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samaltmanfried | 1 year ago

I find something really gross and dystopian about the idea of Ozempic. Developing the willpower to resist short-term gratification, and the ability to make long-term decisions about your diet and health are some of the most important ingredients to living a good life. The idea of letting a drug do the thinking for you because you just can't trust yourself really horrifies me.

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orwin|1 year ago

You just don't understand how food addiction works. Going from 34 BMI to 28 (I'm at 26 now) was the hardest thing I ever done, and I had money, great friends, a great family and a doctor that followed me twice a month.

Willpower is not a muscle, it's a well that fill doing what you enjoy, and clear when used. During my diet, my work ethic was at the bottom, and I couldn't force myself to go out meet new people.

Now that I have a healthier weight and stopped dieting hard (I'm still constantly hungry, but now it's my life), I'm a great coworker, I met a lot of people, made life-changing decisions and I have a lot of willpower left to do all the little things right. If I had a drug that helped me control my appetite at the time, i would have taken it.

titanomachy|1 year ago

> Willpower is not a muscle, it's a well that fill doing what you enjoy, and clear when used.

I won't negate your experience, since this is such a personal thing, and it's not like we have a rigorous scientific understanding of these things. But to me, willpower does feel like a trainable thing. Doing hard things seems to make me better at doing other hard things. Limiting my TV makes me less likely to compulsively eat later. Working out hard makes me less likely to lie in bed scrolling on my phone. Doing hard coursework makes me more focused at work.

The caveat is that these changes seem to happen pretty gradually, and the gains can be lost pretty easily, just like with muscle.

But being in a perpetual caloric deficit can be pretty rough and can definitely sap your energy. Glad you found your way to a healthier weight.

Funes-|1 year ago

How have fat people gotten thinner without those meds up until now, then? Was their addiction not as strong as yours, as you seem to imply? They just didn't "understand"? Look, I went from being an absolute fucking fatass to 8% body fat out of willpower alone when I was 17. It took a lot, namely destroying every bad habit I upheld for years regarding food and exercise, but I wanted to do it bad enough, so I did. It was a really extreme and sudden change of mindset, like a flip of a switch, actually, because I had enough of the bullying and lack of self confidence. One day I just got mad enough and changed my whole life.

timewizard|1 year ago

> You just don't understand how food addiction works.

Would you concede that some foods are more addictive than others? Doesn't this suggest other remedies like food regulations, at the very least, should be deployed in concert with seeming "miracle drugs" like GLP-1 agonists?

AlisdairO|1 year ago

Respectfully, have you ever had anything in your life that you have struggled desperately with, and needed help? Anything at all that might give you a little empathy on the topic?

I was obese twenty years ago, and lost the weight via diet and exercise. Keeping that weight off is the single hardest thing I have ever done, and a battle I still have to consciously fight every single day. Doing so causes me a great deal of pain and frustration, and I know that I'm someone who is right on the edge of not being able to control my weight. Why should it be that difficult? So that I can pass some kind of purity test?

The fact is that the food we eat has evolved over time, and is too hard to resist overconsuming for a large fraction of our population. If we can create more addictive food, why not create antidotes? If we could easily treat alcohol addiction with a pill, would we tell alcoholics to just apply willpower instead? Why would we want people to suffer like that?

firesteelrain|1 year ago

I took compounded Mounjaro for two months. It was like a jolt to the system and got me back on track. I learned how to eat better and alter what I eat plus tracking it. Started walking and going to the gym. Started with 7k steps and now easily over 12k a day on average. I don’t drink soda and if I do it js Coke Zero, Pepsi Zero or Diet Coke. We just don’t buy it. I didn’t know about maximizing my protein and fiber.

It wasn’t short term at all like you say. Something was seriously wrong.

It’s everything though - if it was that easy to just start doing it then people would.

I needed a jolt and impetus to get better. I was depressed, worryful, everything.

I have lost 40 lb. I went from 255 to 229 with the assistance of Mounjaro. I stopped taking it but kept up with the regimen. I am now down to 214.

Some people who take it don’t do it right, they still eat crap and so those are the people who rebound or think they need to go up to 15. I was taking 2.5 then 5 when I stopped.

Yea it is willpower and discipline. Being on the medicine as an assistant along with a lot of research spurred by the community such as maximizing protein, fiber and water intake to become satiated was all that did it with exercise.

foxyv|1 year ago

Consider the fact that, if a drug can make you skinny, perhaps a drug can also make you fat. Or, even your own body can make you fat. Sometimes, what we think are our choices, have more to do with our biology and environment.

