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As for the show, I have mixed feelings. They just kept jumping the shark time and time again so at some point it got sort of normalized.
They'll definitely gain weight, it is quite easy to tell that they aren't exerting much effort during pedal assist.
Tire noise is enormous though. I think their tires are made / selected with this in mind, as young males often do like to get attention. Most e-scooters are way quieter than these ugly things.
But somehow the Dutch have this collective amnesia on the topic, and today nobody remembers how the "snorfiets" problem of 10-15 years ago has pretty much disappeared, to be replaced by a quieter and safer mode of transport (even ilegally modified E-Bikes usually fall far short of modified "snorfiets" speeds).
> [...]appear to be designed without pedaling in mind,
> as exerting effort without proper ergonomics would
> quickly become uncomfortable and painful.
The "fat bike" design is something that wouldn't work well unassisted, because it trades a severe increase in rolling resistance for better ride comfort.
But as a clean sheet design it makes more sense than the alternative. Why incorporate a complex suspension design (which, to be fair, some of them also have), when you can just have the tire absorb the bumps in the road? The marginal cost in electricity is trivial.
It's only a trend because people are not using them like bikes. The people who still want to pedal but need help because of illness, old age or too-long-distances for normal cycling often purchase actual bicycles which use normal bike parts.
> The "fat bike" design is something that wouldn't work well unassisted, because it trades a severe increase in rolling resistance for better ride comfort.
That is an understatement. People would quickly develop knee and/or lower back pain if they had to put any effort for any meaningful distance.
I live in the Netherlands, where the average teenager used to ride a regular Dutch city bike. Internal hub, no-frills bicycles.
Nowadays, however, fat e-bikes are all the rage among that age group. They are quickly becoming extremely popular, and are essentially electric scooters without plates or registration. Many of them require little or no effort to pedal, and can carry up to two riders in them. These are also designed to meet regulations, while also being able to easily be modified to circumvent them, such as removing speed restrictions, and removing the need to pedal itself.
This is also reflected in the shape of these things, which generally does not account for ergonomics. Their seat and handlebars are usually fixed in place. They appear to be designed without pedaling in mind, as exerting effort without proper ergonomics would quickly become uncomfortable and painful. You can actually see some such bikes in the linked article.
Time will tell whether this is truly healthy to them, but I have a hard time believing this to be the case. I think the fat bike demographic might start putting on weight.
But then again, take a stroll around a shop-laden street in Japan and you'll see the exact same thing. They just like it that way.
Funny thing is how for interior design they do a full 180 and typically go very minimalistic.
But to add to this, I feel like there are different kinds of addictive behaviors at play that are more susceptible to one medication or the other and are based on different systems.
For instance, the food-craving reduction in GLP-1 is almost certainly not just related to reward and goal-seeking behavior. It literally affects hormone signaling for satiety, and slows down the movement of food through the stomach, and affects, globally in the body, responses to metabolic signals. And it probably has a global effect on the way every cell in the body works, which might be why there are positive health effects beyond just the weight loss.
ADHD medication, on the other hand, targets the goal-directed activity system directly. It seems much more likely to me that reduced appetite is just as much driven by the focus and "let's get shit done" mode that is artificially increased with dopamine. Both result in reduced eating but through massively different pathways. Basically, you pay attention to the biggest wave in the pond (the waves in the pond being a metaphor for all the things your brain COULD pay attention to). So when the goal-stuff gets increased in size, the food-seeking is automatically smaller by comparison, and less likely to drive your behavior and thinking.
I don't think I can say that there is much of a pattern between ADHD and overeating, just based on how easily I can predict if someone is overeating or not if I know they have ADHD. That is, it would be a coin toss.
The simplistic answer would be: Semaglutide reduces addictive behavior if it's driven by emotional regulation needs, and ADHD medication reduces pure drug-like craving. As seen in studies where people that start lisdexamfetamine (ADHD medication common in the EU) have a huge reduction in actual amphetamine abuse.
Case in point: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... Findings In this Swedish nationwide cohort study of 13 965 individuals, lisdexamphetamine was significantly associated with a decrease in risk of hospitalization due to substance use disorder, any hospitalization or death, and all-cause mortality.
Emotional regulation issues are one of the most difficult ADHD traits and it's quite under recognized for how badly it affects many of us. This is likely the reason why anxiety misdiagnoses are also fairly common.
Often, I think that it’s a bad move, as the clinical effect of losing around 20 kg would have to be matched by some extremely high frequency and severe side effects. Overweight is still not sufficiently appreciated for how dangerous it is, especially after they ramped up production so much that there isn't a real shortage anymore.
Ironically, most of the people who respond well to Ozempic and stay on it have few psychiatric problems. But those who almost desperately want to get off it after a while might be those who have a psychological component to their overeating. The obvious suspect then is eating as emotional regulation. So one could extrapolate, at least as a hypothesis, that the ones who have worse life expectancy due to regained weight after a year of usage are the ones who have a double set of problems stacked against them: overweight and emotional problems. That would have a huge effect on longevity.
This is PURE free association though, no deep analysis behind it.
I have also heard about people with ADHD being on GLP1 agonists that it does a lot for their reward seeking behavior and impulse control.
This makes me wonder two things:
- Whether at some point these molecules will also start being used for ADHD and addiction treatment in general. I think they hold a lot of promise for issues rooted in the reward system.
- Whether a sizable portion of people who struggle with their weight have co-morbid ADHD which creates or worsens their overeating issues.
Have you noticed anything along these lines in your practice?
But why is the water making its way to the edge all the time?
Eventually the whole protomolecule thing settles down, and afterwards you have essentially politics and genocide in space, which can be good but almost feels like a different genre.