When I'm manic, I get very, very skinny, sometimes frighteningly so. When I'm on meds, I get fat. I'm not trying to get thinner in the former instance, and I'm REALLY not trying to get fat in the latter - I have worked so, so hard with diet and exercise, and I can never win against the effects of my meds. And these experiences have made me forever aware that the moralizing vision of obesity is just fucking wrong. Our bodies react very differently to similar behaviors when it comes to weight loss. What cruelty to tell people who have found something that finally works that it's "spiritually deadening" or whatever the fuck.
I lost 90lbs in 2008-9. I kept most of it off over the subsequent 15+ years. Getting to the low point was easy compared to staying at the low point, which was impossible. I gained and lost the same 30 pounds roughly ~10 times between 2009 and 2025. The gaining happened notwithstanding the fact that I knew I "never wanted to go back" and "always had to be on a diet." My appetite was such that it was trivially easy to overeat even the nutritious food that makes up 95+% of my diet. The losing was always an absolute fucking grind. I knew I could do it and I knew how to do it--it just sucked to have to do.
I got a script for tirzepatide in 2025 and it has been transformative for me. I am *effortlessly* at a body weight I would have struggled to maintain pre-GLP1. In the past, I would deny myself foods I love like pizza because of my penchant for overeating--"one slice becomes five slices and eventually those 30lbs come back." Now I can have a single slice of pizza and not be obsessed about whether I can have another.
I've done it the hard way. I've experienced the satisfaction of hard work leading to a desirable outcome. Tierzepatide is so much better. If I saw Arthur Brooks, I would slap him in his stupid fucking face.
This is because calories in/out isnt the cause of obesity but just a description of the disease process. Fuel partitioning disregulation is. Your meds disrupt fuel partitioning. People who talk about adiposity as some kind of blunt thermodynamic problem rater than a "why is my body prioritizing fat storage over fat burning, resulting in hunger and low energy as caloties are overearmarked for storage" are completely missing that calories in/out are dependent variables in a complex system. Just because one can starve to death by restricting calories doesn't mean obesity is a reverse starvation problem. People arent interested in the evidence that the actual food matters and not all calories have the same impact on adiposity either want to moralize about willpower or believe that calories counting garbage food can work if only people "try hard enough". Ozempic is not a fat loss drugs. It is a catabolic drug. It doesn't address the fuel partitioning problem, hence muscle/tendon loss in tandem with fat loss.
Science really doesn’t know whether there are negative impacts to long term use of these drugs. As a lay person I do understand 2 things that are cause for caution if not alarm. And that is first that these drugs slow digestion by paralysis of stomach for a spell. Second, 90% to 95% of the body’s serotonin is manufactured in our guts. Serotonin controls your mood and overall well being. I do wonder if there will be a future correlation drawn between GLP-1 use in a patient and subsequent increase in SSRI dosage to help keep person from depression/ anxiety due to drop in natural serotonin levels. Time will tell. This because the fine print on Ozempic and its cousins packaging states one must take these drugs for life, once on them, to maintain the effects.
Over the course of about 4 years I lost 270lbs, going from 522 to 250. I reached my low last April and it was great, but I’m now back up to around 325, having regained 70-80lbs in about 8-9 months.
The problem I ran into was that 1) my willpower was exhausted but 2) I still have that disregulated appetite that made me super obese to begin with. If I eat a very bland, low processed, high protein, low carb diet, I can kinda keep my hunger and eating in check. During my loss I locked down my whole life and oriented my entire self towards my #1 goal of weight loss. Once I’m in maintenance the decisions of when to abstain and when to indulge become arbitrary in a way that’s been hard for me to navigate. So if I allow more foods in, it’s a real short road to get to my body urging me to eat 1-3k calories OVER my maintenance. My body and mind just orient me towards eating, mostly junk food, but eating a lot nonetheless. And I’m now in a position where I can’t make weightloss my all-embodying life orientation anymore, so it’s been hard!
So while it’s been disheartening to regain and have to do it again, I’ve got a doc appointment coming about getting on a GLP. I showed I can do the work, can build the discipline, but I can now take a drug that fixes the exact thing that’s wrong with me. I’m planning to write about my experience after, I’d love to live a life not dominated by my struggle with food anymore.
yes, I'm in the same boat. My weight never got so high, but pretty much the only way I've found to lose weight is to stay on a pretty strict low carb diet. When I do the weight comes off. But this is REALLY hard to stay on long term.
But if (when) I break diet it the one nice dinner turns into some desert the next night turns into me buying a bunch of junk food every day within a week or two.
Currently I'm back on diet, I actually made it all the way through the holidays without cheating.
I feel this man! It's like there's an extremely narrow tight rope I need to walk on to keep it in check. Like it seems like you have a similar experience, on Thursday you're fretting over having an extra 120 calories of vegetables because you're a little "real" hungry, but then on Saturday you can do a grocery store haul of 6k calories for your "psychological" hunger. The switch flips and it takes over, and you know you weren't even going hard enough in restriction for it to be a real rebound.
And even then, I feel like we don't have good language to describe all of this. Like in the previous paragraph I tried to distinguish between different hungers. I know what real hunger feels like, it's not real hunger most of the time, at least for me. It's just that I desire to eat, it consumes my thoughts. When I walk the tightrope I don't have these consuming feelings and orientation towards food, but I'm currently deep in it again and hate it.
