The Global Obesity Epidemic

[dann]

In and of itself, processing is not the problem. It depends on the kind of processing and the kind of ingredients that are added by processing - and the processing of those ingredients. I have mentioned trans fats several times in this thread. Trans fat should never have been allowed as an ingredient in food. It's not quite as unhealthy as smoking, but definitely not good for you.
But other things besides food, processed or not, have an impact on weight and health. Genetics and exercise, for instance. See post 515.

 

[novaphile]

Part of the problem of processed food, is the balance between sugar and fat.

There is a simple test that anyone can perform at home.

1. Try eating unsweetened cream, see how long it takes to feel satiated.

2. Try the same with sugar.

3. Now mix the cream and sugar together and see what happens.

If you hit the magical 50:50 ratio of sugar and fat, you can eat forever without triggering the satiation reflex. This is why people can sit down and eat an entire tub of icecream.

Manufacturers try to hit that 50:50 mark, because it means that people will consume more of their food.

I've mentioned elsewhere, working in a factory bakery, where the bakers refused to bake 'hamburger buns' for an American chain that operates in Australia. The bakers refused, because of the incredibly high amounts of sugar and fat (and salt to cover it up IIRC) in the American recipe.

Going by what people post about American 'processed' foods, things are even worse, because the sugar is High Fructose Corn Syrup and that fats are often 'trans fats', both of which have been shown to have dietary consequences.

Finally, the 'processed' foods often have dietary fibre removed, which, when present has health benefits in terms of slowing down the digestive process and aiding/cleaning the gut.

In my case, I'd always reach for an orange (in fact I have one every day) rather than drink orange juice.

The orange juice typically has the sugar from many oranges, and often extra sugar added, without the pulp.

Note that the sugar spikes from over sugared food is implicated in Type II diabetes too.

 

[Orphia Nay]

Can you (or someone) explain why it matters that the cheap, calorie dense food is nutritional deficient and processed?

In other words, if we had cheap, calorie dense, nutritionally adequate processed food , would we not still have a global obesity epidemic? Or does the fact that it is nutritionally deficient cause people to eat more? Perhaps we're conditioned to think that eating more will automatically satisfy some nutritional need our lizard brains are noticing we require.

I can't see how the fact that food is "processed" can have that much to do with anything, unless the claim is that by processing foods in certain ways they can be made more cheap, calorie dense, nutritionally deficient. I'm sure that's true, but most food we eat is also processed in some way. This may just be a nitpick, I'm more interested in the question about nutritionally deficient foods.

Calorie dense food often has no fibre. Fiber is very important for satiety. Lack of fiber causes health problems including overeating, constipation, gut problems.

Also, nutritionally deficient food is causing malnutrition and vitamin/mineral deficiencies. Obesity and its related non-communicable diseases is a form of malnutrition.

 

[Puppycow]

New drug from Eli Lilly works on appetite much like Novo Nordic's Wegowy and Ozempic.


Not for poor people without health insurance: "The list price of Mounjaro is $1,023.04 per month, according to Lilly."

Someday these drugs will get cheaper. I hope that day comes sooner than later.

Patents expire after 20 years, so at that point anyone could make these drugs.

But 20 years is a whole generation. A lot more people will grow up obese or grow into middle age obese.

Even if these drugs were affordable for everyone, I don't know if they are a panacea. I asked my doctor in Japan about it and he seems to be very much against them (at least for obesity). Even if he hadn't, I think the price is currently too high for me. They are definitely pricing it for maximum profit rather than maximum sales. Part of the reason is that it will take time to ramp up production capacity, but I also think they are happy to just keep it expensive for as long as market conditions (lack of competition) allow them to.

 

[Agatha]

Mounjaro is sold privately (it's not available on NHS prescription) for about £160 to £200* for a four week supply in the UK, so nothing near the $1023 as stated above. The US health insurance companies must be being price gouged by the manufacturer.

*And I reckon most of that is the cost of the over-engineered Kwikpen delivery system. A vial and 4 syringes would be way cheaper.

 

[Orphia Nay]

I heard something about Australia being a hub for poorly-manufactured Ozempic rip-off products, and how there are shortages of the real thing, and that people who are prescribed it for their diabetes are having trouble getting prescriptions filled.

Also, that the list of possible side effects of Ozempic is enormous.

