The high price in the US of weight-loss drugs


The drugs Ozempic and Wegovy, although developed to treat diabetes, have become wildly popular outside its original target population because it seems to be highly effective in reducing weight as well. This has resulted in it becoming harder for diabetics to gain access to the drugs as well as their price rising.

US senator Bernie Sanders has long been a critic of the pharmaceutical industry and how it charges highly inflated prices in the US that are available for much less elsewhere in the world. He has been successful in pushing for the cost of insulin and asthma inhalers to be drastically reduced and now he is targeting Ozempic and Wegovy.

The blockbuster weight-loss drugs Wegovy and Ozempic are arguably as omnipresent in the American zeitgeist as Taylor Swift or the iPhone. The drugs and others in its class are associated with the sparkle of Hollywood, on the lips of Oprah and considered transformative by doctors.

But the giant market for drugs like Wegovy, including not just the roughly 11% of adults who have diabetes but also the 42% of adults who have obesity, has conjured one of the demons of American healthcare – price.

Americans paid 10 times more for Ozempic than patients in the United Kingdom in 2023 – $936 a month compared with $93. Wegovy costs Americans $1,349 a month, compared with $296 in the Netherlands (the drug is not yet available in the UK).

That wild discrepancy has captured the attention of one of the drug industry’s loudest critics, the US senator Bernie Sanders.

“What we’re focusing on right now is what may end up being one of the best-selling pharmaceutical products in the history of humanity, and that is Ozempic and Wegovy,” said Sanders. “These are very important gamechangers helping people with diabetes and obesity.”

Sanders is preparing to square up against the chief executive of the Danish pharmaceutical giant that makes both drugs, Novo Nordisk. Under threat of subpoena, its CEO, Lars Fruergaard Jørgensen, agreed to testify before the same committee in September. But even for Sanders, the challenge is formidable.

“You’re taking on a company which will make billions of dollars every single year, many billions of dollars from the US, on just this product,” said Sanders. “So, do I think this is going to be a difficult challenge? I do.”

The catch with using these drugs to lose weight is that although they seem to be very successful in doing so, you cannot stop using them. It turns out that if you do stop, much of the weight comes back.

As director of the Washington Centre for Weight Management and Research, Domenica Rubino has become frustrated with growing perceptions over the last three years that weight loss drugs such as Novo Nordisk’s Ozempic and Wegovy, and Eli Lilly’s Mounjaro, are permanent cures for obesity.

“Obesity is not like an infection where you take antibiotics and you’re done,” says Rubino, sighing. “It’s not any different than hypertension or diabetes or the many other chronic illnesses that we deal with, where you have to use chronic medication.”

After 68 weeks of semaglutide injections, the average patient lost more than 15% of their body weight, but within 12 months of treatment ending, patients regained two thirds of their prior weight loss on average. This was associated with a similar level of reversion to the patients’ original baselines in some markers of their cardiometabolic health – a category which includes conditions such as diabetes and heart attacks.

The main theory for why the majority of patients regain weight so rapidly when they stop taking medication is because the regions of the brain relating to appetite are still dysregulated, priming the person to overconsume. GLP-1 drugs only mask this dysregulation, and when their effect is removed, their food cravings soon return.

“People don’t always appreciate this,” says Rubino. “I try to explain that these are chronic medications, but I think everybody secretly feels, ‘Yeah, but you know what, I’m different, and once I hit my weight goal, I’ll be ok.’ But the reality is, the brain is quite powerful.”

But this may not be the only explanation. Martin Whyte, an associate professor of metabolic medicine at the University of Surrey, explains one possible theory as to why people tend to regain weight after they stop these medications. The doses of GLP-1 provided by semaglutide and tirzepatide are far greater than the body would naturally expect to receive, he says, which may suppress the body’s ability to secrete GLP-1 on its own. As a result, people’s hunger may return even more voraciously when they cease their doses, he explains.

“What may be happening, and we don’t know for sure, is that when you stop them, your body’s left in a GLP-1 deficit which has a major impact on the satiety signal going to the brain,” says Whyte.

The problem with weight is that once fat cells are created in the body, usually in adolescence, they never go away, they just shrink or grow larger as one’s weight fluctuates.

Researchers have found that the number of fat cells in your body is set during adolescence and remains constant through adulthood, regardless of whether you gain or lose weight. The findings may help to explain why it can be so hard for some people to drop pounds and keep them off.

Although scientists have long suspected that the number of fat cells stays stable during adulthood—shrinking or swelling as the body’s weight changes—they had no accurate and safe method for tracking the longevity and turnover of fat cells in the human body.

