He described nausea quite often when I saw him but the results were pretty astounding.
He then hit a wall where gastroparesis would happen quite often and I happened to be at his house when one of these bouts got very severe. He went from feeling bad, to hunched over in pain and started projectile vomiting in the span of 30 minutes. He said it was clearly the meal he had eaten several days ago...it was awful.
I believe this happened to him several more times - and AFAIK he stopped taking it, and promptly regained some weight back.
Mounjaro by Lilly is still diabetets only, wonder what their obesity-specific brand name will be.
It became clear during COVID that a lot of people seem to presume there's some way for researchers to just "look at what's happening," and there isn't.
Initially my appetite almost completely went away, but then it came back to what felt like normal. There were days where I felt like I was eating too much or binging, but the weight kept coming off at about 2lbs per week. Also, being free from the food noise was incredibly liberating because I'm otherwise always thinking about food.
I ended up stopping because I would get incredibly sleepy at about 10pm to the point where staying up was almost impossible. I tried eating more thinking it was a blood sugar issue, but that didn't help. It just didn't work with my schedule.
I plan to get back on it, or an alternative like Mounjaro.
Hm. May have located the problem.
This is considered to be the first generation of weight loss drugs that work. There will probably be better ones.
So I think "other medications" is doing a lot of heavy lifting here. It depends on what medications they're talking about. I think since incretin mimetics are more "social" medications and taken usually by a younger crowd, it would make sense that more people are drinking than maybe other groups.
Side note I had never even heard of this combination of buproprion-naltrexone being prescribed for weight loss. I am not sure how common it is
> Seven CVOTs enrolling 56,004 patients with T2DM were identified, with a median follow-up time ranging from 1.3 to 5.4 years. [...] Conclusion: Pooled analysis of CVOTs did not suggest any increased risk of either acute pancreatitis or pancreatic cancer with GLP-1RA treatment in T2DM patients.
I was gaining a lot of weight and simply walking for 30min was exercise (which sounds embarrassing in retrospect as I type it). So I did that daily around the neighborhood. That got easier, all I cared about was doing it daily not the outcomes, then I started going on a bike rides with slow increasing intensity, then got a gym membership, and now 2yrs later I’m in excellent shape, addicted to the feeling after working out, and do ~45min of fitness 5 days a week.
I know binge eating seems to be the issue with this one in particular but for me I naturally started to eat better on days I do fitness, I feel like eating things that give me energy. My body demands it. When I had relapses into not doing daily fitness I almost always eat poorly in a negative cycle just sitting on the couch drinking alcohol because I don’t have energy to go out.
Not to get preachy (everyone has a solution) but I think too many people do dramatic gym efforts or massively change diet with Keto (or w/e) then burn out quickly instead of starting small and focusing on routine/habit as the goal #1… not obsessing about how much calorie burn you can pack into x minutes before going back to nothing in 2 months. Fitness is a basic lifestyle routine like showering and brushing your teeth, it’s not a huge hard commitment when it’s paced properly and a natural daily thing.
I don’t think it has anything to do with whether people do a massive change or not. I think the people that enjoy exercise usually never have to do a massive change because they are already doing it from natural enjoyment.
Besides my point was that most overweight people would lose weight simply walking around the block every day. That’s not asking people to go for a run when they weigh 250lbs+ which will always suck unless you very slowly work up to being able to run more than a half a block and wear knee supports.
The thing about working out daily is that the first 10min always sucks bad after but after you’re done it feels great - for the rest of the morning. Being depressed is harder in that mind state which feeds into more physical activity.
Like I said though you have to start small.
Seems to me that there must be a safer way to reduce someones appetite.
And in those communities and in my personal experience, this kind of thing virtually never happens. I've been in a calorie deficit since roughly mid May at this point, and have felt no nausea, haven't vomited, have felt nothing, really. I can barely tell I'm taking a drug. The only perceivable effect is I'm not hungry, and this seems to be the common takeaway from bodybuilders and models and what not doing this. My wife has been taking it for over a year and a half now and has had no side effects.
But I'm not out there trying to maintain my pizza and ice cream diet while outsourcing portion control to a drug. I'm also not trying to lose 80 pounds in a year. I don't eat out, weigh and measure and plan all of my food, and haven't had a dessert or a drop of alcohol since last Christmas. Likely won't have another until this Christmas.
