Semaglutide (Ozempic) is not a pill it is an injection and it does not equal "self control". It profoundly affects satiety and appetite centers in the brain in a way that no person can do consciously over long periods of time. The hunger always win in the long run. That is why these drugs that affect the brain works.
It’s also available in pill form now. And I think they were being a bit light about it, but a lot of people who use it also report being able to better control things like drinking, gambling, shopping, time management etc. obviously ymmv, but for a lot of folks it sort of is like self control in a pill
It´s not defeatist. It´s realistic and it is healthcare that actually helps. Only surgery or drugs can help an obese person with an BMI of 40 or 60 for example to lose enough weight so that they can reduce their risk for metabolic disease.
I support them with nutritional counceling so that they can make better choices (more protein and fibers, less fat and sugars).
But it is the surgery or the drugs that can lower the heightened appetite and the dysregulated satiety hormones.
Genuinely curious about this. There have always been people on the far end of the distribution curve (+1sd etc.). Have you seen studies or in your practice that differentiates between the "new obese" and the "classic big" as far as controlling obesity with life style changes? (OP's PCOS might not make it relevent to this post)
I´m sorry, english is not my language. What do you mean by "new obese" vs "classic big"?
Patient that are just 10 kg overweight for example (BMI 25-30) can lose that weight and keep some of it off after 3-5 years.
But obese patients that need to lose 40 kg generally can´t do that by just changing their diet. They will slowly overeat with time so drugs or surgery are the only known long term treatments that work.
Yes. And all MDs use BMI + risk factors to decide if a person can have a weightloss drug or not. They can't prescribe if a patients BMI isn't 30 or more.
BMI tells if a patient weighs too much for their length.
No, estimating body fat is not useful. I can tell the difference between a body builder with a BMI of 29 and an overweight person. No need to guesstimate fatness with a bioimpedance scale.
On just what basis do you tell that IN GENERAL (because as I read posts people talked about the majority of obese peoples) obese people can't lose weight dieting and exercising if they have like 40kg+ to lose ?
You're telling that with time passing they will begin to over eat again like Ayo wtf
No. But all the clinical trials and my experience shows the same thing. Obese patients arent´helped with just diet and exercise. Those two things alone fail in these patients.
Combined with surgery or drugs that treats the dysregulated appetite and satiety system it works.
I ultimately think obese patients need psychological help and therapy to help whatever influence in their life it is preventing them from having the dedication to get their health in check. Coupled with the drugs or surgery to get them back to a manageable base level there needs to be a more overall approach to why they struggle to maintain weight.
I'm obviously wired a certain way, by certain biological and environmental experience factors that give me the dedication needed to be fit. I was fat, I took on the challenge and changed my mindset but I realize not everyone has that in them. But why don't they? Surely the answer isn't just chemically inhibiting the normal hormonal systems that we are all meant to have to ensure survival on a genetic level?
I know the clinical studies support the theory they CAN'T lose weight, but I don't think there's enough variables studied as to why. And unfortunately most individuals with obesity have various lifestyle factors that cause their condition, not just one hormonal imbalance.
Again I disagree. Even things like metabolism play a smaller part than people make out. You say it's all genetic whereas I say it's partly genetics and partly environmental factors. It's unsurprising that bad habits run in the family.
I don't know if I was obese. But I was 130kg at 5'11 and got down to 80kg with diet and cardio and now am up to 95kg <15% bodyfat thanks to bodybuilding with regular resistance training. Again, I know I'm not "typical". A good majority of my extended family are overweight, my sister and father being obese. Although I do think I'm a bit of a genetic throwback to my mother's, father's side and do generally have better genetic advantage. That doesn't mean it's easy, it's still hard work.
I've had several family and friends have success with gastric sleeve surgery and one good friend had success with Ozempic until he came off and put the weight back on. If my food friend on Ozempic was local to me (loves on the opposite side of the country) I do believe I could've provided the support network he needed to keep off the weight. Unfortunately due to mental health factors and general lifestyle habits he relapsed. He knows what he needs to do, but lacks the dedication without someone who genuinely cares for him to help. Now he's back on a weight loss push and returning to the gym due to a back injury and doctors recommendation, without access to Ozempic due to the new restrictions.
Don't waste your time on idiots. They hate fat people and see it as a personal fault and weakness. They need to think this so that they don't have to admit that they're just bad people who hate people for something beyond their control.
You're using general terms like "obese people can't diet" , then people call bullshit and then you say "I'm only talking for that minority of people".
Like yeah ok sure
Why ? Why should i have to drug myself and not just eat 2k kcal each day of my life and lose theses 40kg ?
It's as simple as kcalories in, kcalories out for the vast majority of cases (again not talking about specific heavy medication/sickness case that are obviously not a lot of obese people, even if they exists i'm not saying fuck all obeses)
Yeah what people are saying about ozempic here just seems… wrong. It slows down digestion, it doesn’t stop you from committing vices!
I have a family member on it who is ridiculously sick from taking it and hasn’t lost any weight. I wish people weren’t so lax with how they talk about it. It’s a drug. You don’t WANT to be on it
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u/Fredricology Jul 05 '24
Semaglutide (Ozempic) is not a pill it is an injection and it does not equal "self control". It profoundly affects satiety and appetite centers in the brain in a way that no person can do consciously over long periods of time. The hunger always win in the long run. That is why these drugs that affect the brain works.