The researchers also examined fat cells in biopsies from nearly 700 adults of various ages and weights. They compared their data to that from a previous study of children and adolescents and found that fat cell numbers quickly climb through the teen years. Overweight children seem to gain more fat cells than normal-weight children. But fat cell numbers level off and stabilize in adulthood.

The scientists then looked at how fat cells change after severe weight gain or loss. Non-obese men who added significant pounds had a boost to fat cell size but no change in number. Later weight loss caused the fat cells to shrink but not vanish. Likewise, people who lost weight after stomach-stapling surgery had the same number of fat cells 2 years later. The cells, though, were smaller because they contained less fat, or lipids.

“If you are overweight and you lose weight, you still have the capacity to store lipids because you still have the same number of fat cells,” says Buchholz. “That may be why it’s so hard to keep the weight off.”

People who are overweight are sometimes viewed, by people who are not, as weak and not having the willpower to consume less. That is unfair. Yes, willpower is a factor but people who are overweight require much greater willpower than those who are not, because the level of enzymes that signal if one is full is much higher for them. The level of food intake needed to reach the state of feeling satiated is much higher, and hence they are constantly feeling hungry in ways that thin people are not. It is an issue of biology, not psychology.

We need to also get rid of the stigma associated with weight. The goal should be to be healthy, not thin. Weight is a problem only if it affects someone’s health and prevents them from doing the things that they would like to do.

But as long as being thin is viewed by society as being desirable in itself, the appeal of weight loss drugs is going to be very strong. Diabetics are reconciled to the fact that there is no cure as yet for their condition and that their treatments must be continued indefinitely, but people who seek to lose weight using these drugs are not as aware and may be in for a rude financial shock when the lifetime costs are factored in.

Comments

  1. Katydid says

    I’m always surprised that every article makes the point that stopping a drug means the symptoms will come back. Well…duh? Stop taking meds for high blood pressure and the blood pressure climbs. Stop taking meds for high cholesterol and cholesterol climbs. Stop taking meds for multiple sclerosis and the symptoms return.

    As for the cost of the drugs; yes, that’s obscene. I used to help out a handicapped neighbor who has since passed--in particular, running errands. Among other meds, she was on one of the earlier generations of blood sugar-controlling injectibles (Victoza). Because I picked up her meds from the pharmacy for her, I was there a few years back when it was $200/month, and within a year, was up to $1200/month. This was even before the hype for weight loss, when it was just a diabetes medication.

    As for obesity, it’s never as simple as calories in<calories out. The brain and the gut are engaged in a dance, and if there are any miscues, as Mano points out, it's much harder for someone to lose weight than for someone whose body chemistry is balanced.

  2. John Morales says

    One thing not mentioned in the OP: Adverse effects
    https://en.wikipedia.org/wiki/Semaglutide#Adverse_effects

    Possible side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion/heartburn, dizziness, abdominal distension, belching, hypoglycemia (low blood glucose) in people with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease (GERD).[15] It can also cause pancreatitis, gastroparesis, and bowel obstruction.[35]

    The US FDA label for semaglutide contains a boxed warning for thyroid C-cell tumors in rodents.[13][14][15][25] It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma, in humans.[13][14][15][25][36]

  3. John Morales says

    BTW, there’s been speculation Trump has been on those drugs.

    (Hopefully so, given those possible side-effects)

  4. garnetstar says

    I was wondering if these drugs make you lose *fat*, exclusively, or if they only make you lose *weight*. There’s a big difference: if you start eating a large calorie deficit (withought a lot of different and specific kinds exercise), your body loses any kind of tissue, which includes both muscle and fat.

    This, as young ballerinas have found, is very dangerous, because one organ that loses muscle is your heart. Your heart muscle actually thins down until the heart is much weaker, and so several young ballerinas died of heart attacks just from suddenly standing up.

    Also, the more muscle anywhere in your body that you lose, the more your basal metabolic rate goes down, as muscle tissue consumes a lot of calories. So when you stop the drug, you have so little muscle and your metabolic rate is so low that even a very small amount of daily calories is in excess, and you can gain weight, more than you weighed initially.

    If the drugs only suppress appetite, I’ll bet it’s weight lose, not loss of fat only. Dangerous, unhealthy, and not (as noted) permanent!

  5. anat says

    John Morales @2: Many of the side effects are temporary and can be controlled by increasing the dosage gradually. A lot of people are happy with these medications, side effects and all.

  6. John Morales says

    anat, that’s nice to know.

