Weight Loss Thread

Khane

Khane

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sleevedraw said:
Work at one and maybe you'll get a different perspective on things. Doctors and hospitals aren't saints either.
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I worked for a benefits company that offered a stored value debit card for healthcare spending for 18 years. I wrote software that processed all kinds of claims data including information from pharmacy benefits managers who negotiate a lot of this shit. Who's claiming doctors and hospitals are saints?
 
BrutulTM

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A friend of mine worked at an insurance company and he said he had to quit out of conscience. He said "You spend half of your time telling people you're going to take care of them and the other half trying to avoid paying them any benefits when they have a claim."
 
sleevedraw

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I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
 
Kithani

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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Imagine being the insurance prior auth team and considering yourself the good guy lmao
 
Izo

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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I'm evil. I bill zero. Muahahaha.
 
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unhappyendings

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Every level of the system has significant actors trying to claim their piece of the pie with incompetence and negligence sprinkled in. It is just a game of whack-a-mole for the patient to locate the dick coming to fuck them next. Many do not even realize they are getting fucked.

Every level has people trying to do the right thing as well.
 
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Cad

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sleevedraw said:
I have a very clear conscience working in prior auth. Ask me about the times when doctors are trying to CT the heads of kids and exposing them to a very significant amount of radiation when they are acting "down" (no neuro changes on exam, no attempt at trialing talk therapy or antidepressants, just on a hunch). Ask me about the times when surgeons try to "unbundle" services (i.e. try to bill for 2 codes when they are captured by 1) just to drive up the bill.

This is not to say that all companies are good, because they certainly are not.
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I don't do health insurance stuff but we are coverage counsel for some of the big property and casualty companies. Claimants are absolutely trying to rip the insurance companies off on every single claim. Lots of them are represented by sophisticated counsel trying to rip the insurance companies off. (I'm careful not to say "us" here on purpose, I am not my clients, put down the pitchforks.)

It's an emotional issue regarding health care because "somebody" has to be the one to say no to care... and doctors sure aren't... (as if we don't all also complain about the cost of care in the next breath) while also thinking *our* care should be 100% covered even if it's expensive.

The problem as I see is that the process just isn't accurate/efficient enough - people get denied that probably should be covered, and people get covered that probably should be denied, and there's enough overlap that everyone is fucking pissed about both of those situations.
 
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Noodleface

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sleevedraw said:
Here's the article if you want to do do a deep dive.

There are some cost savings realized from weight reduction, but (a) GLP-1s have their own set of complications such as pancreatitis which can eat into their cost savings similar to bari surgeries having complications, (b) bari surgeries also achieve some cost savings from weight reduction, so that needs to be factored in, and (c) medication adherence is an issue with GLP-1s.
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Interesting read. Thanks
 
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Aldarion

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This is one of the best and most honest pieces I've read on weight loss in a long time.
substack.com

Is the Fattest Place in America the Starbucks Drive‑Through?

Sweet coffee, whipped cream, liquid sugar, and why exercise can’t save us
substack.com substack.com
We do not need another campaign telling people to count calories harder or buy gym memberships in January.

We need to say, clearly, that:
  • Sweet makes us fat, especially when it comes in liquid form and especially when it comes early and often.
  • Coffee chains and “healthy” juice bars that sell liquid dessert for breakfast are part of the fast‑food problem, not an escape from it.
  • Ultra‑processed, corn‑ and soy‑based products designed to be eaten quickly with those drinks are not “food” in the evolutionary sense. They are feed.
Click to expand...
 
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ShakyJake

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So, progress update for anyone that's interested:

I've been on Tirzepatide (GLP-1 injection) for a month now. I haven't bothered getting on the scale..I've just been doing the "jeans test."

About a year ago, my 32" jeans were getting too tight, so I bought some 33"s. Those eventually got uncomfortable too, which is what finally pushed me to try this medication. After just one month, the 33"s are now totally comfortable again.

It's kind of wild how the medication works. I genuinely have almost no desire to eat. I subscribe to Factor meals, and even though their portions aren't huge, I couldn't finish one this past week. Ended up throwing it out, which honestly made me feel a little bad.

By the way, this stuff isn't nearly as expensive as I thought. I'm paying about $250/month... nowhere near the $1,000+ I kept hearing about.

Bottom line: shit works.
 