I empirically know cookie is bad for me right now, I know cookie will make me feel bad both physically and psychologically in this moment, and yet all my body is currently oriented towards is getting cookie, many cookies. I know how to eat healthy and can feel the benefits, it's just that my body really pulls me to do otherwise if I don't stay super strict with my eating.
I feel that so much, I've often used that analogy. And it's especially hard because you're tempted everyday, multiple times a day. Even if you engineer your life to not be tempted there will always be a special occasion that warrants a treat. You feel great, diet's great, doing good in the gym, it's all good what can one thing harm? And then a week later you're wondering how you even stayed on the diet in the first place, desperately trying to get a streak going again.
I find it’s easier to just quit processed sugar cold turkey than to limit myself to “just the occasional treat.” When I’ve managed to go a few weeks without any added sugar (a difficult feat!), my taste buds seem to undergo reprogramming, such that when I then taste something sugary, it feels wrong. Like “this tastes artificial, real food isn’t meant to be so sweet.” Alas, as you say, sticking with a no-sugar diet is really, really epically hard!
Thank you! Funnily enough I had started to really hit my stride with losing weight right when the drugs came out. I was doing well and had it under control. Over these last 8 months I always felt I was 1 fresh start away from having it under control again. Finally decided it’s time to stop waiting and get it treated.
The drugs have always been on the table from what my docs have told me, but since my previous insurance didn’t cover them and I was doing well enough I didn’t pursue it. I initially started right before they came out, and bariatric surgeries were in the conversation if it didn’t work out. Regardless, it’s just time now
In addition to Freddie’s great point above, why does Brooks think that overweight people aren’t struggling and achieving at *other things entirely*? I’m not going to give up playing my instrument or learning languages in order to instead spend those hours for a chance at getting thinner. I think I would be much less happy if I exchanged my hobbies for different hobbies that I don’t like nearly as much.
I'm one of those people who naturally maintains a fairly healthy weight without particularly trying (not notably thin, but not fat either). I was shocked when I heard from people about the idea of "food noise", the constant mental background chatter of wanting food, which GLP-1s quiet. I just don't experience such a thing; my bad eating habits are things like when I eat a bunch of unhealthy snacks or order take-out because my ADHD hit me and I forgot to prep dinner.
I've come to realize while listening to the stories of people on GLP-1s that most obese people just experience hunger differently and more intensely than I do. I think having ADHD and often discussing mental illness has helped my perspective on this. Different minds work differently. Most people don't really get why doing simple daily chores and keeping up with appointments is so difficult for me without my Adderall. I don't really get why eating a smaller portion and avoiding certain foods would be so hard for some people without their Ozempic. In both cases, we might be able to overcome these struggles and reach each other's baseline with an intense exercise of willpower, but I'm glad that we don't have to and can take the medications instead.
I feel like I could’ve written this almost verbatim. Interestingly, one thing that really helped my understanding of just how differently we experience the world was going through a period of not having my ADHD meds work properly and ending up with symptoms that were very different from my usual ones. My partner also has ADHD, and some of his symptoms are quite different from mine (way more time blindness, significantly more forgetfulness, etc). Despite him telling me that some of his behaviors that drove me a little nuts were because of his ADHD (and also being aware of them as common symptoms), there was a tiny part of me that somehow didn’t truly believe him. It was only after I went through a couple of months where my symptoms became more like his that I finally understood. Before, I’d never done things like going downstairs to grab scissors and then immediately forgetting why I’d gone downstairs. It was a very humbling experience, and as frustrating as the whole thing was, I’m actually really grateful that it happened and that I was able to have my eyes opened like this. I’m now much more careful about judging people’s subjective experiences. I can’t imagine what it would be like to have to live with constant food noise, and it is infuriating that Brooks is dismissing this amazing medical breakthrough because he thinks we should all value the struggle more. Seriously, wtf.
I had a revelation when I was pregnant with my first kid. I had a craving for croquettes and sent my husband out to get them. I happily ate 3/4 of them and then suddenly felt so full, like I'd be sick if I ate anymore.
*I had never had this feeling before.* I had never not been able to finish a portion of food because I felt too full. I'd heard the expression plenty! Sadly, this only happened during my first pregnancy and never returned.
Something to keep in mind is that Adderall affects people with ADHD very differently than it does those without ADHD, in a way that may seem counterintuitive. For me, Adderall is very calming - it quiets my mind and body - and this is not at all how I understand people describing recreational use of amphetamines (the whole amped up thing, which is essentially the opposite of what I experience). In my case, the medication has at best a very mild appetite suppressant effect. Caffeine is a stronger appetite suppressant for me than Adderall is.
That's true! When I first went on Adderall, I lost a small amount of weight, but I think my body has adjusted to taking it every day because I gained that weight back and I now have what I think is an average appetite. Even if I skip my medication for a day, I only feel a tiny bit hungrier than I do on it, so I don't think it affects my appetite much, but I know it's a common side effect for other people.
"Users still need to follow a diet and exercise plan to achieve their goals"
I feel like this is misleading and throwing the haters a bone they don't deserve. I'm quite sure many people would lose weight on these drugs without making any (conscious) changes to their lifestyle whatsoever. I've been on tirzepitide for just over a year and I gotta say it would have taken great effort and discipline to maintain my original weight! I'd have needed to force myself to eat and change my diet to be more calorically dense - I'd need to make five trips per week to Paris Baguette to replace a meal with cake instead of my usual one. Maybe you can reach more ambitious weight loss goals by stacking changes in diet and exercise on top of the drugs, but if all you want is a healthier BMI, making zero effort besides taking the drugs seems like a solid option.