    Me, since I am neither diabetic nor need to lose bodyweight, I’ll pass on the temporary and manageable side effects.

    And, hey, if they’re happy to be on those “medications” on a persistent basis at whatever cost, good for them.

    (Gotta be better than a gastric sleeve, no?)

    Anyway. My comment was motivated by this:
    “The catch with using these drugs to lose weight is that although they seem to be very successful in doing so, you cannot stop using them.”

    I was suggesting that may not be the only catch.

  7. Mano Singham says

    Katydid @#1,

    I agree with you that it should not, in general, be surprising that when you stop using a drug, the symptoms that were being treated by it would return.

    But I think that many people do not understand the mechanics of weight loss. They may think that the drugs destroy fat cells so that the number of such cells actually get reduced when they lose weight.

  8. John Morales says

    Mostly done for cosmetic, not for health reasons, but still.

    Sometimes, the harvested fat is then injected back, as in, say, a BBL.

    But it’s not quite a tissue transplant.
    After a while, the body absorbs the injected fat.

    (Ah, vanity!)

  9. John Morales says

    [PS do not watch an actual liposuction procedure unless you are not that bothered by deliberate mechanical damage to the body and attendant gore

  10. John Morales says

    To be fair, it’s based on (supposedly) informed consent and under anesthesia.

    So, you know, these drugs aren’t quite so bad.

    (Tough shit about your smelly farts, but hey… manageable, no?)

  11. Katydid says

    @9, Mano: Okay, yes, I see your point. I think that’s probably a general statement and accurate for that percentage of the population that doesn’t think very deeply about anything.

    Then there’s also the lack of education on critical thinking and science. There’s a commercial on tv that shows a man in fitness clothes jogging through town. He passes a shop with some man screaming that he got ripped eating nothing but hot dogs. Or the summer Starbucks commercial showing young, thin, attractive people guzzling down super-sugared drinks and smiling as their children drink those drinks. There’s a cohort of people who believe all of this is good health.

  12. Katydid says

    @13, John Morales; you do realize that just because a side effect MIGHT happen, it doesn’t HAVE TO happen, right? My neighbor who was on the first-gen semaglutide for diabetes never had any of the side effects that might happen. OTOH, had she let her high blood sugar go unchecked, she could have lost a limb or gone blind.

  13. garnetstar says

    John, thanks for the semiglutide link, but, it doesn’t specifically answer my question.

    Suppressing appetite does mean, of course, that you get into a large calorie deficit, and, as the article says, you do lose weight, much of it consisting of fat. So yes, as it says, you do lose fat.

    But, if that’s all these drugs do, suppress calorie intake, then you lose muscle as well. There’s no mechanism in just suppressing appetite that causes *only* fat loss. From that article, the mechanism will lead to muscle loss as well. Which is a bad thing.

  14. anat says

    garnetstar, when you weigh less your body needs to make less of an effort to support you and move you around, so at least some muscle loss is not a problem. The question is how much muscle loss is too much.

  15. sonofrojblake says

    “As for obesity, it’s never as simple as calories in<calories out"

    Ah, the old "the first law of thermodynamics doesn't apply here" argument.

    If it was that simple there'd be no money in it, so it's vital we all understand that it's very, very complicated.

  16. Jazzlet says

    garnetstar re the fat loss or not
    What happens in any weight loss programme is that your fat cells become smaller, the number of fat cells you have remains the same, and remains pretty consistently the same once you finish adolescence. This is one of the reasons it is so easy to put on wieght again, those cells are just waiting to be blown up with fat again, and also why some people find it harder to maintain a healthy weight, they literally have more fat cells, so starve your teenagers! /slight sarcasm at the end there.

  17. Holms says

    As for obesity, it’s never as simple as calories in<calories out.

    Appetite and metabolic rate are complex, but weight is still a matter of burning what you take in. In order to gain a molecule of fat, a molecule of fat )or constituent atoms) must be taken in and stored.

  18. Holms says

    (The only exception to caloric intake that I can think of is water weight, and while there are some disorders of fluid retention which add to this, their prevalence is quite low. A person who is fat is almost certainly fat due to caloric intake and not water.)

  19. John Morales says

    Holms, perhaps inform yourself.

    There are numerous metabolic and systemic problems that affect weight, without even considering “food deserts” and other socioeconomic and location problems.

    Caloric intake is but one thing.

    Also, people are not bomb calorimeters.

    Jazzlet has a point; not always, but certainly sometimes applicable.

    Or, it depends.

