Why Regulators Can’t Curb Social Media Hype for Weight Loss Drugs

Yves here. This post is from last week, but as someone who was once fat and has gone to great effort reverse that, I can relate to how hard it is to get and keep weight off, and thus how many eagerly take up weight loss products and schemes.

Abuse of diet aids is a long standing problem. One of the drugs mentioned here, Ozempic, is advertised a lot on old people TV, which means it has fat margins. It also has the usual long list of dangerous side effects. And this article claims the weight comes back once patients stop taking the drug.

Bodybuilders have long been fanatical about finding ways to get “ripped” for contests, so that community is a source of leading/bleeding edge approaches to lowering body fat (generally speaking, their approaches don’t get a following unless they work…with not much concern as to anything beyond short-term bad heath effects). When I was a kid, one of the methods that had a reputation for being effective was an ACE stack, aspirin, caffeine, and ephedra in a specific ratio. You had to cycle off one week out of four or two weeks out of eight for the metabolic stimulus to continue to work…which is not easy. Imagine dragging your unstimulated tail around. There was a weird partial crackdown: it became illegal to sell ephedra bu not illegal to buy it, so if you could find a source, you were not the one at risk. Ephedra was finally banned by the FDA in 2004.

A trainer at one of my gyms (who also sometimes did professional shoots) was hooked to an OTC weight loss product (perhaps one of the earlier formulations of Dexatrim but I think it had dexedrine as one of its active ingredients). He went all over Manhattan to buy up the last supplies.

I was told by someone years later that this trainer has signs of neurological damage. So yes, most of these potions are strong stimulants or mess with your liver and that’s not such a hot idea for any length of time.

I’d be curious if any readers have had first or second hand experience with Ozempic or other GLP-1 agonists.

By Darius Tahir and Hannah Norman. Originally published at KFF Health News

Suzette Zuena is her own best advertisement for weight loss.

Zuena, the “founder/visionary” of LH Spa & Rejuvenation in Livingston and Madison, New Jersey, has dropped 30 pounds. Her husband has lost 42 pounds.

“We go out a lot,” Zuena said of the pair’s social routine. “People saw us basically shrinking.” They would ask how the couple did it. Her response: Point people to her spa and a relatively new type of medication — GLP-1 agonists, a class of drug that’s become a weight loss phenomenon.

But she’s not just spreading her message in person. She’s also doing it on Instagram. And she’s not alone. A chorus of voices is singing these drugs’ praises. Last summer, investment bank Morgan Stanley found mentions of one of these drugs on TikTok had tripled. People are streaming into doctors’ office to inquire about what they’ve heard are miracle drugs.

What these patients have heard, doctors said, is nonstop hype, even misinformation, from social media influencers. “I’ll catch people asking for the skinny pen, the weight loss shot, or Ozempic,” said Priya Jaisinghani, an endocrinologist and clinical assistant professor at New York University’s Grossman School of Medicine.

Competition to claim a market that could be worth $100 billion a year for drugmakers alone has triggered a wave of advertising that has provoked the concern of regulators and doctors worldwide. But their tools for curbing the ads that go too far are limited — especially when it comes to social media. Regulatory systems are most interested in pharma’s claims, not necessarily those of doctors or their enthused patients.

Few drugs of this type are approved by the FDA for weight loss — they include Novo Nordisk’s Wegovy. But after shortages made that treatment harder to get, patients turned to other pharmaceuticals — like Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro — that are approved only for Type 2 diabetes. Those are often used off-label — though you wouldn’t hear that from many of their online boosters.

The drugs have shown promising clinical results, Jaisinghani and her peers emphasize. Patients can lose as much as 15% of their body weight. Novo Nordisk is sponsoring research to examine whether Wegovy causes reductions in the rate of heart attacks for patients with obesity.

The medications, though, come at a high price. Wegovy runs patients paying cash at least $1,305 a month in the Washington, D.C., area, according to a GoodRx search in late March. Insurers only sometimes cover the cost. And patients typically regain much of their lost weight after they stop taking it.

Hype Is Driving Demand

But patients are not necessarily coming to doctors’ offices now because of the science. They are citing things they saw on TikTok, like Chelsea Handler and other celebrities talking about their injections. It leads to the questions “how come she can get it” and “why can I not,” said Juliana Simonetti, a physician and co-director of the comprehensive weight management program at the University of Utah.

