That sure is a big list of stuff that helps people _who manage to stick to it_. They're very difficult to stick to, judged by rates that people actually do it.
Most of them are less effective than the drug you hate. All of them can be done in addition to the drug you hate.
It all comes down to what medicine is for. Are we trying to help only those who have superhuman willpower? Or are we trying to help normal people too?
A few good questions there, with answers that go deeper into what society and government should be about.
It is absolutely true that there are issues sticking to a healthy diet. As I have said many times in this thread, while being attacked and accused of being some kind of an elitist jerk (I am not), I have battled this issue for years myself. My old-school parents came from a generation that was uninformed and imposed rules such as having to finish everything on your plate, etc. One example of some of the consequences of this is that I lost my sense of satiety. This is hard for some to understand. There are people out there --I was one of them-- who never felt full. That signal simply did not exist.
BTW, you put words in my mouth. I never said, I hated any drug, Ozempic included. All I have done in this thread is state a fact: No person needs drugs to lose weight. On HN, these inconvenient truths, get you a mob attack from every angle.
We could argue that it is difficult. Sure. What we cannot do is pretend that what I said isn't true, because it is.
Now, let's address the difficult part, which is important.
Yes, it is hard. We all know this.
Why?
Because our food system is filled with poisonous addictive shit. That's why.
Here's one of the many interesting elements in this story. The very same agency that approves something like Ozempic, the Food and Drug Administration, also has power over matters related to our food supply.
OK. Great. Isn't this agency supposed to have a layer of people with scientific training working on food and drug issues?
"For more than 100 years, the FDA has been working to carry out our mission of promoting and protecting public health, and that means your health."
Really?
So...the poisonous addictive food sold all over the US --you know, the stuff that makes it very hard to get healthy-- goes through their hands.
If their mission is, as they say, promoting and protecting public health, how is it that they approve a drug with horrific potential side effects to give the illusion of getting healthy without first addressing and regulating root causes?
The root cause of obesity, diabetes, metabolic disease and the myriad afflictions related to this (like cardiovascular disease) is our food supply. There is no doubt whatsoever that this is the case. None. At this point there are probably hundreds of peer-reviewed studies to prove this from almost any imaginable angle.
Why do they approve a non-solution in a form of a drug you have to be on for life? Do they not know that this drug does not fix the massive problems THEY ARE CAUSING by not "protecting public health" by treating bad food like the epidemic it has caused?
I've had people on this thread claim that people in this country are too stupid to read food labels. Bigoted positions aside, OK, let's say that is actually true. Why hasn't the FDA found a solution for that? For example, by severely limiting hyper-processed foods, sugar in its various forms, fillers, certain types of preservatives, etc. Why has the FDA allowed the sale and use of what I am going to call unnatural oils into our food system? You buy nuts thinking that they might be healthy for you, only to discover --if you look-- that they have been cooked in harmful oils.
This is a big topic. The FDA is almost single-handedly responsible for causing a metabolic disease epidemic in this nation.
It would be like a illicit drug rehabilitation center selling the same illicit drugs in their town. They sell both the root cause and a fake solution. That's the FDA.
On the effectiveness of the various programs I listed. They are extremely effective. In fact, they do something Ozempic cannot do: They reverse the root causes of not only getting fat, but all of the afflictions that come with that condition. You can literally reverse type 2 diabetes and metabolic disease. These are not fake solutions, they are real. And, yes, they take work. Well, people have to make a choice. Sometimes it can be hard.
That choice starts with fasting for three to five days. This isn't difficult at all. Ask anyone who has done it. The comments I frequently hear go along the lines of "I was very surprised because it was so easy. I was not hungry at all". Fasting for a few days (not intermittent fasting, a full 3 to 5 days, water only) actually rewires your brain. You come out of it a different person. And, from there, getting on a sensible diet is incredibly easy. All you have to do from that point forward is avoid crap: sugar, flours, juices, refined foods, hyper-processed foods. That means meats, vegetables and fruits. The entire range of good eating habits, from vegetarian on up is on the menu. This isn't difficult at all. Yet, from my experience, you have to start with a fast or the probability for failure is significantly greater.
> It all comes down to what medicine is for. Are we trying to help only those who have superhuman willpower? Or are we trying to help normal people too?
And we come to your last question, which is important. What is medicine for? Let's go with the definition given in the Wikipedia article as a starting point:
"Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others."
A few key points there. They list medical responsibilities for the promotion of health in this order:
In the context of metabolic illness, prevention is the only ethically-supportable path. This isn't really about weight loss. Weight gain is just one of the results of consuming bad food and, obviously, too much of it. One could very well argue weight gain is the least important side effect.
Sometimes I view contemporary medicine with a cynical eye. They are like the police cars that have the "To serve and protect" slogan on their doors. Cops, good intentions aside, are never there to prevent a crime. They are always there to put on a massive theatrical performance with cars, trucks, lights, vests, armament and more. Tough job, I respect them, but they don't protect anyone except for the rarest of circumstances.
Medicine is the same. In the US, doctors barely see you for a few minutes and toss pills at you for everything. It is only reasonable to expect doctors happily prescribing pills to lose weight rather than having to invest the time and effort necessary to actually accomplish what's in the middle of the scale in the definition above: prevention.
Why is this?
Well, once again, we have to look at our government agencies for mucking things up. Our healthcare system is convoluted beyond recognition at this point. The ACA didn't fix anything at all, it actually made it worse. Why? Because doctors have to treat people like cattle if they want to keep an office and make a living. We have the most ridiculous system one can imagine, one where, rather than "protect and serve" with whole life health support and services, we wait until someone comes to a doctor with a horrible metabolic disease, stroke or heart attack and then --just like the cops-- we put on an awesome job full of drugs and technology. We fix nothing. We prevent nothing. And we do not make anyone healthier.
Something like Ozempic is the tip of the iceberg. When you dare look below the surface and --to mix metaphors-- dare point out the emperor has no clothes, you get attacked mercilessly by those who simply cannot or do not want to think below that surface.
We have serious problems. We have an unhealthy society that is being poisoned every day with shit food that government agencies do not regulate as they should. People are up in arms about legalizing marijuana without even bothering to understand that they health disaster being caused by our industrialized food system is orders of magnitude worse than anything MJ could every be charged with.
Nobody needs drugs to lose weight. What people need are government agencies that actually do what they are supposed to do and "protect and serve" the population, not help poison them and then say "hey, just take this drug".
Most of them are less effective than the drug you hate. All of them can be done in addition to the drug you hate.
It all comes down to what medicine is for. Are we trying to help only those who have superhuman willpower? Or are we trying to help normal people too?