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self_made_human

amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi

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joined 2022 September 05 05:31:00 UTC

I'm a transhumanist doctor. In a better world, I wouldn't need to add that as a qualifier to plain old "doctor". It would be taken as granted for someone in the profession of saving lives.

At any rate, I intend to live forever or die trying. See you at Heat Death!

Friends:

A friend to everyone is a friend to no one.


				

User ID: 454

self_made_human

amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi

16 followers   follows 0 users   joined 2022 September 05 05:31:00 UTC

					

I'm a transhumanist doctor. In a better world, I wouldn't need to add that as a qualifier to plain old "doctor". It would be taken as granted for someone in the profession of saving lives.

At any rate, I intend to live forever or die trying. See you at Heat Death!

Friends:

A friend to everyone is a friend to no one.


					

User ID: 454

Starting an infamously difficult and lengthy modded campaign after becoming a new dad?

Sure. Why not.

"I can no more remember all the books I've read than I can all the meals I've eaten, but they have made me nonetheless."

Feel free!

Well, it's true everywhere I've cared to look. Definitely everywhere I've ever been.

At that point, biology becomes the most parsimonious candidate.

To quote a line usually attributed to Kissinger: “Nobody will ever win the battle of the sexes. There’s too much fraternizing with the enemy.”

Man would know. Mao once jokingly offered the United States ten million Chinese women, and Kissinger responded by proposing to study their “utilization and allocation”. Presented with ten million prospective ABG baddies, the man commissioned a feasibility study. You can take the professor out of Harvard.

His name was also literally Kissing-(h)er. He'd know.

I, as a rule, tend to avoid the gender wars. I have too much sympathy for the opposition. I’m half-woman on my mother’s side.

I am fond of women, as a whole. Their strengths, as a class, seem reasonably complementary to mine. So do the weaknesses. I am sure there are men capable of independently organizing socialization, remembering the kid’s vaccines, and keeping track of the miscellaneous errata that constitute a functional household. Some of them probably even know when their bedsheets were last changed.

Women make this look effortless, at least until they explain, with considerable justification, how much unacknowledged effort goes into making it look effortless.

Look ladies, I open jars. I get you flowers. I work like a donkey to be a good provider. I even come with bad puns. Some might call me emotionally aware, with the usual parenthetical qualification: for a man.

I appreciate that this doesn’t settle who’s booking the dentist.

So you’ll usually find me sitting on the sidelines, sighing, and wishing we could all get along. Or get it on, given this is an age of declining TFRs.

Unfortunately, “have you considered liking each other?” is an inadequate explanation for how we got here. If I had to offer an overarching, semi-evidence-based account, it would go something like this.

First, the economic necessity of a husband has declined.

A woman with her own income, access to contraception, and some institutional support has substantially more scope to remain single than her grandmother did. Marriage can become something she evaluates on its merits. Is this particular man going to make her life better? Does she actually enjoy his company? What is his position on discovering where the laundry basket lives?

What do you offer her over a dildo?

This is quite rough, given that your grandfather’s principal qualification was “has a job”.

There are obvious benefits to being wanted. There are also uncomfortable implications for those of us who might previously have got by on being needed. A man can be perfectly decent and discover that his contribution no longer clears the threshold. He's competing with the life she already has, including her friends, her peace, and so on. Women tend to be happier without a man than vice versa.

Second, a great deal of socialization has migrated online, taking courtship with it.

The American research showing online meetings displacing introductions through friends is real, even if “online” is a broader category than Tinder and America is not the entire planet. Once enough people go somewhere to find partners, everyone else acquires a reason to join them.

Even the conscientious objectors feel the pressure. You might prefer meeting someone through friends, at a party, or during repeated accidental encounters that gradually become less accidental. Unfortunately, your friends are busy, the party is next month, and the attractive stranger has headphones in.

Your phone is right there.

The apps are seductive because the next attempt costs almost nothing. The cumulative experience can cost quite a lot. You can only resist so much solo, if everyone else caves.

They also make certain qualities much easier to evaluate than others. Height photographs well when expressed as a number. A capacity for affection under adverse circumstances requires considerably more demonstration. Being funny helps, but so does having someone around long enough to hear the joke.

A man who becomes attractive after six ordinary conversations may struggle in a venue where he gets half a second.

Third, expectations can adjust more slowly than circumstances.

Women’s educational and professional gains create some awkwardness for an inherited script in which the man is supposed to be at least as accomplished as his partner, preferably a little more so. If you want someone educated, successful, attractive, available, and enthusiastic about you specifically, the intersection can become rather small.

