Comment Re:"Just eat less, keep input output" know-it-alls (Score 4, Interesting) 116
To all of those who say "you just need better impulse control", piss off.
As someone on Zepbound currently who has had pretty good results, I'm going to agree and disagree with you.
1) Yes -- 100% with you, they can f all the way off -- In late 2020 I gained about 30 lbs (14kg) out of nowhere in about a month with no significant changes to my diet. My then PCP says something to the effect of how I need to control my diet more. At the same time other things were starting to shout: 'something is wrong here!', my A1c was elevated for the first time ever and mysteriously my lower left leg got rather swollen. Just to put that amount of weight gain into perspective... it's roughly as though you ate 200 costco hot-dogs in addition to what you would normally eat.
2) Yes -- Diet and exercise are not always effective -- in the wake of that and for several years after with my then doctor making snide comments like 'you know it's good to be hungry' I tried literally everything -- extending my workouts, caloric restriction down to where my intake was only around 1000 calories per day and somehow I was continuing to gain weight... our traditional understanding of weight says 'not possible' but as a 6'3" guy eating ~1000 calories per day I should be dropping weight rapidly (and sometimes I would for about 3 days before it reversed). All told it crept up another 40 lbs on top of the earlier 30 lbs while that same PCP was saying 'those calories are sneaking in somewhere'. All the while other lab-based health markers are continuing to ring alarm bells like my A1c was continually going up... random spikes and drops in others... but no, "just put down the entire costco pie you housed last night fatty" even though all I actually ate the day before was a plate of lettuce and a 160 calorie protein shake.
3) No -- it wasn't hunger control or 'food noise'. I said F-this doctor, found a new one eventually and also went to mayo endocrinology... 5 minutes into my first visit: "you've got almost every indication of hypercortisolism". 6 months of testing that confirms excess cortisol and non-responsive to suppression tests, but the imaging is unable to locate the suspected adrenal adenoma. I suggest we try a glp1 and see if we can have any impact and just over 1 year later, I've lost all the weight I'd gained in the past 5 years. My diet and exercise stayed pretty consistent with my previous baseline.
Another more anecdotal part of my personal story -- I took a cruise to Europe a couple months prior to my first visit to the endo -- first two weeks were on a ship and I felt like I ate a ton. 2 more weeks staying with my in-laws who think 50 lbs of cevapi and pljeskavica with 4 loaves of bread is a light meal -- I somehow lose 15 lbs. Stress reduction from a month on vacation... food quality difference... random noise? I don't know, but it was an interesting blip.
