It's a side effect of the treatment regimen that many people in all likelihood aren't even aware of so it's good to report it like this
So if you have a treatment for moles, and a patient (trial participant) has a mole on their back treated and then falls down the stairs or is run over by a trolley the agency wants you to do an analysis to see if the treatment might have had something to do with getting run over or not taking the lift.
Note: this is not an exaggeration. I have written phase I and phase II clinical trial protocols earlier in my career.
It sounds more like malnutrition and starvation.
I'll concede it may still be better than being fat, though.
That said, based on googling telogen effluvium seems to have lots of causes not related to malnutrition, even if insufficient protein is one of the causes.
I know with the famous 382 day fast guy they fed him vitamins, but I don't believe they do that with GLP-1/Ozempic prescriptions? https://en.wikipedia.org/wiki/Angus_Barbieri%27s_fast
It feels like people want there to be some horrible side effect to these drugs. Idk if it’s some moral objection to weight loss without discipline, or just general mistrust of big pharma.
Being able to lose weight is, in many minds, associated with self-discipline. A route to the same goal that elides self-discipline is consequently viewed as a cheat, a shortcut.
It's a product if the cultural pervasiveness of the Protestant work ethic and its relation to the health and wellness domains. That fine, in my opinion, if one is Protestant, but why carry the baggage for someone else's religion if you're not one, ya know?
Of course, all that ignores that people's bodies are different, and some people will be slim no matter what they do, while others are doomed to be heavier regardless what they do on their own (barring extremes like developing eating disorders), but I'm not sure it would matter even should everyone understand that -- a large proportion of people need someone they perceive as lesser whom they can look down upon, and physical appearance is a quick and easy means to categorize others.
While this is true in individual cases, it is obviously not by any means common. Unless the human species has had some extreme mutations in the last 100 years (and only in the West). Yet this is brought up in every thread about obesity, because believing yourself to lack agency is more convenient.
The second is psychological, people whose bodies work normally and they do everything wrong on their own.
The third is structural. Countries in which a huge part of the population is obese while other similar countries don't have that problem, have systemic issues that cause that. In the US it's the fact policies all around favor food that cause obesity and make healthy food be extremely expensive, which is the opposite of what countries where obesity is uncommon do.
Fix this last issue, wait two to three generations, and you'll see obesity fall to normal levels, at which point, yes, bringing up the moral argument for some of the few remaining cases may even become valid.
Physically, that's not possible. If calories consumed is less than calories burned, the body cannot add weight. It doesn't have access to zero-point energy.
There are a plethora of conditions that cause your body and to not use energy. Whether it be physical disability that prevent movement, or diseases that dis-regulate your metabolism.
There are many people who eat sufficient food and are perpetually lethargic. Their body has the energy, and chooses not to use it.
When I did chemo, I actually put on weight, despite eating almost nothing. I had pretty bad nausea despite my 4 anti-emetics, so food was difficult to eat. Even drinking water was hard.
So how could I have possibly put on weight? Well I was sleeping 16+ hours a day, not moving at all, and my hormones plummeted. I lost most of the muscle on my body. I obviously don’t know what my basal metabolic rate was, but it must have been incredibly low. Even my brain, which uses a lot of calories, didn’t work right. I couldn’t think right.
Rather, my point was simple: calories-in and calories-out is correct, but the mistake evangelists of this ideology make is assuming calories-out is fixed or even a simple equation. It's not, and this is what pushes your narrative from "science" to "ideology".
Indeed, you said this instead:
>There are a plethora of conditions that cause your body and to not use energy
Now, grammatically it makes no sense, but I thought "and" was just a typo and then sentence read as: "There are a plethora of conditions that cause your body to not use energy" to witch I responded.
But now? You pay a very heavy price because you can very cheaply get your entire daily supply of calories in a single meal.
And don't forget, a lot of these people are set up for failure by their parents. The number of overweight children I see is staggering. These kids are almost certain to spend their lives being overweight or obese because of what their parents feed them. A drug that helps someone overcome that is a very good thing.
