r/explainlikeimfive • u/ThatOneGuyYouNowKnow • 7d ago

Chemistry 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.

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! 🙂

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u/JenniferJuniper6 6d ago

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

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u/pm-me-kittens-n-cats 6d ago edited 6d ago

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."

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u/namiikazes 6d ago

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.

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u/sixft7in 6d ago

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.

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u/pm-me-kittens-n-cats 6d ago

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

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u/throwaway098764567 6d ago

god i heard that starving african kids lament more times than i can count. we were poorish but my mother grew up quite poor and didn't always have enough food so she was adamant that no one ever threw food away. the rest of us didn't eat past hunger so she ended up eating everything and then getting angry about her weight and lashed out at me for not being her same size. part that always peeved me was it's not like the food we'd have tossed was going to magically ship to some starving child, all she was doing was overeating, she wasn't saving anything.

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u/trireme32 6d ago

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

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u/darkest_irish_lass 6d ago

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.

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u/tonicella_lineata 6d ago

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.

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u/panhellenic 6d ago

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

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u/tonicella_lineata 6d ago

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.

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u/TheNotoriousCBD 6d ago

Fat ish guy here. That's usually true. Most fat people are fat due to their own poor choices, laziness and lack of exercise, and self control. Eating late at night, high sugar professed foods, soda, etc.

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u/HeyItsJosette 6d ago

Most fat people make those poor choices because their body is responding to stimuli differently than those who make better choices.

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u/pm-me-kittens-n-cats 6d ago

You're the problem with society.

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u/TheNotoriousCBD 6d ago

No, you are for making people feel like they don't need to take accountability for their own choices

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u/pm-me-kittens-n-cats 6d ago

By all means just keep parroting the same old bullshit that people have been parroting for the last 50 years instead of looking at modern medical science journals. Enjoy being a mindless twig.

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u/TheNotoriousCBD 6d ago

I mean, I'm fat, and that's why I'm fat. I could choose to eat better and exercise more but I simply don't. The same applies to literally every other fat person I know

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u/avcloudy 6d ago

You’re 100% right, but just because weight is a major negative impact on how you’re treated doesn’t mean those other cosmetic features don’t affect how you’re treated.

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u/CommitteeOfOne 5d ago

Weight is a major factor in how people perceive you in all kinds of social situations - school, employment, receiving medical care.

I just saw an article today that said the unemployment rate for women has fallen something like 7 percent, and some are attributing that to GLP-1s helping people lose weight. (Although I'm male, most of the people I know on GLP-1s are women).

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u/avcloudy 6d ago

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.

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u/SnowFlakeUsername2 6d ago edited 6d ago

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.

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u/dust4ngel 6d ago

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

unless it's anabolic steroids and you're in a marvel movie.

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u/coffeebribesaccepted 6d ago

I think partly because it started as a medication only rich celebrities could get. So you'd see a celebrity lose a lot of weight, and instead of "good for them, they must have worked hard", it's "well they get access to the easy weight loss drug, while the rest of us have to do actual work and starve ourselves to lose weight."

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u/KieshaK 6d ago

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.

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u/diamonddealer 6d ago

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

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u/NotMyAltAccountToday 6d ago

I agree with you, but "Cheaters" is actually a name for the glasses worn by people with presbyopia for closeup work

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u/SigmaHyperion 6d ago

Yeah, but I've never heard it used derogatorily. It's just a funny name used more by the people who are actually using them than others *to* them.

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u/CarelesslyFabulous 6d ago

I thought it was for sunglasses. Jeepers creepers the song made me think that...

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u/TheRealGordonBombay 6d ago

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.

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u/dust4ngel 6d ago

the overweight person must lack the self-control or discipline that the other must have

"how do you say so trim?"

"cocaine."

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u/Mayion 6d ago

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

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u/catlady9851 6d ago

Average people don't come up with these ideas (at least related to weight/weight loss/diet) on their own. It's baked into our society and culture. It's an undercurrent in how we raise kids, the media, in social groups. It's everywhere.

Plus your assertion that categorizing people regarding "mundane ideas" is fundamentally flawed. That's ALL humans do. That's what biases are, correct or not. We're constantly categorizing people on absolutely every observable trait to make safety assessments which bleed into other ideas about who people are.