If I hit a wall, I'll increase the dosage. If I max that out, there are more powerful drugs like retatrutide coming down the pipe. I have little interest in spending hours of my life in the gym! I'd much rather spend my time engaging in the struggles I actually enjoy - sitting at my computer, crafting the perfect internet comment, optimizing Ultracube uptime in modded Factorio, or working on the next problem in Project Euler...
I'm never going to feel sorry for the people who lost and kept off weight through heroic effort and now watch with chagrin as millions of people do it easier. My sympathies are reserved for the ~20% of people the drugs don't work for. Hope they get similar solutions soon! If you do happen to be one of those people who has lost and kept off a bunch of weight through heroic effort, you should consider the drugs! Put that impressive capacity for effort toward becoming the next tech billionaire or solving hunger instead!
Lost 30% of my body weight (started around a 33 bmi) on tirzepatide with 0 effort, just eating what I felt like which was not much. Had to count calories to make sure I was eating enough. Have always exercised, fat or thin--health benefits of exercise are great but don't have much to do with weight in my experience.
On the "heroic effort", I did that! And honestly it took orienting my whole life around that. I don't want to do it again. I'm electing to go on the drugs now because I need to use my willpower on other endeavors that are much more worthwhile. It's hard to do other things when I have to use an amount of willpower day to day just to not indulge in an eating spiral that most other people just don't have, at least at this magnitude!
I don't expect anyone to take on a heroic effort just to live a normal life. Sure the tools are out there to do it without drugs, but at least from my experience I just got something in me pushing me to eat far more than what others are driven to eat. It's wild
And that’s just it - MOST people don’t have the “heroic” reserves of willpower. They might have other things going on in their lives that need some of those reserves. They can’t afford to direct all their willpower toward their diet. The GLP drugs are a godsend for turning off the “food noises” in most people’s head, and enabling them to use the willpower toward different ends.
“Heroic willpower” is for athletes or new parents or inventors. It should NOT be *required* to stay at a healthy weight. This is where GLP drugs come in for those who otherwise would have to tap into those heroic reserves. And I say they should be covered by any insurance for anyone who needs them.
Yeah, my sister (among others I know) have made very few changes and lost a lot of weight. They look better and feel better. But isn't exercising just a good on its own without even considering weight loss? According to the study cited in the article, the vast majority of people who kept the weight off just walked. I don't think they had to reorient their whole lives around fitness. I think most doctors recommend daily activity for people regardless of BMI.
The gym is great for you. But it won’t make an obese person lose weight long term without diet changes. Workouts just make you hungry. That’s why GLP1 drugs and weight loses surgery are so good for obese people. They work. And they make you healthier.
Obviously one should attempt a lifestyle only based treatment for weight loss first. But if it doesn’t work the first time , it should be augmented with medical intervention. And it should attempted prior to becoming obese , when one is just over weight.
We shouldn’t have untreated obesity in the USA. When somebody gets overweight and can’t get back down to healthy , we should be intervening prior to them becoming obese.
I wonder what Brooks would think about me, someone who lost about a third of my body weight 10 years ago without meds or surgery, etc. I did that by changing how I eat and exercising more. Perhaps he'd consider me a person with "real character and strength." OK. But then I'd tell him:
Losing weight wasn't actually all that hard for me relative to other life experiences because I was in the unique position of having employer-sponsored health insurance for therapy that helped me change my habits, a cheap gym and grocery store directly across the street, a lot of free time & no kids, a boyfriend who helped me learn how to lift weights for free, and the energy of a 26-year-old. I was playing the weight-loss game on Easy Mode. A lot of people aren't.
I'd tell him that what *was* a struggle was having a binge eating disorder for years that was made only worse by the way people treated me when I was heavier, and the relentless internal battle I waged (and often lost) every day against the compulsion to annihilate myself with food.
If by taking these meds, someone reaches the same end state I did -- feeling better in their body and no longer having to wage that internal war -- I don't doubt that they will feel similar satisfaction. The ostensibly character-defining struggle doesn't have to be what you put your body through to change it; often it is what you've already endured in it. The accomplishment can be the choice you made to do something, anything, to feel better.
I think a lot of this bad argumentation comes from a sort of holdover puritanical Boomer anti-abundance thinking.
Silver bullets feel too easy, and their puritanism won’t allow them to accept these into their hearts, so they derangedly fret about the sort of material progress they’re ostensibly supposed to support.
I think the dumbest thing about the whole "Being thin through effort is virtuous" idea is that for the vast majority of human history, the hard work was in getting enough food to eat. Those of us with the instincts to eat whenever food is available are virtuous ants who will survive the hard winter, meanwhile the grasshoppers who just eat when they feel like it and gain no weight have nothing to fall back on when the famine comes.
I know two groups of people who have used GLP meds, the first group is categorically obese and trying to achieve a healthy weight, and the second group is already at a fairly healthy weight and trying to achieve a perfect body. The second group is the one Arthur is writing to, but he didn't frame his question correctly, possibly because, being a thin man himself that I assume circulates in privileged spaces with little obesity in sight, he didn't realize his own bias and therefor didn't know he was framing his question incorrectly.
"Is fixing problems actually bad?" is such a tired and obnoxious question. It usually goes hand-in-hand with a bunch of "just world" and "naturalness = goodness" ideas, which help prop it up.