The excitement — which doctors worry may cause some patients to use medications inappropriately — is coming also from business interests. Some are doctors promoting their venture-capital-backed startups. Others are spas hawking everything from wrinkle-smoothing and lip-plumping to, yes, weight loss benefits of semaglutide, the active ingredient in Wegovy and Ozempic; their prices, often in the hundreds of dollars, are well below what consumers would pay if picking up the prescription at a pharmacy.

In the U.S., the FDA has oversight over ads from the pharmaceutical industry, which must acknowledge risks and side effects of drugs. But ads from people who write prescriptions don’t necessarily have the same restrictions. FDA regulations apply if the prescriber is working on behalf of a regulated entity, like a pharmaceutical manufacturer or distributor.

“The FDA is also committed to working with external partners, including the Federal Trade Commission (FTC), to address concerns with prescription drug marketing practices of telehealth companies on various platforms, including social media,” agency spokesperson Jeremy Kahn emailed KFF Health News.

Pharma firms run campaigns to educate health care professionals or raise “awareness” that may indirectly tout drugs. Novo Nordisk has an ongoing internet campaign to redefine and destigmatize how Americans think of obesity — and, left unmentioned, the drugs that treat it.

KFF Health News also found that, beyond the industry group’s examination, at least two other entities were promoting Novo Nordisk products in the United Kingdom.

Australian regulators have taken down nearly 1,900 ads as of early March for improperly plugging various GLP-1 agonists, an agency spokesperson told KFF Health News. Novo Nordisk says it didn’t put up the ads, the majority of which were for their product Ozempic. The regulators are declining to say who’s involved.

Doctors are also sounding alarms about the publicity. They believe patients will be driven to use these medications off-label, obtain unreliable forms of these drugs, or exacerbate other health conditions, like eating disorders. The drugs act in part as an appetite suppressant, which can dramatically reduce calorie intake to a concerning degree when not paired with nutritional guidance.

Elizabeth Wassenaar, a regional medical director for the Eating Recovery Center, believes the drugs and associated advertising buildup will inadvertently trigger eating disorders. KFF Health News found ads showing thin patients measuring themselves with a tape measure and stepping on the scale, with accompanying captions goading viewers into going on GLP-1s.

“They’re being marketed very, very pointedly to groups that are vulnerable to experiencing body image dissatisfaction,” she said.

Remi Bader, a curve model and TikTok creator specializing in documenting her “realistic” clothing buys, told one podcast her story of coming off a “few months” on Ozempic. She said she gained twice the weight back and that her binge eating disorder got “so much worse.” One study, published in the journal Diabetes, Obesity and Metabolism, found two-thirds of lost weight came back after discontinuation of semaglutide.

But social media users and influencers — whether with white coats or ordinary patients — are hopping on every platform to spread news of positive weight loss outcomes. There are those, for instance, who had gastric bypass surgery that didn’t work and are now turning to TikTok for guidance, support, and hope as they begin taking a GLP-1. There’s even a poop-centric Facebook group in which people discuss the sometimes fraught topic of the drugs’ effect on their bowel movements.

Commercialism and Compounding Spark Excitement and Concern

Some have been so delighted by their medication-assisted weight loss they have become brand ambassadors. Samantha Klecyngier has dropped at least 58 pounds since she started on Mounjaro. She heard of the drug and her telemedicine weight loss program, Sequence, on TikTok. She and many others who have experienced considerable weight loss since starting the medication regimen point to its positive impact and their improved quality of life. Now she officially promotes the company on the app.

Though Klecyngier, a mother of two from the Chicago area, is not diabetic, she uses Mounjaro. When she was growing up, her parents had Type 2 diabetes and other chronic diseases that led them both to have open-heart surgery. Her father lost his life to complications of diabetes. She wants to avoid that fate.

But Klecyngier’s story — combining a personal journey with a profit-making entity — is symbolic of another trend on social media: commercialism. There’s a spate of startups eyeing big money matching pharmaceuticals and related support with patients. (Sequence, the company Klecyngier pitches, just got acquired by WW, also known as WeightWatchers.)

Some doctors use social media to educate viewers about the drugs. Michael Albert, chief medical officer of telehealth practice Accomplish Health, says offering information to his more than 250,000 followers has helped point patients to the medical practice. It’s received thousands of patient inquiries, more than the clinic can take on.

Companies like Accomplish — startups with well-credentialed doctors — are the glossy side of this social media boom.

