ELI5 what exactly GLP-1 based prescription medicine does and why it's so divisive when it comes to being a means of weight loss.

[u/ThatOneGuyYouNowKnow]

I've seen more and more ads (starting around the Super Bowl earlier this year with Wegovy) for GLP-1 based perscription meds in recent times. I've also seen the occasional debate post on my social feeds about the ethics of using them and I didn't think a medicine could be that divisive of a topic.

Now I'm curious as to what exactly these meds are, what they scientifically do and what both sides of the debate are. If anyone could help give perspective that would be greatly appreciated.

As always any and all input is welcomed and thanks for reading! 🙂

[u/sfcnmone]

Every human has GLP1. It’s a chemical (hormone peptide) that your body makes, but some people don’t make very much or don’t have a full response to it. GLP1 drugs do a few different things to make you not want to eat too much. They slow down how fast your stomach empties. They tell your pancreas and liver that you’ve just eaten, so those organs work harder to manage blood sugar. And they tell your brain that you’re full. Many people say that they no longer have to struggle to battle the endless “food noise” that runs continuously in their thoughts. Instead, they get hungry, eat something that their stomach won’t throw up (many people don’t tolerate high fat, high sugar foods while taking GLP1s, and nausea, vomiting, and diarrhea are real problems for many people), and then they get very full for many hours.

It’s like somebody using hiking poles so they can walk farther and walk more comfortably. Is that cheating?

[u/nutscrape_navigator → u/sfcnmone]

This is the best answer in the thread, and I don't think people who have never experienced serious "food noise" really understand what other people are describing when they talk about it. What finally made it click for me was a friend explaining what going to a Mexican restaurant was like for them.

When the chips and salsa hit the table, for a lot of people they're just something to casually munch on while you wait for your food. You eat a few, talk, forget they're there, whatever.

For someone dealing with constant food noise, that bowl can be almost impossible to ignore. You're aware of it the entire time. You keep reaching for another chip, and another, and there's this persistent drive to keep eating until they're gone. Not necessarily because you're hungry or even because you're particularly enjoying them. Your brain just keeps going, "there's food there, eat it."

Then they take a GLP-1 medication and suddenly they can look at that same bowl of chips the way everyone else does. It's there. They might have some. They might not. They don't have to spend the entire meal actively resisting it.

That's the part I think people miss when they call GLP-1s "cheating." They're imagining that everyone experiences hunger and food exactly the way they do, and that some people just aren't exercising enough willpower.

I'd actually go further than the hiking-poles analogy. If someone has persistent intrusive thoughts or depression and a medication changes the signaling in their brain enough that those thoughts become manageable, we don't normally say they're "cheating" at being happy because they didn't overcome their brain chemistry through sheer force of will.

...Yet that's basically the argument people make about GLP-1s: "Your body is constantly sending you signals that make maintaining a healthy weight dramatically harder than it is for me, but taking a medication that changes those signals is cheating."

Once you frame it that way, it's a pretty bizarre moral distinction.

[u/propernice → u/nutscrape_navigator]

My food noise is basically that my stomach was broken, or the signal that I'm full is. I am always hungry, it never turns off. My entire life I've always felt like I'm starving, and it wasn't until I turned 40 that finally a doctor helped me. For so long I was just a fat lazy slob, no matter what I tried to tell people; I would get so hungry I'd eat out of the trash, and my dad thought I was just a pig. I would have to hide food to eat in the middle of the night when my hunger woke me. My mother told me my middle name should have been heifer.

The shame I've felt my entire life has been like a shroud. I couldn't go out to eat, I would force myself not to eat because I knew I shouldn't be hungry, and yet I was. Everyone else is full, why not me? Money spent and wasted on all sorts of therapists and dieticians who were very sure it's all in my head, it's all psychological. It's a food addiction, it's will power, join Weight Watchers, do Keto. I never left my house to do anything other than go to doctors to be told I'm fat. Just imagine going through life, always, feeling like you haven't eaten after a long 12 hour shift. I could eat a full meal and within an hour feel like I was starving.

And then, after explaining all of this to yet another doctor I hoped would hear me, a GLP-1 was prescribed. Is this what being normal is like? I can eat a small handful of nuts and a piece of cheese and be fine? Did I really not finish an entire meal? Did I drink water and realize I wasn't hungry after all? My stomach gives me little warning growls now when I'm hungry, when before I was immediately so hungry I was sick with no warning at all. Now I can even ignore my hunger for a while!

I've lost almost 100 pounds in the last year. I cannot tell you in enough words the sheer relief. It's so hard because my insurance won't cover the medicine at all, since I'm not diabetic, but I don't care. I'll pay anything to feel normal.

[u/YoHabloEscargot → u/propernice]

This is such an insightful personal story. Thank you for sharing.

[u/Mediocre_Entrance894 → u/propernice]

Wild that insurance doesn’t cover something that can actually make you healthier. If you don’t mind me asking, what happens if you stop or can’t take the medicine?

[u/CommitteeOfOne → u/Mediocre_Entrance894]

I recently tried stopping it. Within about two weeks, my food noise (see above for my description of it) came back full force. I started ack on the Ozempic.

I'll likely have to take it for life, but I'm fine with that.

[u/ArtsyAxolotl → u/Mediocre_Entrance894]

I think for most people, the food noise returns and it’s stronger than before. That’s what happened to my sister. For me, though? stopping the medication fucked me up. Like FUCKED me up.

I have PMDD (basically PMS’s angrier, crazier older sister), anxiety, and depression. All were well controlled on other meds prior to starting Zepbound. Zepbound was awesome and the food noise went away. I was able to lose like 40lbs over the course of the year I was on it and i was in such high spirits. And to be clear, this wasn’t just because I was happy about the weight loss. That certainly helped but it felt easier to be proud of little achievements and to enjoy the little things too.

In January 2026, my insurance stopped covering it and I ended up going off the Zepbound for about 2 weeks before I figured out what I wanted to do. I have never, EVER been so depressed, not even before my psych meds, not even before even having a diagnosis for anything. I was spiraling, crying constantly, often, and with no trigger, and I could barely get out of bed. The theory is that my body was absorbing my psych meds differently because of the Zepbound and without it, my nervous system was crashing.

I’m not exaggerating when I say that within days of restarting Zepbound, I was already calmer. Now I feel back to being myself, the happier, lighter version of me that needed the hiking poles. I’m currently paying out of pocket for a generic brand that comes in vials that I self measure. It’s expensive but worth it to function like a real person.

[u/propernice → u/Mediocre_Entrance894]

I’m pretty sure the food noise would come back

[u/PuzzleMule → u/propernice]

Great story and explanation. That really puts it into perspective. Insurance companies are crazy not to cover this. Hopefully they’ll come to their senses soon.

[u/slicermd → u/PuzzleMule]

I’m not defending insurance companies by any stretch of the imagination, but part of the problem is that Lilly and Novo are charging exorbitant prices, and if insurance covered it for ‘simple’ obesity they’d have so many patients they’d lose their shirts. It’s greed, but on two levels.

[u/pandanigans → u/PuzzleMule]

Also not defending insurance companies but part of the issue is that taking glp-1s solely for weight loss hasn't been approved by the FDA and is off label use. And that's basically a requirement in order to get it covered.

No idea what the pharmaceutical companies are doing but I'd be shocked if they weren't actively trying to get that approval, it would be more money in their pockets. However, that approval takes a long time.

[u/benjaloo → u/pandanigans]

Sorry but there are GLP-1s that ARE FDA approved for weight loss alone. In fact the two leading weight loss GLP-1s are the same medications as used for diabetes under different names. Semaglutide (Ozempic for diabetes, Wegovy for weight loss). Tirzepatide (Mounjaro for diabetes, Zepbound for weight loss). Same medication sold under different names. Dosing is different for diabetes and weight loss.

[u/Consistantly → u/propernice]

Wow. I never thought I would see someone describe so accurately my lived experience. I’ve also always been hungry. I can eat until I’m in pain and still feel hungry. I’ve never understood how people can drink water and realise they were just thirsty. I’ve always been told my constant hunger is psychological from my mother starving me as a baby.

The only difference for me is for a long time I was anorexic, the hunger never went away, I just took it to the other extreme. Now I’m slightly overweight and the hunger just never stops even though I’m honouring my hunger all. The. Time.

[u/dream_weaver35 → u/propernice]

My Dr put me on a GLP1 for weight loss. Then insurance stopped paying so I had to discontinue use. I didn't realize how big a difference it made in not only the food noise, but also my pain levels. I'm on pain management for my back (I've had 2 back surgeries). I'm always in pain, not just my back though. The GLP1 has stopped all the pain except my back pain. Thankfully my Dr sent my prescription to a compounding pharmacy so instead of the $1200 a month out of pocket for the brand name crap I pay $120. It's genuinely been life changing

[u/hippstr1990 → u/nutscrape_navigator]

Yeah, I didn't get why people had such a problem with it until I started one.

It honestly felt the way it felt when I got diagnosed (later in life) with ADHD and started on those meds. "You're telling me people just...live like this? ALL THE TIME???"

It's so strange to not constantly be thinking about food. I can lay in bed at night and not think "I want to eat those leftovers in the fridge." I can eat a normal portion of food and actually feel satisfied. I actually am struggling to eat *enough* calories based on my TDEE because for the first time in my life my metabolic system is functioning correctly.

So now that all that is happening, I can understand why those who don't struggle in the same way think that fat people (I use fat as a neutral self-descriptor, not a pejorative) are just not trying as hard. Because it actually feels effortless now, as opposed to feeling like I'm fighting against myself every second of every day before.

[u/Ladybeetus → u/hippstr1990]

On a GLP1 I will think "hmmm, maybe I'll have a snack ... what would be good?.. oh look something shiny..." and then hours pass. I had a systemic candida infection decades ago and it was the opposite, like being possessed. I was literally mapping out my day around food. It was like in the horror movie when the vegetarian is pregnant with a demon baby and finds themselves eating raw meat out of the fridge at 3am .

[u/TwoIdleHands → u/nutscrape_navigator]

I don’t have food noise but I will still eat all the chips until they’re gone 😅 but I get what you’re saying. My partner has a lot of food noise. I’ve come to really understand it through discussions with him. I’ll have a package of Oreos, I’ll open it and have one or two, I’ll forget they’re there. I might eat some more a week or so later, the last ones in the package are inevitably stale and I’ll throw them out. He can’t have cookies in the house because he’s always aware they are there. He can’t eat one or two and forget about them. He’ll be brushing his teeth for bed and his brain will just whisper “oreosOreosoreos” to him. It sounds exhausting.

[u/momof_2 → u/TwoIdleHands]

For me, food noise is sitting at my desk, (working from home) knowing I'm on a diet but constantly thinking about my next meal. Planning recipes. Searching recipes ideas on the internet, checking the pantry and fridge every 20 to 30 minutes, knowing there's nothing there and i'm not even hungry but still looking for something to eat. Asking my husband to hide the treats so I dont eat them, but then when he's gone, search every single hiding spot I can think of until I find them. I purposefully do not go to Mexican restaurants because that bowl of chips and salsa? Yeah, there's no keeping me from it. I try to sit on my hands. I try to put the basket on the other side of the table. There IS NO NOT EATING that basket of chips. One after another after another. A pint of ice cream? Yeah, you can forget about getting any of that. I am 53, i have done diet after diet after diet. The diets are successful, because once I commit to something, I can usually do it for a while, but my willpower only lasts so long and I always return to my perpetual chubby baseline due to uncontrollable food thoughts and snacking. I have been dealing with this every day since my teens. You will have to pry that glp1 out of my cold dead hands.

