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Yes.
The mechanism via which the body "hungers" is somewhat complex, but can be usefully simplified down to the action of ghrelin, a hormone produced in the stomach which makes you hungrier, and leptin, which does the opposite.
Surprisingly, obese people have more adipose tissue, which produces leptin. However, it ceases to have the usual satiety inducing effect, as the body becomes resistant to its action. The way this is perceived is the body interpreting the lack of signal for being full as a sign of starvation.
And starvation sucks. Other than disease, it's probably what's killed the most humans in all of history, and you can imagine that it's a very unpleasant state that the individual feels compelled to rectify. The easiest solution being to eat more, till the pain goes away.
They're also being struck with a double-whammy. In lean people, eating causes suppression of the levels of ghrelin, in obese people, it doesn't. So they feel less full, with the same amount of food, as compared to those at a healthy weight. Hence they feel compelled to not just eat, but eat excessive amounts for the sake of relief.
I can only reiterate that starving sucks, and the body will drive you crazy in order to avoid that feeling. It's too dumb to know or care that you are, objectively, perfectly well fed. Waterboarding feels just as bad as actual drowning despite the ~nil risk of death.
While doctors usually feel compelled to tell their patients to watch their weight and diet, this almost never actually works. I consider myself a pragmatic one, and advice that isn't actioned in practise is about as useless as advice that doesn't work at all. I was on the Ozempic hype-train well before it was cool.
My mother is very obese, and has been for over half her life now. She's diabetic, and has developed fatty liver with hepatic fibrosis. Her own commitments to working out and dieting never held. She's a doctor herself, so she knows, on an intellectual level, what the risks are. She's been driven to tears by the scolding she gets from my grandpa or my dad who genuinely care for her and want her to lose weight, and after gentle suggestions failed, were driven to tough love.
None of it worked. She loved to eat, and reducing her caloric intake was pure agony. For a long time, I was resigned to the seeming inevitability that she'd head into cirrhosis, and I'd have to steel myself up for a liver donation. It's a nasty, nasty surgery, nothing like giving away a kidney. It leaves a grossly disfiguring scar, leaving aside the significant risk of death during and after the procedure. I'd do it for my mom, because I do love her.
Eventually, when Ozempic, or oral formulations of semaglutide, became available in the Indian market, I badgered her into seeing her endocrinologist and getting it prescribed. Despite the initial nausea and diarrhea, she eventually adapted, and lost the lost weight she's ever managed, and kept it that way. Right now, my priority is hounding her into going to that gent again and getting that dose upped, it's well overdue.
Exhortations to exercise failed. Asking her to watch her portion size and not snack failed. Driving her to tears failed.
The pill didn't.
When people get on their high horse and claim that using drugs to solve your problems is a crutch, it takes everything I have to not tell them to go fuck themselves with a rusty pole. It saved my mom, fuck you. Nothing you have to offer, including your empty words, comes close.
To hell with willpower. A world where we can power through our problems with pills is a better one as far as I'm concerned.
I'm a doctor for many reasons, but ranking highly among them is that I have an urge to find solutions to problems that actually work. Telling people to use their will to get over depression or diabetes doesn't, and the same is true for obesity. Claiming the moral high ground and virtue signaling? Doesn't beat adding years of healthy lifespan.
Well obviously.
But when I broke my leg I got a crutch.
What the fuck I was supposed to do? Crawl? Walk on leg with broken bone, injure it further and howl in agony?
Crutches exist for a reason! There are stupid way to use them, I guess, but typical use of crutches is extremely useful in an obvious way!
I do not have problems solved by Ozempic as far as I know, but if I could pop a safe pill to solve procrastination issues I would do it!
When people call something "a crutch" they refer to the specific chronic problems they cause in long term use, and in particular that you can get habituated to them in a way that stops you from taking the harder steps required to get back to walking normally.
In this case it seems particularly evident that the issue with drugs that trick you into not feeling hunger at your normal rate is that it becomes that much harder to operate normally without them.
Unlike OP, I think a world where people can only solve their problems by becoming addicted to complex and expensive drugs is a bad one.
Now of course the effects of obesity are so bad that it's probably better to take the drug if you can't muster the willpower, but it's like taking opiates for back pain. Weening yourself off of the drug should be the ultimate goal, otherwise you're just embracing a different kind of slavery.
You simply regain your appetite, and around half the weight back in a year if you stop Ozempic. I don't see how that's not strictly better than not taking it.
The hell is a "complex" drug? Does it have a hard to pronounce name? Does it have a large molecular weight? Does it act on more than one signaling pathway?
