The Global Obesity Epidemic

[Orphia Nay]

He absolutely wouldn't have lost weight without the drugs.

In the case of my friend, he readily admits that the excess weight has been acquired over 20+ years due to an over-fondness for food and a lack of exercise (initially because he didn't like it, later because his knees and back hurt too much).

Unless he takes the drugs forever, there is a real risk that the weight loss will be temporary.

Has he been able to start exercising again?

Is even temporary weight loss such a bad thing?

Remembering that weight loss due to diet and exercise changes can be temporary too.

 

[dann]

I remember reading fairy recently that temporary weight loss is better than being permanently obese, and that even 'yo-yo' dieting isn't as unhealthy as it has been claimed, but I can't find the source.

I doubt that (over-)fondness for food is what makes people fat even though fat people may say so.
I am fond of food and enjoy eating. I think most people are, whether they're slim or obese. But when I'm full, I don't feel like eating anymore.
I think the over in over-fondness is just another way of describing dysregulated appetite, which is why modern weight-loss drugs work.
Gourmets or foodies are more fond of food than most people, but they aren't necessarily obese.

(I watched The Menu a couple of weeks ago. Great film!)

 

[The Don]

Has he been able to start exercising again?

Is even temporary weight loss such a bad thing?

Remembering that weight loss due to diet and exercise changes can be temporary too.

AIUI weight loss followed by weight gain is a bad thing because it usually involves a significant loss of muscle mass in the loss phase which isn't regained when the weight goes back on.

He hasn't restarted exercise, mostly because he doesn't really enjoy it.

You're absolutely right that weight loss due to diet and exercise can be temporary - especially if the lifestyle changes aren't permanent. Relying on a drug to manage appetite risks the lifestyle changes not being permanent when the drug is stopped.

 

[Orphia Nay]

AIUI weight loss followed by weight gain is a bad thing because it usually involves a significant loss of muscle mass in the loss phase which isn't regained when the weight goes back on.

He hasn't restarted exercise, mostly because he doesn't really enjoy it.

You're absolutely right that weight loss due to diet and exercise can be temporary - especially if the lifestyle changes aren't permanent. Relying on a drug to manage appetite risks the lifestyle changes not being permanent when the drug is stopped.

You're right about the muscle loss.

Could Ozempic weight loss be saving people's lives, though? If their blood markers are so bad they're put on the drug and they're resolved with weight loss, surely living longer is a plus, even if they have to go back on the drug later?

 

[dann]

Yes, it probably can save people's lives:

Weight-loss drugs 'slow down the ageing process', scientists suggest (The Guardian, Aug 31, 2024)
Semaglutide – contained in Ozempic and Wegovy – has ‘far-reaching benefits’, with people dying at lower rate from all causes
Weight-loss drugs are poised to revolutionise healthcare by slowing down the ageing process and by allowing people to live for longer and in better health. That is the dramatic message from leading scientists after studies were presented last week at the European Society of Cardiology Conference in London.
Research has already found that semaglutide – also known by the brand names Wegovy and Ozempic – reduced the risk of death in people who were obese or overweight and had cardiovascular disease.
But fresh studies have found that Ozempic has impacts beyond what was originally imagined for the drug. People who took the drug died at a lower rate from all causes, not just from cardiovascular causes, researchers discovered.

 

[The Don]

You're right about the muscle loss.

Could Ozempic weight loss be saving people's lives, though? If their blood markers are so bad they're put on the drug and they're resolved with weight loss, surely living longer is a plus, even if they have to go back on the drug later?

I suppose people could be on Qzempic (or similar drug(s)) for the rest of their lives, either consistently or periodically to support their yo-yo dieting but that's treating the symptoms not the cause IMO. It's certainly very good for the drug companies and I suppose if we accept the premise that a lot of people simply have no control over their weight then it's a way of trying to partially tackle the global obesity epidemic.

