What do we REALLY think about the weight loss jabs?

I hadn't expected such basic concepts to be so beyond you that you were reduced to calling them meaningless because you've backed yourself into a corner, but mmmkay. Guess it's either that or explain quite why you're so keen to insert comparisons about thin and unhealthy vs fat and healthy. It's not like that bears any resemblance to what's actually happening.

🤣 I don’t think anyone is sitting there exclusively eating KitKats! But the evidence doesn’t really show an improvement in diet quality either. And as a pp said, why would it?

Most studies are small and obviously reflect the diet preferences of the patient population (ie large portions and/or calorie dense/nutrient poor foods). Mostly they show a reduction in overall intake, but nutrient deficiency. I AI’d the summary

• UK - n=38. Mean intake was 1,337 kcal/day. All participants below the fibre recommendation, 45% below protein requirements, and substantial micronutrient shortfalls were found. https://lifestylemedicine.bmj.com/content/1/Suppl_1/A1.2
• USA - CRAVE study, n=43 enrolled; 28 completed. Semaglutide/tirzepatide substantially reduced food intake over 24 weeks, but overall diet quality did not significantly improve. https://pmc.ncbi.nlm.nih.gov/articles/PMC13334816/
• USA - tirzepatide RCT, n=55. Tirzepatide reduced cravings for sweets, carbohydrates and high-fat/fast foods, but didn’t increase preference for fruit and vegetables. https://pmc.ncbi.nlm.nih.gov/articles/PMC12515769/
• USA - tirzepatide RCT, n=114. Tirzepatide reduced food intake, hunger and cravings for high-fat and sweet foods. Again, fruit and vegetable cravings did not increase. Link
• USA - n=16,143. Adults eligible for GLP-1 treatment had poorer diet quality and greater micronutrient inadequacy, although differences were largely explained by waist circumference. This describes the population likely to receive WLIs, rather than an effect of the drugs themselves. https://jn.nutrition.org/action/consumeSharedSessionAction?JSESSIONID=8B076E65107378630CDBF43448FCD4F3&MAID=TwMJ5QwsO2fjn3rP%2FzTNDQ%3D%3D&ORIGIN=528091075&RD=RD&exp=m530hR8kZkWFrMZ4YxEPNA%253D%253D

🤣 I don’t think anyone is sitting there exclusively eating KitKats! But the evidence doesn’t really show an improvement in diet quality either. And as a pp said, why would it?

Most studies are small and obviously reflect the diet preferences of the patient population (ie large portions and/or calorie dense/nutrient poor foods). Mostly they show a reduction in overall intake, but nutrient deficiency. I AI’d the summary

• UK - n=38. Mean intake was 1,337 kcal/day. All participants below the fibre recommendation, 45% below protein requirements, and substantial micronutrient shortfalls were found. https://lifestylemedicine.bmj.com/content/1/Suppl_1/A1.2
• USA - CRAVE study, n=43 enrolled; 28 completed. Semaglutide/tirzepatide substantially reduced food intake over 24 weeks, but overall diet quality did not significantly improve. https://pmc.ncbi.nlm.nih.gov/articles/PMC13334816/
• USA - tirzepatide RCT, n=55. Tirzepatide reduced cravings for sweets, carbohydrates and high-fat/fast foods, but didn’t increase preference for fruit and vegetables. https://pmc.ncbi.nlm.nih.gov/articles/PMC12515769/
• USA - tirzepatide RCT, n=114. Tirzepatide reduced food intake, hunger and cravings for high-fat and sweet foods. Again, fruit and vegetable cravings did not increase. Link
• USA - n=16,143. Adults eligible for GLP-1 treatment had poorer diet quality and greater micronutrient inadequacy, although differences were largely explained by waist circumference. This describes the population likely to receive WLIs, rather than an effect of the drugs themselves. https://jn.nutrition.org/action/consumeSharedSessionAction?JSESSIONID=8B076E65107378630CDBF43448FCD4F3&MAID=TwMJ5QwsO2fjn3rP%2FzTNDQ%3D%3D&ORIGIN=528091075&RD=RD&exp=m530hR8kZkWFrMZ4YxEPNA%253D%253D

I don't need AI to see that out of those, two of them state that there was an improvement in diet quality (the decrease in sweets, high fat and UPFs is a bit of a clue there) and they are, in terms of statistical significance, data slop - the first was based upon a self reported three day food diary by 38 participants, the second 28 people, 55 and 114.

The final one is what the participants' diet and nutritional was like before commencing GLP-1 medication due to meeting the prescription criteria for a medication and, in the absence of either a handy Time and Relative Dimension in Space vehicle or a spare De Lorean, it is rather difficult to envisage the thought process where you are attributing a conclusion such as this to baseline data.

Honestly, anyone else rolling their eyes at this.

id love to know what’s driving you, it’s not a concern for fat people. I wonder if we could see you if we would know. Either way it’s your business.

but, seriously, you’re obsessed about fat people getting slim. Which is your bad luck.

Honestly, anyone else rolling their eyes at this.

id love to know what’s driving you, it’s not a concern for fat people. I wonder if we could see you if we would know. Either way it’s your business.

but, seriously, you’re obsessed about fat people getting slim. Which is your bad luck.

The point of the latter study is precisely that diet before was terrible, and the smaller samples show diets don’t vastly improve. If you think a massive lack of basic nutrients is an improvement, then fair enough. ‘Fewer UPFs’ seems like a very low baseline, and certainly not one I’d claim was a healthy diet. That seems blindingly obvious to me, but we’re all different.

Can be useful when used properly. Muscle loas is the biggest issue so patients should be told in order to use the Jabs they still have to asign to a Gym and do strength and weight training. Otherwise they will loose muscle which has massive health impacts. If they are unable to stick to that then no Jabs.

