Personality, Behavior, and the New Weight Loss Drugs

After researchers scoured eight databases and came up with seven suitable English language studies published as recently as last month, they undertook a brand new multi-author meta-analysis of information on personality traits associated with childhood obesity.

Despite multifaceted ongoing attempts to prevent and impact the problem, “the overall progress of childhood obesity interventions has been far from satisfactory.” Childhood obesity continues to rise in countries with low, middle, and high-income levels. Meanwhile, adult studies show that the influence of personality traits on obesity counts more than socioeconomic factors or even the highly suspect FTO gene.

About the lack of success thus far in controlling childhood obesity the authors say,

One critical reason is that most of the existing interventions only focused on the proximal factors of obesity such as behaviors, but paid little attention to the rooted drivers motivating behavioral changes such as personality traits.

The Five-Factor model posits five dimensions of personality traits, namely extraversion,
agreeableness, neuroticism, openness, and conscientiousness. Together, these are said to
“reflect a person’s inherent patterns of cognition, attitude, emotion, self-regulation or coping strategies and have been shown to be related to multiple health-related behaviors.”

As it turns out, the only trait that merited attention in this context was conscientiousness, “the tendency to be self-controlled, perseverant, and disciplined to social norms” and the association is a negative one. In other words, children who score low on that quality have more of a tendency to be obese. And, “No consistent patterns were found in the associations between the other 4 dimensions of personality traits and BMI/obesity in children.”

According to the study results, the conclusion is:

Low conscientiousness has been found to be consistently associated with childhood obesity. Causal associations of personality traits with the risk of childhood obesity remain to be clarified in future studies.

“A growing body of evidence has revealed an association between personality traits and obesity, but the findings regarding this association among children remain mixed.” Not much there yet, but this is definitely the sort of thing that needs to be looked into before blithely authorizing the prescription of the -tide drugs to kids. How do the drugs’ known side effects mix with the five dimensions of personality delineated by the Five-Factor model?

And what about the one that stands out, the negative association between obesity and conscientiousness, “the tendency to be self-controlled, perseverant, and disciplined to social norms.” Those traits definitely show up in a child’s behavior, and many behaviors can be taught and cultivated, especially at a young age.

Is it possible that training designed to teach children to pick up after themselves, keep quiet in class, and persist in trying even after they fail at a task — is it possible that this kind of upbringing could also help them avoid obesity? And avoid the necessity for weekly injections of the latest weight-loss drugs?

Your responses and feedback are welcome!

Source: “The association of personality traits with childhood obesity: A systematic review and meta-analysis,” ScienceDirect.com, August 2023
Image by FolsomNatural/CC BY 2.0

Behavior, a Big Word

One problem with people is: Often it is not that difficult to put a finger on What Is Wrong, but sometimes people want to take a deep dive into the cesspit and spend a monumental amount of energy, endlessly elaborating on what is wrong.

Another way to do things would be like Abraham Maslow. Study the people who are doing well, and figure out which of their traits might be transmissible. Traits are expressed by behavior, so concentrate on behaviors that can be taught and learned. Then, devise a way to get people to want to learn them.

It covers a lot of ground

Just as our diet basically means everything we eat, our behavior basically means anything we do. It encompasses all of human nature. There has been a lot of talk, probably ever since people could talk, about how much anyone ought to take it upon themselves, or be empowered, to interfere with other people’s behavior.

Imagine a very basic society, confronted by a member who will neither hunt nor gather. Life was rough for everyone, and a person who refused to fulfill the most obvious societal obligations might very well be ostracized. Snubbed, shunned, excluded, avoided, rejected, shut out, expelled. Even though they did not possess the brains we have today, early humans probably thought, “When this perfectly capable person refuses to help himself, the rest of us suffer for it. We don’t need the aggro. We’re letting him go.”

The pain of largeness

And what does ostracize itself mean? To leave a person out of conversations, friendships, groups, privileges, rights, comfort… which is what, in our society, often happens to obese people. The younger ones are especially vulnerable to ostracism, not having other means to compensate for the social handicap of being too big. They get left out and pushed out. It is a variation of the ancient scenario in the previous paragraph. Even though we are now very advanced, it inspires a similar thought. “If someone with excessive fat does not care enough to help himself, it weakens and endangers all of us.”

Then, we rationalize our distaste by listing all the different ways in which uncontrolled obesity statistics will mean the end of civilization, or an equally dire outcome. One expert sees things differently. In the pages of his book, Overweight: What Kids Say, Dr. Pretlow refers again and again to the depression, unhappiness and misery of children and teens who are stuck in a bad situation and don’t know how to get out. His personal empathy and compassion are obvious. The work leaves the reader feeling that helping obese young people to thrive is an ambition both worthy and doable. If we take care of these kids, civilization will have an easier time taking care of itself.