(*Cough* Brooks, wanting me to suspect that if I fix a certain problem, that's actually bad, because I'll miss out on the "satisfaction" of "struggle." No dude, you go ahead and struggle if you want. Me, I'll be moving onwards and upwards. Not falling for that shtick.)
I think one reason that question keeps such a foothold is because it sounds deceptively similar to an actually-good question: "Will fixing this problem backfire in unexpected ways?"
THAT is a question you have to ask it constantly in medicine. I often tell people that the body is like an an economy. It's really hard to go in and tweak just one little thing. You come up with awesome-sounding ideas like price ceilings, and then they fuck you over. When you tweak something in the body, usually you should expect a cascade of downstream effects, and very frequently a lot of these will be negative. (Simplifying dramatically: If there weren't a lot of negative downstream effects, evolution might have already done what you're trying to do.) That's why you usually don't want to fiddle with things that aren't broken until you really understand what's going on in fine-grained detail. In an economy and in a body, it's tough to get a free lunch.
As an aside, this is especially true about the chemistry of a body rather than the plumbing of it, which is why I happily got a deceptively risky-sounding never-before-done method of top surgery, but I don't do much exogenous testosterone. People think that combo is weird: "What do you mean, you did top surgery wide awake without an IV with a guy who had never done a top surgery before, but you think taking testosterone is dangerous?! Every trans guy takes testosterone and they aren't dying!" But I think if you study surgery and then study sex hormones, you'd realize this decision combination easily falls out of a consistent risk/reward function. I can track most of the important cascading effects of the surgery I got. I do not think we can do that very well with sex hormones. I got a free lunch from my surgery that I am not confident I can get from taking exogenous testosterone.
So there's a true thing, which is that it's hard to get a free lunch. But the goal should still be to get the free lunch! Or at least a cheap lunch! Just because it's harder than it looks doesn't mean LUNCH is bad!
So of course I was pretty suspicious of hunger hormone agonists being a free lunch. Still am. I take an off-and-on small dose of retatrutide as an aide to bulking/cutting cycles, so I can build more muscle faster without worrying that it'll be hard to take off the accompanying fat later. I have some uncertainty about whether that's smart. Frankly I wouldn't be shocked if I get some weird disease from that in 40 years. C'est la vie.
But that's where the worry comes from - unexpected biological ramifications. Not ONCE have I been worried that making fat loss easy is somehow spiritually bad for me.
Like Jerusalem said, people have plenty of hardships in life. I have no shortage of hardships, so I certainly do not need to preserve my existing ones like they're an endangered species.
Maybe someday when we live in a utopia, we can preserve a few of our last problems so we have something to "struggle" with. But for now, we can all stop playing 4D chess and accept that solving problems is good. And if solving those problems creates other problems, then we should solve the second-order problems too.
Even if we reach utopia, we don't have to preserve struggles, we can just impose them on ourselves. We can just strive for ever more difficult levels in video games or learn musical instruments or go hiking or whatever other endeavor would give us satisfaction.
Hi Jerusalem. I am an active, licensed consulting Internal Medicine and Diabetologist Specialist (FRCPC U. of Toronto 1976) in Red Deer, Alberta Canada I have been the Principle Investigator of more than two hundred mostly phase 2 and 3 diabetes and CV international risk factor studies, including the LEADER semaglutide protocols. I have also been one of Canada leading prescribers of the GLP1s Victoza and Ozempic since they were approved in Canadaover over a decade ago.
I loved your excellent "Argument" refuting Arthur Brooks misguided Free Press article suggesting that GLP1's may not make a person happy, or that a lack of will power may be the main cause of weight regain. Genes that increased appetite and the hypersecretion of insulin, the main hormone that promotes efficieint storage of nutrients in fat cells, enabled our hunter-gather ancestors to both control the blood glucose and survive periods of famine. These genes haven't change significantly in the past century although most current indiviuals are much less active and consume far more energy dense food than our ancestors. Thus, the current global pandemic of obesity and Type 2 diabetes.
GLP1's such as Ozempic/Wegovy, and the more effective GIP-GLP1dimer Mounjaro/Zepbound, blunt this genetic predispostion by reducing both appetite and the bodies resistance to insulin. This enables the glucose to be controlled with less injected or pancreatic insulin, and thus facilitates the release of free fatty acids from fat cells. It also explains why these fantastic new medication need to be taken indefinitely.
When I'm manic, I get very, very skinny, sometimes frighteningly so. When I'm on meds, I get fat. I'm not trying to get thinner in the former instance, and I'm REALLY not trying to get fat in the latter - I have worked so, so hard with diet and exercise, and I can never win against the effects of my meds. And these experiences have made me forever aware that the moralizing vision of obesity is just fucking wrong. Our bodies react very differently to similar behaviors when it comes to weight loss. What cruelty to tell people who have found something that finally works that it's "spiritually deadening" or whatever the fuck.
I lost 90lbs in 2008-9. I kept most of it off over the subsequent 15+ years. Getting to the low point was easy compared to staying at the low point, which was impossible. I gained and lost the same 30 pounds roughly ~10 times between 2009 and 2025. The gaining happened notwithstanding the fact that I knew I "never wanted to go back" and "always had to be on a diet." My appetite was such that it was trivially easy to overeat even the nutritious food that makes up 95+% of my diet. The losing was always an absolute fucking grind. I knew I could do it and I knew how to do it--it just sucked to have to do.