The female doctor and the well-paid electrician may look financially compatible on paper. Whether they meet, share friends, enjoy the same things, and recognize each other as plausible partners is another question. Money, education, and status overlap without being interchangeable. Men participate in this sorting too. Most of us are wonderfully open-minded about dating outside our milieu, provided the opportunity happens to someone else.

None of this requires a conspiracy. A lot of individually understandable preferences can produce unpleasant collective results.

On the other hand, I wouldn’t heavily weight gender-war rhetoric as a guide to what people actually want.

A surprising number of the angriest voices seem perfectly willing to shack up if they meet Mr or Ms Right. Their sweeping denunciation of the opposite sex contains an exemption clause for someone hot who texts back.

I suspect much of it functions as a fashionable costume for status-signaling, or as emotional armour. “I have rejected this entire category of people” feels rather better than “I would quite like one of them to choose me”.

Specific tale: A 6'3 male virgin that mistrusted all women as gold diggers, despite his painful lack of income. He participated in an obscure sport I play. One female participant in the sport was getting married. Invited 6'3 man, and suggested to one of her promiscuous female friends that maybe he just needs to get laid. The 6'3 man is laid at the wedding, turns out much more chill about women afterwards.

Oh boy.

Call me cynical, but I suspect being 6'3 had something to do with how readily this intervention could be arranged.

Height carries a lot of... uh, weight.

I recognize some of the emotional territory.

My childhood and most of my teenage years were spent rather starved for feminine attention. I was either at an all-boys school or attending extracurricular tuition. There were girls at the latter, but the grind is a harsh mistress.

I spent years bemoaning the fact that I wasn’t getting laid, finding solace mainly in the observation that neither was anyone else in my cohort.

The exceptions were a handful of cool kids from socialite families, apparently operating under a different licensing regime. Everyone else understood that college was where you acquired a reasonable hope of getting poon. If that failed, well, you would eventually get married.

A surprising fraction of Indian men don’t have sex until then. Older research on Indian youth is consistent with premarital sex being far from universal, though self-reports on a taboo subject deserve the usual raised eyebrow. The restrictions apply to women too, of course. Parents tend to loosen the leash once you’re away studying or working, partly because surveillance becomes less feasible.

I remember the angst, the horniness, and the desperation. I remember how much of it subsided once I started having some luck with the ladies.

To this day, I have considerable sympathy for incels in the original, technical sense. It sucks to want a meaningful relationship and be unable to find one. The absence of sex is unpleasant enough. The suspicion that nobody will ever voluntarily make you their person reaches considerably deeper.

Then some well-meaning soul tells you to enjoy being single.

Yeah, thanks buddy. I have the experience, which is why I've avoided it the moment avoidance was an option.

I look at people who struggle and think: there but for the grace of $Deity go I. I could have been dumber, shorter, less funny, less fortunate in where I lived or whom I met. It would be flattering to interpret my eventual success as evidence of outstanding character. I wish.

And then I look at people who seem to have it all, who get laid effortlessly, and grumble to myself.

The cosmic irony of my gay brother being the handsome one is not lost on me. When we went clubbing in the UK, we seemed to attract exclusively feminine attention.

At gay clubs.

Bruh.

The disparity rankled more when I was younger and doing less well. Having experienced both the resentment and its gradual attenuation, I find it difficult to treat the resentment as either incomprehensible or particularly trustworthy.

You can notice a real unfairness and still spend far too much of your life staring at it.

This is where I would advise men to tend to their own. Quite literally.

Working out, getting a better job, dressing presentably, cultivating friendships, and simply putting yourself out there are all rather boring suggestions. They are also things you can actually do. Going on a grand crusade against sexual inequality brings about negative dates.

I understand why self-improvement advice irritates people. It can sound like an assurance that effort will eventually be rewarded, delivered by someone whose reward arrived before he had to test the proposition very seriously.

There are no guarantees. Some people try hard and remain lonely. Some have disadvantages a haircut won’t meaningfully address. They deserve sympathy without first presenting receipts from the gym.

But you still have decisions to make about tomorrow.

You can improve your chances while improving the life you inhabit between attempts. You can become more socially connected, more competent, better dressed, and easier to live with. Those gains remain available even when a particular woman declines to cooperate with your carefully constructed redemption arc.

The global equilibrium is largely beyond your control. Your own contribution is somewhat more tractable.

