Weight Loss Meds (Wegovy, etc)

[verticaldoug]

Originally Posted by mcteague

I had this conversation with someone recently. I noted that very few in my high school class, back in the early 70s, were fat. The kids that we considered fat would only be a bit overweight today. Genes certainly don't change in that short a period of time. My guess it comes down to how much more processed food, and fast food places, there are now. Plus, kids are far more sedentary now than in years past. Bit by bit it all adds up. I'm 6' and 160 lbs but could still stand to lose a couple of pounds around my waist. I rarely say it out loud as I look very slim and most people take that claim as a humble brag. Still...I notice it.

Tim

https://pmc.ncbi.nlm.nih.gov/articles/PMC3147141/

There are some studies with Rats and food addiction. If rats eat their normal diet, they don't over eat and don't become obese. However, switch to a processed food diet, and the little buggers gorge themselves.

Once you take the processed foods away, and offer them their normal diet, they don't go back to eating it right away. They eventually have to be starving before they will eat the healthy food.

The high fat/sugar content process foods rewires your mind a bit. This is what is really going on. Maybe it is all high fructose corn syrup.

[nmrt]

I do not know what really is going on with the food in the US to lay blame on a major culprit. But we do gets bits and pieces of the usual food additive culprits every now and then via research -- HFCS, pharmaceuticals in our food, highly processed things that do not look like food but taste "great". Still, it is an inescapable fact that we are getting fatter as a nation. Where was this obesity 30-40 years ago? Why is it that we are blessed with this obesity when other developed nations have 3-4-5 points lower BMI that our good 'ole USA?

Is obesity a moral failure? For everyone? Of course not! Are there people who have genuine medical issues leading to their weight? Of course! When looking at a population, we can see all sorts of cases. But I feel, as a nation, we look to drugs as a panacea. That is unsettling, and as we parrot their "advertisements" on why we should be taking their drugs, we are moving farther away from addressing the real causes of obesity. For most people, genetics plays a HUGE role. But for many, many people, do not discount the type of food they eat and their lifestyle.

Originally Posted by verticaldoug

https://pmc.ncbi.nlm.nih.gov/articles/PMC3147141/

There are some studies with Rats and food addiction. If rats eat their normal diet, they don't over eat and don't become obese. However, switch to a processed food diet, and the little buggers gorge themselves.

Once you take the processed foods away, and offer them their normal diet, they don't go back to eating it right away. They eventually have to be starving before they will eat the healthy food.

The high fat/sugar content process foods rewires your mind a bit. This is what is really going on. Maybe it is all high fructose corn syrup.

[unterhausen]

My health would really benefit from losing weight. I had a number of health setbacks that have led me to weighing more than is good for me. And my high BP goes away when I weigh 40 lb less than I do now.

I have to say that Wegovy and Ozempic already work for me even without taking them. I was volunteering for a 200km ride outside a bbq restaurant, and i was going to eat lunch there. Then the first rider showed up looking much better than he did when I saw him 2 years ago, really slim and muscular. He was riding faster than a lot of pretty fast riders. Apparently he's taking Wegovy. The problem is you have to work out a lot to keep from losing muscle. He says he barely has time to ride because he's always working out.

So anyway, seeing him led me to skip the bbq for lunch. Working already and I'm not even taking it.

I am not a big fan of the way these drugs work. And if you do go on a long ride, you have to taper so your stomach works normally.

[professerr]

First off, I’ve always been very lean, and so has my family, so I’ve got no dog in this fight, so to speak. But I have quite a few friends and family who take all sorts of meds to treat health conditions that they could otherwise clearly address with the appropriate doses of diet and exercise: high blood pressure, various heart disease, pre-diabetes, diabetes, joint disease etc. But these conditions can also be treated with a pill, like statins, metformin, and what not to treat these conditions. So they take the pill. And people applaud them for staying on top of their health.