I got a script for tirzepatide in 2025 and it has been transformative for me. I am *effortlessly* at a body weight I would have struggled to maintain pre-GLP1. In the past, I would deny myself foods I love like pizza because of my penchant for overeating--"one slice becomes five slices and eventually those 30lbs come back." Now I can have a single slice of pizza and not be obsessed about whether I can have another.
I've done it the hard way. I've experienced the satisfaction of hard work leading to a desirable outcome. Tierzepatide is so much better. If I saw Arthur Brooks, I would slap him in his stupid fucking face.
Amen 🙏
Well said. I appreciate this perspective.
This is because calories in/out isnt the cause of obesity but just a description of the disease process. Fuel partitioning disregulation is. Your meds disrupt fuel partitioning. People who talk about adiposity as some kind of blunt thermodynamic problem rater than a "why is my body prioritizing fat storage over fat burning, resulting in hunger and low energy as caloties are overearmarked for storage" are completely missing that calories in/out are dependent variables in a complex system. Just because one can starve to death by restricting calories doesn't mean obesity is a reverse starvation problem. People arent interested in the evidence that the actual food matters and not all calories have the same impact on adiposity either want to moralize about willpower or believe that calories counting garbage food can work if only people "try hard enough". Ozempic is not a fat loss drugs. It is a catabolic drug. It doesn't address the fuel partitioning problem, hence muscle/tendon loss in tandem with fat loss.
Science really doesn’t know whether there are negative impacts to long term use of these drugs. As a lay person I do understand 2 things that are cause for caution if not alarm. And that is first that these drugs slow digestion by paralysis of stomach for a spell. Second, 90% to 95% of the body’s serotonin is manufactured in our guts. Serotonin controls your mood and overall well being. I do wonder if there will be a future correlation drawn between GLP-1 use in a patient and subsequent increase in SSRI dosage to help keep person from depression/ anxiety due to drop in natural serotonin levels. Time will tell. This because the fine print on Ozempic and its cousins packaging states one must take these drugs for life, once on them, to maintain the effects.
Over the course of about 4 years I lost 270lbs, going from 522 to 250. I reached my low last April and it was great, but I’m now back up to around 325, having regained 70-80lbs in about 8-9 months.
The problem I ran into was that 1) my willpower was exhausted but 2) I still have that disregulated appetite that made me super obese to begin with. If I eat a very bland, low processed, high protein, low carb diet, I can kinda keep my hunger and eating in check. During my loss I locked down my whole life and oriented my entire self towards my #1 goal of weight loss. Once I’m in maintenance the decisions of when to abstain and when to indulge become arbitrary in a way that’s been hard for me to navigate. So if I allow more foods in, it’s a real short road to get to my body urging me to eat 1-3k calories OVER my maintenance. My body and mind just orient me towards eating, mostly junk food, but eating a lot nonetheless. And I’m now in a position where I can’t make weightloss my all-embodying life orientation anymore, so it’s been hard!
So while it’s been disheartening to regain and have to do it again, I’ve got a doc appointment coming about getting on a GLP. I showed I can do the work, can build the discipline, but I can now take a drug that fixes the exact thing that’s wrong with me. I’m planning to write about my experience after, I’d love to live a life not dominated by my struggle with food anymore.
yes, I'm in the same boat. My weight never got so high, but pretty much the only way I've found to lose weight is to stay on a pretty strict low carb diet. When I do the weight comes off. But this is REALLY hard to stay on long term.
But if (when) I break diet it the one nice dinner turns into some desert the next night turns into me buying a bunch of junk food every day within a week or two.
Currently I'm back on diet, I actually made it all the way through the holidays without cheating.
But I'm sooo hungry (or really munchy).
I feel this man! It's like there's an extremely narrow tight rope I need to walk on to keep it in check. Like it seems like you have a similar experience, on Thursday you're fretting over having an extra 120 calories of vegetables because you're a little "real" hungry, but then on Saturday you can do a grocery store haul of 6k calories for your "psychological" hunger. The switch flips and it takes over, and you know you weren't even going hard enough in restriction for it to be a real rebound.
And even then, I feel like we don't have good language to describe all of this. Like in the previous paragraph I tried to distinguish between different hungers. I know what real hunger feels like, it's not real hunger most of the time, at least for me. It's just that I desire to eat, it consumes my thoughts. When I walk the tightrope I don't have these consuming feelings and orientation towards food, but I'm currently deep in it again and hate it.
I empirically know cookie is bad for me right now, I know cookie will make me feel bad both physically and psychologically in this moment, and yet all my body is currently oriented towards is getting cookie, many cookies. I know how to eat healthy and can feel the benefits, it's just that my body really pulls me to do otherwise if I don't stay super strict with my eating.
I equate it to being an alcoholic.
One cookies is too many, but a dozen is not enough.
I feel that so much, I've often used that analogy. And it's especially hard because you're tempted everyday, multiple times a day. Even if you engineer your life to not be tempted there will always be a special occasion that warrants a treat. You feel great, diet's great, doing good in the gym, it's all good what can one thing harm? And then a week later you're wondering how you even stayed on the diet in the first place, desperately trying to get a streak going again.
I find it’s easier to just quit processed sugar cold turkey than to limit myself to “just the occasional treat.” When I’ve managed to go a few weeks without any added sugar (a difficult feat!), my taste buds seem to undergo reprogramming, such that when I then taste something sugary, it feels wrong. Like “this tastes artificial, real food isn’t meant to be so sweet.” Alas, as you say, sticking with a no-sugar diet is really, really epically hard!
