I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
Terzepitide took me from always wanting food to actually being able to focus on other things fully. I was concerned with being able to inject myself weekly, but it's easy and worth the 1-2 minutes a week. If you start, the dosage schedule is more a suggestion than an absolute. I noticed side effects getting worse so I dropped back to a lower dose and have held there for a couple months now. Only real drawback has been from a friend giving me a hard time after seeing the vial in my fridge, but he seems to be coming around after seeing obvious results.
Exercise absolutely helps as it helps regulate blood sugar more effectively. A surprising effect of building muscle and exercising is that your body becomes more insulin sensitive and your blood sugar stabilizes instead of having drastic swings.
It is of course true that caloric input is a thermodynamic limit and restricting it sufficiently relative to caloric expenditure will cause you to lose weight. (Lisa, in this household we obey the laws of thermodynamics...)
However, not all calories are the same, metabolism is dynamic, and the brain is complex and exerts a powerful influence over behavior.
Increasing exercise will make you hungrier and most people are simply unable to resist this and end up not losing weight. It is why there is a common saying that "you cannot outrun your fork." Restricting calories generally is difficult in today's environment with plentiful calorie dense food everywhere. People don't cook as much as they used to and restaurant meals have more calories than ever.
AFAIK GLP-1 drugs work because they calm the minds desire to eat which is baked in deeply from millions of years of our ancestors struggling to get sufficient food.
I can burn 750 calories in an hour of cardio (used to burn more when I was younger) which most people would find hard, that's equivalent to a large fast food hamburger which most people would find easy.
When I was working out at Crunch (long after I got kicked out of that other gym) I would go across the street and get two tacos at Taco Bell which is good from the perspective of athletic performance because it puts back the glycogen you use and you'll use the protein to make muscle. But from an energy perspective it's close to neutral.
Muscle is good for you anyway in many ways, not least metabolic and in terms of mental health. I had an elite athlete workload back in the time I was trying to start a business based on foundation models about a decade early and it helped me keep it together though now I have
and my cardiologist told me to exercise less! I am still obese in terms of either BMI or fat percentage but I just saw a specialist for "medical weight loss" (e.g. Zepbound) I was told I had a huge lean body mass and that would help me lose weight. Wearing normal clothes I don't really look fat but in the wrong gym clothes next to the fit 20% of college students I have one hell of a gut.
The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn.
You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.
More importantly we have decades of irrefutable evidence that diet and exercise alone are about as effective as abstinence only sex education. It's great there are people that can just decide to eat less, but it's foolish to assume that can work for everyone.
It's odd how people act as tho there's a "moral argument" against using a tool to help reach the goal. It feels a lot like the argument that "morals are from religion", as if you need god to know that murder isn't really a productive activity (unless you work in a slaughterhouse).
I wish American money could go back to having "mind your business" printed on it instead of "in god we trust", it was a huge loss to all of us when that garbage was passed. It was also a huge loss when everyone just decided to go along with saying "taxpayer money" instead of saying "public funds/money", but slippery psychological slopes are everywhere.
> You can’t really exercise enough to offset the food you can eat in a day
This is not true. There are plenty of activities that a healthy, enthusiastic person can do for quite a few hours per day that burn calories rapidly, and it takes serious effort to eat enough to offset the calorie usage. Think distance running, skiing, cycling, rowing, etc.
Sometimes people go to extreme technological measures to optimize their ability to consume calories (see recent record-setting marathon results). Sometimes people rely on extremely calorie-dense foods (butter, nuts, etc) so they can carry meals with them that are not wildly calorie-deficient for their long, unsupported travels.
When people are burning calories at this rate, they are probably not doing it for exercise — they’re probably either doing it because it’s fun or it’s part of an adventure.
I’m suspect that, if someone is overweight but in good enough shape to cross-country ski for six hours a day, then even if their body tends toward telling them to eat too much, they could probably lose weight by doing so for many days in a row.
I had the fastest weight loss at my life at a time when I was having something like a manic episode, had a psychogenic fever, was doing two hours a day of cardio plus crazy numbers of weightlifting sets three times a week and on a basically liquid diet because I was having trouble with my jaw.
Most people though will just eat more when they exercise, though dieticians say that more muscle is good for your metabolism and almost everybody would benefit from getting in some cardio and weights (i'm one of the rare exceptions who's been told to moderate my exercise, but I am the kind of person who can't understand how other people can make it through the day without going to the gym.)
People at the extreme end can struggle to eat enough food to maintain body condition, like I had a friend in college who trained for ultramarathons and you couldn't pinch anything on him even though he was eating all the time. Olympic swimmer Michael Phelps was a representative for the blockbuster heartburn medication Prilosec because he was burning 10,000 calories a day on his side!
> You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
People racing the Tour Divide, a 2700 mile solo unsupported bikepacking race through the Rocky Mountains, lose weight when riding their bikes 18 hours a day for 2-3+ weeks straight. They describe being unable to choke down enough food even though what they are eating is very calorie dense. Hotdogs, burritos, burgers, pizza, a pound of gummies every day, chocolate milk and ice cream when resupplying, McDonalds where they fill their hydration bladders with PowerAde, anything they can get their hands on quickly when they arrive at a small mountain town which frequently has nothing more than a gas station.
Great? When I worked landscaping I would plow through 2-3 double quarter pounder meals every lunch break. And then a dominos pizza or three when I got home for dinner. Plus a gallon or two of full sugar soda throughout the day, and snacks.
It’s not practical in the least for the average office worker to outrun the fork. It’s just silly advice and pointless to even bring up. When it takes an hour or more of treadmill work to cancel a single donut you don’t need to think about it any longer than that.
You exercise for health. Not to lose weight. Until you are at the margins and can consistently create an extra 100-200 calorie deficit by walking for an hour every evening or whatever.
My three gym days a week don’t do much for the scale. Those are for physical and mental health. The weight part is in the kitchen.
It's physics that you just need to go a certain speed to put an object in orbit.
That doesn't make it an easy thing to do.
Fat people are aware of diet and exercise. They aren't stupid.
Until you have been chronically obese, or helped someone that is chronically obese, you don't understand that it is a deeply rooted subconscious issue, not a physics issue.
Fat people don't want to be fat, anymore than depressed people want to be sad. But something in their minds or bodies makes it non-optional. Pharmaceutical interventions change that thing.
When people - in their millions - say that this is the only effective thing, you could, I dunno, believe them. Or at least believe the pharmacological/medical science, which is, to circle back, all just physics.
They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
My meaning was more that indulging in that hunger would result in me just eating an exorbitant number of calories, way past anything it would be reasonable to burn off without spending 4 hours a day every day in the gym... but you're completely right that even if I did spend that time in the gym it wouldn't help with the calories-in-calories-out equation, because it would just make me more hungry.
Exercise will burn calories, yes. But my life doesn't fit the several hours of exercise a day, every day, forever, that would be needed as an already-small person to burn the 1000+ excess calories a day my body is constantly hungry for.