It may be saving people's lives, or it could merely be delaying their (obesity related) deaths. If people have long periods of significant improvements to their quality of life then treating the symptom will have a benefit. OTOH if their quality of life doesn't improve significantly and they simply exist for longer dealing with their obesity related illnesses then I'd question the benefit.

 

[macdoc]

What a load of meaningless crap.
I just love the speculative nonsense...".I suppose, it could be merely, it may be' etc etc ad nauseum.."
Glutides work to reduce many more risks than just weight and are you taking some sort of moral nose in the air .....oh if they only did this or that they don't really need drugs....??

Tiresome.
I don't really care if you question the benefits....millions of people are benefitting including me who has first hand knowledge ....not speculative.
For me specifically
Drop from 132kg to 108 over 2 years...53 lb with no feeling hungry or forcing my body to "not eat" nor did I diet in any manner. No yoyo diets which I never did.
Instead I eat until I'm satiated which is the norm for humans.
Glutides just reset that satiate level.
I no longer get "hangry" headaches and can go past mealtime without fear of migraine. It is keeping my blood sugar levels under control so I am no longer on the bubble for Type2 but am not diabetic in any form. 5.7 a1c down from 6.9 to 7.1 prediabetic/preglutide.
It costs me $6.70 for 4 weeks dose.
Do I care if it''s lifetime - not in the least ...there are loads of other benefits and the side effects are annoying but the trade off is superb.
I don't need to list all the benefits that have accrued - there is lots of coverage in this thread not the least of which reducing the consumption of fast food and other snacks and the diet industry is being eviscerated.
I'm 77 and expect to be taking other drugs the rest of my life as well, panadol daily, celebrex as needed, reflux blockers, pseudoephredine ....that's it - having eliminated other blood sugar drugs like DuoDart.
Will it extend my life....yes very likely.
Will it improve quality of life - already has.

Quitchyerbellyachin .
and listen to the people in the field who do know what they are talking about and those like me that have first hand knowledge as a patient.

 

[angrysoba]

I suppose people could be on Qzempic (or similar drug(s)) for the rest of their lives, either consistently or periodically to support their yo-yo dieting but that's treating the symptoms not the cause IMO. It's certainly very good for the drug companies and I suppose if we accept the premise that a lot of people simply have no control over their weight then it's a way of trying to partially tackle the global obesity epidemic.

It may be saving people's lives, or it could merely be delaying their (obesity related) deaths. If people have long periods of significant improvements to their quality of life then treating the symptom will have a benefit. OTOH if their quality of life doesn't improve significantly and they simply exist for longer dealing with their obesity related illnesses then I'd question the benefit.

All life-saving treatment is delaying someone's inevitable death.

That also goes for peope who have cancer treatment or surgery.

And of course, there are numerous treatments which result in people taking the medicine for the rest of their lives. Diabetes, blood pressure meds, etc...

At least it gives someone the opportunity to then change their lifestyles.

What if someone cannot or will not change their diet and/or get more exercise? (And while we are at it, exercise by itself is a very poor prescription for weight loss. Most people who try to do that end up eating more, or being more sedentary after exercise).

Some people argue that the thing to do is to change the food environment. Good idea? Maybe, but it WON'T happen, and anyone we know who is obese won't be able to make it happen.

So, instead, let them take the meds and lose weight and be able to spend more time with their family.

 

[angrysoba]

What a load of meaningless crap.
I just love the speculative nonsense...".I suppose, it could be merely, it may be' etc etc ad nauseum.."
Glutides work to reduce many more risks than just weight and are you taking some sort of moral nose in the air .....oh if they only did this or that they don't really need drugs....??

