This is not a miracle drug. It needs to be injected, comes with a risk of serious side effects and we don't have long term safety data. However, diabetes and obesity are also serious so anything that promises to help on that front is welcome news.
There is an oral once-a-day version sold under the brand name Rybelsus. It is very likely that if they did a similar tests for it you would see similar results as for the injection version (Ozempic).
Would just loosing weight actually help with diabetes? I thought it had more to do with nutrition than sheer body mass, which explains why so many non-obese people get it while many morbidly obese people never do. I can definitely see how reduced mass would help reduce strain on the heart, though.
At the risk of sounding like a proselytizing bastard, but doing it out of genuine concern and sharing what little knowledge of nutrition has personally worked for me: Have you tried a low carb diet like keto?.
It's the only thing that's been able to help me with fast, consistent results and the modest willpower I can dedicate to the problem.
I'm sorry in case you weren't looking for advice.
I lost 70 pounds (nearly a third of my weight) through just restricting my intake to two tiny meals a day. It sucked really hard at first (I was in what felt like physical discomfort and didn't defecate for a week when I started), but it worked and I've kept it off. It takes time (for me the better part of a year), and making a decision and the willpower to stick with it no matter how much it sucks (as long as you know it's safe).
My hunger is still all in my head to this day. I'm sure the challenge of not overeating will last the rest of my life, but the tradeoff of weighing less is worth it.
If you want to read about how far the mind can take you, read David Goggin's book, Can't Hurt Me.
At that weight, you are very likely already regularly connected to your doctor, and have probably tried many things, and anything anyone says here will probably sound rude, ill-informed, or trite.
Regardless, you can get through this. Day by day. Good luck.
It (Ozempic) has already been approved for treatment of diabetes 2 for a couple of years. Maybe you could qualify.
The trials mentioned is basically just a phase 3 trial of the product specifically for weightloss.
> In those taking semaglutide, the average weight loss was 15.3kg (nearly three stone), with a reduction in BMI of -5.54. The placebo group observed an average weight loss of 2.6kg (0.4 stone) with a reduction in BMI of -0.92.
With n=1961, this is well beyond significant.
Also, this is a hunger control drug, and anyone who's been on a diet can tell you that's probably the hardest part.
> The drug, semaglutide, works by hijacking the body’s own appetite regulating system in the brain leading to reduced hunger and calorie intake.
So the same weight loss can be accomplished by simply eating less.
Intermittent fasting is great for that[0]:
> I prefer the daily method: Fast for at least 16 hours per day. The aforementioned New England Journal of Medicine study was based on an 18:6 structure: 18-hour fast, six-hour window.
> "16:8 is a great place to start," Stephens says, "but it may not be a weight-loss window for many people. That's because fat-burning ramps up between hours 18 and 24 of the fast. 19:5 was a great weight-loss sweet spot for me, and I lost at about a pound per week when doing it. With 19:5, you fast for 19 hours a day and have an eating window of five hours. Your sweet spot may be different from mine, of course. Maybe it will be 18:6 or 20:4." Experimentation is key, she adds.
I'm on it for the past two years or so. Haven't lost the 20% weight yet. Still waiting. Its kept the blood glucose #s in better check, but it was a nudge vs a big shove.
Then again, i'm on 1mg/week, rather than the 2.4mg that the study used.
What _HAS_ helped me is keeping track of what i'm eating, and making sure i account for the occasional snack, and various things I'd drop on my food (sour cream on tacos for instance).
I find it unbelievable that people find it difficult to watch one's weight, and adjust accordingly. I was always very slender in my life, and wore the same size clothes for years. I began working out a few years back, and in just a few months, I started growing out of my old clothes. How can the majority of people in the U.S. not notice their weight gain, and not care at all?
Your comment is likely to get downvoted to minimum because it's out of touch, but it does raise an interesting point. Some people have way more of a compulsion than others. Other people's compulsions don't make any sense to someone who doesn't have them (ever seen someone with OCD do their things?), which explains your experience of bewilderment.
The better question is, what's behind the difference in behavior?
Very ignorant comment. Of course people are aware of their weight. The issue is very complex. A person may not prefer their weight, but not want to change their lifestyle. They may be depressed, causing them to make poor decisions, find comfort in binging, etc. The weight could cause sleep problems which compound the problems.
Your comment basically amounts to: "I've never dealt with this medical issue and don't understand anything about it. I also believe that it's easy to fix if everyone acted like me."
I seriously hope you review your thinking on this and learn more on the subject.
Have you ever considered that some people are genetically predisposed to being overweight, just like you are probably genetically predisposed to being slim? I'm not saying that's the only reason--obviously exercise and diet play a huge role--but not everyone is starting from the same baseline here.
I would guess probably the biggest reason for people being overweight in the US is the abundance of cheap and delicious food and alcohol. It's simply really easy to become overweight living in the US.
I personally find it unbelievable that people don't understand how complex of a topic this is.