Just like you can't will yourself to be healthy if you are sick with the Flu. Some people can't just will themselves to be skinny. This is why we have drugs and treatments, because our bodies are not perfect machines that work the way we want them to.

pkaye|1 year ago

> Consider the fact that, if a drug can make you skinny, perhaps a drug can also make you fat.

Yes that would be Prednisone. People call it the devils tic-tac. Its a wonder drug with terrible long term costs to your body especially at higher doses.

timewizard|1 year ago

> with our biology and environment.

Our biology hasn't changed much in recent years. Our environment has. So has our obesity levels. I mean, it's an "environment" that has "super size," as a default option.

JofArnold|1 year ago

This is the kind of comment that can change a person's life. Really thoughtful. I'm going to quote it in future. Thanks.

est31|1 year ago

There is multiple effects fighting against people who want to lose weight:

* habits. often times, obese people use food as a stress response, as a reward, etc. this then makes them relapse.

* "target weight" of the body. there is a memory effect where once you have built up fat tissue, your body wants you to return to that weight. In other words, it's not just the first step that's hard, but all the steps thereafter. Relapse is easy.

* fat tissue makes you more hungry.

* environmental issues, like unwalkable cities, an entire industry putting chemicals into foods that make you addicted to them, its excessive marketing, missing availability of non-processed foods (large percentage of US population lives in food deserts), etc.

It's not just discipline of the individual holding them back.

throw101010|1 year ago

It's also unlike most addictions, you have to eat few times a day if you don't want to die... alcohol, drugs, gambling are not required to survive, eating is.

crooked-v|1 year ago

Telling everyone "just get better willpower" is about as useful on a societal level as looking at a disabled person at the bottom of a set of steep stairs and telling them that the struggle is good for them.

jeroenhd|1 year ago

I know it's an unpopular opinion, but I agree, at least partially. I think you're underestimating the "developing willpower" part, but I do think that helping people lose weight the themselves should be the solution, not chemicals.

These weight loss drugs are conditioning people to feel satisfied with less food in their stomachs, but only while they take the medication. If you don't put the same serious effort into improving your lifestyle, you're going to end up overeating again, gaining all that weight back, and probably going back on weight loss pills. Instead of solving the unhealthy dependency on food that most seriously overweight people struggle with, you're adding a dependency on medication.

Where I live, these drugs haven't even passed medical review for weight loss yet, they're purely prescribed for diabetics. That doesn't stop the illegal second hand market (taking drugs out of the hands of diabetics that are much better served with them) unfortunately.

In general, I do think weight loss drugs are better for society as a whole, as they save people from the ticking time bomb that is obesity, but I wish we could come up with a better solution.

djur|1 year ago

The best way to change your lifestyle is to change it, and GLP-1 agonists make it easier to change your lifestyle. In fact, they don't work at all if you don't. Someone who's unable to change their diet and exercise routines while taking a GLP-1 agonist wasn't going to be able to do it without the medication, either.

And this talk of "dependency on medication" is ridiculous. Lots of people take medication every day to live a better life, or they use medical devices like eyeglasses and hearing aids, etc. That's one of the blessings of modern society.

tjpnz|1 year ago

I do make good decisions and put in 10k steps everyday, which according to my stepcounter puts me in the top 5% for people my age. I've managed to slow my progression into the abyss; but I'm still going there.

Truth be told, my body can't effectively lose and maintain weight unless I'm eating a strict 1500 calories and replacing the walking with an hour long run each day. I know this because I've tried it and managed to maintain it for 6-months. It was a herculean effort and despite the results I paid a toll both physically and mentally. This isn't to say that the laws of thermodynamics don't apply to me; but my body will fight against them harder than most.

(I believe I would be a good candidate for these drugs. The only thing stopping me is the thought of having to be on them indefinitely.)

steveklabnik|1 year ago

Do you object to pencil and paper because people write down reminders because their memory isn't good enough to remember everything?

loeg|1 year ago

Ozempic helps many people make better long-term decisions about their diet than they would otherwise. Do you think no one without extraordinary willpower should be able to "live a good life?" The drug doesn't "do the thinking for you."

plantwallshoe|1 year ago

Would you be horrified at drug that made heroin addicts not want to do heroin anymore?

paulpauper|1 year ago

Just flip it around: what if there were a drug that made people fat? Is it an insufficient willpower issue then? Willpower works for some, but the drugs make it easier.

latentcall|1 year ago

I don’t understand why the USA doesn’t just ban processed foods? I know USA only cares about profit but come on. Other countries don’t eat like we do.

djur|1 year ago

Because there's no coherent regulatory framework to "ban processed foods", no country has ever done such a thing, and it would be political suicide to be the party that banned cheeseburgers, french fries, and Coca-Cola.