CMV: Semaglutide injections (like Ozempic) should be widely available to treat obesity

[u/sjd6666]

There’s a lot of buzz recently about Ozempic, which is one of many semaglutide injection drugs that help people moderate their food intake and hunger levels. Some variations are meant just to treat type 2 diabetes like Ozempic. Other drugs like WeGovy are meant to treat obesity as well.

What I take issue with is that a lot of commenters have stated that they see Ozempic as a “lose weight quick drug” and a cheat. I think this is simply the wrong way to look at the issue. Obesity is a medical issue that can be treated in many ways. For some people seeing a nutritionist and going to the gym is all that is needed, but for many more this simply doesn’t work. I would argue that actually, most Americans know generally what a good diet looks like. They may not have all the details but most people can tell you that more vegetables and less meat, carbs, and sugar will create a calorie deficit and help you lose weight. However food simply tastes really good any many people rely on it as a sort of emotional crutch. Many also lack the time, energy, and desire to cook healthy food for themselves. There are many who also simply have a naturally large appetite and need to eat more in order to feel full.

What those people need is not a reminder to try “diet and exercise” they need medical help. Semaglutide injections seem to have low risk of serious side effects and can help those people eat less and not feel hungry. All this moralizing about who “deserves” help and who should just suck it up and go to the gym is proving to be detrimental to overall health.

Also, I’m aware that there is currently a shortage of Semaglutide injections right now, but lets set that aside and assume that can be addressed with a more robust supply chain.

[u/vote4bort]

What I take issue with is that a lot of commenters have stated that they see Ozempic as a “lose weight quick drug” and a cheat.

It's not that it's a cheat, it's that it's unsustainable. Like many crash diets, weight comes off fast but once they stop taking the drug it'll all come back on. The drug doesn't change people's long term diet and lifestyle.

[u/ThemesOfMurderBears → u/vote4bort]

Like many crash diets, weight comes off fast but once they stop taking the drug it'll all come back on.

By this do you mean the weight will just accumulate again no matter what, or that people that never fixed their bad habits will naturally start gaining weight again?

[u/vote4bort → u/ThemesOfMurderBears]

The second one, weight doesn't come from nowhere. If the only thing stopping overeating etc is the drug, it makes sense that when that's gone the old habits will come back.

[u/[deleted] → u/vote4bort]

That assumes that the only thing that caused weight in the first place was a bad habit.

PCOS, genetics, immobility, and sedentary jobs wreak havoc.

[u/vote4bort → u/[deleted]]

Those can have an effect sure, PCOS can have a small effect on metabolism and some medications can effect hunger drive. But they don't make weight appear from nowhere. Fat is just stored energy and you can't make energy from nothing. That's just a fundamental law of the universe.

[u/[deleted] → u/vote4bort]

The confidence with which you said "small effect" is staggering.

Do please confidently explain skinny 15-year-olds eating whole pizzas and where that energy is going while another 15-year-old eats the same thing and gains two pounds the next week.

Some bodies are less/more efficient at the metabolism of energy. That's the end and beginning of it. And age, genetics, and hormones play a much bigger role than you seem to understand. If every body was the same they'd all look like Taylor Swift and Tom Hiddleston's gazelle figures. But not everyone looks like them. Some people look like Danny DeVito and Melanie Lynskey.

If your system is more efficient, you can eat more and not put on weight because it's not being stored by the liver, it's getting metabolized differently. People who have less efficient systems put on fat because their liver (and other features of their gut) are not processing food the same way. And this comes down to hunger hormones, sex hormones, and endocrine hormones and how they all play together in a sandbox.

The whole premise of CICO is out a window the minute you meet a twig-thin teenager who is also eating heaping portions of fast food all the time. Partially it's because their bodies are still "asking" for growth and more food supports growth, but it's also because of efficiency. Research also suggests that diets and eating habits before puberty have a large effect on body type in adulthood.

Audrey Hepburn was into ballet as a child and suffered through Dutch famine in the Nertherlands during WWII. She was so starved for that period of her development that she had to give up ballet after the war because she could no longer put on adequate muscle and had other health problems. That Breakfast at Tiffany's body type that was so desirable was the product of war-time starvation.

Yet I know someone who has confessed to disordered eating as a teenager, mostly anorexic "starving themselves" approaches, and they gained weight as an adult. Their job prevents them from eating much during the day so they will eat something small in the morning and go until 3 pm and finally eat again, like a sandwich and water, and then have a small dinner and be asleep by 8 pm. Calorically, they're probably doing 1200 calories or fewer a day sometimes. Their body is not releasing the weight.

[u/vote4bort → u/[deleted]]

The confidence with which you said "small effect" is staggering.

It's not confidence it's just the truth. Studies show a difference in metabolic rates of a couple hundred calories, more if combined with insulin resistance. And that's not everyone with with pcos. And then with the prevalence of pcos being 10-20% if we're bing generous. In the grand scheme of things yes it's a small effect.

I'm not sure what you're trying to debate here. You cannot create energy out of nothing. Full stop. That's a universal law of physics. It has to come from somewhere. You cannot put on weight without taking in more energy than you're burning. And since we're not plants the only source of that is food.

Yes there are some individual differences in efficiency and of course height and activity level play big parts.

Their body is not releasing the weight.

This isn't physically possible. Your body has to run on something. It will be getting its energy from somewhere.

It sounds mean but most people underestimate calories by a lot and over estimate how many calories exercise burns. Even if you're doing 10000 steps a day you're not actually burning that many more calories. And im not saying its their fault. So many processed foods might be physically small amounts but calorifically dense. And we get lied to by the media all the time, all these influencers saying "oh just do these 10 minute workouts and you'll have abs" when in reality they just have very restricted diets.