But there are others — like many spas and weight loss centers — that offer the drugs, sometimes without much medical support, often alongside Botox and dermal fillers. Obesity doctors worry such marketing is creating unrealistic expectations.

Some spas and telemedicine operators claim to have “compounded” semaglutide. But compounding — when pharmacies, rather than drug manufacturers, prepare a drug — is a risky proposition, doctors caution. “The risks are enormous,” Simonetti said, warning of potential contamination from poor compounding practices. “The risks of getting bacteria,” she warned, “the risks include death.”

Weight loss clinics also frequently tout unconventional additions to semaglutide, including vitamin B12 and amino acids. Some patients incorrectly believe the former helps with nausea, Jaisinghani said; other clinics tout greater weight loss.

Novo Nordisk spokesperson Allison Schneider told KFF Health News in an email that the company shares doctors’ concerns about compounding and that it’s begun sending letters warning “certain Health Care Providers” about the related risks.

Some operations defend their use of often-cheaper compounded drugs. LH Spa & Rejuvenation, founded by Zuena, offers a compounded semaglutide formulation from QRx Weight Loss for $500 over four weeks. The spa learned about the regimen from a doctor. “I’m purchasing it,” Zuena said. “It comes next-day air in legitimate vials with lot numbers, expirations.” Patients’ injections and dosages are overseen by on-site medical staff.

Most operators in this burgeoning industry are keen to emphasize their products’ high quality or their company’s good works, as they seek money. Ro, a telehealth firm offering GLP-1s, said its marketing campaign in the New York City subway “aims to start an important, sometimes difficult, conversation focused on de-stigmatizing obesity as a condition.”

This widespread tactic is nothing short of maddening for pharma industry critics. “They talk about trying to destigmatize obesity at the same time they’re talking about losing weight. They’re co-opting the concept,” said Judy Butler, a research fellow at PharmedOut, a Georgetown University Medical Center project focusing on evidence-based practices for drugs. “They’re trying to sell a weight loss drug.”

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  1. PlutoniumKun

    I just happened to read this just after reading an unusually good and sensible diet article in the Guardian by Tim Spector who is a nutritionist with a good grounding in science:

    Eat Fibre first and ditch the juice.

    Competitive cyclists are also a mine of often dubious information on weight loss, although unlike body builders they are less concerned with losing upper body muscle too, which is not a great idea. The traditional and very effective way was a 2 hour morning ride on a single espresso. They also tend to advocate undernourishing on exercise days and eating well on rest days which is very tough for anyone but a dedicated athlete.

    Fasting was always my favourite approach, but some of the latest research seems to point against the internets favourite method – intermittent fasting. It seems the latest studies question whether the benefits are due to anything other than eating less because of the time restrictions. I think the key is to minimise eating later in the evening – there is clear evidence that our bodies are more efficient at using incoming calories when taken earlier in the day. I think it now seems that fasting is only really effective when the fasts extend more than 24 hours, but this isn’t doable for many people. The benefits are, however excellent, so long as you are very careful to maintain a high level of nutrition and, in particular, take plenty of protein. Its also important to ‘mix up’ your eating schedule to ensure your metabolism doesn’t adjust in the wrong way. It does seem that ‘shocking’ the body with non-routine fasts is the most efficient way to get the proven benefits.

    Personally, I find a morning smoothie with a good helping of vegan protein powder is a very effective way of filling myself up and reducing hunger later, so long as you are careful not to drink too fast (this spikes insulin). I make my own as I just don’t trust so many formulations – I mix raw pea protein with raw chocolate, green tea, some nuts and frozen blueberries. I use the leftovers as a base for a smoothie later, usually with greens, etc.

    Of course, these new drugs may work well, but as with all supplements, they tend to have the effect that people use them to avoid lifestyle changes, which is the only proven way to keep your weight down without losing muscle mass and modern diseases at bay.

    1. Objective Ace

      some of the latest research seems to point against the internets favourite method – intermittent fasting. It seems the latest studies question whether the benefits are due to anything other than eating less because of the time restrictions.

      I never understood this “arguement”. It’s not an arguement against intermittent fasting, it simply explains the mechanism with which it works. if anything, its an arguement for intermittent fasting. If you need another reason besides weight loss, intermittent fasting also silences mTOR and activates autophagy–cleans out all the old proteins, damaged cells, and other gunk we dont want accumulating in our bodies.

