I've lost significant amounts of weight (60+ pounds) three times in my adult life, through simple calorie restriction (intermittent fasting, including before I'd ever heard the term). Every time, I've gained the weight back. At the beginning of 2022, I was the heaviest I've ever been.

I've accomplished very hard things in my life, including those that take sustained effort. Sufficient willpower isn't a problem for me in general. I honestly only ever hear "it's easy, just eat less and move more" from people that have never actually been fat. "I did it and I lost 15 pounds, no big deal!" and the like. 15 pounds is easy for me to temporarily lose too. I've done it enough times I should know ;)

I've heard people say that the solution is to eat (healthy food) when you're hungry, and stop when you're full. The thing is, I'm never full. I can eat until I physically can't eat anymore (not something I do regularly, of course), and as soon as my stomach has emptied a bit, I feel fairly hungry again. "Eat until you feel full" is literally a human experience I had never really had.

On this drug, I finally know what people are talking about. I still like food, and I still get hungry. But it doesn't dominate my thoughts. I eat, and don't feel like eating again for hours. I eat something that I'd normally easily eat all of like a big burrito or whatever, and I feel quite full halfway through with no desire to finish. I'm steadily losing weight, with none of the usual preoccupation with hunger, ascetic adherence to a strict calorie plan, etc. But above all, I feel like I must be experiencing what most thin people experience all the time. I'll be perfectly happy to take the drug for the rest of my life, though I do hope affordability improves.

As for side effects: I've had some heartburn, but none of the other commonly reported side effects.

I had this exact same experience when I was prescribed a drug that, as a side effect, blocked receptors in parts of the brain responsible for signalling satiety from food.

I went from having trouble eating enough food to maintain a healthy weight, and just not being hungry, to suddenly being unable to feel full at all. It was like I always had room for more, no matter how much I ate. And I was constantly hungry, felt like I was starving 24/7 and would ruminate about food so much that it impacted my ability to sleep or concentrate. My brain was obsessed with preventing me from "starving" and it ultimately dissolved the illusion of willpower that I thought I had.

No longer take that drug, but it was an eye opening experience. I didn't know that was a thing people could experience, as someone who was always skinny. It really drove home that we are products of our biology and made me more empathetic with those who struggle with food.

Unfortunately that stopped working for me after a few months. Hopefully this one will work better.

Good luck either way.

Personally, I can say that while Bupropion didn't help me lose weight that it did at least help me stop gaining weight. I've never taken it with naltrexone though. In fact, I'm long-term opiod agonist therapy for chronic pain developed in my early 20s. This actually has more or less the opposite effect of opiod antagonists such as naltrexone. They've definitely had a negative effect on my ability to lose or maintain my weight, although I seem to have achieved some kind of balance where my body plateaus after a certain weight.

I feel exactly the way you do, and yes, I was fat, lost it in one go and never gained it back. I try to keep my BMI around 18, never went over 20 since losing weight. It's been around 15 years now. I still have the exact same unlimited appetite I have always had. If you put food I like in front of me, I'm going to eat it.

I don't do anything special. I eat the same foods I always have, just less of them. Got really good at counting and never get more food than I need. The trick is to not put yourself in a situation where you have to stop eating in the first place. It's hard to just stop eating something you want to eat. Not that hard to stop yourself from going to the store again or ordering more (especially when other people are around).

I feel like most people never get serious enough about counting, try to eat stuff they don't enjoy, waste effort on exercise or let other people interfere.

Well, actually...

I'm fat. Like BMI 40 fat. Most of my life I have been fat. I was laughed at in school for it, as far back as I can remember. It probably wasn't all that bad when I think back. Certainly not as bad as now. But I was the fat kid in class, and I felt like the fat kid.

Anyway, I have lost a lot of it at a few points. Once by going to a place with more disease than I could handle. Months of intermittent diarrhea helps apparently. And once I reduced intake to about 1200 kcal per day for a year, combined with walking around for 5 hours everyday. I got to BMI 26 or something. Not very obese, but still overweight. It felt amazing to be able to do a lot of things, but it also took a LOT of time and effort.

But then I got a job, and kids. And I started to backslide. Just an hour per day walking during my commute, instead of 5 during the day... And oh, that pastry looks gooood. Slowly at first, with intermittent periods of faster backsliding because life required a bit more from me.

I got it back faster than I lost it.

I have re-lost it a few times after that. Each time the losses are a bit less, and the peaks get a bit higher. I always gain it back faster than I lose it. And annoyingly, initially, gaining it back feels way better than losing ever does. Like finally laying down after a day of strenuous work. Or like the first breaths of fresh air after being cooked up in stale air for a while.

During my losing periods the things you describe help. Keep the food away, and you don't have to expend effort to not eat it. I even enjoy the healthy stuff.

But that's not how it is during my gaining periods, oh no. I get bored with the good food, and start craving the bad. I go to the shops to buy stuff. A small packet of candy at first, or a pastry. But that spirals out of control quickly. Soon I start scheming:

* How can I get the food without my family noticing?

* If I go to multiple shops I can buy twice as much without looking like a greedy fuck.

* Oh, and I won't be able to go tomorrow, so I should make sure I have supplies for the day.

* And eating only candy makes me sick, so I should also buy crisps so I can alternate and keep eating.

