Ozempic
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I wonder if we've created a problem with the diets we follow, and are solving that problem with very expensive GLP-1 meds. Would eating differently accomplish the same thing? At least for some people?
Almost certainly yes, probably for a fair number of people.
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it. To say nothing of the knowledge that would be needed.
One other issue is the role of the gut microbiome in obesity, something I've seen mentioned but don't know a lot about. What I mean is, there may be other causes of obesity that just eating differently will not solve.
@ShiroKuro said in Ozempic:
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it.
I’m going to disagree here. Changing the mindset is difficult, but except in extreme cases of poverty obtaining the food is not. A few anecdotes, if I may.
My sister works at a food bank that is nicely supplied with the good stuff. What she finds is that their patrons don’t want the good stuff (artisan bread from local bakeries, fruit, veg, etc. from government programs and various farms, whole wheat things, beans, rice) they want processed and snack foods. White bread, chips, soda, cookies, packaged meals. A lot of the fresh stuff goes to waste. Reasons include that they just don’t like the unprocessed stuff or that they deserve better - an argument I find maddening.
I’ve spoken before of the toddlers. Great people, salt of the Earth, lousy diets. All of them struggle with weight issues, some to a rather extreme extent, and they’re teaching their kids to be the same. Jane (Mom) makes an attempt - always lays out veg and fruit for Sunday supper - but few eat it. Several won’t eat anything green, or fruit, or beans. Lots of snacks before dinner - all delicious but all highly processed. Great scratch cooked food but lots of gravy. Crazy rich desserts. Big portions, lots of butter.
One went on Mounjaro and lost some 80 pounds. She’s happy about it and her diabetes is in remission, as are any number of other medical issues, but she still craves brownies and won’t eat vegetables. Another is on OZ and progressing nicely but is about to bail on it because he feels lousy when he eats the food (pizza, mostly) he really likes. This sort of thing is hard to fix, and advertising makes it hard to even modify.
I live on the border of two towns, the one to the south that is heavily Appalachian, older, and lower income; and a more affluent suburb to the north. The difference in grocery stores - and grocery carts - is striking.
The main grocery store to the south caters to the tastes of the locals - and of course they do. Aisles and aisles of soda, candy, chips, and boxed meals. Limited produce, very little meat. Lots of bacon and sausage, beer, heat and serve stuff. None of it is cheap, but it’s what they want.
Their carts reflect this, and sometimes I wonder what keeps them alive. That has a name BTW, “cart shaming”. I’m supposed to feel bad about it but I don’t and I keep it to myself. The store also has plenty of healthy options but they’re hard to find. If their patrons wanted them they’d be displayed more prominently.
To the north are stores more like the ones I was used to seeing in CA. More produce, more kinds of rice, more staples, better selection of breads and such. Still aisles and aisles of questionable choices but more of the better choices featured prominently. The carts tend to reflect this and the clientele at least appear to be healthier.
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
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Agreed. Add in that healthy food is generally an interest that comes along later in life when you start to understand the consequences of the alternative. But I think Steve is right in that healthy food is available most places. Getting people to eat it is a different issue, especially when they were not raised on it.
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The only person telling me what I should and should not be eating is my doctor. I do not believe the government should be in the doctor's office whether that be reproductive health or any other health issue. I'm not against the government issuing pamphlets on healthy eating and healthy lifestyle choices, but gross generalizations need to go, as do nanny state nagging. There are likely as many reasons for being overweight as there are numbers of people. (There was a NYT article about this not too long ago.) Warning labels based on correlations should not even be considered for food. Information labels are non-judgemental and useful. The French eat white bread, and a lot of it. Their pastries are sine qua non, cheese is consumed daily. Raw milk. A healthy, positive attitude towards food, they celebrate it. And they allow enough time in the structure of their lives for full enjoyment. The break for lunch is two hours, men, women, and children. In the US you're lucky to get half an hour. They eat later, after the day's work is over and they respect the end of the work day. In a word, they eat to live, not the other way around. We can't afford that in the US. Sad.
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KFF did a report on the costs associated with GLP-1s.
And a Reuters report about how two-thirds of people who go on the GLP-1s are not taking them after a year.
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aumônier
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The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans.
Mik, you know this stuff.
What are PBMs, what do they do, how do they make their money, why do we need them, and what would be lost if we dropped them all in to a volcano?
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@ShiroKuro said in Ozempic:
At the same time, eating well is incredibly difficult, especially for those in lower income groups, between the cost of healthy food and the availability of it.
I’m going to disagree here. Changing the mindset is difficult, but except in extreme cases of poverty obtaining the food is not. A few anecdotes, if I may.
