If you have an open mind, I'd like to assign you some homework if you like. Take a look around r/zepbound and count the following:

1. Posts from folks who diet+exercise, or who have tried diet/exercise and nothing's worked so they then turned to Zepbound ("excited to hit the gym," "my diet is finally starting to work with Zepbound" and similar)

2. Posts from folks who haven't tried diet/exercise and turned to Zepbound first. (e.g. "I'm excited to eat dessert and laze around on my couch all day!" or "Zep is so much easier than before, no more keto for me" and similar)

Which group do you think would have more posts?

Selection bias probably prevents us from being able to count "Zepbound didn't work for me, but diet and exercise did" posts, which is why i suggest this.

Here's my hypothesis: I think self-control is generally uncorrelated to losing weight. Perhaps it's necessary to have self-control to lose weight "the simple way," but certainly not sufficient. I know lots of friends who've struggled and found it's not so simple.

It’s been studied pretty well. Possible effective solutions to the US obesity epidemic are pretty much limited to:

1) Radically alter aspects of food culture, work culture, social policy, and business regulation.

2) Magic pill (/injection)

There appears to be no imminent progress on the many parts of #1 that need serious work, so if we want a big turn-around in the next half-century, #2 has suddenly and surprisingly become a real possibility.

I run three miles a day, never drive anywhere (bike or bus), eat reasonably healthy, and I'm still 20 pounds overweight. And what really scares me is that running is the only exercise I enjoy and if my weight fluctuates up just 5 pounds or so, I start getting hip/knee/foot etc pain. If I gain 10 pounds through some lapse in morality, I won't be able to run anymore and I'm cooked. If that happens, I'm banging down my doctor's door for a pill.

You don't have to worry about which government subsidy is going to help big ag at the expense of your health. It's all of them.

To paraphrase: Instead of relying on medication that helps with issues caused by our society, let's completely change the society so it's no longer the issue?

That's very idealistic, in my opinion.

What is a realistic path to this? Being from Europe I visited US last year and was horrified at the quality of your food. You see a lot of documentaries/youtube videos/etc... discussing the problem, but how do you even go about this?

But you already live in a system that promotes that, quite heavily. Healthy food and active behavior make you more physically attractive, which is in turn linked to better life outcomes along almost every metric you can care to think of.

There is, in fact, already an enormous, fully endogenous incentive to do those things. The fact many people are not keeping in shape (myself included) suggests the allure of food really is just that appealing.

This is like saying, "All things being equal, I'd prefer Santa Claus bring presents on Christmas Eve than have to go shopping for my kids."

It's like well duh of course you'd prefer the impossibly unrealistic miracle.

As compelling as the theory that "unhealthy behavior" is root cause of the obesity epidemics, at this point it seems to me that the weight of evidence suggests an actual physical disruption. It's not supposed to be _this hard_ for (some) people to maintain their weight; something is actually not working right.

https://slatestarcodex.com/2017/04/25/book-review-the-hungry... might be interesting in the same direction.

It would be interesting to run an experiment where everyone in first world countries was able to (and had to) walk to the grocery store to buy their groceries. It seems like that would promote useful exercise while self regulating consumption.

You'd prefer that. Great. Meanwhile we live in this reality.

The government isn't going to help you.

This evening, go for a one minute walk.

Tomorrow evening do the same.

Next evening do the same.

Repeat.

The journey of a thousand miles begins with the first step.

When the majority of the population is so far gone from being in a healthy weight, promoting healthy food for the masses is not going to help that majority. Yes, walkable cities and so on would be great, and promotion of healthy food and habits is great (remember Michelle Obama asking "why are you people so fat wtf?") for future generations, but Ozempic et al. provides a solution where otherwise, a lot of people are simply "lost".

The two are not mutually exclusive.

The problem is that you can't undo millennia of evolution that has pushed us towards the situation where people are obsessed with food and struggle to limit themselves. We also shouldn't forget that not more than a century ago famine and rationing was still commonplace. Certainly my parents were still raised in an environment that hadn't gotten used to food being plentiful and were always forced to eat everything they had at all times and rewarded with food, this has been engrained in myself since I was young as well. I'm lucky that I managed to move away and isolate myself and lose a lot of weight but the important thing to note is that once I got down to a lower weight, everything was easier, getting up in the morning, walking, jogging, working out, talking to people, going outside. Now I've probably gained back 30% of what I lost and if I could take Ozempic to lose 5kg the rest would come a lot quicker because I'd be able to run further and have more energy generally.

All that is to say, these two are not mutually exclusive and if people receive this drug everything we already do to promote a healthy lifestyle will become much more realistic for many people, as far as I understand Ozempic removes the desire of hunger, it's not like people can continue their bad habits and take the drug and lose weight. Furthermore once they assume these habits, the generational cycle of raising children and over indulging will likely come to an end and we will probably not need the drugs as much.

TL;DR, people want to be healthy, they just don't have the tools or motivation to do it. Losing weight will likely be a gateway to many health improvements and benefits for future generations

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Genuinely not trying to be a dick, but if you have time to peruse hn you might have time to go to the gym

I'm glad for RFK Jr. for this reason.

Nobody talked about this in the mainstream conversations in the past.