Almost. Researchers are finding that if we use a peptide (GLP-1) or related drug to artificially suppress appetite, people can keep about 40lbs off at one year after the weight loss: https://healthsciences.ku.dk/.../researchers-find-the.../ .
This is sognificant, because in studies and at medical weight loss clinics, the 10 year follow-up is a 99% fail rate. At the 2-3 year follow-up, over 90% of success stories, testimonials, and jaw-dropping transformations turn to complete failures. It’s so bad that most clinics won’t even publish anything after year 3.
I have clients who are 80-150lbs lighter at 10-20 year follow-up. I have peers who do as well. I’ve seen outliers. They exist. There are people 200+lbs lighter at 5, 10, 15 years later. It is exceeding rare; but it exists. In ALL of these cases, I’ve only witnessed the continually successful approach being centered around long-term development of strength and habit-building for athleticism. On the dietary side, tactics vary greatly. Some had surgical alteration of the body so they can’t physically binge easily. Others rely on a cocktail of drugs. VERY FEW lock in a lifelong balanced practice with regard to food.
Thus, although I’m as anti-intervention as you can get, perhaps we have to acknowledge that the most widespread substance abuse and drug addiction is food and drama. You heard me: people are friggin ADDICTED to food, stress, and drama. AND, frankly, it’s maybe going to take medications for most people. Drug therapy may not be ideal. But if the average people walking around are severely mentally ill junkies, it’s probably not going to work to tell them “move more; eat less.” That’s to say nothing about how that advice misses the point altogether: a lot of people need to eat MORE of nutrients in order to keep excess useless body mass off. A lot of people need to learn to stop getting high from seeking and choosing drama and chronically invoking stress responses. Yes. It’s a real thing. We dump dopamine and get high when we thrust our brains into drama:
It sounds odd to people who don’t study human behavior as their profession. But there is an opiate-like high from the drama of wrecking your health, quitting a healthy diet, sabotaging love-ones, stressing work environments, engaging in useless debates, and so on. That’s right: there is a mental “payoff” from failing. There is a psychological “benefit” from drama addiction.
So, incretin drugs like GLP-1 may play a critical role in offsetting the widespread self-destruction. With appetite more sated, people won’t get quite as high from sabotaging themselves. This has to do with the neurotransmitter balance associated with satiety and hunger-reduction. To a certain extent, cravings and hunger are a yearning for drama. They are the withdrawal symptoms of sobriety. People tell me “the craving/hunger is overwhelming.” And I say, “welcome to sobriety.” Getting and staying sober is a daily journey. You don’t get the luxury to quit your addiction without a single withdrawal symptom.
That’s probably where GLP-1 can step in. I’d add that you should also pay attention to nutrient sufficiency, choline and cholinomimetics until you’re past the 3-5 year barrier. But all of that is going to take more than popping a pill a day, which is simply too much for people. On average, anything beyond a pill from the doc is too much. Just a reminder that half of people who would die from skipping a life-saving pill DO SKIP taking that one simple daily step: https://www.uspharmacist.com/.../medication-adherence-the...
Morbid obesity in America DOUBLED in the exact same period of time that FitBit and other tracking technology exploded into popularity. Obviously, I believe in health and fitness. Absolutely people should incorporate healthy behaviors. But human behavior doesn’t care about exercise science, nutrition science, or logic. Rational approaches to irrational problems can’t cut it. We need non-rational solutions to our non-rational problems.
Paradoxically, swapping one drug for another may be precisely the answer. I hate to say it. But I am ultimately a pragmatist. We have to do what works, regardless of what we believed “should be.” And right now, GLP-1 is looking pretty good for people who just straight up are not going to manage themselves or develop discipline.
Sustainable weight loss is here; it just may look unlike anything we expected. And that could be a good thing.