[matthewaveryusa]

>These three disorders could really be “CKM syndrome,” which can be treated with drugs like Ozempic

The article is trying so hard not to say that obesity is the cause. I call it the obesity pipeline: You start off young and obese and you don't have diabetes and it's all fine. Stay obese long enough and you get diabetes -> metformin. Stay in a diabetic state long enough and you get heart disease -> statins. These are obesity comorbidities.

[tsimionescu]

There is an alternative possibility: you start out with a metabolic disorder, that will eventually grow into diabetes. Along the way, it will make you obese and cause (directly or indirectly) heart and kidney problems.

Unfortunately, since Ozempic treats diabetes with or without obesity, and it also treats obesity without diabetes, it won't help us figure out if obseisty is a cause or a side effect of diabetes. But there really is little reason to pretend it's clear either way.

[phil21]

History is a pretty strong indication that it’s clear to me.

I find it exceptionally hard to believe populations at scale went from relatively “normal” weights to obese as the majority due to an emerging novel metabolic disorder. All within 1 to 2 generations.

Much simpler explanation is that diets and lifestyles changed leading towards obesity. Whether or not a metabolic disorder happened somewhere in the middle there seems irrelevant to me. It’s very clear to me that obesity causes the issues and not the other way around.

I’m open to thinking differently about it, I just find the evidence uncompelling as someone who was obese the majority of my adult life. Given the unique circumstances of how I grew up and then later experienced life, I’m quite confident obesity is primarily caused by lifestyle. Put simply - put yourself in a situation where obesity becomes easy to achieve and the majority of people will become obese.

Humans being what they are will of course have myriad of outliers to refute the point, but outliers are uninteresting to discuss in this context.

[Aloha]

I'm T2D - I've come to believe obesity is a side effect of diabetes, if I'm not on my medications, I can fast for 2-3 days before my blood sugar comes down, because my liver is constantly pumping out glucose into my system.

There is no doubt that hyper processed foods make this condition more likely, but its not just "you have weak willpower and got fat and sick" - I know a ton of fat people who do not have and will likely will never develop T2D.

[lawlessone]

I think obesity just speeds up the onset, plenty of older skinny people with heart disease.

This is just my unqualified opinion to be clear

[osdamv]

I can run 10 km, MTB 30 km, fat level at 18% and still have prediabetes.

Sometimes is just a bad roll on the genes.

[arevno]

I know that by modern standards, 18% is better than average, but it's also still pretty fat for men. Men should strive for a 10-14% range. <10% is associated with hormone (specifically testosterone) deficiency, and >14% is both aesthetically disgusting, and bad for metabolic health.

Try losing more fat, to the 12% level, then check your biomarkers again.

[e40]

What does metformin have to do with it? I'm not obese, but I'm on metformin.