To think that people pretend not to understand obesity

Yep it’s looking more and more likely that a maintenance dose will be the way forward.

Yep. I no longer engage with anyone who hasn't read the easily available and well-established science around why people develop obesity.

You have to tune out to them, OP. You get uneducated dickheads commenting on every topic under the sun - this is no different. “Just eat less, move more”… oh - silly me, I hadn’t realised that, despite being very successful in every other element of my life, that had escaped me, thank you for the info!’

I’m nearly 4 stone down after 6 months on Mounjaro. Coming to the end of the loss I wanted, and will stay on Mounjaro for long term, to maintain.

After 50 years of dieting, overeating & binging, gaining, dieting, over-eating and binging, (since actual appetite suppressants aged 8 in the 1970s 😡) it’s almost a literal miracle to me.

Good luck with it, OP.

I don't care what your take on it is and have no interest in defending mine to you. I'm here to express solidarity with the OP.

I agree - don't have anything against WLI or ADs and in fact ADs have helped me massively. Just got to deal with the very real effect that being menopausal brings, in my case. It is harder! (I'm not a candidate for WLIs for other reasons.)

I think this is definitely part of the reason people have a negative attitude towards weight loss injections.

What they perhaps don’t factor in is that a regular weight person and an obese person have a different starting position in the same race. If you have a high BMI, you will have a higher level of insulin resistance. Insulin resistance messes with your hunger signals, it makes you crave food more. There have been controlled studies done where the same nutritionally balanced food was given to people with normal BMI levels and people with high BMI / obesity. The normal BMI group reported fullness and satisfaction after eating. The high BMI group reported still feeling hungry and craving sweet food after eating the same meal. This is what insulin resistance does. It makes the battle harder.

Mounjaro levels the playing field and gives people with high BMI the chance to resolve their insulin resistance so they can get to the same starting point in the ‘race to maintain a healthy weight’ as everyone with a normal BMI.

I know two people who’ve each lost 5 stone, largely through stopping buying and therefore eating all the snack foods they used to have (chocolate, crisps, biscuits, cakes etc) and exercising a bit more, mostly just walking, nothing hard core.

One of them had also cut out the vast amounts of full fat Coke she used to get through every week.

Genetics may not change that quickly but that does not mean they don't have an impact. Look into epigenetics. The environment (eg UPF) can absolutely have differing effects on different people on the basis of underlying genetics which have not changed.

This is it, the amount of food available and the choice of food available is through the roof compared to say just a generation or so ago. Combine that with people being less active- even just something simple like internet shopping not existing before, is it any wonder more people are obese now. I don't see how people can claim its just down to hormones or genetics- humans dont change that quickly! It's the food industry and lack of activity that has changed big time.

Agree, I was overweight, started tracking my calories and exercise. I actually had to have a lot less calories than I was told (probably partly because you can’t track everything accurately and also because no one likes to recommend 1000 calories or less, even for a short amount of time) and did over twice the amount of steps recommended until I started to lose weight, only then did I start losing consistently. Also for me I needed to see good losses straight away otherwise I gave up, I learnt this over a two year weight loss journey. I don’t do running or cardio yet because I find I’m so hungry doing that I eat too much so I’m waiting till I’m my goal weight to reintroduce it, but everyone is different and it takes a while to find out what works for you.

Yeah going back 40 years there was far less obesity, but going back 40 years we did not have the same food around, we did not even have a lot of food on tv: I think there was Delia Smith and The Food Programme, and absolutely no cult of the celebrity chef. We didn't have tons of ingredients that were pretty bad for you really, not mainstream like it is now. If you put a 30 year old in a supermarket in a rural town from the early 80s they'd be shocked at how little there was. Processed food was Findus Crispy Pancakes and Pot Noodles, you didn't find things like popcorn chicken in southern fried batter, you didn't have 3-for-2 offers, big fridges were rare, and you didn't sit around with computer games because they hardly existed. And we for sure ate less, portions were smaller, we didn't eat out a lot and you didn't have takeaways at the press of a button.
There have been so many massive changes all over society, it's impossible to single one out. I think it's that the odds of having a great metabolism AND no confounding factors like depression/ADHD/metabolic factors, AND a decent income and time so you can really prep the food are kind of stacked against us and we barely notice.

I think a comparison with WLI and antidepressants stands though.
Of course it's ridiculous to say to someone with depression oh just go for a walk, even though the walk would help. But if the person with depression took medication that lifted them enough they they could consider getting dressed and leaving the house for the walk, then it seems possible. And they could then benefit from the walk, which would help their depression.
WLI are a similar tool for a different disease. They're doing the handholding, hormonally, that allows the obese person to do what they need to do to lose the weight and hopefully move towards better health.
People saying 'just' go for a walk or 'just' eat less are missing that it's really not that simple for a lot of people. That's why it's brilliant that the medication exists to help.

@NorthernGirl1981 its not that simple. I’ve spent a lot of time trying to work out what causes my weight gain and addressing that to the point I can maintain quite easily. But I could not lose no matter what I did. After 4 years of futile struggle I went on mounjaro and I’ve lost nearly 2 stone and want another stone off then I hope to taper off and I hope the work I did before that will the kick in and help me maintain.

What in the holy hell have I just read?

I just want to make sure you're not patting yourself on the back for your words of 'wisdom' @mnreader

Good luck @Mezzoprezzo. I hope you feel good about having made the right choice for you.