Your responses and feedback are welcome!

Source: “Abraham Maslow, His Theory & Contribution to Psychology,” PositivePsychology.com/ 09/29/17
Image by Sandra Cohen-Rose and Colin Rose/CC BY 2.0

Enhancing the Language With Drugs

First came the “Ozempic face,” in which the buccal mucosa, or fat, goes away, leaving the face looking gaunt and aged, and which may or may not be reversible. Even with a loss as relatively minor as 20 pounds, women are left gasping at the appearance of the stranger in the mirror.

Predictably, the “Ozempic butt” was not far behind (haha). This is “the saggy, deflated appearance of the buttocks following rapid weight loss.” A quotation is attributed to Zsa Zsa Gabor: “As a woman, you have to choose between your fanny or your face.” Sadly, it seems that the -tide drugs do not leave room for even that choice, but remove fat indiscriminately from places where it needs to be:

Several frustrated users recently told The Post that their fingers and wrists are shrinking before their eyes, making it impossible to keep on their expensive wedding rings and bracelets.

Malnutrition is part of the picture, too. Depending on how much of a handicap the patient is burdened with, due to age and genetic makeup, this tragedy might be avoidable with slower loss goals, a very nutritious diet, and weight-bearing exercise.

The manufacturers are quick to declare “not our fault,” which is fair enough. The medication is not directly responsible, but shedding the pounds too fast definitely is. The condition can be helped by the surgical removal of extra skin, or the use of dermal fillers, and also by non-surgical means such as “radiofrequency, energy-based devices, and lasers.”

Psychological damage

Then, there is the term “Ozempic shaming.” Random citizens just love to hop on the nearest social media platform and vent about their disapproval of others who utilize the -tide family of pharmaceuticals for weight loss — especially when those others are celebrities.

If a media personality tells the truth about taking one of the -tide drugs, a legion of critics stand ready to pounce. If such a person is suspected of lying about it, the criticism is even more fierce. And if they take neither course, but just stay chubby, another contingent of judges descends upon them with harsh condemnation. Actor Emily Simpson (“Real Housewives of Orange County”) says the phenomenon boils down to, “damned if you do, damned if you don’t.”

Even Simpson’s admitted use of liposuction did not draw as much wrath as the mere suspicion of Ozempic use. Aimed at her and other media types, headlines tend to include some form of the word “accuse,” as if they were in danger of being arrested for something much, much worse.

And it hurts. Simpson, a three-time mother who happens to be an attorney, told the press,

I’ve done so many things in life and I’ve accomplished so many things, but the one thing that everybody wants to talk about is my size. And it’s just exhausting to me.

The accusers tend to be righteous, claiming that their concern is for diabetes patients endangered by shortages of the drugs. Or they are mad at anyone who “takes the easy way out” rather than working hard to earn a slimmer figure. Others want to decide exactly how overweight a public figure ought to be, before opting for the -tide drug option. Many angry randos resent the ability of celebrities to afford drugs when ordinary people cannot. Overall, it makes for an ugly situation.

Your responses and feedback are welcome!

Source: “Understanding Ozempic Butt: Can You Avoid It?,” HealthNews.com 06/19/23
Source: “Ozempic users spark spike in ER visits: Shocking new side effects,” NYPost.com, 06/19/23
Source: “Those experiencing ‘Ozempic shaming’ speak out about the backlash they faced,” ABC7NY.com, 08/09/23
Image by Mike Lewinski/CC BY 2.0

The New Drugs, Through a Jaundiced Eye

Somebody started calling them the -tide drugs, which is neat and concise; and Leon Gussow, M.D., an expert in the areas of emergency medicine and poisons, writes about them. GLP-1 receptors occur in the stomach, the pancreatic islet cells, and the brain, from where they send messages to each other and the rest of the body, answering vital questions. Is it time for the stomach to empty? How much insulin needs to be produced? Are we full yet?

And here is the answer to a question that is rarely addressed in the popular press: Why does this stuff have to come in a needle, anyway? Dr. Gussow writes,

Naturally occurring GLP-1 has a half-life of a minute or two, while semaglutide has a half-life of 165 hours, which allows it to be injected subcutaneously once a week. These drugs […] do not rev up metabolism. Semaglutide and tirzepatide can be thought of as eating disorders in an injection pen.