And I have trouble imagining what winning the gender war would even mean. Everyone becomes sufficiently suspicious and exhausted that they stop bothering? The sexes retreat into separate camps, each enjoying the satisfaction of having correctly identified the other as the problem?

I look at South Korea and feel little enthusiasm for exploring this possibility.

Face it. If you’re going to be k-selected, lean into it.

I use the term loosely. I mean the strategy of becoming a viable long-term partner, finding someone you like who likes you back, and investing heavily in the resulting arrangement.

I’m the product of quite a lot of this. Coached most of my life to be a Good Indian Boy: get into med school, get through med school, get into a specialty. Sex and love be damned secondary tertiary.

There were drawbacks to this upbringing. I have mentioned the horniness.

But I think it has worked out for me. I didn’t need the comfortable backup of an arranged marriage, and I appreciate that most people reading this don’t have that option. I also benefited from luck, including the sort you only recognize after meeting someone whose presence makes your earlier disappointments feel less consequential.

It really does take one lady you like, who likes you back. Then you bump uglies.

You can still notice the men with better cheekbones, the easier lives, the apparent abundance. I certainly do. But having someone whose company you actively want makes the rankings considerably less urgent. There are flowers to buy. Someone needs to book the dentist. With luck, there will also be some bumping of uglies.

So try some self-improvement. Give other people repeated opportunities to discover that you’re good company. If that doesn’t work, we can drink some pity beers together. I mean that sincerely.

Otherwise, I would like people to chill the fuck out a little. Enough of this battle takes place in your head that it is worth inspecting who keeps sending in reinforcements.

I've been AWOL on the check-ins for a few weeks. Work getting the better of me, mostly. I had a minor breakdown last week, but then I've been on vacation with my brother. It's helped.

I forgot what it's called. It definitely exists, and uses some kind of token system to ration gameplay.

To actually revolutionize robotics [...] would require entirely local models running on local power, local compute

Why entirely local? That is, as far as I can tell desirable rather than necessary, in a world with wireless internet connectivity. Your fridge might have an internet connection these days.

Waddle is an example. Their agents control robots through code and action models, build reusable skills, and even collect data to train smaller policies. Phillip Isola discusses the broader implications here.

I did say to give the robotics people a year. On reflection, I'd be willing to water that down to two or three. I'm not a robotics expert, and I certainly wasn't announcing that we've solved human dexterity. SOTA-Robotics:Human mobility is not SOTA-LLMs:Human Cognition, the latter is much closer, but it's trending the same direction.

But the possibility that robots inherit substantial capabilities from each improvement in frontier models seems rather consequential to me.

If you want a empirical definition its science fiction AIs like the Culture, The AIs in Hyperion, Daneel in Foundation.

A Culture Mind is a hell of a minimum specification. Two of the three examples are ASI, not AGI. I haven't called Astra an ASI.

And fictional examples don't give us an empirical definition. Which capabilities are required? How reliably? Why should I care whether it has emotions when assessing whether it can do my job?

“It's only able to really solve problems” is a rather confusing counter-argument. Depends on the problems, surely. Likewise, working towards an assigned goal doesn't tell us much about how general the intelligence doing the work is. I spend most of my working day performing tasks I am assigned, that do not intrinsically motivate me, mostly because I get paid for it.

The competitive advantage that you retain is the ability to learn shit without requiring millions, even billions of examples.

You're conflating training the model with teaching the trained model something new. I don't start from a blank brain when learning a game either.

ARC Prize tested Astra on unfamiliar interactive environments. It scored 62.7% with their standard interface, and 99.9% with an interface preserving its reasoning state. In the latter setup (at maximum reasoning effort) it used fewer actions than the median successful human on 96% of levels.

That isn't a comparison of total training data or energy efficiency, which wouldn't necessarily be the decisive factor:

Let's say a hypothetical architecture X is 1000 times less sample efficient than a human for a given unit of performance - well, it would be unfortunate if we managed to give it 10,000 times the training data a human can ingest, wouldn't it?

A mere year or two ago, a lot of people were awfully confident that we'd run out of training data, or that synthetic data and RLVR wouldn't pan out. God knows what the frontier labs are up to these days, but it has clearly not proven an impediment.

It does make “these things need millions of examples to learn something new” rather difficult to sustain, regardlws sof practical relevance - which I dispute. They observed it figuring out unfamiliar mechanics and constructing symbolic models to plan around them. Your claim about analogical reasoning needs similar qualification. I do not believe they're the same thing anyway.