It's just something to keep in mind depending on your specific goals. I feel like, at least until I stopped reading the news, I was getting bombarded almost daily with scare articles like this claiming you'll be miserable, sick, your face will sag and age prematurely, all kinds of ridiculous shit. I can't speak to what it's like to have lifelong problems with food habits and to be over a hundred pounds past the recommended BMI range, or what any means of changing that will do to you. But if you are a reasonably fit person who wants to be absolutely shredded, or someone who has been and can be shredded and has lost weight plenty of times before, but just want it to not be a miserable four months, these drugs are absolute gold. Not just bodybuilders, but dancers, gymnasts, climbers, weight class fighter, anyone with a strong incentive to be very lean most of the time. Maybe we don't matter as much to public health compared to fighting the obesity epidemic, and maybe we're not very common on a place like Hacker News where most readers are probably sedentary and have never been athletes, but we're still a demographic and the GLP-1 revolution has been a godsend for us. They're far safer than anything that existed previously. They just take what you were already doing and put it in easy mode.
Being fat is similar to being a drug user. At first, you actually are fat and happy. Over time, being fat will absolutely reduce your happiness from the medical, societal, and physical issues that arise. Similar to how drug users build up a tolerance and instead of using the drug to be happy, they use the drug to feel normal.
And just to state a simple fact, I do not condone shaming people with weight control issues.
But it isn't really the same. Drugs, the really bad ones will probably ruin your life or kill you in the space of two or three years.
Being fat unless it's super super severe often won't start impacting your health seriously until your 30's or 40's.
on the opposite side anorexia will kill you much faster than obesity
Fat shaming doesn't help anyone lose weight, it just makes you feel superior.
If it was available readily and cheap, I'd be curious to give it a try, though I have no desire to ever get below 10% body fat.
That seems like it could allow for some not-real-great bacteria to multiply, in an environment they're happy with.
Yakult would potentially head that off / stop those bacteria from doing that.
That's just the more serious longterm effects. The reversible short term ones are immediate.
I was at a birthday hike for a friend - up a short granite hill for good views, some slow meandering around a lake. Very relaxed stuff. One of her guests couldn't make it up the hill. Full on bawling, had to leave early. This woman could not participate in even a casual hike for a friends party and she clearly wanted to be able to.
I was fat but below the obesity level before I started my whole thing and the first "benefit" I noticed was that I could do any physical activity. I might be bad at it, but I could rock climb, and kayak, and play basketball with people. The "Oh, I can't do that" was simply _gone_.
* Anorexia nervosa, about 5.1 deaths per 1000 person-years
* Obesity, about 200 deaths per 1000 person-years.
It's good that we discourage smoking, even aside from the secondhand smoke component.
Accident while biking? Nope - too risky, no care for you. Eat red meat and get cancer? Too bad, no treatment for you. Same for drinking wine, or doing any of the thousands of things "they" say MAY raise your cancer risk.
Joint problems happen to all manner of people, thin or fat, but we'll only pay for treatment for the thin ones.
It just goes on.
With a single payer system you could also price it into things like red meat and alcohol through a sales tax that goes to insurance.
As a casual bicycle user, you're far more likely to have a serious bicycle collision from being hit by a car driver.
Better to be fat and happy than skinny with someone controlling your life
Should anyone have to do this? Of course not, but if the choice is between this or projectile vomit every waking hour, it’s not a hard choice IMO.
Lastly, I just wanted to take a moment to think about how useless pharmacies have become that they can’t actually do this for you anymore and literally just count out pills, or more realistically push a button on a machine that counts out the correct amount.
If a cyclist gets hit by a car at any significant speed, he's likely seriously injured or dead, while the car driver is likely unscathed, at least physically.
If two cars collide, unless they are traveling at quite high speeds or are particularly unlucky, everyone will probably walk away, as they are surrounded by a steel structure that has been specifically engineered to protect vehicle occupants in the most common crash scenarios, in addition to the protection provided by safety belts and airbags. The cyclist has none of this.
If two bicycles collide, well it depends but scrapes and possibly broken bones are likely, along with possible concussion or worse head injury.
This is an infrastructure problem, not a bicycle problem. The infrastructure problem exists because places like the USA prioritize cars.
Even the two bicycle collision you describe is quite rare outside of competitive sports. People casually bicycling to work aren't going at such speeds, don't go closely in opposite directions, and really have no reason to do so.
Bicycling is very safe when you remove car interaction from the equation.
Check out this YT channel for more info backed by data: https://youtube.com/c/notjustbikes