I'm in gaining mode now. I ate a box of Pringles, a box of cookies, and a box of candy, just today. In addition to the regular meals with my family. I'm here. I see myself doing this, but I can't seem to stop. Until it runs its course. After a few months or a year or two, I can usually cycle back into a losing mode for a few months.

A doctor might help, but I'm not going. The medical state of the art of dealing with obesity seems to be "just don't". A consult seems pointless and humiliating.

I've learned to take and make fat jokes, and other than that to not think too much about this. My BMI will probably keep oscillating higher and higher, and I guess that means I'll get some obesity disease at some point. Maybe that'll stop it, but I'm not confident it will.

I guess we all have our issues, and this seems to be mine. C'est la vie.

This one hit hard. If you swapped "crisps" and "candy" for "MDMA" and "ketamine", people would tell you to go to rehab.

No judgment here, but a lot of your behaviour sounds like addiction underpinned by a coping mechanism. If you replaced <food> with alcohol or drugs people would point out how your relationship with the substance is pathological.

IMO food is the most cruel of addictions as it is fuelled by our most primal of instincts to survive, it is also why I think Big Sugar is the most sinister of institutions...

Not even remotely a doctor, so take all this with a grain of salt if you're in a similar spot. Mostly based on my own life experiences and having to work on childhood trauma and what that entailed in my case (food addition being just one amongst many maladaptive coping mechanism).

The point of this article seems to be that that is changing. Doctors actually have something to offer you now.

One thing that's helped me: I just make a rule to myself, 'go from one healthy thing to another'. I just try to find more and more relatively healthy (or at least harmless) and appealing outlets and tell myself that, whatever I do, I may not do something ideal but I'm going to choose one of them.

(A healthy outlet is one where I feel better after I do it than when I start.)

I don't follow it perfectly, of course, but it has helped result in a major shift.

In the movie he does some of the things you mention, but I don't think he was vilified in the movie. I saw him as a hero at the end. Some fat people on youtube were very offended by "The Whale", I'm curious if it is universally offensive to large people.

- There's no good or bad food. The number is the only thing that matters. Don't feel bad about eating chips and candy everyday. That's pretty much what I do. All you need is to hit the number.

- Always keep track of how much you've eaten. A big binge is not an excuse to stop counting. After a year or so, counting will become second nature and can be done purely with mental math. But initially, you want to write all the numbers down. Date | calories in | morning weight.

- Don't tie the counting efforts to any other effort. You mention walking 5 hours a day. That's some other unrelated thing. Don't ever mentally link this to your weight loss effort. If you want to do it, do it, but it should have nothing to do with losing weight. Counting and keeping records is your primary job.

- Your family should know what you're up to. They're there to help you achieve your goals. If you've already eaten, they shouldn't let you have a family meal with them. If they just let you get away with this, let them know you don't appreciate it. When you mess up, they should care and think it's a bad thing.

- Get this idea of a "cycle" out of your head. There is no cycle, every day is a new day. Your behavior only looks like some cycle caused by external forces post facto. Everybody trying to form a habit has a similar experience. There is nothing weight loss specific going on here. When you break a good streak everything can go out of the window. This is why it's important to keep the required actions as simple as possible. The more you couple different efforts the harder it's going to be. When you mess up you have to take the loss and move on. A good streak helps but don't dwell on breaking it.

- You have to have a sense of urgency and importance. Those around you should too. "I guess that means I'll get some obesity disease at some point" - just think how ridiculous that sounds. You know you can potentially prevent a serious disease (most people never have that opportunity) but you're just gonna sit there and let some cycle run its course. I mean, come on! How can you wake up everyday and not want to stop it today? What about your children? Perhaps they will inherit your eating habits (stats do show high heritablity), perhaps it would be nice to show them how to keep it under control? You owe it to them. Why doesn't your spouse think that's a huge deal?

It's one of the few things in life where you are literally guaranteed to get a good result if you do what you're supposed to do. There's a lot of advice on how to do this or that, get rich or whatever. But you can never prove these things are guaranteed to work so I can understand if people have a hard time motivating themselves. With weight loss you have a 100% guarantee of success. Personally, I don't see it as some random little problem. Pretty much any effort in life looks like this. You want an outcome, you think of the necessary actions and then the entire ballgame is about actually implementing these actions.

It’s so hard to eat healthy, I honestly cannot fathom how people do it.

When I started taking semaglutide, I finally understood it. I'd eat a salad... and be full and more than satisfied! I'd look at a muffin right after lunch, and go "eh, better things to do with my time" instead of immediately having an overriding desire to eat eat eat. Before, I could eat half a pizza and still be hungry (way out of what my body needs); now, a slice is more than sufficient and satiety lasts well into the next morning.

GLP-1 agonists makes eating healthy trivial and automatic, instead of a dieting state where you're thinking about food literally constantly throughout the day for months or years on end.

Too many people are convinced that everyone has the same subjective experiences of hunger and craving, but it's simply not the case. Some people implicitly hold this idea because it's a convenient ideology that allows people to morally congratulate themselves for having a functioning satiety circuit.

Where does this line of thinking stop?

Is everything pre-determined by genetics?

Is everyone who is smarter than me, just actually lucky that their dopamine system works correctly, and mine doesn't, and hasn't since I was a very young kid?

