Other medications become lifelong medications but without this level of scrutiny. I am 100% in favor of finding a more permanent treatment, but switching blood pressure meds, and cholesterol meds, and other daily meds for a single once a week med is a massive improvement, especially since the all source mortality data keeps rolling in showing the efficacy here is orders of magnitude better than all the other medications out there. A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.
I doubt that willpower or lack thereof is a significant factor. It's more a matter of habits and discipline. Willpower can allow you to resist temptation for a few hours but it's not sustainable.
I know several people who were formerly obese and have achieved sustained weight loss without drugs or surgery. The common factor seems to be that they "hit rock bottom", sort of like a drug addict, and decided to make permanent lifestyle changes in order to survive and stop letting down those who depended upon them. These lifestyle changes are often pretty drastic, and involve more than just eating less and exercising more.
If people want to take GLP-1 drugs and understand the risks then I have no problem with that and don't see it as a moral failing. But they might want to evaluate whether this is just masking the symptoms of some deeper mental health condition.
A constant issue here is that we keep calling this a 'weight loss drug' and society views being fat as a moral failing ant that you 'just don't have the will power' to overcome. We need to stop. If this is a lifelong drug it is worth it compared to the relatively ineffective, and just as lifelong, alternatives out there.
I have noticed much less moralizing over the issue now compared to 2-3 years ago. I think more people realize these drug are safe and effective and not 'taking the easy way out', but rather a treatment for a medical problem than just blaming laziness or gluttony.
This is just as weak as a counter argument. If every argument that concludes that lifestyle changes are necessary, in most situations and for most patients, are just written off as some sort of moral high ground and not necessarily something to take seriously, then what do we have left?
Is there seriously no functional difference between healing a broken bone and getting someone to stop smoking? The only problem is just that we haven't found the right medication for the latter? Evidence of necessary lifestyle changes as part of some moral crusade?
The science is pretty clear on the subject and it is up there as one of the most well studied in medicine. Yes, anyone can stop smoking and anyone can gain or loose weight. Yes, lifestyle changes are the most imporant factor in a treatment being successful.
There's a common misunderstanding that medication and lifestyle changes are two separate things, and we should do one or the other, with medication being the "easy way" out.
No. The way GLP-1 drugs work is by lifestyle changes. People on GLP-1 agonists will, on average, eat smaller portions, are more inclined to eat healthier food, and will even exercise more.
If you take GLP-1s and don't do the lifestyle changes, they don't work. So are these drugs useless? No. They make the lifestyle changes more attainable. In your smoking example, it's similar. We have cessation drugs, I know because I've used them. No, they don't magically make you stop smoking. But they do make it easier.
We need to rewrite how we view these drugs. They don't take away your power, your strength. No, they help you find it. You had the strength all along, but these are tools to help you exercise it.
I don’t think that’s a fair assessment. I’m all for life-long drugs that help with weight loss, I don’t view it as a moral failing. That said, it is easy to see why so many people are concerned about these drugs: people taking them can look terrible (“ozempic face”). Gaunt, sick, hollowed out, look at people like Sharon Osbourne, that’s the public face of these drugs. And so when people are committing to life-long use of these drugs, it is being viewed with the very visible side effects in mind, and that is concerning to a lot of people after these drugs seemingly appeared overnight.
"Ozempic face" is actually just "unhealthy rapid weight loss face". Ozempic makes it easier to starve yourself, but that isn't how it's supposed to be used.
But it is factually true that it’s a matter of willpower, no amount of reframing it is going to change that.
It’s not like others like myself, currently on a cut cycle, don’t experience hunger. The idea that we are just “lucky” ignores all the willpower and discipline we fight through to do it ourselves.
I’ve eaten about 800 calories today and it is 4pm. Just finished 90 minutes on the indoor bike. My stomach feels hungry. I experience that and just sit with it. That is the difference.
