Which is no surprise to anybody with common sense, the data for discontinuing GLP-1s show exactly the intuitive outcome. Zero diet change, zero habit change for the vast majority of users. Weight loss is accomplished via biochemical tricks to eat less volume of calorie dense junk food, rather than diet substitution. When the artificial appetite suppression ends, volume of the same food increases again leading to weight yo-yo. Plus why start to exercise when you’ve got a magic weight loss drug?
Don’t get me wrong, there are some people using these drugs to get out of a pit of inertia with weight and sedentary lifestyles. But it’s small. GLP-1 drugs will have most users hooked for life because they don’t have the discipline and motivation to maintain the weight loss without it. Cha-Ching!
> they don’t have the discipline and motivation to maintain the weight loss
That argument has been tried for years and yet it fails nearly 100% of the time. Should we be trying something different than claiming it's a moral issue? Or is that too scientific?
If you owe the bank $10,000,000,000 that's the banks problem.
Obesity is a 'bank problem' issue. When everyone around the globe is massively gaining weight, in every country on this planet that's not in a war or famine, this isn't a human willpower issue. Something has changed, and to ignore that is unscientific.
All that has changed is the environment and lifestyle humans live in, and it's quite obvious discipline and willpower cannot overpower that environment on average.
The change was far too rapid for anything else to be remotely the primary cause.
If you put a past heroin addict locked in a room with unlimited heroin readily available, chances are likely 9 times out of 10 that person is going to partake eventually. Same goes for our food environment and way of life.
We could stop companies spending billions shoving the heroin down people’s throats with advertising. But I guess selling them more drugs is a better solution.
You see, companies have a way of stopping that and it only costs millions. They pay off the politicians and the politicians say that companies have more freedoms than individuals.
That doesn’t suggest it isn’t a human willpower issue. If anything it suggests there is a fundamental flaw in human willpower in general. That when we get fat, happy, sedentary, peaceful, that most humans are susceptible to taking it easy, becoming lethargic, chasing easy quick neurotransmitters.
I think the reason I am not obese myself is that I am aware of all this. The hedonic treadmills. Calories in calories out. What processed food actually means. Understanding what the ingredients actually do. Maintaining an active lifestyle.
For me, the way forward was simply education. Once aware of all this, it becomes impossible to live another way. Maybe that is what we should market to people: knowledge that empowers lasting changes to behavior instead of quick fix shots/pills/diets.
It's entirely discipline and motivation. Just because only a select few people carry it through and maintain it doesn't change that. Just very few people in this world are truly disciplined and self-motivated.
You can see it all around you in one form or another:- overweight/obesity, alcohol consumption, smoking/vaping, people spending 5+ hours staring at glowing rectangles.
Why do we need to try anything? This comes down to individualism versus collectivism.
Besides, the logical consequence of the portion of my comment you highlighted is that the majority of GLP-1 patients will need to be on these drugs forever to maintain these benefits long-term. We have precisely one trial of 5+ years of patients taking liraglutide, and ~2 years for semaglutide. Some side effects and long-term consequences could be entirely unknown.
All the side effects I've seen of GLP-1s are positive, and we've had diabetes patients taking them for much longer than that.
Anyway, it's fairly obvious that discipline is not a solution to weight loss, because weight gains a) happened in lab and pet animals on the same timescales they happened to humans and b) are reversed by moving to higher altitudes.
So to be productive, you should be telling people to move to Colorado.
It's possible that there could be long term side effects that we don't know about, but given the number of people taking these drugs we would likely already have seen some indication of them. I guess we will find out!
Is it for everyone? Perhaps not. But to outright unequivocally say it's not is simply outright incorrect.
It was absolutely motivation and discipline for me. One day I just decided enough was enough and I threw the proverbial kitchen sink at it.
I am perhaps an outlier in that I'm not ashamed to say I was obese in the past because I simply lacked the motivation and desire to do the work to change it. It was easier and more comfortable being fat than in shape.
I definitely agree telling an obese person to eat less and move more is about as useful as telling a depressed person to just stop being depressed. But lets not make outlandish claims either.
Great, your one of the few. Statistics are pretty clear that most people cannot willpower their way out of their food seeking behaviours. They are to a large extent not under your concious control.
correcting satiety signaling on a chemical level more directly addresses the problem in those folks.
yes, the food environment is the main problem, in a way, but only because it punishes having a certain set of chemical and lifestyle parameters and rewards others.
Processed foods are much cheaper per calorie than "healthy" options.
GLP-1 helped me kick my cravings for junk food, but that just meant I was eating more of the "expensive" stuff. Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit.