That's part of it. A very motivated 5' 9" person can learn to dunk a basketball, but it's a lot easier for someone who is 6' 4".
Similarly, there are probably built-in biological settings for how strongly someone feels the desire to eat.
the thing is though, at least as far as our society is concerned: thats a fact not a missrepresentation
https://en.wikipedia.org/wiki/Gluttony
and yes, using tools like GLP-1 is a moral failing. a proper christian would just be more disciplined. and be a straight up better human from that too.
but hey, i'm an atheist, and struggled with my weight all my life to varying degrees. The way fat people generally undersell the issue that theyre fat and keep wanting to be victiums / not responsible for their own actions is extremely dystopian however. and its flabbergasting our societies have degraded so far to no longer even be able to tell that.
Yes, there absolutely is a sense of "it was hard for me, but I did it anyway, you should do the hard thing too". But that's not out of nowhere. Willpower is a muscle. If someone never exercises it, it's going to atrophy. It doesn't need to be shameful, but people who promote these things need to seriously consider the reality that most people's hunger is caused by something real, and just not being hungry does not solve any of those underlying problems.
My mother is a little bit overweight, which is a problem of calories OUT being too low. She doesn't exercise enough. She doesn't have energy to exercise. That's a problem of calories IN being too low. She's taking a GLP-1 now to lose weight. It very exactly does not solve either of those issues. She has less energy. Most of the weight being lost is muscle mass. I think it's despicable that these things were rushed through the medical system. I don't think it's the layman's fault for being manipulated into thinking it's medicine.
I lost now 42 kg from my heaviest (5 kg left to reach my ideal weight of 73 kg), the first 20 i absolutely needed eat less and to fight the hunger pangs (which are more painfull than ankle sprain due to my fucking grehlin receptor being whack), some medical help was needed anyway (i fasted for 5 days under medical supervision to reset my leptin levels, and stayed in ketosis for 3 month prior to that to reset my insulin resistance). 20 kg loss over 18 months. I thought exercise would be enough for the last 20, but i took 5 year to loose 5, and only a change in diet finally helped me go under 80.
NGL, all that is very difficult if you have issues at home or in your life. My family might have individual flaws but as a unit we've been doing great since like 2006, and my income in 2019 when i started my weight loss was comfortable enough for me to have a great apartment, private medial help and a good overall social life.
If people need GLP-1 to get back in track, they should absolutely go for it. I do think we should help them, once they are close to their optimal weight, to sever from GLP1 though, i've heard about the "rebound", imho it is way easier on the mind to eat as much as you use to than forcefully reduce your portions (your leptin/grehlin level were unfucked by GLP1, so your old eating habits are now only psychological, not hormonal)
I also don't think you understand how living with kcal deficiency works on the long run. Have a look at the Minnesota starvation experiment. When in deficit for long the mind constantly goes to "what/when are we going to eat?" and it only gets worse from there. It becomes an obsession. It takes over everything. My understanding is that glp-1 reduces that.
It also helps for people who have too much extra weight, or incapable (waiting for hip replacement, or the elderly) of exercising.
I have been on diet and managed to go back to the target weight (lost around ~16% of bodyweight) but the food noise was real and constant. It is not a one off "I am not going to eat anymore" that was a decision to be made every minute until next meal came around. I do cycle 10-12 hour a week and the occasional footbal game but finding the deficit that is not causing the food noise is different for everyone.
GLP-1 is produced by the body to regulate and balance food consumption. People whose bodies produce less than the correct amount eat more because they feel a lot more hunger than people whose bodies are normal. Taking in GLP-1 drugs, if following medical advice, brings their level back to what it should have been all along, in which case most wouldn't have become obese at all.
I'm such a case. Clinical exames never showed up any clear problem associated with weight gain, so for my entire life my obesity was linked by everyone, doctors included, to lack of willpower.
I only discovered what my issue was when I took a genetic test and discovered that my DNA came with these lovely traits:
* I feel more intense hunger than the average people, so I need to eat more than they do to feel satiated. If I eat the same amount a normal person does, I leave the table literally still hungry.