Congrats, your metabolism (FAO, gluconeogenesis, insulin sensitivity, …) works well. Don’t assume that’s the case for everyone, because it’s well researched that this is highly individual.
People are different. Using your own achievements as evidence of other’s failings isn’t useful, we are all different. I can fast for 23 hours a day, 365 days a year (omad) with ease, not because I have more willpower than my fat friends, but because I’m different. My fat friends are objectively stronger and more resilient than me in almost every aspect of life, yet by your measure, because hunger doesn’t bother me, I have more willpower than them? Willpower isn’t measured on outcomes.
You can't make this point here without getting down voted to oblivion.
I know many ultra endurance runners and they are all in very good - healthy - shape. The only thing they all have in common is that they are very, very disciplined people.
I don't think my ability to sit with hunger without fainting or experiencing massive headaches is due to my willpower. Fortunately, at least I'm not ignorant about it and don't write comments like yours.
How can you say that with any certainty, though? How do you know that hunger hits you in the exact same way it does another person? That overcoming it requires the exact same amount of willpower in all people?
Oh, you can't reach the items on the higher grocery shelves no matter how hard you stretch? That's just a deficit of tall-power. I also experience items on high shelves. No, you shouldn't use a stepping stool to grab those items; just stretch more, and grow taller, like me! Look how good I am at being a bit taller than you! Your failure to be slightly taller is a character flaw, feel bad.
Interesting link: a company called Fractyl Health is studying a surgical procedure they call "Revita," that they hope can keep weight off for patients after they discontinue GLP-1s.[0]
The premise, IIUC, is that obesity is driven partly by mucosal overgrowth on the duodenum. This thicker-than-expected layer of mucus is less porous, which leads your digestive system to underestimate the number of calories you've consumed. Revita basically re-surfaces the duodenum.
So, the idea is that you get to a lower weight with the GLP-1 drugs, and then Revita can hopefully reset your set point there.
Their first clinical trial is still in progress, but I think it's interesting to watch.
Fascinatingly, the body already has a mechanism for this: fasting. One of the many beneficial side effects is rapid mucosal atrophy, decreasing villus height and crypt depth.
You can find evidence of this in the literature, but it’s absurdly understudied, because big pharma would rather sell you a subscription to life.
Fortunately there are many good people in the world, especially in the field of medicine, who want to help their patients unconditionally. So there are glimmers of hope, like some of the top cardiologists in the world going against status quo and treating patients with fasting regimes instead of surgery.
Surprised this is still in first trial. I can recall reading about something like it in 2017. Apparently clearing the duodenal mucosa is a preparatory step for a gastric band fitting, but they found patients were making improvements before the bands were being fitted so a study was started to see if this less invasive procedure might be enough by itself.
My impression (and I'm not a scientist) is that the mucosal overgrowth comes from eating an obesogenic diet. (Some combination of too much sugar / salt / wrong types of fat?)
If you get the procedure and don't go back to an obesogenic diet, then it should be permanent.
Just like alcoholism, or any kind of other addictions.
I've struggled with alcohol abuse, and once you come to the realization that you're abusing it, the fix FOR ME was relatively simple: I stopped (under medical supervision) drinking, or to be more precise: I stopped starting to drink. I have no problems not drinking, I have a problem that when I start I cannot stop.
I have the same issue with food. Not eating is a lot easier than stopping to eat. But I cannot completely stop eating.
Yet with alcohol people are like: hey, good for you.
With my weight issues people are like: dude, just eat less, or exercise more.
"Just Eat Less" is roughly the way to lose weight, but the problem is not that fat people are so unbelievably stupid that they didn't know this. I am sure for some people it really is that simple. Not us.
My weight has been a bit of a rollercoaster. I've never been terribly thin, but I've been "not technically obese" from time to time. I'm currently back on the downswing, but God, what a pain in the ass. It feels like gaining weight is incredibly easy and losing it is incredibly hard (and I do believe this is validated by the science, because you wind up with more fat cells when you first gain weight, which I guess is both relieving and terrifying.)