Ozempic isn't particularly expensive. Most middle class people in the West can afford it, if it's not covered by insurance. There are legal or grey market sources that are significantly cheaper. And as more alternatives arise, including generics, it'll only get cheaper.
Gym memberships cost money too.
And Ozempic isn't "addictive". Do people not know what that word means?
Is insulin addictive to a diabetic, because they'd fall sick or even die if they stopped?
I would like to see you wean yourself off oxygen and water. Perhaps, to be less challenging or immediately lethal, clothing or shelter. Otherwise what are you but a slave to biological necessity?
This is all such immensely confused thinking that I don't know how such beliefs can even arised. At the very least, it is factually incorrect.
I'm not making the argument against taking the drug, I'm making the argument against being stuck in a local maximum.
One that relies on an international supply chain for its industrial production and the existence of a large enough empire to secure sea lanes. A type-2 technology.
Apparently they don't anymore.
From The Oxford English Dictionary, Volume 1:
From The Oxford Advanced Learner's Dictionary:
Saying diabetics are addicted to insulin because they would die without it is a tautology.
So is saying men are slaves to biological necessity. These are realities well understood since antiquity.
Such addictions may well be natural, but they are cumbersome, and one of the common criticisms of modernity is that it has tricked people into novel addictions under the guise of liberating them from natural ones. I would have thought this line of reasoning to be popular enough as to not demand explanation. But here we are.
I could throw it all back in your direction, but I'm afraid I know too well the source of your confusion, and it is that you think American Psychologists among other colleges of experts have dominion over the English language and its conceptual space. As if they can declare the valence of things by fiat.
It is an all too common sort of delusion that leads people to demand pronouncements from these priests as to whether certain lifestyles are or are not illnesses.
But as we are now in a place that is open to people who are not adherents of this religion, I therefore enjoin you to consider that such authority is not self-evident.
You probably mean minima.
Now, you define a "complex" drug as one that relies on international supply chains and "the existence of a large enough empire to secure sea lanes". I have to admit, this is a.. novel definition. Are you typing this on a "simple" device? The phone or computer you are using relies on a supply chain of such staggering, globe-spanning complexity that it makes Ozempic's look trivial. If you have taken a Tylenol in the past decade, there is an excellent chance it was manufactured in India or China and shipped across those same sea lanes. Unless you are a primitivist writing on handmade parchment, you are a beneficiary of these "complex" systems. It seems strange to draw the line here, at a medication that saves lives.
Oh, not all diabetics would die. They could, in an ideal world, live short but tortured lives! Is that a tautology?
So? Care to reproduce such arguments in full instead of waving at them?
You will not literally die without electricity or information technology. You seem to conveniently enjoy that particular fruit of modernity, while crying about this one.
Once again, the number of people who eschew electricity or computers seems awfully small. Modernity is, on the whole, quite nice. It could still do with improving.
I am not an American Psychologist, nor do I think they have "dominion over the English language". I also happen to think you're twisting that poor thing to your own ends, with willful ignorance of your actions.
Spare me your sophistry. If you Google "definition of addiction", one of the first hits is the Wikipedia article for the same, which says that:
Ozempic doesn't cause "substantial harm". Any negative consequences are grossly outweighed by the upsides of not being obese, let alone diabetic.
Your definition is ridiculously archaic, and by that definition, one could be addicted to collecting stamps, to morning walks, or to breathing. You have diluted the word to uselessness.
I have no "authority" over you, and never claimed to. Short of mod-abuse by banning you, which I've never done and have little inclination to do. I still have little patience for such clearly confused, utterly sloppy thinking, with the added temerity of trying to take the moral high ground through word-play.
No.
I suppose Jacques Ellul only died 30 years ago. But I would have expected everyone here to be long familiar with this ancient history given we discuss the philosophical implications of AI on the daily.
Of course.
The section on medicine as a human technique is of course most relevant to this conversation, but I don't recommend skipping around if you are unfamiliar with philosophy of technology and the associated jargon.
No. Semiconductors are arguably the most complex things mankind has ever made. Especially using this definition.
No, it's a non sequitur.
I'm not sure what part of my writing evoked any kind of detectable emotion. I assure you it is purely analytic. I'm critical of modernity whilst living in it. What else could be reasonable?
Call me an ungrateful atheist for living in creation if you must. I can't help but look at what I'm doing.
So I was indeed right to believe you take the DSM-V to have the power to decide the meaning of a word that has existed since the 1500s.
