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Comment by tetrisgm | Hacker News Reader

Used to be 300lbs. Going down to 200 took 18 months of eating 400 calories as many days as I could endure, and fill myself with water.

It's a thankless process. You fight years of muscle memory that tells you that you should treat yourself. Your brain is telling you about all your cravings and how hungry you are. You could be happy and full right now.

Worse, when you eat, it'll take 30 mins for you to feel full. It's all stacked against you.

Eventually you reach your goal. What now? Can you treat yourself? Loosen up? Chill? The moment you do it's a slippery slope.

It's hard to maintain lost weight because your entire body is a machine that you have trained to want this, and happiness and success looks like learning to let go.

The determination and drive to fix it is very difficult. I can understand how the craving gets appealing with time as things have settled.

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>eating 400 calories as many days as I could endure, and fill myself with water

Wow 400 is insane, good job! I've read that even the most extreme diets are usually 8-900 but 400 is really something else.

It must have been tricky to cover nutritional needs.

Almost certainly not. Vitamin supplementation would almost certainly be unnecessary if those 400 calories were reasonable, and even then a multivitamin is calorie free.

Fortunately now weight loss is basically solved due to ozempic and friends. Suspect a very large % of the population will be on these things indefinitely

https://www.drugs.com/ozempic.html says

> after 30 weeks, patients on Ozempic 0.5mg had lost 2.6 kg more than the placebo group, and patients on Ozempic 1mg lost 3.5 kg more than the placebo group.

That doesn't seem all that much weight loss to me, and it sounds far from being "basically solved".

Also, financing the drug seems to be an unsolved problem, except for the rich.

I am on Mounjaro 10 mg for the past 3 months. I have lost 20 pounds. So far so good, looking to loose more but I seem to have plateaued right now I have not lost any additional weight in the last month... would like to get to 170 which would be another 30 pounds. Luckily my wife works for a hospital and has excellent insurance which covers it. Most people have to pay equivalent to an expensive car payment for it.

Sounds like very low dosages; for comparison:

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.147...

> mean weight loss was 17.3% (SD: 9.3%) with [2.4mg] semaglutide and 2.0% (SD: 6.1%) with placebo

Re financing, they’re incredibly expensive in the US, but in the UK Ozempic ends up being ~£200 a month, and many people seem to find they save that much in food costs. Also this stuff is dead easy to manufacture, every pharma company seems to have their own version in the pipeline, and some of the very first versions (eg liraglutide, from memory) aren’t too far off patent expiry.

I wonder if this might mean that a version 1.x or 2 is somewhere in the pipeline with (eventual) better results to some nth degree. Really hoping we can get some more of these in the US and that the prices will come down as things change.

They very much are! Retatrutide and (semaglutide + cagrilintide) and danuglipron seem to be the ones to watch

Wegovy, the weight loss indication for the same drug as Ozempic, has people titrate up to 2.4 mg/week. Ozempic is generally titrated up to 2 mg/week for T2D. The study you’re looking at used doses lower than is typical today.

> financing the drug seems to be an unsolved problem, except for the rich

Wait a few years for patents to expire (or go grey market with pirated surplus from the factory)

Yeah, those numbers don't account for how much wad more painful for the placebo group

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