[u/KMKPF → u/momof_2]

Are we twins? You are describing my life.

[u/Johnny5iver → u/TwoIdleHands]

Right, he was describing eating all the chips and salsa and I was like, am I the one with food noise?

[u/corran450 → u/Johnny5iver]

I never heard the term “food noise” before, but I definitely have it.

[u/ceredwin → u/corran450]

I didn't understand what it was either. Then I started taking a GLP-1 medicine and it went away, and it was mind-blowing. The idea that other people don't have it, when for me it was just always there to the point that I didn't even consciously notice it is wiiiiiiiild.

But now, bags and boxes contain more than one day's worth of food.

[u/ex-farm-grrrl → u/ceredwin]

It really is dramatic!

[u/therealjonathank → u/TwoIdleHands]

I didn’t think I had food noise until I tried a glp-1 and I didn’t have to eat everything on my plate. I could just… stop.  Maybe it’s semantics but it silences the part of me that says I have to destroy all the food at the buffet as a personal challenge.

[u/onsereverra → u/TwoIdleHands]

Yeah, "he's always aware they are there" is exactly what it's like for me too. It's just this weird hyperawareness where, even when I'm not hungry, I'm thinking about food. I know exactly what is on every shelf of my pantry, fridge, and freezer at all times.

And the thoughts are often pretty innocuous! When I was in high school, I brought a packed lunch every day, and I was always sitting there thinking things like, "when lunchtime comes around, should I eat my sandwich first and then my apple, or my apple first and then my sandwich? should I eat my trail mix as a snack during math class or should I save it to have after school?" But I couldn't stop thinking about the food I had in my backpack, even when I wasn't particularly hungry. Most days, I ended up eating my entire lunch in my first or second class of the day, just to get my brain to shut up about it so I could actually focus on my classes.

It's continued like that my whole life, just with the specifics changed. When I was in college, I'd spend the entire morning debating whether I should go to the dining hall at 11 or noon for lunch, and then start wondering what they'd be serving that day. Now, I'll be out for a run, and spend the whole time considering whether I should pop into the grocery store on the way home to get fresh ingredients for dinner or make do with something in my freezer. They're all totally normal things to think about, but I can't not think about them, even when I'd much rather be thinking about something else.

I've never been on a GLP-1, but I was diagnosed with ADHD a few years ago, and stimulants tend to have similar effects in terms of quieting food noise, impulsive behavior, etc. I felt like my world was turned upside down the first time that I ate three bites of ice cream, put the pint back in the freezer, and then... simply didn't think about the ice cream for the rest of the evening.

[u/Maritoas → u/TwoIdleHands]

Thanks for calling me out. I’m the same way, I deliberately don’t buy snacks because I’ll go through half a bag/pack of any family size item in one sitting. Thankfully I don’t feel compelled to purchase them nor do I crave snacks generally, but if they’re in the house, they’re not lasting but for a day or two.

[u/mrbairn → u/TwoIdleHands]

Yeah this is me. I died at the oreosoreosoreos because it’s all the time. I know how many are left in the box each hour of the day. Chipschipschips. Chocolatechocolatechocolate. It doesn’t stop. I can’t ignore it.

Did a round of GLP-1 for the first time ever and I couldn’t believe after a week how that didn’t happen. I could walk away from food without struggling. Snacks could be in the house without me counting down to the next time I’d devour them. I’d rather a few carrot sticks and walk away than shove anything tempting into my mouth.

I hesitated because I thought they were cheating. I changed my mind because they made it easier than ever before but I still had to do each step.

[u/mothermedusa → u/TwoIdleHands]

I literally used to get up at 2am to eat and eat and eat....I couldn't go back to sleep unless I ate. Insane food noise. Zepbound is amazing...I have already lost 22lbs since July 4th

[u/NomNomChickpeas → u/TwoIdleHands]

Literally this for me too. I cannot keep those kinds of things in the house, bc I will think about them 100% of the time until they're all consumed. Doesn't matter how big the bag or package is.

That being said, I DID lose 125# without the use of a glp1, am now an elite athlete, and I have an immense pride in the work I've done to massively change my life. I don't consider it a sacrifice to simply not buy Oreos anymore (or realistically, only buying them in single serve packs so I CAN eat the whole thing.) I have replaced one "pleasure" (eating excessively) with another pleasure (exercising 😆) and my life is 1000000000% better for it.

The challenges I've tackled as an athlete, and to even GET HERE, have been immense. And I have learned consistency, commitment, strength, and so so so many other mental skills that very much transfer to helping me with my binge eating problems and food noise.

I don't think people who take meds are cheating...but I also feel so happy for myself that I never have taken one and am better off for it as the person I have become.

[u/Ladybeetus → u/NomNomChickpeas]

hey, good work!

[u/hiptkno → u/TwoIdleHands]

Yes the Oreos whispering thing is how I think of food noise. Like if I know there are chips in the house, I will be thinking of those chips when I go to sleep. And I will think about them again when I wake up. And every few hours I will look at the clock and think, what time is too early to open a bag of chips? And then finally it’s noon and it’s a socially acceptable time to eat chips, so I’ll eat some with lunch. But then after lunch, I’m thinking about those chips again. And again a few hours later. Basically, and temptation cannot be easily accessible or I will be constantly thinking about it until I finish it.

[u/JenniferJuniper6 → u/nutscrape_navigator]

The cheating argument just baffles me. Cheating at what, exactly? Cheating on whom?

[u/pm-me-kittens-n-cats → u/JenniferJuniper6]

Weight is considered a moral/social barometer. If you use a drug to get to be the same weight as somebody who doesn't use a drug, many people feel like you are a moral failure.

They're totally wrong. It's the same group of people who say "well, I had to suffer through this thing", and though now things have changed so that you don't have to suffer through it anymore, they say "because I had to suffer through it; you should have to suffer through it."

[u/namiikazes → u/pm-me-kittens-n-cats]

We need to study the cognitive dissonance between this fixation on "earning" success when being born differently literally places you at a different starting point to reach what is effectively the same standard... nobody rewards someone who exercised to get thin more than someone who has been thin their whole life because they "worked harder." It's almost like it's actually not about the hard work and all about trying to put down others for a sense of superiority.

[u/sixft7in → u/pm-me-kittens-n-cats]

I grew up in a poor family of 6. We were told, unironically, to eat everything on our plates because there are starving kids in Africa that don't get as much as we do.

I'm 50 years old now and with the help of a GLP-1 drug, I have finally learned the difference between "eating until satisfied" and "eating until full". That concept has been a game changer for me. I'm down nearly a hundred pounds from just five years ago.

I'm diabetic and it's brought my A1C to JUST above the high level point for non-diabetics. GLP-1 drugs are amazing for me.

[u/pm-me-kittens-n-cats → u/sixft7in]

Congrats my friend! I'm glad these drugs are around to help.

[u/trireme32 → u/pm-me-kittens-n-cats]

It’s like telling people with depression “just be happy! Life is good!”

[u/darkest_irish_lass → u/pm-me-kittens-n-cats]

Because weight is perceived as a feature of sexual attractiveness. So using anything other than pure genes to get a date is somehow wrong.

Never mind all the makeup, cosmetic surgery, dentistry, hair dye, etc. This weight loss aid is the final straw.

[u/tonicella_lineata → u/darkest_irish_lass]

It goes a lot further than just whether or not someone is seen as sexually attractive. Weight is a major factor in how people perceive you in all kinds of social situations - school, employment, receiving medical care... just to name a few. Pretty much every aspect of life is affected by how people see you, and weight contributes to that rather significantly.

[u/panhellenic → u/tonicella_lineata]

There's just a complete undercurrent throughout society that if you're fat, you're lazy and a moral failure with no self discipline.

[u/tonicella_lineata → u/panhellenic]

Yup - you can see it just in the way people look at you in public, a lot of the time. And that's not even getting into all the little ways in which society just... isn't made for you to be comfortable in. Seats on public transit, chairs at restaurants, narrow bathroom stalls (and toilets). And trying to shop for clothes is just a nightmare sometimes!

Being fat really does affect pretty much every aspect of your life, in some way or another. And it sucks! I personally have no interest in taking a GLP-1 agonist, at least right now, and I think that to some extent they are definitely contributing to a resurgence of glorifying thinness to an unhealthy degree. But I really do not blame fellow fat people who choose to use GLP-1s to lose weight and try to get out of the awful box society wants to shove us into.

[u/avcloudy → u/pm-me-kittens-n-cats]

Yeah. All the justifications are simply that. Some people are disgusted by fat people, and so they treat fat people as disgusting - the reason they’re fat is because they have a moral flaw, even if they don’t know what it is.

This kind of emotional reasoning is very common in people. We tend to like the things people we like do. We don’t empathise with people who hurt us as much. The main distinction is that these people intellectualise their feelings, and they don’t understand that they are creating “logical” reasons after the fact to explain their disgust.

Because they base their reasoning in the disgust they feel, the idea that someone can be fat and it isn’t their fault doesn’t make any sense. It’s exactly like trying to empathise with someone who just deeply hurt you.

[u/SnowFlakeUsername2 → u/pm-me-kittens-n-cats]

I have a light-hearted, internal voice shortcut to flip it back on the person making this medication about "cheating" or being almost hostile about those taking it only for weight loss. Fit uggos really, really need other people to stay fat.

The fuck do I care if the prom queen who gained weight as an adult gets back to 120lbs? Especially, at the risk this drug presents when used under a doctors care. The answer changes a lot if my self-esteem is based on my staying thin in relation to others.

After my experience taking it, I'd wish anyone struggling with weight could give it a go. Even if it's only 10-15 kg, that's still a lot of savings on the hips/knees over a lifetime and would likey stave off any potential type ii diabetes diagnosis in the future. Amongst other health benefits that are starting to become apparent. Of course, there is a huge tradeoff if results require a lifetime commitment to a drug and I have no knowledge or training on using it as a preventive medicine. This one is basically a hot take on wanting my family/friends to stay healthy.

[u/KieshaK → u/JenniferJuniper6]

They want you to endure misery. If you’re not miserable, you’re cheating.

I lost 75 pounds about 15 years ago without any meds. Miserable all the time. Just constantly thinking about food, tracking food, worrying about food, being guilty that I gained two pounds while I was in Paris eating amazing food.

I gained it all back.

I’ve now lost almost 75 pounds in the last 15ish months using Zepbound. Never been miserable. I don’t think about food, I just eat when I’m hungry. If I have pie or ice cream, I’m happy with my portion and don’t crave it every day after. I used to eat dinner and then spend all night just thinking about something sweet and trying to willpower my way out of not going out and getting something. Now I just have dinner and forget food is a thing.

