Time magazine’s article:

https://time.com/6330809/ozempic-wegovy-mounjaro-healthy/

Fascinating article. Despite having taken several of them myself over the past few years, (including Saxenda and Wegovy), I'm very hesitant to embrace a world where weight loss drugs are the first line of defense against obesity. I say this knowing that at least some of my issue comes down to poor nutrition choices, made far too easy by an environment swimming in garbage foods and a culture that values quick convenience over everything else. When I commit to good nutrition, my weight decreases. I don't get skinny, or even "not obese" but I do lose weight. When the snacks and junk food make their way back in the house and I have stressful weeks with work where I'm at my desk for 12 or more hours and fast food feels like my only option because I'm too tired to cook, I gain weight.

In about the past 60 years, we've gone from 13% obesity to 40%, with a 10x rise in severe obesity. This isn't just a weird thing that happened in a vacuum. There are pretty obvious reasons for this, some that could possibly be solved with significant changes to our food policies and investment in real nutrition instead of lining the pockets of pharmaceutical companies and massive food corporations. Much of our so-called food today has been designed to be addictive, by the same folks who brought us cigarettes, no less. That should give people pause the next time they're in the grocery store looking at all those shiny boxes and bags.

On the other hand, in the days when only 1% of the US population was morbidly obese...that was my family. And some of my family lived really long lives, into their 90s. Except the ones who didn't and died young. And you don't know which you'll be until it's too late. Up until my 40s, I was one of those people who had healthy bloodwork despite being 90+ lbs over my "ideal weight." I didn't worry about my weight because I was healthy. But that changed rapidly with middle age as my weight went even higher. Now I take blood pressure meds and am prediabetic. My feet and joints ache and I worry what that means as I age. I wish I had done more to keep my weight lower when I was younger and developed better habits early on. I can't believe how ignorant I was of nutrition facts when I was in my teens and 20s.

One thing I know is I can't afford $12k or more a year for the rest of my life to take these "miracle drugs." I'm not sure who really can or should. I'm grateful for surgery being an option, but it's not for everyone, and neither are the drugs. As a society, I would like to see more acceptance of humans in all sizes, and more focus on real health and nutrition instead of fads and gimmicks that make a few people really rich.

8 hours ago, NickelChip said:

Fascinating article. Despite having taken several of them myself over the past few years, (including Saxenda and Wegovy), I'm very hesitant to embrace a world where weight loss drugs are the first line of defense against obesity. I say this knowing that at least some of my issue comes down to poor nutrition choices, made far too easy by an environment swimming in garbage foods and a culture that values quick convenience over everything else. When I commit to good nutrition, my weight decreases. I don't get skinny, or even "not obese" but I do lose weight. When the Snacks and junk food make their way back in the house and I have stressful weeks with work where I'm at my desk for 12 or more hours and fast food feels like my only option because I'm too tired to cook, I gain weight.

In about the past 60 years, we've gone from 13% obesity to 40%, with a 10x rise in severe obesity. This isn't just a weird thing that happened in a vacuum. There are pretty obvious reasons for this, some that could possibly be solved with significant changes to our food policies and investment in real nutrition instead of lining the pockets of pharmaceutical companies and massive food corporations. Much of our so-called food today has been designed to be addictive, by the same folks who brought us cigarettes, no less. That should give people pause the next time they're in the grocery store looking at all those shiny boxes and bags.

On the other hand, in the days when only 1% of the US population was morbidly obese...that was my family. And some of my family lived really long lives, into their 90s. Except the ones who didn't and died young. And you don't know which you'll be until it's too late. Up until my 40s, I was one of those people who had healthy bloodwork despite being 90+ lbs over my "ideal weight." I didn't worry about my weight because I was healthy. But that changed rapidly with middle age as my weight went even higher. Now I take blood pressure meds and am prediabetic. My feet and joints ache and I worry what that means as I age. I wish I had done more to keep my weight lower when I was younger and developed better habits early on. I can't believe how ignorant I was of nutrition facts when I was in my teens and 20s.

