Comment by toomuchtodo | Hacker News Reader

Comment by toomuchtodo | Hacker News Reader

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> Preface this by saying I have nothing against Ozempic, and its uses. But there are people (myself included) who do not believe for one second that there are people who if they actually watch what they eat and exercise, can't lose weight. Outside of extremely rare conditions, I don't believe that's possible. And yet so many people claim it. Just admit that you want a shortcut, there's nothing wrong with that.

My sibling, who has an addictive personality trait, required bariatric surgery after attempting for years to lose the weight (~120lbs overweight). Their doctor told them if they didn't lose the weight, it was going to kill them. Post surgery, they are in the best shape of their life. Insurance covered it, because they demonstrated they attempted all other options first. They simply can no longer overeat now due to the plumbing update.

But sure, laziness. Feelings over data. Shockingly common.

(these drugs were in clinical trials at the time their surgery was scheduled, and were inaccessible to them)

>But sure, laziness. Feelings over data. Shockingly common.

What point do you think you're proving here? Your sibling, with some rare condition, is anecdata.

Do you honestly think this is the common use case for Ozempic? Maybe you should try looking at the data. America has an obesity problem, and it isn't because there's widespread metabolic conditions. People eat too much and move too little. The use of this drug is 90% cosmetic. And, as I said, have at it. Elon using this drug was one of the first times I'd heard of it. Metabolic condition, of course.

This is no different than half the population having ADHD and being on stimulants. Or Quaaludes. Or whatever. It happens over and over.

America does have an obesity problem and you think it's willpower. Does that make sense? 41% of the population just can't will their way to a healthy BMI? You say my sibling has a "rare condition" while admitting America has an obesity problem? Does that sound rare?

I absolutely believe these drugs are a solution for genetic predisposition and a society that has engineered people into unhealthy lifestyles. Remember this comment when the next Pepsi semi trailer rolls by.

> This is no different than half the population having ADHD and being on stimulants. Or Quaaludes. Or whatever. It happens over and over.

I think we have different ideas of genetics and brain chemistry leading to outcomes.

>You say my sibling has a "rare condition" while admitting America has an obesity problem? Does that sound rare?

I'm giving you the benefit of the doubt. I have no idea what was wrong with your sibling. But if you're telling me that they had a controlled diet and exercised and still became obese enough that it put their life at risk, I'd say that's a rare condition, yes. Do you think that is 41% of the population? How about 30%? 20%?

>America does have an obesity problem and you think it's willpower. Does that make sense?

Yes, it does make sense.

Dieting (and/or caloric restriction) is harder than not. Exercising is harder than not. I struggle with both myself. This is how the brain works. I'm sort of astounded that this is news to you.

Oh, and if I get to the point where Ozempic is useful to me, I'll take it. But I won't tell people I have a condition.

I agree with your general idea that America’s obesity problem is not generally genetic. It’s fairly recent, and much too recent for genetics to be a major factor.

But I disagree that it’s a willpower problem. It’s a society problem.

I moved from America to Europe and there is little obesity here — because you get daily exercise automatically by walking around (due to good city designs), and toxic food is illegal.

Compared to the standards in America where you walk to your car in the driveway (and that’s the extent of walking that your city provides), and none of the food in the grocery store is actually what the box says (because it’s all chemical imitations).

In Europe, there are no hurdles to overcome because you get good food and exercise automatically just by living there. In America, you can overcome the hurdles with willpower, but you shouldn’t need to in the first place, if society just created a healthier environment.

>and none of the food in the grocery store is actually what the box says (because it’s all chemical imitations)

Grocery stores here are packed with junk, yes. But they also have an abundance of healthy foods. Probably more than any nation on earth.

I don't know if "willpower" is the right term, but it conveys the idea.

Cost, good design, and knowledge of nutrition are all factors here.

In short, it's less mentally costly in Europe to be fit, whereas in the US life is optimized to minimizing healthy activity.

I think it's a myopic take to observe a society-wide increase in obesity and shrug it off to not enough people watching their CICO.

As you say exercising is hard. Passing up a burger or a piece of pie is hard too.

My question to you is this. Is it equally hard for everyone? I'd say no, for some people running (when not being chased) is fun and for others it's a chore. Some people really really like a piece of pie after dinner and some are mildly interested.

If you put some people in a place where they don't technically need to move more then getting up off the couch then they won't. If you can eat all you want some will really eat a lot and others won't.

I think the world we find ourselves in is one where in respect to food and exercise we're limited only by desire. You can say metabolic or whatever but it seems to me some people just have a higher bar to clear - and unless you know what that is for you and them it's hard to begrudge them wanting help.

https://news.ycombinator.com/item?id=37473954 (Food Can Be Literally Addictive, New Evidence Suggests)

https://www.cell.com/cell-metabolism/pdf/S1550-4131(23)00051... (Habitual daily intake of a sweet and fatty snack modulates reward processing in humans)

https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.2878 (Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta-analysis)

Alcoholism, ADHD, obesity. The common thread is dopamine. Amphetamine raises the background level of dopamine, semaglutide flattens the reward peak.

Would you reasonably expect an alcoholic to stick to three drinks a day? Same deal with food in many cases.

https://www.scientificamerican.com/article/could-new-weight-...

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