Personality, Behavior, and the New Weight Loss Drugs, Part 2

The mission of the newly available or soon-available substances is elegantly expressed in this AP article:

The obesity drugs lower blood sugar and slow down digestion, so people feel full longer. They also affect signals in the brain linked to feelings of fullness and satisfaction, tamping down appetite, food-related thoughts and cravings.

Because people feel full longer, they eat less and lose weight.

That is one reason why neither tirzepatide nor its semaglutide rivals can work for everybody. People are just wired differently, and some of them act on beliefs and motives that others find bizarre. Behavior is multi-factorial, and one of the possible factors is patient non-compliance, a subject that Childhood Obesity News has examined at length.

No matter what, a certain amount of non-adherence will always be with us. Imagine the frustration of a doctor who helps a patient gain access to -tide injections at a steep cost or, worse yet, at a discount — and then the patient doesn’t use the stuff.

Different demographics

People with diabetes do want to not suffer the consequences of the disease. They don’t want to pass out in public, or lose a foot, so they might be more diligent rule followers. But when the same drugs are injected or swallowed for weight loss, that crowd might justify a fear that has already been expressed.

It is both sad and likely that, once embarked on a course of -tide drugs, many overweight and obese people would take a deep dive into fat-logic. “I’m covered, let the drug worry about doing the work,” such a person might think, and go on to fool herself or himself into believing that now, they can eat more than ever, because the drug will fend off further weight gain.

Even more serious is the problem of people who don’t even bother to rationalize what they basically want to do in any case. These meds work by persuading the body that hunger has been assuaged. The stomach is filled to capacity, and there is no actual need to add any more food. That is a rational conclusion, but rationality has nothing to do with this kind of hunger.

If the person is simply into “eatertainment” or “recreational eating,” what then? Someone who enjoys a video game can sit there and play it for 10 hours at a stretch. Someone who enjoys chewing and swallowing can do that for half a day, too. If the hunger is not physical but emotional, a distended belly can’t fool the emptiness inside.


The persuasive information (aka advertising) aimed at people who are curious about the -tide drugs has quite a lot to say about things like neurotransmitters that need boosting, and about cravings and hunger. But hunger does not all come from the same place.

A popular media platform published an article whose title suggested that the new class of weight-loss drugs could end obesity. That is quite an ambition, and an impossible one. Like many other things in life, obesity is multifactorial. One factor is, some folks are not reachable by logic, or even by an appeal to their own self-interest. Somehow they forget the other attractive features of life, narrowing self-interest down to “I’m interested in eating more. And I’m interested in it now.”

Your responses and feedback are welcome!

Source: “How do Ozempic, Wegovy and Mounjaro work? What to know about drugs promising weight loss,”, 04/27/23
Image by Sam Nabi/CC BY-SA 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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