As we know, malnutrition is not good for anybody, even one that is trying to lose weight. But Dr. Gussow also mentions that patients who take semaglutide or tirzepatide can get queasy just by looking at food, sometimes to the point where they prefer not to eat. It sounds as if a person could get the same effect and save $1,000 a month, just by carrying around a photo of something aversive (yucky), and looking at it periodically.

A deep downside

He also brings up details that not enough people seem aware of: “[W]eight reduction from the drugs alone can involve significant loss of lean body mass,” and oh, by the way, when the patient stops using the -tide drug, not only will the weight return, but instead of lean body mass it will be fat.

Some would say the solution is obvious: Just stay on the drug forever. At this point, that seems unlikely. Mansur Shaheen reported for The Messenger:

32% of patients using Wegovy, Ozempic, or a similar competitor were still using the medication a year after prescription. A British study published last year, partially funded by Wegovy and Ozempic manufacturer Novo Nordisk, found that users of these drugs regain around two-thirds of lost weight after stopping the injections.

In other words, around two-thirds of patients quit just after the one-year mark. Cost is definitely a factor. Because of the expense, the shortages which will probably recur at least periodically in the future, and the side effects, it seems reasonable to expect that most users will soon just give up.

Obesity medicine specialist Dr. Christopher McGowan reminds us, “As I stress with all my patients, medications like Wegovy and Ozempic are designed for chronic, continuous, potentially life-long use. They are not short-term solutions.”

The lizard king

As for the new weight-loss drugs, Dr. Gussow wrote about the original members of the group:

These injectable synthetic drugs — semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro) — are derived from a peptide found in Gila monster venom.

In itself, that is not a bad thing. Nature is a bountiful pharmaceutical resource, and humans have always been grateful to get the medicine out of any obliging plant or animal.

Almost 30 years ago, endocrinologist Daniel Drucker was fascinated to learn that the poison produced by a lizard could regulate blood sugar. He put that together with the ever-increasing diabetes demographic, got his own Gila monster, and went to work. Recently, Julia Belluz elaborated on the subject:

Ten years later, a synthetic version of a hormone in the venom became the first medicine of its kind approved to treat type 2 diabetes. Known as a GLP-1 (for glucagon-like peptide-1) receptor agonist, the medicine set off a cascade of additional venom-inspired discoveries.

Your responses and feedback are welcome!

Source: “More Questions than Answers about Injectable Weight Loss Drugs,” Journals.lww.com, July 2023
Source: “A Majority of Ozempic, Wegovy, Patients Stop Using the Medication After Only a Year, Likely Regaining Lost Weight,” TheMessenger.com, 07/12/23
Source: “How a lizard’s venom inspired the promising weight loss drug Wegovy,” Vox.com, 07/05/23
Image by Verde Canyon Railroad/CC BY-ND 2.0

Processed Food Documentary Stirs Things Up

A 42-minute video report from the German broadcast service DW has proven quite popular on YouTube, with well over a million and a half views and nearly three thousand comments since it appeared a month and a half ago. “Junk Food — The Dark Side of the Food Industry” is about allegedly healthful junk food and obesity.

It highlights, among other atrocities, the ability of giant corporations to extend their tentacles into every nook and cranny of any country. This is especially true of Nestle, the most massive food and beverage company on earth; which among other egregious errors believes that it should be able to buy all the water in the world and sell it back to people for many, many times more than what the corporation pays for it.

Nestle produces over 2,000 brands of products, and the public relations department claims a “presence” in 188 (or, according to another source, 194) countries, although that just means an office or something. Actually, it is unlikely that the behemoth’s presence is not felt in every single country there is.

People need jobs, so it would be unfair to hate on most of the over 300,000 employees. The blame accrues to the relatively small number of top executives… and to the lust of investors for “passive income,” no matter how much damage is inflicted on the world’s population or the planet it lives on.

Too little, too late

The guilt resides within the processed foods that are high in caloric content, but often do not even make a person feel full. Nestle acknowledged it, at least within the company. Admittedly, it has since removed some products from its roster, which might not even be among the most harmful, and may have been slated for extinction anyway, for any number of reasons. The record of correction is not very impressive, and only makes critics ask, “Why haven’t you done more? And sooner?”

Back in 1999, in a secret meeting of top food industry execs from the USA’s eight biggest food-selling giants, one CEO admitted culpability and the need for change, but all the others were angry at this betrayal.

At the same time, Nestle and other corporations continue to legally challenge the rules against misleading labels. They resist including any sort of warning labels, which supposedly inspire “unnecessary fear” in consumers. They try to deceive the public with claims that labeling is not beneficial. This behavior, in turn, brings about accusations that they show nothing but contempt for customers, and indifference to the suffering caused by intensely processed foods containing way too much sugar, salt, and fat.