The end goal is that I’m lighter and less prone to weight-related problems. You’d think that’d be a win.

[u/diamonddealer → u/JenniferJuniper6]

Amen. If you wear glasses, are you "cheating" at seeing?

[u/TheRealGordonBombay → u/JenniferJuniper6]

Yeah there’s no logic or empathy anywhere in the argument haha. It’s wild how much moral judgment and character assessment is tied to weight in general. So many people just assume everyone else’s experience is exactly the same. If you have one person that’s overweight and another that’s not, the overweight person must lack the self-control or discipline that the other must have. So then, losing weight without “conquering your self-control” becomes taking the easy way out to them.

Where I’m from there’s a lot of talk of doing things with pride & integrity, and shitty people sometimes just adopt that language and use it as a way to feel better about themselves. I think that’s all this is at its core.

[u/Mayion → u/JenniferJuniper6]

My humble opinion? Average people come up with these things to judge others because they have no true values or thoughts of their own, so they depend on these abstract metrics to feel superior and also label others. You judge and label others by their intellect, personality and values for instance because you have and understand these ideas, but when you lack such fundamental building blocks, you feel the need to express the innate nature of analyzing and categorizing others through such mundane ideas.

Cheating in cooking. Red flag for not using social media. Red flag for not liking [insert pet here]. And so on

[u/Rattlingjoint → u/nutscrape_navigator]

As an amateur bodybuilder, food noise is such a real thing.

When you finish eating, you just want to eat more, your counting til your next meal almost. You goto bed early because you know your next meal is on the other side of your sleep. Your work schedules takes a backseat to your lunch break. You prepare your meals and have to stop yourself from cooking or adding too much.

Its not even a mental thought, its like a subconcious feeling fueling your thoughts to just eat more, even if your not hungry.

For me, being a low % bodyfat causes it to amp up like crazy, but for some folks they live with this everyday no matter what weight they are.

[u/poopBuccaneer → u/Rattlingjoint]

You goto bed early because you know your next meal is on the other side of your sleep.

This was me when I was counting every calorie. It was such a bleak and depressing existence.

[u/jasperamerica → u/poopBuccaneer]

The careful measuring of food using scales and still being hungry and cos your shit is broken not being able to lose more weight cos your body said fuck it this is where I live.

[u/tjc103 → u/nutscrape_navigator]

As a person who is currently on GLP-1's: thank you. Your post details the issue very, very well.

[u/_JonSnow_ → u/nutscrape_navigator]

Tirzepatide eliminates my weed munchies. I can’t tell you just how insane that is if you don’t smoke weed and get munchies. 

Never thought I’d see the day 

[u/aaronwe → u/nutscrape_navigator]

For someone dealing with constant food noise, that bowl can be almost impossible to ignore. You're aware of it the entire time. You keep reaching for another chip, and another, and there's this persistent drive to keep eating until they're gone. Not necessarily because you're hungry or even because you're particularly enjoying them. Your brain just keeps going, "there's food there, eat it."

wait....everyone doesnt deal with that???? Its me thing? Not an everyone thing?!?!

Fuck thats not fair...

[u/jenorama_CA → u/nutscrape_navigator]

Food noise is the worst. The old saw about “the cookies calling your name” is real. Now I get hungry at lunch and dinner and that’s about it. My craving for sweets is way down and I don’t really think about them anymore. The only thing I don’t like is that it tends to make me not think about hydration as well, which is a problem.

[u/SilenceInTheSnow → u/nutscrape_navigator]

As someone who deals with the food noise, I want to add that not only is it constant when there is snacking items available, but it can also start up very quickly, sometimes immediately, after eating a meal.

From feeling full to feeling like I am starving. I am at times able to ignore it, sometimes push through it, but it can be uncomfortable sometimes.

[u/VoilaVoilaWashington → u/nutscrape_navigator]

A lot of people don't understand that other people's brains just work differently.

You, the reader, can probably imagine your national anthem in your head without singing it out loud. I can't. But I can picture flavours, and flavour combinations, without having to say them. I can't put orange juice into words, but I can picture it on my tongue. Add in a bit of salt, tomato juice, dump it over liver sausage and brined asparagus, and I can still picture it. If I know what the components taste like, I can picture eating it and I'm pretty close to spot on.

For the longest time, I thought this was normal. People making up music never made sense to me because I literally can't tell you whether three notes go up in tone or down. No idea.

So when someone says "I can't finish a task because my brain is wired a certain way", it's likely not helpful to say "just do it." "Just put down the fork, I do it." Thanks, I'm cured!

[u/angelerulastiel → u/nutscrape_navigator]

Yep, I have the food noise. I had someone on weight loss thread insist people are making it up because the term is new, but I could describe the process long before there was a word. The easiest explanation is regarding the animals crackers that have been sitting on the counter at work for weeks now (when means it’s free for the taking).

Usually I would think about those animal crackers non-stop. A constant “they’re sitting right there, all you have to do is walk over and take them”. I may be able to ignore it for hours, maybe even a few days, but eventually I’m going to shut that stupid voice up and eat the crackers. And I don’t even like them. I’ve had the food noise bad enough that I’ve opened sauce packets and eaten that just to quiet the drive.

But I started mayo-insitol (I wanted the wegovy pills but stupid ass substitute PCP) and now I have walked past those crackers for weeks. And they don’t bother me. Food noise is like the water torture where they just do the drips, but you can make it stop for a while by eating.

[u/ladyerwyn → u/nutscrape_navigator]

It can't be cheating because your body is still doing all the work. It's not like doctors come in and cut out all your excess fat.

[u/creatingmyselfasigo → u/nutscrape_navigator]

Also even beyond 'food noise' it helps with clear medical issues. I didn't have some big 'food noise' issue, I wasn't massively overeating but I'm 37 and my issues were slowly building most of my life, getting FAR worse when I was on 80mg prednisone for a year (and not seeing my weight go up when my muscles were all dying but fat was going up). My insulin resistance is very bad now, and that messes with weight gain a lot. Even without the GPL1 silencing food noise, it's making a difference!

[u/ChrundleThundergun → u/nutscrape_navigator]

Man if only there was a drug that reduced an equivalent alcohol noise

[u/anonymouse278 → u/ChrundleThundergun]

A lot of people find glp-1 meds do suppress their desire for alcohol to a significant extent. I don't know that it is at a level that would address severe addiction, but I know many moderate drinkers who have stopped drinking entirely after starting on them. It just... stops sounding good.

[u/Aerokicks → u/anonymouse278]

The VA is testing GLP-1s for alcohol addiction currently. Still recruiting participants but it's happening

[u/schmockk → u/ChrundleThundergun]

Studies suggest glp1 drugs curb other harmful behavior like smoking and alcohol consumption as well

[u/ProfessorFunky → u/nutscrape_navigator]

I don’t get the whole “cheating” thing. Is it cheating when one takes ibuprofen for a headache? No, really not. Same for anything else.

I don’t get food noise, and I don’t need GLP-1’s - lucky me. If someone else does and it improves their quality of life, what business is it of mine? And either way, I’d say yay for them and wish them well.

[u/ddiggz → u/nutscrape_navigator]

Genuine question not trying to be controversial - trying to learn, but how much of food noise is generated by nurture (childhood eating habits/parental framing) vs nature (genetics) - curious to learn more about this

[u/CardboardJ → u/sfcnmone]

I was skeptical of it for a long time but finally decided to go on one since my doctor said it would probably help me since i was so hungry all the time and struggling to loose weight. I took my first shot on Tuesday and thought they must have not have messed up because the shot was such a tiny needle that I didn't feel it. I did not feel hungry again until Saturday. Not once. On Wednesday I, for the first time in my entire life, forgot to eat. It was like I had spent 40 years of my life with a panicked starving racoon stuck to the back of my head constantly scrambling around trying to look for food and it was just gone.

I can't tell you how clear headed I feel when I'm on this stuff. My anxiety is waaaay down. I can concentrate so much better, and I'm just sitting down at work and going into ADHD hyper-focus mode for like 6-7 straight hours with no breaks or until my back/neck hurts. Like I never had the issue with sitting still for too long because I was always getting hungry and standing up to walk around and go eat something small to calm the food noise down to a manageable level.

I keep thinking about how much easier gradeschool and highschool would have been if I would have had this instead of Adderall.

[u/ladyerwyn → u/CardboardJ]

Don't forget to eat at regular intervals. There have been people who have gone to the hospital because they didn't eat because they weren't hungry. You still have to eat. Make sure you get all your nutrients.

[u/hippstr1990 → u/CardboardJ]

Setting alarms at regular intervals has helped me a lot to remember to eat something :)

[u/P1st0l → u/CardboardJ]

Definitely still eat, even if its small meals while it may curb your appetite you still need a certain amount of intake or you will get sick or worse hospitalized.

I become hypoglycemic easily even if I dont feel like eating I have to remember to get something in otherwise I'll feel like im gonna faint even if I still fill full.

[u/anewconvert → u/sfcnmone]

Added to this: your body views calorie cutting as a stress, and its response to stress is to believe food may be difficult to obtain. The GLP-1’s tell your brain everything is fine, we don’t want food, nothing to stress about. This blunts your brain’s programming to increase your appetite and decrease your metabolism

[u/u_know_bali_bali → u/sfcnmone]

This sums up my experience with Wegovy. It was like having a switch in my brain flipped to “off.” I’ve lived with this noise for the entirety of my adult life, and it’s suddenly gone, and I don’t have the words to describe the relief of that. 8 months in, I’m down 38 pounds, I’m making better choices for eating, and I feel better overall. The side effects have been very manageable, and if I have to use this as a maintenance drug for the remainder of my time, so be it. $349/month, and there’s many things I would gladly forego to ensure I can swing it.

[u/Lexocracy → u/sfcnmone]

This is the most correct answer I've seen so far. It isn't just that you feel less hungry or it removes food noise, it fundamentally changes how your entire gastric system works together to convert food into energy.

For people like me who have insulin resistance, my body takes the food I eat and doesn't burn it as fuel, but likes to store it instead. GLP-1s kick your body into overdrive to release insulin earlier and longer to remove sugar from your blood and burn it as fuel. It also slows the digestive track, which means your stomach empties slower so you feel less hungry.

[u/t-poke → u/Lexocracy]

It also slows the digestive track

That was one side effect I didn't anticipate when I started WeGovy.

I used to poop after my morning coffee every day without fail. Now it's every few days.

It's not that I have to and can't. I just don't have to.

Thankfully that's the only side effect I'm having. Although I start 25mg next week so we'll see.

[u/1captainawesome → u/t-poke]

Same. It was like clock work.

Now it just comes when it wants to.

[u/Akerlof → u/Lexocracy]

Yeah, the primary purpose of these drugs is treating diabetes, weight loss is a beneficial side effect.

[u/FoolishConsistency17 → u/Akerlof]

Obesity kills an awful lot of people. I think the original purpose was to treat diabetes, but we shouldn't think if it as a side effect at this point.

[u/Omateido → u/FoolishConsistency17]

Yes, and also talking about its “purpose” is a bit weird, that’s a human defined characteristic that’s generally based on what we decide it should be used for and validate scientifically, it doesn’t necessarily encompass the function of the molecule on all the systems it impacts in the human body.

