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vidarh 13 hours ago

Given that we know that diets and changing habits doesn't have lasting effects, what doesn't sit well with me is to risk my health to avoid taking a drug that helps.

brazukadev 13 hours ago | parent [-]

changing habits do have lasting effects, I'm not part of this "we" that doesn't know that.

topgrain2 13 hours ago | parent | next [-]

People talk past each other on this because for an individual it technically can work, and sometimes does, but on a population level, as extensively studied by people whose job it is to study that, it definitely does not work. Even with tons of regular attention from professionals and a cohort selected to have above-average motivation, it’s surprisingly poorly-performing (and that’s a crazy expensive level of intervention)

Think about how we describe contraceptives, medically speaking: a failure rate is tracked and promoted that’s the in the wild rate of failure, not the ideal-use rate of failure (which can be effectively zero!). The diet and exercise equivalent of a contraceptive couldn’t be sold, because its failure rate would be way higher than its success rate.

So “we” (people who’ve paid attention to the science on it) know it doesn’t work (on a population level), like for-sure definitely does not work, but a person reads this assertion of fact and goes “but wait it worked for me, this person must be dumb or something” but that’s not it. It’s two different perspectives on what it means for it to “work”.

yakz 13 hours ago | parent [-]

I think it'd be more accurate to say that informing people that they should change their behavior doesn't work. A person changing their behavior can escape obesity. The reality is that most people won't be able to change their behavior without some other kind of assistance.

topgrain2 11 hours ago | parent [-]

Even with extensive assistance (which is way too expensive to widely deploy) outcomes are weak.

Last I checked, researchers in the specific area of high-touch weight interventions were excited that they finally had a tool that might more-than-barely work… in glp-1 agonists.

yakz 11 hours ago | parent [-]

I didn’t mean to suggest that GLP-1s don’t count as assistance.

Informing people that they can avoid pregnancy and STDs if they’d just stop fucking each other doesn’t work at scale either.

vidarh 13 hours ago | parent | prev | next [-]

If you succeed at changing your habit, it works.

However, all the evidence is that the vast majority of people fail at changing their habits in ways that produce lasting weight loss, so it does not generally work as advice for reducing your weight.

So you're technically right, but it is irrelevant, because we don't know how to actually get people to change habits with any meaningful rate of success.

At this point it is downright harmful and wildly unethical to recommend it when we now have a far more successful option.

brazukadev 35 minutes ago | parent [-]

You didn't say "trying to change your habits" don't work. You said changing habits don't work. This is false, harmful and wildly unethical.

shlant 4 hours ago | parent | prev [-]

they have long lasting effects if the changes are long lasting. Almost never the case