I lost 100 lbs over 18 months. And, I found it much easier to change my lifestyle on a GLP-1 drug. Naturally thin people / people who don't have some environmental sensitivity are super judgy about GLP-1 drugs, and closet judgy about fat people. It's just not so simple as "lazy/poor diet/no exercise."

I went from nutritionist appointments that were like "are you lying about your food intake? because if not, you have some serious problem with something in your environment" to "yep, it was easy to cut out a couple things that bothered me," and weight came off astonishingly rapidly.

And this anecdote a person on HN[1] "reached a peak of 340, and in exactly a year, while maintaining the same CICO, but changing from the SAD to strict non-Keto Paleo, became 214".

(I want to ask this in a non-combative way, but 3 days later I still can't. How did you know the couple of foods(?) which were bothering you, which were the problem, and your nutritionist did not know about them, and you weren't lying to the nutritionist? I can't make sense of that without also accusing you of hiding them from the nutritionist, or the nutritionist being terrible at their job).

[1] https://news.ycombinator.com/item?id=27936397

This is work in progress, though. 3rd generation medications are already way more efficient than 1st gen. Saxenda ever was. A further increase in efficiency is likely.

"And these people have skipped changing their lifestyle, exercise, diet, and attitudes around food."

That sounds very judgmental of you, like if they were skipping school. Bad truants!

What about "found the necessary changes too hard/complicated to sustain"? That is closer to reality. People juggle all sorts of obligations, some are doing multiple jobs, commuting 90 minutes each way etc. - they may be just too fatigued to exercise regularly and cook healthy meals at home.

There are 110,000,000 overweight people in the USA and another 110,000,000 obese people. Is it really closer to reality that everyone is a two-jobs no time for exercise, or is it more that Starbucks Mocha Frappuccino has 500 Calories and Starbucks has 15,800 stores in the USA and $36Bn annual revenue? And McDonalds, KFC, and all the rest. Is it closer to reality that people are snacking on some snack food on the couch out of habit and not paying attention to how many calories that is in a week, because it's just habit and gone in seconds? Is it closer to reality that Uber Eats and Door Dash and Domino's advertise to manipulate you into believing that you don't have time to cook at home and they are a good option? Is it closer to reality that there are food deserts with only junk easily available?

> "That sounds very judgmental of you, like if they were skipping school. Bad truants!"

It is judgemental of me, like if you want to pass your exams but skip studying, that would be bad. If you aren't exercising and are eating terribly and are obese, this lets you silence the alarm bells while saying "I don't have time to exercise". That doesn't seem as good as eating better and changing your life to include movement.

I don't perceive health as a reward for virtue, so even though I understand your analogy with exams, I cannot really accept it.

Ask yourself where fast food comes from. It is a) fast, b) cheap. Of course it is going to suit people who a) don't have time, b) don't have much money. A union of those two wants covers a big part of the contemporary Western population.

Composition of food is another biggie, I agree with you on that. Too much sugar everywhere. That said: we are naturally wired to crave sugar, only someone more and someone less. If fentanyl was legally sold on every corner in fancy packaging, starting with kids, would you blame the resulting junkies for being weak-willed? Or acknowledge that the environment is really fucked up?

I personally don't respond to sugar that much and I can go weeks without it, but that's not my virtue. It is blind luck of my genome or possibly microbiome. I don't drink much either, but again, that's blind luck of my genome or possibly microbiome which makes me dislike the taste of alcohol. Not my iron will, which I don't have.

It is my experience that a lot of people are judgmental about the fatties because it increases their own perceived self-worth. ("We are the virtuous ones, unlike them.") Pretty arbitrary, but humans be like that.

>Ask yourself where fast food comes from. It is a) fast, b) cheap

It is not cheap. Eating fast food regularly would probably more than double my food budget. And yes, I do eat meat regularly.

N.B. the claim from the quote is 'at least 15%', many users will realize larger benefits.