One thing I know is I can't afford $12k or more a year for the rest of my life to take these "miracle drugs." I'm not sure who really can or should. I'm grateful for surgery being an option, but it's not for everyone, and neither are the drugs. As a society, I would like to see more acceptance of humans in all sizes, and more focus on real health and nutrition instead of fads and gimmicks that make a few people really rich.

Interesting!

Neither of those drugs is going to "end obesity" when obesity can be a symptom of poor economic status and they cost almost $2000 a month in some cases. Maybe ending obesity for the wealthy but for the average person you see in Walmart? No.

1 hour ago, pintsizedmallrat said:

Neither of those drugs is going to "end obesity" when obesity can be a symptom of poor economic status and they cost almost $2000 a month in some cases.

One just has to look at how much weight people really lose on these drugs. Many people will most likely just be "less obese" but not "no longer obese", even if one could afford taking the drug for life.

Those drug won't "end obesity" - just as WLS never did.

5 hours ago, pintsizedmallrat said:

Neither of those drugs is going to "end obesity" when obesity can be a symptom of poor economic status and they cost almost $2000 a month in some cases. Maybe ending obesity for the wealthy but for the average person you see in Walmart? No.

They are definitely priced out of range for the use of the general population.

4 hours ago, summerset said:

One just has to look at how much weight people really lose on these drugs. Many people will most likely just be "less obese" but not "no longer obese", even if one could afford taking the drug for life.

Those drug won't "end obesity" - just as WLS never did.

This is something I had not considered. Are we cured or in remission?

2 hours ago, GreenTealael said:

This is something I had not considered. Are we cured or in remission?

Remission is a great way of looking at it. Without diligence in the form of lifestyle changes including good nutrition and proper exercise, the weight comes back. I should mention, when I was taking Saxenda and Wegovy, my insurance plus coupons covered all but between $25-50 of the monthly costs. At that price point I would consider taking it in the future if WLS wasn't enough to maintain my goal weight, but with 100 lbs to lose, meds won't get me there, whereas surgery hopefully will.

1 hour ago, NickelChip said:

Remission is a great way of looking at it. Without diligence in the form of lifestyle changes including good nutrition and proper exercise, the weight comes back. I should mention, when I was taking Saxenda and Wegovy, my insurance plus coupons covered all but between $25-50 of the monthly costs. At that price point I would consider taking it in the future if WLS wasn't enough to maintain my goal weight, but with 100 lbs to lose, meds won't get me there, whereas surgery hopefully will.

The fact that your insurance covered it is a miracle.

20 hours ago, GreenTealael said:

This is something I had not considered. Are we cured or in remission?

I was more aiming at the fact that most patients having WLS don't reach a normal weight. I don't know, however, how many people get out of the obese BMI into an overweight BMI. With the drugs it's the same.

What you said is definitely something that's worth considering though. I don't know if we're cured or not after having WLS.

With drugs that answer is IMO easier to answer: you have to take it for life just like e. g. antihypertensive drugs. These drugs don't cure high bloods pressure. When patients stop taking them, blood pressure is high again.

Well said, @NickelChip. I agree that we need radical change from our policy makers at the highest levels, and some real nutritional education. Part of my journey is that I have finally gotten very angry about the marketing/indoctrination and policy lobbying that the for-profit "food" industries have been allowed to get away with, at the expense of our health in the USA.

I'm old enough to recall that the first food pyramid from the USDA said to eat 6-11 servings of bread, rice, cereal, or pasta every day. As a young person, I thought I was practicing healthy eating when I would have two servings of cereal for breakfast, then two sandwiches for lunch, and three servings of rice for supper. 9 servings was totally within the guidelines, so why was I gaining weight???

Thank you for sharing the article, @GreenTealael. I felt like I was reading about myself! Body size, obesity, health and their places in society and the science of medicine seem to get more complicated every day. I found the short history lesson on BMI quite fascinating.