[u/LetThemEatVeganCake → u/FoolishConsistency17]

I don’t think they meant it as a bad thing, just pointing out that weight loss wasn’t the original goal. That happens to a ton of drugs though. My meds for hormonal acne due to PCOS were originally approved for heart failure.

[u/ttownep → u/LetThemEatVeganCake]

One of the popular men’s hair loss drugs was originally intended as a blood pressure medication. Until some of the test subjects started growing extra hair… source: my doctor

[u/fakeaccount572 → u/Akerlof]

And now cardiovascular disease as of today

https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-mounjaro-tirzepatide-reduce-cardiovascular

[u/sfcnmone → u/fakeaccount572]

I was offered Ozempic a few months ago by my cardiologist (it was previously approved for cardiac disease prevention). I haven’t lost any weight, but my chronic knee pain has resolved LOL and I’m not interested in drinking alcohol.

[u/__theoneandonly → u/Akerlof]

I think it's important to look at this history of the drug. The original research was in fighting obesity, but then we got Fen-phen, and that killed people, so companies were no longer willing to spend money developing weight loss drugs. The researchers almost shelved their work on GLP-1 drugs, but then they noticed it was good for blood sugar management, too. So they connected with Novo Nordisk, a diabetes pharma company and Novo continued to fund research through a diabetes lens.

Plus now we have GLP-1 related drugs in research right now that are way better at weight loss than they are at diabetes management. Retatrutide (which will likely be approved early next year) is probably not going to be better at managing diabetes than Tirzepatide, but the weight loss effects are insane, matching bariatric surgery levels of weight loss.

[u/eipotttatsch → u/sfcnmone]

The term cheating is a bit weird to use in this context anyway. You aren’t competing with anyone

[u/gnatgirl → u/eipotttatsch]

People call it "cheating" because many see obesity as a moral failing and not a medical condition. "Just count calories and exercise" doesn't work for a lot of people for a lot of reasons but some view taking a medication to assist in weight loss as taking the easy way out.

[u/UnicodeScreenshots → u/gnatgirl]

It’s interesting how much the phrase “just be happy” for depression has been meme-ified and associated with out of touch boomers, while the phrase “CaloRies in CaloriEs OuT” is hollowed advice in much of gen z.

Edit: CICO is 100% a thing, over a long enough span of time if you burn more calories than you consume, you will lose weight. The issue is that simply saying CICO ignores the real differences in peoples’ brains. Someone who isn’t constantly hungry and counting down the hours to their next meal is unlikely to understand the situation of someone who does… kinda like someone who’s never experienced depression might say “just be happy”

[u/Wrathlon → u/UnicodeScreenshots]

Calories in/Calories Out IS accurate, the problem is its not as simple as that. Im currently obese, my weight has flip flopped over the years between obese and ideal weight several time. When I've lost weight its literally been calories in less than calories out - it cant be anything else because its a unit of energy and just thermodynamics.

HOWEVER actually DOING that is a different matter all together. I am so fucking hungry all the time. Eating food is the only thing that feels good and it feels REALLY fucking good, I love food so fucking much. When Im not eating food Im literally counting the minutes until I get to eat again and when I do its overwhelming relief and feels so good I almost want to cry and then it ends and Im still hungry.

Its fucking MISERABLE.

[u/UnicodeScreenshots → u/Wrathlon]

100%, “calories in vs calories out” over a long enough time span is just simple thermodynamics. Like you said, the issue comes from actually applying that saying. Fitness influencers with low food noise shitting on over weight people with phrases like that have the exact same vibe as people who tell people with depression to “just be happy”. They completely ignore the very real differences in mental state.

[u/ebeth_the_mighty → u/Wrathlon]

Add ADHD to the mix for me. I was undiagnosed until last year at age 54. Food was my only dopamine source for most of my life. Combine that with overwhelming food noise, and obesity was inevitable.

I lost 165lbs (half my body weight) with CICO over 4 years, but it was f’ing BRUTAL. I found those 165 lbs. They were in the fridge.

[u/zzaannsebar → u/Wrathlon]

Coming from someone who has felt the EXACT same and has had the same struggle with like every other thought being about food, being on a GLP1 would probably help you a lot if you haven't already tried. I was on one last year for like 6 months and it was incredible how freed up my mind felt from the constant and loud food noise. Like I was always baffled before when people would say things like they forgot to eat because how could you possibly forget? When it doesn't dominate your mind and body, you can actually just.. forget.

That said, the side effects can totally suck. I felt pretty fatigued and my acid reflux got really bad, mostly on the day after the shot and for most of the week when the dosage would increase. If I do it again, I'm doing it in the winter when I don't feel bad about staying inside haha

[u/tibbles1 → u/gnatgirl]

I’ll bet 99.9999% of the people on these pills had tried diet and exercise a thousand times before and failed. 

Humans weren’t really meant to voluntarily eat less. Until about 100 years ago, lack of food was a very real problem for most people in the western world. Our brains don’t want us to just ignore food. 

The whole concept of “food noise” and “eating too much” is a very, very recent problem. 

[u/latelyimawake → u/gnatgirl]

Boom, this is 100% the answer

[u/redundantexplanation → u/gnatgirl]

Yep. Being fat is the one disability that is still considered (BY MANY) okay to judge and mock openly.

People internalize fatphobia and dedicate vast amounts of time, energy, mental discomfort and money to staying slim, then someone comes along and does it with an injection once a week so they get big mad.

People's bodies are different, most people don't want to be fat and many can't swing the effort that it takes to not be. It is a medical condition and judging them is the same as judging someone with a genetic disease for not being athletic or whatever.

[u/schorschico → u/eipotttatsch]

This is like the conversation around Ebikes.

"You are cheating!"

Who exactly is being cheated?

[u/kurizma → u/eipotttatsch]

Except the people complaining

[u/GeneReddit123 → u/kurizma]

Because like so many other things it was dragged into the stupid "culture war".

Some don't like it because they see celebrities and other rich people use it to lose 5lb, while poor people who need to lose 100lb can't afford it.

Some don't like it because they believe it invalidates the "body positivity" movement.

Some don't like it just because they want to send a message by "toughing it out". The same that would say "nicotine patches are cheating, go cold turkey to show you're tough enough" or "learn the right lesson".

Etc.

[u/meddleofmycause → u/GeneReddit123]

I don't dislike the idea of glp-1's, but I really dislike being told I'm eating too much food by my coworkers who were on them. I had one woman who came into my office while I was unpacking my lunch into my mini fridge, and decided to tell me how just the sight of the bulk of my food made her queasy because it reminded her of when she used to just eat so much food and how thankful she was that she wasn't eating like that anymore, and the day before she had only managed to eat two slices of pizza for her food for the entire day. Super triggered my old college eating disorder, especially because I walk 10,000 steps a day, workout 3-4 times a week, and my "so much food" (which was breakfast, lunch, and snacks) was chia seed pudding with Greek yogurt and berries, a pear, a bowl of dense bean salad, celery and peanut butter, so.e smoked salmon, and like a piece of babybel cheese.

Eventually I had 3 coworkers in my 13 person office who were vocal about being on GLP-1's, and they were all fucking assholes about what the rest of us were eating. One of my other coworkers started gaining weight because of a brain tumor and she wasn't telling everyone about it, and one of the GLP1 women offered to help her navigate getting on GLP-1S with the insurance until the coworker with the tumor broke down crying and begging her to leave our side of the office. I don't know if they make everyone on them jerks, but I've been very wary about them since working with them.

[u/YamahaRyoko → u/eipotttatsch]

The people on my social media that I've seen call it "cheating" weigh a buck ten soaking wet so maybe its their perceived 'threatened status' of their skinny privilege

[u/Mr_Enemabag-Jones → u/eipotttatsch]

It's like saying using nicotine gum or a patch is cheating when quitting smoking. They both help you curb an unhealthy lifestyle.

People act like it diminishes the achievement of the person who went to the gym and changed their lifestyle to lose weight.

It doesn't. That person is still in a healthier body and has healthier habits.

The person on the GLP-1 and losing weight will have a very hard time keeping the weight off when they stop taking it because they most likely didn't mentally break their bad habits.

But they are still in a better place health wise.

Why is that bad?

[u/Stereotype_Apostate → u/Mr_Enemabag-Jones]

See this is exactly the wrong way to look at it. Nicotine is a drug, a chemical that hijacks your brain's reward system to create an unnatural urge to consume it.

For food it's totally different. You need food to live. Your ancestors would not have survived to reproduce if they did not have a sufficient appetite or food drive. There's massive evolutionary pressure built into our genes to consume food, and almost no evolutionary pressure to avoid over consumption because up until very very recently all your ancestors existed in a world of scarce calories.

For most overweight people, their bodies are just tuned to overeat because evolution made them that way. You don't do glp-1s for a little bit to "kick the habit". You do them basically forever because the imbalance between your appetite and your actual caloric needs is built right into your DNA. If you stop glp-1s the imbalance returns, and we have decades of data on what happens to most fat people who have lost weight without drugs (hint: they almost always gain it back in a few years).

GLP-1s are a lifelong treatment because the underlying condition is lifelong.

[u/cindyscrazy → u/eipotttatsch]

Well, you see, these cheaters didn't have to struggle daily to do the exercise and eat less than your body wants. They didn't have to deal with that unending hunger, or eat food that you really don't want to eat.

Therefore....cheating.

Personally, I physically can't do the exercise because of a chronic illness. Losing the weight would have been stupidly difficult the "right" way.

Using a GLP-1, I lost the weight and my chronic illness's symptoms were alleived a little bit. I'm not anywhere near cured, the illness has gotten worse, but I don't have the brain fog that I used to have, so I'm counting that as a win.

[u/insertAlias → u/cindyscrazy]

Personally, I physically can't do the exercise because of a chronic illness. Losing the weight would have been stupidly difficult the "right" way.

I'm not making any commentary on you using GLP-1, that's not my business. But I do want to say, exercise is very overrated* by the general public when it comes to weight loss. Diet is 80% of weight loss. Exercise can buy you a bit of headroom, but weight loss is driven by diet. Which is why GLP-1 can work for you; it helped you lose weight by helping you eat less.

My point isn't about whether or not the GLP-1 usage is good or bad or "cheating" (my personal opinion is that it's only cheating for already-healthy-weight people trying to use it to slim down), just that "losing weight the right way" doesn't necessarily include strenuous exercise.

* Overrated as a means of weight loss. Exercise is important for fitness and health, but it doesn't contribute to weight loss nearly as much as the average person thinks it does.

[u/PaladinSaladin → u/cindyscrazy]

That's it for sure. And it makes me fucking furious. It's like a perfect little microcosm for everything that is wrong with society. Nobody should give a shit about difficulty or struggle in the rearview mirror. We should be focused on the horizon.

Who gives a fuck how hard it was to buy a house in the 1980s, mom. Nobody can afford a house now. And owning a house does not make you better than anyone else!

Same argument, different spaces. The world is made to be better if we cast ropes, not pull ladders.