No this is the most repeated and most incorrect thing in the whole debate about food.
More than a billion asians eat nutritious, cheap and calorie-balanced meals every day, unprocessed.
Staples like legumes and rice don't cost much and are very nutritious. And supplementing with moderate amounts of seasonal fruits and vegetables and moderate animal protein is still very affordable and healthy.
A kilo of (dry) legumes is about $3.50, about 3500 calories (50% more than an average human needs per day), delivers >200 grams of protein, > 100 grams of fiber, some healthy fats and enough carbs to power you and a good set of vitamins.
Hell if you get down to it, vitamin pills to supplement any deficiencies is a budgetary rounding error.
Compare that to either Doritos and you don't get anywhere close. Doritos cost >$10 per kilo, and cost >$100 per kilo of protein, has low fiber, high fat, high salt. It's not nutritious, actively harmful and actually extremely expensive to fuel the body this way.
And it makes sense: processing ingredients leads to a more expensive product than the base ingredients. This is true in every economic sector. Only uniquely, in the food sector ultra-processing doesn't only lead to higher prices for the customer (the reason companies do it in the first place) but also less healthy outcomes.
Doritos are made of corn and vegetable oil. The prices of these ingredients are orders of magnitude lower than the end-product. Corn is like 30 cents per kilo, oil about $1.50. If you want the same nutrients without processing like frying etc, you can eat literal orders of magnitude cheaper.
> More than a billion asians eat nutritious, cheap and calorie-balanced meals every day, unprocessed. [...] rice
This is one of those reasons that the term 'processed' food is stupid. White rice is a very processed food - what is the removal of the bran and germ but processing? And many other 'processed' foods undergo processing with the same sort of ramifications for health.
Legumes are also not complete proteins in the majority of cases - soy is a significant exception here. Soy has a PDCAAS of 1, the same as whey, but lentils range from .5 to .7, many beans are around .6, etc., and this can end up meaning your 200g of protein ends up being quite different in impact to many of your body's uses for protein than someone else's 200g of protein.
PDCAAS is dumb when looking at multiple foods. E.g., beans and rice, when consumed together, are like, 0.99, depending on the ratio. That is, the sum is greater than the parts.
Adding rice might get you close to that for the amount of rice you eat, but 1 cup of beans will get you 16g of protein and 1 cup of rice will get you 4g of protein.
So a chunk of your protein intake would still be incomplete. It's not like the ratios are perfect so that a cup of each gets you 20g of PDCAAS 1.0 protein. Doing some quick napkin math looking at the AA makeup and protein digestibility of the two, it's like 14g equivalent of PDCAAS 1.0 protein.
~25% is a pretty significant gap if you're trying to hit optimal levels for things like muscle growth, etc.
From what you just wrote, it appears you misunderstood what I said. Just to be clear:
Red kidney beans (50g): PDCAAS = 0.88, Protein = 11.25g
Basmati rice (50g): PDCAAS = 0.7, Protein = 4.5g
Red beans + rice (50g, 50g): PDCAAS = 1.0, Protein = 15.75g
Milk (500g..): PDCAAS = 1.0, Protein = 15.5g
So, from a protein perspective (according to PDCAAS), 500g of milk will give you the same amount of usable protein as the 100g rice and beans meal. There is nothing left on the table.
So, just eating kidney beans, PDCAAS would say that you aren't really getting the full benefit of the "protein on the label". But once you combine it with rice, you are getting the full benefit (according to PDCAAS).
You can't look at the digestibility of the two foods in isolation to make the calculations.
As long as you are eating a varied diet, PDCAAS is pretty pointless. If you have an eating disorder, or food scarcity issues, then it might become important.
From a US perspective at least, you are right but also wrong. Like yes, it's cheaper to buy raw potatoes and dried beans and cook healthy food vs. ultra-processed "junk food." However, when most people attempt to eat healthy they do not opt for dried beans and potatoes every day. There is a huge time cost to preparing those ingredients.
And anecdotally, when I am eating healthier I am opting for a larger range of ingredients. Probably to keep my mouth interested as I am not getting the food that's been engineered to be perfect to my palate. While potatoes and beans are in my diet, I am also opting for a lot of vegetables that are more expensive, paying more for fresh herbs and interesting spices. I am almost always buying canned beans, sauces, and other foods with some processing to speed up prep time.
