Such a leap, but whatever. Good doctors will always try to get diabetics and those with high blood pressure to change diet and start exercising first. Then, if unsuccessful, will offer medication. My own father keeps his diabetes at bay through diet and exercise to keep off the needle.
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Itâs the general topic of this thread 
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And stop putting words in my mouth. I have an issue with people using these drugs for vanity reasons because I think it sets a dangerous precedent for those with body image issues and issues with eating disorders. Thatâs all Iâve said against it. Iâm out.
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Unlikely a young child is making their own food choices, or will stand up to choices made for them by parents. Since we canât change their environment, yes, I think it is better for kids to get medication than suffer obesity and a short life span. Pretty sure the parents are likely obese as well, and I donât think education is going to help, or it already would have. No one thinks potato chips are good for you.
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Typically in these kinds of cases you are also doing g a lot of parent education , right @sly123 ?
Meh. My father had his heart attack after lots and lots of recommendations by his doctor to change diet and exercise. I wish the good doctor had just put him on a statin instead.
Very sincerely, I think when doctors err, 9 times out of 10 they do so by not pushing meds soon enough and emphatically enough.
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I work in surgery so I canât do education due to time but the majority of these kids do have a dietician assigned as part of their treatment team.
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Statins tend to raise blood sugar levels, so those who are diabetic or become diabetic as a result may need more drugs for that problem.
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Yep, on average the relative risk is ~1.15.
But doctors shouldnât let this modest increase give them clinical inertia when the benefit/risk ratio is favorable, as it often is. (In the case of my dad, he survived his heart attack, and hasnât had a recurrence. He takes a daily statin with no side effects and a blood glucose that continues to be excellent after 20 years on this statin.)
I feel the same way about semaglutide and other weight loss meds in its class. They may prove to have downsides that havenât yet been discovered. That said, semaglutide has been around for over a decade with a good safety profile. And one has to consider the benefits, not just the âwhat ifs.â
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I have hesitated to jump in here, but here goes. I am 5â9" and have, throughout my adult life moved between a size 8 and a 14. When I am an 8 or a 10, I am in a healthy BMI range. At 12 or 14, I look overweight and I am on the low end of the overweight BMI range.
Fortunately, my size 14 periods have been fairly limited as I am able to lose weight. If I want to lose 1 1/2 lbs a week, I eat a strict 800 calorie a day diet. Most of the time I stay at a 10 or 12. I donât do enough weight bearing exercise, but I am active (kayaking, swimming, walking, snorkeling, etc) and can walk, easily, 8 or 10 miles with no problems (huffing, soreness the next day, etc). We were in Europe for 5 weeks earlier this year and there were only a couple of days I did not exceed 20,000 steps. All my lab stats are excellent and the only medication I am on is occasional Immitrex for migraines.
On my paternal side, there are 12 cousinsâ11 of whom are women. Every one but me is obese. My uncle had childhood diabetes. My grandmother who worked 8-14 hours a day on a farm and had no access to processed foods was also obese. Clearly, there are some genetic issues with weight.
Hereâs the thing: I am always hungry. Always. Hunger pangs, rumbling stomachâŠthe whole thing. I stop eating because I know what a normal portion size isânot because I have ever felt satisfied. A year ago though, I was briefly on some medication where one day I realized at lunch I was not hungry. I was 57 years old and for the first time ever, I understood what people mean when they say âNo thanks. Iâm not hungry.â Truly a lightbulb moment.
I feel like I move through my days with a Herculean amount of willpower. Fortunately, I can afford good food. Add to that, Iâve had a relatively easy life which makes it easier for me than some to devote the mental bandwidth to summoning that willpower.
Based on the BMI requirements, I would not qualify for these drugs, but I have to say that I am VERY interested. I wonder if a low dose (like the every 3 weeks dose someone mentioned earlier) would allow me to go through a day when I am not constantly physically uncomfortable. As I understand it, these drugs could make whatever is haywire with my physiology normal. I imagine that insofar as they would give me some reliefâto the point that I could completely âbe in the momentââthey might change my life.
I absolutely understand the biological basis and the logic of telling (or thinking) an overweight person to eat less. Clearly, if he/she went on a hunger strike, they would lose weight, right? But my point is to encourage some of you not to oversimplify the cause or the solution to obesity.
Our hunger drive is probably the strongest drive we experience and some(not all) obese people experience hunger in a way that I imagine is similar to what people who struggle with substance abuse cravings experience. I wonder how many of the folks with the (well intentioned, Iâm sure), âJust eat lessâ advice would say to an alcoholic or a meth addict " Why isnât the therapy and education enough? You donât need any medical intervention. Just drink less." I suspect most people understand that would be insensitive and unhelpful.
(I also wonder how many people who have never struggled with their weight would be able to suddenly cut 25% of their food out of their diet if they (for some hypothetical reason) were told âjust eat lessâ. )
I am not diabetic. I donât have a stressful family life. I did not have a sedentary job. I donât have money problems. I donât have issues with access to good grocery stores. I have never had a schedule or physical limitations that made it difficult for me to go outside and take a walk. If I had to cope with any one of these health or social obstacles, OR a metabolism that is even slower than mine, in addition to managing my constant hunger, I absolutely would not be the odd woman out at family gatherings.
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Thank you for your input and sharing your journey with us.
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Just drink less.
Ironically, in my lifetime, there was a whole society that literally said that to alcoholics, who were viewed as just not having enough willpower.
The addiction genes are strong and, I suspect, not that far removed from the obesity genes.
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Nope. You said it all against the people who are just not âtrying enough.â Over and over.
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In terms of caring about oneâs weight - is there a difference between men and women? Because my personal observation has been that women appear to be much more concerned about their being overweight/obese than men appear to be.
Itâs just an observation. Men I have known who are obese have become motivated to lose weight either because they get scared straight by a serious medical concern or because their wives constantly nag at them about it. Sorry if that is sexist - itâs just what I have personally seen.
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Thereâs certainly much more of a social media imperative for women to look âperfect.â
That is creeping up for men too, though.
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That is a common observation, and there have been studies on the topic, with the results matching the usual stereotypes:
https://onlinelibrary.wiley.com/doi/abs/10.1002/j.1550-8528.1997.tb00662.x
Another study indicates that females experience weight-based stigma more than males do:
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In general, yes. In American society (or at least in American white, middle, upper-middle, and upper class society), women are encouraged to food restrict (i.e. âwatch their weightâ) even at a normal body weight. And straight women are heavily penalized in the dating market for being overweight.
In contrast, men are not typically encouraged to restrict/diet/watch their weight until they are at least mildly obese. Men do not tend to get penalized in the dating market until they are moderately obese. So overall, men tend to get less pressure to restrict, and consequently are less likely to worry about their weight, and less likely to develop restrictive eating disorders such as anorexia.
An exception to this is in weight conscious sports such as wrestling where men are put under a lot of pressure not to gain weight. Another exception is for gay men, as gay men are heavily penalized on the dating market for being overweight (just as straight women are.) Of note, wrestlers and gay men have rates of eating disorders approximately on par with women.
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Overweight womenâs ailments and illness are also not taken seriously by medical professionals, symptoms tend to be attributed to hormones or excess weight. Hormone fluctuation and mood changes are less likely to affect men. This also puts more pressure on women to be thin.
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âYou donât think those 40% of Americans who are obese have not already tried diet and exercise?â - Many have. Some have not - Iâm married to a worrisome example.
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