    Here, for you:
    https://www.youtube.com/watch?v=GQJ0Z0DRumg
    Proteins, fats, carbohydrates, alcohols… all burned and metabolised differently.
    For example, proteins use a not-insignificant portion of their calories merely to be processed into bio-available matter.

    Anyway, you are conflating mass with fatness, not that you should be embarrassedted.

  20. John Morales says

    [now, this is subtle. Notice what I did not embed, and what I did embed]

  21. sonofrojblake says

    @Holms, 23:

    In order to gain a molecule of fat, a molecule of fat )or constituent atoms) must be taken in and stored

    No. You’re thinking mass when you should be thinking energy. If you ingest 2500 calories and expend 2000 calories, that excess 500 calories has to go somewhere -- first law of thermodynamics. In the body’s case, the mechanism for storing excess ingested energy is by depositing fat, with the idea that in lean times when food’s less available, it can be called upon.

    Similarly, if you ingest only 1500 calories but expend 2000 calories, that extra 500 calories has to come from somewhere -- first law of thermodynamics again. And the only place it can come from is by converting the mass of your body (usually fat, but as has been established, in a pinch your body will convert muscle mass to energy too).

    One can of course get into the weeds of complications of the metabolism, but ultimately no amount of blather can contradict an iron law of the universe -- you can’t create energy out of nothing, and you can’t destroy energy. Ingest more energy than you expend, and it MUST remain in your body in one form or another. Ingest less energy than you expend, and the energy you expend MUST come from somewhere, and the only place it can come from is your body. I have yet to see any information from any reputable source that contradicts the first law of thermodynamics. Therefore, if I’m presented with someone who contends that they “can’t lose weight”, I am forced to conclude they’re either eating too much or not doing enough exercise.

  22. Holms says

    #25 John

    Holms, perhaps inform yourself.

    I did, I studied biology at university. You?

    #28 son
    No, I used molecules and atoms deliberately. The body has no ability to create or destroy them, only to rearrange them. The energy you talk about comes from them -- changing their configuration to liberate energy ending in an electron transport chain and a proton pump in a mitochondrion; or to store it long term probably as a fatty acid.

    And whatever is done with it, it is only there for the body to play with because the person ate it.

  23. sonofrojblake says

    The body has no ability to create or destroy them, only to rearrange them. The energy you talk about comes from them — changing their configuration to liberate energy

    Well, yes. And their configuration when they arrive in the body is rather important. Specifically, they have to arrive in the body in a configuration that has stored energy in a form that the metabolism and liberate it.

    Consider: a teaspoon of sugar contains more energy than a teaspoon of water and a pencil lead. Why? The atoms involved are precisely the same ones, are they not? (Carbon, hydrogen, oxygen). The proportions are not exactly the same… but you could in principle do the sums and come up with an amount of water you’d need to drink and the amount of graphite you’d need to eat to consume the atomic equivalent of a teaspoon of granulated sugar.

    The ENERGY balance is what matters, NOT the atoms, and the graphite and water don’t come with any calories, do they? They’re no USE to you.

  24. Holms says

    My god, of all the things to fixate on. The phrasing “In order to gain a molecule of fat, a molecule of fat )or constituent atoms) must be taken in and stored” hints at food, wouldn’t you think? Maybe even takes it as assumed?

  25. John Morales says

    I did, I studied biology at university. You?

    Computer science, philosophy, logic, pure and applied math, some astronomy, some psychology.
    No biology.

    (So, what is it about which you imagine I am incorrect?)

  26. John Morales says

    “The drugs Ozempic and Wegovy, although developed to treat diabetes, have become wildly popular outside its original target population because it seems to be highly effective in reducing weight as well.”

    Nah, seems about right to me.

  27. John Morales says

    “The sildenafil compound was originally developed by Pfizer for the treatment high blood pressure (hypertension) and angina pectoris (chest pain due to heart disease). During the heart clinical trials, researchers discovered that the drug was more effective at inducing erections than treating angina.”

  28. John Morales says

    In passing,

    “Minoxidil was first introduced as an antihypertensive medication and the discovery of its common adverse event, hypertrichosis, led to the development of a topical formulation for promoting hair growth.”

    [Feeling lazy. Just select the text, context-click for “search”, if you want sources. All genuine quotations]

  29. John Morales says

    Historically:

    “Thousands of people suffered serious heart and/or lung damage after taking the diet drugs fenfluramine (Pondimin) or dexfenfluramine (Redux). Levin Sedran & Berman served as Co-Lead Counsel in the Fen-Phen (Diet Drugs) litigation, a case that resulted in a class settlement valued at over $7.65 billion.”

