Random Thoughts.....What Are You Thinking?

He tried. He failed.

It isn't at all about your mother. Its all about chemical balances in your brain.

Probably crying 'cause she can't get the guy she preferred over you.

Its part of the human condition. We want what we can't have while denigrating what we can have.

Paged!

Did you turn down many guys in your days?

That is part of the female condition.

https://www.medpagetoday.com/cardiology/prevention/116170



me mashing that X button:

FFT remaster not having the new jobs or any new jobs is sad... Dark Knight was fun, but I always wanted to make Holy Knights. I hate when they remove stuff, either out of laziness or to appease some weird crowd that wants things perfectly preserved (even tho they are changing a lot of other stuff.)

Also DB Sparking zero new update, who the hell is Shallot. They make so many weird characters but don't add the cool ones like Android 21.

The catch is you need to keep taking, and paying for, the drugs for those changes to stick.

Are you suggesting that The American College of Cardiology (ACC) is a corrupt entity taking kickbacks from big pharma to peddle these lies?????

I think the truth is that 'lifestyle interventions' are defined in the medical sense as doctors telling you to eat better, exercise more, and giving you tips on how to accomplish it. That doesn't produce results because most people are dopamine fried and lack any willpower to actually perform the activities.

I don't think that GLP-1 drugs are more effective than adhering to lifestyle changes, but it's pretty clear they are more effective than being told what lifestyle changes to make. From a public policy standpoint, that means they are a valid treatment. There's still plenty of reason not to take them if you have self-control.

So, I wouldn't say the statement is wrong at face value. I'm still going to think less of people who use them, though. I also have serious doubts about their long-term safety. If you aren't able to eat healthier, eating a smaller quantity of trash food is just starving your body of key nutrients. Plus, they make you literally crap the bed.

No, I am not suggesting it.

I am saying it.


Effing gross.

The catch is the side effects.

I think people may be underestimating just how many people ignore their doctors advice when they offer lifestyle intervention advice or don't understand what to do. In their defense, some of these things have spectrums and challenges.

Going to the gym for instance. It can be an intimidating atmosphere no matter how welcoming it is. That and a lot of people who are addicted to engagement - guilty - find it boring as hell. Many folks "exercise" by doing it at home but never really push themselves because they don't know what to do. Some gym memberships are expensive and training is even more expensive, which leaves it to people who can afford it. That's not considering folks with limitations - I went from exercising 6 days a week to barely 2-3 b/c CTS makes it impossible otherwise even postop - I find ways to manage but it's very difficult to motivate myself to do it because the only exercise mechanisms I have left bore me to death.

Dieting can be hard too. They go eat a salad because that's society's form of 'dieting' then get hungry an hour later and eat ***. I have people in my life who have no clue about nutrition to a laughable extent. Most doctors aren't going to sit there and lecture people who proper eating habits because they don't have time. Everything we eat has sugar in it also and unhealthy food is a lot cheaper than eating healthy is unless you grow your own food, so again this comes down to an income issue and with larger families it becomes harder. If you have kids, the tendency for shitty food to be sitting around is a lot higher too even if it isn't in your house.

This all assumes people can keep it up anyway even if they can afford these things. There's a reason gyms get slammed in January then are emptied out by March.

Then there are people who just ignore it entirely and move on or don't go to the doctor at all.

Don't get me wrong, it's a self discipline and control problem barring some circumstances. That said, intervention via weight loss drugs is more likely to prevent the average person from having some cardiac event because lifestyle changes are difficult, expensive, hard to maintain, and require some education on the subject, making them less reliable.

Maybe I missed it, but im pretty sure the article says that the drugs are better than making lifestyle changes, not the drugs are better than getting advice on lifestyle changes but not following through, which seems to be the key defence here.

Tier list according to the article:
S-the drugs
A-workout and eat better
F-anything else

The article is vague, but the studies are based on real people in real conditions. Participants aren't locked in a room, fed on a schedule, and chained to a treadmill for 45 minutes a day. It seems pretty clear that the reason they concluded that isn't blatantly lying, but inclusion of non-compliant patients.

From a medical standpoint, they should include non-compliant patients. If you tell 100 cardiac patients to diet and exercise and a dozen or so succeed, awesome. But, if 45 of the same patients would've succeeded on GLP-1s, you can make a legitimate case for prescribing them first.

How many fat people do you think are walking around unable to realize that eating better and exercising would cause them to lose weight? I'm sure there are a few, but most just don't have the willpower. A doctor telling them to do it won't change that (usually).

Here you go again, interjecting with “its good if you cant maintain lifestyle changes”.

The article should not flat out explicitly state that the drugs are better than lifestyle changes, except this is exactly what it is doing. It did not make any statement that is open to interpretation in ways you are trying to defend. It flat out said “the drugs are better than lifestyle changes”.

