Comment by djur

Comment by djur 4 days ago

"A lot of people experience significant GI issues. And it isn’t clear yet if those issues are reversible after stopping."

I don't think there's any reasonable definition of "a lot" where this is true. A significant number of people experience GI issues. Most of them subside after a time. There is some evidence that a small number of people may experience more severe GI issues that don't go away after stopping.

"It’s still best for people to naturally control their weight and diet."

What is your evidence for this? Right now, it's looking like the "unnatural" GLP-1 agonists are racking up quite a score against "natural" methods like "willpower" and programmed diets. It's not a useful distinction, in any case. These medications cause reduced calorie consumption, and reduced calorie consumption causes weight loss naturally.

willcipriano 4 days ago

The only advantage I know of for the natural way is you can retain more muscle mass potentially[0], so your relative body composition is probably better than someone who lost 75 pounds with Ozempic (eg. Ozempic Face).

[0]https://www.theatlantic.com/health/archive/2024/02/ozempics-...

[0-1] Especially if you: Try to consume about 1 gram of protein per day per gram of lean mass, lift weights, limit cardio intensity and duration (30 mins on stationary bike 3x a week worked for me)

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hombre_fatal 4 days ago

In the first study (https://www.nejm.org/doi/pdf/10.1056/nejmoa2032183), the semaglutide group lost less LBM than the control group.
> the proportion of lean body mass relative to total body mass increased with semaglutide.
In the second study (https://link.springer.com/article/10.1007/s13679-023-00534-z), in the STEP 1 trial, the semaglutide group lost less LBM (40%) than the placebo group (56%).

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- djur 3 days ago
  
  Yeah, the lean mass loss effect associated with GLP-1 agonists is just the effect of rapid weight loss without lifestyle and dietary changes other than calorie restriction. There's nothing about Ozempic etc. that keeps you from eating more protein, working out more, and so on (in fact, it makes it easier to do those things in most cases). People are noticing "Ozempic face" because the people who are losing weight through calorie restriction via GLP-1 agonists previously would have just failed at dieting and kept the weight on.
  
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  willcipriano a day ago
  
  > There's nothing about Ozempic etc. that keeps you from eating more protein, working out more, and so on
  Except that the population that takes it never develops those skills.
  
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  consteval a day ago
  
  Not necessarily true - it's a lot easier to workout when you're actively losing weight. Obese people aren't stupid, they've tried working out before. Turns out it's hard, it hurts, and the benefit you get from working out in relation to weight is slim to none. If they're on the right track already and their mind a little clearer, I'm sure it makes it more likely for them to work out.
  It's also easier to workout if you don't drink and smoke, which Ozempic also helps with.
  
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[removed] 4 days ago

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