We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Semaglutide, and the drugs that will follow it, may soon replace most bariatric surgeries. “Slowly, slowly, slowly, we outcompete the surgeons,” predicts Macklin, who is already referring many fewer patients for surgery. “They know we’re coming.”
Semaglutide treatment is not just for "obesity," however defined. I've seen it work well for just ordinary overweight people who have tried, without lasting success, to get fit. It alters the fat-retention wiring. Any internist can put you on the program.
These are indeed very encouraging. I will be even more encouraged when we can learn what started interfering with the signals from body to brain around 1980 so that our evolutionary advantages started going haywire.
A subset of people who display discipline in a dozen other areas did not suddenly lose this ability in that generation. Something else is happening. So far calorie reduction, no matter how difficult, is the only solution, even against the tide of the body adjusting and readjusting to perceived starvation. But these new things coming on line are going to help folks.
Assistant Village Idiot
First define obesity in a way that makes sense. We know "fat people" who carry 100, 200, 300 lbs of fat. They are clearly obese. We also know people with maybe 40 or 50 lbs of fat and they are technically "obese" by some arbitrary measure. Almost without exception the truly obese, 200-400 lbs overweight or more, are obese because of their genes. Not carbs, not simply over eating, and definitely not because of some "good carbs, bad carbs" hocus pocus.
If you are 40-50 lbs overweight a good diet and exercise and enough self control to stay with it can easily get you back to your ideal weight. If you are 200-400 lbs over weight, in theory a good diet and exercise could get you to a normal weight BUT because your body is actively working against you it would be like torture and it would extraordinary self control to do it. Maybe there will be some medicine someday that will melt off 400 lbs but I doubt it.
A better answer is to not gain that kind of weight; to never become obese. Again if you are genetically predisposed to weight 500 lbs by the time you are 30 or 50 this would take a lot of self control and effort BUT it would/should be easier than trying to lose that weight after you put it on and carried it around for years.
One aspect of weight management that always seems to be overlooked is the emotional component. I have been struggling with my weight for 15 years--not obesity, but I should lose about 15% to be at an ideal weight.
I have discipline in every other part of my life, and I understand nutrition, the value of exercise (which I do and enjoy), and CICO. Yet I never lose more than five pounds because all of my self-control regarding food (and everything I know intellectually about how, when, and how much to eat) goes completely out the window when I am under emotional stress, which is unfortunately pretty often.
I'm not optimistic about the effectiveness of weight-loss drugs in the face of the pretty-common problem of emotional eating.