No matter how many attempts it takes to fix my body, I'm obviously going to just keep trying, because obesity is horrible for you in so many ways. It saps your energy, it's carcinogenic, it increases your blood pressure and risk of heart disease, but it feels like one of those struggles that is never-ending. I've improved my diet numerous times but it never feels like it's quite enough.
There's a lot of very visible and conscious messaging about losing weight.
There's an equal and opposite level of messaging to keep eating, which is less conscious and runs under the radar.
Snacks are literally designed to be addictive. TV ads start from birth. Most restaurants have huge portion sizes. "Family" and "Festival" events assume overeating is expected. Junk food is cheap and quality food is expensive. Overeating is framed as being "naughty" but also indulgent and nurturing.
All of this is a huge social problem that's not acknowledged at all.
It's very, very hard to Just Eat Less when there's a constant barrage of messaging encouraging you to do the opposite, and you're not even aware of it.
The contradictory messaging is actually a classic crazy-making psychological double bind. So of course it's very difficult to make a dent in this, and even harder to permanently change habits so all the contradictions no longer influence you.
Entirely anecdotal, perhaps useless information (and off-topic for anyone who doesn't current consume caffeine) but I've never had an easier time losing weight than I have since I entirely quit using caffeine after decades of normal usage.
After eliminating caffeine its like a switch entirely flipped in my brain turning off all the usual cravings I'd have for carbs/sugars/etc.
The quitting caffeine part was pretty horrible though. Not just because of the headaches (which weren't actually super bad for me) but I went through a couple of weeks of what I assume was for-reals depression/anhedonia as my brain figured out how to operate with non-blocked adenosine suddenly suppressing my dopamine levels.
> It feels like gaining weight is incredibly easy and losing it is incredibly hard
I feel like there is more to it.
Obviously, I sympathize with you, and I noticed that when I switch from a bulking cycle to a cutting cycle, it is a bit difficult to adjust for the first couple of weeks as well.
But by god, I truly am struggling to switch the other way around, and it takes me months to adjust to the bulking cycle, even with the help of stuff like weed. And when I don’t work out aggresively and don’t keep track of my cycle, it feels just natural for me to default to eating way less, as opposed to the other way around.
To be clear, this isn’t meant to be a dig at your take. All I mean is that, I feel like the whole issue is a bit more complex.
> "Just Eat Less" is roughly the way to lose weight
Maybe the messaging should be "eat healthier"? How many obese people cook for themselves and eat exclusively from the outer aisles of the grocery (fruits, vegetables, seafood, meat, eggs, dairy)?
I could be wrong but I have to imagine the average obese person has a terrible diet. Portion control won't work at that point, you're already doomed to fail.
To be fair, most people have a terrible diet, it's just that some lucky individuals have the metabolism to overcome it. It seems like those people are increasingly the exception and a bad benchmark for how humans should eat.
> the problem is not that fat people are so unbelievably stupid that they didn't know this
I don't suggest this applies to you, but even a small amount of searching around and reading stuff on the web will reveal a substantial subgroup of outright thermodynamics deniers.
(and I do believe this is validated by the science, because you wind up with more fat cells when you first gain weight, which I guess is both relieving and terrifying.)
the data is pretty clear . the vast majority of dieters fail, even when the bar for success is set really low, like a 2-5% long-term weight loss of starting body weight for an obese person is considered a success.
the problem is, obese or formerly obese people clan eat a lot of anything before the full feeling sets in, no matter what. Eggs, chicken..does not matter.
since I also share the ability to cold turkey on most anything, what you can completly stop eating is processed food, or anything that requires an advanced chemical engineering degree to decipher, ditch most of the carbs, ALL of the sugar.
