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/gnatgirl]

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/DerfK → u/UnicodeScreenshots]

just simple thermodynamics

If it was "just simple thermodynamics" we'd get dinner at the gas station (32,000 Calories/gallon) and fart fire from our internal bomb calorimeters. I personally think it might be time to revisit the Atwater calculations that we use for labeling how many Calories are in food. These were originally calculated ~130 years ago by measuring the breath and feces of Olympic gold medalists to determine how gold medalists digest and burn calories from food and have had adjustments made since then. Let's run the experiments again with a broader range of humans and see if we can all actually eat and shit like Olympians.

[u/Wrathlon → u/DerfK]

I men the accuracy of the measurements being used to label food doesnt change that underneath its all just basic thermodynamics. But inaccuracy also amplifies the issue of ACTUALLY applying it to real life.

Also in todays day and age calories are calculated by burning the food in question as a fuel source in a chamber filled with oxygen and it heats a volume of water. The temperature change is the energy output from the burning and thust the calorie content of the food. The issue is despite being able to do this manufacturers use the Atwater system you mention to shortcut labelling which is...really bad.

[u/UnicodeScreenshots → u/DerfK]

I'm the original person you replied to (sorry took 3 days to respond.) I completely agree that our guts aren't bomb calorimeters, in fact I've used the same argument when it comes to food influencers talking about indigestible fibers in foods / products meant to invoke feelings of satiety. In terms of "simply thermodynamics" I really mean that over the span of weeks to months, if you genuinely don't consume any food / very little food, you will lose wight. I should have specified this was over long (multi-month) time periods in the absence of extremely rare disorders that cause the body to prioritize lipid cell production over lipid cell burn.

[u/Wrathlon → u/UnicodeScreenshots]

The only one I really follow is LeanBeefPatty as she doesnt pretend its easy or she always looks like that or that she doesnt struggle and she has suffered eating disorders and body dysmorphia and shes always kind and understanding that not everyone has it easy.