I was watching Colbert the other night and Oprah Winfrey came on. She looks amaze balls. She recently confirmed that she used medication to lose weight. I believe that Ozempic is one of the main medications used(?).
I don’t know anything about how this medicine works or whether there are bad side effects or any other other concerns, but it’s apparently working.
I have a granddaughter who is going to struggle with her weight all of her life if she doesn’t get some kind of miracle, so I’m really interested in this subject. She already gets teased and bullied and it breaks my damn heart. So, Is this a miracle?
Oh, another thing is the laser removal of fat. Maybe that will turn into something more widely available and affordable?
I’m using “cured” in the title, but maybe “very successful treatment against” the disease is more appropriate? Also, I know miracle may be the wrong word too, but it would sure feel like one to me.
I think calling obesity a disease is not accurate. Relatively few humans have medical conditions that cause them to be obese, for most of us it has been some combination of indulgence and emotional fragility. Once one is or has ever been obese, there are definitely medical issues in nearly everyone that make it very difficult to lose the weight and keep it off, if that’s what you meant.
I had two doctors (cardiologist and endocrinologist) urge me to take drugs like Ozempic to lose weight, after I had an episode of atrial flutter (dealt with) and converted temporarily from pre-diabetic to diabetic (also now reversed). I declined for reasons (see below for brief discussion) and took it on myself to prove to doctors that a person could do it on his own. So far I have lost over 60 pounds, and my goal is to lose another 50. Those doctors spurred me to make up my mind to lose weight by myself by their assumptions that I couldn’t or wouldn’t do it on my own. In other words, they made me mad enough to take control.
Reasons for not taking these medications (some of these may be misguided, I don’t know): taking these drugs to lose weight is making a shortage condition in these drugs for actual diabetics worse; it seemed very likely to me that I would have to take them for the rest of my life to keep the weight off, which I was not willing to do; I knew my eating habits were awful and felt confident that I could change them.
I hope your granddaughter gets whatever help she needs, but I wonder if putting a young person on this kind of drug forever is a wise thing to do.
I agree. It is not a disease in most cases. It is a condition. I am overweight. Obese? Not sure…it is “normal” middle age weight gain as I become more sedentary and don’t eat as well as I should.
But it is not a disease. This is something I can correct on my own with no need for medicine or medical intervention.
There are some medical conditions that may lead to obesity but I think those are relatively rare compared to the many who are over weight.
Ozempic has had some issues in certain people, most notably causing the digestive system to stall out. I think the longer one is on it the more likely it is.
Obesity in itself is mostly a function of our modern lifestyle. It’s easy to eat too much of things that are not good for us and too easy to avoid physical and mental exertion which would burn more of that other stuff off. As such I think obesity is a natural result of modern life. It’s what happens if you put a human being in the environment we exist in. So we could change our environment, or change ourselves. Either one is going to produce individual failures along with successes. But I feel if we could do more to change our modern lifestyle to lessen obesity that would pay greater immediate dividends to chemically altering our metabolism, however the latter is also an option and can be complementary.
And I am speaking mostly en-mass here, as there are some who could greatly benefit from medications to lose weight, and become healthier.
So no I don’t think it has been cured, though I do see some movement towards the idea that a healthy active lifestyle is needed for the general heath of the population and infrastructure should be build around that basic need of humanity…
Agreed. And I believe calling obesity a disease outside of those rare medical conditions is counterproductive blame passing. No need to beat ourselves up constantly either. If obesity was the only problem in the world it would be a lot more manageable.
While it is possible that we will find a cure for obesity, I don’t think anything can legitimately be called a cure unless it has a history of success for at least 10 years. So many, many methods have been called “the cure” over the years, and all of them have either turned out to be successful for a relatively small portion of people, have unacceptable side effects, or even be dangerous.
I’ll make a note to come back to this thread in 2033 to see where we are with Ozempic and the other similar drugs.
As for Oprah, one time she lost a lot of weight and did a show about how she did it, and I was so inspired that I sent away for the show transcript. That was in 1986!
I recommend the book The Hundred Year Diet for a great overview of the history of weight loss solutions in the U.S.
I am not as quick to dismiss the disease model for obesity. Fundamentally, we do not know the cause of the great rise in obesity over the last 50 years. Lots of “obviously” stuff that people like to say, but very little real data to back it up. Taking in too many calories causes obesity, but that is like saying “death was caused by the heart stopping.” 100% true, and also completely uninformative.
Consider the disease model of substance abuse and addiction. It has gone a long way to change the perspective on addiction from being an individual’s failure of character and will power, to recognize chemical changes and compulsions that are incredibly powerful, and have many different causes.
Obesity is similar. The global rise in obesity is not simply a bunch of people giving in and having a second dessert. It is vastly more complex than that. Continuing to think of obesity as a personal failing is only helpful to bullies.
A drug that interrupts the hunger, eating, obesity cycle could go a long way towards being a cure. Removing the desire for the first dessert, let alone the second one, would go a long way towards reducing obesity. Semaglutide and others may be such a drug.