Meat, veggies,fruit,grains,nuts,the most complex packaged foods I buy are yogurt, and bread from an outfit that contracts farmers to grow wheat, pickles, stuff from wierd and wonderfull ethnic groceries where they openly miss there country and insist on having you try the good stuff!, wild food, tucked away farm markets, but most of all, I put my body in charge, which requires listening, but once you realy clean up, perhaps you will find as I have, that certain off the record indulgences have very significant negative phisiological repercusions, on a one to one basis.
but this practice is not for dilly dalyiers, so
Other countries do not have obese people, but have many drinkers!
It is issue of food and ingrediences. Too many sugars, fructose syrups from corn... If fat american moves to asian country, he loses fat, without changing a diet.
I have observed that being addicted drugs gets way more sympathy than being addicted to food even though the neural pathways and other factors are the same.
We need to start looking at obesity as a hunger disorder, and not as the result of an addiction, a lack of knowledge about nutrition, or a lack of self control.
When an obese person regulates their eating and loses weight, the hunger often doesn't go away - and often increases. This is physical, not psychological hunger. When the obese person almost inevitably returns to eating to fullness, they regain weight.
When a person takes GLP-1s, hunger is greatly reduced, and an obese person can eat less food while still achieving satiety without gaining weight. When they stop taking the GLP-1s, the hunger returns, and when they return to eating to fullness, they regain weight.
Similarly, when a person takes stimulant weight loss medication, they can eat less food while experiencing less hunger, and thus lose weight. Similarly, when they go off of the stimulant (or develop a tolerance), the hunger returns and when they return to eating to fullness, they regain weight.
In many obese people, the hunger is present even when they eat a nutritious meal at the appropriate number of calories to maintain their weight. Common advice is to say "this mix of macros or foods makes me satisfied!" and, well, that's great for you but not universal.
People who naturally feel reasonably satisfied with an appropriate number of calories to maintain their weight still experience hunger, but not with the intensity or insatiability of that hunger that many obese people do.
While it does occur with some who have severe eating disorders, most obese people do not overeat themselves into obesity by continuing to eat long after they're full. They eat until the hunger goes away.
It's the hunger. Take away the hunger, and the weight goes down. Bring back the hunger and the weight goes up. It's simple, it's obvious, and few say it.
In many obese people, the hunger is present even when they eat a nutritious meal at the appropriate number of calories to maintain their weight. Common advice is to say "this mix of macros or foods makes me satisfied!" and, well, that's great for you but not universal.
Yup..the high failure rate of dieting is true regardless of the type of food or the macros. Lecturing to 'just eat healthy' as the default mode of advice does not work for the large majority of obese people..this is supported by the literature and anecdotal evidence.
I don't count calories. I went off Ozempic (now Mounjaro) and I gain weight at about 0.5-1kg a month.
As I am resistance (gym) training, significant % of that ends up being muscle mass rather than fat.
So I end up taking Mounjaro for about 1-2 months every 3-4 months, approximately 33% of the time being "on".
Funnily, I end up with bulk/cut periods without doing them explicitly. This ends up working well for growing muscles.
Notice all people in the story are women. I guess pairing GLP-likes with bodybuilding works quite well for men. As times goes on, I end up needing mounjaro less due to my increased muscle mass.
When you restart taking it after an "off" period, do you immediately resume whatever dose you were at before? Or do you taper up each time? (Curious because I know for many people, side effects level out after they've been at a given dose for long enough, but temporarily return whenever they increase their dose; not sure how "off" periods affect that kind of tolerance.)
> "The environment that people live in needs to be one that promotes health, not weight gain. […] Obesity is not a GLP-1 deficiency," he says.
This is my biggest issue with weight healthcare, the idea that if only the patient would eat correctly they wouldn’t be overweight. It’s not some moral failing a person often over eats, it very well could be some physiological issue that should be treated. It would be like telling someone with asthma that they just need to get into better shape to breathe better.
I don't have a horse in this race, but from my personal experience eating satiating whole foods with lower glycemic index, higher fiber and protein content makes it very difficult to gain excessive weight.