  30. John Morales says

    Look: if you’re taking pills with (possible only!) side-effects just to lose weight, it better be medically-indicated, not just faddish.

    My point (again!): it’s not just about the expense and the evanescence of its effects, not even about the (possible only!) side-effects, but about peer pressure and plain old vanity.

    (There is no possible medical reason for BBLs)

  31. John Morales says

    Oh, and of course, Big Pharma $$$.

    (That should have gone without saying, but it’s Holms at hand, so…)

  32. sonofrojblake says

    hints at food, wouldn’t you think? Maybe even takes it as assumed?

    Well yes -- that was MY point. That the atoms and molecules (the mass) are NOT the issue -- the ENERGY contained in their specific configuration is the key. And the difference between food and not-food is precisely that -- is there ENERGY in it that my body can use, or not? (I leave it as an exercise for the bored to argue whether such things as salt are food, being as they are the sort of trace minerals vital to the continued functioning of the energy transfer machinery without themselves containing any energy).

  33. Holms says

    #34 etc John
    You have lost the thread. Hint: you asked me a question in a reply to my post at #29, which was in reply to yours at #25. You asked me what you were wrong about in our conversation, and I responded to that specific question.

    #40 son
    None of this is relevant to my #23.

  34. John Morales says

    But, Holms, you wrote “the post”, in the comment threads to the post at hand. 🙂

    I can’t help it if you want to play the pronoun game.

    I surely answered about the post, no?

    (Heh)

    OK, so… what was I wrong about, in your estimation?

    (In my comment, which is not the post)

    And, come on!
    “The post was silly from the first line.” is not super-informative, is it?

    (Vague bluster is what I get, alas)

  35. Holms says

    Common internet parlance, post also applies to replies to the original post, hence ‘OP’ to refer specifically to the Original Post (or poster) as opposed to all the others that follow. Perhaps you’ve also noticed the text on the button you click on with every reply?

    Anyway, you replied as if to correct me (“Holms, perhaps inform yourself” sets the tone); and then you added things that did not correct anything I said or point out an error.

  36. sonofrojblake says

    Holms, #23

    In order to gain a molecule of fat, a molecule of fat )or constituent atoms) must be taken in and stored

    Me, #28:

    You’re thinking mass when you should be thinking energy.

    Holms, #29:

    I used molecules and atoms deliberately. […] The energy you talk about comes from them

    Me: #30:

    they have to arrive in the body in a configuration that has stored energy[…]The ENERGY balance is what matters, NOT the atoms

    Holms, #31:

    The phrasing […] hints at food

    Me, #40:

    that was MY point. That the atoms and molecules (the mass) are NOT the issue — the ENERGY contained in their specific configuration is the key

    Holms, #41:

    None of this is relevant to my #23.

    Eh? I mean, it’s not relevant if you’ve forgotten what you wrote in #23 I guess, but I can’t see any other way that it’s not laser-focused on the fact that your contention in #23 is simply wrong. I think we’re done here.

  37. John Morales says

    Better, Holms.
    Though I’m sensing a little bit of perfunctoriness in your efforts, recently.

    Common internet parlance, post also applies to replies to the original post, hence ‘OP’ to refer specifically to the Original Post (or poster) as opposed to all the others that follow.

    The Original Post(er), yes. I’ve been around a while.

    Perhaps you’ve also noticed the text on the button you click on with every reply?

    I also notice the difference between the act of posting and the comment that act posts.
    You know, the noun and the verb.
    So, did you notice the text is “Post Comment” rather than “Post Post”?

    Heh.

    (Your attempted pedantry is weak)

    Anyway, you replied as if to correct me (“Holms, perhaps inform yourself” sets the tone); and then you added things that did not correct anything I said or point out an error.

    No, I added considerations you ignored, as I did with the OP.

    “There are numerous metabolic and systemic problems that affect weight, without even considering “food deserts” and other socioeconomic and location problems.”

    As I wrote above, people are not bomb calorimeters, and they’re no factory-produced to particular tolerances. They’re not spherical, IOW.

    (If you can’t get a single sentence, you’re not gonna get an entire treatise, are you?)

  38. John Morales says

    Was I too curt, Holms?
    Here’s a nugget (but you know all that, having done biology back in your salad days) there are other factors at play even beyond those I’ve hitherto noted.

    (Did you study how come there are floaters and there are sinkers?)

  39. Holms says

    #46 John
    Can’t say I’ve noticed a difference, I post when I choose and as time permits. Perhaps these interactions simply weigh on you a little more heavily.