 

[dann]

Skeptical Greg will appreciate this one, I think:

A large study suggests that there might be a striking reason to limit your intake of ultra-processed foods — early death.
The study of 115,000 people found that those who ate large amounts of ultra-processed foods, especially processed meats, sugary breakfast foods and sugar and artificially sweetened beverages, were more likely to die prematurely.
The research, published Wednesday in the journal BMJ, adds to a growing body of evidence that has linked ultra-processed foods to a higher rate of health problems. Ultra-processed foods encompass a broad category ranging from cookies, doughnuts and potato chips to hot dogs, white bread and frozen meals. Scientists say what these foods have in common is that they are typically formulations of industrial ingredients that are designed by manufacturers to achieve a certain “bliss point,” which causes us to crave and overeat them. They also tend to be low in nutrients such as fiber, vitamins and minerals.
High levels of ultra-processed foods linked with early death, brain issues (May 8, 2024)

From the list of "what these foods have in common:
1. More than three ingredients
2. Thickeners, stabilizers or emulsifiers
3. Added sugars and sweeteners
4. Ingredients that end in ‘-ose’
5. Artificial or ‘fake’ sugars (the point seems to be that they are used to hide the bad taste of the unhealthy ingredients)
6. Health claims (!)
7. Low-sugar promises (!)
8. Instant and flavored varieties
9. Could you make it in your kitchen?
The ultra appears to be particularly important!

Eating ultraprocessed foods raises the risk of developing or dying from dozens of adverse health conditions, according to a new review of 45 meta-analyses on almost 10 million people.
“We found consistent evidence linking higher intakes of ultra-processed foods with over 70% of the 45 different health outcomes we assessed,” said senior author Wolfgang Marx, a senior research fellow at the Food & Mood Centre at Deakin University in Geelong, Australia, in an email.
Ultraprocessed foods linked to heart disease, diabetes, mental disorders and early death, study finds (CNN, Feb 28, 2024)

Ultra-processed food (UPF) is directly linked to 32 harmful effects to health, including a higher risk of heart disease, cancer, type 2 diabetes, adverse mental health and early death, according to the world’s largest review of its kind.
The findings from the first comprehensive umbrella review of evidence come amid rapidly rising global consumption of UPF such as cereals, protein bars, fizzy drinks, ready meals and fast food.
In the UK and US, more than half the average diet now consists of ultra-processed food. For some, especially people who are younger, poorer or from disadvantaged areas, a diet comprising as much as 80% UPF is typical.
Ultra-processed food linked to 32 harmful effects to health, review finds (Guardian, Feb 29, 2024)

 

[Skeptical Greg]

Thanks for that..


It's all profit driven , with no oversight for health implications.

 

[dann]

I heard something about Australia being a hub for poorly-manufactured Ozempic rip-off products, and how there are shortages of the real thing, and that people who are prescribed it for their diabetes are having trouble getting prescriptions filled.

Also, that the list of possible side effects of Ozempic is enormous.

Other Ozempic 'side effects':
America's favorite weight-loss drugs are impacting Denmark's currency and interest rates (Aug 18, 2023)
Ozempic-maker Novo Nordisk becomes biggest company in Europe amid worldwide scramble for 'miracle' weight-loss drug (ABC, Sep 8, 2023)
Novo Nordisk invests more than 42 billion Danish kroner in expansion of manufacturing facilities in Kalundborg, Denmark (Finance Yahoo, Nov 10, 2023)
Novo’s Massive Deal Drives Danish Krone Weakening, Analysts Say (Bloomberg, Feb 7, 2024)
Novo står for en femtedel af nye job i 2023: 'En sand jobmotor i dansk økonomi' (DR.dk, May 10, 2024)
One fifth of new jobs in 2023 are in Novo: 'A true creator of jobs in the Danish economy'

 

[angrysoba]

Skeptical Greg will appreciate this one, I think:



From the list of "what these foods have in common:
1. More than three ingredients
2. Thickeners, stabilizers or emulsifiers
3. Added sugars and sweeteners
4. Ingredients that end in ‘-ose’
5. Artificial or ‘fake’ sugars (the point seems to be that they are used to hide the bad taste of the unhealthy ingredients)
6. Health claims (!)
7. Low-sugar promises (!)
8. Instant and flavored varieties
9. Could you make it in your kitchen?
The ultra appears to be particularly important!

Well, the list is just what the definition of “ultra-processed” means, but the reason why there is an association between ultra-processed food and obesity/death is this bit…

Scientists say what these foods have in common is that they are typically formulations of industrial ingredients that are designed by manufacturers to achieve a certain “bliss point,” which causes us to crave and overeat them.

In other words, highly palatable foods leads to greater consumption of calories.

