[justrealist]

I don't think you understand how stupid and googleable most customer support questions are.

Doctors will have more time for real questions if they aren't answering idiotic questions. You are living in a bubble.

[SoftTalker]

Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed.

[ceejayoz]

I promise you, doctors have been telling fat people it's their fault for many, many decades. It's one of the most common complaints of fat people in a medical context - that the first response to nearly any medical issue is "well you should lose weight".

https://www.nbcnews.com/health/health-news/doctors-move-end-...

> When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits.

> On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease. The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.

[rsynnott]

… Doctors have, of course, been doing that for about a century. It isn’t particularly effective.

Ozempic actually is effective, and will likely lead to significant improvements.

[justrealist]

Are you really trying to blame obesity on doctors? Impressive.

[arcticbull]

> Doctors would also have more time for real questions if they told fat people to exercise and quit eating so many pop-tarts instead of giving them shots with a host of risky side-effects that then have to be managed.

There is no scientific evidence, whatsoever, that diet and exercise is an effective way of losing a clinically significant (>5%) amount of weight and keeping it off for a long period if time (5y). Go ahead and try and find even one study that shows this is the case.

When you diet and exercise, your basal metabolic rate slows down as much as 20-30%, permanently, and your hunger increases. Your BMR is where the vast majority of your energy expenditure goes, no matter how much you work out. In fact there's reason to think that more exercise will actually slow your BMR. Body weight set point is principally genetic and epigenetic, as evidenced from twins studies.

Maybe we'd make some progress on this particular topic if we stopped throwing out tired tropes and blaming people. The only scientifically proven methods of achieving significant, long-term sustained weight loss for most people are GLP-1/GIPs or bariatric surgery (but even there, only a gastric sleeve or roux-en-y work, lap bands do not).

Here's a 29-study meta-analysis which walks you through what I said in more detail [1] and of course the famous Biggest Loser study where everyone on that show regained all the weight in the six years following. The more they lost on the show the more they gained back. [2]

Let's not even get started on the use of insulin to treat type 2.

It's pretty wild how backwards our approach to metabolic health is from a clinical perspective. Your response here is a perfect example.

Now look at Tirzepatide. 90% success vs. 5% success. [3]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/

[3] https://www.nejm.org/doi/suppl/10.1056/NEJMoa2206038/suppl_f...