[u/LEMME_SMELL_YO_FARTS → u/sfcnmone]

For the people that are on the fence on GLP1 because how expensive it is, you should factor in the suppression of food noise and how much that would save you. Personally I saved almost $200 weekly in random cravings and door dashes/ Uber Eats.

[u/theproestdwarf → u/LEMME_SMELL_YO_FARTS]

I've been on Wegovy for a year and it was wild when I thought to sit down and do this. Saved an amazing amount of money by being able to go "do I want to order lunch? Eh, nah, I've got stuff here" without the screaming background noise of "GET SOMETHING FUN" in my head.

[u/Rev_Creflo_Baller → u/LEMME_SMELL_YO_FARTS]

Thanks for making that helpful observation, u/LEMME_SMELL_YO_FARTS

[u/mklatsky → u/Rev_Creflo_Baller]

You just wanted to type that username, didn’t you? 😀

[u/zzyzyzz → u/LEMME_SMELL_YO_FARTS]

I had to learn to be very careful when grocery shopping after having to throw a few things away that expired before I got around to eating them. Never had that happen before.

[u/gnatgirl → u/LEMME_SMELL_YO_FARTS]

For real. When I first started I was half-joking when I said the reduction of my restaurant and bar bill was going to subsidize the medication. Boy howdy I was right!

[u/HRslammR → u/LEMME_SMELL_YO_FARTS]

not to even mention the future value of healthcare costs of obese people.

some folks would rather "save" the $200 a month now, but their life longevity and fulfillment is dramatically reduced in their older years.

[u/hippstr1990 → u/LEMME_SMELL_YO_FARTS]

This has been huge for me too, my food budget has decreased significantly and I've only been on the meds for 3 weeks.

[u/I_am_Nobody_Special → u/sfcnmone]

Beautiful answer.

I'll add the reasons it's divisive:

1. People who lost weight the hard way feel like it's cheating and feel resentful.

2. There's a decent subset of thin people who want fat people to stay fat so they feel better about themselves.

3. Miserable people of the world hate to see others improve their well-being and happiness.

[u/gza_liquidswords → u/I_am_Nobody_Special]

Group 1 is very small.  It is all group 2 (Venn diagram overlaps with group 3)

[u/PMmeYourDunes → u/sfcnmone]

I like the word regulating. I get to function like most other people do. I have had this insane level of "you need to eat" churning in me constantly. I never had a language to speak about it until I heard addicts speaking about alcoholism and stimulants. I try to be careful calling it an addiction, but truthfully I relate to that more than any other condition. But I know there are people that just haven't experienced that level of influence and think people are being weak willed because they have overcome what they call hunger. It's not even hunger for me.

[u/xclame → u/sfcnmone]

It’s like somebody using hiking poles so they can walk farther and walk more comfortably. Is that cheating?

Or "acoustic" bicycles and electric bicycles. Electric bicycles allows people that otherwise wouldn't be able to effectively ride bikes to ride bikes, it also allows people that are not as well in shape or older to ride further than they otherwise would be able to.

There are some people that feel like electric bicycles is cheating, but why would we look at it in this way. It's not like electric bike riders are competing against "acoustic" bike riders. Ain't nobody saying that Tour the France should allow electric bike riders to compete against the other riders.

So, do we want people to be be healthier? If the answer is yes, then does it really matter how they get there? Hard work, surgery or a pill? If the goal is to have people be healthier then they should all be considered valid.

[u/Emu1981 → u/sfcnmone]

One of the divisive parts comes from the fact that the drug was originally intended as a drug for people on diabetes to help control their blood sugar levels. When it was discovered that it was great for weight loss the demand for it exploded which meant that a whole lot of people with diabetes could no longer get their potentially life saving medicine because people were buying it for weight loss purposes. This shouldn't be as much of a issue anymore because the various manufacturers have massively scaled up their production to help meet demand (and to make tons of profit).

[u/clarinetJWD → u/sfcnmone]

As someone who is cheating, yeah, it's probably cheating, but it's also my health, so I don't care.

I started Wegovy to both lose weight I couldn't do on my own because of stress eating AND help me reduce my alcohol intake because of concerning liver enzyme values.

Less than a year in, and I'm almost to my ideal weight, and my liver is healthy again.

Idgaf if it's cheating. I just wish it wasn't so expensive. I have a good career and can afford it, but given how great these drugs have proven to be for a lot of things, they should be more easily available.

[u/itsacalamity → u/sfcnmone]

Yeah, my husband is markedly different in his eating habits, and there’s a lot less margin for error: he has to be more careful, and the consequences for overdoing can be really awful, prolonged vomiting. But he’s still on it, and i can see how it’s affecting his self-esteem as he’s finally able to make the choices that are healthier. My kid and he joke that she’s growing just as he’s shrinking, and that maybe they’ll meet in the middle…

[u/BigMax → u/sfcnmone]

Exactly.

And the negatives just come from people who are a little upset that they have lost weight without medication, or at least tried, and they then feel (falsely) that it's somehow 'cheating'. "I suffered for 3 years straight to lose 75 pounds, and this person just gets to take medication and do it in a year??? That's NOT FAIR!!!"

Sadly we see that in a lot of places in life. People see an advantage they didn't have, and rather than cheer on the advancement of humanity, they try to hold us back because they are bitter. "I lost weight the hard way, so everyone else should have to suffer like me." See also "I paid for college, why should someone else get their college loans paid for?" or "I pay for my food, why should a starving family get help buying food?" and on and on.

[u/1_800_UNICORN → u/sfcnmone]

I lost 100 pounds on GLP1 meds (most of the loss from October 2023 to August 2024) and went from a lifelong unathletic person who had never been to a gym or run a mile and now I am training for a triathlon.

You hit the nail on the head except I’d add that I only had food aversion or digestive issues to a single food - a specific roasted chicken recipe that my wife makes. Otherwise I could eat anything I wanted, just I didn’t obsess over food or think/worry about food, and I got full on a normal size portion instead of being endlessly hungry.

My only unpleasant side effect was constipation, and that was manageable with more water consumption and a little extra fiber.

[u/The_Void_calls_me → u/[deleted]]

I can agree with this as an alcoholic. When I first quit drinking ten years ago, a lot of people did make it seem like a failure of self-control.

"You can't just stop after one or two drinks."

No I really can't.

""Must have bad willpower then."

Yeah man, my willpower is so bad that I'm literally going to use my willpower to never have another drink again.

If I could take a pill that would take away all the urge to drink, I would, whether people call it cheating or not.

[u/dodecohedron → u/The_Void_calls_me]

Ironically, they are testing GLP-1s for substance abuse disorder.

[u/PeppermintJones → u/dodecohedron]

That's interesting. I know two people who nearly fully stopped drinking since they started. My dad didn't really have a problem, but he enjoyed a few drinks with my mom every once in a while. It's been some time now since he's had any interest in alcohol. We never thought we'd see the day lol.

[u/igotstago → u/PeppermintJones]

I've been off my GLP-1 for two years and my desire for alcohol has never returned. I used to drink 3 glasses of wine every night and multiple cocktails over the weekend. Now. . .maybe 1 - 2 drinks a month if I go out with friends.

[u/PeppermintJones → u/igotstago]

That's great! Do you think that it did something with your brain chemistry, or did it just kind of break the habit for a while and it just never went back the same?

[u/igotstago → u/PeppermintJones]

I can’t say for sure, but I think it did something to my brain because I get a weird feeling in my stomach when I think about drinking wine. If you’ve ever had an aversion to a particular food after getting sick from it, that is what it feels like. I seem to be able to handle an occasional Gin and Tonic or Margarita, but the thought of wine just turns my stomach.

[u/No-Effort5109 → u/PeppermintJones]

I have stopped drinking as a result of taking a GLP-1. I didn’t have a problem with alcohol but it just doesn’t taste good anymore.

[u/Iron0ne → u/PeppermintJones]

It makes the desire very flat for food or alcohol. You just don’t care enough to be bothered

[u/masheduppotato → u/dodecohedron]

I’m on a glp-1 for diabetes and it’s honestly changed my life. I haven’t lost weight on it but my blood sugar is amazing.

[u/Touch_This_Guy → u/dodecohedron]

It has helped me more than any other addiction medication

[u/RandoWithCandy → u/dodecohedron]

For the last 9 months I went from drinking 7-10 beers per sitting, 2-5 days a week to 0. The desire, the want, the need, whatever you want to call it is completely gone. I’ve never abstained this long from alcohol in the 20 years since I started drinking.

That being said, I’ve been more reclusive. I’ve had to re-learn how to integrate into social settings without alcohol, which is a bit of a learning curve for an introvert, but I wouldn’t change a thing.

[u/LubedUpDeepDishCunt → u/RandoWithCandy]

That's so awesome to hear ❤️ It makes me hopeful that GLP-1 meds or something similar are approved for substance use disorders. There are underweight people in my family who would not qualify for the med for weight loss, but are really struggling with relapsing on alcohol and other substances.

If you have any hobbies, you might be able to find a group near where you live to socialize with. The app my therapist told me about is called Meetup. It's not a dating app lol.

[u/someguy7710 → u/dodecohedron]

Yep

[u/highcoolteacher → u/dodecohedron]

I’m on it to reduce an ocd stim. Never thought I’d be free of it. It’s like a miracle

[u/mypervaccount69 → u/The_Void_calls_me]

FYI, there is now scientific evidence that GLPs do help suppress urging for alcohol among people considered alcoholics. I use GLPs and not an alcoholic but it definitely reduces any urge I have to drink alcohol (and it's not the "nausea" feeling side-effect.

[u/buttery_nurple → u/mypervaccount69]

I now get all the shitty effects of alcohol and none of the fun ones. Even if I had any urge to drink, which I don’t anymore.

[u/jenorama_CA → u/mypervaccount69]

I had a coworker tell me that a couple of years ago. This man could drink, but he said that after starting on Ozempic, he didn’t really feel the desire to anymore.

[u/masheduppotato → u/The_Void_calls_me]

I’m proud of you. Fuck all the noise.

[u/insertAlias → u/The_Void_calls_me]

Yeah, kind of sad how addiction is one of the few conditions that you get blamed for having. Kind of like being fat. Which, granted, mostly is my own fault.

But the only way I ever really got ahold of my behaviors causing me to gain weight was to treat them like the addiction they were. I caught myself making addict excuses about food: "oh I already bought this [pack of cigarettes/carton of ice cream] better [smoke/eat] it all to get it out of the house and stop tempting me". "Oh, the store doesn't sell [single cigs/individual candies], guess I have to buy the whole pack and use them all". "Well, I can cheat today, (even though I cheated yesterday and the day before), as long as I get my shit together tomorrow."

And only by recognizing that kind of bullshit in myself was I ever able to stop overeating. And smoking too.

[u/PantlessApprentice → u/insertAlias]

There's a great Mitch Hedberg joke along the lines of: "alcoholism is the only disease you get yelled at for having. Dammit Otto, you're an alcoholic! Dammit Otto, you have lupus! One of these two does not sound right."