Edited November 16, 20232 yr by BeanitoDiego

On 11/16/2023 at 11:21 PM, BeanitoDiego said:

As a young person, I thought I was practicing healthy eating when I would have two servings of cereal for Breakfast, then two sandwiches for lunch, and three servings of rice for supper. 9 servings was totally within the guidelines, so why was I gaining weight???

Well, when you were gaining weight you simply ate more calories than your body needed. 9 servings might have been too much and maybe 7 servings might have been sufficient enough. What all of these recommendations never seem to consider (or at the very least they're not considering it sufficiently enough) are the individual caloric needs of people.

The (traditional) diets of the leanest populations in world contain lots of carbohydrates. I wish we would stop villainizing "carbs", therefore throwing some many-ingredient-concoction I wouldn't even consider "bread" any longer together with rice, fruit, oats etc. (no, when you're eating a banana you might not "have as well a candy bar").

Edited November 18, 20232 yr by summerset

4 hours ago, summerset said:

I wish we would stop villainizing "carbs", therefore throwing some many-ingredient-concoction I wouldn't even consider "bread" any longer together with rice, fruit, oats etc. (no, when you're eating a banana you might not "have as well a candy bar").

As a kid in the 1970s and 1980s, I remember that "cereal" meant Cap'n Crunch (peanut butter flavor if you were lucky, or that one with the fruity "berries" if mom wasn't paying attention while shopping), and a sandwich was a slice of Oscar Mayer Bologna between two pieces of Wonder Bread (with French's yellow mustard and a side of Fritos, of course). And I couldn't have told you what a "serving" of any of them was, aside from whatever fit in my bowl or on the plate. It was easy to make all the wrong choices and think you were doing okay. I really wish we'd been taught the difference between healthy food choices and unhealthy ones. Although it is far from perfect, the newer My Plate guidelines are at least better, and easier for kids to visualize. And yeah, the idea that a piece of fresh fruit is the same as a candy bar "because sugar" is insanity.

4 minutes ago, NickelChip said:

As a kid in the 1970s and 1980s, I remember that "cereal" meant Cap'n Crunch (peanut butter flavor if you were lucky, or that one with the fruity "berries" if mom wasn't paying attention while shopping), and a sandwich was a slice of Oscar Mayer Bologna between two pieces of Wonder bread (with French's yellow mustard and a side of Fritos, of course).

The interesting thing is that people seemed to have eaten even worse than today (including children) - yet a lot less people were obese.

1 minute ago, summerset said:

The interesting thing is that people seemed to have eaten even worse than today (including children) - yet a lot less people were obese.

I think it's partially the ingredients. The amount of added sugar has skyrocketed. Also portion sizes have become so large, and what we get in restaurants influences how much we serve ourselves at home.

I found this great article that shows the USDA illustrated guidelines starting from the early 1900s. In 1956, people were told 2 servings milk, 2 servings meat/egg/beans, 4 servings of veg and fruit, and 4 servings of bread/cereal. I can picture those amounts in my head and it feels reasonable. By 1992, we were being told a minimum of 6 bread and 5 veg/fruit, with upper limits provided that would make it "okay" to have 11 bread, 9 veg/fruit, 3 milk, and 3 meat/bean. If you assume 3 meals per day and take the upper limits, just imagine having 3-4 bread/grains, plus 3 veg/fruits, plus 1 meat, and 1 milk for every meal, every single day! And the government experts are telling you that's a great idea!

In 1956, I might follow these guidelines to eat like this:

Breakfast:

1 bowl oatmeal, 1 glass milk, 1 serving berries

Lunch:

A sandwich consisting of 2 slices bread, a serving of sliced meat, and a slice of cheese, plus an apple

Dinner:

A serving of meat, a potato, and a green vegetable, plus a dinner roll with a little bit of butter

But you get to the 1980s and we're being told that's not nearly enough food. Eat more and be healthy!