This is such a "one weird trick your doctor doesn't want you to know!" anecdote. Mounjaro and Ozempic are generally prescribed in instances where dietary interventions are insufficient and perhaps one of the last resorts before bariatric surgery. If your dietary interventions worked for you -- great! But there is only a certain class of people for which they work for, and it is rude to assume the OP hasn't tried these methods already (it would be surprising if they hadn't, since so many people can't help themselves from offering this kind of advice unsolicited).

With regards to cutting out fat, if you are advocating for a weight management plan for the general person, it is really too prescriptive and doesn't take into account that someone following your diet should not be accidentally increasing your carbohydrate intake (fruit sugars are still sugars!), resulting in the diet being a total wash. The gold standard for diet-based weight management is food journaling, and not cutting out an entire group of macronutrients without holistic consideration of your diet.

I was slightly overweight, 22% body fat 6’2” 220, and was suggested semaglutide (generic ozempic) all other standard health metrics in the healthy range. It’s not some crazy last resort drug, it’s basically everywhere and readily available to anyone that want it.

I’m 6’1”, and my goal weight is 210. In theory I should get down to 180, but expect I’d be too skinny. Currently 246, so I have 6-8 months for my personal goal, and at $1200/month, I may self fund for the remaining 3-4 months to hit that goal. Not sure if I’m willing to drop another $6k to hit 180lbs.

The gold standard for diet is whatever people can maintain longer term!

That is of course more correct :) But the first step is building intuition about what and how you’re eating!

and... this person now takes these last-measure pills forever? or here in the real world, do they use the pills to lose weight, and then maintain that normal weight forever with... perhaps a diet trick that works?

people who have to take last-measure medication usually don't stop eating when they are full. i know, it's weird to tell someone who doesn't stop eating when they're full, how to still maintain weight if they... don't stop eating when they're full. i'm a weird guy with ADD and get side-tracked easily. I got an appointment with the florist about that next week, hopefully he can recommend a medication.

yes, a doctor will not tell you diet tricks. if you are asking your doctor for diet tricks, we need to step back a minute. when you're done grocery shopping at jiffy lube, drive home, sit down, and carefully read this link.

this is what a doctor is. a doctor will give you general health guidelines, but knows very little about diets. https://en.wikipedia.org/wiki/Physician

Obesity is often a chronic medical condition that’s not solely controllable by willpower. There is no difference between taking pills for treating obesity as a chronic condition vs any other chronic condition, like type 1 diabetes. Decades of treating obesity as a personal failing have resulted in worse and unsustainable health outcomes.

And again, you are being far too presumptuous about OP’s interventions. And I certainly don’t know what this business about ADD appointments at the florist or grocery shopping at Jiffy Lube you’re talking about is.

I suspect a chat bot, maybe not got-4, but maybe Bard? It’s close, but there was no point and the references were off but weirdly close. Like florist could be psychiatrist.

I suspect someone who lacks social interaction in life, so does not understand subtle satire. Like a problem that could be solved by a florist. By talking to the florist, making friends with the florist, and having some bbq outings with the florist and her friends on the weekends.

but before one would do that, which may be an insurmountable long-term goal, someone should compare going to a florist for pills, to going to a doctor for making up diets.

I believe “grocery shopping at JiffyLube” is a reference to consuming oils in one’s diet.

I’m hopeful that it’s more like 3 months out of the year. Looking back over the years, I’ve gained roughly 5lbs/year since I hit 30. Now in my late 40’s, during Covid, it seems like that went to 10lbs/year. The first 3 months on mounjaro, I lost 20lbs, so that cycle should be sufficient. I’d stay on it permanently, if it weren’t for the $1200/month.

Here's something I tried that's a 5-year max type of solution. If my suggestion for "stuff your face with fruit" isn't for you, maybe this is. If you absolutely Have to eat fatty foods, there's Alli. It clumps about 1/4 of your fat intake into large balls, so you poo it out. For small weight gain like yours, perhaps it's enough reduction to maintain current weight. You can't take it longer than a few years, because you'll have vitamin issues. Oil-soluble vitamins dissolve in the clumped fat and don't get absorbed.

I tried this a few years before going with my "apple diet." It works, but my bloodwork after a few years said I need to stop. There is a catch. The first year, you Cannot pass gas. That clumped oil that comes out, comes out very easily, and unfortunately Alli makes you gassy too. This side-effect goes away in about a year if you power through it.

Not a dietician or a doctor, but perhaps your mounjaro treatment can be cycled with Alli (cheap, OTC) every few years to save some cash. Invest in a large bottle of Dawn dishsoap. Put it in a spray bottle and spray the bowl after you do your stuff. You'll have to, just trust me.

What's your bloodwork and cardio like now and what does your doctor say? No fat + high carbs flies in the face of everything I've read that was published in the last 20 years. Maybe you've found another path to health?