For example, you cannot explain why people are overweight people by saying they are:
- generically stupid
- ignorant
- lazy
- self-deprecating
- biologically inferior
- weak willed
Clearly there are other more fundamental issues involved. What psychological needs and stress are involved? What environmental factors are present (or missing)? I think that to a degree you can generalize this to things like drug consumption and addiction.
I believe people have their agency and I greatly admire those who start and sustain significant health improvements of any kind. There is a reason there are so many self-help charlatans: the real key to unlocking success is complex.
For the record, I am not one of the people downvoting you. To address your question, this is not a U.S. problem. This is a modern dietary problem. Some countries are just late to the game and the stats have to play catch-up. People are eating a lot of sugar, processes foods, alcohol, excessive carbohydrates, basically sugar sugar and more sugar. This spikes insulin and eventually the cells in the body become resistant to the hormone. It take a while for this to reach the stages of metabolic syndrome, pre-diabetes or diabetes. Because of the time it takes, people do not associate the bad behavior with the bad outcome. Most are either unaware or in denial. [1] The report is from 2017, but this problem is only getting worse and it is not limited to the U.S. It is also not limited to people that are overweight. When people have any of the previously mentioned conditions, the liver becomes fatty. Eventually the liver starts putting fat into other parts of the body. Sometimes it is super obvious large belly but sometimes the fat is stored around the internal organs. This is actually very dangerous, not because of weight, but because of the increased risk in cancer. Working out is a great thing to do, but it will never account for more than about 15% of weight loss. The rest is related to environment and dietary intake, or lack thereof. So many are in denial or unaware that even talking about this in a public forum quickly becomes taboo and results in emotional responses.
The US is a pretty big place but there are some cultural/regional reasons that explain some of the trends. For starters a lot of the country doesn't have access to nutritious food and grows up eating calorie dense but nutritiously void foods. Then you've got portion sizing/control (or a complete lack thereof). It's still pretty normal to eat meals sized for folks doing manual labor but in a lifestyle that is increasingly sedentary.
But to answer your question directly; some people do notice and do care but feel powerless to halt it, other people do not notice because it's sort of a gradual slide/they are already overweight and do not spend a lot of time thinking about their body.
There are some foods I just can not stop eating. The Lindt chocolate balls are a prime example.
The only thing I can do is keep unhealthy food out of the household, which was easier when I was single. Now that I'm married, with kids, and a wife that likes to bake, it's much harder.
BUT: I get that "I find it unbelievable that people find it difficult to watch" feeling when I watch an alcoholic polish off a bottle of booze, or when I see someone with a substance abuse problem polish off a bag of an illegal substance.
Turns out that a lot of people have issues with self-control. I guess I'm lucky that my self-control problems are just food. Could be worse.
It's easy to dismiss people as gluttonous slobs, but the reality is more complicated. Metabolic rate is a big factor: we've all known people that ate with no limits and didn't work out yet were always in shape, as well as people that always watched what they're eating, tried working out and still couldn't lose the pounds.
It takes a lot more willpower and self-control to stay healthy if you're in the 2nd category (Source: I'm fat and lazy).
I'm in the same boat and I think we are lucky to have good genetics/lifestyle. American culture clearly makes the majority of it's inhabitants fat. Your lack of empathy is understandable but something you can change. I've worked on this to help, rather than criticize overweight people I care about.
Avoiding getting fat was the reason I started lifting weights. Eating is so much fun. Tasting good food is one of the greatest pleasures. The only things standing between me and +50kg are Sport and MyFitnessPal.
Casual flippancy and anecdotal experience does not outweigh the countless research that has unveiled the myriad of reasons why people gain unhealthy levels of weight.
[+] [-] meowster|5 years ago|reply
https://news.ycombinator.com/item?id=26113655
(83 points, 124 comments)
[+] [-] ufo|5 years ago|reply
https://blogs.sciencemag.org/pipeline/archives/2021/02/15/gl...
This is not a miracle drug. It needs to be injected, comes with a risk of serious side effects and we don't have long term safety data. However, diabetes and obesity are also serious so anything that promises to help on that front is welcome news.
[+] [-] kasperni|5 years ago|reply
There is an oral once-a-day version sold under the brand name Rybelsus. It is very likely that if they did a similar tests for it you would see similar results as for the injection version (Ozempic).
[+] [-] CivBase|5 years ago|reply
[+] [-] slimbods|5 years ago|reply
[+] [-] buryat|5 years ago|reply
[+] [-] mixedCase|5 years ago|reply
[+] [-] meowster|5 years ago|reply
https://en.wikipedia.org/wiki/Angus_Barbieri%27s_fast
I lost 70 pounds (nearly a third of my weight) through just restricting my intake to two tiny meals a day. It sucked really hard at first (I was in what felt like physical discomfort and didn't defecate for a week when I started), but it worked and I've kept it off. It takes time (for me the better part of a year), and making a decision and the willpower to stick with it no matter how much it sucks (as long as you know it's safe).
My hunger is still all in my head to this day. I'm sure the challenge of not overeating will last the rest of my life, but the tradeoff of weighing less is worth it.
If you want to read about how far the mind can take you, read David Goggin's book, Can't Hurt Me.