I could probably do sugarless if I were single and alone, but I'm not even the primary cook in my household, so it's not going to happen.
agreed, it's either all or nothing for me.
So my treat after dinner is usually blueberries or cherries or something like that. And I do just fine with it,
But I'm almost 4 months in on low carb now. Only 10 to do!
Get you some tirzepatide. For real. It's an amazing aid.
I've thought about it, but I have HUGE anxiety when it comes to taking new medications or supplements.
Didn't use to have that problem, when I was 20 I could and did take anything under the sun, but somewhere around 35 it developed.
So, at least for now, I will probably keep struggling. My current plan is 11 months of dieting, then a month of gluttony around Christmas.
It’s not new. GLP1 drugs are old enough to drink. The first one was approved by the fda in 2005. Sema has been on the market since 2017.
Millions on people world wide have used the drug for type2 diabetes. It’s a very well studied drug.
New to me. I had the same problem going on stations. But eventually did it
You deserve massive kudos for losing that much!
I’m a little surprised you weren’t previously offered these drugs.
Thank you! Funnily enough I had started to really hit my stride with losing weight right when the drugs came out. I was doing well and had it under control. Over these last 8 months I always felt I was 1 fresh start away from having it under control again. Finally decided it’s time to stop waiting and get it treated.
The drugs have always been on the table from what my docs have told me, but since my previous insurance didn’t cover them and I was doing well enough I didn’t pursue it. I initially started right before they came out, and bariatric surgeries were in the conversation if it didn’t work out. Regardless, it’s just time now
I buy my GLP 1 drugs grey market from China for 300 bucks a YEAR.
Ironically for Brooks *this post* made me very happy.
In addition to Freddie’s great point above, why does Brooks think that overweight people aren’t struggling and achieving at *other things entirely*? I’m not going to give up playing my instrument or learning languages in order to instead spend those hours for a chance at getting thinner. I think I would be much less happy if I exchanged my hobbies for different hobbies that I don’t like nearly as much.
I'm one of those people who naturally maintains a fairly healthy weight without particularly trying (not notably thin, but not fat either). I was shocked when I heard from people about the idea of "food noise", the constant mental background chatter of wanting food, which GLP-1s quiet. I just don't experience such a thing; my bad eating habits are things like when I eat a bunch of unhealthy snacks or order take-out because my ADHD hit me and I forgot to prep dinner.
I've come to realize while listening to the stories of people on GLP-1s that most obese people just experience hunger differently and more intensely than I do. I think having ADHD and often discussing mental illness has helped my perspective on this. Different minds work differently. Most people don't really get why doing simple daily chores and keeping up with appointments is so difficult for me without my Adderall. I don't really get why eating a smaller portion and avoiding certain foods would be so hard for some people without their Ozempic. In both cases, we might be able to overcome these struggles and reach each other's baseline with an intense exercise of willpower, but I'm glad that we don't have to and can take the medications instead.
I feel like I could’ve written this almost verbatim. Interestingly, one thing that really helped my understanding of just how differently we experience the world was going through a period of not having my ADHD meds work properly and ending up with symptoms that were very different from my usual ones. My partner also has ADHD, and some of his symptoms are quite different from mine (way more time blindness, significantly more forgetfulness, etc). Despite him telling me that some of his behaviors that drove me a little nuts were because of his ADHD (and also being aware of them as common symptoms), there was a tiny part of me that somehow didn’t truly believe him. It was only after I went through a couple of months where my symptoms became more like his that I finally understood. Before, I’d never done things like going downstairs to grab scissors and then immediately forgetting why I’d gone downstairs. It was a very humbling experience, and as frustrating as the whole thing was, I’m actually really grateful that it happened and that I was able to have my eyes opened like this. I’m now much more careful about judging people’s subjective experiences. I can’t imagine what it would be like to have to live with constant food noise, and it is infuriating that Brooks is dismissing this amazing medical breakthrough because he thinks we should all value the struggle more. Seriously, wtf.
I had a revelation when I was pregnant with my first kid. I had a craving for croquettes and sent my husband out to get them. I happily ate 3/4 of them and then suddenly felt so full, like I'd be sick if I ate anymore.
*I had never had this feeling before.* I had never not been able to finish a portion of food because I felt too full. I'd heard the expression plenty! Sadly, this only happened during my first pregnancy and never returned.
An important note is that Adderall is a form of speed. So it's also an appetite suppressant.
Something to keep in mind is that Adderall affects people with ADHD very differently than it does those without ADHD, in a way that may seem counterintuitive. For me, Adderall is very calming - it quiets my mind and body - and this is not at all how I understand people describing recreational use of amphetamines (the whole amped up thing, which is essentially the opposite of what I experience). In my case, the medication has at best a very mild appetite suppressant effect. Caffeine is a stronger appetite suppressant for me than Adderall is.
That's true! When I first went on Adderall, I lost a small amount of weight, but I think my body has adjusted to taking it every day because I gained that weight back and I now have what I think is an average appetite. Even if I skip my medication for a day, I only feel a tiny bit hungrier than I do on it, so I don't think it affects my appetite much, but I know it's a common side effect for other people.
"Users still need to follow a diet and exercise plan to achieve their goals"
I feel like this is misleading and throwing the haters a bone they don't deserve. I'm quite sure many people would lose weight on these drugs without making any (conscious) changes to their lifestyle whatsoever. I've been on tirzepitide for just over a year and I gotta say it would have taken great effort and discipline to maintain my original weight! I'd have needed to force myself to eat and change my diet to be more calorically dense - I'd need to make five trips per week to Paris Baguette to replace a meal with cake instead of my usual one. Maybe you can reach more ambitious weight loss goals by stacking changes in diet and exercise on top of the drugs, but if all you want is a healthier BMI, making zero effort besides taking the drugs seems like a solid option.
