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Monday, November 15. 2021
Fixes for overweight or obesity
"Diet and exercise" are typical suggestions for the sedentary or over-eaters. However, strict nutritional plans rarely work for overweight people in the long run, and exercise has minimal effect on fat loss (but is essential for general fitness). Nutritional self-control is difficult for most people. Most, not all. 70% of Americans are overweight by some measure.
Metformin is a typical medicine for overweight, pre-diabetes, etc. In my experience, it is not very effective and has many side effects.
In my view, semaglutide might be the current gold standard. It's a tiny weekly injection, done easily at home. Like everything, it has some side effects but not much. It can be labeled as Wegovy or as Ozempic. You have to qualify as meaningfully overweight to get a prescription. It definitely reduces appetite, but has other beneficial physiological effects especially on the insulin system. Can it permanently re-jigger your food compulsions after months of use? It is not clear.
Semaglutide is on-label for Type 2 diabetes, or pre-diabetes, and off-label for weight loss alone.
If you have overweight issues, discuss it with your doctor as an option. It could save your joints, your heart, maybe your life (for a while). I would try it, if eating were one of my hobbies.
Posted by Dr. Joy Bliss in Medical, Psychology, and Dr. Bliss at 14:23 | Comments (13) | Trackback (1)
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It is my opinion that the gradual increase in obesity up to about 1980 is easily explained by prosperity, as our bodies have starvation-avoidant mechanisms of preserving against even moderate deprivation, which are no longer needed - and are in fact counter-productive now.
But in 1980 it all accelerated at a surprising rate, greater than would be expected from abundant food and less physical labor alone. (And we started dieting and exercisin g then, so go figure.) The possible chemical culprits are several, but mere bad habits is not sufficient explanation. Therefore, if chemicals got us into 80% of this mess, I don't mind chemicals getting us out.
Aaahh now I get it - the Dems aren't disrupting supply chains and crashing the economy for political gain - they are saving us from the evils of prosperity.
You forget about the growth of sedentary time (ie screentime) that has been constant since 1980. You can blame the explosion of TV, then computer, then internet and mobile device content. Today, people spend most of their day sitting still.
Overweight and obese are too very different things. Overweight is normal and perhaps desirable. 10% above BMI 25 is in fact quite healthy. 50%-200% above BMI 25 is obese and most likely caused by a genetic issue. If you are obese, say 400 lbs and 5' 10" you aren't going to fix it except by extraordinary measures.
These two things should not be lumped together. Overweight is arbitrary and in many cases not even an issue for health and longevity. Obesity is not arbitrary and it negatively affects your health and longevity.
You can diet and/or exercise yourself from overweight to BMI 25. You need medical intervention to go from 400 lbs to 160.
For most of us, common sense and a few self rules can make a difference. Right after I had cancer and surgery in 2001 I went up from 205 to 225 in about six months of feeling sorry for myself and eating too much ice cream, cookies and drinking beer and not moving around very much. Working with a low carb diet I went back down to 205 within a few years and stayed there until I finally woke up a few years ago when I turned 70, no soft drinks, no sweets in the house, very few carbs like new potatoes that are steamed. Eating a high protein diet cooked at home from fresh ingredients not worry about butter and fat and I am much more mobile at 185, down 40 pounds and at 76 years old I feel better than I did 20 years ago. My wife and I like our fresh veggies and I mostly grill fish, chicken, beef and pork in small portions. Two eggs and two pieces of bacon in the morning, a tiny snack of nice flavored cheese, fresh fruit and a few crackers for lunch and then a well prepared meal in the evening. I do the cooking and she cleans up and we sit down at the table without TV in the evening and enjoy visiting with each other. She drinks her glass or two of box wine and I drink a few Scotch and waters and our health numbers keep improving.
We have enough to eat and save our evening left overs about half the time for lunch. I do boiled shrimp once a week, sautéed or grilled fish once, very small grilled beef tenderloin once a week and pork chops or tenderloin are in the rotation along with grilled boneless, skinless chicken thighs. I go on line looking for new recipients and in the last few years i have learned how to really sauté onions to add wonderful flavors. This last week we joined friends to eat in a restaurant and I could have cooke the food much better for about 20% of the price we paid. Part of the fun of being old, 76 years of this stuff, and retired is having fun cooking and learning how to slow down and enjoy each day.