My sister works at a food bank that is nicely supplied with the good stuff. What she finds is that their patrons don’t want the good stuff (artisan bread from local bakeries, fruit, veg, etc. from government programs and various farms, whole wheat things, beans, rice) they want processed and snack foods. White bread, chips, soda, cookies, packaged meals. A lot of the fresh stuff goes to waste. Reasons include that they just don’t like the unprocessed stuff or that they deserve better - an argument I find maddening.
I’ve spoken before of the toddlers. Great people, salt of the Earth, lousy diets. All of them struggle with weight issues, some to a rather extreme extent, and they’re teaching their kids to be the same. Jane (Mom) makes an attempt - always lays out veg and fruit for Sunday supper - but few eat it. Several won’t eat anything green, or fruit, or beans. Lots of snacks before dinner - all delicious but all highly processed. Great scratch cooked food but lots of gravy. Crazy rich desserts. Big portions, lots of butter.
One went on Mounjaro and lost some 80 pounds. She’s happy about it and her diabetes is in remission, as are any number of other medical issues, but she still craves brownies and won’t eat vegetables. Another is on OZ and progressing nicely but is about to bail on it because he feels lousy when he eats the food (pizza, mostly) he really likes. This sort of thing is hard to fix, and advertising makes it hard to even modify.
I live on the border of two towns, the one to the south that is heavily Appalachian, older, and lower income; and a more affluent suburb to the north. The difference in grocery stores - and grocery carts - is striking.
The main grocery store to the south caters to the tastes of the locals - and of course they do. Aisles and aisles of soda, candy, chips, and boxed meals. Limited produce, very little meat. Lots of bacon and sausage, beer, heat and serve stuff. None of it is cheap, but it’s what they want.
Their carts reflect this, and sometimes I wonder what keeps them alive. That has a name BTW, “cart shaming”. I’m supposed to feel bad about it but I don’t and I keep it to myself. The store also has plenty of healthy options but they’re hard to find. If their patrons wanted them they’d be displayed more prominently.
To the north are stores more like the ones I was used to seeing in CA. More produce, more kinds of rice, more staples, better selection of breads and such. Still aisles and aisles of questionable choices but more of the better choices featured prominently. The carts tend to reflect this and the clientele at least appear to be healthier.
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
Good comments all around.
@Steve-Miller said in Ozempic:
Education, maybe? Perhaps, but it’s going to be mighty tough to get people to change, particularly when they’re bombarded with advertising 24/7. Equally important is that people have a right to spend their money as they please and eat what they like.
It’s complicated.
It certainly it is complicated!
Education, while needed, definitely won’t do it alone.
And no, as @wtg said, the high tech pharmaceutical solution isn’t sustainable either.
I don’t have any solutions. I haven’t figured out how to drop the weight I gained during the pandemic, and Mr SK, who exercises and eats more healthfully than most, is now pre-diabetic. So there you go.
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KFF did a report on the costs associated with GLP-1s.
And a Reuters report about how two-thirds of people who go on the GLP-1s are not taking them after a year.
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My guess would be that many stop because of the cost. Others stop because of side effects, some of which appear to be avoidable and others that don’t.
I also think at least some stop because they get tired of not being able to eat the way they like to eat.
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A web search lists the same reasons I did above and one more. Some people lose weight like crazy on GLP and others lose more slowly. There are generally plateaus. People who lose more slowly can get frustrated and give up.
The people who lose weight most quickly appear to be people who have a lot to lose and people with poor diets when they start. Interesting that these same people are also the ones who do well on IF routines.
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But, after getting a CT-scan and seeing a neuro-ophthalmologist, it was revealed he had non-arteritic anterior ischemic optic neuropathy (NAION), a condition in which the loss of blood flow to the optic nerve causes sudden vision loss.
Recent studies have shown an association between drugs such as Ozempic, Mounjaro and Wegovy — which have become phenomenally popular for weight loss — and an increased risk of NAION [.
Of the estimated 15 million Americans now taking such medications for Type 2 diabetes and weight loss, only a relative few have experienced the issue, but for those who have, it’s life-altering.
From my eye researcher friend:
Another thing associated with these drugs is cataract formation. I have a 30-something patient recently who was having trouble seeing at night, not because she couldn't see under low levels of iullumination, but because lit signs were blurry and headlights dazzled her. This began a year after starting tirzepatide. She also had naturally very large pupils.
No one thought to look at her lens because she was so young.
The public is doing a clinical trial on themselves. I'm so glad I haven't had to fight obesity.
