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| ▲ | diath 6 hours ago | parent | next [-] | | The only thing that GLP-1 agonists prove is that CICO does indeed work - if you force yourself into a caloric deficit through the inhibition of hunger hormones using drugs that you will lose weight. It has nothing to do with people choosing to eat highly processed unhealthy foods over healthier options. When you're on Ozempic or peptides like Retatrutide/Tirzepatide you don't think "I will not eat a bag of chips today because it's unhealthy and calorie dense", you simply don't think about eating because your feeling of hunger is inhibited. | | |
| ▲ | toomuchtodo 6 hours ago | parent | next [-] | | You are incorrect. GLP-1s modify food desires as well. “Will power” is merely hormone levels in this regard. https://jamanetwork.com/journals/jamanetworkopen/fullarticle... > Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes and obesity treatment. Their effects on appetite and satiety are well established, but less is known about their associations with food purchases. Case reports and small observational studies suggest that GLP-1RA initiation is associated with altered preferences from highly processed, energy-dense products to minimally processed foods. We examined whether initiation of GLP-1RAs for treatment was associated with changes in nutritional quality and processing level of supermarket purchases. > Changes in purchasing patterns after GLP-1RA initiation were seen across most nutrient categories. Opposed to comparisons, after the first prescription, participants purchased fewer calories, sugars, saturated fats, and carbohydrates, alongside modestly more protein. The share of ultraprocessed foods also decreased. Although modest at the individual level, these changes may accumulate at the population level, particularly given increasing GLP-1RA use. | | |
| ▲ | diath 6 hours ago | parent [-] | | Food desires are simply addictions like smoking. If you cease consuming high amounts of processed food and sugar (through the inhibition of hunger), then you also kill these cravings. | | |
| ▲ | KittenInABox 6 hours ago | parent [-] | | GLP-1 functioning as methodone is fine for me tbh. Medically assisted addiction management is pretty gold-standard for a lot of addictions! |
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| ▲ | JoshTriplett 6 hours ago | parent | prev [-] | | > The only thing that GLP-1 agonists prove is that CICO does indeed work This is incorrect, as demonstrated over and over again. For many people's bodies, consuming less will result in the body changing its metabolism to burn less, and not dipping into fat stores. Conversely, for many people's bodies, exercising more does not in fact change their metabolism and the amount of energy they burn. (There are studies that going from "zero" to "not zero" makes a meaningful difference, but "not zero" to "quite active" often doesn't.) "CICO" is not useful or actionable for many people. | | |
| ▲ | slopinthebag 5 hours ago | parent [-] | | That there is variance in energy expenditure both within a population and within a person over time doesn't mean that a caloric deficit doesn't work. It just means that using a single scalar value (which is usually a gross estimate) to drive your caloric intake is a poor approach. The body has means to regulate it's energy expenditure to maintain homeostasis, and in some people it can be a hundreds of kcal difference. But if you're trying to lose body fat on a 10% estimated deficit and fail, the conclusion shouldn't be that a 20% deficit will also fail. | | |
| ▲ | JoshTriplett 5 hours ago | parent [-] | | For some people, a 50% "deficit" fails. And the entire concept of "X workout burns Y calories" is completely bunk. Again, there have been multiple studies to this effect. | | |
| ▲ | ses1984 5 hours ago | parent | next [-] | | Are you actually saying some people don’t lose weight on a 50% caloric deficit? Is there any evidence of that? | | | |
| ▲ | slopinthebag 5 hours ago | parent | prev [-] | | It's not physically possible for a 50% deficit to fail, what you probably mean is that their energy expenditure was incorrectly estimated at +50%. | | |
| ▲ | JoshTriplett 4 hours ago | parent [-] | | No, what I mean is that their body's energy expenditure changed in response to the change in their caloric intake, with no other changes taking place. | | |
| ▲ | slopinthebag 4 hours ago | parent [-] | | The body may try to maintain homeostasis but 50% sounds way too high. Someone with a tdee of 2200 kcal will not be able to maintain their weight at 1100 calories for very long. | | |
| ▲ | JoshTriplett 3 hours ago | parent [-] | | Adaptation in energy expenditure includes both metabolic adaptation as well as "NEAT" ("non-exercise activity thermogenesis"); the latter includes subconscious changes in posture, fidgeting, and various other things that can increase/decrease the body's energy expenditure by a massive degree, in an effort to (as far as people can tell) maintain a "set point" in the body that is difficult to change. This set point resists both weight gain and weight loss, both attempting to resist the change in the first place and attempting to undo it if successful. I'm not suggesting that it's impossible to lose weight through sufficiently large caloric restriction. I'm observing that it is not anywhere close to as simple as "CICO", because CO is heavily a function of CI, rather than the popular incorrect perception of CO being things like "exercise". | | |
| ▲ | slopinthebag 44 minutes ago | parent [-] | | Neat can maybe explain a couple hundred kcal variance in most people, perhaps there are exceptions but 50%? I've never seen that in the literature. Calories in calories out is just the summation of expenditure and intake, just because the body is complex and there are many interdependent factors doesn't mean it cant be resolved to a vector which determines weight gain/loss. The problem is people google a tdee calculator, get some scalar which is likely wrong, perhaps substantially, make lifestyle changes, and then have an expectation of some result in a specific timeline that isn't realistic, and then eat a bunch of sodium, put on 2 lbs in their "deficit", and think the diet made them fatter! Or they read that -3500kcal == -1lb fat, calculate their calories burned from the machines at the gym, and get frustrated when it doesn't work (I'm guilty!). Weight loss is actually really hard because it really just requires a sustained effort over a long period of time to achieve anything. You might not see any results for weeks as your body adjusts, you get your diet locked in, etc. And since your weight can vary so much day to day, it's hard to stay motivated. Ozempic kind of bypasses these problems. You know what else works? 20k steps a day and eating on a backpacker budget :P |
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| ▲ | whackernews 8 hours ago | parent | prev [-] | | Eh? I mean, this sounds potentially interesting but I don’t understand it! | | |
| ▲ | toomuchtodo 7 hours ago | parent [-] | | “We fixed the glitch.” https://pmc.ncbi.nlm.nih.gov/articles/PMC12742762/ https://www.sciencedirect.com/science/article/pii/S003193842... https://time.com/7340807/history-debate-insurance-glp-1s/ https://recursiveadaptation.com/p/the-growing-scientific-cas... The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,' - Dr. Gitanjali Srivastava, Vanderbilt Medical Center | | |
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