On the asthma front, from experiences with someone close to me -- getting in great physical shape (with caveats regarding training) DID indeed help greatly with broncho-constriction and higher scores on FEV. Basically symptoms and inhaler use went down tremendously over a few years and a physical transformation.
Before GLP-1s, there was rarely any such thing as "satiation" for me. Getting full was something that happened without the feeling of having had enough. The main effect of wegovy, for me, was having a feeling of not needing to eat rather than just feeling too full to eat. It was quite an experience, and one I am not sure I had had in more than 30 years.
I find for me that doesn't work. I have to actively count calories to lose or maintain a healthy BMI range. If I don't, no matter what I eat, I end up stabilizing in the overweight category. I'm lucky enough that my wife has a very flexible work schedule where she is able to cook most meals for us, but she hates weighing everything out so I can track... we've tried to stop the tracking multiple times but it never works. I'll think I'm eating to the same satiety level as before, but I end up slowly creeping back up in weight. My wife is fine either with or without tracking for maintaining her weight, though she does also seem to have an easier time losing when she's counting her calories. I think this is why it's so hard to have discussions about it, people's experiences literally don't match even when they try the same things. I suspect I'd be one of those people that if they tried Ozempic would be able to lose tons of weight, and who would shoot back up as soon as they stopped, unless I track the whole time... at which point I wouldn't need the Ozempic in the first place
As someone with asthma, let me tell you that they _do_ need to get into better shape to breathe better. Part of that is a medically proven practice called pulmonary rehabilitation, but also, regular cardiovascular exercise at different intensities and direct training of the abdominal muscles has a marked improvement both on pulmonary function (to a limit, but even more important as you age) and oxygen utilization from the reduced pulmonary function. Finally, both acid and laryngeal reflux are silent contributors to asthma by introducing acid and pepin into the airways, and weight loss can improve the symptoms of those.
Thank you for sharing this and elaborating on what I've seen firsthand. Another thing we've noticed is that an increase in VO 2 Max, which does take quite a bit of time to change, makes a major difference.
Altitude is another factor, due to dry and colder air and lower oxygen -- a double whammy for asthma.
Some people have literally been able able to overcome asthma — or at least significantly reduce symptoms — by learning to breathe better. Getting in better physical shape can be part of this. That doesn't necessarily work for all patients but at least some have been successful.
Until we are able to fix the environment and culture, we're stuck with medications like this. The good news is that glp1 medicine can be used to break addictive behaviors, so it is the very tool that can help change our environment by reducing demand for junk food.
Question for people who have trouble losing fat (this was never my problem): have you ever tried instead of dieting to just force yourself to eat more fruits, vegetables, and protein daily while also allowing yourself free range in the remaining appetite room to have whatever? The human mind/brain/whatever doesn't do well with deprivation of a high dopamine reward, but what would happen if you started to shift your tastes by insisting that it get used to a more healthful diet as a precursor to getting what it wants?
I ask this because when I was younger, I also had tastebuds warped by hyper-palatable foods, but after incrementally getting my diet to such a clean and optimized place, I literally feel bad even while chewing and tasting something like a donut, heavily salted and oiled potato chips, or candy. It's probably like how I would have felt if I literally mixed a tablespoon of oil and sugar or salt together and swallowed it.
Is it that hard to shift the system toward better habits by incremental introduction of better ones, and crowding out the bad? Exercise helps here, because once you begin to enjoy fitness, you get a stronger feedback loop with the bad food creating bad outcomes.
I feel like they should try the potato diet. I recommend it, not because I believe it is effective (it wasn't for me), but because it is very good at removing the pleasure from eating. When you are eating to survive, you will come to understand how what being sated is. From there, I found I could lose weight because I had broken the habit of eating for any other reason than to fuel myself. Although, admittedly, I enjoyed losing weight this way better than the potato diet.
With some people, I think they have just lost what being sated feels like.