[+] [-] numbsafari|5 years ago|reply
At that weight, you are very likely already regularly connected to your doctor, and have probably tried many things, and anything anyone says here will probably sound rude, ill-informed, or trite.
Regardless, you can get through this. Day by day. Good luck.
[+] [-] kasperni|5 years ago|reply
[+] [-] rasz|5 years ago|reply
[+] [-] friendly_chap|5 years ago|reply
[+] [-] pizza234|5 years ago|reply
> [...] adhere to the reduced-calorie diet and increased
> physical activity, providing guidance, behavioural
> strategies and motivation. Additionally, participants
> received incentives such as kettle bells or food scales to
> mark progress and milestones.
[+] [-] Karunamon|5 years ago|reply
> In those taking semaglutide, the average weight loss was 15.3kg (nearly three stone), with a reduction in BMI of -5.54. The placebo group observed an average weight loss of 2.6kg (0.4 stone) with a reduction in BMI of -0.92.
With n=1961, this is well beyond significant.
Also, this is a hunger control drug, and anyone who's been on a diet can tell you that's probably the hardest part.
[+] [-] rebuilder|5 years ago|reply
[+] [-] miles|5 years ago|reply
So the same weight loss can be accomplished by simply eating less.
Intermittent fasting is great for that[0]:
> I prefer the daily method: Fast for at least 16 hours per day. The aforementioned New England Journal of Medicine study was based on an 18:6 structure: 18-hour fast, six-hour window.
> "16:8 is a great place to start," Stephens says, "but it may not be a weight-loss window for many people. That's because fat-burning ramps up between hours 18 and 24 of the fast. 19:5 was a great weight-loss sweet spot for me, and I lost at about a pound per week when doing it. With 19:5, you fast for 19 hours a day and have an eating window of five hours. Your sweet spot may be different from mine, of course. Maybe it will be 18:6 or 20:4." Experimentation is key, she adds.
[0] https://www.cnet.com/health/intermittent-fasting-lose-weight...
[+] [-] mgarfias|5 years ago|reply
Then again, i'm on 1mg/week, rather than the 2.4mg that the study used.
What _HAS_ helped me is keeping track of what i'm eating, and making sure i account for the occasional snack, and various things I'd drop on my food (sour cream on tacos for instance).
[+] [-] rabuse|5 years ago|reply
[+] [-] whatshisface|5 years ago|reply
The better question is, what's behind the difference in behavior?
[+] [-] greenonions|5 years ago|reply
Your comment basically amounts to: "I've never dealt with this medical issue and don't understand anything about it. I also believe that it's easy to fix if everyone acted like me."
I seriously hope you review your thinking on this and learn more on the subject.
[+] [-] briga|5 years ago|reply
Have you ever considered that some people are genetically predisposed to being overweight, just like you are probably genetically predisposed to being slim? I'm not saying that's the only reason--obviously exercise and diet play a huge role--but not everyone is starting from the same baseline here.
I would guess probably the biggest reason for people being overweight in the US is the abundance of cheap and delicious food and alcohol. It's simply really easy to become overweight living in the US.
[+] [-] tgflynn|5 years ago|reply
[+] [-] mr-wendel|5 years ago|reply
For example, you cannot explain why people are overweight people by saying they are:
- generically stupid
- ignorant
- lazy
- self-deprecating
- biologically inferior
- weak willed
Clearly there are other more fundamental issues involved. What psychological needs and stress are involved? What environmental factors are present (or missing)? I think that to a degree you can generalize this to things like drug consumption and addiction.
I believe people have their agency and I greatly admire those who start and sustain significant health improvements of any kind. There is a reason there are so many self-help charlatans: the real key to unlocking success is complex.
[+] [-] LinuxBender|5 years ago|reply
[1] - https://www.cdc.gov/media/releases/2017/p0718-diabetes-repor...
[+] [-] uncledave|5 years ago|reply
Need to treat the causes not the symptom. Magic pill to kill 25% of your weight leaves the causes behind.
Poverty and terrible work culture tend to drive it primarily. I see more fit and healthy people in well balanced jobs.
[+] [-] burnished|5 years ago|reply
[+] [-] gwbas1c|5 years ago|reply
The only thing I can do is keep unhealthy food out of the household, which was easier when I was single. Now that I'm married, with kids, and a wife that likes to bake, it's much harder.
BUT: I get that "I find it unbelievable that people find it difficult to watch" feeling when I watch an alcoholic polish off a bottle of booze, or when I see someone with a substance abuse problem polish off a bag of an illegal substance.
Turns out that a lot of people have issues with self-control. I guess I'm lucky that my self-control problems are just food. Could be worse.
[+] [-] gigel82|5 years ago|reply
It takes a lot more willpower and self-control to stay healthy if you're in the 2nd category (Source: I'm fat and lazy).
[+] [-] interlocutor2|5 years ago|reply
[+] [-] sawmurai|5 years ago|reply
I can absolutely relate!
[+] [-] jscheel|5 years ago|reply
[+] [-] dageshi|5 years ago|reply
[+] [-] SomeHacker44|5 years ago|reply