If I hit a wall, I'll increase the dosage. If I max that out, there are more powerful drugs like retatrutide coming down the pipe. I have little interest in spending hours of my life in the gym! I'd much rather spend my time engaging in the struggles I actually enjoy - sitting at my computer, crafting the perfect internet comment, optimizing Ultracube uptime in modded Factorio, or working on the next problem in Project Euler...
I'm never going to feel sorry for the people who lost and kept off weight through heroic effort and now watch with chagrin as millions of people do it easier. My sympathies are reserved for the ~20% of people the drugs don't work for. Hope they get similar solutions soon! If you do happen to be one of those people who has lost and kept off a bunch of weight through heroic effort, you should consider the drugs! Put that impressive capacity for effort toward becoming the next tech billionaire or solving hunger instead!
Lost 30% of my body weight (started around a 33 bmi) on tirzepatide with 0 effort, just eating what I felt like which was not much. Had to count calories to make sure I was eating enough. Have always exercised, fat or thin--health benefits of exercise are great but don't have much to do with weight in my experience.
On the "heroic effort", I did that! And honestly it took orienting my whole life around that. I don't want to do it again. I'm electing to go on the drugs now because I need to use my willpower on other endeavors that are much more worthwhile. It's hard to do other things when I have to use an amount of willpower day to day just to not indulge in an eating spiral that most other people just don't have, at least at this magnitude!
I don't expect anyone to take on a heroic effort just to live a normal life. Sure the tools are out there to do it without drugs, but at least from my experience I just got something in me pushing me to eat far more than what others are driven to eat. It's wild
And that’s just it - MOST people don’t have the “heroic” reserves of willpower. They might have other things going on in their lives that need some of those reserves. They can’t afford to direct all their willpower toward their diet. The GLP drugs are a godsend for turning off the “food noises” in most people’s head, and enabling them to use the willpower toward different ends.
“Heroic willpower” is for athletes or new parents or inventors. It should NOT be *required* to stay at a healthy weight. This is where GLP drugs come in for those who otherwise would have to tap into those heroic reserves. And I say they should be covered by any insurance for anyone who needs them.
Yeah, my sister (among others I know) have made very few changes and lost a lot of weight. They look better and feel better. But isn't exercising just a good on its own without even considering weight loss? According to the study cited in the article, the vast majority of people who kept the weight off just walked. I don't think they had to reorient their whole lives around fitness. I think most doctors recommend daily activity for people regardless of BMI.
The gym is great for you. But it won’t make an obese person lose weight long term without diet changes. Workouts just make you hungry. That’s why GLP1 drugs and weight loses surgery are so good for obese people. They work. And they make you healthier.
Obviously one should attempt a lifestyle only based treatment for weight loss first. But if it doesn’t work the first time , it should be augmented with medical intervention. And it should attempted prior to becoming obese , when one is just over weight.
We shouldn’t have untreated obesity in the USA. When somebody gets overweight and can’t get back down to healthy , we should be intervening prior to them becoming obese.
Agree that line is misleading. One should do those things to prevent muscle loss but the weight comes off without it.
I wonder what Brooks would think about me, someone who lost about a third of my body weight 10 years ago without meds or surgery, etc. I did that by changing how I eat and exercising more. Perhaps he'd consider me a person with "real character and strength." OK. But then I'd tell him:
Losing weight wasn't actually all that hard for me relative to other life experiences because I was in the unique position of having employer-sponsored health insurance for therapy that helped me change my habits, a cheap gym and grocery store directly across the street, a lot of free time & no kids, a boyfriend who helped me learn how to lift weights for free, and the energy of a 26-year-old. I was playing the weight-loss game on Easy Mode. A lot of people aren't.
I'd tell him that what *was* a struggle was having a binge eating disorder for years that was made only worse by the way people treated me when I was heavier, and the relentless internal battle I waged (and often lost) every day against the compulsion to annihilate myself with food.
If by taking these meds, someone reaches the same end state I did -- feeling better in their body and no longer having to wage that internal war -- I don't doubt that they will feel similar satisfaction. The ostensibly character-defining struggle doesn't have to be what you put your body through to change it; often it is what you've already endured in it. The accomplishment can be the choice you made to do something, anything, to feel better.
This was such a treat, please make this weekly!
I think a lot of this bad argumentation comes from a sort of holdover puritanical Boomer anti-abundance thinking.
Silver bullets feel too easy, and their puritanism won’t allow them to accept these into their hearts, so they derangedly fret about the sort of material progress they’re ostensibly supposed to support.
David, could you stop slandering Boomers? Puritanical judgmentalism knows no age boundaries.
While that’s true of puritanical judgmentalism in general, I used the moniker because this specific brand is indeed unique to Boomers.
Millennials have a different brand of puritanical judgmentalism that’s not really relevant here, so it wasn’t worth mentioning anyone else.
I think the dumbest thing about the whole "Being thin through effort is virtuous" idea is that for the vast majority of human history, the hard work was in getting enough food to eat. Those of us with the instincts to eat whenever food is available are virtuous ants who will survive the hard winter, meanwhile the grasshoppers who just eat when they feel like it and gain no weight have nothing to fall back on when the famine comes.