    For my part, I’ve noticed an increasing tendency for you to return to add bits and pieces to a thread as and when they occur to you, as demonstrated here with your slow quad post over the course of 8 hours. That suggests a difference between us: after I read responses and post, I move on; by contrast you appear to become preoccupied with it throughout the day.

    The Original Post(er), yes. I’ve been around a while.

    Ah good, then you know perfectly well that in internet parlance, the subsequent replies are often called posts as I said.

    No, I added considerations you ignored, as I did with the OP.

    Sure, you were just being constructive! I always lead my constructive posts with a verbal shit on the person first too: “Holms, perhaps inform yourself.”

    And, considerations that I ignored? I guess you missed the mention of appetite and metabolic variance.

  40. John Morales says

    Perhaps these interactions simply weigh on you a little more heavily.

    <smirk>

    Still trying to claim I’m a fragile melty snowflake with low self-esteem?

    Heh.

    (Wishful thinking is wishful)

    Ah good, then you know perfectly well that in internet parlance, the subsequent replies are often called posts as I said.

    Well, other than by the system here. “Post Comment”, it says.
    And by clueless people.

    Sure, you were just being constructive! I always lead my constructive posts with a verbal shit on the person first too: “Holms, perhaps inform yourself.”

    O, so very sensitive!

    I guess you missed the mention of appetite and metabolic variance.

    (sigh)

    I really need to elucidate, eh?

    OK, one aspect at a time.

    Protein takes the most energy to digest (20-30% of total calories in protein eaten go to digesting it). Next is carbohydrates (5-10%) and then fats (0-3%). Thus, if you eat 100 calories from protein, your body uses 20-30 of those calories to digest and absorb the protein. You’d be left with a net 70-80 calories.

    So, 100 calories is 100 calories, right? As determined by a bomb calorimeter.

  41. anat says

    Another thing regarding calories in/out: One thing that happens when trying to create a calorie-deficit over time is that the body ‘decides’ to spend fewer calories on self-maintenance -- this may mean fewer calories dedicated to the ongoing work of the immune system, or wound healing, or any other ongoing tasks of the body. So the calorie deficit that needs to be created in order to maintain the weight loss trend increases. Our bodies would rather be fat and unhealthy than lose fat. this may tell us something about what were the worse short-term threats to our ancestors a long while back.

  42. KG says

    anat@52,
    Sorry -- more specifically, for what the body “decides” to use less calories doing.

  43. Holms says

    Still trying to claim I’m a fragile melty snowflake with low self-esteem?

    No, I’m successfully claiming “these interactions simply weigh on you a little more heavily” and so forth.

    Well, other than by the system here. “Post Comment”, it says

    I must have missed the bit where that somehow makes common jargon not apply here.

    O, so very sensitive!

    To you, describing a tone = vulnerability.

    So, 100 calories is 100 calories, right? As determined by a bomb calorimeter.

    Not only is that not a claim of mine, you might recall I spoke more in terms of the material involved rather than energy.

    Maybe.

  44. John Morales says

    No, I’m successfully claiming “these interactions simply weigh on you a little more heavily” and so forth.

    Successfully claiming, sure.
    Being about as wrong as one could be, just as sure.

    (You’re my antagonist, you ain’t heavy)

    I must have missed the bit where that somehow makes common jargon not apply here.

    I refer you to my #34.

    To you, describing a tone = vulnerability.

    Such a vivid imagination!

    No.
    To me, imagining a simple suggestion that you should educate yourself a verbal shit on the person first too: “Holms, perhaps inform yourself.” is being rather sensitive.

    (Be aware that ‘vulnerability’ and ‘sensitivity’ are not synonymous)

    Not only is that not a claim of mine, you might recall I spoke more in terms of the material involved rather than energy.

    Well, duh. Thus, I wrote: “No, I added considerations you ignored, as I did with the OP.”

    See, a claim you ignored is not a claim you made; this is about as basic as could be!

    (Why you think I was supposedly correcting you about something you wrote is left as an exercise)

    So. What about stools, then?

  45. Holms says

    #57 John
    Your own words make the conclusion inescapable: you paused to consider whether to post what you did, citing our prior interactions. You considered not posting an endorsement of my comment because of them. By your own words, and in stark contrast to me, our dynamic weighed on you.

    Pause to note that “Perhaps these interactions simply weigh on you a little more heavily [than they do on me]” is not a claim that they weigh heavily on you, only that they are lighter -- a little lighter -- on me.

    I refer you to my #34.

    #43.