I believe there's a fair bit of evidence to the effect of, any "diet" that restricts one's food options - be it calorie restriction, low fat, low carbs, low protein, intermittent fasting, no sugar, whatever - will result in weight loss as long as it's stuck to. Which makes sense logically; if normally you'd eat whatever you felt like, and then you restrict what (or when) you're "allowed" to eat, some substitution will be done, but you'll likely also just eat less.

And then when you go off the diet (either intentionally, or more likely, by just slowly drifting back to the norm), you'll return to eating what you were before, and will return to your original weight. Which is why the only diet that works is one you can stick to indefinitely. So, if the parent can stick to a no fat, high complex carbs diet for life, it will probably work for them.

I’ve been a fan of the keto diet (low carb high fat) for a while. But I suspect any diet that cuts a very large group of foods like carbs or fats out forces you to be more mindful of what you’re eating. And that’s a large part of the weight loss on those diets.

Elsewhere in this thread it was stated that food journaling was the gold standard in weight loss, which also I’d expect to increase mindfulness around eating.

How complex are pasta, rice, pint of blueberries, 5 medium apples, 2 mangoes, and a pound of grapes?

Pasta, rice, and fruit have huge amounts of simple sugars.

After 2 years, my blood pressure went back down to a steady 110/75, heart rate about 55-60, bad cholesterol is on the low of normal range. I do about 2 hours of cardio with light weights per week, no longer lift. That's not a lot, but it's enough to stay at the same blood pressure for many years now.

I don't do high carbs - fruit are not high in carbs you actually process. I eat normal portions of complex carbs like bread and pasta, normal sized meals. I eat a ridiculous amount of fruit, and that has some sugar in it, but it's actually not that much. What that does is increase my fiber intake to ridiculous levels - and that has many benefits.

My issue was that I use food as an anti-depressant, and to deal with stress. The solution had to involve eating a lot, but minimizing calories. That's why the fat had to go - I can eat twice as many carbs as fat for the same weight. When you look at things like fruit - a lot of those "carb" calories you don't even metabolize since it's fiber.

I don't think I have discovered some magical solution, but it works for people like myself, who have what I consider a minor mental illness called 'self-medication with food.' Mental problems are a lot harder to fix than just not using oil and replacing nuts and chips with fruit. My solution to win the war was not to fight it and learn to live w/ the fact that I'm not perfect, and adjust the lifestyle to that.

High carb diets are a bad idea. I eat normal balanced meals, just with no fat. Long-term high fat diets are for people who want liver damage, and stop eating when they're full. A little bit of fat makes you full, unlike carbs. But keto is terrible for your health if you do it for decades.

The tiny amount of fat I do get, is from things like red tuna and other low-fat fish. It's amazing how little good fat you actually need in your diet, if you look that up. Literally one can of chunk light canned tuna is all you need for the day.

Now here's something groundbreaking that's pretty good - thin and wide no sugar no fat pancakes: 1 cup flour, 3/4 cup fat free fairlife milk, 2 packets splenda, 1/2 cup Egg Beaters. mix real well so it's runny with no flour chunks. no need for baking powder. real short spray of oil to just get some drops on a teflon pan. no need to spray when you flip.

Now my diet is not high carbs, but let's address the "no fat+high carbs = bad." the reason that's everything you've read in the last 20 years, is because that's what you chose to read. there are different diets for different causes of fatness in people.

fat makes you full faster so helps you eat less calories. carbs make you work out harder, so you burn more calories. if you have an active lifestyle - carbs and no fat. if you sit on the couch after sitting at the office, you want fat and no carbs. dietary fiber isn't something you should count as carbs.

if the reason you're overweight is because you like to constantly eat, and it has zero to do with hunger - you don't want any fat. you want the most amount of food for the least calories, and fat is double of carbs per gram. you want lots of indigestible fiber a normal amount of carbs, and eating the potatoes with that thick rough skin, with the skin.

> I stopped using cocaine and for some reason gained weight, the post

Not at all, the two events are clearly separate in my account of history, and are actually about a decade apart. The weight gain, as with 99% of people, comes from a testosterone change once you approach 40yo.

It's really strange how you and a few other people just keep making up weird scenarios, then attacking those to make yourself feel superior. I don't get it. It was 1/4 book page of simple text. How is it possible to read something that simple, that short, and then make up something completely different in your head. This explains a lot of politics, but I don't get what people with that mental illness are on HN. Please stop. You are not superior - you have reading comprehension problems.

This is kind of weird because there’s a lot more data to suggest now that dietary fats are almost never the problem when it comes to obesity, and in fact dietary fats are really important for a lot of critical processes (brain function, neuroprotection, hormone synthesis). I get it for caloric restriction though since fat is denser than protein or carbs.

That last line does not belong on most respectable websites on the internet.

Just imagine all the testing he had to get to reach this conclusion. GP has suffered enough.

If he hasn't learned by now, your post isn't going to teach him