I'm sure this response will get down voted but its an honest question. This line of thinking that everything is genetically pre-determined seems both accurate and somewhat depressing.

It means that if I'm skinny and can't gain weight, I need to take steroids and lift. Or if I'm fat, I should take a GLP-1 agonist. If I'm underperforming in my career or school, I should take adderal or similar pharma solutions.

What role does good old fashioned hard work and discipline have in this day and age?

Would you be willing to believe that, out of 7+ billions people in the world, there is at least one person whose brain is set up to constantly hammer them with feelings of hunger? (I'm not sure how a basic proposition like this could be rejected, since the chemicals and processes that govern hunger are something that science actually has some understanding of, and we also know that basically anything can go haywire.)

Next: if you can believe that one person is such an outlier, can you believe that hundreds are? Thousands? Millions? Whatever size that group is, it seems like a possible answer to your worry of when these lines of thinking stop. Perhaps some outlying group of people do actually need something more than "good old fashioned hard work and discipline", especially considering that thousands of years of people repeating such sentiments hasn't solved quite a lot of problems (beyond just obesity).

Not only was there a fascinating example of this the unfortunate man was documented by a doctor of the era.

https://en.wikipedia.org/wiki/Tarrare

Yes, those people exist as outliers. But a population-level outlier theory doesn't explain why obesity is growing in the population.

Obesity is similar. This feeling of hunger is thrown out of whack often not by genetic but by lifestyle. I’m lucky enough that I haven’t felt it all my life, but I have felt it during multiple phases of my life; i know exactly how eating the wrong kinds of food can teach your body to eat more than it needs and to adapt to that new number.

Our environment sucks ass.

I think this might be a misunderstanding. Rates of ADHD may be higher but I think it's more likely we have an environment which now challenges people with ADHD more than in the past.

The advent of electrical lighting did not cause an increase in pattern-reactive epilepsy, it just created conditions in which pattern-reactive epilepsy were more likely to be triggered. I believe now is the same.

If you eat until you are no longer physically capable of eating more it sure matters if you ate vegetables or pastries.

That's speculative I believe. Last I checked, I think they chalked this up to better diagnosis.

If the problem was all in poor impulse control and hunger felt differently by some people genetically predisposed to feel it (but >30 percent in some states in the U.S. feel it that way?), there would have been many more fat people in the 1970s, 1980s, and 1990s, when highly palatable food became available. And, I reiterate, those who wanted to or had no problem getting fat could certainly do so. In fact, there were (some) fat people even then.

One thing that has certainly changed over the decades is the social acceptance of obesity and being fat in general. In my country, which is not the United States, people are still asked what happened when they put on a few visible pounds or promise to start working on it before anyone says anything.

I recently visited Buenos Aires and the difference in weight between women and men compared to what I see in the United States/California was hard to believe. It was quite surprising to see so many women and men young and old in good shape, or at least at a good weight.

But in the United States (and other countries) being fat and terribly out of shape is personally and socially accepted. Let me take an opposing and politically incorrect position for a moment, strange as it may seem: if I had a kid who was overweight, I would firmly tell him or her that he or she must lose weight. Would that work? It's hard to say, but it's something I wouldn't accept lightly.

But it's like the differences we see in the way people dress, even though clothes are not part of a physiological process that is apparently easy to hijack. How is it that people show up dressed in a way that 30-40 years ago would have appeared offensive to others-I'm thinking of going to the supermarket in pajamas. Well, for one thing, that way of dressing and showing up in public has become accepted. People of my parents' generation would have been ashamed to show up in public in pajamas. Ashamed to show up in public in pajamas. But nowadays, whether one considers the loosening of dress codes as good or bad, it is socially accepted and becomes almost a need. In fact, for the younger generation, what was once considered normal (for most people), such as making phone calls or being groomed, is almost physiologically intolerable.

There's more than just social acceptance of obesity and pajamas in the grocery store at work.

The social acceptability of being fat leads to psychologically easier consumption of calories. Personally, if it were not for the shame I would feel, I would eat 1 kg of ice cream every night. I have a great appetite, but also a great capacity for restraint.

The "mysterious weight gain" not explained by calories is, at this point, rather speculative.

That was the problem. The lab animals have had their food careful measured for several decades with essentially the same food/lifestyle, but weight was being gained at a rate higher than other animal populations. Because it's unknown the "why" part is speculative, but they've got some interesting ideas. Changes in animal husbandry standards, endocrine-disrupting chemicals and infectious agents were considered as possible factors.

From the study:

"There are multiple conceivable explanations for these observations. Feral rats could be increasing in weight because of selective predation on smaller animals or because just as human real wealth and food consumption have increased in the United States, rats which presumably largely feed on our refuse, may also be essentially richer. But these factors cannot account for the findings in the laboratory animals that are on highly controlled diets, which have varied minimally over the last several decades." (https://royalsocietypublishing.org/doi/full/10.1098/rspb.201...)

As for your actual question, it depends on the particular thing we're talking about. For obesity, we've tried telling people to do more hard work and discipline, and it's been a spectacular failure. Plenty of people who do work hard and have incredible discipline in other areas of their life fail when it comes to getting to a normal BMI. There are large subjectivities involved, but when I got down to a 22 BMI at one point via the hard work and discipline route, I was constantly overwhelmed with thoughts of food, literally every waking second; this was despite trying and adhering to probably a half dozen different diets. Most people able to maintain a constant 22 BMI don't experience this.