  2. KLG

    Different drug classes, but does anyone remember Fen-Phen? Different approaches to weight loss work. For me it was ditching the extraneous carbohydrates (soft drinks; bread, which “whole wheat” or not is mostly glucose) and eating more protein and fat. Lost 25 pounds without ever feeling hungry. Yes, n = 1 but the experiment worked. Cholesterol and triglycerides remained well in the “safe” range, but that is probably a simple matter of genetics.

    An endocrinologist colleague is alarmed at the abuse of Ozempic and these other drugs. Medical students who are on social media more than I am (i.e., all of them) are following this closely. This might not end well?

    Regarding bodybuilders, I have known many. My earliest memories are that “isometric” exercise was a key. Turned out most of these gym rats were also using anabolic steroids. After a while they were very easy to spot.

    1. CanCyn

      I too find sugar and the processed carbs like wheats/grains that become glucose are the enemy when it comes to my own weight loss/maintenance. I lost over 30 pounds almost effortlessly, eating decent whole foods, no worries about fatty meats, way more veggies than fruits all the while all my blood ‘numbers’ (cholesterol, triglycerides, sugar levels, etc) all moved into and stayed in the healthy range. No doubt calorie input and output have something to do with weight management but calories are not the whole story. I firmly believe that we know little about human nutrition because it is yet another thing no one can profit from, hence all the weight loss drugs.
      As has PK I have found intermittent fasting to be of some use. I am sleeping better these days now that I usually stop any kind of eating or drinking by 7pm. Fewer nighttime trips to the bathroom and just generally a more restful sleep.
      My current goals are focused on fitness after some years of pandemic sedentariness aside from walking, my body has lost strength and muscle tone. As with nutrition, I find sifting through the plethora of stuff about exercise and fitness on the net more helpful than the traditional advice that our doctors provide. Through various sources I have landed on a routine that includes daily walking and 1 weekly session of high intensity aka HIIT) activity for cardiovascular health. Weight training for strength and yoga for mobility. The yoga and walking are the only things I’ve done long term, the HIIT and weights are new so it is too soon to discuss benefits. As a 61 year old I know that strength and agility can only help with avoiding the falls and sedentary ways that plague many elders. I simply want to be able to do what I want/need to do physically for as long as possible.

  3. The Rev Kev

    Can’t say that I am a fan of using drugs to lose weight. Probably it would be a good idea for some people but most people no. You see people use drugs or special diets or whatever and their weight yo-yos as they take it off, put it back on again, and then take it off yet once more. I could stand to lose a few kilos myself so will just use a moderated intake of food. So basic things like no snacking between meals, no eating just because you’re bored, cutting back on coffee, etc. When I do this the weight drops off at a steady rate. If I have a celebratory meal or a treat, it is only a blip and will be absorbed anyway. Some people recommend fasting and that probably works too as part of a regualr dietary regime. In other words, just basic rules that are part of your permanent life style and not something to be done like a crash program. If given a choice between a peanut butter sandwich or an apple, you already know which you should choose without looking it up online or using an app. Some people need extra help because of their physique but most people can get it done.

  4. SocalJimObjects

    Sometime last year, I wrote a post about how I had successfully lost quite a bit of weight, like basically going from a BMI of around 31 to around 24. The good news is that I’ve managed to keep the weight off, but further attempts to lose more weight have not worked out. Nowadays I am walking more steps than ever like around 20K to as many as 30K steps a day (as opposed to 10K to 15K) while keeping my food intake the same, but sadly it appears that my body has plateaued in its ability to shed more pounds.

    Wondering if anyone has any practical tips in rebooting the body’s metabolism? I am now actually considering to eat MORE, but at the same time, I am afraid that I’ll just become fat again.

    1. Noor Safi

      As someone who deliberately cuts around 5-9kg every spring after a autumn/winter bulk, I’d recommend counting your calories for a week or so while weighing yourself – if you aren’t losing weight, cut 100 calories and check over the next week.

      However, you shouldn’t be trying to lose weight for too long a period. After about 3 months at the most, spend two weeks eating at maintenance (you’ll have to discover this as well, whatever calorie intake that doesn’t cause your weight to fluctuate).

      Incline walking is a great way to burn calories and raise your heart rate without leaving you feeling either lethargic or hungry – as HIT cardio tends to do.