Proper continual learning remains a significant advantage. I said so. Whether that advantage remains economically decisive as scaffolding improves is what I'm uncertain about. I lean towards a no.

Alternatively, we could solve continual learning, or simply reduce the temporal delta between train-deploy-train to the point that it has no practical relevance.

A model contributing original mathematics, writing software and learning unfamiliar environments already exhibits an awful lot of generality. It can even hold a conversation, which, I will note, would have been mind blowing not that long ago.

Call it AGI or don't. A rose by another name smells just as sweet, and has just as many thorns.

My concern is how much useful work it can do, how quickly that range is expanding, and what remains exclusively ours. I don't expect the terminology to buy us much time. I certainly don't want to spend more time arguing terminology.

I don't think I've talked about it. I've never been a particularly sports-oriented person. It just never appealed to me, beyond occasionally kicking a football around during recess.

That has been the story of my entire life so far, and I don't think it's likely to change anytime soon.

I was expecting AI to affect politics. I was not expecting to have no idea what that would look like. I very nearly spat out my drink when I saw Trump shit-talking Effective Altruists on X (or some intern with the password, whichever, at this point the distinction is academic).

At this rate we're getting a proper Race™, and with China, because who else could plausibly compete? Add the steadily growing military appetite for LLMs and it won't take more than one serious war before someone in the US government looks around and decides that nationalizing the labs might make perfect sense. I would not bet against that person getting their way.

I'm still reasonably optimistic that we'll land on an acceptable outcome, where "acceptable" means anything other than "everyone dies" or permanent disempowerment under a totalitarian regime whose values are inimical to mine. I want to stress the despite in "despite recent events." We have some very interesting people in charge of things, for a generous definition of "in charge"; nobody seems to have much actual control. Trump would be the closest, which is...

I've made half a peace with all of this. We could call it resignation. It's not quite fatalism.

It could be worse. The major labs calling for voluntary slowdowns and then unilaterally implementing them is a very good thing, IMHO. We have had some major warning shots, in the Yudkowskian sense, and it seems to be having >0 impact.

Now, after a lot of use and a lot of deliberation, I've more or less concluded that Astra is dangerously close to AGI, and probably meets most reasonable criteria for it (good luck finding a consensus definition; the goalposts are on Mars). I'd like to see proper continual learning, of course. In terms of raw intelligence, though, we're there and the right scaffolding buys enough in-context learning that the gap stops mattering for an absurd range of practical applications.

Navier-Stokes, people. Rogue agent swarms on the internet. Aren't you stoked about things?

I want to muster up the balls to just declare it: AGI is here. The issue is that I don't know whether my reluctance is epistemic caution or a psychological hangup - in the sense that saying it out loud would mean it's never been so over, or that it's barely started, and I can't tell which of those I'm more afraid of.

Does it even matter? I'd rather look at what the models actually do than argue semantics. They do things I could never do, and in some cases they've done things that eluded generations of the smartest humans we had. The competitive advantage I retain (and most people, really) is increasingly just whatever comes free with being a physically embodied, low-latency neural network with continual learning switched on by default. Which is to say: a body and a brain. Both increasingly close to obsolete.

Give the robotics people a year, since LLMs are already revolutionizing robotics too (why the fuck not). Maybe we get "true" continual learning, or maybe we get increasingly sophisticated substitutes, constant-train-and-deploy on timescales short enough that the whole question becomes moot. I'd take either.

So, uh, this is me, self_made_human, saying the future is here. It's just not evenly distributed and it smells weird. Welcome to the Singularity, motherfuckers. Enjoy your stay. It'll be many things, and boring won't be one of them.

The more the world turns into what I expected it to become, the more ridiculous and unreal it all feels. I miss when this was LessWrong nerd bullshit. I saw "STOP AI" graffiti on the way home from work today. I was watching the AI Doc on Netflix, occasionally getting exasperated, and then feeling strong emotions about the fact that I know most of the people interviewed, and have spoken to some of them personally in calmer times.

I'm going to do my best to enjoy the ride and have a life for as long as my individual actions still make a difference to my outcomes. I expected this to happen. I have mixed but slightly positive feelings now that it is.

I've managed to do a lot of things, but a sufficient amount of exercise eludes me. The gym isn't happening, but the pushups have fewer excuses. I'll try, thanks.

They'd be a good candidate. Especially when you can get away with an overarching strategic AI that either writes scripts or queues tactical actions for "normal" game AI to implement.