* My body accumulates more fat than the average person, so even if I eat the same amount they do and keep constantly hungry, I accumulate some fat.
* Caloric-reduction diets don't work for me. So the years and years I tried and tried them had little effect, and were mostly wasted effort.
* Fat-reduction diets also don't work for me. Good thing I didn't lose time with those since everyone recommended me the useless caloric-reduction ones.
* The only diet that has some effect for me is the Mediterranean one, which I didn't know about and no one had ever recommended.
* Physical exercise has little effect for me, as I gain less muscle mass from it than the average person. So the years of walking and the many attempts at going to the gym were also mostly wasted effort.
* And physical exercise causes more pain for me than it does for the average person, so all the time I was doing those, I was suffering more than most people while getting worse results then they do from it.
If your genetics is normal on all those fronts, then sure, a bit of willpower fixes that. With that combo though, and fully not knowing you have any of that? Not a chance.
You don't know this.
> These things are useful for a few months
You don't know this.
> For anyone else (most people), it's much healthier to learn how to do difficult things.
You don't know this.
> Willpower is a muscle.
I know you mean this in a figurative sense, but what exactly is "willpower"? There has to be a physical (and physiological) mechanism for "willpower", no?
Do you believe that can be aberrant physiological conditions?
I do. I also believe over-eating is a manifestation of some type of "aberrant" physiology.
She has a PhD in biotechnology and works in a lab. She is also quite thin (always was).
It's crab mentality disguised as moral position. It's especially obvious when the same people advocate for free access to drugs, alcohol or gambling. You should have freedom you do anything as long as it doesn't improve your life or move you to in social hierarchy.
- Concerned about fatphobia
- Worried Ozempic might create a two tier society
- Believe we should have unrestricted access to gambling and drugs
This sounds like a goomba to me.
Isn't the whole point to read about what others think or experienced to learn about things you personally hasn't?
Edit: also regarding the moral/discipline thing, to many people me included the larger issue is absolutely not this, it’s obviously a good thing if people can improve their health. It’s that we are unhappy that the answer to food designed to be addictive and that is poisoning people is having to research a drug and having the whole population take it to protect themselves. I have a hard time celebrating such a waste of resource and a supposed market "innovation" hiding yet another government failure at regulation. When people were poisoning themselves with lead pipes, the answer was not having the whole population take a drug to manage the effects of lead poisoning. Even if there was absolutely 0 side effect I would be happy for the individuals losing weight, but unhappy with the larger picture.
Ultimately everything is risk calculus. Ozempic, like all drugs, has risks. When you compare ozempic versus not taking ozempic, it’s not like those risks disappear.
Take, for example, vision loss. The risk of vision loss IS NOT “ozempic” versus “no risk”. Because the default of doing nothing is typically diabetes which causes… vision loss. So, it’s entirely possible that the risk of vision loss is much higher from not taking ozempic than taking ozempic.
I had cancer and I had to do multiple types of chemotherapy. It damaged virtually every organ in my body. But it’s not like that risk would disappear if I didn’t do chemo, even though chemo caused the damage. Because the alternative is death. You have to weight these things, and too often people just assume that the default of “do nothing, take no drugs” is safe. It’s not.
Anyone can take a lot of GLP and crash diet very easily.
If any person is capable of rapid weight loss naturally with no drugs, they already have enough willpower and ability to diet sustainably.
News: "Another nasty Ozempic side effect: Clothes no longer fit"
Research suggests that these drugs may lead to emotional flattening, which can impact feelings of attachment and desire in relationships.
In an economic sense the cost that you'd associate with those is research, which you would have already paid when choosing to use a drug with a net positive effect.
Ehhh no. But thanks for making my point.
People import it from China from suppliers and do not know how to properly dose it. Many are using it in knee jerk fashion with no proper dosing protocol.
Why they do it? it's because it's cheaper this way and they have to answer or explaining the use to no one.
Others have this strange idea, "if i am using GLPs, exercise and dieting is no longer needed".
When long term experienced GLP users say, you still need a dieting and workout protocol, https://www.reddit.com/r/tirzepatidecompound/comments/1omfgx...
