re: New diabetes medications prove the OT wrong, obesity is not always a choice

Once you get to a certain level of fat it’s not a choice anymore. But everybody has and makes choices before that point.

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So you stay on it long term

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yes and set points are a real thing but its from total TDEE being reduced not BMR. and it works both ways, losing and gaining. body like to stay in hemostasis and you have to force it to change.

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The new set point lasts as long as a patient is on the drug, they say. Patients who ate a lot before they started taking one of the drugs feel less hungry and fill up more quickly—sometimes after one slice of pizza when they once ate the whole pie.

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This is how Janumet works for me. Combine it with good diet choices and do a bit of exercise and it's a wonder.

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let’s get this straight, I’m not a personal trainer,

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Did I say you were a personal trainer? Did I say that you were trying to sell stuff? No I did not. I said that the author of your link was a personal trainer whose trying to sell his book and supplements.

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I work as an engineer

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That explains why you can't admit that you are wrong.

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as far as the study, the part you linked was on rats.

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That is because human experimentation in laboratories is not allowed.

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second it says they hypothesized

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All medical research starts out as a hypothesis that was performed on lab rats. Do you realize that in medicine we use things that have shown to do something even if we do not know exactly how? For example, GLP1 agonists have cardioprotective effects and various mechanisms have been hypothesized for this but none have been proven. Those hypothesis have been developed using observational data on humans and experimental data from rats. This is good enough for the AHA to recommend using them for their cardioprotective properties. However, since you say research on lab rats is not proof, you probably think that the AHA doesn't know what they are talking about.

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of course the metabolism slows some

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So you admit that metabolic adaptation occurs. So it is not debunked.

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not much as far as bmr.

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1. I never mentioned BMR.

2. What do you think determined BMR? The expression and nonexpression of genetic material.

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D) glp1 has no mechanism to increase metabolism so how would it prevent a stall?

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Science has not discovered all the indirect effects and the mechanisms that cause them yet. That is why research is still going on. Oh wait, you probably do not understand that either.

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Gene expression doesn’t change that

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Do you even know how genes work?

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Oh and I said most GPs don’t know shite about exercise and diet.

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Well this GP does. In addition to having an MD, I also have degrees in exercise science and nutrition. As well as a masters in degree in biology that was very heavy in genetics. In addition to my work as a PCP I also work at a weight management clinic.

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I sure as hell don't know everything,

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You obviously know very little about what you are talking about.

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I'm pretty good at finding and understanding research papers,

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I do not think that you are.

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You as a doctor need to come to the realization that despite what they say, not every obese person wants to lose the weight and saying they are being complainant with food and exercise logging doesn't mean they actually are. hell go ask anyone how much a serving of Peanut butter is and 99% will be wrong.

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Which is why patients at weight management clinics are required to meet with dietitians to educate themselves on serving sizes and a lot of other stuff. It is also why they have to log their exercise and for the ones that we think are faking their logs are required to have a personal trainer who submits reports on the patients.

Also your concentration comment and the other comments about people in starvation situations not being obese are just stupid but prove my point. People in concentration camps or starvation situations do not have the option of choosing to eat. As a result their bodies modify their gene expression to keep them alive. So genes do affect metabolism and body weight.

Basically you have read a few books but do not understand what you are talking about and need to STFU. Since it blatantly obvious that you have no idea what the f**k you are talking about, I am not going to respond anymore so you don't have to bother bumping the thread again or throwing another multiple post massive hissy fit.