This also is more common in our current society, for whatever reason (likely not genes, since we're close enough to our grandparents), than it was historically. This isn't some natural state of affairs we live in.

So, bring on the drugs! If there are ones that help other things with minimal side effects, bring them on too. Everyone wins, because we end up with a better, happier, more productive society.

Out of curiosity, what kind of food were you obsessing over, specifically? Why were you craving that kind of food, instead of, say, lettuce?

As to why, who knows. I'd be "starving" but have zero desire to eat lettuce, but then jump on the first chance I got to eat a couple cups of rice.

So, maybe you already tried that, but there's a psychological/addiction angle that's seldom explored when it comes to simple carbs and obesity.

That said, if there's a drug that you can take that'll numb those cravings down to a healthy level, there's nothing wrong with that.

An analogy: "hard work" is what your car's engine does when you throttle it up. But that "hard work" isn't going to take you very far — or even in the right direction — if the car's wheels aren't aligned and balanced equidistantly on the car's axle. This "imbalance" will mean that any power put into the system, just gets shunted into running you faster and faster in circles, and/or into "spinning your wheels" and "burning out."

Bringing the car into balance is an overriding concern. You won't get anywhere without first doing that, no matter how hard you push the engine. Once you've done that, though, then the amount of power you're pushing through the engine — your "hard work and discipline" – becomes relevant.

My brain doesn't produce the same amount of dopamine as a non-ADHD human's brain. It's morally neutral to fix that with medication, same as it's morally neutral to wear glasses, imo.

Well, much more is, than isn't, it seems. You may trim the sails, but life will provide you your wind direction... And in this case:

"As many as 400 genes have been shown to affect body weight in one way or another."

https://www.genomicseducation.hee.nhs.uk/blog/obesity-is-it-...

So no, we’re not genetically predetermined to be hungry.

There’s something in our environment that’s messing with our circuits. Either some toxins (e.g. endocrine disrupters) or hyper palatable food (artificially engineered for max enjoyment and min satiety), or maybe something else.

As someone who's always been thin and doesn't have a strong appetite, I couldn't agree more. I'm just enough outside the norm yo be able to recognize it.

There are times when I simply can't force myself to finish my food and it goes to waste, but the upside is that many people assume that people in my body fat range are somehow virtuous for not "overeating". That's not the case at all - I don't eat particularly healthy, don't have any particular exercise routine beyond walking, and I don't limit myself. I just get full quickly and have a metabolism that burns what I eat.

It's always hard to know others' experiences. I have a friend who genuinely tried to help me lose weight in college with the typical advice and a lot of support: he had the strategy of just eating until he was full and then stopping, and he just couldn't get why that didn't work for me. But when he hit his 30s, he suddenly started ballooning up and suddenly couldn't put his strategy into practice, to his great frustration. Did his willpower dry up overnight? Nope; something else changed to upregulate his appetite.

(I pointed him to semaglutide, and he's already halfway to returning to his college weight.)

Sometimes I lose 15lbs when having a bout of constipation due to goddamn IBS.

Every person in my life, friend or foe or family or partner finds it clever and completely acceptable to tell me I'm "too skinny and need to eat more".

Others without my experience just don't get it. Glad these overweight folks have a tool to help them.

> I could not overeat to save my life

You are likely eating the wrong foods. It is _highly individual_ what kind of food can people eat in large caloric quantities. Start calorie tracking and experimenting more, you can figure this out. Some people do well with oatmeal (tastes like soggy sawdust to me), some with various nuts (peanut butter is a fitness industry staple), others make themselves milkshakes etc etc.

Progressive overload is key here, don't just expect to start eating 4000kcal/day, it is not going to happen (and would not be productive anyway).

> I cannot concentrate with a meal in my stomach

Same here. I feel like eating makes me lose about 10 IQ points, not great (though I am at a place in life where I can make this sacrifice). Maybe more sugar would be helpful here.

You may also find the /r/gainit subreddit englightening.

I've been trying to eat more since I was 20 (am 34 now). It's been getting more difficult as I get older, especially with the onset of IBS a few years ago - now more foods and what used to be regular quantities cause my stomach to balloon.

All my experimentation has landed me on.. a mostly meat diet. Which I don't love (it's expensive, kills animals, impacts climate) but I can digest it more easily than vegetables or grains.

Oats are my everyday ~500cal first meal. If you find them unpalatable, try my recipe (it's literally my favorite thing to eat):

Combine in a jar night before and leave in fridge: 1/2 cup rolled oats, 1/2-1cup water/alt milk (amount depending on consistency you enjoy), half scoop flavorless protein powder, tbsp peanut butter, raisins, walnuts, pumpkin seeds, chia seeds, maybe 1/2 banana (if you need it to be a little sweeter).

I prepare mason jars with dry ingredients for the week, and add water to one or two every evening and put in fridge. Oat+raisin+pb combo tastes like my fav cliff bar. Banana + walnut are also amazing together.

I also recently got a vitamix and have been making vegetable smoothies midday to try and get more of them in my diet. I still cannot drink more than 500ml, else extreme fullness and bloating, but it's something. I'll add oats + avocado + protein powder to make it a meal with proper macros, but then I get to regular dinner time mostly full :)

Eating when full is a real bane for me. But there's bigger fish to fry in life, so I'll be a skinny guy.