GLPs are very useful but they are not needed by vast majority of people who use it.
And key questions
1. Do you really need GLPs? how did you figure this out?
2. How much do you need?
3. What's your dieting and workout strategy?
Very few GLP users actually run through these questions.
People should stop pushing it as a “miracle” and instead see it as a “tool” used in specific cases.
I do encourage anyone who can remotely afford the name-brand drugs to buy them, but even with price cuts they're still quite expensive. So while I'm never going to encourage buying pharmaceuticals from sketchy grey market producers, I find it very hard to tell the people who can't afford GLP-1s that they have to just deal. It'd be like not being able to buy painkillers.
What's the source of this info?
The market is filled with "Eat X for weight loss, eat Y for weight gain."
The average person actually does not choose the right strategy for weight loss which is "Calorie Deficit"
But implementing it is not "EASY" until you understand how expenditure, calorie intake, and weight movement work, which is too much work to understand for an average Joe.
OKAY, vasty majority of people on HackerNews can probably wrap their head around these concepts if they find the right resource, but average Joe can't.
Let's take something as simple as "calorie deficit."
Being at a calorie deficit itself requires knowing two things:
1. How much you burn in a day (total daily energy expenditure or TDEE)
2. How much your intake is for the day
Deficit = TDEE - Intake
You can do calorie counting for #2. But what can you do for #1?
The average guy does not know how to calculate these properly, let alone judge weight movement, which can move a lot in the opposite direction due to water weight fluctuations that can exceed 1 kg+ of movement a day.
Have you seen the math required for figuring out "Maintenance Calories?, see this: https://macrocodex.app/knowledge/rethink/adaptive-tdee/
And all the factors that go into this? see this: https://macrocodex.app/knowledge/macrocodex/smart-calorie-bu...
We've 17,000+ users why? because #1 is a difficult problem for many.
>What GLP-1s immediately illustrate to most people who try them is that there's a real, physical problem with their appetite that only GLP-1s successfully correct.
That doesn't mean every guy who is overweight by 5-10kg needs GLPs.
>A few weeks after I started taking GLP-1s, I started to feel full again for the first time since college. Everyone should work out daily and maintain a varied, healthy diet, but I did and they never made me feel that way alone.
Sorry but most people diet poorly, dieting well requires training and education.
GLP users themselves say this, https://www.reddit.com/r/tirzepatidecompound/comments/1omfgx...
Have you actually worked on this problem? or you just make bunch of assumption and accept them as "truth"?
At the end, I am not a GLP “hater.” If you fail to stay at a deficit for several weeks (deficit 300-400kcal) due to poor appetite regulation, you feel insanely hungry even after volume eating methods, improving physical activity by walking more and lifting 1x a week etc..., you are perhaps a valid candidate for GLP, so you can reach out to doctors.
Eating whole foods, lifting 1x a week, and walking 10k steps (at zone 2 pace) are something everyone should do, regardless of whether they are fat or not!
But saying all fat people need GLPs is something I am not going to agree with.
> “For people taking or considering GLP-1 receptor agonists, the main takeaway is: do not panic, and do not stop an effective treatment on your own because of your hair or nails—but do mention these symptoms to your doctor,” study author Charles Taïeb, a clinical dermatologist at Necker University Hospital in Paris, told Gizmodo.
Wow. Sounds pretty fuckin serious. Can't believe people are taking these highly dangerous drugs instead of mustering up a mass of eternal self-discipline they clearly already don't have and never will. Shame on them and the doctors! Side-effects are very serious even if the people taking about them are like "uhhh yeah not a huge deal, but like, be aware and talk to your doctor about it", why not just try being a perfect human being like me! Try not being fat! I am very smart!!!!
That take does have some merit actually. The easier it is for people with low self-discipline to reproduce, the less self-disciplined future generations will be, and they might simply be unfit to handle future cataclysms.
Case in point: imagine teleporting to America in year 1000 and telling locals that they should go through a few plagues in order to build immunity. They'd call you crazy and then rip your heart out, and centuries later die from diseases brought by the Spanish.