This is where my issue stems with this ***. I dont have a problem with the drugs for those who are too far gone, who dont have the time or are incapable, who cant commit, who need the crutch etc. Its the professional suggestion that the drugs are BETTER than fixing the problem at the root cause.

I'm not some stan for the drugs dude, you're just being willfully ignorant. The actual text from the doctor that was published in the journal is:


Her evidence:


The average weight loss for people who can stick to a diet and exercise plan is every pound they wanted to lose. If you can stick to it, it works. 100% of the time. You don't need to use this ridiculous logic to imply professionals don't believe that. The idea that suggesting lifestyle changes is being weighed against the probability patients understand and stick to them should not need to be outright stated.

You don't know who Shallot is? :(

Neither did I until the DAU. It's a DBZ Legends character.


I suck so bad at linking youtube videos, only on this site..

I *** quit


Edit: I got it.mobile.link= bad
App link= bad
Desktop link= good

I know you're a smart guy, so I'm certain you know what "in conjunction" means. That quote you cited is suggesting to take the drugs while trying lifestyle changes.

But of course, why would big pharma want you to even attempt to fix yourself when you can buy the fix from big pharma?? No need to GIT GUD, just pay-2-win.

You'll ***yourself in your sleep, but hey, atleast you can stuff yourself full of cheeseburgers and doritos all day long and look good doing it.

decent article here if you've got time to skim


https://pmc.ncbi.nlm.nih.gov/articles/PMC5145017/#sec10

I bought Blade Runner to watch on Youtube.

Yeah, I paid for it, your filthy outlaws.

The first one?

Yep

Welcome to the club of real enlightened nerds ;)

Next time, when someone says Roy Batty is the best villain ever and "tears in rain" is the best quote you no longer need to Google what those are!

Don't forget to also watch 2049, play the 1997 video game and trpg version to level up your enlightened nerdiness further ;)

Wait till you find out that the movie

That's basically it.

Not necessarily, and what I'm gonna say is in-line with the spirit of your subsequent posts.

Acknowledging your weaknesses and accepting your limitations, and dealing with them in a realistic way is better than idealistic, perfectionist thinking or prideful ignorance. Less-than-ideal solutions are still preferrable to no solutions at all.

But they still require a drive to change for the better, and involve some hardships (money, resilience). Let's not pretend that undergoing bariatric surgery is a walk in the park, pre or post-op. Or that it's a magical solution with no failure rate if you don't watch out what you eat.

I have family members that have undergone multiple bariatric surgeries, and reversal of them when they had complications.

Same family members also on GLP1 agonists. GLP1 type drugs don't work if the individual has too many fat cells - according to doctors - so will not work on its own for certain extremely obese individuals, like this family member.

My concern is with long term viability, and I have always encouraged life style changes and not whole sale "go to the gym 5 days a week" type stuff - I know that is not feasible for them.

I can't speak for everyone, but for at least this individual, they just like sweets too much.

They don't have to eat salad every day, though yes that would do it too. They just have to stop stuffing their face with refined sugar and replace that with healthier foods like fruit and whole grains - which they have a lot of.

For most people money and education is not the problem, just willpower. "But I like beer" I often hear.

Yeah, well, you also have a beer gut so what do you want most, not being at risk of a heart attack, or a cold beer.

Same thing with this individual. Taking GLP1 drugs doesn't make them want refined sugar any less - that is also a drug.

Yeah, anybody who dealt with close ones struggling with any of the metabolic syndrome components understands the frustration of seeing them fail to implement the necessary lifestyle modifications.
Heck, my nephrologist friend takes it personally with his patients sometimes, lol.

Humans are creatures of habit. For most people, it's very challenging to change habits, especially the older you get (and the longer you've adhered to them).
That's why having different helpful options is a good thing.

I never really grasped this in my younger medical years. I used to think it was a simple, no-brainer choice for patients: eat well or pay the price with your health. But I didn't give much thought to the fact that I'm basically telling this 50 year-old, for example, to change his breakfast habits of 30 years, matter-of-factly, pretending it's as simple as changing his car's tyres. It's worse if it's traditional food. Some people spend their lives eating no more than 20 (assumption on my part just to illustrate the point) types of dishes. Imagine telling them that 15/20 are bad for their health. It feels like swimming against the current, and most people around you won't be helpful neither. So it was unreasonable on my part to think that way without acknowledging how hard it can be & the need for help & potential for relapse. You and I are fortunate enough to have learned about nutrition at a relatively young age.

I'm sure you understand all of that, I just felt more chatty than usual I guess.

watched a bit of mrhappy playing ffxiv mobile. not for me, but it actually looks decent. might have been cool if the ffxi one didn't get abandoned.

Considering the studio that was going to make it. FFXI mobile dying is a win for our community.

In the long term everyone dies.