FDA approves once-weekly 2.4mg semaglutide for chronic weight management

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everydayupsanddowns said:
This discussion reminds me of the thread that followed the Dr Chris van Tulleken programme ‘what are we feeding our kids’.

Part of ultraprocessing is to improve texture, flavour etc. Part of it is to extend shelf life, and make things easier / effortless to cook or reheat. Ingredients you wouldn’t find in a domestic kitchen, and ingredient lists that number dozens of ingredients. And the proportion of the average shopping basket that fits that category is increasing.

And that study (the name of which escapes me) showed that people on average ate 500 calories a day more of ultraprocessed foods, than the moderately or minimally processed alternatives. But as @mikeyB says, they still don’t really know why this it. Certainly the presenters n=1 month long 80% ultraprocessed experiment didn’t do him any favours. And his brain showed new ‘addiction-like’ connections. After 4 weeks.

So while there certainly is a degree of personal responsibility, there is also no point in continuing to stigmatise and shame people who are genetically predisposed to be attracted to those foods, and living in a ‘food environment’ where those are cheap, ubiquitous, easy, and borderline addictive.

The shaming-it’s-all-your-own-fault approach has had 20-30 years to have shown how well it works. And here we are.
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Like that program though, it doesn't make sense to blame the food. These are the ingredients from the vege mince. Ultra processed, I'd have it again, but it doesn't replace real mince.
I think they nailed it in the study. There was less protein, and more fat and carbs in the "processed" food.
So to eat the same amount of protein daily, which they did, they had to consume more food overall.
And obviously some of it does taste better, but that's not the consistent thing.
 

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travellor said:
Like that program though, it doesn't make sense to blame the food
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Is it blame? Or simply making observations?

There seems to be an association between consuming higher proportions of ultraprocessed foods, and negative food-related outcomes, where people find it harder to control their appetites, and the food itself doesn’t seem to support health.
 
everydayupsanddowns said:
Is it blame? Or simply making observations?

There seems to be an association between consuming higher proportions of ultraprocessed foods, and negative food-related outcomes, where people find it harder to control their appetites, and the food itself doesn’t seem to support health.
Click to expand...

Just edited the previous post.
We crossed I think.
"I think they nailed it in the study. There was less protein, and more fat and carbs in the "processed" food.
So to eat the same amount of protein daily, which they did, they had to consume more food overall.
And obviously some of it does taste better, but that's not the consistent thing."
 
travellor said:
Just edited the previous post.
We crossed I think.
"I think they nailed it in the study. There was less protein, and more fat and carbs in the "processed" food.
So to eat the same amount of protein daily, which they did, they had to consume more food overall.
And obviously some of it does taste better, but that's not the consistent thing."
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I think this is the "protein leverage" model which IIRC Kevin Hall dismissed as a possible explanation for the results - maybe go back and check out his commentary, where he basically goes through a bunch of possible explanations & doesn't get enthusiastic about any of them.
 
For a review setting out the detailed brain science behind "Wegovy" as it stood at the start of development (if not any kind of rational explanation for the name) see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888559/

I glaze over about 20% of the way in, but my takeaway is just how much very detailed knowledge has been built up in a short time. Thanks to imaging tech, and the sacrifice of many rats.
 
Eddy Edson said:
I think this is the "protein leverage" model which IIRC Kevin Hall dismissed as a possible explanation for the results - maybe go back and check out his commentary, where he basically goes through a bunch of possible explanations & doesn't get enthusiastic about any of them.
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It would be interesting to see if a high protein diet led to a reduction in calorie intake.
Although "low carb high protein" seems to be the new "low carb high fat" at the moment.
 
travellor said:
It would be interesting to see if a high protein diet led to a reduction in calorie intake.
Although "low carb high protein" seems to be the new "low carb high fat" at the moment.
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I think there are studies supporting protein and fibre as the most satiating food components, and there are a bunch of credible people (eg the Guyenet guy referenced above) who say that upping protein can help reduce calorie intake.

BTW, the same studies don't give any support to the idea that fats are more satiating than carbs; that seems to be just more low-carb cult woo.
 
Eddy Edson said:
I think there are studies supporting protein and fibre as the most satiating food components, and there are a bunch of credible people (eg the Guyenet guy referenced above) who say that upping protein can help reduce calorie intake.

BTW, the same studies don't give any support to the idea that fats are more satiating than carbs; that seems to be just more low-carb cult woo.
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The vege mince was actually fairly high protein, high fibre, and indeed very filling.
It needed onion, garlic, chilli, and I stuffed them with a blue cheese, taste wise was poor by itself, but it worked overall with a salad.
 
travellor said:
It would be interesting at least.
20 percent fat mince, with a couple of Oxo cubes and an onion, spooned over pasta?
Or drain the fat off first.
Less than 100g of meat each, saving some for tomorrow.
I don't think I'd like to eat it, so that would save some too.
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Yes, drain the fat off.
You can easily bulk it out by adding some frozen veg or replace the oxo with some sauce.
As for the pasta, you could easily drizzle it in garlic butter you can make yourself for next to nothing in seconds. Alternatively add some kidney beans and change the pasta for boiled rice. Again, all for just a few pennies.

The point is that we can't keep blaming cost.
It's a problem of education and overcoming inertia in people.
 
everydayupsanddowns said:
So while there certainly is a degree of personal responsibility, there is also no point in continuing to stigmatise and shame people who are genetically predisposed to be attracted to those foods, and living in a ‘food environment’ where those are cheap, ubiquitous, easy, and borderline addictive.

The shaming-it’s-all-your-own-fault approach has had 20-30 years to have shown how well it works. And here we are.
Click to expand...

