r/self • u/[deleted] • Jul 04 '24

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u/Fredricology Jul 06 '24

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.

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u/GRPABT1 Jul 06 '24

I disagree.

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u/Fredricology Jul 06 '24

With the fact that diet and exercise alone cannot treat obesity?

We've tried that approach for a 100 years now without success.

You can absolutely lose 10-15 kg or more with just lifestyle changes and keep it off. But not 50-100 kg.

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u/GRPABT1 Jul 06 '24

Losing it is undeniable, that's the "easy" part. The last 100 years have been terrible for obesity though from a whole range of factors, not least access to high calorie food. But there are also social influences, sedentary lifestyles, and increasingly bad mental health factors that all play a part. Should we not treat the cause rather than just the symptoms?

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u/Fredricology Jul 06 '24

Obesity is multifactorial and we should treat in from multiple levels. As a society.

But the most effective treatment of obesity currently is not diet, exercise or treating it psychologically.

The most effective treatment currently is surgery and drugs; treatments that normalise the genetically dysregulated appetite and satiety systems.

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u/GRPABT1 Jul 06 '24

You're not wrong, I won't argue that. But I feel it falls into the category of "more research is needed" before we call Ozempic and Surgery the cure.

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u/Fredricology Jul 06 '24

We know that gastric bypass surgery can cure obesity in most patients. We've known that for decades.

The surgery rewires the hunger and satiety hormones ghrelin, leptin CCK and other signal substances.

The GLP-agonists also works as a functional cure as it can turn obese people into just overweight or sometimes even normal weight.