    And whether you get over yourself enough to admit that point or not, there is also context. I responded to a question: “So, what is it about which you imagine I am incorrect?” Note the first person pronoun. You asked a question with “I” as the subject, yet thought my reply was about Mano.

    To me, imagining a simple suggestion that you should educate yourself a verbal shit on the person first too: “Holms, perhaps inform yourself.” is being rather sensitive.

    Ah, you meant sensitive to mean perceptive as opposed to delicate and similar? Fair enough, accepted.

    See, a claim you ignored is not a claim you made; this is about as basic as could be!

    The why did you post:

    No, I added considerations you ignored, as I did with the OP.

    “There are numerous metabolic and systemic problems that affect weight, without even considering “food deserts” and other socioeconomic and location problems.”

    To reference your reply to my #23 and #24, in which I mention metabolism?

  46. John Morales says

    Your own words make the conclusion inescapable: you paused to consider whether to post what you did, citing our prior interactions. You considered not posting an endorsement of my comment because of them. By your own words, and in stark contrast to me, our dynamic weighed on you.

    Fine, fine. Comfort yourself as you wish.

    And it was indeed #34; you know, the immediately succeeding comment responding to your claim.

    (That’s the example of the common jargon not applying here)

    The[n] why did you post:

    No, I added considerations you ignored, as I did with the OP.

    Because I added considerations you ignored, that’s why.

    (See, adding stuff you did not mention is not correcting what you did mention)

    BTW, for at least some people, willpower actually works.

    I knew someone who went from rather corpulent to rather thin over around 6 months and kept the weight off. No drugs, no surgery, not that much more exercise. Just eating less.

    It is actually doable.

  47. John Morales says

    Meh. No stamina, some people.

    Try again.

    I responded to a question: “So, what is it about which you imagine I am incorrect?” Note the first person pronoun. You asked a question with “I” as the subject, yet thought my reply was about Mano.

    Ahem. @34: ““The drugs Ozempic and Wegovy, although developed to treat diabetes, have become wildly popular outside its original target population because it seems to be highly effective in reducing weight as well.”

    Nah, seems about right to me.”

    Is it not obvious to you, even now?

    I was correct about thinking that the claim I quoted (the post itself, not the comments in the associated thread) seems about right to me.

    Ah well, let me try to help you deal with me.

    You ever read https://en.wikipedia.org/wiki/The_Monkey%27s_Paw ?

    (I used to DM D&D, and my wish-granting was in that same vein)

  48. says

    The TV ads for Wegovy are kind of weird. There’s lots of people — most apparently a bit heavyset but not what I’d call “fat” — dropping whatever they’re doing to join some spontaneous parade/procession through their very clean and wealthy-small-town-or-suburb-looking streets to some destination or objective that’s never specified. One of those people is a middle-aged dad who’s showing his teenage son how to fix a car; but then sees the big spontaneous procession going by; so he just hands his son the wrench as if to say “Okay, you’re on your own, I’m off to join this happy parade to god-knows-where, bone for tuna working for your tuition money!” Seriously, WTF were they trying to say with that ad? “Just walk away from your entire life and start taking our brand-new weight-loss drug instead!”?

  49. says

    One can of course get into the weeds of complications of the metabolism, but ultimately no amount of blather can contradict an iron law of the universe…

    God’s balls, this stupid argument again? Just because all matter is governed by “iron laws” of physics, doesn’t mean you get to quote the iron laws and pretend you’re saying something useful about something vastly more complex and idiosyncratic like metabolism and diet. If you want to talk intelligently about diet and weight, then you have no choice but to “get into the weeds of complications of the metabolism” (not to mention the weeds of complications of psychology and its interaction with physiology) — quoting basic laws of thermodynamics doesn’t get you out of any of that.

    Seriously, who here is “contradicting an iron law of the universe?”

  50. Holms says

    #59 John
    You are the one that already needed to overcome his misgivings before posting. Thanks for conceding the point though.

    (See, adding stuff you did not mention is not correcting what you did mention)

    I guess you’ve reached the stage where you have forgotten, or are hoping that I have forgotten, that you in fact did try to correct something: “Anyway, you are conflating mass with fatness, not that you should be [embarrassed].” I say ‘attempt’ specifically because I did not make that conflation, but the attempt was there.

    Since you still, still don’t get it, the sentence “The post was silly from the first line” was in reference to the post you made in which you tried to correct my own, i.e. #25. Though to clarify, that should not be taken to mean that the entirety of #25 was silly, but starting with that silliness was a bad start.

    And I am not the one that needs advice as to how to deal with his interlocutor. Again, you’re the one that needed to take a calming breath before *gasp* agreeing with me.