      31 to 24 is a fantastic cut, it likely isn’t working anymore because your body has adapted over time. Eating at maintenance is important to undo these adaptations and bring your body back to a baseline. A caloric deficit has additional negative impacts that accumulate the longer the cut goes on for.

      1. James

        HIT cardio makes you hungry until your body adjusts to it – for me this took about 6 months. I am a big believer in exercise and I am skeptical of drugs and very skeptical of diets.

    2. CanCyn

      It may be what you’re eating as much as how much. If you’re eating carbs I suggest you cut them try a ketogenic diet. And if walking is your only exercise you should add some weight training and a weekly HIIT workout. The keto diet can help you switch from glucose burning for energy to fat burning and the weight training and HIIT will give your metabolism a boost.

      1. Arizona Slim

        That diet worked for me. As in, I shed 7-10 unwanted pounds in a couple of months.

        Nowadays, I call myself keto-friendly rather than keto-militant. And that works for me too.

    3. Antagonist Muscles

      High intensity interval training (HIIT) is great exercise as noted by CanCyn above. SocalJimObjects’s comment implies a certain rigidity when it comes to exercise, in particular walking. You only have a limited amount of time dedicated to exercise each day. If you walk 10k, 20k, or 30k steps, those increased amount of steps take a lot of time and its value quickly tapers off, reaching the point of diminishing returns.

      I don’t know the reason why you are not running. Typical reasons are: (1) it hurts my knees and joints, (2) I already have musculoskeletal injuries, (3) I am overweight, (4) I am too old, (5) I just plain dislike running. Nobody is saying you have to run. You can bicycle, swim, row, play tennis, play soccer, etc.

      Nevertheless, let me focus on HIIT and running just for a moment. Here is the exact exercise I did this morning before I read NC.

      1. Lap | n/a | 1 | 2.30.00
      2. Pullup | BW | 5 | {
      3. Parallel bar dip | BW | 5 |
      4. Pistol squat | 20 | 5 | 3.00.00}

      BW – body weight; second column – weight; third column – repetitions; fourth column – time. Sorry for the formatting. I don’t know how to force a monospaced code block in WordPress. Moderators?

      Repeat 1-4 three or four times, which means 16.30.00 or 22.00.00 minutes total. The lap around the park has two points where I sprint for 5-10 seconds. Congratulations, you are in pretty good shape if you can do all this.

      I always dislike how gyms force me to segregate my aerobic and anaerobic parts of my workout. In this particular complex workout, I deliberately combine running and strength training. My heart is elevated for 16+ minutes. I likely have crossed the threshold where my body is burning fat. Whatever glycogen reserve I have is being taxed from the strength training.

      If you are repeatedly doing the same exercise, your body just adapts and you get decreasingly less benefit from exercise. Thus, if you can only dedicate twenty minutes of time for exercise daily, you had better choose twenty minutes of tough exercise. Even I have to change my exercise routine occasionally, in order to push my body (and mind) to new limits. Bruce Lee said it best:

      Use no way as a way. Use no limit as a limit.

  5. A guy in Washington DC

    As a former semi-blimpo-American, I’d like to state the obvious. If you put more gallons of gas in the car than you burn by driving the car, eventually you will need a bigger gas tank.

    Gallons in = Gallons out (+ or – retained gasoline)
    Calories in = Calories out (+ or – weight gain)

    And I totally congratulate Yves for saying “the word that dares not speak its name” when she says:
    “as someone who was once fat and has gone to great effort reverse that, I can relate to how hard it is to get and keep weight off, and thus how many eagerly take up weight loss products and schemes.” Ruthless truth is what I love about NC.

    I have no solutions for you. As for me, I eat out rarely and never order takeout. I am a slave to what is in my refrigerator but I control what goes in the refrigerator. I exercise moderately and keep track of the exercise. I try to slowly increase the amount of exercise. Sometimes I fail, but at least my records remind me of my failings. And a stretching class occasionally reminds me that I need to stretch.

    And as for advertising, anyone who in any way gets compensated is a shill. And the Federal Trade Commission can regulate that.

  6. Telee

    I think a consideration of what food we are eating should be part of the conversation. It is estimated that in the US, 70% of the foods of the foods we eat are highly processed and loaded sugar, salt, and highly inflammatory seed oils and chemicals. This is the bulk of what is available at supermarkets. The strategy of the food industry is to attract our taste buds so that sales will be made. Their first priority is not promoting good health.
    I recall that when I was young, obese children were a rarity. Friends my age agree with this observation. Over the last several generations, the diet of many people has radically changed.