 

[Orphia Nay]

Well, the list is just what the definition of “ultra-processed” means, but the reason why there is an association between ultra-processed food and obesity/death is this bit…



In other words, highly palatable foods leads to greater consumption of calories.

Bingo.

Though not forgetting that ham/bacon/processed meat is a cancer risk for other reasons too, I think.

 

[angrysoba]

Bingo.

Though not forgetting that ham/bacon/processed meat is a cancer risk for other reasons too, I think.

Possibly, although that is somewhat disputed, if I remember. But the study in question did not find any association between ultra-processed food and cancer. The all-cause mortality came from other issues.

Compared with those in the lowest quarter of ultra-processed food consumption, participants in the highest quarter had a 4% higher all cause mortality (hazard ratio 1.04, 95% confidence interval 1.01 to 1.07) and 9% higher mortality from causes other than cancer or cardiovascular diseases (1.09, 1.05 to 1.13). The all cause mortality rate among participants in the lowest and highest quarter was 1472 and 1536 per 100 000 person years, respectively. No associations were found for cancer or cardiovascular mortality.

https://www.bmj.com/content/385/bmj-2023-078476

Given that these numbers come from people who were nurses and health care workers, I wonder how much they did or even could have controlled for socioeconomic status.

I could be going out on a limb here, but given that people who are poorer or in less stable relationships are more likely to eat convenient ultra-processed foods, I might even wonder if they are even the relevant factor at all. They may have died earlier because they were poor.

 

[Skeptical Greg]

They may have died earlier because they were poor.

Doesn't that correlate to eating a lot of (ultra)processed foods?

 

[angrysoba]

I could be going out on a limb here, but given that people who are poorer or in less stable relationships are more likely to eat convenient ultra-processed foods, I might even wonder if they are even the relevant factor at all. They may have died earlier because they were poor.

Doesn't that correlate to eating a lot of (ultra)processed foods?

Yeah, that is what I am suggesting as a possibility.

There could be other attendant factors that could increase all-cause mortality that come as a result of generally being poorer.

 

[Skeptical Greg]

There could be other attendant factors that could increase all-cause mortality that come as a result of generally being poorer.

I agree. Things like quality of housing and the related infrastructure; heating, cooling, plumbing, pest control and etc..

 

[dann]

The high price of Ozempic and Wegowy in the USA may ruin the health-care system in the USA, so the population of Denmark should encourage Novo Nordic, the company behind the two brands of medicine, to lower the price.
Bernie Sanders appeals to Denmark: Put pressure on Novo Nordic to make them lower their prices (Berlingske.dk, May 13, 2024)

Tell Bernie from me that he should read up on how capitalism works. Danes have as much influence on the prices of Danish companies as Americans have on the prices of commodities produced in the USA.
So, Americans, won't you please put pressure on Pfizer and Moderna to make them lower the price of their mRNA vaccines. Some poor countries can't afford them at all, and in Denmark only 65+ are eligible to get them - and only once a year.

(By the way, Ozempic and Wegowy are bloody expensive in Denmark, too!)

 

[Manopolus]

Gary Taubes at Low Carb Houston, 2018

A long presentation, but very thought provoking IMO

The global obesity epidemic: Is dietary and animal fat the culprit?
Evidence based on 20 years of investigative journalism.

While I don't claim to be an expert, I'm actually pretty sure that that, the insomnia epidemic, the increasing popularity of depression, and lastly, the increase in auto-immune disorders can all be chalked up to a widespread vitamin D deficiency.

...which in turn is due to the skin cancer scare that originally occurred in the context of widespread tanning bed use and a growing hole in the ozone layer, both of which have actually already been dealt with somewhat. But pharma doesn't want to lose their sunscreen money. And in reality, it's also not the only reason people go outside less.

Don't get me wrong. Sun exposure does increase the likelihood of skin cancer. That's proven. But so does a vitamin D deficiency, and in the latter case it increases the incidence of ALL cancers. That's also proven. A third thing that is proven is that producing vitamin D in your skin is more effective than getting it through supplimentation. One last point... the incidence of skin cancer IS NOT greater near the equator, despite the fact that UV levels are greatly increased at those latitudes.

The only reason I bothered to look into this is because I have severe psoriasis, which can be helped somewhat by sunbathing, so I may have a bit of a bias at this point. There's also a UV treatment device for psoriasis, but I refuse to pay hundreds of dollars for fake sunlight. The real thing is entirely free. And yes, it's that time of year again locally, so it's on my mind.

The links to obesity?

