dine in at all from a restaurant in 2024. It is much easier to not over eat the boring keto meals I make myself. My "cheating" is eating basmati or jasmine rice with a stir fry instead of cauliflower rice.
There is actually not enough known side effects for me to take GLP-1s. They are either complete miracle drugs or side effects we don't currently understand haven't come out in the wash yet.
We have a pretty good track record when a new powerful medication like this is introduces of doing things quite wrong. There are probably risk mitigation strategies we will learn in the coming decades that we simply can't know right now. Otherwise, these are basically free lunch miracle drugs. That seems an easy short.
I wonder if with time, you can learn from this drug, form the helpful habits/behaviors and then stop taking it.
Personally, I love food. I can't live without stuffing candy in my mouth. But I also have a tendency to get fat, so I weight myself every day, and based on that I either have a diet day or a cheat day. Moreover, I do a lot of physical exercise every day. The idea of having to depend on a drug to live is scary to me.
Having said the above, I'm sure that one day we'll create a drug that makes life of majority of population better, and we'll be able to administer it to everyone without major consequences.
I've never had this reaction to fast food before. I only eat mcdonalds every few months and yea it's not the highest quality food, but I don't think there's anything in it to make you sick any more than other burger places have. I imagine you'd have to have restricted fast-food nutrition for quite some time before you feel a difference.
I'd like to see a study comparing people who ate mcdonalds who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic, or how much of the craving for mcdonalds is rooted in feeling like crap in the first place.
(Granted, I've never had an issue with maintaining my appetite before, in fact I have issues keeping weight on, so I might have a fundamentally different relationship with food.)
> I've never had this reaction to fast food before.
I do. Because of it, I eat fastfood when I'm willing to pay that price, ~5x/decade.
> I'd like to see a study comparing people who ate mcs who thought of it like slop vs those who saw it as a treat. I'm curious how much of this is psychosomatic.
The notion that our psychology could be holding us back from fastfood completeness is one that never occurred to me. I like how novel it is.
For those who do, it makes them have a normal appetite.
Additionally, it seems to make junk food taste less appealing and real food more appealing.
I used to view eating as a chore and it was great. Then (no joke) I got into tech and everywhere I work they have fancy food or frequent team lunches or something of that nature.
I wish I could go back.
My shits, however, have been glorious since starting the drug. Truly pleasant steamers that rocket right out.
This may be an ignorant take and if it is I apologize, but isn't it a choice anyway? A calorie deficit and minimal exercise will have you cutting body fat. Or am I missing something here?
You will probably land on "not often hungry". The feeling of being full very quickly when you do eat will stay
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Zepbound/Mounjaro on the other hand has been fantastic. I just noticed I was hurting my muscles a lot and realized it was because I was losing muscle mass. I started taking protein shakes and that seems to have fixed it. Wish I’d realize it sooner as I’ve hurt my hip joint and can’t ride my bike which was primarily how I was exercising, so I need to go to physical therapy. I’m on 10mg and frozen at 260, have an appointment to go to the next dosage on Monday. Hopeful I’ll keep losing weight and get down to around 200.
... what? Get a better medical provider, you can stay on 2.5mg as long as it's effective. Your hunger will come back. Going up every month is poor practice if you have hunger-suppressing effects, whatever the manufacturer says: speak to an endocrinologist who's experienced with prescribing it instead. The first couple of weeks I had no appetite, but I stayed on 2.5mg for three months and had a healthy appetite by the end, and continued to take it slow. Lost about 1kg a week, and enjoyed my food just fine.
Respectfully, you're in week 3, I think it's worth giving it a few months before you start sharing your experiences of it on the internet.
The much more common experience of this drug -- when you've been on it a little while and you've found a good dosage -- is you enjoy food, you have an appetite, you're just not ALWAYS thinking about food. There is enough anecdata in the many subreddits to constitute actual data about what a typical experience taking any of these things feels like.
It already is.
> Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month
Uh, you're allowed to stay there as long as you want. I was on 2.5 for two months and asked my Dr to up the dose, as progression kind of stalled in the second month. I've been hanging out around 3.5-4.5mg/week since then losing ~5 lb/month steadily.