But the corporations are kind enough to tell governments that the real need is for education programs, a spurious argument to which any government might very well reply, “No, we would prefer for you to stop doing those reprehensible things that the public, unfortunately, needs to be educated about.”

Speaking of deceptive labels, there are 15 pseudonyms for sugar (or more like 56, according to another source), so customers can be easily fooled.

This site lists several categories of Nestle sins, including “Promoting Unhealthy Food and Mislabeling.” Out of all the various breakfast cereals, they make half the ones that contain the most sugar, fat, and salt.

The big companies which should concentrate their resources and efforts on feeding people decently, instead are top-heavy with gigantic legal departments. All this litigious talent allows them to continue abusing their customers and, less directly, everyone else.

Your responses and feedback are welcome!

Source: “Junk food, sugar and additives — The dark side of the food industry | DW Documentary,” YouTube, July 2023
Source: “Nestle’s Water Controversy, Explained,” Mashed.com, 12/27/21
Source: “About Us,” Nestle.com, undated
Source: “Why Nestle is one of the most hated companies in the world,” ZMEScience.com, 05/08/23
Image by Fitmomtribe.org

Old Thoughts and New Applications

As we have known all along, but need to keep learning, behavior pretty much all starts between the ears.

Thousands of years ago, ancient philosophers wrote up the very best ideas. Socrates said, “Just as one person delights in improving his farm, and another his horse, so I delight in attending to my own improvement day by day.” Epictetus said, “Adopt new habits… Consolidate your principles by putting them into practice.” Marcus Aurelius, known as the philosopher king, was a champion of the self-improvement concept. Since those days, everything we have heard and read about habits is pretty much repetition and rephrasing.

What about obesity?

“Moderation must be our delight” was a catchphrase back then. The authors on this site say that adherents to the Stoic philosophy thought human bodies should be maintained “in fighting shape — at fighting weight” because life is, in one sense, a battle. The writers at DailyStoic.com sum it up:

They also knew… that when we feel awful, we act awfully. A person disgusted with themselves has less patience for others. A person who easily loses their breath, more easily loses their temper… or their self-control. We must avoid the vice of overdoing our overeating.

If you can cultivate good habits, you can survive — even thrive on — what lies ahead. If you relapse and fall to the level of your worst habits, these hard times will only be harder.

Their list of major precepts from the ancients includes advice to get up early, walk a lot, and connect with other people (especially the ones you love). Every day we should read the works of knowledgeable others, journal our personal experiences and thoughts, and mentally review the day before ending it.

And “make time for mastery.” In practical terms, what does this mean? Not to let ourselves stagnate in the “rut of competence.” We need to embrace “profitable difficulty” by perfecting the skills we already have and perfecting new ones. If happiness is what we seek, there is none greater than the pursuit of excellence, which means constant self-improvement, which involves a lot of habit-formation skills.

When eating is a habit

Anything we do several times a day, like eating, is bound to be encrusted with habits.
Plato recommended what today we might call the Mediterranean diet, emphasizing “cereals, legumes, fruits, milk, honey and fish.” A scholarly paper says,

[M]eat, confectionery and wine should be consumed only in moderate quantities. Excesses in food lead to ailments and therefore should be avoided. Plato considers physicians responsible for the regulation of human diet, for medicine is a science and not merely an art as in the case of cookery.

The BrainWeighve smartphone app can help with good habit formation in several ways. As one example, it acts as an accountability partner by asking the user to divulge various facts and reacting to them like a mentor. It also connects humans to each other, to lend mutual aid and support.

Your responses and feedback are welcome!

Source: “The Power of Habits: What The Ancients Knew About Making Good Ones & Breaking Bad Ones,” DailyStoic.com, undated
Source: “Dietetics in ancient Greek philosophy: Plato’s concepts of healthy diet,” ResearchGate.net, August 2001
Image by BrainyQuotes

Habit Hints Can Change Lives, Continued

Some advisors speak of rewards, but beware, because that notion may backfire. Sure, give yourself little rewards — but a new hairbrush, rather than a cupcake. Be very cagey about it, and watch out for hidden traps. Our bad habits are so bossy and rude, they can trick us into thoughts like, “I went on that hike, now I deserve an order of fries with catchup” — which is utter nonsense. The reward you deserve is the self-respect that comes from keeping the promise you made to yourself.

Avoid triggers. Like, avoid the fast-food joint, even if that is where your friends hang out. Make some new friends. Measure your progress, but don’t get crazy about it. If weight loss is at the top of your agenda, maybe mount the scale twice a week, not twice a day.