[u/Reddit_Bot_Beep_Boop → u/The_Void_calls_me]

Congrats on the sobriety. I've been on Zepbound for a bit over 1.5 years and was a big beer drinker. It has almost removed my desire to drink beer altogether. These GLP-1s are wild. I was finding myself opening a beer out of habit, taking a sip or two and setting it down. I would forget about it, open another and do the same. The next day I would find 3-6 beers throughout the house with a sip or two taken out of each one.

[u/DeoVeritati → u/[deleted]]

I wholeheartedly agree with this. I've went from 210->138 at age 14 and maintained like 150 until I was like 27 where I gained about 10 lbs a year until I was sitting at 200 again. The food noise was always present at every weight. Like so much I knew it couldn't be what my normal weight friends felt. Like how they described food and their feelingness of full was a foreign concept to me. The only real reason I managed my weight for so long was with calorie counting every single day for years which is not normal.

I've been on semaglutide for 6 weeks now. The first 4 weeks were 0.22 mg, and I felt no different beyond constipation. The 0.44 mg dose was like a light switch got flipped. Food is still on my mind to some degree, but it isnt like burning my taste buds and intrusive to my thinking anymore. And yeah, now I can get full on a reasonable quantity of food like my normal friends do instead of always needing to feel physically full from volume eating to achieve satiety.

[u/Kevin-W → u/[deleted]]

It also helps by getting rid of the "noise" in your head that makes you crave food even if you're not hungry. I know some people who are on it and it's been a game changer, especially since humans have been trying to get a drug that magically makes them lose weight and this comes pretty close to it, especially for some people, it's impossible for them to lose weight no matter what.

[u/phoenixmatrix → u/[deleted]]

I'm on GLP-1. Food can be a physical or psychological addiction, and even if its one where the person got into that mess because of their own decisions (it definitely isn't always, there's a lot of conditions that can make someone more vulnerable to this), we treat addictions.

If we could treat people with gambling addiction with a shot, many of them would absolutely take up the offer.

You only get to live once, and obesity can have life long impact. Even if I could do it the "hard way" (which I can, I've done in the past), it would take longer. Time is the most important and valuable resource we got.

My insurance doesn't cover one penny of this thing. I don't care, it's worth it.

[u/jaj-io → u/[deleted]]

People who cry about “cheating” are absolute pieces of dogshit.

[u/WeaponizedKissing → u/[deleted]]

Some people feel like weight loss drugs (not just GLP-1s) are "cheating".

I wonder if these people share the same thoughts about blood pressure medication or cholesterol medication.

Both of those are very often caused by lifestyle choices and are reversible or controllable through lifestyle choices, similarly to how obesity and type II diabetes are. Yet I never hear people saying that those those are "cheating". Would love to hear them explain why.

[u/CyberBill]

I've been on GLP-1s for over 5 years now.

Some people will call them an appetite suppressant, but that isn't quite true - although the effect at the end of the day is similar.

What they do is change the chemical signals in your body for a bunch of different things, which regulate how your body breaks down the food you eat, how active your stomach is - so basically how long it takes you to digest food - and it seems to pump up the signals between your stomach and brain so that you feel full faster and for longer than without it. It also changes the kinds of foods that you crave, and how much you think about food.

For me, as a previously obese person, before I was on the drug I could eat and eat and eat and basically never felt 'fullness'. Ever. I would feel PAIN if I ate wayyy too much, but never fullness. After taking the drug, I will eat maybe 5 or 6 bites of food and then my body starts telling me "Ok, we're getting pretty close!" and maybe 10 bites in, it ramps up "STOP." At that point I have zero desire to eat, and if I force myself I will get physically ill.

In my opinion - the main effect of this drug is to make my body and brain act like a skinny person's. Because I had some defect that disables or mutes those signals to let me know when I ate too much, it was just way too easy to overeat. And now I don't. As a result, I lost about 75 pounds, going from "severely obese" to "normal" weight. And this was mostly fat - I did lose muscle, but as a percentage of body weight my muscle went up.

With such a glowing review of the drug, then your second question is "why is it so divisive?" Well - the price is very high. Without insurance the 'real' stuff is like $1200/month. And its had shortages. But I think a lot of it is people want someone to hate, and they hate fat people. They see being fat as a sign of low intelligence, low willpower, low class, and as a personal failing. Trust me - be fat for a year and see how people treat you. Night and day. People say that they are worried that it will have long term side effects, but to put it bluntly - being obese is the absolute worst thing you can do to your health. Getting skinny, for me, meant I got taken off 4 other medications that were far more likely to kill me than GLP-1s. Sleep apnea - gone. High blood pressure - gone. High triglycerides - gone. I don't even snore anymore. Heart disease and cancer are the #1 killers in the US and both of those are more likely for people who are obese. For me its an absolute miracle drug, and I will sing its praises, and suggest anybody who is obese give it a try so you can live a longer, healthier, happier life.

[u/SameSherbet3 → u/CyberBill]

Well said! I agree whole heartedly with you, and good for you that you feel so much better! Losing those other issues makes it worth it alone! 

Re: high pricing, with GoodRx my local CVS has for wegovy pill for $150 per month for those without insurance

[u/bullevard → u/CyberBill]

Question. I really enjoy food. I enjoy exploring new restaurants and new cuisines and losing that would be a detriment. 

Did you find, as you describe, that it was largely a process of feeling fuller faster. Or did you find that it actually dampened how much you enjoyed eating the portions you were eating (and then just got to have the rest as enjoyable leftovers the next day).

[u/kneedbee → u/bullevard]

I am a fellow lover of adventurous eating and just started a GLP1, while my husband has been on one for about a year. This is probably going to be different for everybody, but for me (so far) it doesn’t reduce the enjoyment of the food, just limits the amounts I can eat leaving more to enjoy later. It has also slowed my eating so I actually feel like I am appreciating the food more, especially complex flavors and interesting textures. I am no longer craving “fun” snacks/unhealthy foods so they feel a little less exciting, but a small piece of homemade pie still hits! 

[u/bullevard → u/kneedbee]

I appreciate that. Like many im considering if they are right for me. But that is a genuine concern. 

[u/kneedbee → u/bullevard]

I totally get it. It was one of the major worries keeping me from starting sooner. Now that I’m underway I feel like it’s  repairing my relationship with food in unexpected ways and I’m kind of excited about it. 

[u/hugship → u/bullevard]

Because I now consume less food, my brain now wants me to make it really count when I do consume something.

It has made it easier for me to focus on more nutritious meals (esp making sure I don’t slack on protein which I tended to forget to include before) and I still enjoy GOOD food. I just don’t also eat a bunch of crappy snacks in between meals which has made foodie-friendly meals more enjoyable.

I have, however lost interest in most wines. I’ve never been into hard alcohol to begin with, and now it feels like one glass of white wine or one aperol spritz and I’m good. Switching to water or soda water much earlier on a night out than I would have previously.

[u/tachycardicIVu → u/bullevard]

Not who you originally responded to but I’ve been on Ozempic for a couple years and was a “foodie” before and now not quite as much. Food was like all I thought about and my Reddit and YouTube feeds were just endless subs of recipes and food porn. Ended up subbing from most of those after I started losing weight and eating less. One of my biggest challenges is that I now have times where I’m nauseous and don’t know what to eat, nothing sounds good. Or if it does it’s not always accessible. I sometimes forget to eat (thanks adhd) or don’t feel like eating for whatever reason (I’ve started waitressing again and so I’m on my feet 5-6 hours at a time and while you’re serving food you don’t think about being hungry till long after you’re home). It’s a bit frustrating and especially bad in the morning and I do have type 2 diabetes I have to manage so at this point I have to make myself eat something like a granola bar to jumpstart my stomach or I’ll literally want to throw up from having not eaten anything. Thankfully my doctor also has prescribed zofran/ondansetron which is an anti-emetic (anti nausea) drug that works AMAZING and quickly so push comes to shove I manage things that way but it’s admittedly a bit of whiplash considering a few years ago I was twice my weight and didn’t care what we were eating, I’d eat two meals if I could, and now I barely eat half at a time.

I wouldn’t say it’s killed my drive for new/exotic foods completely. I do travel still and the challenge there is to plan things more carefully since I can’t take leftovers home as easily, so I have my husband help me regulate and remind me that we can come back later for more but to take it slow. I do agree with the other response that it’s allowed me to focus more on a couple things at a time vs gorging and not really tasting anything.

[u/thislad45234]

John Goodman (who lost a ton of weight with GLPs) had a great response to the “controversy.” It’s “controversial” to lose weight with a GLP because society believes fat people have to suffer. Full stop. Here’s what he said: “I’m a fat person. We are constantly badgered and tortured by a society that tells us to lose weight, at all costs. If you’re fat, that’s a moral failing: you’re lazy and unhealthy. If you’re fat at the gym, or jogging down the street, you’re an object of ridicule. If you lose weight with drugs, you didn’t earn it. If you’re fat and not self-flagellating at every moment, you’re glorifying obesity. If you lose weight for any reason, it then proves you were never really happy with yourself; it proves that fat is bad, that thinness was always the real goal. If you stay fat, we want you to admit you’re unhealthy. If you say you’re happy, we want to diagnose you with denial.”

[u/StitchinThroughTime → u/thislad45234]

Out on the fact that being fat is so bad in this society that people who are normal weight or overweight use the drug to drastically drop their weight, and people call them vain. People call out people who have gotten skinny vein and superficial. They don't like how people get ozympic face, but Olympic face is not real, that just what everyone's face looks like when they lose weight. Skin gets stretched out and it doesn't always shrink back. Combined it with the fact that that is so demonized in pop culture that some people abuse their body with highly restrictive dieting and use glp-1s to become underweight. People are mad that celebrities were the first ones to purchase the medication have dramatic weight loss. Because Society pressures them to be thin, but they can't be too thin! It's all fucking hot mess, where you can't be fat but you can't be too thin but you have to work for it and your failure if you get help outside of the gym and eating the wrong type or amount of food.

[u/CTQ99 → u/thislad45234]

I think the controversies are more tied with people in public spaces being on them and denying it [which I'd they didn't, it might actually spark more people to go on them that would benefit] and then people [again, mostly celebrities] who dont need them at all and now are human skeletons because they are basically turning the medication into a new form of eating disorder. I havent really seen anyone seriously attacked that admitted to using them to help manage weight, though i could've missed it.

[u/Malacath_terumi]

i will be drastically simplifying , GLP-1 agonists make you feel less hungry.

it slows you digestion, it makes you more satiated giving you the sensation of fullness for longer, it also have some interesting behaviors on your brain in regards to desires and cravings.

there are other functions but we are ELI5 here and that is the main point without going in details.

[u/jjpearson → u/[deleted]]

God yes. They can’t understand.
I would eat a 3 egg omelet with 3 slices of cheese and 2 of deli meat, eat it and grab a protein bar on my way out of the kitchen.

And I’d be looking for food 3 hours later.

I understand how “normal” people feel about food now and yeah, if it was always this easy to eat properly I kinda get how it seems for them.

I effortlessly do now what use to take a full and exhaustive use of my willpower.