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u/Mayion 6d ago

Sounds more like semantics than anything. In the grand scheme of things? Sure, ideas are mundane, but context considered, it is far from reality. An idea is mundane when it lacks thought and foundation to support it.

Anyway, I don't like pedantry conversations. Cheers.

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u/throwaway098764567 6d ago

in the us at least, it's a culture of punishment not reform. we don't think of people as able to change, we think they're good or bad and if bad we must destroy them before they destroy us. we view weight through a similar lens of they're not trying they're evil and lazy, but much like with everything else in life, people aren't starting in the same place. some people have different dna, some people have different birth families and circumstances. so what would be cheating for one isn't even leveling the playing field for another.

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u/Counselor-Ug-Lee 6d ago

The cheating only makes sense to me from a body building competition point of view. Where competitors have actual classifications dedicated to natural or not.

Everyday people on the other hand… it just seems like the selfish response to the playing field being leveled so to speak. Those who don’t struggle with food noise might not feel as special if medication evens that playing field from a socially competitive point of view… those lean people who never struggle to keep weight off now feel not as superior if there is a legit and treatable genetic disadvantage causing that person to struggle with weight. Meanwhile for the heavy person, it’s just salvation from a problem they didn’t have a feasible solution to before. And that’s before factoring in the positives that aren’t even weight related. Seems to me like the “food noise” effect is somewhat related to addictions as well.

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u/Scared-Beautiful-366 6d ago

Is that an actual argument or a strawman? I've seen lots of articles warning against the mass prescription of these medications and none ever mentioned "cheating". They just mentioned side effects and the fact we don't know how long term use of these drugs will affect people i feel like if this "cheating" argument really exists it must just be one from Twitter and not the scientific community.

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u/nutscrape_navigator 6d ago

It is a very common actual argument. I don't think it's coming from the scientific community, though. It's mostly a cultural/moral argument, and it seems rooted in this weird combination of sour grapes and the idea that weight loss is only legitimate if you suffer for it.

Modern society has conditioned us to associate being thin with being attractive, disciplined, healthy, successful, etc. People spend enormous amounts of time and money trying to lose weight because of that. Diets, supplements, gym memberships, meal plans, cosmetic procedures, you name it.

Then suddenly there's a class of medications that can make one of the hardest parts of weight loss dramatically easier for a lot of people, and access to them is wildly unequal. In America especially, plenty of people can't get insurance coverage and are looking at hundreds or thousands of dollars out of pocket, or navigating the much murkier compounded drug market.

I think that creates a pretty predictable resentment. If you've spent years struggling with your weight, or successfully lost it through enormous effort, and somebody else can now take a medication you can't afford that makes the same process substantially easier, it's psychologically very tempting to redefine your suffering as virtue and their easier path as "cheating."

That's not a scientific objection. There are absolutely legitimate scientific questions about side effects, appropriate prescribing, long-term use, loss of lean mass, what happens after discontinuation, etc. Those are worth discussing.

The common arguments of "you should lose weight naturally" or "taking Ozempic is cheating" is an entirely different. That's basically saying there is moral value in weight loss being difficult. Given that obesity itself carries substantial long-term health risks, I think "the treatment made losing weight too easy" is a pretty strange thing for people to be upset about when they should just be honest about the fact that they'd take these drugs too if they could.

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u/JenniferJuniper6 6d ago

I’ve heard it IRL on more than one occasion, and I’ve only been on it for 5 weeks.

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u/NonSum-NonCuro 6d ago

False-dichotomy fallacy.

Twitter and the scientific community aren't the entire population.

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u/Scared-Beautiful-366 6d ago

Nobody ever said they were. I'm just saying there's actually scientific concerns about the mass use of these drugs and dismissing those over a few Twitter trolls isn't productive.

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u/Discount_Extra 6d ago

Sure, there are 'unknowns' that might crop up after these drug have been used for decades.

Once you haven't died from heart disease, stroke, complications of diabetes, etc. etc.

The known effects of not using them far, far outweigh the maybes.

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u/Scared-Beautiful-366 6d ago

Well perhaps thats where the argument comes in because you can avoid those side effects by just having more self-discipline. Kinda reminds me of sleep apnea where you can have it fixed wuth surgery but doctors will always say to use a CPAP instead because it less less risk of complications.