    1. Piotr Berman

      Excess weight at young age may be a real problem, and sensible nutrition that would keep cravings away.

      For example, very few cereals lack added sugar. I use Grape Nuts, simple formulation, whole grain sweetened a bit by malting, with an extra benefit that I need to bike 2 miles one way to get it, with a pleasant route. In any case, response to diet varies, one person is OK with periodic fasting, another does better with a constant routine that does not include binges.

      Scientifically, it would be valuable to compare what changed from days when the predominant BMI was much lower than today. Some differences presumably matter. It is not like the supply of weight loss pills or supplements was so much better in those days.

    2. James

      I lived in Warsaw for a year in 1997. Everyone was slim. There were essentially no western or processed foods available – western style supermarkets were just starting to open. (OK – there were a couple of McDonalds and Dominos Pizza places, but the average Pole could only afford to eat there once or twice a year.)

      When I returned to Warsaw for a wedding in 2012 the people were eating a western diet and looked completely different. The fourteen year old girls were chubbier than their mothers – as in much chubbier.

    3. Tim

      The core problem of obesity in this country is not big boned people, it is addiction pure and simple.

      Physical addiction, not just mental. These engineered foods, engineered to taste good are indeed the source.

      The problem with food addiction has always been that you can’t quit it cold turkey. Resolving a physical addiction through moderation is nearly impossible for homo sapiens, and despite being built like a twig, I really sympathize with these individuals.

      These new drugs deal with the physical addiction, they deal with the craving/hunger.

    4. JBird4049

      Look why the FDA or the Food and Drug Administration was created a century ago. Just do not do it when eating. To me, it is likely that all the additives now in food that was not fifty years ago is a major cause. When the corn syrup that is in most of the processed foods both because people are more likely to again by it and because Big Agriculture needs someway to get rid of all the extra corn that they grow.

      While less physical activity and stress eating are also causes, the creation of Frankenfoods are also a reason; do not think that companies would not deliberately poison their customers. Again, look at the history of food before government regulations and I believe that the FDA is one of those agencies that is under regulatory capture.

  7. Brooklin Bridge

    I was lucky. When I reached 210 Lbs and was supposed to weigh 170 or thereabouts I stopped eating on Mondays. Nothing else, no diets, no calorie counting, just 24 hrs. with only water and juice. The reason I’m lucky is because if I get interested or absorbed in something I just don’t think about eating or at least enough so that I could tolerate those fasts. It wasn’t always easy. My willpower is probably a little lower than that of others, certainly no higher. After about 3 months of that I was down to 180. At that point I stopped the fasting and after a while went back up to 190 but oddly didn’t go all the way back to 210. Then more recently age hit along with tragedy. Over the last four years, I lost appetite and went down to about 140 and have since come back up to about 155. I don;t have that much interest in eating except when hungry (and the few cookie or cheese binging exceptions to that don’t seem to do anything).

    Along the way, somewhat aside from the above, one thing became very real to me through watching others. When you have to cook for people in the household as part of your daily routine, it’s incredibly difficult to stop eating or counting calories, or sticking to exercise programs or what ever, and even more so to stop binging especially if one is prone to it the first place. This is something to remember keenly when trying to encourage others such as taking on or sharing some of those chores if possible.

  8. MaryLand

    I’m no expert by any means, but I lost 30 lbs. in a year’s time. Too slow for most people, but slow and steady wins the race. Also I am not that young, so losing slowly helps the skin adjust. When I hit a plateau for a month or so I would stop being so careful about what I ate and allowed myself some treats for about 10 days. Then when I went back to eating more sensibly I started losing again. That doesn’t always work, but it also gets me motivated again since I don’t feel totally deprived. I am a rebellious person by nature and rebel against any strict diets. The only way I can do it is to not measure anything or limit portions. I just observe what seems to work and choose more of those foods that I “discover “ work for me. It’s the only way I have been able to lose. As has been said, emphasize foods that are not highly processed, cooking from scratch when possible. And I have to keep certain foods out of the house that trigger binges. Never totally easy, but I can work with it this way.

  9. Asburn

    My daughter suffered from ADHD, anxiety, and depression. She was under the care of doctors and psychologists for some years, usually accompanied with a cocktail of prescribed drugs. All of this was of little help. She finally weaned herself off the medications, including Adderall, which had suppressed her appetite. Not surprisingly, she quickly gained a lot of weight.