Readit News
I know several people who were formerly obese and have achieved sustained weight loss without drugs or surgery. The common factor seems to be that they "hit rock bottom", sort of like a drug addict, and decided to make permanent lifestyle changes in order to survive and stop letting down those who depended upon them. These lifestyle changes are often pretty drastic, and involve more than just eating less and exercising more.
If people want to take GLP-1 drugs and understand the risks then I have no problem with that and don't see it as a moral failing. But they might want to evaluate whether this is just masking the symptoms of some deeper mental health condition.
I have noticed much less moralizing over the issue now compared to 2-3 years ago. I think more people realize these drug are safe and effective and not 'taking the easy way out', but rather a treatment for a medical problem than just blaming laziness or gluttony.
This is just as weak as a counter argument. If every argument that concludes that lifestyle changes are necessary, in most situations and for most patients, are just written off as some sort of moral high ground and not necessarily something to take seriously, then what do we have left?
Is there seriously no functional difference between healing a broken bone and getting someone to stop smoking? The only problem is just that we haven't found the right medication for the latter? Evidence of necessary lifestyle changes as part of some moral crusade?
The science is pretty clear on the subject and it is up there as one of the most well studied in medicine. Yes, anyone can stop smoking and anyone can gain or loose weight. Yes, lifestyle changes are the most imporant factor in a treatment being successful.
No. The way GLP-1 drugs work is by lifestyle changes. People on GLP-1 agonists will, on average, eat smaller portions, are more inclined to eat healthier food, and will even exercise more.
If you take GLP-1s and don't do the lifestyle changes, they don't work. So are these drugs useless? No. They make the lifestyle changes more attainable. In your smoking example, it's similar. We have cessation drugs, I know because I've used them. No, they don't magically make you stop smoking. But they do make it easier.
We need to rewrite how we view these drugs. They don't take away your power, your strength. No, they help you find it. You had the strength all along, but these are tools to help you exercise it.
It’s not like others like myself, currently on a cut cycle, don’t experience hunger. The idea that we are just “lucky” ignores all the willpower and discipline we fight through to do it ourselves.
I’ve eaten about 800 calories today and it is 4pm. Just finished 90 minutes on the indoor bike. My stomach feels hungry. I experience that and just sit with it. That is the difference.
I know many ultra endurance runners and they are all in very good - healthy - shape. The only thing they all have in common is that they are very, very disciplined people.
Other people might have it worse and it might stay with them longer.
Could you keep it up if you were 10x as hungry as you are now for next 5 years?
Okay... how?
You can't just make incredibly bold claims, say "it's a fact!" and then move on. No, you have to back them up otherwise you're just a bullshitter.
I don't know what other people, anyone else, is feeling. How do I know my hunger is their hunger?
The premise, IIUC, is that obesity is driven partly by mucosal overgrowth on the duodenum. This thicker-than-expected layer of mucus is less porous, which leads your digestive system to underestimate the number of calories you've consumed. Revita basically re-surfaces the duodenum.
So, the idea is that you get to a lower weight with the GLP-1 drugs, and then Revita can hopefully reset your set point there.
Their first clinical trial is still in progress, but I think it's interesting to watch.
[0]: https://www.fractyl.com/our-platforms/revita/
You can find evidence of this in the literature, but it’s absurdly understudied, because big pharma would rather sell you a subscription to life.
Fortunately there are many good people in the world, especially in the field of medicine, who want to help their patients unconditionally. So there are glimmers of hope, like some of the top cardiologists in the world going against status quo and treating patients with fasting regimes instead of surgery.
https://www.mdpi.com/2072-6643/16/1/128
which says that the changes reverted quickly after resuming normal feeding
Does this reduce mucous production going forward? Otherwise, it seems like it would be a temporary effect.
If you get the procedure and don't go back to an obesogenic diet, then it should be permanent.
Fascinating.
Just like alcoholism, or any kind of other addictions.
