In 2021 I lost a good chunk of weight the old fashioned way. From 250ish to 215. I did it with "good old fashioned working out and not eating more". It was a miserable, white-knuckle experience. I was eating healthy food, enough calories (moderate but sane deficit), but the only thing I thought about at all moments was getting to the next meal. What snack is low enough calories to have to make it. It was miserable. As soon as I let up a bit, everything unraveled and I found myself back in the 250s by the start of this year.

Now I'm on Tirzepatide (Zepbound), and I'm back to 235ish, and trending lower. I still work on eating healthy, but now I'm not just HUNGRY at all moments. My life continues, and I only have to make individual healthy choices at meal times, and grocery times, rather than a constant struggle at all waking moments. It's seriously a big difference.

Saying that the cure for obesity is to eat less is like saying that the cure for heroin addiction is to stop using heroin. It's both clearly true, and also useless.

I don't think I've ever seen someone seriously put forth the argument "all you need is Ozempic".

For context: I am an overweight type 2 diabetic. I lost about 70 lbs before my doctor started me on Mounjaro (another GLP-1 agonist). My diet and exercise routine were far from perfect, and it took me about a year to lose that weight. My doctor started me on Mounjaro, both for type 2 diabetes and weight loss. I have lost 20 lbs in about a month on it, which means I will lose three times the weight if that pace keeps up (very unlikely). When my doctor and I discussed starting Mounjaro (which the doctor suggested, not me) he made it very, VERY clear that diet and exercise were important things to work on as the weight came off.

The key there is that the pace of weight loss will not keep up as the body's caloric needs reduce due to that weight loss. So naturally a GLP-1 user will plateau if they do not adjust their diet (and potentially exercise routine, though diet is much more important) as the weight comes off. You know what really makes it easier to have the energy to a healthy meal, to work out, and to take care of yourself? Losing weight! You know what helps form those healthy habits in people who did not form them during childhood? Reduced cravings for calorie dense food! Both of those things are where Ozempic and other GLP-1 drugs shine. It gives the person on them the space to make those changes without cravings, without feeling hungry, and at a faster pace than they could do naturally.

So yes, in the short term, these drugs are a great catalyst for change, but I don't see many medical professionals saying "oh just stick someone on Ozempic for life and that's that!" because for the vast majority of people who would use those drugs for weight loss cannot achieve their goals with just the drug alone.

Because not everyone has willpower and discipline. People who do have those strengths often think it is just as simple as saying, "Just take care of yourself", but it is not that easy for many people. High blood sugar also increases cravings, which makes it even harder, bringing on a downward spiral.

This drug can help break out of that spiral and fix the craving/willpower problems.

Why doesn't everyone play piano? Why isn't every person a super athlete? Why doesn't everyone meditate 40 minutes a day? Why doesn't everyone study super hard in school and become an engineer or doctor or lawyer?

The hard truth: Not everyone is capable of those things. Period.

40% of the US population is considered obese. That is a HUGE number. At a certain point, you can no longer blame individuals. There is something wrong, and we identify it as an environmental problem.

So if we have a drug that will make a huge amount of people healthy, what is the downside? And for the record: Ozempic affects appetite so they eat better, that is part of the drug.

Willpower and discipline don’t seem to be what keeps other countries skinnier than the US (and most of them are also getting fatter…) so I don’t know why we expect that to get the US out of this mess.

Evidence: people from skinnier countries move here and consistently get fatter. It’s a societal/environmental problem, if we’re talking about “what would a policy fix look like?” and not “what can I personally try to do to save myself despite being up against a societal/environmental problem?”

Telling people they are morally bankrupt sinners (slothful and gluttonous) and heaping guilt and shame on their shoulders has unsurprisingly failed to stop the issue.

Why do you think that telling people to “just stop being fat” will suddenly start working?

Most people don't work out enough, or don't eat well enough. If we had some kind of intervention that would easily cause people to work out, we would use that intervention. If we had some kind of intervention that would easily cause people to eat well, we would use that intervention. The reason working out and good diet are good is because of good health outcomes. If we have some kind of intervention that skips straight to the good health outcomes, we would use that intervention. It seems like Ozempic is _that_ intervention, so we will use it. I will likely choose Ozempic for myself once it is available to me.

Treat human beings or any organisms as biological machines. Here, many chemicals (hormones, for instance) regulate many processes in such machines. Whatever one has eaten so far, genetic history, environment, etc have changed hormones to a level where the model of dieting and working out doesn't work any longer. So, semaglutide and tirzepatide work on such regulatory hormones (GLP-1, GIP). In other words, what this research tells us that humans are not controlled by their personal will.

> why is taking a drug a novel & cool idea

https://www.glamourmagazine.co.uk/article/post-your-pill-tre...

drug companies have spent millions on destigmatizing pharmaceuticals. its a superpower, apparently. a large swath of this userbase convinced themselves they have adhd and need medication for it. changing tabs on your chrome browser or not being able to do "deep work" = i have an uncurable disease and i require legal meth, for life. you can see how this translates to ozempic.

silicon valley/tech culture has prioritized get rich schemes, cure alls like adhd meds, you don't have to eat just drink soylent for every meal, etc. ozempic falls in line nicely there, and i think among this community and others in this vein, you'll see alot of support for it. its sad, because tech/programmers/IT people use to be very contrarian and open minded. you get in trouble for saying things like "personality responsibility", "discipline', "self-control".

> Are doctors required to explain this before prescribing this in US?

doctors famously aren't trained on nutrition or fitness. ironically the prestige is being a specialist, not well rounded. strange.

Why are we bothering with contraception and STD vaccines when people should just not have sex unless they're trying to get pregnant?

Completely missing the point of GLP-1 agonists. The point is that it breaks the cycle by giving you the willpower to eat less. It doesn't magically make the calories you eat not contribute to your weight, it just makes it easier to eat less and still feel full. It also counteracts insulin resistance, which is another problem inherent to obesity.

It's just human nature. This is the health equivalent of trying to turn lead into gold. It's my unproven opinion that the negative effects of these treatments are understated and this will be a passing fad.

[dead]

I want everyone who says this to submit a picture. Just wearing gym shorts, so we can get a good look. I assume nobody making this a moral issue will have so much as love handles. Because if they do, why aren't they working out harder and eating a bit less?

I've met plenty of skinny fat people who think they're healthy.