I’ve heard people use Arthur’s line of logic to explain why Waymos are bad for society lol
I know two groups of people who have used GLP meds, the first group is categorically obese and trying to achieve a healthy weight, and the second group is already at a fairly healthy weight and trying to achieve a perfect body. The second group is the one Arthur is writing to, but he didn't frame his question correctly, possibly because, being a thin man himself that I assume circulates in privileged spaces with little obesity in sight, he didn't realize his own bias and therefor didn't know he was framing his question incorrectly.
Or maybe he's just a dick writing clickbait.
I don’t agree. I generally enjoy reading his writing. Also, this comment feels like something the folk on X would enjoy.
Minor correction to the intro - "Worst Take of the Week" is alliterative but not palindromic.
The acronym is a palindrome, which is what I think she was referring to.
WTOTW!
Also, I really miss the Bad Takes podcast Matt Y used to make. I'd love for The Argument to revive it or something similar.
"Is fixing problems actually bad?" is such a tired and obnoxious question. It usually goes hand-in-hand with a bunch of "just world" and "naturalness = goodness" ideas, which help prop it up.
(*Cough* Brooks, wanting me to suspect that if I fix a certain problem, that's actually bad, because I'll miss out on the "satisfaction" of "struggle." No dude, you go ahead and struggle if you want. Me, I'll be moving onwards and upwards. Not falling for that shtick.)
I think one reason that question keeps such a foothold is because it sounds deceptively similar to an actually-good question: "Will fixing this problem backfire in unexpected ways?"
THAT is a question you have to ask it constantly in medicine. I often tell people that the body is like an an economy. It's really hard to go in and tweak just one little thing. You come up with awesome-sounding ideas like price ceilings, and then they fuck you over. When you tweak something in the body, usually you should expect a cascade of downstream effects, and very frequently a lot of these will be negative. (Simplifying dramatically: If there weren't a lot of negative downstream effects, evolution might have already done what you're trying to do.) That's why you usually don't want to fiddle with things that aren't broken until you really understand what's going on in fine-grained detail. In an economy and in a body, it's tough to get a free lunch.
As an aside, this is especially true about the chemistry of a body rather than the plumbing of it, which is why I happily got a deceptively risky-sounding never-before-done method of top surgery, but I don't do much exogenous testosterone. People think that combo is weird: "What do you mean, you did top surgery wide awake without an IV with a guy who had never done a top surgery before, but you think taking testosterone is dangerous?! Every trans guy takes testosterone and they aren't dying!" But I think if you study surgery and then study sex hormones, you'd realize this decision combination easily falls out of a consistent risk/reward function. I can track most of the important cascading effects of the surgery I got. I do not think we can do that very well with sex hormones. I got a free lunch from my surgery that I am not confident I can get from taking exogenous testosterone.
So there's a true thing, which is that it's hard to get a free lunch. But the goal should still be to get the free lunch! Or at least a cheap lunch! Just because it's harder than it looks doesn't mean LUNCH is bad!
So of course I was pretty suspicious of hunger hormone agonists being a free lunch. Still am. I take an off-and-on small dose of retatrutide as an aide to bulking/cutting cycles, so I can build more muscle faster without worrying that it'll be hard to take off the accompanying fat later. I have some uncertainty about whether that's smart. Frankly I wouldn't be shocked if I get some weird disease from that in 40 years. C'est la vie.
But that's where the worry comes from - unexpected biological ramifications. Not ONCE have I been worried that making fat loss easy is somehow spiritually bad for me.
Like Jerusalem said, people have plenty of hardships in life. I have no shortage of hardships, so I certainly do not need to preserve my existing ones like they're an endangered species.
Maybe someday when we live in a utopia, we can preserve a few of our last problems so we have something to "struggle" with. But for now, we can all stop playing 4D chess and accept that solving problems is good. And if solving those problems creates other problems, then we should solve the second-order problems too.
Even if we reach utopia, we don't have to preserve struggles, we can just impose them on ourselves. We can just strive for ever more difficult levels in video games or learn musical instruments or go hiking or whatever other endeavor would give us satisfaction.
Hi Jerusalem. I am an active, licensed consulting Internal Medicine and Diabetologist Specialist (FRCPC U. of Toronto 1976) in Red Deer, Alberta Canada I have been the Principle Investigator of more than two hundred mostly phase 2 and 3 diabetes and CV international risk factor studies, including the LEADER semaglutide protocols. I have also been one of Canada leading prescribers of the GLP1s Victoza and Ozempic since they were approved in Canadaover over a decade ago.
I loved your excellent "Argument" refuting Arthur Brooks misguided Free Press article suggesting that GLP1's may not make a person happy, or that a lack of will power may be the main cause of weight regain. Genes that increased appetite and the hypersecretion of insulin, the main hormone that promotes efficieint storage of nutrients in fat cells, enabled our hunter-gather ancestors to both control the blood glucose and survive periods of famine. These genes haven't change significantly in the past century although most current indiviuals are much less active and consume far more energy dense food than our ancestors. Thus, the current global pandemic of obesity and Type 2 diabetes.
GLP1's such as Ozempic/Wegovy, and the more effective GIP-GLP1dimer Mounjaro/Zepbound, blunt this genetic predispostion by reducing both appetite and the bodies resistance to insulin. This enables the glucose to be controlled with less injected or pancreatic insulin, and thus facilitates the release of free fatty acids from fat cells. It also explains why these fantastic new medication need to be taken indefinitely.