    About a year and half ago, she began a program at a local gym with a personal trainer that consists of mostly weight training with some cardio. The results have been amazing. She has lost over 35 lbs, without any real dieting, has become more self confident, and shows no signs of depression at all. She is enrolled at the local community college and has a part time job. Just an amazing transformation for someone who barely made it through high school due to her anxiety.

    Regular healthy exercise along with the immediate feedback from increasing her strength and seeing her visible weight loss has been far more beneficial than the small fortune we spent on her medical care and pharmaceuticals.

  10. Ashburn

    My daughter suffered from ADHD, anxiety, and depression. She was under the care of doctors and psychologists for some years, usually accompanied with a cocktail of prescribed drugs. All of this was of little help. She finally weaned herself off the medications, including Adderall, which had suppressed her appetite. Not surprisingly, she quickly gained a lot of weight.

    About a year and half ago, she began a program at a local gym with a personal trainer that consists of mostly weight training with some cardio. The results have been amazing. She has lost over 35 lbs, without any real dieting, has become more self confident, and shows no signs of depression at all. She is enrolled at the local community college and has a part time job. Just an amazing transformation for someone who barely made it through high school due to her anxiety.

    Regular healthy exercise along with the immediate feedback from increasing her strength and seeing her visible weight loss has been far more beneficial than the small fortune we spent on her medical care and pharmaceuticals.

  11. Savita

    I’m not a fan of Tim Ferriss really. Because of his values and ethics primarily, which includes the people he considers heroes. However one of the earliest things he did really does belong to him, and continues to be the most impressive thing he has achieved. It’s an eating approach he calls the Slow Carb diet. He collected data from thousands of practitioners of it. And has collected scores of before and after pictures and tons of testamonials. Apparently its an approach to eating now chosen by professional athletes, professionals in the entertainment industry. The book 4 Hour Body by Tim Ferriss goes through it. His next book 4 Hour Chef has lots of suggestions for implementing, plus some easy ‘one pager’ guides to applying the slow carb diet. And every second personal trainer has a blog hawking it now so the internet will help although the books are best
    The 4 hour body book has the more thorough detail. He explains why ‘calories in, calories out’ is incorrect amongst a lot of other background. How does the eating plan work? It’s cleverly designed with compliance in mind. And exercise is not required, its only supplementary if desired. It’s not a diet, its a lifestyle choice to follow indefinitely.
    The overall view is keep insulin steady. That’s the atmospheric view.
    The guidelines are, Protein with every meal. At least two or three meals a day. Work out a few meals that suit and eat the same ones every day. No carbohydrates, so no juice, no fruit, no grains. and only specific vegetables that are not starchy. Eat whatever you want from the list of approved foods, and eat as much as you want. No calorie or food counting. A glass of red wine at night is fine.
    And a cheat day once a week. For psychological reasons obviously. The most controversial aspect. But he learnt this from bodybuilding. It’s proven the insulin spike is neessary to defeat a plateau. It creates certain hormonal changes after having followed a low carb diet for a period.Ferris has demonstrated this metabolic spike unequivocally increases fat loss mechanisms. There are some other interesting tweaks he learnt from bodybuilders, such as depressing the blood sugar levels before eating, and doing some optional standing squats 15 minutes prior to eating, for glucose metabolism. But these are optional. Tens of thousands of people have reported achieving really rapid weight loss in short periods of time, through this method of harmonising the regulatory systems in the physiology. Like the body just ‘finds its way’ again and surplus baggage just falls away in response. I’m not going to say ‘metabolism’ because thats what wikipedia might call a weasle word in this field and I’m not qualified to say its the correct word. But reorganising the bodily use and application of glucose is in essence the strategy behind the eating plan. By regulating insulin levels. I think the Slow Carb diet is the one outstanding thing Ferriss will forever be remembered for providing.

  12. Anonymous lifelong fat guy

    First hand experience with semaglutide:
    – constant, deep, nausea.
    – loss of balance
    – insane cravings for refined carbs
    – loss of appetite for protein, couldn’t look at high protein foods like lean meat.

    Studies show serious muscle loss with high ratio of muscle to fat lost.

    I quit after 2 months. You couldn’t pay me to start again. I’m convinced this is seriously bad stuff.

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