Get regular

In the realm of giving and receiving advice for self-improvement, the word “routine” shows up a lot — especially with the adjective “daily” attached to it. Establishing a routine takes conscious work, and the sooner we get over expecting it to be easy, the quicker we can transition it to unconscious habit.

A routine is more than just itself. Once established, routine is a foundation we can build on. New good habits are more viable when attached to ones that are already established. Good habits like to hang out with each other and reinforce each other. They can act in concert and remind you of each other with cues like time, place, and circumstance.

Remodel the top floor

An almost universal recommendation is to look inside. The mind is the laboratory of life, and with help and application, we can trace down a mental wrinkle that is keeping us obese, or track the twisted root cause of some destructive habit.

A surprising number of people allow their bodies to accumulate weight as a form of self-defensive armor. Columnist Caitlin Johnstone recently revealed that she suffered violent sexual assault at age 19. The backlash was the gaining and retention of many pounds of body fat. “Made me feel secure. Invisible.” Johnstone is an incredibly intelligent woman, but in that particular area of life, getting her head together took decades.

We are advised to reflect on our habits, goals, motives, hangups, etc. For someone unaccustomed to self-observation and self-analysis, it can be a fascinating practice. Doing the brain work promotes a buy-in on the deepest subconscious levels, and once a conviction has been planted, it likes to cultivate other convictions, for company.

It is pitifully easy for humans to fool ourselves, but that tendency can work for us, too. “Mind games” have a rather negative reputation, and should not be imposed on another person. But the mind games we play with ourselves are fine, if they lead to a positive outcome. Pondering our situation can lead to results, like maybe a new willingness to change and adjust. Ultimately, the mind is the source of all progress.

Your responses and feedback are welcome!

Source: “I Was 19,” CaitlinJohnstone.com, 07/05/23
Image by Katrina Wright on Unsplash 

Habit Hints Can Change Lives

Both recently and farther back, all our posts about establishing good habits show plenty of overlap. That is perfectly understandable, because if a technique effectively solves a problem, a lot of people will hear about it and try it, and then share the hot tip with a bunch of other people. From the random sample of habit-formation advice articles we have looked at over the past few days, it is obvious that certain methods are recommended over and over again. When it comes to good old common sense and self-preservation, few concepts are patentable.

Among the modern experts recently quoted by Childhood Obesity News, many recommend starting with “baby steps,” changes so tiny and easy they cannot be resisted. The persistent practice of small incremental improvements can work wonders. A person can build up an effective workout routine by starting with one pushup and a couple of squats each morning, and then by slowly but relentlessly adding on.

Practice vigilance

And what if you skip a day? It happens. But… slack off for two days in a row, and now it’s no longer just a slip, it’s a pattern. A good recommendation is to forgive yourself for your first miss, and then never let it happen again.

Self-discipline sounds like a real bummer, but try calling it something else — like “keeping the promises I’ve made to myself.” Call it fulfilling a commitment that you made to the person you know best and want to love most — just for practice, before looking around to find someone else to make a commitment to.

Although adherence to a self-promise is great, flexibility is important too. Say you’re used to having a nice jog in the evening. But it’s raining. There are puddles and the pavement might be slippery. It’s getting dark, visibility is low, and drivers can’t see well. Maybe it would be better to forget about it, just this once. Or, how about this — be flexible! Put on a raincoat and galoshes and get out there for a nice brisk adventure on the sidewalk instead.

Go for a goal

Starting with a specific goal is widely recommended, but even if your dearest wish is to avoid or escape obesity, the goal does not have to be a digit on the scale. In fact, using a specific number of pounds as a goal may not be such a good idea, because if you achieve that number, it’s quite possible you will then feel like you deserve a little reward, like maybe a whole pizza and a quart of ice cream.

Try a more abstract goal, like “I will lose weight until my knees no longer hurt from carrying around those extra pounds.” When that is achieved, a new goal will present itself — maybe to dig a certain dress out of the back of the closet, and start planning to wear it again. It’s good to be strict with oneself, but not rigid. We need to leave some space for new dreams to appear.

Finding the right social support is highly recommended. It is good to have allies, whether they are a whole exercise class or a single accountability partner. We don’t need to live in a commune to partake in a community. Some are ready-made, like classes at the Y. Often, locating like-minded people is ridiculously easy. If you have kids, and they do sports, you might find a workout group or partner among the other parents. It is helpful to have co-exercisers who are slightly better than you, but not so far ahead that their success will discourage you.

Your responses and feedback are welcome!

Image by Michael Coghlan/CC BY-SA 2.0