Yes let's infantilise and restrict those stupid lazy fat people 🙄 or just bog off. No one is so interested in medication for any other disease.

I have no idea what you’re finding so difficult, but I don’t think I can help you any further.

I have had gallbladder issues (cholecystitis) in the past, although not at all for several years now. I think a fat free diet is relevant. Eating some fat, especially unsaturated good fats, keep the gallbladder moving. No fat for a while, followed by high fat, can be a disaster. Obviously just after I had the problem, I was sensitive to fat of any kind, and I think that’s what confuses people. Several months later i introduced it gradually.

I don’t use or want to use injections, although I wouldn’t be allowed them anyway. I suspect that some people lose weight too quickly on them.

Yes, I agree you're unlikely to be able to help any further. You certainly aren't going to provide us with a cogent explanation of why you keep trying to steer conversation towards a comparison between thin and unhealthy vs fat and healthy. Not to worry though, people can join the dots.

The smaller samples aren't big enough to be taken seriously. I can find you larger samples saying the opposite just on the WLI board on MN, including myself.

Hi, I hope I'm not being inapropriate here, and I can see there is a robust debate going on , but I just wanted to add my 2pence worth with regard to the jabs. I was put on Mounjaro around 12 weeks ago. It was mainly for diabetes and secondary weight loss. I am on 5mg. In that time I have lost 3stone, but I felt compelled to write because of the effect on my diabetes. I was diagnosed type 2 in 2019. I was on a lot of medication as diabetes is also affected by sleep quality (I'm an insomniac.) and stress (I have many anxiety disorders including cPTSD.). I think I was on 4 tablets for diabetes alone in one day. I've recently had a full blood test that included HbA1c, the test for blood sugar. 48 and above is diabetic, 42 and above is prediabetes. I am so pleased to say my last reading was 39!!! I've not been that low ever. It's all the mounjaro. It really changed my eating habits and how I felt about sweet stuff. The food noise is coming back now a bit but I don't want to go up another dose yet as I'm having other health issues to deal with, but the result has really spurned me on and I want to continue to eat as healthy as I can. I just want to sing it's praises and the consultant that put me on mounjaro!
Thank you for letting me interrupt you, and I hope someone finds my post encouraging.

I wasn’t steering anything - it was a point that’s now been lost, but the only relevance was that simply losing weight isn’t a panacea so it’s quite important that we collectively maintain expectations on governments to make sure green space, public transport, healthy food, etc are accessible because just reducing obesity through drugs is not enough. I genuinely do not see what’s difficult or controversial about that.

It's the use of terms like maintain, and the initial eyes off the ball which you later agreed wasn't really accurate. The terminology you keep using doesn't make it clear enough that we weren't properly doing these things pre WLIs anyway, still aren't and that there's no evidence WLIs have impacted on that at all.

If you wrote that we needed to start doing these things in a way that could help reduce obesity, and didn't have anything to say about thin unhealthy people vs fatter healthy people as though that were the actual choice being made, I'd agree with you. And the policies you list are good and beneficial things even if they don't do anything to reduce obesity rates. We should do better at them either way.

You’re nitpicking terms because you disagree with the perceived premise. Fine, you want me to point out that things were before WLIs (which I had thought went without saying) , so I do that and then that’s insufficient, you insist it’s not clear. It’s an internet message board, I’m not giving evidence at a select committee!

You were the person who first said it was better to be thin and unhealthy, and I disagreed with that and made the comparison with fat and healthy vs thin and unhealthy. Yet you’ve badgered me every since that it’s an example of me ‘boxing myself in’ or ‘steering the conversation’. At no point did I say or imply it was a binary choice.

I don’t understand your problem with the word maintain.

I have zero problem with debate or disagreement, or being called a fucking idiot. But some of these posts are clearly not about the subject matter and are people bringing their own defensiveness about weight/weight loss/whatever. For the avoidance of doubt, I couldn’t care less what individuals of any size choose to do with their bodies, be fat be thin be whatever you want by whatever means you like. I find it abstractly interesting what that all means, and how that affects health at a population level. I am fucking astonished that people could find that offensive.

You’re nitpicking terms because you disagree with the perceived premise. Fine, you want me to point out that things were before WLIs (which I had thought went without saying) , so I do that and then that’s insufficient, you insist it’s not clear. It’s an internet message board, I’m not giving evidence at a select committee!

You were the person who first said it was better to be thin and unhealthy, and I disagreed with that and made the comparison with fat and healthy vs thin and unhealthy. Yet you’ve badgered me every since that it’s an example of me ‘boxing myself in’ or ‘steering the conversation’. At no point did I say or imply it was a binary choice.

I don’t understand your problem with the word maintain.

I have zero problem with debate or disagreement, or being called a fucking idiot. But some of these posts are clearly not about the subject matter and are people bringing their own defensiveness about weight/weight loss/whatever. For the avoidance of doubt, I couldn’t care less what individuals of any size choose to do with their bodies, be fat be thin be whatever you want by whatever means you like. I find it abstractly interesting what that all means, and how that affects health at a population level. I am fucking astonished that people could find that offensive.

It isn't nitpicking. Words have meanings. In the case of the word maintain, it means carry on doing something you're already doing or keep in good condition, and we've actually been doing a pretty shit job of the things you mention for a long time. What we'd have to do is get better.

And what I said is that it's better to be thin and unhealthy than fat and unhealthy. Leaving the second part of the sentence makes it less clear! It was in fact you who brought up fat and healthy, not me, and that matters because this fat and healthy group aren't relevant to the people we were discussing.

I don't think the last paragraph is addressed to me so I won't comment on that.