1. Incidence of obesity has been scientifically linked to the amount of time one typically sleeps in a day. The more sleep you get, the less likely you are to be obese. Melatonin regulates sleep... and is also what darkens your skin when you get a tan. I can also tell you from experience that I get a heck of a lot sleepier a lot more often during the season when I actively participate in proverbial sun worship (a.k.a. nude sunbathing, although full nudity isn't an absolute requirement. It just maximizes the effect... that and I often have psoriasis on my butt, and sunlight's effect on that is best with a direct application to the affected area).

2. Sunlight exposure... and even heat, itself, suppresses the appetite. Air conditioning is not a dieter's friend.

That's just off the top of my head. There may be more possible links, but I don't know about them if so.

 

[Skeptical Greg]

I am at risk for skin cancer and have had a couple removed.. I avoid the sun and take a D supplement.. My number is above average.

We have also discussed that low D levels were associated with more severe cases of Covid-19.. There was no indication that D supplements after contracting Covid had any benefit.

 

[Manopolus]

I am at risk for skin cancer and have had a couple removed.. I avoid the sun and take a D supplement.. My number is above average.

We have also discussed that low D levels were associated with more severe cases of Covid-19.. There was no indication that D supplements after contracting Covid had any benefit.

Hmm... not a factor you can use, then. I can, though.

But I'm only slightly soft around the edges. I'm not particularly obese and never have been. I top out at 220 lbs. without trying. It varies over time, but never more than that --not yet, anyway-- but that's at 6 foot 4, or 193 centimeters if you prefer metrics. It definitely helps the psoriasis, though.

 

[angrysoba]

While I don't claim to be an expert, I'm actually pretty sure that that, the insomnia epidemic, the increasing popularity of depression, and lastly, the increase in auto-immune disorders can all be chalked up to a widespread vitamin D deficiency.

Well, here is a podcast episode of the Studies Show, where they talk about all the vaunted claims of vitamin D being some kind of universal panacea.

They conclude that most of the claims about vitamin D are complete nonsense.

https://www.thestudiesshowpod.com/p/episode-36-vitamin-d

Besides what is this "insomnia epidemic"?

 

[Manopolus]

Besides what is this "insomnia epidemic"?

Hmm... may be less of that than it seems to me. Old people are always complaining about lack of sleep, so maybe I just know too few young'uns nowadays and it has warped my perception. I've got nothing if you're looking for a cite. I just have my own possibly flawed perceptions and a memory that can't come up with where, specifically, the notion came from.

Also, I would tend to agree with the podcast if they're talking about supplements, which they are. It's far better to make it directly where your body expects it than to have it sitting in your intestines. It's sort of like how eating oxygen doesn't help shortness of breath (it just makes you belch). Also, melatonin and vitamin D aren't exactly the same thing, although they're certainly connected to the same process and I've been using vitamin D rather loosely as shorthand for both (or more specifically, for sunshine on the skin vs lack thereof). I think it's actually melatonin that supposedly does the trick for psoriasis, but don't quote me on that.

Here's a related, 9-year-old, youtube video by someone who knows more than I do if it helps:



If I didn't do that right (Doesn't seem to work right for me), here's the URL: https://www.youtube.com/watch?v=nWIOXarmwXc

It's not an exact match... I pulled from more than one memory of random things I've come across, and this one was extremely random (very few views).

Admittedly, a look at their Facebook link looks a bit shady and their webpage no longer exists... so maybe that was a bad source. I didn't check that before posting, sorry. Looks like they were detox peddlers. I do know how to vet my sources, but I didn't bother this time (or even look at the name of the creator).

So... oops.

Hopefully unnecessary disclaimer: I am neither a biochemist nor a doctor. I just read stuff that concerns or interests me, and occasionally watch youtube videos. My only degree is a BFA in art.

 

[macdoc]

Originally Posted by Orphia Nay View Post
Also, that the list of possible side effects of Ozempic is enormous.

So is the list for aspirin..

On the other hand the list of positive side effects of Ozempic grows every week.

In addition to helping people lower blood sugar levels and lose weight, these medications may also help treat or lower your risk of the following conditions.
Heart attack and stroke. ...
Kidney disease. ...
Colon cancer. ...
Alzheimer's disease.
19 Mar 2024

https://www.healthline.com/health-news/ways-ozempic-wegovy-improve-health#Alzheimers-disease

I'm down 46 lb over a year with Ozempic despite having a tough year with the loss of my 30 year old son to cancer and a motorcycle accident that saw me 100 days in recovery and reduced activity due to injury recovery. I've been pretty much a couch/bed potato for a year.
I'm a stress eater but semi-glutide effectively blocks my appetite - in addition the low blood sugar headaches I used to get are gone.
The other positive benefits are just bonus.