  51. John Morales says

    Heh.

    You are the one that already needed to overcome his misgivings before posting. Thanks for conceding the point though.

    There, there. Sure.

    (Not like I ever think about any other posts ever about anyone ever about whatever topic given whatever history

    I guess you’ve reached the stage where you have forgotten, or are hoping that I have forgotten, that you in fact did try to correct something: “Anyway, you are conflating mass with fatness, not that you should be [embarrassed].” I say ‘attempt’ specifically because I did not make that conflation, but the attempt was there.

    <smirk;gt;

    Random guesses are random.

    Also, mine was an observation, not a correction.

    And, also, you personally imagine that did you not make that conflation.

    See, asserting you did not is not the same as arguing you are not, unless for you assertion is the same as arguing. And argue you did not, other than by assertion.

    Since you still, still don’t get it, the sentence “The post was silly from the first line” was in reference to the post you made in which you tried to correct my own, i.e. #25.

    Heh, chewtoy is chewy.

    Nah, I entirely got what you intended to express, but I chose to respond to what you actually wrote.

    I am having fun with you, Holms.
    I was then, I am now.

    And I am not the one that needs advice as to how to deal with his interlocutor.

    Of course not. You are the one that heeds not advice. 🙂

    Again, you’re the one that needed to take a calming breath before *gasp* agreeing with me.

    Heh.

    Butting egos with me is fun, but you know.
    We did that once before, and Mano closed the thread.
    I apologised to Mano, and by now it’s evident what’s going on again.

    So, there you go.

    Carry on, but unless it’s about the post topic instead of ego-butting (I do like a good bottom), I’ll leave you to it.

  52. Holms says

    You are the one that already needed to overcome his misgivings before posting. Thanks for conceding the point though.

    There, there. Sure.

    Your own words show that you had a moment of uncertainty as to whether you should voice agreement with me given our arguing. And that you consider non-engagement with an argument acceptance of that argument. So yes, surety is what I have.

    Random guesses are random.

    Informed by your behaviour and your expressed insecurities and hence not random.

    Also, mine was an observation, not a correction.

    And, also, you personally imagine that did you not make that conflation.

    You made an incorrect claim; the conflation was entirely a product of your exegesis.

    See, asserting you did not is not the same as arguing you are not, unless for you assertion is the same as arguing. And argue you did not, other than by assertion.

    A fascinating statement, given you have yet to go beyond simple assertions that my post made that conflation.

    Of course not. You are the one that heeds not advice.

    If not needed, why heed it?

    Heh, chewtoy is chewy.

    Feels more like being gummed.

    Carry on, but unless it’s about the post topic instead of ego-butting (I do like a good bottom), I’ll leave you to it.

    I’m sure you make an excellent bottom, but before you flounce: you took issue with my post, I have simply been responding to your criticisms. This chain of silliness began at #25.

  53. sonofrojblake says

    @Raging Bee, 62, falling at the first hurdle:

    If you want to talk intelligently about diet and weight

    Hahahahahahaaaaahahaaha. Good luck finding one of those conversations. Meanwhile, here we have, at literally post #1:

    As for obesity, it’s never as simple as calories in<calories out

    Nobody ever wants to truly engage with the fact that if you burn more calories than you consume, you get thinner. It’s just not the message people want to hear. Hence the weight loss industries.

    And the classic at #23:

    In order to gain a molecule of fat, a molecule of fat )or constituent atoms) must be taken in and stored

  54. says

    Hahahahahahaaaaahahaaha. Good luck finding one of those conversations.

    Actually, there are plenty of people having such conversations. They’re just not having them with simpleminded physicists and physicist-wannabees.

    Meanwhile, here we have, at literally post #1: “As for obesity, it’s never as simple as calories in<calories out."

    Yeah, that statement is verifiably true, and doesn’t contradict any “iron laws” of physics.

    Nobody ever wants to truly engage with the fact that if you burn more calories than you consume, you get thinner.

    Yeah, right, you’re another brave heroic physicist, talking down to people you know nothing about, regarding health issues you know nothing about, and pretending you’re cutting some gordian knot with a simple truth that no one else ever had the guts to face until you showed up. Just like those physicists bribed funded by the Heartland Institute to pretend basic physics is a real science and climatology isn’t.

    Fuck off to bed, and take your patronizing know-nothingism with you.

  55. sonofrojblake says

    @67: it’s usually pointless trying to argue with a Jehovah’s Witness about what they consider doctrine, so Im going to wish you well in your beliefs and leave it there.

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