While I'm sure we all are a bit different satiety wise (and I've found it greatly depends on how much I've been eating overall recently), your experience on the drug is not what the rest of us feel like all the time. It's unfortunately normal for our biology to basically want to shove calories down our mouths all the time. I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

The kind of "fullness" you get on semaglutide isn't natural. I've never felt like that my entire life. The closest thing would be after something like a Thanksgiving meal, but that's more of a "my stomach hurts" than "I really don't feel like I can put more in my stomach."

My sister in law is the skinniest, most in shape person I know. She's 35, has had 3 kids, and has abs, an ass she clearly worked for, etc. My wife (unfortunately) regularly compares herself to her and in this case also thinks like you, that it just comes naturally. She gave me her old phone so I could test some stuff on it as I don't have an Android phone handy. She didn't wipe it. MyFitnessPal was on there, and she was limiting herself to 1400 calories a day.

Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

And it needs to be said in case my wife ever finds this: she's also ridiculously hot and even though she can't see it has, at times, been skinnier than her sister.

Not for me.

>I consciously pace my food intake every single day. I just had a huge plate of nachos, some christmas cookies, and a pickle...and I could still eat more. The only reason I ate that much is because I feel a cold coming on so I relaxed my usual limits.

This is completely alien to my experience.

I eat until I get full, then I stop eating. I do not have any difficulty whatsoever maintaining a healthy weight. I don't think about calories at all. I have no idea how many calories or nutrients are in anything I eat; I've never paid attention to the that part of the label. It does not enter my mind for even a moment.

Sometimes I exercise regularly, sometimes I slip and get lazy for a while. Sometimes I eat a lot of fast food, sometimes I pull myself together and make better stuff at home. Throughout all this, my weight does not noticeably budge at all. I've been 20-22 BMI for my whole adult life.

>Almost all of us work for it. Truth be told, and please hold your downvotes for this, I get a little upset when the rest of you get to have insurance pay ridiculous sums of money for a medication that makes it easier for you than the rest of us, side effects aside, and you think it's simply evening out the playing field.

I didn't work for it. It doesn't mean I'm a good and diligent person, it means I got lucky with my biochemistry and genetics. In another life, a different sperm would have met a different egg and I'd end up with different alleles and I'd end up fat.

It isn't fair that I'm living my life on diet easy-mode. If semaglutide can replicate this for people who aren't so genetically lucky, that's a fucking miracle.

You give some thought to it every day, but do you think about it every minute? You could still eat more, but do you still have the same intrusive hunger to eat that you did before you started the nachos?

> Almost all of us work for it.

Your claim here seems to be that you work for it harder than people who have less success. But do you have any actual evidence of that?

Like, can you truthfully say that to keep your presumably healthy BMI you overcome nearly constant thoughts about how hungry you are? Can you eat an entire pizza and still be hungry except it's physically painful to eat?

People vary in their experiences of satiety. Many people do manage to be thin without constantly feeling hunger; that's what being on semaglutide does.

Same as the other poster, yes, but I can also still eat more without pain if it's a Large Domino's Pepperoni Pizza. If it's the Dominos "Deep Dish" though, that's my maximum. I can regularly put away a large Little Caesars pepperoni without trying, it's just a "normal meal".

The difference between me and people fatter than me is that after a large meal like this, my body stops "demanding" food for 1-2 days. Thats what keeps my weight in a +/- 3 lb range.

I know the difference because every once in a blue moon after I turned 30, my body's hunger signals will make me un-satiable. The experience of suddenly being unable to diet was jarring. I've managed to fix that somehow, thankfully. But it was very, very clear over several weeks that dieting was entirely beyond my control no matter how much willpower I had.

And yes, I could easily eat more than one pizza. It’s a habit to simply stop at a few pieces, or more if I haven’t eaten much that day.

I’ve also taken growth hormone peptides that make you insatiably hungry. Literally insatiable - far beyond what I assume could be natural. I still usually limited myself. If I needed more I made popcorn or something and then went to bed hungry.

Yes. Except that it’s not physically painful not to eat (that would happen probably at 1 1/2 pizzas, but I almost never go there).

I’ve been feeling this way and limiting my food intake since teenage years (almost half my life). Sometimes more, other times less successfully (six pack to love handles, but never beyond that).

If this was well and truly about the money you'd support it, because it's going to be cheaper than paying for long-term medical costs of obesity.

No, how you feel on the drug isn't how most of us skinny people feel. I'm probably somewhat uniquely qualified to make that distinction at the moment. The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat. It's one thing if you recognize it, but it's beyond annoying if you don't.

Someone could just as easily say that you've had access to a cheat your entire life and are now bitter other people have access to it. The fact that you have a stronger satiety response does not mean you are morally superior or are more entitled to a healthy life than others.

Disagree.

I am skinny.

I spent almost no time thinking about it.

I eat whatever I want. If I overeat, my body feels bad... it tells me to stop.

After fasting 24 hours, my hunger turns off. I have no cravings. I am not eyeing chips and cookies with lust. I do not dream of roast chicken dinner.

Our human experiences of hunger and satiety differ more than I ever would have imagined.

Now should I look for a moral judgement? On me? On you?

I think I'll find something more positive to do with the rest of my day.