Sounds like you're pretty sensitive to it, which is nice. You can lower the dose even further if you think it's too strong at 2.5mg/week.
It is definitely a game changer.
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I'm single, live alone, work a lot, and earn a lot. Food delivery apps are hella expensive... but I still pay it quite frequently. Yes, I am ashamed, thanks for asking.
> 'A movie theater chain recently analyzed their user data and discovered that 72% of their profits came from concessions, primarily from impulse purchases made by people who swore they "wouldn't buy anything."'
This combination of non-descript source, precise numbers, and 'quotes' looks like the usual bullshit one reads in self-help books. I conducted a quick online search but couldn't find any direct source for this claim (although the number might be in the right ballpark).
I'm seeing papers claiming both increased and decreased impulse control.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces.
Maybe that's because malls have been struggling for years and are trying new tactics in response to that?
> Whole Foods is shifting from endcap promotions to subscription services.
So many industries are shifting to subscription services, because it's so lucrative. What evidence do we have that this is triggered by Ozempic patients??
When will I get downvote privileges on this site...
I would also gently point out the evidence for tempering alcohol only seems to be evident with people who have high BMI https://www.pulsetoday.co.uk/news/clinical-areas/mental-heal...
So yes, its worth thinking about how our economy is organised.
But the thing that is going to kneecap the US economy in the short terms are one of the following:
o Tariffs
o Cutting government spending (especially welfare)
o a steep rise in unemployment caused by government firing of civil servants
o fucking with the structure of the monetary system
o AI eliminating whole classes of jobs (taxi driving, phone centers, clerical work, etc etc)
Kids these days
I certainly don’t think Simon is preparing for this massive economic shift; I think they’re reacting to an existing trend.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces. They're doing this because they recognize the writing on the wall.
Malls have been dying for years, and COVID felt like the nail in the coffin.
[0] https://web.archive.org/web/20231006122607/https://www.bnnbl...
[1] https://www.marketwatch.com/story/coca-cola-and-pepsicos-sto...
One was completely shut down in 2022 after years of decline, another lost all but one anchor and was auctioned off for unpaid property taxes.
In general this was a correction. The US ranked first in 2018 for retail sq ft per capita at 23. To put this in context, the next highest country, Canada, had 16 sq ft per person, and most developed countries sit around 3-4 sq ft per person. https://www.statista.com/statistics/1058852/retail-space-per...
In my entire office, there's one overweight person that I know. Out of thousands of employees. There could be more, and other cities might be different, but you get the idea.
The author intentionally or mistakenly applies some numbers to whole populations.
Keep chaining impacts while eliminating small coefficients, your end result will be off by more than a few orders of magnitude.
EDIT: I need to be more clear about my point: My BigTech office does not represent my country stats: Canada has a 26% obesity and 36% overweight adult population. Just taking those numbers, applying them to all populations is wrong.
The analysis is wrong in other subtle but important ways as well. A 25% increase in performance of an allegedly low performing group of a company would not increase the overall company's efficency as much.
[0] https://www.cdc.gov/obesity/data-and-statistics/adult-obesit...
You're doing it far worse than they are. The obesity rate in the US is something like 30%, with some regional variation.
That seems incompatible with the numbers that show something like 3/4 of the US population being overweight.
(And yeah, BMI isn't great, but it works pretty well with an aggregate population of sedentary individuals, which the population at large is.)
Though treating the symptom is undeniably good, it also lets the deeper problems that lead to it go unchecked, and my fear is that it will lead to novel problems down the line. How recreational drugs are being replaced by social media is a good example of this; less harm to the body, undeniably good, but still harmful to the mind, and enabling new industries to pop up and find new ways to exploit people.
To be clear my problems aren't with Ozempic, and I believe it should be researched further and, if safe (which seems to be the case), widely available. But the fact is that many nations are able to maintain healthy weight without drugs, and I think if we fail to continue asking why that is, the same societal patterns that led to self-destructive individual behavior in the first place will remain unaddressed.