I am not sure there's any credible mileage in the genetically pre-disposed argument to be fair.

There's a difference between shaming people and highlighting the root cause of obesity and as a society we're not great at recognising the difference. I'm not sure how helpful it is going to be to avoid mentioning the elephant in the room which is over-eating the wrong types of food.

I do think the solution might be some form of hands-on community-based education night classes teaching cooking in a social environment. If that's combined with showing how to cook fresh food at low price with demonstrations of portion sizes and it's done in a supportive and fun environment where peopke see it as a night out then I'm sure that will work.
 
Nice idea, getting the poor folk out to night classes. Where? No money for buses or a cab. And who looks after the kids? Who pays for the fridge at home? Who pays for the cooker? Many people have neither.

It’s a non starter as long as there is a government in England which is happy that the rich get richer, as they have in this lockdown, while the poor get poorer, and dread the day when the £20 a week boost to Universal Credit during the pandemic gets taken away. It’s not that the government can’t afford it - they spend £1820 per second on nuclear weapons, for example. Just for fun, work out how many seconds there are in a year. Your tax money.
 
mikeyB said:
Nice idea, getting the poor folk out to night classes. Where? No money for buses or a cab. And who looks after the kids? Who pays for the fridge at home? Who pays for the cooker? Many people have neither.

It’s a non starter as long as there is a government in England which is happy that the rich get richer, as they have in this lockdown, while the poor get poorer, and dread the day when the £20 a week boost to Universal Credit during the pandemic gets taken away. It’s not that the government can’t afford it - they spend £1820 per second on nuclear weapons, for example. Just for fun, work out how many seconds there are in a year. Your tax money.
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This is a discussion about obesity.
My point is that the biggest source of that comes from over-eating and choosing pizzas, cakes and takeaways over significantly cheaper home-made food.

I have no doubt that there are people in the country who don't have fridges, cookers etc but it's probably best not to divert the thread with a totally different subject.
 
pm133 said:
I am not sure there's any credible mileage in the genetically pre-disposed argument to be fair.
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Well there is research which suggests that 40-70% (iirc) of a person’s propensity to gain weight may be genetically influenced.

There are known genetic markers which influence and control taste and the sorts of flavours, textures, and foods which you are drawn to, along with those that control and influence a person’s sense of fullness and also appetite. In addition there are genes which control what happens to the food and energy a person takes in, and how readily they convert to adipose tissue, and where that ends up

I can’t remember now if it was a paper I read, or just a sound bite in a TV programme. But it certainly caught my ear.

I suspect it’s not all nature, and not all nurture, but is a complex balance between the two. But I am satisfied that the degree to which a person has a ‘sweet tooth’ or is ‘naturally slim’ is at least in no small part down to their genes. After all, at some stages in human history the ability to easily lay down fat stores against famine periods would have been an evolutionary and survival advantage.
 
I’m not a great believer in the theory that laying down fat in humans is a survival advantage to any significant degree. That’s what some animals that hibernate do. We can’t hibernate. Obesity would be significant disadvantage in human history - if you can’t run and hunt, or toil in the fields you would be a drain on society, such as it was. And life was short, by modern standards.

Archaeologists don’t dig up bones with the markers of obesity, and in recorded history obesity was a privilege of the idle rich. Henry VIII changed from an athletic youth to a fat layabout. George IV had a prodigious appetite, and was much mocked and scorned by a newly literate populace. Who by and large, couldn’t afford to get fat.

Even when I was a lad, being thin meant you were poor. The only kid at my junior school who was overweight had a dad who owned a crisp factory.

Having said all that, what does it add to the nature or nurture debate?
 
.... and the only fat little girl at my junior school was the youngest child of the garage round the corner's owner - she had 4 older brothers, all of whom also worked there - and all evidently spoiled her rotten and treated her to sweeties and new toys at will (apparently) - but having said that, she then grew up into a very normal, slim, unselfish and hard working adult!
 
We all know someone who can eat anything, and never put on weight, and we all know someone on a permanent diet.
 
everydayupsanddowns said:
Well there is research which suggests that 40-70% (iirc) of a person’s propensity to gain weight may be genetically influenced.

There are known genetic markers which influence and control taste and the sorts of flavours, textures, and foods which you are drawn to, along with those that control and influence a person’s sense of fullness and also appetite. In addition there are genes which control what happens to the food and energy a person takes in, and how readily they convert to adipose tissue, and where that ends up

I can’t remember now if it was a paper I read, or just a sound bite in a TV programme. But it certainly caught my ear.

I suspect it’s not all nature, and not all nurture, but is a complex balance between the two. But I am satisfied that the degree to which a person has a ‘sweet tooth’ or is ‘naturally slim’ is at least in no small part down to their genes. After all, at some stages in human history the ability to easily lay down fat stores against famine periods would have been an evolutionary and survival advantage.
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I found a link talking about that claim (see below). It's talking about "heritability estimates" of 40-70% being needed. I'm not sure that this necessarily means that genes contribute 40-70% towards obesity. In fact, I'm pretty certain it doesn't mean that.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955913/

I did quickly dig up a piece of recent research published in the BMJ 2 years ago (see link below) by some Norwegian researchers who did find a genetic link.
They found that there is a genetic link for higher BMI's but they also found that those without those genes also increased their BMI (although I think to a lower degree). Their overall conclusion was that environment was the main contributor and I think that seems a reasonable conclusion.

https://www.bmj.com/content/366/bmj.l4067

As an aside, I do wonder if genetic differences in obese people are being driven by over-eating poor quality foods rather than genetic differences driving obesity. That would be an interesting piece of research on its own.
 
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