And yet when it comes to addressing the reasonably serious health condition of the OP being 40lbs overweight — something that now could also be treated with a pill — we instead get all these sneering suggestions to “pass on the twinkie plate” or insinuations that overweight people are foolish, or ignorant, or lack will power, or have some sort of mental illness. I don’t know why, but there’s something about health issues related to physical appearance that trigger this sort of eagerness to judge. (And I confess as a skinny guy, I’ve had this reaction too)

I say what ever your health condition is, doing something to address it is the important thing. So if you’re unhealthfully overweight, sure, diet and exercise is pretty clearly the preferable treatment — but only if it works. If not (which is usually the case), then take a damn pill if you decide the risks/side effect are worth — just like treating any other health condition.

[fourflys]

thanks for all the responses!

As the OP, I haven't felt attacked by anyone on this thread yet.. there have been some folks who have some interesting thoughts, but I don't think there was any malice intended.. for the record, I have also, in the past, thought that folks can just "eat better".. and I could totally eat better and do more exercise for sure, and maybe that is the direction I go with this..

I will say that these meds are a great option for folks who have tried everything else and haven't success, for whatever reasons..

Thanks all!

[mistermo]

I recently listened to a program on these GLP-1 agonist drugs where experts weighed in. One called obesity a disease where another was politely refuting this label, asserting that obesity has societal, not disease-state origins.

It's my understanding that the tendency to become an alcoholic (and other addictive behaviors) is underpinned by genetics. Not all of us have these genes.

Over the last generation, the prevalence of obesity has skyrocketed with the movement to processed foods, increased sugar consumption, larger portion sizes, increase food accessibility, and sedentary lifestyles.

Our genetics have not changed in the last couple decades, but our lifestyle and food choices have. Most of us have the ability to maintain a healthy weight but it requires a discipline and a lifestyle that are inconsistent with the societal norms of today. If obesity is a disease, it would have been just as prevalent in previous generations.

[EB]

A disease is defined as an abnormal condition that affects the function of an organism and isn't due to some immediately obvious external cause like being hit by a car.

Diseases can be caused by the environment that an organism is in. For example, lead poisoning is caused by exposure to an environment that is contaminated with lead. Radiation poisoning is caused by exposure to radioactive material. Interestingly, radiation poisoning was almost unknown as a disease until Madame Curie's experiments - so a disease can be strictly modern because the changes to the environment that cause it are strictly modern.

The disease model exactly fits the modern condition we have seen where it has skyrocketed as the modern diet, and specifically the way modern food manufacturing operates, have come to dominate people's diets, together with changes in physical activity as modern life requires more and more sedentary activity. Most people work for a living and their job requires them to be sedentary - the ability to choose to go ride a bike whenever you want for however long you want is not something that most people in the United States have. These environmental conditions are quite distinct from earlier eras.

I would also caution against overestimating the role of free will in any of this. Whether free will even exists is an interesting question - consider the radical personality changes that sometimes occur with individuals being treated for Parkinsons with dopamine agonists. It is not clear to me how many of our choices are really choices or merely responses to our environment, like with supposedly "lesser" animals. Much of what we consider rational choices turn out to be post-hoc rationalizations of our emotional or conditioned responses. I would not argue that human beings are simply automatons - but we are very poor judges of how much control we actually have over ourselves at any given moment.

[fourflys]

Originally Posted by mistermo

I recently listened to a program on these GLP-1 agonist drugs where experts weighed in. One called obesity a disease where another was politely refuting this label, asserting that obesity has societal, not disease-state origins.

It's my understanding that the tendency to become an alcoholic (and other addictive behaviors) is underpinned by genetics. Not all of us have these genes.

Over the last generation, the prevalence of obesity has skyrocketed with the movement to processed foods, increased sugar consumption, larger portion sizes, increase food accessibility, and sedentary lifestyles.