I've struggled with alcohol abuse, and once you come to the realization that you're abusing it, the fix FOR ME was relatively simple: I stopped (under medical supervision) drinking, or to be more precise: I stopped starting to drink. I have no problems not drinking, I have a problem that when I start I cannot stop.
I have the same issue with food. Not eating is a lot easier than stopping to eat. But I cannot completely stop eating.
Yet with alcohol people are like: hey, good for you.
With my weight issues people are like: dude, just eat less, or exercise more.
(I stopped sharing the food story with people).
"Just Eat Less" is roughly the way to lose weight, but the problem is not that fat people are so unbelievably stupid that they didn't know this. I am sure for some people it really is that simple. Not us.
My weight has been a bit of a rollercoaster. I've never been terribly thin, but I've been "not technically obese" from time to time. I'm currently back on the downswing, but God, what a pain in the ass. It feels like gaining weight is incredibly easy and losing it is incredibly hard (and I do believe this is validated by the science, because you wind up with more fat cells when you first gain weight, which I guess is both relieving and terrifying.)
No matter how many attempts it takes to fix my body, I'm obviously going to just keep trying, because obesity is horrible for you in so many ways. It saps your energy, it's carcinogenic, it increases your blood pressure and risk of heart disease, but it feels like one of those struggles that is never-ending. I've improved my diet numerous times but it never feels like it's quite enough.
There's an equal and opposite level of messaging to keep eating, which is less conscious and runs under the radar.
Snacks are literally designed to be addictive. TV ads start from birth. Most restaurants have huge portion sizes. "Family" and "Festival" events assume overeating is expected. Junk food is cheap and quality food is expensive. Overeating is framed as being "naughty" but also indulgent and nurturing.
All of this is a huge social problem that's not acknowledged at all.
It's very, very hard to Just Eat Less when there's a constant barrage of messaging encouraging you to do the opposite, and you're not even aware of it.
The contradictory messaging is actually a classic crazy-making psychological double bind. So of course it's very difficult to make a dent in this, and even harder to permanently change habits so all the contradictions no longer influence you.
After eliminating caffeine its like a switch entirely flipped in my brain turning off all the usual cravings I'd have for carbs/sugars/etc.
The quitting caffeine part was pretty horrible though. Not just because of the headaches (which weren't actually super bad for me) but I went through a couple of weeks of what I assume was for-reals depression/anhedonia as my brain figured out how to operate with non-blocked adenosine suddenly suppressing my dopamine levels.
I feel like there is more to it.
Obviously, I sympathize with you, and I noticed that when I switch from a bulking cycle to a cutting cycle, it is a bit difficult to adjust for the first couple of weeks as well.
But by god, I truly am struggling to switch the other way around, and it takes me months to adjust to the bulking cycle, even with the help of stuff like weed. And when I don’t work out aggresively and don’t keep track of my cycle, it feels just natural for me to default to eating way less, as opposed to the other way around.
To be clear, this isn’t meant to be a dig at your take. All I mean is that, I feel like the whole issue is a bit more complex.
Maybe the messaging should be "eat healthier"? How many obese people cook for themselves and eat exclusively from the outer aisles of the grocery (fruits, vegetables, seafood, meat, eggs, dairy)?
I could be wrong but I have to imagine the average obese person has a terrible diet. Portion control won't work at that point, you're already doomed to fail.
To be fair, most people have a terrible diet, it's just that some lucky individuals have the metabolism to overcome it. It seems like those people are increasingly the exception and a bad benchmark for how humans should eat.
I don't suggest this applies to you, but even a small amount of searching around and reading stuff on the web will reveal a substantial subgroup of outright thermodynamics deniers.
the data is pretty clear . the vast majority of dieters fail, even when the bar for success is set really low, like a 2-5% long-term weight loss of starting body weight for an obese person is considered a success.
