Because other interventions have the consequence of actually working.
If we compare the efficacy of "telling people to lose weight" vs taking ozempic, there is a stark contrast. Pooled results show that education and counselling[sic] did not significantly reduce weight (SMD –0.73, 95% CI –1.89 to 0.42, n = 3 studies; I 2 = 98%)[1]. The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo[2].
Telling people to just lose weight is not an evidence-backed intervention to affect weight loss. Continuing to practice it is equivalent to practicing folk medicine or alternative medicine. Despite us wanting it to work, it does not. Like all interventions, pharmaceutical interventions have the possibility of side effects, and it's up to the patient and doctor to weight risk vs reward. There is variation in both for each case, but we have to keep in mind that the mere existence of side effects is not typically a reason for categorically deciding against using a drug.
My bad guys, didn’t mean to be negative in my original post.
Definitely lacking in compassion. Whether it be obesity or anorexia, these are almost always symptoms of something deeper underlying. I shouldn’t be so flippant.
I think I still have to stand by my belief that semaglutide won’t truly solve people’s relationship with food though. That requires going deeper than the temporary solution drugs might provide.
> I think I still have to stand by my belief that semaglutide won’t truly solve people’s relationship with food though.
That sounds fair. I see a lot of over/under weight results as a symptom of a maladaptive coping mechanism for some other issue. Sometimes the issue is simply not having meaning in one's life, but it really can be anything from depression, to anxiety, to lack of friends because of social phobias or low self-esteem.
Looking at this this way helped me find more compassion and less contempt. I hope it helps you too
So easy to invent imaginary diseases to cover for decadent lack of willpower and portray a decent life hygiene as something as heroic as firewalking or quitting crack.
My mom is obese because she developed an autoimmune disorder while she was pregnant with me that attacks her thyroid. She has extremely abnormal thyroid cells that have to be biopsied twice a year and she has to take daily thyroid medication or she will die. She is about to start on Ozempic as well because the thyroid medication is not enough.
To manage her disease, she eats much less and much healthier (e.g., steamed kale for dinner every night) than everyone else in my family, and yet she is the obese one amongst us.
Please stop acting like life-saving drugs are evil and everything can be managed through willpower alone. My mom would be dead without modern medical science, and I would have died in the womb with her.
Are your seriously implying that your special case is statistically significant or that people like me are against the use of medicine for these? Your blog post completely misses the point: I didn't write imaginary just for kicks.
Statistically, people that manage to quit most chemical addictions have lower recidivism rates than people who lose weight through dieting.
So, possibly it is?
I for one have far less trouble keeping any of my drug and alcohol use to reasonable levels than I do avoiding overeating. I can quit drinking or smoking pot for months or years on end without even much thinking about it, but my attempts to lose weight without tirzepatide tended to be huge struggles that I would crash and burn on after 6 or so months.
The entire point of the ADHD diagnosis, in fact, is about the inability or reduced ability to "just focus more", and the medicine's purpose is to alleviate that imbalance
Do you think obese people have never tried just eating less? That doctors never tell them to do this and they never give it an attempt?
Yes, it is possible for every obese person on this planet to eat less and stop being fat. 100%.
But for some people, this is actually really difficult to do! And the more fat you put on, the more feedback loops there are in your body that push you towards eating more. Insulin and ghrelin response are big ones, but it wrecks your sex hormones, too - you're almost certain to see massive testosterone drops in men, which further stimulates your body to deposit more fat and build less muscle.
Being told to lose weight by diet and exercise is probably the most prescribed treatment on the planet, and one with one of the absolute lowest success rates.
“Why” is a weird question. We don’t know why. We do know that people don’t just eat less. Haven’t in decades. No plan that relies on changing that is practical.
> Why not just lose weight by eating less? I know that sounds like a dumb question.
Because it requires willpower and discipline, this just a pill/injection doing all the heavy work for you. Hence the success in USA. There are countries where this drug is semi unknown.
And it's becoming more and more known because obesity is a growing problem for nearly the entirety of the developed world.
If you're so convinced that obesity is a moral failing, then just put 'no fatties and no fake skinny glp-1 users' in your tinder profile, and all of the rest of us can move on with our days.
I don't know where you live, but the places where obesity isn't on the rise are heavily outnumbered by the places where it is. It's a global problem.
Easy and cheap access to calorie dense food and food heavy in sugars seems to nearly universally be something that significant portions of the population have difficulty resisting overindulging in, regardless of culture.
But genuinely, aren’t you just paying money to… not spend the money on food instead?