npr.org
This drug is a true gamechanger
In the SURMOUNT-1 study, people who took the highest dose of tirzepatide, most of whom had a BMI of about 30 or higher but did not have diabetes, lost about 21% of their body weight during the 72 week study. As researchers point out, for people who have bariatric surgery, typical weight loss is about 25% to 30% of their weight, one or two years after the surgery. In the tirzepatide study, 36% of people taking the highest dose lost 25% or more of their body weight.
this is comparable to bariatric surgery
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I think it is more likely that this is an effect of the other major cause of obesity: A Decrease in physical activity.
It sounds like you didn't read the twitter thread in my first post, but Active Energy Expenditure (AEE) has actually increased over time. Basal Energy Expenditure is the amount of energy you use just to keep alive. Adjusted for body composition (it's known that muscle expends more basal energy than fat), the amount of Basal Energy Expenditure has decreased over time.
How do we get back, then?
That is the question, isn't it? This playlist looks into a lot of what might have gone wrong. His primary theory is substituting poly-unsaturated fats (PUFA) for saturated fats, but there are a few other things we could be looking at.
Unfortunately that just tells us how to stop digging the hole, it doesn't tell us how to fix it. There are people who report removing PUFA and increasing Saturated fats stopped weight gain, but it didn't make their weight go down significantly. However, it did make their temperature go up, which might be an indicator their BEE went up as well.
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