Could be done even in Paradox games, as opposed to more discrete turn based strategy games. "Ah, I'd like to organize a naval invasion, this is the current map layout, order all units to move to X port" and it just happens.

People are doing incredibly cool things with LLM integration in Rimworld.

It started off with "journals" where an AI would look at the game state and recent event, and write something about it (RimLegend, RimChronicle). Then came mods that let you "talk" to pawns, taking direction from their personality and relationships (RimDialogue, RimTalk, EchoColony).

That was fun enough, but didn't directly affect gameplay. Well, what I wanted the most is coming to fruition: the AI storytellers the game has being supplemented by actual AI. Or at least significantly more intelligence than dice rolls with various degrees of randomness (RimAI, Rimteller, Claude Storyteller, Tales from the RimWorld). That's somewhere where Rimworld falls flat compared to a much more simulation-oriented game like Dwarf Fortress - your actions have remarkably little impact on the wider world, forcing a lot of dirty scripting to give an impression of responsiveness, and trusting the player to make a coherent narrative out of it.

That means events in the game can be directly impacted by what an external LLM dictates. I haven't tried it yet, but we're about to start a golden-age anytime now, significantly easier in games where you don't need low latency instant decision-making.

No more five quadrillion rabid crows because you made your floors too shiny, or a group of orphans wanting enough medical supplies to stock my hospital in order to ransom their friend (at least in theory). Events can (hopefully) start to make sense in context. Just imagine what you could do in terms of diplomacy - there's already a semi-viral standalone geopolitics sim out there, where instead of a Paradox style interface, you just say what you, as the leader of a simulated nation, want to do.

Or quests that are truly unique. Base building made easier by telling an LLM what to do (RimAgent). Giving pawns a mind of their own.

As always, token pricing remains the biggest barrier, but $/unit of intelligence continues to drop precipitously.

I've been watching gameplay for years (I am too tired to get the actual games), and I get the strong impression - corroborated by most players - that the game is significantly less jank these days.

Like, definitely plenty of jank, just less of it. The physics has improved to the point that people are using legitimate HEMA tactics and finding benefit from it.

I do appreciate the concern, and the last week suggests that it's correct. I'm going off on vacation, which means I get a much needed break, and won't need nearly as much of the stimulants. That'll help, and if it doesn't I'll reconsider the GLPs, thanks!

I remain grateful for giving up on my (rather progressed) plans to switch from medicine to CS or ML a few years back. I'd started teaching myself when GPT 3.5 came out, and when 4 was realized, I gulped and decided medicine was the safer option.

I do not regret this decision. You guys are, unfortunately, rather screwed. I hope that we as a society figure something out, and soonish, it's only going to accelerate from here.

I suppose we're both in the same boat. My appetite is drastically diminished, though I'm on stimulants which provide additional suppression.

Down 2ish kilos since.

In fact, I'm now concerned I'm not eating enough, between the workload and sheer exhaustion, I've been skipping a lot of meals. I can do with losing a few more kilos, but at that point I'll either cut down the dosing or force myself to eat more regularly. Interesting problem to have.

That's a good point. I have been eating far less than I should, and that's not great for me. I appreciate the advice, and the kind words!

I'm going through hell at work. My mental health must have miraculously improved to well above the usual baseline, because I haven't collapsed yet.

Halfway through the day, I find myself so sore that even 500mg of naproxen doesn't cut it. To save my liver and kidneys, I've been avoiding more, or trying to handle the breakthrough pain with non-NSAID analgesics.

I have been sleeping poorly. Just enough to be functional, but the stress has me waking well before an alarm even when I only fall sleep late. It gets worse and worse through the week, though I manage to discharge some of the debt over the weekends.

At least I have dextroamphetamine. I can only hope that strong doses, and an upcoming vacation with my brother will help with things.

Fuck me. Only way out is through.

No.

Others have very kindly pointed out that the child did not have a life fit for a child, and that there was no hope for a cure. Thanks.

Well, I've seen a baby with icthyosis vulgaris during my career (Google that at your peril), and when you're that fucked, and end to the misery is in everyone's best interests.

It is worth noting that medical technology has, for a while, allowed to us to keep a lot of people alive, but not alive, if you get what I mean.

Thank you. I'm glad I did it, it was one of the most concrete examples of me failing in hard to see ways, my limited energy carefully rationed. Being able to overcome the tendency to procrastinate in some ways, while feeling utterly helpless in others.

I think that was the biggest ticket item. Compared to that, canceling a gym membership I don't use is nothing.