I think your analysis suffers from comparing processed food engineered to taste great to the blandest, driest raw ingredients. Factoring in the time and secondary ingredients to make those raw ingredients taste great adds a lot of cost. Add in the cost of more varied ingredients bc very few people want to eat beans, potatoes, rice, and bland chicken every day. And further, you're missing the savings processed foods add by being shelf stable. They can sit on a shelf or in a freezer for months or years vs. fresh produce with a much shorter lifespan.
So yes you can eat very cheap and very healthy, the vast majority of people will loathe that life over time. You can eat kind of cheap, very healthy, with a limited number of ingredients and have things taste great if you have a LOT of time to devote to cooking, this will still not satisfy many.
I just want to clarify that I'm obviously not suggesting to eat 3500 calories of beans daily, and that's it. Just like I did not straw-man OP by claiming he was arguing that we should live on 100% doritos.
I just made a simple comparison between two food types, on the one had the example OP gave (doritos), and on the other hand the most common staple foods eaten in the world, like grains and legumes.
Again if I have to repeat that, the most common staple foods in the world.
That I hope does enough to dissuade you from making the argument that eating these ingredients is a ridiculous endeavor. It's actually what the majority of healthy humans eat on this planet for centuries, the standard, the norm.
It's for anyone obese to figure out why they don't apply this norm.
Take legumes for example, cooked as a Daal it is eaten by more than a billion people all the time. 20 to 30 different types of pulses are cooked, and hundreds of recipies exist. If you walk into your local Indian restaurant, you'll experience a wide range of intense flavors. To say these are the blandest ingredients is incorrect, virtually everyone would prefer to eat such food daily compared to doritos for breakfast, lunch and dinner.
The idea that ultra-processed foods are a staple in my diet, is insanity. I'd be disgusted. I love ultra-processed foods as an occasional snack, not as a diet. My diet is healthy, affordable and tasty. Google and youtube are full of examples of affordable, tasty meals.
Minimal processing is completely fine by the way. There's little wrong with a good canned bean for example, great shelf life, minimal salt, maximal convenience, good nutrition, good price. Thrown into a salad with a simple dressing of olive oil and lemon juice, with some cut vegetables, gives a complete meal. Not more expensive than doritos, healthy, full of vitamins, calories, low glycemic index, protein, and 'cooking' is a matter of throwing the ingredients in a bowl and mixing, childs' play.
Same with the daals I mentioned, mostly a matter of throwing ingredients into a pot. Cooks itself with no supervision in less than half an hour while you're on your phone. Stores 5 days in the fridge or months in the freezer. Can be a great breakfast or dinner multiple times a week.
There's just tons of these options that are delicious and easy, cheap and quick, enjoyed by billions. Obese people just need better education and mentorship in my opinion. I could never be fat because my parents and environment showed me normal food culture, without it I'd probably be fat. I truly believe in the power of mentorship here, which isn't properly institutionalised or commercialised, which is why so many people lack it.
This is the kind of thing that looks good on paper but then breaks down when you try it.
If you are seriously comparing the attractiveness of “legumes” (what legume and recipe is that?) with the attractiveness of Doritos I don’t know what to tell you.
If you cook something that is nearly as attractive as ultra processed foods, the price skyrockets.
> Processed foods are much cheaper per calorie than "healthy" options.
Attractive is a separate topic. Regardless of budget, for many people a chocolate cake will always be the most attractive food, regardless of cost. Doesn't mean we should have people living on chocolate cake diets.
Eh there was no comparison at all in attractiveness, but purely in price per calorie / nutrition. I don't see the issue in the comparison?
OP said processed foods are cheaper per calorie than healthy, i.e. eating healthy is more expensive and more difficult.
Nothing at all was said about 'processed foods are more tasty, thus eating healthy is more difficulty', so I didn't reply to it.
Then OP provided Doritos as an example. And I countered by showing that the worlds staple foods eaten by billions, non-processed, are much cheaper than eating processed foods like Doritos example OP gave. That's all.
Now as for your point on taste: try eating a nice daal at your local Indian restaurant and tell me you'd rather eat bags of doritos every day for breakfast, lunch or dinner. If you prefer Doritos then I don't know what to tell YOU.
You are SO SO wrong if you think ASIANS are not eating processed garbage slop food too.
Please actually go to east asia, go into their markets, and look on their shelves. They have SO much processed crap. Most Asians will gleefully tell you their love of the worst possible instant noodle (i.e. Mama brand) along with American cheese or other slop on top. Asians have the highest food standards when they want to, but their lows are as low as ours are. They love love LOVE spam for gosh sakes!
Also white rice has terrible macros and is why they have crazy rates of Diabetes despite low obesity rates.
> Processed foods are much cheaper per calorie than "healthy" options.