In Australia I've switched to liraglutide in the past two weeks ( Ozempic unobtanium ) and so far little difference

There is good reason why there is high demand, high success and companies like Weight Watchers giving up on what is nearly always yoyo diet programs to pivot to drug assisted weight loss.

The other bit of good news is that people who quit semiglutide - 50% keep the weight off.

 

[Puppycow]

Mounjaro is sold privately (it's not available on NHS prescription) for about £160 to £200* for a four week supply in the UK, so nothing near the $1023 as stated above. The US health insurance companies must be being price gouged by the manufacturer.
*And I reckon most of that is the cost of the over-engineered Kwikpen delivery system. A vial and 4 syringes would be way cheaper.

That's a common problem.

Prices for new US drugs rose 35% in 2023, more than the previous year

Feb 23 (Reuters) - Pharmaceutical companies last year launched new U.S. drugs at prices 35% higher than in 2022, reflecting in part the industry's embrace of expensive therapies for rare diseases like muscular dystrophy, a Reuters analysis found.
The median annual list price for a new drug was $300,000 in 2023, according to the Reuters analysis of 47 medicines, up from $222,000 a year earlier. In 2021, the median annual price was $180,000, opens new tab for the 30 drugs first marketed through mid-July, according to a study published in JAMA.

Given that the median annual wage for all U.S. workers in 2023 was $48,060 according to the Bureau of Labor Statistics, that means that the annual price of these medicines is more than 6 median workers' annual wages. It's kind of infuriating.

Further, Americans do pay a lot more for medicines than people in other countries because of US politics.

Prescription Drug Prices in the U.S. Are 2.78 Times Those in Other Countries

Prescription drug prices in the United States are significantly higher than in other nations, with prices in the United States averaging 2.78 times those seen in 33 other nations, according to a new RAND report.

The gap between prices in the United States and other countries is even larger for brand-named drugs, with U.S. prices averaging 4.22 times those in comparison nations.

The RAND study found that prices for unbranded generic drugs—which account for 90 percent of prescription volume in the United States—are about 67 percent of the average cost in the comparison nations.

I guess the good news there is that generic drugs are actually cheaper in the US. As long as you can find an adequate generic substitute and avoid brand name drugs as much as you can, maybe you can do OK. The problem is with health insurance people have less incentive to choose the cheaper alternatives. Also, new drugs like Ozempic or Mounjaro are still under patent and therefore lack generic alternatives.

20 years. That's how long patent protection lasts.

 

[Puppycow]

On the other hand the list of positive side effects of Ozempic grows every week.

https://www.healthline.com/health-news/ways-ozempic-wegovy-improve-health#Alzheimers-disease

Wow.

The Food and Drug Administration (FDA) announcedTrusted Source that the GLP-1 medication Wegovy is now indicated to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and either obesity or overweight.
. . .

The FDA states that Wegovy’s efficacy and safety for this indication were studied in a multi-national, multi-center, placebo-controlled, double-blind trial that randomly assigned over 17,600 participants to receive either Wegovy or placebo.

Wegovy significantly reduced the risk of major adverse cardiovascular events (cardiovascular death, heart attack, and stroke), which occurred in 6.5% of participants who received Wegovy compared to 8% of participants who received a placebo.

A placebo-controlled, double-blind trial is the gold standard of evidence. That seems to be roughly a 19% reduction in major adverse cardiovascular events.

Novo Nordisk reported that those in the semaglutide group showed a reduction in kidney disease progression as well as cardiovascular and kidney death of 24%.

Possible benefits for addiction?

While there is not any conclusive data published yet regarding GLP-1 agonists and their effect on addiction in people, he added that there are two randomized controlled trials underway examining the potential role of these medications in substance use disorders, smoking cessation, and other use cases.

Why might GLP-1s help with these areas? In addition to affecting the stomach, the medications also work in “particular centers in the brain, within a dopamine-mediated pathway to decrease addictive-like symptoms,” explained Spielvogel.

Not proven yet, but under study.

This one is not double-blind, but still interesting:

One key finding is that of 18,518 people with diabetes who took GLP-1s, they had a 25% reduction in colorectal cancer compared to 18,518 people with diabetes who took metformin for diabetes.

 

[The Atheist]

Fark nails it with today's headline:

“Outrageously” priced weight-loss drugs could bankrupt US health care. Eating less still free.