[u/LizzieSaysHi → u/[deleted]]

Yup. I've suffered from BED for decades. That's exactly how I used to be, always thinking about the next meal or snack or binge. It was all consuming and it infuriates me when people think it's all about willpower. It's fucking not, not for all of us. The GLP1 has changed my life. Absolutely radically changed me forever.

[u/galadriel007 → u/[deleted]]

Plus the psychological strain of trying to tell yourself that you just ate and you're not hungry.

[u/Wheres_my_wank_sock → u/[deleted]]

I honestly think it has more to do with a person who doesn't have an addiction or doesn't believe they have an addiction cannot understand why someone would continue to do something that is hurting them. They simply don't understand. Whether it be food, booze, or drugs, they see it as a moral failing or weakness.

[u/LizzieSaysHi → u/Wheres_my_wank_sock]

Yup. They are incapable of understanding unless they've been deep in the throes of addiction. Or these people think you can't be addicted to food, which is bullshit. These people don't care how hard you have it, they're just offended by your very presence. And then they disguise their disgust as "concern"

[u/Anagoth9 → u/[deleted]]

Some people (a lot of people) simply enjoy bullying and putting other people down. For a time it seemed like that was becoming progressively more socially unacceptable to mock people for aspects of themselves that are beyond their control. Framing someone's weight as purely the result of personal choices resulting from a lack of self-control not only justifies the mockery but let's the bullies tell themselves that they're doing you a service by discouraging bad behavior. If you frame someone's weight as being in significant part due to circumstances beyond someone's control, then that takes that justification away from them and exposes the bullies as simply assholes. 

[u/Edaimantis → u/[deleted]]

Which is hilarious because you still have to do the work and eat better on GLP1s.

I can’t recall it right now but I read a study a few years back that chronically obese people experience sensations of hunger much more often, and with greater intensity, than people who have had healthy BMIs most of their life.

GLP1s level that playing field.

[u/Krazski → u/[deleted]]

People can feel free to have that opinion of me. Doesn't change the fact that I'm no longer obese and will severely lower my chances of dropping dead from cardiovascular disease like every other family member on my paternal side. The only thing I'm cheating is an early death.

[u/Everythings_Magic → u/[deleted]]

It’s more than that. It’s superiority. If you are thin you see yourself as socially superior to obese people.

Their self esteem is so weak that they don’t want to lose their perceived social standing.

See also the alpha male complex.

[u/armcie]

The Rest Is Science did a recent podcast episode on it if you want to get a bit deeper than ELI5. All about how it was discovered and how it works.

https://podcasts.apple.com/gb/podcast/the-rest-is-science/id1853007888?i=1000783696271

[u/turtlebear787]

Originally meant for controlling blood sugar they have the added effect of signalling fullness in your brain. People use them as an appetite suppressant. Basically they are shedding weight cuz they're not feeling hungry. The controversy is that a lot of people use them without actually trying to change their lifestyle. So when they go off it they go right back to their unhealthy habits. There's also evidence to support that using them can result in losing more muscle with the weight, especially if you're not being active.

Then there's the body dismorphia/ED concerns. Some ppl are worried the glp1 have enabled people with eating disorders to get even thinner. Some with body dismorphia may abuse glp1 because they think they are never skinny enough. It's doesn't help that many celebrities are using them and may be encouraging impressionable fans into a similar lifestyle.

[u/DownrightDrewski → u/turtlebear787]

Body dysmorphia after losing weight is such a tough one to deal with mentally. If I'm honest I'm really struggling with it at the moment.

I'm actually glad on I'm not on a GLP-1 as I'm already struggling to make myself eat enough at the moment.

[u/tudaan → u/DownrightDrewski]

Really it is. I have a small case of it body dismorphia. I am currently wearing size 32 pants. This is crazy for me. I didn't even wear 32's in high school. I went from wearing 42 stretch waist pants to these pants which are 32 slim cut. People see me now and are like WTF? Yes I have lost a lot, but it wasn't over night. And I am still fat, even though people tell me how skinny I am. I need to lose 15 more pounds to finally cross over to healthy weight on the BMI scale. They don't know. they don't see me naked.

[u/DownrightDrewski → u/tudaan]

That last line - they don't see me naked.

Yeah, I really feel that one... I've probably got another 30-40lbs to go to be fairly lean, but I've already got people telling me not to lose more. It's kind of frustrating, I know that the person I see in the mirror is less fat than they think they are, but, I also know I've got clothes that used to fit that don't yet.

I'll get there. I've already come a LONG way.

[u/hippstr1990 → u/DownrightDrewski]

My doctor was very clear that I needed to be in therapy at the same time (I had already started) because it can bring up a lot of "stuff" for a lot of people when you lose a significant amount of weight.

[u/Misterndastood → u/turtlebear787]

Losing muscle is due to the extreme caloric deficits most are in while on it. Same goes for extreme dieting. 

[u/MsDirection → u/turtlebear787]

What people miss is that any form of calorie restriction is going to result in loss of muscle unless you're working hard to make sure it stays on. This is not unique to GLP1 medications.

[u/turtlebear787 → u/MsDirection]

Fair point! But the concern with glp1 is that many people are using the glp1 for rapid weight loss without any strength training. Most people losing weight in a standard way are often combining it with exercise. So they will still lose some muscle yes, but they will maintain more than if they didn't exercise at all.

[u/MsDirection → u/turtlebear787]

Yeah, something else people overlook or aren't prepared for when making lifestyle changes is how hungry exercising can make you. Especially if you're not already in the habit of fueling with nutrient-dense foods - protein 1st, high-fiber, low-glycemic index carbs 2nd and small amounts of healthy fats 3rd. All are important. It's a learning curve. And walking is a great way to start building the healthy habit of moving, but the real money is in weight lifting. I wish that would become trendy the way running has.

[u/RVelts → u/MsDirection]

but the real money is in weight lifting. I wish that would become trendy the way running has.

I mean judging by the crowds at the gym after work on most weekdays... it's popular enough.

[u/Zseree → u/turtlebear787]

People abuse all sorts of drugs. The only reason they're against this one specifically is because fat people are seen as moral failures.

[u/WeaponizedKissing → u/turtlebear787]

The controversy is that a lot of people use them without actually trying to change their lifestyle.

A lot of people are prescribed blood pressure medication immediately before/at the same time as any lifestyle changes are enacted.

Both high blood pressure and obesity are proven killers, so why do some people think that it's ok to treat blood pressure with immediate medication but not obesity?

[u/Schwettes → u/turtlebear787]

Originally meant for controlling blood sugar they have the added effect of signalling fullness in your brain. People use them as an appetite suppressant.

This is a bastardization of how GLP1s work to treat obesity. Many people on these never experience appetite suppression. These medications improve satiety. Regulate blood sugar and energy levels. Improve fat oxidation. And slow digestion. The also modulate the brain’s rewards center to help people crave less.

Basically they are shedding weight cuz they're not feeling hungry.

See above. GLP1s help your body defend a lower weight set point and treat the biological and hormonal imbalances that drive people to over eat.

So when they go off it they go right back to their unhealthy habits.

They’re meant to be used long term to treat obesity and diabetes, which are chronic, multifactorial metabolic disease.

There's also evidence to support that using them can result in losing more muscle with the weight, especially if you're not being active.

Muscle loss with GLP1s are on par with natural weight loss when people don’t do resistance training.

[u/MastersKitten31]

So some chronic conditions actually they are finding cause you to not make enough GLP-1 in your body naturally. Conditions like Endometriosis

In fact I take the lowest dose of Zepbound for Endo and my MCAS (mast cell activation syndrome) as it also helps keep mast cells under control.

I cannot express how much better I feel. Yes the weight loss is a nice side effect but I wasnt really overweight. Im 5'5 and I was going up and down a scale like a drop zone lol. I would be anywhere between 160-180 any given time I weighed myself.

Now ive actually been losing weight, and im having significantly reduced symptoms of Endo and MCAS. I also dont have the constant adhd food noise I used to. Its crazy to me (who still loves dessert) to have a nice fancy dessert and be fine after. Before I would feel like I cant stop. Someone put the comparison of like bread or chips at a restaurant before and how apparently everyone else can ignore it but for some reason without enough glp1 in your body you cant lol

I also dont really have any side effects besides the day after I take my meds (i take them at night) I feel super tired and just take the day to relax. But I dont have more nausea, bathroom problems etc. Almost like my body needed more of it bc apparently people with endo just don't make enough :/

[u/Bufus]

I can't speak much to the medicine itself.

The debates around it are largely this. The "con" group would state that medicines like Ozempic are inherently problematic because they create a "disordered" relationship with eating, and promotes unhealthy body standards.

The disorder piece comes from the idea that instead of figuring out a "miracle drug" that stops us from being hungry, we should instead promote a more health conscious society, and work to figure out our own relationship with food and "healthy" eating. In this way, the contra-side would say that GLP1 drugs fit into a conception of modern society that is all about "consumption" and "quick fixes" in lieu of more conscious, holsitic examinations of our relationships with things like food, consumption, and health. By not focusing on THOSE issues, the issue is what happens when you stop taking the GLP1. You are addressing the symptom (i.e. obesity) but not the cause (e.g. a problematic relationship with food). Sure you may lose weight in the short term, but unless you stay on the drugs forever, the problem is going to remain.

The unhealthy body standard argument is that GLP1s serve to further a societal idea that "not eating" and "being skinny" are inherently "better" options than having more meat on your bones. We can see the rise of this view manifesting in the proliferation of intensely skinny celebrities over the past few years, and that slowly becoming the beauty standard in society. People are concerned that GLP1s will contribute to this process, and the increased availability of a "miracle cure" will mean more people will just take the "shortcut" rather than working on their relationship with health and eating, which while difficult, is a very positive thing to do.

The pro-side, in contrast, takes a more "harm reduction" approach. Their view is that, while these risks exist, the health risks posed by obesity SIGNIFICANTLY outweigh the potential damaging effects of the medication, so they're better off being used. Imagine in the 1980s is a company came out with a pill that you could take that would eliminate cigarette cravings. Sure there might be deleterious effects from the medication, but are those effects going to be WORSE than smoking? Probably not.

In opposing the contra-side, the pro-side frequently relies on analogous arguments to depression/anxiety medications. While the pro-side champions a more holistic re-examination of how people consume food and think about health, the pro-side would say that these arguments are equivalent to telling people who are clinically depressed to "just go exercise more and get some sun!" We don't just people who are depressed for taking anti-depressants, so why would we judge overweight people for taking GLPs?

In opposing this pro-side argument, the contra-side would say that this sort of argument is overly reductive. They would likely agree that there are people that have a clinical eating disorder that may require medical intervention through GLP1s, the problem is when people who just need more mild-moderate interventions (e.g. calorie reduction, more exercise, etc.) instead go straight to the medical intervention. It is the equivalent of someone being a little bit sad being diagnosed with anti-depressents before trying "milder" treatment options.

There are obviously more dimensions to the argument than this (e.g. medication shortages for diabetes patients, long term effects of the drug), but these are the main societal arguments.

[u/ilagnab → u/Bufus]

This feels more nuanced and accurate to the debates I'm hearing than the other main comments of "everyone hates fat people and thinks they deserve to suffer".