I don't really think this is a healthy way to look at it.

Yes every day is a struggle for most of us. I've been in the "healthy" BMI for a majority of my adult life, but only just barely. This requires constant effort and work for me. I assume that most "fit" people are similarly fixated on the quest to remain healthy.

But clearly, there's "something" that we have which makes it possible for us to succeed at this, which people who do not succeed lack. I don't begrudge them taking a shortcut, and I don't mind if they never understand my version of the struggle here, because I don't claim to understand theirs.

Fundamentally, we need to understand that our physiology has not evolved in a situation where we are both sedentary and have unlimited, good tasting food at our disposal, and any tools we have to make this situation easier should be embraced.

This is closer to disordered eating than healthy eating.

> The rest of us have worked hard our entire lives to stay skinny and now you all get a cheat

Ah, the student loan forgiveness argument, and the pro-spanking argument: I suffered, so you should as well, because suffering is intrinsically moral and pleasure is bad.

I believe she was losing what little weight she gained during pregnancy.

It’s not about suffering. Like I said, as long as you’re aware of it I don’t really care past the fact that I’m paying for it with my insurance premiums…but as someone else pointed out, it should be cheaper in the long run.

Personally, I eat when I am hungry. My body typically generates hunger signals around the times I routinely eat. At other times I'm usually not hungry. Sometimes, I'll eat just for taste, but that is rare. I've had periods of time where I was trying to gain weight for fitness reasons and it was a real struggle. My natural state is to be skinny and it's quite hard for me to deviate from that. There a plenty of people like me and there are also plenty of people who tend to be overweight unless they actively fight it.

Clearly there are differences. There are extremes and their is a continuum between those extremes. You can exert some amount of willpower to change your position on the continuum, but the closer to the extremes you are, the harder it will be to arrive at a "normal" position.

And this is just inherent feelings of appetite. Some people may additionally be subconsciously eating to fill some kind of emotional hole or trauma. There is a lot going on and I wouldn't want to be too quick to judge.

Apart from people like you, perhaps. I also have a friend like that but he has pretty severe untreated ADD so I think that plays a part.

It's honestly just what you're used to.

If you eat tonnes of sugar and fat then that's what you crave.

If you cut sugar out of your diet, after a while the amount of sugar you used to eat will taste wayyy too sweet. Same with fat - eating chips for example will leave a gross fatty taste in your mouth.

99% of food bought out will have a whole lot of oil, fat, and sugar in it.

Eating healthy starts by controlling what goes into your own food. Cook and prepare meals yourself. Once you're in the habit of doing this you simply start to replace bad food for good.

Don't buy junk in the first place, then you won't eat it. Always shop for food when you've already eaten (and thus not hungry). Slowly reduce / eliminate the amount of fatty and sugary food in your meals. Just drink water (seriously, just water, no sweeteners).

Combine that with an exercise routine and you'll be set.

Apart from them seemingly equating fat and sugar as equally bad, the comment was spot on.

I do wish that more people understood the basic research on satiety, though. I suspect more diets would be successful if people were eating ~2g of lean protein per kg of goal weight along with a lot (I'm not sure if people have studied amounts here) of dietary fiber.

Other than that your comment seems to contradict itself, I'd fully agree.

I'm not sure what you mean by this. Could you elaborate?

> I think that many people discover a particular diet that works for them psychologically and expect that to be the case for everyone.

and then did just that for a high-protein, high-fiber diet. OTOH, that worked for me too, so it is certainly something to try.

Re-reading your comment though, I realized that I probably misunderstood it and that you were referring to independent research that came to the same conclusion.

Yeah - I probably didn't word that the best.

Lots of deep fried, Canola oil or vegetable oils, bacon etc.

I agree that "fat" isn't harmful, but I do think people get a taste for the nasty ones.

Bacon might be a problem for other reasons; for instance, maybe the CVD correlation with saturated fats will pan out. But in terms of basic metabolism, appetite, and hunger, the current trend seems to be away from the idea that people should avoid bacon-like fats.

I'm not here to say "bacon is the answer" so much as to say that your original post, suggesting that there's a simple nutritional answer to this problem, is both glib and not especially well-informed. The truth is: this stuff is very complicated, and there's a lot of uncertainty.

I agree that nutrition is complicated, and I am in no way an expert, but I really don't think we need to get so complicated to live a moderately healthy lifestyle.

In general most people know what foods they should be avoiding. I'm not saying stop eating avocados and almonds (although I've heard avocados use a ridiculous amount of water to farm). I am saying maybe don't chow down on potato chips, pizza and then eat a muffin - and then repeat roughly the same diet the next day... when I think of fatty foods, these are the types of food that come to my mind (and I'm assuming that's what comes to mind for the general population as well).

Of course if we go down a technical track or move away from the general population nutrition gets complicated super quickly.

On the subject of vegetable oils, this is why I say to avoid them - https://chriskresser.com/how-industrial-seed-oils-are-making...

Lastly, bacon is delicious.

Here's some more of my non-expert opinion: delicious things should be eaten in moderation.

People with satiety issues (for instance, with hormonal disregulation, issues with insulin resistance, etc) aren't necessarily as well served by the "everything in moderation" message.