The article referenced is at Ars Technica and highlights just how much the drugs could cost US healthcare: https://arstechnica.com/science/202...ght-loss-drugs-could-bankrupt-us-health-care/

The level of absurdity surpasses anything I've ever seen. Just put the ******* cake down and back away.

 

[Puppycow]

You never see obese wild animals, but there are definitely obese pets.

Evolution gave people and animals big appetites for a reason, but we just got too good at making food. We also made exercise optional. Escalators, elevators, cars and other modes of transportation. It's no wonder people are fatter than they were 40 years ago. People are critters. They will follow their natural instincts instead of using their brains often.

 

[Orphia Nay]

Wow.


A placebo-controlled, double-blind trial is the gold standard of evidence. That seems to be roughly a 19% reduction in major adverse cardiovascular events.


Possible benefits for addiction?
Not proven yet, but under study.

This one is not double-blind, but still interesting:

Do we know if the ‘benefits of Ozempic’ are because of the drug, rather than because of the weight loss?

 

[Puppycow]

Do we know if the ‘benefits of Ozempic’ are because of the drug, rather than because of the weight loss?

Seems like it doesn't matter, but I was thinking about this question to myself, and I believe it's probably because of the weight loss. But if the weight loss is because of the drug, then ultimately it's because of the drug.

 

[Skeptical Greg]

Doesn't that fall under " correlation rather than causation " ?

I saw a report that most of the people who stopped taking the drug gained the weight back.
Were the cardiovascular benefits lost also?
I would think, probably.

 

[dann]

You never see obese wild animals, but there are definitely obese pets.

Evolution gave people and animals big appetites for a reason, but we just got too good at making food. We also made exercise optional. Escalators, elevators, cars and other modes of transportation. It's no wonder people are fatter than they were 40 years ago. People are critters. They will follow their natural instincts instead of using their brains often.

No, if it were all due to nature, people being critters, poor people wouldn't be be much more likely to be obese than the rich.
See earlier posts about this. The rich can afford more, including more food, but they can also afford better, more delicious and healthier food. They live in better neighborhoods where their surroundings encourage them to take walks, bike rides, whatever, or they play tennis at their country clubs.
Exercise may be optional, but people don't have the same options.
When human nature is used as an explanation for something, the explanation is usually wrong.

There are things that can make up for the disadvantages of being poor in this respect, and they have very little to do with nature:Infrastructure plays a role, nudging plays a role.

Even the pets of rich people are probably in better shape than the pets owned by poor people, but I haven't seen any statistics. If your surroundings make it a pleasure to take your dog for a walk, it's likely that you'll both get more exercise.


ETA:

Det er pudsigt, at der fortsat er eksperter der tror at befolkninger bliver tykkere hvis de har råd til at købe mere mad. Det er helt galt, og der er ikke skyggen af dokumentation herfor. Så ville de rige være de tykkeste, og de fattige tyndere. Det er ikke mange tilgængelige kalorier i butikkerne, men derimod peger forskningen på at det er for mange stivelsesrige kulhydrater og sukker som er skurkene. De smadrer apprtitreguleringen, og for én til at overspise.
Arne Astrup, former president of World Obesity Federation (Facebook, Mar 2, 2024)

It is strange that some experts still think that populations get fatter if they can afford to buy more food. It is completely wrong, and there is no documentation for this. It true, the rich would be fat and the poor would be skinny. The point isn't many available calories in stores. Research points out that too many starch-rich carbohydrates and sugar are the villains. They destroy the appetite regulation and make you overeat.

 

[dann]

Wow.

A placebo-controlled, double-blind trial is the gold standard of evidence. That seems to be roughly a 19% reduction in major adverse cardiovascular events.

Possible benefits for addiction?
Not proven yet, but under study.

This one is not double-blind, but still interesting:

Something even better than Ozempic and Wegovy may be on the way:
Danske forskere udvikler nyt vægttabsmiddel, som de tror kan overgå Wegovy (Videnskab.dk, May 15, 2024)
Danish researchers develop new weight-loss drug that they think may surpass Wegovy

GLP-1-directed NMDA receptor antagonism for obesity for obesity treatment (Nature, May 15, 2024)

 

[macdoc]

I saw a report that most of the people who stopped taking the drug gained the weight back.

what ever you saw was wrong. 50% keep the weight off which was a surprise for me.
You get used to smaller portions and stomachs do shrink but permanently moving the satiation point has proven very difficult.
Glutide drugs move the satiation point - sometimes to an annoying degree and its most often a hard reset....comes down like a portcullis saying ENOUGH I'm done....I love to eat and there were only a few meals I could finish because they were so tasty...I'm a sucker for thick bolognese pasta dishes.
But today I've have one piece of toast and one english muffin and I'm content.
Also gone are the heachaches that used to accompany not eating on time or enough ...getting hangry....that's a welcome change.