Otherwise I over eat crap and gain weight easily
It is issue of food and ingrediences. Too many sugars, fructose syrups from corn... If fat american moves to asian country, he loses fat, without changing a diet.
When an obese person regulates their eating and loses weight, the hunger often doesn't go away - and often increases. This is physical, not psychological hunger. When the obese person almost inevitably returns to eating to fullness, they regain weight.
When a person takes GLP-1s, hunger is greatly reduced, and an obese person can eat less food while still achieving satiety without gaining weight. When they stop taking the GLP-1s, the hunger returns, and when they return to eating to fullness, they regain weight.
Similarly, when a person takes stimulant weight loss medication, they can eat less food while experiencing less hunger, and thus lose weight. Similarly, when they go off of the stimulant (or develop a tolerance), the hunger returns and when they return to eating to fullness, they regain weight.
In many obese people, the hunger is present even when they eat a nutritious meal at the appropriate number of calories to maintain their weight. Common advice is to say "this mix of macros or foods makes me satisfied!" and, well, that's great for you but not universal.
People who naturally feel reasonably satisfied with an appropriate number of calories to maintain their weight still experience hunger, but not with the intensity or insatiability of that hunger that many obese people do.
While it does occur with some who have severe eating disorders, most obese people do not overeat themselves into obesity by continuing to eat long after they're full. They eat until the hunger goes away.
It's the hunger. Take away the hunger, and the weight goes down. Bring back the hunger and the weight goes up. It's simple, it's obvious, and few say it.
Yup..the high failure rate of dieting is true regardless of the type of food or the macros. Lecturing to 'just eat healthy' as the default mode of advice does not work for the large majority of obese people..this is supported by the literature and anecdotal evidence.
I don't count calories. I went off Ozempic (now Mounjaro) and I gain weight at about 0.5-1kg a month.
As I am resistance (gym) training, significant % of that ends up being muscle mass rather than fat.
So I end up taking Mounjaro for about 1-2 months every 3-4 months, approximately 33% of the time being "on".
Funnily, I end up with bulk/cut periods without doing them explicitly. This ends up working well for growing muscles.
Notice all people in the story are women. I guess pairing GLP-likes with bodybuilding works quite well for men. As times goes on, I end up needing mounjaro less due to my increased muscle mass.
yeah that is how ppl become obese. over 2-5 years it adds up
Notice all people in the story are women.
Probably due to social media. Women may be more inclined to show off their success online. Also, women respond better to these drugs compared to men.
This is my biggest issue with weight healthcare, the idea that if only the patient would eat correctly they wouldn’t be overweight. It’s not some moral failing a person often over eats, it very well could be some physiological issue that should be treated. It would be like telling someone with asthma that they just need to get into better shape to breathe better.
On the asthma front, from experiences with someone close to me -- getting in great physical shape (with caveats regarding training) DID indeed help greatly with broncho-constriction and higher scores on FEV. Basically symptoms and inhaler use went down tremendously over a few years and a physical transformation.
Altitude is another factor, due to dry and colder air and lower oxygen -- a double whammy for asthma.
https://www.penguinrandomhouse.com/books/547761/breath-by-ja...
We still need to talk to our Congress critters.
I ask this because when I was younger, I also had tastebuds warped by hyper-palatable foods, but after incrementally getting my diet to such a clean and optimized place, I literally feel bad even while chewing and tasting something like a donut, heavily salted and oiled potato chips, or candy. It's probably like how I would have felt if I literally mixed a tablespoon of oil and sugar or salt together and swallowed it.
Is it that hard to shift the system toward better habits by incremental introduction of better ones, and crowding out the bad? Exercise helps here, because once you begin to enjoy fitness, you get a stronger feedback loop with the bad food creating bad outcomes.
Also, not everybody enjoys fitness.
I don't like it. I still go 5 times per week and have been doing it consistently for the last 2.5 years
I'm muscular, a bit overweight.
With some people, I think they have just lost what being sated feels like.