Food cravings aren't purely intellectual any more than needing to urinate is; intellectually, I can hold it until I find an acceptable bathroom, but physically, the severity of the urge and thus the energy required to regulate it varies based on how much liquid I've consumed, how long I've been waiting, and whether anything I drank is diuretic.

Similarly: depending on your hormonal profile, different foods will probably have different impacts both on satiety (the feeling of being full, of additional food being a welcome stimulation) and on "cravings". Some people can eat a "balanced" diet in moderation, across all the macronutrients, and be just fine; some people will consume simple carbohydrates (bread, rice) and immediately have an urge to eat more, as a dose-dependent response to the carbohydrates they've consumed.

For those people, "eat a little of everything, don't overdo it on the bacon" might not be good advice. There is in fact not that much evidence that eating bacon (or other high-fat, high-protein foods) is especially bad for you. But those foods also tend to quickly produce satiety, and they don't seem to generate food cravings directly in response to their consumption. Maybe for them the bacon, cheese, and eggs is a good call, as long as they're steering clear of the carbohydrates. It's a very big open question right now.

(Again: I'm only considering the goal of minimizing caloric consumption --- weight management --- not other food health considerations.)

Different people are different, and one of the things we are probably getting very wrong in dealing with nutrition is trying to come up with a single set of guidelines for everybody.

Learn to cook well so that eating out would result in lower quality meals compared to what you could make yourself.

Once you're controlling what goes into your meals, instead of outsourcing it, that makes it easier to control portion sizes, how much fat/oils go into things (I've found that restaurant dishes have an absurd amount of fat in them even when eating at "good" places), how things are sweetened, what you can use as healthier substitutes and what not.

You can eliminate almost all sugars with low to zero calorie substitutes, you can replace bread/panko/etc with low-carb flours, if you're frying you don't need more than a teaspoon of cooking oil, many sauces you can learn to make yourself instead of buying corn syrup and soybean oil-laden sauces from stores, etc.

Make it a rule to not buy things that come in boxes, buy fresh or flash frozen ingredients and make things from scratch. Stay in the produce, meat and fish sections of the store and ignore everything else outside of things like spices, frozen vegetables and protein.

Give yourself some leeway, too. You don't want to go into an all-or-nothing mindset, because that might lead you to giving up on eating healthily altogether if you break your diet. If you can find a way to treat yourself with something healthy that you like, that would be great. Sometimes I crave pancakes, despite them being nearly 100% carbohydrates. I eventually ended up with a recipe that substitutes wheat flour with almond and coconut flour, and to replace the syrup, a berry sauce reduction sweetened with erythritol. Barely any carbohydrates and the berry sauce is better than maple syrup, IMO, and goes with a lot of different meals.

tldr: reduce the opportunities to eat unhealthily, and increase the opportunities to eat healthily, even if you don't take those opportunities all of the time.

Who is it for?

Why do you think this is a new/novel idea the person you are replying to, and others reading it, has/have not heard before?

> Sometimes I crave pancakes, despite them being nearly 100% carbohydrates. I eventually ended up with a recipe that substitutes wheat flour with almond and coconut flour, and to replace the syrup, a berry sauce reduction sweetened with erythritol. Barely any carbohydrates and the berry sauce is better than maple syrup,

This reads like an elaborate troll, at that!

Wanting to lose weight isn’t necessarily about health, and eating a lot of fat is an effective way to lose weight.

However the fats used in restaurants are often used for frying, and likely have been used repeatedly for many hours. Oils used for frying can quickly produce compounds that are not great to consume, like various aldehydes, VOCs, free radicals etc[1]. If they've been used for hours, the chances of those compounds being in your food are high.

They are often low quality, as well, like soybean oils that can be high in fats that can be unhealthy in excess and might contribute to CVD.

I bring up the fat thing not because I think fats are the reason why people gain weight, I'm well aware of how high fat low carb diets are effective. I bring it up because restaurants often put fats into food you might not put it in at home, and the food can soak a lot of it up, turning what might be a 500 calorie dish into something that's 1200 calories or more. If you're trying to watch what you eat, eating out can make that hard because you don't know exactly how much food you're actually eating, and you can't really rely on nutritional breakdowns you might find online or from the establishments themselves.

The foods the fats are in also seem to be high in carbohydrates, which isn't great for ketosis.

I also bring it up because of Ulillillia's decision to degrease the pizzas that were the only thing he ate. By doing that he was able to lose weight while literally only eating pizza for every meal for years.

[1] https://news.ycombinator.com/item?id=32818910

That's probably the most important lesson you need to learn before starting.

1. log your weight everyday on a graph

2. eat very small portions, no carbs

3. when hungry force yourself to drink a large glass of water

4. drink hot tea at scheduled intervals

5. eat lots of popcorn, get the raw grains from Safeway and put them in microwave for 4 mins in a large bowl with a cover

Source: worked for me. And is a basically daily staple

There are some simple tricks you can try if you're currently maintaining a stable weight. The simplest is to get slightly smaller plates. Your brain will naturally try to visually match what your old portions looked like on the old plates, but now the plates are smaller so you're eating a bit less.

No other change in behaviour is needed to see some benefits, but of course going for a half hour walk after dinner and shifting more of the food you put on that plate towards greens also helps.

For me that forced me to eat healthy daily and it has almost healed my affliction upon religiously following such a diet.

