I went down from 390lbs to 240lbs gradually over 5 years. I have maintained a weight of 240lbs since then (6'1" tall).

The first year was the most dramatic loss of 100lbs. I was miserable and didn't know what I was doing other than counting calories. The rest of it was more considerate of total nutrition, and that's what made my good eating habits stick.

I say this because while I'm not a doctor I think GLP-1 is probably unnecessary for the vast majority of patients. Better food and information is more available than ever before.

I would strongly advise to watch your A1C and get out of the diabetes danger zone if you are. Most people can drop a few percent in as little as 6 months and it makes a massive difference in mental health. Blood glucose has a direct impact on the brain and overall cardiovascular health. If you drink alcohol, you might want to take a break also to let your liver/kidneys/pancreas do their jobs properly and restore insulin sensitivity and other hormones. Look into the "fruit paradox", and more generally get a good salad in for lunch to address nutrient deficiencies. Not crappy salads either. You're not a rabbit. Treat them like the amazing sandwiches without bread that they are.

Sounds like old advice, because it is, but I find people aren't listening because they want to more deeply understand why to do it and what the effects are. Convenience and unintuitive pricing are false bargains that get in the way of healthier habits. Focus on nutrition and not quantity. Change your groceries, change your life.

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rootusrootus 4 hours ago | parent [-]

> I say this because while I'm not a doctor I think GLP-1 is probably unnecessary for the vast majority of patients.

We have mountains of evidence that willpower fails for something like 99% of everyone, which is far from a vast majority. I applaud anyone's efforts to become healthier, however (though 240 at 6'1" is still obese, I would still explore medicine if I could not get any lower "naturally").

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sublinear 4 hours ago | parent [-]

Thanks for the reply. Your perspective framing this as "willpower" is precisely what I'm concerned about.

I didn't need any willpower to do this and I'm not even humblebragging nor think of myself as a tough guy. I'm saying that healthy habits are simply a matter of understanding. If someone wants to take GLP-1 on top of that, it's their call. Many seem to be under the impression it's so vital for their specific situation to lose weight or avoid a heart attack and I think that's plainly false. We shouldn't be feeding fear, and humans aren't that unique.

I did not change my diet. If anything I just added more variety with a specific intent and it worked. Even just changing the order in which one eats things (fiber before sugary foods) can make a big difference. Once I got the blood glucose under control all the strong cravings and eating mistakes basically went away on their own without my conscious effort. The body is all connected and driven by hormones.

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cthalupa 2 hours ago | parent [-]

> I'm saying that healthy habits are simply a matter of understanding.

Plenty of people have heard everything there is to hear on this, understand it, and still fail to implement it.

> I did not change my diet.

You plainly did. You do not lose weight without your diet changing.

> If anything I just added more variety with a specific intent and it worked.

This is changing your diet.

> Even just changing the order in which one eats things (fiber before sugary foods) can make a big difference

Changing your diet to eat more filling foods is a very frequently recommended thing, yes.

> Once I got the blood glucose under control all the strong cravings and eating mistakes basically went away on their own without my conscious effort.

My blood glucose has always been excellent. It did not stop me from having food noise and cravings.

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sublinear 2 hours ago | parent [-]

Sorry, you're right. I meant that I did not make significant changes to my diet. My point was I didn't really change what I eat, but how I eat. I still hate certain vegetables like carrots, kale, brussel sprouts, etc. and just added more of the nutritionally equivalent and culinarily far superior vegetables I was already eating.

That's not willpower. That's looking things up in the USDA database and tweaking my existing recipes. Why force nasty carrots onto the plate when I can eat spinach, cantaloupe, pumpkin, sweet potato, etc.?

I guess I also didn't emphasize enough that I took things super slowly? Taking 5 years to do what I did is a really modest goal. I just wanted to manage risk with minimal change. This is the pareto principle in action.

If we're really going to argue over stats, the effects of GLP-1 is meaningless noise in comparison and probably way harder to commit to. I just wanted to eat good and not feel like shit all the time. Isn't that what everyone wants? What if instead of there being "one weird trick" or a "miracle drug", we consider that basic nutrition is simply misunderstood and full of hundreds of weird tricks that are proportionally much easier to implement and they're damn tasty too?

	▲	cthalupa an hour ago \| parent [-]
		I'm not knocking anyone meeting their goals without GLP-1s. It's obviously possible in absolute terms - people have been making great body transformations for as long as we've had fat people. But everything you did, plenty of people try to do and fail at it. You are making it sound like this is all it takes and that it's easy. It might have been for you! But it might not be for other people. The fact of the matter is the overwhelming majority of people that are obese and go on GLP-1s have tried other interventions before and failed at them. ~70% of all obese people have tried to lose weight in general, ~50% have recurring attempts, and while I don't have stats to back it up I am confident that the sort of people who are willing to go and inject themselves every week are the sort of people that have tried to lose weight in other ways. > probably way harder to commit to. A subcutaneous injection once a week is nothing. Dealing with constant food noise? I could maintain that if the rest of my life was stress free, and that's how I would drop 30lb. Once stress came back? So did the weight. Because for me, rearranging food doesn't matter if I still can't stop thinking about it even if I'm not actually hungry. I'm on reta. It does barely anything to suppress my appetite - physical hunger has never been my issue. And I can easily eat however much I want - most days I am below 2k calories, but Saturday was an annual event with friends and I'm sure between food and alcohol I was probably at 5k calories for the day. But what reta does, is absolutely murders my food noise. I don't think about food constantly. I don't go eat because I got bored. The only thing I have to commit to for it is, once a week, put a needle on my injector pen, twist the dial to the right dosage, poke it into a spot where I still have subcutaneous fat, depress the twist top. Once a month I reconstitute a new vial.