> Instead of $0.50 worth of Doritos as a snack, I'm eating $1.50 worth of Greek yogurt and $1.50 worth of fruit.
I won't bother with currency conversion because we're comparing ratios.
50 cents here gets a third of a 200g bag of generic brand potato chips, so 360 calories. Doritos are probably at least twice that expensive but whatever. (The generic-brand sandwich cookies that are my personal vice, are cheaper yet. There's so much variation within these vaguely-defined food categories that I can't take the comparison across categories seriously.)
$1.50 gets probably a half dozen bananas here, at around a hundred calories per. Never mind the yogurt. (If you're buying fresh cut fruit you're simply doing it wrong.)
So if you're purely comparing calorie counts and finding yourself on less-calorie-dense options then yeah there's a ratio but it's still not as bad as people think. But this is still fundamentally committing a fallacy equating "less calorie-dense" with "healthy".
The same 360 calories from white rice cost me perhaps 15 or 20 cents (plus the time and energy to cook). I'm not big on brown rice but I'm sure I don't have to pay several times as much for it unless it's some fancy boutique thing. 360 calories from dried split legumes (packed with protein and fibre), similarly, are in the ballpark of 30 cents. Perhaps you don't "snack" on those things, but you get the point.
I pressure cook beans. On induction or gas it takes about an hour to make a gallon beans from dry, and then I eat that for one meal a day for a week. You can get a 3 quart pressure cooker and just make less. I’ve also seen people use stainless steel bowls to cook multiple things in the same pressure cooker.
> Same with rice and beans, unless you're buying instant packs you have to plan and cook them, and be around to eat the leftovers.
You can freeze cooked rice for months with very little loss of quality, and reheating frozen rice is quick and easy. Just put the frozen rice in a bowl, add a little bit of water, cover, and microwave for 3 minutes.
I make 12 servings in my rice cooker, then fill 12 one serving containers and freeze them.
There are millions of people who are obese - not just fat - primarily from fruits. Those people have a history of obesity preceeding modern processed foods, and it's because they have very dense fruits (and starches) available to them in plenty.
Greek yogurt is super easy (and cheap) to make yourself if you have an instant pot:
Put 3L of milk and some starter from your last yogurt batch in the instant pot and press the "yogurt" button. Set an alarm for 10h.
Pour the yogurt into a strainer lined with a cheese cloth, and a capture vessel underneath for the whey, then put it in the fridge overnight.
You now have 1.5L of Greek yogurt that tastes head and shoulders better than anything you'd get at the supermarket. Takes me about a week to eat it all.
If you're worried about a spoiled batch ruining your next starter, you can take the whey from the straining step, pour it into an ice cube tray, and keep it in the freezer. 2 cubes is plenty for 3L of milk and can keep for 6 months.
Even easier is to do it in quart mason jars imo after heating the milk to 190f for 30 mins in a pot and allowing to cool to 110f before seeding with bacteria. No need to strain with cheesecloth after incubation, just pour out off the top if desired. 12hrs incubation seems to work best for me. Going from frozen definitely needs 12hr as the bacteria will be slower starting than unfrozen source. You can get away with merely some scrapings off a yogurt ice cube as sufficient for seeding. Seems it can keep for a lot longer than 6 months in freezer fwiw; my freezeback is probably over two years old and still just as viable.
Are you really only eating $0.50 worth of doritos? Large bags of chips are like $8 now. Imagine 1/16th of that bag which isn’t all that large of course. It would be like four chips.
People must be getting prescribed this medication in a vacuum without any corresponding nutritional guidance. I can't see any way of going back to my previous eating habits, mainly because I've really had my eyes opened to how mindless some of my eating was before.
Just like any weight loss and gain, this is the sort of things that happens over years. You lose the weight, then five years later realize your weight has started creeping back up. Once you're heavy the battle never really ends.
It is no surprise given the issue at hand. I mean it is people who failed at dieting and managing weight using the methods shouted from rooftops for a century or more now. Doctor could say whatever and its clearly in one ear out the other. A lot of these patients are taking it as a silver bullet, a quick fix. If you have to actively manage your diet anyhow while on the drug, the whole issue around diets and exercise the drug attempts to surmount, one wonders at the purpose of the drug.
You're in the faux enlightenment that everybody gets during weight loss. Everybody I've ever known losing weight starts discovering the wonders of healthy eating and nutrition as they lose weight, vowing never again to go back to their old habits. Then they slip further down the line and 1-2 years they're back to their original weight, plus some.
Weight loss isn't the challenge. Maintaining it for the rest of your life is.