Most nutrition advice is so bad you basically shouldn’t believe anything anyone tells you, including, especially if it’s from an expert.

Nothing from a plant is healthy? That sort of absolute statement flies in the face of history and common sense and I can't imagine it's true for all humanity.

Also figuring out when I'm "brain hungry" (brain is bored and wants to munch on something/get reward for hard day at work) and when I'm "body hungry" (body actually wants some energy and is slowing down, fingers/feet getting colder etc.).

I can easily eat 7-8,000 calories in a day, and there's no amount of stairmaster can fix that.

I've also previously taken modafinil, and had situations where I've had caffeine having been caffeine-free for a while, and the appetite-suppression properties have me thinking "this is what normal people must feel like". I cannot wait until these drugs become available in the country I mostly live in.

Now getting some frozen pizza for dinner coz I'm lazy/don't have time no longer ruins diet pace for this week

> When I get that "brain is bored" style hunger I go for tea with a squirt of water enhancer in it lately.

Anything with a bunch of milk works well for me for quashing hunger. Weirdly enough I usually feel more hungry in the evening than morning next day (at the very least for first 1-2 hours)

I hear people following a carnivore diet have had success in dealing with this satiety issue. The only things you can eat with this diet are butter (or ghee), beef, and salt.

There is a claim that nutrient difficiency causes the scenario you are describing. Your body is being deprived of what it really needs with your current diet and requires more consumption to continue its search for a particular set of nutrients.

The carnivore diet is not a silver bullet but worth a try. I will also mention it is high protien, high fat, and zero carb which has been shown to result in massive weight loss in relatively short periods of time (counterintuitive, I know).

The high fat requirement is neglected when most first start this diet. People have been trained to fear excess fat so it does take extra directed effort to break out of the mindset.

Many manufacturers also remove fat so nutrition labels are more attractive to misdirected consumers ...this will generally lead followers of this diet away from overly processed foods (added benefit).

Why is it not a great idea?

Basically a keto diet, of course it works due to ketosis.

Cite for this, please?

https://en.wikipedia.org/wiki/Gluconeogenesis

[1] https://www.verywellfit.com/gluconeogenesis-2242007

This is what all the common advice doesn’t address.

The only thing that has helped for me in the past was an SNRI (sibutramine) that was later withdrawn from the market. Then all the weight came back.

> As for side effects: I've had some heartburn, but none of the other commonly reported side effects.

And I looked up the less side effects, it is a laundry list of gerd symptoms.

I can confirm, these symptoms will help you lose weight, but I mean that tounge in cheek, I hope this drug helps a lot of people but doesn't have much in the way of side effects.

But intuitively it does make sense, because one of the primary effects of the drug is slowing down gastric emptying, so it causing heartburn isn't exactly surprising.

Gerd was reported in 5% of Wegovy users compared to 3% in the placebo arm. It’s a risk but it’s not a huge risk.

Nausea especially in the first few weeks was more common, but it was only bad enough to cause <2% of people to discontinue the trial.

I think the mistake people make is they think they can go on a diet temporarily, then go back to the old eating habits and not get fat again. That is nonsense of course, which is why dieting doesn't work. Dieting implies something temporary and you need something permanent.

This is how I feel as a default, I am a perpetually skinny person. Thank you for putting this into words from your perspective in such a crisp way. I wish everyone would have the same (non dominating) relationship with food as a normal occurance (and not some immense mountain to continually climb.)

Also people who have never had an older metabolism. It's different. I was also skinny despite eating a ton and hardly exercising when I was 25. Everyone I know over about 30 can identify when their metabolism suddenly changed. Diet (and to a lesser extent exercise) advice from those who haven't hit their own wall yet is worthless for those who have. Those people need to stop over-generalizing their (limited) experience as universal truth.

People usually just start packing on a few pounds a year (or more) in their 20s and it adds up.

I did a “dirty bulk” while working at Trader Joe’s in my 20s. At the beginning I could barely eat one frozen mac and cheese. A month of heavy eating later and I could easily finish 2 and still feel hungry.

Im older now so I don’t eat like that anymore, but it is still very noticeable to me how easily I get full when I am dieting hard.

I have a similar experience.

There's something similar here I've noticed while testing myself in the past: At least for me, it seems like hunger occurs when the stomach empties by a certain percent of its last maximum. No matter if I barely eat anything, or eat until max capacity, hunger starts after my stomach empties a bit further, but it doesn't take until I'm actually empty (tested by the size of the following meal), and the hunger tends to end after reaching the last maximum. To use some made-up numbers to demonstrate, it's like I can bounce back and forth between 60% full and 90% full or 20% and 30% full, and once I've gone a cycle or two on either of those, the low ends of 60% and 20% make me feel equally hungry and the high ends of 90% and 30% equally full, but I've digested more when the baseline is on the higher end.

It can be difficult pushing from the higher range to the lower range though, have to ignore/squelch the hunger long enough to reach it.

I’ve had a weirdly similar experience due to wildly different histories.

When I was a kid I was on medication that f’ed with my appetite so I literally never learned what hunger was as a kid. As an adult and long off the medication, I just eat and don’t understand the signals my body produces.

When I was younger, I had a healthy and active body and didn’t notice my diet was bad until first I graduated and took a desk job then it accelerated with Covid when I became sedentary and snacks were constantly available. I put on weight very quickly.