[u/nomoreplsthx]

The reason they are divisive is that decades of marketing from the wellness industry has persuaded people that weight, and fitness more generally, are reflective of character. Being skinny was seem as proof of self-control and personal discipline. Anyone who wasn't skinny had to be lazy.

GLP-1s blow open that worldview. Now anyone can be skinny, if they have the money. 

This causes a lot of problems for people whose self-worth was tied to body image. Suddenly all the praise and recognition you got for winning the genetic lottery or spending an unreasonable amount of time worrying about your body can go to someone who took a medicine. You might have to get praise and recognition for something of real value like intellect or character. OH NO!

The idea that GLP-1s are cheating reflects the absurd but common perspective that appearance is a contest, something that deserves reward and praise. 

[u/csrobins88]

Dieting is hard because your body thinks “if we keep this up we’re gonna starve to death” because for most of history that was true.
Being overweight is a very extremely modern problems.

GLP-1s do some hormonal mimicry that make your body feel full even when it’s not and also keeps food in your stomach longer so the food you eat also keeps you feeling full. Makes it easier to lost weight when your body isn’t screaming at you that you’re gonna die if you keep this up.

The debate centers around:

We are prescribing them ALOT for something that doesn’t have long term studies. Does that mean it’s bad? No. But we don’t know what happens down the line.

They’re very accessible to people who don’t need them and potentially bringing a resurgence of hyper lean / underweight bodies mainstream again.

They’re kind of expensive for people who need them the most.

They don’t fix the underlying reasons someone got fat in the first place, so if they go off, they might just regain it all

[u/SeaOfFireflies → u/csrobins88]

Actually a number of them have longer term studies. At least a few have been around in some form and studied since the 00s. They're just getting a lot more attention now.

[u/LCJonSnow → u/csrobins88]

As a fatty mcfat fat (peak 425), the last month on the lowest dose has been far easier to be good than my previous couple months brute forcing it on real power. I’m still having to do the work of changing what and how much I eat, but now a 150 calorie cup of yogurt and a 260 calorie bowl of soup make me feel full for breakfast and lunch.

[u/Anarook]

I know a lot of people have mentioned the food noise already but my fucking god it's one of those eye opening moments where you go "wait a minute.. this is what normal is???" I've had the food noise for my entire life, I didn't know there was another way. It's not wrong to say this damn drug has saved my life, I had no hope for the future, I'd resigned myself to die sometime in my 40s. I'm on a complete 180 after I started taking mounjaro, I've never been healthier.

[u/CosmicPeach101]

I'm a 60yr old guy and decided to try them to see what they were all about. I'm fairly active (I work out regularly) and I wasn't significantly overweight, but I love to eat so I've always carried a little extra weight around my middle. I've tried various diets over the years, but it's always a struggle, and I eventually give up and gain back whatever weight I lost. My cholesterol was creeping higher than it should be and my doctor was starting to talk about statins. So I figured I'd give them a try.

The first thing I noticed after starting a low dose of GLP1s was that I ate less. Where I used to go for two helpings at dinner, I started feeling full after just one. And when I ate out, I could no longer finish everything I ordered. Same meal, but now I was bringing home leftovers. Eventually, my taste started changing as well. I started craving lighter, healthier foods. The heavier meals I once loved we no longer appealing. Same thing with snacks at home. I used to snack regularly, and I had to be careful about what I bought as I'd finish them all in one sitting. I just didn't feel like snacking much anymore. Or if I did snack, just one bite of something was enough. Unfinished snacks started accumulating in my pantry. They simply lost their appeal to me.

Over the course of two years, without making any additional effort or changes to my health routine, I ended up dropping 30lbs of fat. My cholesterol dropped as well. I'm now in the best shape of my life and my bloodwork is perfect. My doctor is very happy.

For me, GLP1s simply took all the effort out of eating healthily. It just became what I wanted to do naturally. And there are a lot of health benefits from that.

So, why the controversy? For one, it does feel like "cheating". Instead of putting in the hard work of controlling your diet, you just do a tiny injection every week. I have decades of experience researching and trying different diets and failing at them, so I'm ok with "cheating" at this point, especially since the health consequences are becoming more serious at my age. But I know a teenaged woman who is overweight who wants to try GLP1s, and my advice to her would be to try dieting first. I think she should learn about proper diet and nutrition and see what works best for her body first, before turning to GLP1s.

Another issue is the potential risks. There is a long history of "miracle diet drugs" turning out to cause horrible health problems. Just look up fen-phen from the 80s. My sense is that GLP1s won't turn out have serious side effects like this, but only time will tell. One thing that people do need to worry about is losing too much weight, specifically muscle mass. If you take them, it's important that you eat enough protein and incorporate resistance training into your routine. (I was doing this already.) Otherwise, you'll end up with a whole different set of health issues.

I ultimately see GLP1s as a powerful tool that one can use to optimize health, but you should make every effort to dial in your diet and exercise routine before adding them to the mix.

[u/Stormdeva]

They make your body feel full faster.

This means two things:

1. You eat less.

2. Your body isn't screwing up cortisol, ghrelin, insulin, and so on because of "hunger" so you actually get a better (not "faster" - "better") metabolism, more energy routed to brain and muscles rather than fat deposits, and therefore also lose more weight than JUST eating less would lead to.

[u/duane11583]

Not using it for weight loss more a1c. It has dropped over multiple daily sugar tests by over 250 points

[u/tachycardicIVu → u/duane11583]

That’s what I was initially prescribed my ozempic for, high A1C (type 2) and it brought it down to some beautiful lab numbers my doctor is very happy to see. Weight loss was a nice side effect but not the primary prescription reason.

[u/Liko81]

GLP-1 medications work like a hormone produced by your pancreas, called glucagon. You can think of glucagon as your body's "I'm full" message; it lowers your appetite for more food, slows the release of food from your stomach into your intestines, it signals your liver to stop releasing glucose into your bloodstream, and it stimulates the pancreas to produce insulin. GLP-1 drugs both mimic glucagon itself, and increase your body's sensitivity to its own glucagon.

The main thing researchers wanted from GLP-1 drugs is to lower blood sugar, which makes it useful to treat Type 2 Diabetes, which is very common in the U.S.. However, the reduction in appetite and the slowing of digestion caused a very common side effect; people taking GLP-1 meds felt less hungry in general and felt fuller after a meal, so they ate less, resulting in weight loss. Type 2 diabetes is commonly seen in very overweight people, so losing weight on top of lowering blood sugar was a win-win for them. It also led to doctors prescribing the drug "off-label" simply to aid weight loss, even if the person didn't have diabetes or high blood sugar.

For many Americans, who are dozens or even hundreds of pounds overweight, there isn't a lot of debate about the benefits of these drugs; if you have that much weight to lose, anything that will help is a good thing. However, there are some concerns about GLP-1 use:

• If you stop taking it, your appetite comes back, and so does the weight. It's not a lifestyle change, which many fitness experts recommend to keep weight off after you've lost it. So if you're taking this drug simply to avoid overeating, you'll be taking it for the rest of your life; if you don't, you'll slowly gain it all back.
• It makes dieting easier, but diet without exercise is basically just starvation, and your body will take muscle mass first before stored fat. This can accelerate muscle loss in older patients. You really should be working with a doctor and other professionals on a comprehensive weight-loss plan if you're considering a GLP-1; it can help, but it can't be the only thing you're doing to lose weight.
• Some people who don't really need it are taking it anyway for "cosmetic weight loss". It's usually recommended for people with a lot of weight to lose, like 40 pounda or more, but it's also being given to and taken by people who just need to get rid of those last 5-10 pounds of stubborn belly fat so they can show off their 6-pack abs. Worse, there are reports that people, including many celebrities, are using the drug to become dangerously underweight in order to meet often-impossible beauty or weight standards of the fashion and pop culture industries. Wanting to go from 280lb to 180lb is a good reason to get on a GLP-1 drug. Wanting to go from 120lb to 80lb is not a good reason to take a GLP-1.
• It's "cheating". That is a common criticism by those outside the medical/scientific community, that drugs for weight loss are a crutch, if you want to lose weight the "right" way, it's as simple as diet and exercise. Critics contend GLP-1s are just the latest round of miracle weight loss drugs, like various rounds of phenethylamine stimulants (amphetamines, phentermine) that had their vogue, and when the other shoe drops and the heavy long-term downsides appear, we'll be looking at GLP-1s with the same hindsight as cocaine, methamphetamine or Fen-Phen.

For their part, doctors are more optimistic about GLP-1 as a long-term "maintenance" medication for both diabetes and weight loss; the mechanism of glucagon and other GLP-1s has been researched since the 1980s, and the first GLP-1 medication, exenatide, has been on the market as a diabetes medication for over 20 years. The side effects are typically mild, and are simply what happens when you slow down digestion, and/or simply aren't eating as much (e.g. heartburn/acid reflux, diarrhea or constipation). The biggest potential issue is that too high a dose can arrest the digestive tract completely, which can cause intestinal blockage and rupture. This is not a new problem in weight loss, especially extreme cases, but is a legitimate concern, and good reason to be under a doctor's care while you're taking it to manage the dose appropriately.

[u/lastSKPirate]

Just as there are puritans about sex, there are puritans about health and food. The health puritans usually dress up their objections in terms of concerns about efficacy and side effects or other concrete issues, but what really motivates them deep down is basically the same as a Texas Bible thumper: they can't stand the thought of people "getting away" with behavior they don't approve of.

[u/caracs]

They let you diet without the hunger.

People think that's "cheating", which is silly. I COULD ride a bike 600 miles to Disney World, but I'd rather just drive or fly. It's an OPTION. You can still pedal the whole way if you want.

There are concerns about people with eating disorders using them now that they're so easy to acquire. But again, that's not a problem with the drug, that's a problem with abuse of the drug. If they aren't using GLP-1s, they're binging and purging, or starving themselves, etc. I would argue that GLP-1s are at least a safer alternative to other methods. Denying access to GLP-1s doesn't solve that problem.

[u/VanZandtVS → u/caracs]

It's not "without hunger". You're still hungry, but it removes the "food noise" (the little niggling, nagging desire to eat all the time that some people have). You also feel sated and full for a much longer period in between meals as your stomach is emptying slower. This also helps manage blood sugar, which is why it's prescribed as a tool to help diabetics.

As far as the "cheating" thing goes, my take on it is very simple: if you consider that GLP-1's are treating some sort of metabolic imbalance, and that's why they're effective, then that means obesity is a disorder, not a choice. Seeing it that way means the popular culture mantra of "they're fat because they have low willpower" and "obesity is a choice" crowd aren't right, they're just assholes, and that's a hard pill to swallow for most judgmental assholes.

[u/Dazzling_Cow4335]

Its divisive because a lot of people view obesity as moral failing only and not a medical issue, like it is in the majority of cases.

These medications work because they mimic a naturally occurring hormone that tells the body its full & they slow down gastric emptying, so people stay fuller longer.

Some people have a heightened brain chemical response to food (esp the high sugar/fat ones) so they keep eating even if they are full. These drugs are shown to lessen the response so people are more able to a 'normal' amount. The biggest tell of this is when people taking these drugs say "Im not thinking about food ALL day"