Our genetics have not changed in the last couple decades, but our lifestyle and food choices have. Most of us have the ability to maintain a healthy weight but it requires a discipline and a lifestyle that are inconsistent with the societal norms of today. If obesity is a disease, it would have been just as prevalent in previous generations.

fairly interesting summary of "disease" in this paper from the NIH site..
https://pmc.ncbi.nlm.nih.gov/articles/PMC1299105/

[PurpleBikeChick]

Originally Posted by nmrt

.... Where was this obesity 30-40 years ago? .... For most people, genetics plays a HUGE role. .

I believe there must be an environmental factor(s).
Obesity rates have risen greatly and I think it would be highly doubtful genetics would change in such a short time.
Late 1980 early 1990s seems to be the inflection point.
Not my field, change in food eaten is high on the list of suspects & increasing sedentary lifestyle IMO.

[nmrt]

I should have clarified my statement. Genetics plays a huge role in "losing weight" and "gaining weight". Some people can lose or gain weight much easier than others.

I am 5 ft 8 in and 140 lbs. To maintain this weight, I exercise 12-18 hrs of week and keep a keen eye on what types of foods I consume. If I did not, I think the weight gain would come in a hurry as it has done in the past.

Originally Posted by PurpleBikeChick

I believe there must be an environmental factor(s).
Obesity rates have risen greatly and I think it would be highly doubtful genetics would change in such a short time.
Late 1980 early 1990s seems to be the inflection point.
Not my field, change in food eaten is high on the list of suspects & increasing sedentary lifestyle IMO.

[mistermo]

Originally Posted by EB

A disease is defined as an abnormal condition that affects the function of an organism and isn't due to some immediately obvious external cause like being hit by a car.

It is not an abnormal condition to gain weight when living a sedentary lifestyle, eating excess sugar and processed foods. This is normal human physiology for most all of us. For most of those who are obese, there is an obvious external cause or causes.

Part of my resistance to the over-application of the word disease, is that it suggests victimization. It implies we have no control over our health state, because we have a "disease" and are therefore victims. We are not. I hope we all agree that there's a correlation between obesity and the prevalence and consumption of processed foods, sugar, portion quantity and the overall accessibility of food. Physiologically speaking, we are no different than we were a generation ago when we WERE living healthier dietary lifestyles.

[Louis]

Originally Posted by Likes2ridefar

My opinion is learn to eat properly, exercise more and with variety, and stay away from the drugs. I don’t buy that the majority of the population is incapable of doing this. For those in the minority that can’t, well, I’m not your guy.

+1

I lose weight when I eat right and exercise.

I gain weight when I don't eat right and exercise.

I stay about the same when I don't eat right and exercise a lot.

[EB]

Originally Posted by mistermo

It is not an abnormal condition to gain weight when living a sedentary lifestyle, eating excess sugar and processed foods. This is normal human physiology for most all of us. For most of those who are obese, there is an obvious external cause or causes.

It is normal for a human being to run a fever and become congested, sometimes to the point of death, if they contract the flu. The point is that disease is a model. In this case, it's a useful one for thinking about why obesity has become so prevalent in the United States.

[AngryScientist]

This has been an interesting discussion.

As far as I know we are all just armchair physicians here though.

I would still like to know if the OP is under the care of a medical professional, and what they advised fort the OP??

There has also been no mention of what, if any steps the OP has taken to reduce the weight (or weight gain) already.

To be clear, I mean no disrespect or attack of the OP at all. I think to have this conversation better, it would be helpful to have a more clear picture of the situation.

[mistermo]

Taking the conversation in a slightly different direction...

I have been diagnosed with a congenital heart condition. I am not obese, though I could lose weight, like most of us. My cardiologist has indicated these GLP-1 agonist drugs have considerable cardiological benefits and has offered to put me on one, to treat my heart, not for obesity reasons.

I'm not one to enter lightly into medication and am trying to learn more about their efficacy, benefits and perils. I'm still undecided.