I plateaued quickly at a 30 lb weight drop and I did not pursue a stronger dose. I will need exercise to do move that down further and at 76 exercise is a chore.

As to bankrupting the health system that's a function on the ****** up US health system.

The level of absurdity surpasses anything I've ever seen. Just put the ******* cake down and back away

dismissing that sarcastically just says you don't get it.

 

[Puppycow]

No, if it were all due to nature,

Let me stop you right there because that isn’t what I said. This is a complete strawman. Of course it isn’t ALL nature.

In fact most of what I was on about is changes to our environment. Nurture. Changes we collectively created, but changes nonetheless. If you go back half a century the rates of obesity were significantly lower. There’s something different about our environment between the 1970s and recent times.

 

[dann]

Your post was all about nature, which is why you started with animals:

You never see obese wild animals, but there are definitely obese pets.

Evolution gave people and animals big appetites for a reason, but we just got too good at making food. We also made exercise optional. Escalators, elevators, cars and other modes of transportation. It's no wonder people are fatter than they were 40 years ago. People are critters. They will follow their natural instincts instead of using their brains often.

This is why you entirely ignore that it is a question of class: Poor people get fat, the rich usually don't. Do you think that's a question of better brains?

That exercise (like so many other things) have become optional is not a bad thing. It's actually great! We're not forced to run around hunting wild animals or following herds of them on their annual migrations. Instead, we can actually pick and choose exercise options and enjoy the exercise that our brains and bodies need. Much like with food.

However, when I say "we," there's the obvious problem that this doesn't include all of us. Some people are severely limited in their options for both food and exercise, so one group of people eat delicious as well as healthy food, others can only afford ****** food. Some people pick the kind of exercise that appeals to them, enjoy it and even look forward to it. Others don't have those options because they can't afford most of them and live in neighborhoods where going for a walk wouldn't appeal to anybody and may even be dangerous.

Some people have the option to take their bike to work and enjoy the ride. Like I said, infrastructure and nudging play a role.

Others have no other option than to spend (often too much) time in a gas guzzler, so they don't get the free exercise. This is unhealthy for both those people and the environment, and it has very little to do with nature not being suited for modern life and everything to do with class society.

Your post was all about modern life being too easy for our lazy human nature. For a considerable number of people it isn't easy, and they are the ones who are more likely to get obese.

 

[The Don]

I'm not sure it's safe to say poor=fat, rich=thin.

Anecdotally, many of my well to do friends are carrying extra weight and don't seem to vary much from the general population, if at all.

 

[angrysoba]

I'm not sure it's safe to say poor=fat, rich=thin.

Anecdotally, many of my well to do friends are carrying extra weight and don't seem to vary much from the general population, if at all.

Well, sure, but we're not talking about individuals. This is just a distribution issue. In the very poorest countries, you won't find many obese people among the poor but will among the rich. But as countries become wealthier, calories are no longer an issue as there is calorie dense food for a comparatively cheap price, so there is no barrier to the poor becoming obese. As for the wealthy, they may have plenty of other things to occupy their time than eating, because they are rich and can buy good quality food while sky-diving and mountaineering, etc...

 

[Puppycow]

Your post was all about nature, which is why you started with animals:

No. It's about the intersection between nature and environment. The point I was making about animals is about the difference between wild animals and domesticated animals. You can see many examples of fat pet cats, but you will not see a fat feral cat (unless someone's pet got lost).

This is why you entirely ignore that it is a question of class: Poor people get fat, the rich usually don't. Do you think that's a question of better brains?

I realize that you are a dyed-in-the-wool Marxist so you see everything through the lens of class struggle, but there are also other perspectives to consider besides Marxism.

That exercise (like so many other things) have become optional is not a bad thing. It's actually great! We're not forced to run around hunting wild animals or following herds of them on their annual migrations. Instead, we can actually pick and choose exercise options and enjoy the exercise that our brains and bodies need. Much like with food.

I agree with you actually. If an epidemic of obesity is the price we must pay for living in a civilization rather than as wild animals, it is a price well worth paying. It's a better problem to have than the alternative: famines and food insecurity.