I think the fact that you'd take Wikipedia's word over that of Oxford reflects poorly on your conception of the world, frankly. But this is a silly semantics exercise anyways. I have clarified what I meant beyond doubt. If my vocabulary irks you, so be it.
No, I've used in in a way you don't like, which is common and in accord with its historical usage. There is a difference.
You misunderstand. It is the expert authority on your own language and thinking I recommend you remedy, not your authority on me.
No. A local maximum is a peak. You seem to be arguing that people on Ozempic are stuck in a state that is better than the alternative (obesity), but not the absolute best possible state (some imagined ideal of pure willpower). If we're torturing a metaphor, that's a local minimum of negative outcomes. But why let basic logic or the meaning of words get in the way of your grand philosophical pronouncements?
And? Darwin died 140 years ago, but we don't treat his theories as gospel just because he's dead. Age doesn't make an argument correct, and name-dropping French philosophers doesn't make your position any less incoherent.
Ah, an appeal to an obscure academic to justify your terror of the modern world. I don't need to have read him to recognize the staggering hypocrisy of your position. You lament the "complex drug" that relies on global supply chains while typing your screed on a device whose complexity makes a vial of semaglutide look like a sharpened stick. This isn't a coherent critique of "technique"; it's just selective, convenient moralizing.
What would be reasonable is to apply your critique consistently, instead of drawing an arbitrary line at a medication that saves people from suffering. You enjoy the fruits of modernity that allow for your comfort and your intellectual hobbies, but you condemn the fruits that rescue others from a life of pain and metabolic disease. It's the pinnacle of entitled, ivory-tower thinking.
Spare me. I didn't cite the DSM-V; I cited the common, modern, functional understanding of a word as it is used by virtually everyone who isn't deliberately trying to be obtuse. You're clinging to an archaic definition from a historical dictionary as if it's a sacred text, precisely because it allows you to dilute the word "addiction" into meaninglessness. By your logic, a marathon runner is "addicted" to running and I am "addicted" to washing my hands between patients. It's a semantic game to avoid confronting the vacuity of your argument. Context matters. If we're talking about cars, I don't define "transmission" as "the act of sending a message" just because that's what it meant in 1400.
This isn't about Oxford vs. Wikipedia. This is about clarity vs. deliberate obfuscation. You are using language as a weapon to feel intellectually superior, not as a tool to understand the world.
And let's be clear about what you're really arguing for when you strip away the philosophical fluff. You say weaning off the drug should be the goal to avoid "slavery." For many, the alternative isn't freedom; it's a return to the biological slavery of a body screaming for food, a slavery that leads to diabetes, liver failure, and an early grave.
You can sit there and pontificate about "novel addictions" and the failings of modernity. I have to look my mother in the eye. I've seen the "natural" state you seem to prefer, and it's ugly and it's brutal. So frankly, you can keep your dusty dictionary and your non-sequitur arguments. They are useless. The pill works.
I think it's interesting that you think negative outcomes is the natural function to look at. I'd be willing to bet you have some attachment to "harm reduction" as a concept.
But isn't it more natural to view the opposite or some sense of self actualization as a more natural metric of well, health?
Sure, but it makes it mighty tricky for it to be "novel".
Ellul is one of the most influential philosophers of the 90s, I'm not sure what you're on about.
Is this really your argument? That technology is immune to criticism so long as its critics use any of it?
I give you my blessing to assume that I'm not just a computer user but also a semaglutide user and even the most egregious of hypocrites if that makes you happy.
Now can we actually talk about implications of altering one's senses on willpower and liberty or was semantics and grandstanding the whole of what you had to say?
The caveat seems to agree with my contention insofar as for the few, it is strictly better to be freed both from natural cravings and from taking a drug their whole lives.
Now of course the real question is which is best if you absolutely have to choose between battling your urges constantly or being addicted, sorry, tied, to a drug forever.
Your contention appears to be that that this is a straightforward choice and that reflection on this matter is the domain of ivory tower intellectuals.
I disagree. I believe that these two situations offer tradeoffs that will appeal differently to the individual and that different lifestyles or ethics will demand different choices on this matter.
For instance, I have a relative whose nationality and living arrangements make it tricky for her to obtain medical treatments regularly, and that has influenced her choices on such matters. Assuming supply chains and the money to buy drugs will be there for all you need for the rest of your life may be reasonable to assume for many, but not for everyone.
Moreover, and in line again with historical criticism of modernity, I am weary of how the availability of yet another therapeutic will affect the selection pressures of humanity in a way that may be pathological or detrimental to the freedom of the individual in the long term.
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