Thanks for the other advice! I am leery of gold or crypto, for various reasons, but general global exposure might not be the worst idea. Shame the Chinese stock market is borderline impenetrable...

I have finally used up a good chunk of my ISA, and put my money where my mouth has regularly been: In shares of the Vanguard S&P 500.

God knows how long I've been putting that off, it was surprisingly painless when I sat down and did it. Financial responsibility, brought to me by the resumption of dextroamphetamine.

Any advice on further diversification of my portfolio? I am not financially stressed, and I have no immediate plans on buying a house etc etc. The most likely significant financial liability in the near term would be a cheap(ish) car. I don't have to worry about providing for my family back home, at least unless things go horrendously, unimaginably wrong when it comes to their investments and holdings.

I would say I have a decent risk appetite, but I am of the opinion that the market is, in general, more efficient than I am. Thanks!

Ah. That's a common enough story.

General advice for the men reading: taking interest in and engaging with the interests and activities of your female partners is important. If you can't generate it organically, then you better learn to fake it.

I can hear the objection already. Faking it is dishonest, she will see through it, and being caught faking is worse than never having tried. I half agree, in the sense that "fake" is probably the wrong word. What I actually mean is something closer to "build a habit."

Look at a person who sets a weekly reminder to call his mother. I wouldn't say he loves her less than the person who simply remembers on his own. The reminder is what love looks like in a brain that is bad at remembering things. The effort is the thing being measured, and is not much worse for being intentionally generated.

I've seen this before - a lot of women will become deeply dissatisfied if you're not doing this. You can be well off, handsome, good in bed, etc etc, but they'll feel that something is missing.

The gap gets filled by small things. Remembering a birthday without being reminded. Asking how her friend's surgery went. Flowers on a Tuesday for no reason, except that she appreciates flowers. Remarking on the fact that she got a haircut. None of these is individually important, which is precisely why they work as a signal. The only reason to do something that does not matter is that you were thinking about the person it does not matter to.

I've gotten better at all of that, with time and intentional effort. I've had exes complain I sometimes appeared checked out, or that I didn't get them flowers. Once that was done and dusted, I set about improving. I'm buying a bouquet today.

That is not to say that the stereotypically male side of a relationship isn't important: being a provider, making her feel safe, taking care of things. These all matter greatly. They are necessary, but in many cases, might not be sufficient.

I find that it's helpful to attach a reference image and ask it to copy the art style closely, on ChatGPT or Gemini. Much more effective than verbally describing the style. You can use multiple different references, in case you don't want it to crib too closely.

Funny timing: I restarted oral semaglutide yesterday. I think you made the right call.

I'd lost a few kilos the traditional way, which in my case meant eating less, running myself into the ground at work, and taking moderate doses of prescription stimulants. Then it plateaued. For months. Still in the overweight range by the charts. After contemplating it on and off for a good while, I bit the bullet.

I skipped the titration schedule, same as last time. Mother didn't raise no pussy, but she did raise an impatient gentleman. Day one brought mild queasiness. Day two has been fine. The appetite effect is subtle so far, and seems to work mostly by early satiety, so I eat less per meal without any change in how often I think about food. It'll take several days to reach steady state, but I feel it anyway.

(Getting this through the NHS is close to impossible unless you're roughly truck-shaped , and it has to be prescribed within a Tier 3 or 4 specialist service, not by your GP. I happened to have plenty left over from a trip to India)

Do I need it? No. Do I have preferences about my own body that the word "need" fails to capture? Yes. That's true for most people, I just happen to have a degree adjacent to the topic.

What I'd want your wife to hear is about my mother:

She has diabetes and obesity, and her liver was paying for both. The kind of situation where nothing hurts until it's already quite bad. For years I carried a low-grade background dread that I'd lose her within a decade or two. I talked her into starting semaglutide. Her liver turned around.

She still has plenty of weight to lose, but I'm less terrified of losing her.

Tell your wife that. When someone you love becomes healthier and is likelier to be around longer, the available emotions are relief and gratitude. Disappointment is a shite dessert.

I'm now trying to get my mother back to her endocrinologist to raise her dose again, or to switch to the injections. I'd like my father on it too. He isn't obese by the numbers, but he has the beer belly, minus most of the beer, since Indian fat distribution handles that part unassisted. He isn't listening to me. Parents rarely do. I'm glad mine occasionally listen without me having to go and poke them with a needle myself.

We live in an age of miracles. It seems a shame to leave them on the shelf. I've taken them out of the luggage at the least.