However, when I say "we," there's the obvious problem that this doesn't include all of us. Some people are severely limited in their options for both food and exercise, so one group of people eat delicious as well as healthy food, others can only afford ****** food. Some people pick the kind of exercise that appeals to them, enjoy it and even look forward to it. Others don't have those options because they can't afford most of them and live in neighborhoods where going for a walk wouldn't appeal to anybody and may even be dangerous.

Some people have the option to take their bike to work and enjoy the ride. Like I said, infrastructure and nudging play a role.

Others have no other option than to spend (often too much) time in a gas guzzler, so they don't get the free exercise. This is unhealthy for both those people and the environment, and it has very little to do with nature not being suited for modern life and everything to do with class society.

Your post was all about modern life being too easy for our lazy human nature. For a considerable number of people it isn't easy, and they are the ones who are more likely to get obese.

I'm not a rich man, just so you know. I've been working my whole life since I left school to earn a modest living. I too am obese. I wouldn't call myself poor, but definitely working class. I would still take that 1000 times over caveman life or primitive life before TVs and air conditioners and computers.

In North Korea, the dictator is fat, but everyone else is skinny. Think about that. If the poorest people in a society are also the most likely to be fat, maybe that's actually a sign that something at least is good there. Better than a society where famines and food insecurity are normal occurences.

 

[dann]

Pets get fat when they are kept indoors, fed too much, and not taken for enough walks.
I'm a dye-in-the-wool skeptic and thus a Marxist.

As for your idea of 'civilization', this is not what I said:

I agree with you actually. If an epidemic of obesity is the price we must pay for living in a civilization rather than as wild animals, it is a price well worth paying. It's a better problem to have than the alternative: famines and food insecurity.

There is no 'price to pay' if you're rich. The price is paid by the poor.
In fact, you got food insecurity and obesity entirely wrong. Food insecurity contributes to obesity. It doesn't prevent it.
Food insecurity and obesity: research gaps, opportunities, and challenges
The Food-Insecurity Obesity Paradox: A Resource Scarcity Hypothesis
Food Insecurity and Childhood Obesity: A Systematic Review
Understanding the Connections: Food Insecurity and Obesity
Household Food Insecurity, Diet Quality, and Obesity: An Explanatory Model

In North Korea, the dictator is fat, but everyone else is skinny. Think about that. If the poorest people in a society are also the most likely to be fat, maybe that's actually a sign that something at least is good there. Better than a society where famines and food insecurity are normal occurences.

As mentioned above, actual famines may not be normal occurrences in your society, but food insecurity is. Cherry-picking the North Korean dictator and people doesn't change the fact that poor people tend to be more obese than rich people. That it's not he case in North Korea is probably be due to the actual famines in that country. It's one of the few things I know about North Korea.

That poor people are more likely to be obese than rich people, is one of the things sit coms often get right: Mike & Molly, The King of Queens, Roseanne. (Often it's only the guy who's obese, as in the fat guy, skinny wife trope. It's been more or less the same at least since The Flinstones, but almost always in sit coms with working-class couples.)

By the way, my links aren't to studies of North Korea. They are links to studies of allegedly civilized countries or articles based on studies of such countries.

 

[dann]

Wow.

A placebo-controlled, double-blind trial is the gold standard of evidence. That seems to be roughly a 19% reduction in major adverse cardiovascular events.

Possible benefits for addiction?
Not proven yet, but under study.

This one is not double-blind, but still interesting:

It appears to be good for the kidneys, too, at least for diabetics:

BACKGROUND
Patients with type 2 diabetes and chronic kidney disease are at high risk for kidney failure, cardiovascular events, and death.
(...)
CONCLUSIONS
Semaglutide reduced the risk of clinically important kidney outcomes and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease. (Funded by Novo Nordisk; FLOW ClinicalTrials.gov number, NCT03819153.)
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (NEJM, May 24, 2024)

The other bit of good news is that people who quit semiglutide - 50% keep the weight off.

That depends very much on lifestyle changes. People have to change diets and exercise habits for the weight loss to last, and it is encouraged to so even while you are taking the drug. I assume that exercise will become more appealing (or at least less of a challenge), once people are no longer obese.

 

[macdoc]

That depends very much on lifestyle changes. People have to change diets and exercise habits for the weight loss to last, and it is encouraged to so even while you are taking the drug. I assume that exercise will become more appealing (or at least less of a challenge), once people are no longer obese.

Why don't you talk about stuff you actually have experienced instead of meaningless speculation and assumptions.