However, I would hesitate to call something a cure when we don’t have a good handle on the causes. I think it would be more accurate to say it is an intervention, and perhaps an effective one, but it is not a cure.
IMHO cure is definitely too strong a word. In medical school I was taught that for the most part internal medicine physicians treat and manage conditions. The typical saying was “a chance to cut is a chance to cure”, such as a surgeon curing appendicitis by removing the appendix, or cutting out stage 1 cancer, or things like that. But I can’t think of any chronic diseases for which we have a “cure” consisting of treatment with medications. Even at the lower standard of “very successful treatment against”, we aren’t anywhere close to that for obesity.
It sounds like you all are considering disease in an odd sense. I’d classify any condition which leads to impairment of normal function as a disease*. There’s no requirement that the only treatment be with medicine or medical intervention. And yes, I think obesity does qualify as a disease, assuming we get away from using BMI as the gold standard and start using other criteria that make sense on an individual level rather than a tool that was designed to be used on populations, not individuals.
Assuming it doesn’t fit into some other category such as an injury, acute impairment due to intoxication, and things of that sort.
How so? Making a diagnosis isn’t about counterproductive blame passing, it’s about determining which disease process(es) best explains whatever the problems a patient is experiencing.
I disagree about not knowing the cause of the rise in obesity over the last 50 years. It seems obvious to me that the main culprit is the widespread availability and low price of highly processed “junk food” in developed nations. There’s a reason obesity wasn’t a major problem in any other time period prior to WWII, and still isn’t today in places where junk food is not a major part of the diet of many people, and it’s not because they had cures we no longer have available, or any other such thing. It’s because the diets they had were not conducive to developing obesity on a large scale.
I don’t want to have a big argument about it, and it appears that the American Heritage Dictionary agrees with you, sort of, taking their definition in the broadest sense.
noun
An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation, environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.
We can regard obesity, then as “an abnormal condition of a … system of an organism resulting from … [mostly] environmental factors.” This isn’t the way most doctors would regard obesity, I think, but never mind them. The fact that the environmental factors require further action on the part of the individual in order to be effective (i.e. all the influences, from advertising to the cynical manipulation of taste so that people crave more and ever more, do require some cooperation on the part of the organism (each of us) in order to have effect) is not trivial, however, and must be borne in mind.
A lot of people get too sick on Ozempic to continue taking it, and most people lose a percentage of their weight and then no more. On its own, it won’t be a “cure”.
I agree with this. Of course the fact that obesity continues to be a problem, which seems to only get worse year by year despite the development of things like ozempic, demonstrates that as individuals we don’t really have control over those environmental factors that can lead to successful treatment. Morally it’s no different than how an individual in the days where smog and other types of air pollution were more prevalent had no control over the air that they were breathing, and thus no control on whether or not they would develop a respiratory disease based on those exposures. I don’t blame the Individual, I blame the environment.
That was when she went on the Optifast diet. She’s struggled with her weight pretty much for her entire adult life, and has lost, and regained, weight many times, and IIRC, featured how she lost weight on her show several times, as well. (FWIW, she’s been a part-owner of Weight Watchers since 2015.)
Another medical side person in near complete agreement with everything you just said. I will expand on cause though. The rise of the obesigenic environment has some multigenerational intermediaries as well, inclusive of epigenetic changes that increase risk across generations.
I’ll also add an expansion to the BMI criteria - I think some of those who are clearly remaining over fat can be healthier than those with less fat but with poorer excercise and nutrition habits.
The best treatment is still avoidance of the obesigenic environment. It is exciting to be in an era where additional effective treatment is also emerging. Personally I won’t quite celebrate until we have a decade or so of follow up though.
That gets us back to the old “will power” view of obesity, which I don’t think is a helpful way to look at either the cause or treatment of the problem. In a very technical sense, it’s true. But it’s no different than saying someone with a substance abuse problem can choose not to consume their substance of choice.
Yes, I would agree with that statement. AFAIK there’s no controversy over that anymore, at least not in the mainstream medical community.
ETA: Assuming we’re talking about things like alcohol, cocaine, opiates, and so on, rather than “addictions” to things that aren’t actually problematic to the person who has them. But I think that get’s us too far away from the focus of this thread.
I think tuberculosis fits, and most cases are now cured with medications:
As for obesity, it will, just like every other disease, eventually be cured unless humanity goes extinct first. And I don’t think we will go extinct.
As to whether the variations on currently approved drugs will cure most cases once viable variations in tablet form are developed and approved and available as cheap generics – it’s way too soon to know. And so far the tablet-form trials seem to have failed.
I haven’t read more than a sliver of the enormous literature here, but food insecurity as the main cause (either involuntary starvation followed by food availability, or the sequala of voluntary calorie restriction AKA dieting) has evidence behind it. I’m not arguing which factors are biggest, just that it isn’t obvious to me.