Comment by hawski

> I understand that those drugs are very useful, but in a way it feels for me like ancient Rome with its orgies and vomit inducing so they can eat more.

https://en.wikipedia.org/wiki/List_of_common_misconceptions

"Wealthy Ancient Romans did not use rooms called vomitoria to purge food during meals so they could continue eating and vomiting was not a regular part of Roman dining customs. A vomitorium of an amphitheatre or stadium was a passageway allowing quick exit at the end of an event."

Purely from a cost perspective - imagine a 79 year old grandma.

Heavily overweight. She is already partially immobile. Pre-diabetic. She may have other conditions, further complicated by her weight. She's on a fixed income.

Which is more probable -

1) A dietary intervention that she attends once a week that revamps her entire daily consumption (but remember, she's on a fixed income) along with some intense exercise?

or

2) put her on a single medication that changes her tastes for sugary and starchy foods, reduces her cravings, reduces inflammation, and in turn, will make her lighter and more mobile.

It is a no-brainer for Medicare. This will save so many downstream costs.

These drugs (mostly) don't allow you to eat more unhealthy food, instead they make it easier to have the self control to avoid over eating / choose healthier foods.

From what I understand these medications make you want to eat less in the first place, so it's not quite the same thing.

The ancient Rome vomiting thing is a myth. https://en.m.wikipedia.org/wiki/Vomitorium

Sorry if it seems not empathic enough…

You should apologize for making it obvious that you don’t know how the drugs work (as illustrated by sibling comments). If your analogy is “gas-guzzling cars”, I would suggest you revisit your reading on the topic.

My understanding is that the drugs keeps you from wanting to eat as much.

That's just not how these drugs work at all.

If everyone 30+ bmi can get to 30 for “free” (not sure where the subsidizing stops, for me it’s free if I’m over 30 bmi), that’s just too tantalizing to pass up, even if the moral applies.

At least it takes a load off one problem (obesity related diseases). Could it actually exacerbate unethical farming even more or lead to even worse outcomes? Hope not.

You may be wrong in the specifics of the mechanism of calorie reduction (reducing appetite vs reducing calorific absorption), but not in the general philosophy.

The obesity crisis (specifically in the US, but elsewhere too) has been caused by bad food essentially - food that is not only nutrient deficient, but also engineered to be as cheap as possible and addictive as possible to get you to buy more of it.

As ever, the US is attempting to fix the symptoms, as opposed to the underlying cause, following the general idea of 'if everyone does what they like, things will turn out ok (somehow)'.

Probably negative health implications of these drugs will surface as people become habituated, and we can continue to shake our heads and wonder how it all went so wrong over there.

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These drugs reprogram the weights in the LLM between the gut and brain, leading to lower calorie intake.

One of the mechanisms of operation is to reduce your desire to eat.

Taking a step back, obesity actually is an adaptation. When food is scarce, you want your body to extract and store every gram of nutrition it can get. And that would provide a distinct advantage when you're trying to reproduce.

The thing is, GLPs don't only suppress eating. There are plenty of substances out there that can do that...and there are plenty of people who can't lose weight by starving themselves, because your body will try to maintain its weight.

The question should be "why isn't everyone obese, given the huge amount of calories available to humans?"