I haven’t fully understood why weight loss drugs are so little used in the US given the health effects of being overweight/obese either. I think it’s good that you’ve shined a light on this and your overview is helpful guidance to someone getting oriented. Many aspects of this feel aligned with my research on the topics.
That said, Plenity (https://www.myplenity.com/) is a non-drug option that looks particularly promising and should potentially be at the top of the list here.
I haven’t looked into the longevity effects of weight loss yet myself, but the treatment here seems pretty unsophisticated and strikes me as likely incorrect. The cited study appears to be correlational rather than causal (only read the abstract, could be wrong). Additionally I would expect that age at which you lose weight has an impact, for example, and last I read a BMI that was borderline healthy/overweight is actually what maximizes longevity. I think there’s significantly more work to be done before the longevity conclusions would seem well-substantiated to me.
That said, I think putting numbers on it is totally fine and a good thing to do as directional information, I’d just prefer their (seemingly high) uncertainty was highlighted.
The mechanism for Plenity, a dry cellulose matrix that expands with water, seems extremely promising, but the experimental results don’t seem that good even when selected by the manufacturer. The one study has weight loss of 6.4% of body weight with Plenity vs. 4.4% with placebo, over six months. Given the publication biases, that’s nothing.
That said, I think the metrics used for most weight loss studies, including this one, are wrong. The control and treatment groups were on equally calorie-restricted diets, and my belief on hearing the mechanism was never that Plenity would accelerate calorie deficits (although it might smooth out sugar spikes), it’s that it would make calorie restriction more bearable, which the study doesn’t seem to have checked for (which is normal for weight loss studies).
A second argument I’d consider is that weight loss is held back by different things for different people, and Plenity is extremely good for a handful of people for which satiety is their main problem. I don’t see anything in the paper that would suggest that, but it does seem possible.
All fair points! That said, I think extended lifespan is a very reasonable thing to expect, since IIRC from longevity research that caloric restriction extends lifespan (from animal studies); this seems like a very natural extrapolation from that.
I think metformin was supposed to have effects similar to caloric restriction, and does appear to reduce all-cause mortality, even though most users are diabetic.
I haven’t fully understood why weight loss drugs are so little used in the US given the health effects of being overweight/obese either. I think it’s good that you’ve shined a light on this and your overview is helpful guidance to someone getting oriented. Many aspects of this feel aligned with my research on the topics.
That said, Plenity (https://www.myplenity.com/) is a non-drug option that looks particularly promising and should potentially be at the top of the list here.
I haven’t looked into the longevity effects of weight loss yet myself, but the treatment here seems pretty unsophisticated and strikes me as likely incorrect. The cited study appears to be correlational rather than causal (only read the abstract, could be wrong). Additionally I would expect that age at which you lose weight has an impact, for example, and last I read a BMI that was borderline healthy/overweight is actually what maximizes longevity. I think there’s significantly more work to be done before the longevity conclusions would seem well-substantiated to me.
That said, I think putting numbers on it is totally fine and a good thing to do as directional information, I’d just prefer their (seemingly high) uncertainty was highlighted.
The mechanism for Plenity, a dry cellulose matrix that expands with water, seems extremely promising, but the experimental results don’t seem that good even when selected by the manufacturer. The one study has weight loss of 6.4% of body weight with Plenity vs. 4.4% with placebo, over six months. Given the publication biases, that’s nothing.
That said, I think the metrics used for most weight loss studies, including this one, are wrong. The control and treatment groups were on equally calorie-restricted diets, and my belief on hearing the mechanism was never that Plenity would accelerate calorie deficits (although it might smooth out sugar spikes), it’s that it would make calorie restriction more bearable, which the study doesn’t seem to have checked for (which is normal for weight loss studies).
A second argument I’d consider is that weight loss is held back by different things for different people, and Plenity is extremely good for a handful of people for which satiety is their main problem. I don’t see anything in the paper that would suggest that, but it does seem possible.
Also, good point about highlighting the uncertainty; I’ve added a disclaimer to that effect at the beginning of the section.
All fair points! That said, I think extended lifespan is a very reasonable thing to expect, since IIRC from longevity research that caloric restriction extends lifespan (from animal studies); this seems like a very natural extrapolation from that.
I think metformin was supposed to have effects similar to caloric restriction, and does appear to reduce all-cause mortality, even though most users are diabetic.
Surgical options may be useful for some as well. https://care.diabetesjournals.org/content/32/4/567.short