Tiresome.
I don't really care if you question the benefits....millions of people are benefitting including me who has first hand knowledge ....not speculative.
For me specifically
Drop from 132kg to 108 over 2 years...53 lb with no feeling hungry or forcing my body to "not eat" nor did I diet in any manner. No yoyo diets which I never did.
Instead I eat until I'm satiated which is the norm for humans.
Glutides just reset that satiate level.
I no longer get "hangry" headaches and can go past mealtime without fear of migraine. It is keeping my blood sugar levels under control so I am no longer on the bubble for Type2 but am not diabetic in any form. 5.7 a1c down from 6.9 to 7.1 prediabetic/preglutide.
It costs me $6.70 for 4 weeks dose.
Do I care if it''s lifetime - not in the least ...there are loads of other benefits and the side effects are annoying but the trade off is superb.
I don't need to list all the benefits that have accrued - there is lots of coverage in this thread not the least of which reducing the consumption of fast food and other snacks and the diet industry is being eviscerated.
I'm 77 and expect to be taking other drugs the rest of my life as well, panadol daily, celebrex as needed, reflux blockers, pseudoephredine ....that's it - having eliminated other blood sugar drugs like DuoDart.
Will it extend my life....yes very likely.
Will it improve quality of life - already has.

Quitchyerbellyachin .
and listen to the people in the field who do know what they are talking about and those like me that have first hand knowledge as a patient.

I met a friend of mine who I haven't seen in twenty years. Last time I saw him he was my weight now (about 80kgs). Now he is 130 kgs. I arranged to meet at a restaurant for dinner about a 15 minute walk from his hotel and had no idea what an ordeal he would find it to walk that far.

I walked him back to the hotel with his family, but getting back there, he was sweating, red-faced and panting, and having to stop every few minutes to stretch out. I began to worry if I was going to give him a heart attack just walking and started to wonder if I should have just called a taxi, but we were already underground in the warrens of Osaka.

Today his family are out sightseeing and he is staying back in the hotel watching Netflix, eating crisps and drinking beer because walking around the castles would be too strenuous.

I told him that he needs to get some more exercise, "everyone tells me that!". So then I suggested asking his doctor about semaglutide. I seriously think he needs it.

 

[macdoc]

Good idea ...he may still eat crisps but the drug will likely stop him eating a whole bag. It's weird - you can be eating something you really like and there is more to eat and you just stop. Don't want anymore.
I will be adding in exercise just cuz I need to get my strength up for riding motorcycle. What I really need is flexibility exercises.
Not worrying about eating is a big stress releiver.

 

[dann]

... (And while we are at it, exercise by itself is a very poor prescription for weight loss. Most people who try to do that end up eating more, or being more sedentary after exercise). ...

It's true that exercise has had limited success as a weight-loss remedy, but it seems to have an impact on appetite control, so people don't get obese in the first place. As for the other benefits that exercise has, being more sedentary after exercise doesn't seem to be a problem at all (unless it's ever after):

'Weekend warrior' workouts may be as effective as daily exercise, study shows (TheGuardian, Sep 26, 2024)
Scientists say total amount of physical activity people get is more important than how frequently they train

So it doesn't really work as a couch-potato excuse for not doing any exercise at all. In fact, almost any level of exercise appears to be good for you and better than no exercise. Going from almost no steps to 4,000 steps a day is an immense improvement. That it has to be 10,000 is a myth.

 

[angrysoba]

It's true that exercise has had limited success as a weight-loss remedy, but it seems to have an impact on appetite control, so people don't get obese in the first place. As for the other benefits that exercise has, being more sedentary after exercise doesn't seem to be a problem at all (unless it's ever after):

So it doesn't really work as a couch-potato excuse for not doing any exercise at all. In fact, almost any level of exercise appears to be good for you and better than no exercise. Going from almost no steps to 4,000 steps a day is an immense improvement. That it has to be 10,000 is a myth.

Oh sure! I absolutely do not want to disparage the importance of exercise. I think it’s highly important for all the things you mention as well as a way to build muscle, manage stress, improve heart health, and probably very protective against cognitive decline such as dementia and Alzheimer’s in later life. I wholeheartedly recommend exercise.

I am making a much narrower point that those who have already gained a lot of weight and want to shed it without making either changes to their diet or use of medication will struggle to shift the weight which in turn can lead to loss of motivation etc…