There may also be a bit of “ well I need to put effort in to not gaining weight- why do obese people assume they have it harder”

I dont think it's that people pretend I think they just genuinely dont understand weight gain or loss and why others find it difficult. If you havent struggled with it and have a healthy relationship with food since childhood then its very difficult to understand. I've always struggled with weight and been in the obese category for a few years but even I could never understand people who were bigger than me, I couldnt understand why people didnt just hit a limit and decide 'enough is enough I need to change.'

I was raised in a family with massive portions and lots of snacks and once or twice weekly takeout so I thought that was normal.

To some extent I dont understand why people dont engage personal trainers or dieticians and counsellors but I'm also aware that there are financial implications etc

I also think a lot of people try diets for a few months or weeks and dont get the results they want so give up. The diet and weight loss advice is so conflicting and confusing but a lot of people underestimate how many calories they consume and how few they can afford to consume before they put on weight. I'm someone who was obese so I can see how someone who's always been a healthy weight wouldn't understand it.

I just genuinely don't understand and can't relate to not being able to control what you eat and be moderate.

Yes the food industry is geared to make you eat vast quantities of the unsatiating processed shite that they produce. But I can just use will power to avoid all of it and eat real food.

I'm not trying to be ignorant. I don't understand the mindset of an obese person at all. My mum has only ever been obese and says things like: "I can't have bread in the house, I'd eat the whole loaf in a day". I always think: "Well just don't!"

I think you're BU as they're not pretending. They really don't understand it. They genuinely think obese people are unable to understand "eat less move more" or too stupid and weak willed to do it.

I started MJ in October and have lost almost 5 stone. I still have around 3 to go. MJ hasn't changed the fact that I have to make the right choices to lose weight but it has absolutely removed the constant all-encompassing hunger of previous weight loss efforts. I don't know what my maintenance will look like when I get there. Will I need to stay on meds? No idea. I'll cross that bridge when I get there.

For now I still have a metaphorical mountain to climb but unlike my failed previous attempts which felt like dragging myself up a cliff edge by my fingers, this time I'm heading up a steady but doable route and getting chance to enjoy the views along the way. I hope it works well for you too OP.

i have to say that I suspect some people on here are less self aware than they realise

until very recently I would say I had a shit diet and fail to get enough exercise ( the diet hasn’t changed - my observation of others has been more focussed on)

in fact it’s almost all home cooked, low UPF, portion controlled and I walk every where - it’s just I notice the crap bits

my mother will tell you it’s crap as I eat crisps
but ahe doesn’t notice that I don’t have slabs of butter on shop bought bread for breakfast …

what I am getting too is that what we think and what happens in reality are often out of sync

1. calories in calories out does work for almost everyone
2. sugar and UPF leads to higher calories in

I became obese after years of being thin. I can only speak personally but for me, depression makes me not want to move my body at all. It's almost never addressed like that. It goes: getting out for a walk will benefit your mental health! Yes, it will, but how do I get to the point where I can go out for a walk? That's what's missing. I think if someone is inclined to see laziness as a driver for obesity, then they are not able to comprehend what leads to the non-movement (not laziness).
I'm not sure that a lot of mental health or exercise advice is geared towards this either. One thing that helps me is to understand what kinds of movement I enjoy (rambling fast through hilly forests; slow but challenging yoga) and what I definitely don't give a shit about doing (couch-to-5k; Zumba).
But when you are depressed, that takes a lot of soul-searching. It's pretty low on the list of things you need to do on any given day.

I don’t pretend to understand obesity in any scientific sense, but it has always been clear to me (as someone with a sweet tooth, who has never had to work out or count calories or do all the things people say you need to do to stay slim) that so much of body size and metabolism is down to genetics.

I have so many friends who eat super clean and run several times a week and still struggle with their weight and have high risk for heart disease. Many also have PCOS or autoimmune conditions.

Sure, processed foods with hidden sugars etc have a huge role to play in obesity as well. But it really pisses me off when people want to understand it as a moral failing on the part of individual people.

Nobody ever sneers at me for being largely inactive with a shit diet - which are things that are true about me, and bad for me, and almost certainly storing up problems for the future. But nobody judges me for it because I look like what people imagine ‘healthy’ looks like.

We could all probably do with looking after ourselves better, but people (particularly women) with bigger bodies seem to get it in the neck all the time from meddlesome other people, with so much weird overinvestment and judgement.

Spain is only just behind the UK re obesity. The concentration is different, so it's the poorer areas that have more. When looking at the causes of death, there's little difference. Wegovy became available last year, about the same time as here, so it's just a, your friends, issue, in terms of not knowing about them. I was there May 2024 and saw adverts.
I've always wondered why some alcoholics, who still eat a reasonable amount aren't obese. Their calorie consumption should be making them obese. The endocrine stuff us interesting. My DD has a endocrine and gastro issues, she's scared to eat and can drop underweight. Her DD, in primary school is very overweight, she has the signs of hormone issues and has a MPA. She eats less than her petite sister. She was born chubby and got bigger while exclusively BF.

I get this, and I do understand the frustration. But saying “medical conditions though!!!!” totally undermines the obesity issue at hand. 2/3 of the population (?) is obese. They do not all have medical conditions.

My child has incontinence issues so had to wear nappies when starting school. People complain a lot about the issue with increasing numbers of children not potty trained by the time they start reception. I KNOW when they are judging lazy parents (possibly even me) that the judgement doesn’t really include me as it is due to a medical condition. I can separate those two issues and understand that the lack of potty training parents is an issue still.

Exactly so it comes down to the food being eaten.

If people come from a poor background, they are likely to eat more poorly in childhood and adolescence, which is when fat cells for later life are established.