I also do some walking and all of my yard work with my lawn and garden and love the fact that we have three kids, one in her 50's and two in their 40's and they work out, run and walk, son rand a marathon last month, they are married to healthy people, are good cooks and have skinny kids. We are indeed blessed.
Leave the table "a little bit hungry". No snacking during the day. Nothing after dinner. Gets easier a time goes on. BMI is now 22.
I've had some luck over the last 3 1/2 months, down 20 lb. I've been doing what is called OMAD (One Meal A Day). I haven't controlled the food, except active avoidance of sugar/HFCS in the food. Drinking black coffee, seltzer water, water.
A few things I've found. At first, I would crash, even if I ate my meal before the activity. This is dangerous as the treatment is to eat/drink sugar to pull out. I picked up some glucose tablets to have a controllable counter if I crashed. This has abated. It seemed early on, my body didn't know how to turn on the use of body fat for energy.
I also, occasionally had cravings an hour or so after eating. It felt like my body was dumping insulin into my system out of habit. I found I can mute this by having a sugar cube. Tried the glucose only but it wasn't as effective. I believe there's something, perhaps a habit forming element that demands fructose. The sugar cube is easy to control dosage without creep. Don't know if the chemical bond on the fructose/glucose in the sugar is important compared to the none in HFCS.
Both of those got less after 2 months.
I did have one meal out, burger/fries. Not off my diet, but I do avoid commercial buns as there's something they put in them, like a preservative that is hit or miss with me. But I did have a diet coke. It was about a month in, interesting experience. First few sip were the chemical bitterness of artificial sweeteners then super sweet taste. I feel the diet soda was a set back and will avoid in the future. Real problem is eating out in the fast food/casual dining is heavy on soda since that's a profit center for the restaurants.
So my feeling is there's a physiological response, likely to the fructose, that my body developed a habit of just dumping insulin post meal. This causes hunger, which you just have a bit to satisfy, and repeat. So the weight problem comes from this stimulus for constant grazing/eating. Then occasionally binge urges for sweets/cookies. I confess the latter were often uncontrollably eaten quickly.
Still working on this, but I feel the real problem is the vicious cycle I relate above. Eat, insulin dump, hunger/eat, insulin dump, repeat all day/everyday. It's less the quantity of one meal (except as for weight loss), than never letting your digetive system rest, clear, and more importantly, the insulin/blood sugar deplete so your body is conditioned to turn to ketosis for a few hours a day for energy.
I wish people would read the research rather than tell us their stories, which they often do not understand that well themselves.
Are we supposed to read the old research that blames everything on fat, cholesterol and salt, or the new research that debunks the old research?
Because the research has been soooo successful in reducing the obesity rate.
By implication, the research may inform, but it is hardly definitive.
Most research consists of an elaborate plan to push your own beliefs and coverup anything that contradicts your beliefs.
When I was being treated for pre-diabetes, my doctor prescribed metformin (after a string of other "new" drugs, injectable Byetta being one). Metformin caused me to have so many blood sugar crashes (including one that almost made me pass out) that I stopped taking it on my own, and told me doctor in no uncertain terms that I wouldn't be his guinea pig anymore. What sent my certain diabetes II into remission was losing a lot of weight by restricting the calories and walking. A whole lot.
Semaglutide is like Metformin NOT intended as a drug to reduce obesity.
Both are drugs to help control type 2 diabetes.
An added benefit of at least Semaglutide is that it MAY lead to weight loss, but that's not one of its main or indeed intended effects. It's merely a happy coincidence.
I'm using both (under close control of my doctors obviously). I'm slowly, very slowly, losing some weight since starting on Semaglutide, but that's countered by needing to drink more as one of the other side effects of the drug is that it tends to dehydrate the body and the weight loss is mostly from it causing you to urinate more.
Re my post about semaglutide and weight loss, I was not entirely up-to-date. As of this summer, it IS now FDA-approved for weight loss in non-diabetics. It is termed "a game-changer."
Tracked: Nov 17, 12:51