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ronne

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Aldarion said:
This is one of the best and most honest pieces I've read on weight loss in a long time.
substack.com

Is the Fattest Place in America the Starbucks Drive‑Through?

Sweet coffee, whipped cream, liquid sugar, and why exercise can’t save us
substack.com substack.com
Click to expand...

This is well written but ultimately is still mostly making excuses for poor eating habits.

Yes drinking a 600 calorie Starbucks milkshake for breakfast will make you fat, but it's not via some kind of biological magic of it being 'sweet liquid', its because it was 600 calories on top all the rest of the food that person is gonna consume that day as well.

Yes yes, not all calorie sources are the same, but for 99% of people that's a minutiae that is like 5 layers removed from the root of the problem - that they simply eat/drink too much. If you want to get to 6% body fat that's when you probably want to start worrying about your calorie sources and macros, but if you're some normal office schlub that is 40lbs overweight the type of calories you're eating is not the problem, it is entirely the quantity of them.
 
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Control

Control

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250 today. Logically I know I must have been this weight at some point in the past, but I have no idea when it was.
 
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Haus

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Sludig said:
Haus Haus

Looks like the move to move your new found love for peptides off the gray market about to be fucked by big pharma.
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I completely expect this. Because what good is anything if big corporations can't get politicians and bureaucrats to make sure they get exclusive access to the profits from it?
 
Noodleface

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190 today. Down 45 pounds or so.

I have my dexcom g7 now and I feel like I am min maxing food so much now. Something interesting to me is I see the blood sugar spike after the 2 hours I believe because of the mounjaro. Changed my perspective of how good my blood sugar was doing. Even so, blood sugar has been in range 98% of the time according to the dexcom.
 
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Cad

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Noodleface said:
190 today. Down 45 pounds or so.

I have my dexcom g7 now and I feel like I am min maxing food so much now. Something interesting to me is I see the blood sugar spike after the 2 hours I believe because of the mounjaro. Changed my perspective of how good my blood sugar was doing. Even so, blood sugar has been in range 98% of the time according to the dexcom.
Click to expand...
My in laws (not diabetic) had those things on for about 6-9 months trying to avoid anything that caused a sugar spike. They ended up like eating chicken breast and vegetables only, avoiding all carbs, and sure their sugar never spiked but they said it was maddening like they just couldn't eat anything.

I think once you fix your insulin sensitivity you should be able to go back to eating at least reasonable amounts of carbs, you don't want to avoid carbs totally, its just miserable. But reversing insulin resistance is hard.
 
moonarchia

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Cad said:
My in laws (not diabetic) had those things on for about 6-9 months trying to avoid anything that caused a sugar spike. They ended up like eating chicken breast and vegetables only, avoiding all carbs, and sure their sugar never spiked but they said it was maddening like they just couldn't eat anything.

I think once you fix your insulin sensitivity you should be able to go back to eating at least reasonable amounts of carbs, you don't want to avoid carbs totally, its just miserable. But reversing insulin resistance is hard.
Click to expand...
It's just hard to eat any carbs while maintaining correct calorie intake. On the plus side, it's the second easiest thing behind sugar to cut out. Replace them with vegetables or protein and you will get a lot more food for the same or less calories.
 
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Noodleface

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Cad said:
My in laws (not diabetic) had those things on for about 6-9 months trying to avoid anything that caused a sugar spike. They ended up like eating chicken breast and vegetables only, avoiding all carbs, and sure their sugar never spiked but they said it was maddening like they just couldn't eat anything.

I think once you fix your insulin sensitivity you should be able to go back to eating at least reasonable amounts of carbs, you don't want to avoid carbs totally, its just miserable. But reversing insulin resistance is hard.
Click to expand...
I still eat carbs but definitely not as much. I just find it interesting that as a diabetic you're taught to test 2 hours after eating but I didn't consider that due to slower digestion from mounjaro it might be further delayed.

I think the key to my eating is that my brain now gets a signal to stop eating. I NEVER got that signal before. No joke, but I could eat until I got sick. I feel like my brain is wired a little different.
 
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Khane

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Its interesting that keto is still so misunderstood. Seems like people still confuse proper ketogenic regimens with things like the Carnivore diet.

You eat carbs on ketogenic diets. You just adjust exactly how much based on your activity levels so you burn through the glycogen and remain in ketosis.
 
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