In the US, though, I don't mean to be super pessimistic but the problems are now so ingrained that I don't really see them improving for at least several generations. Stuff like:
1. Basically everywhere except for a few notable cities are organized around the car. Even if you wanted to walk places in a lot of towns it's near impossible or dangerous due to the road architecture. Fixing this now that it's built is an enormous challenge. I'll be long dead and gone before even a dent is made in it.
2. For decades we've been going in the wrong direction, and I don't see that changing anytime soon. I'm often shocked and saddened by how, well, "thick" high schoolers are these days. Like when I was a kid, there were certainly "fat kids", but it really wasn't that common. And we had a joke that when people went to college they would gain the "freshman 15" due to the all-you-can-eat dining hall plans. To me it looks like the freshman 15 now starts for high school freshman. And while I don't have kids, I've also heard others say how childhood has drastically changed since I was a kid. So much "hanging out", which used to be a physical activity, is now just done on phones. Except for organized sports, kids these days get much less "ad hoc" physical activity. High school is usually the thinnest/most fit a lot of people will be in their lives, and so I think we've condemned a ton of kids to a lifetime of obesity and health problems.
I'm all for changing our structural issues, but I'll take an imperfect solution now over something I don't think will come to pass for decades.
The idea that medical treatment makes us weaker is genuinely harmful nonsense on the order of claiming vaccines make us sick, and you should seriously reconsider your position here.
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Do you have any concern that it's an over correction and leads to significant undereating? Which is also terrible for you. Genuine question for the record.
I have to ask, why? (I'm not in the US, I should add). Like, sure, is the average American overweight? Yes. Are 80% of the top 20% of earners? Seems pretty doubtful, plenty of the rich look to be in reasonable shape.
That statistic suggests that 80% of successful people have such poor impulse control that they end up seriously overweight or obese. And I say that as someone who likes a treat every couple of days, but exercises enough to maintain a fairly healthy weight.
Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
Me too! Maybe later... <kidding>
Adderall?
The analogy for a GLP-1 agonist for procrastination would be something safer yet possibly more effective.
This might be my biggest unknown with GLP1s, how does it affect people with reward system issues — it could dramatically worsen a procrastination problem if it dampen the will to reward seek.
Then again it has only seemed to do this for vices so far
The consequences are significant health issues like obesity, diabetes and cardiovascular diseases. Healthcare systems struggle with preventable conditions while millions experience declining health and shorter lifespans. These corporations employ questionable strategies: marketing to children, lobbying against regulations, funding misleading research, and shifting responsibility to consumers.
Medications like Ozempic represent a threat to this model by reducing appetite and interrupting compulsive eating. Recent industry concerns about declining sales show how these medications could undermine their business approach. If consumers regain control over their eating habits, corporations may finally face consequences for practices that have profited from health problems for decades.
I've just never bought this.
Does grandma manipulate you when she adds sugar to her cherry pie? Does she manipulate you when she adds salt to her mashed potatoes?
Foods -- "ultra-processed" or not -- don't "manipulate" you. They literally just either taste better or taste worse. Grandma, and her grandma before her, used sugar, fat, and salt, and thank goodness they did. These are normal ingredients. It's not like they're nicotine or heroin or something.
I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
You're not being manipulated. You're just choosing to eat what you choose to eat based on what you like.
Junk food definitely is designed to abuse our natural instincts and needs, from packaging to ingredients. Go one year without processed food, you won't physically be able to drink coke or eat fastfood
Similarly, fig trees don’t make Fig Newtons. They make figs.
Is plain old sugar, animal fat, and salt unhealthy in large quantities? Of course, but eating grandma's mashed potatoes and cherry pie once a week will not materially affect your health. Meanwhile you pass 8 taco bells on your way home from her house, not to mention the 3 fast food ads you heard on youtube or the radio. Come on.
Manipulation implies a purpose, so I’d say no. Does grandma have an ulterior motive? She adds sugar to express herself through the art of baking or does she need a favor?
> I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
..Yes?