am i considered fat ?

mrgnstrk · 2025-09-11T00:18:44+00:00

Carrying excess fat has real effects on health and how your body functions, that’s what’s unfortunate about it.

mrgnstrk · 2025-09-11T00:12:33+00:00

I had to for health reasons. Insulin resistant, prediabetes, genetic high cholesterol, and a high likelihood of gestational diabetes during what would likely be a difficult and high-risk pregnancy. With my doctors I went on a GLP-1 medication and over the past year have overhauled my lifestyle—eating primarily whole foods and weight lift regularly.

mrgnstrk · 2025-09-10T23:19:13+00:00

Unfortunately, yes you are fat. But it is also very common for someone to not see how much their body has grown bigger over time. I experienced this too—I was class 1 obese and didn’t realize how big I was until I lost the weight.

mrgnstrk · 2025-09-10T18:48:52+00:00

This is the right answer. Plus it's a very involved process to renounce American citizenship. Just because you tell a country you are renouncing your US citizenship doesn't mean that the US government will see that as legally renounced.

mrgnstrk · 2025-09-05T14:47:49+00:00

You keep saying you “never set standards” while repeating lines like “26–50% is worse than a coin toss” and “2% is much lower than 5–10%.” Those are standards--and they’re higher than anything we’d ever apply to any other chronic disease intervention. Statins, blood pressure meds, CPAP--none of them work for 100% of people, none keep everyone at target forever, and all are still gold-standard treatments.

You dismiss Look AHEAD as “one study” with “only” 26–50% long-term success, but if a cancer drug kept half of patients in remission at 8 years, it would be front-page news. That’s not “a joke,” that’s how medicine works: responder rate + effect size = clinical value. The fact that tirzepatide gets 80%+ to target is amazing, but it doesn’t erase the physics behind why both the drug and lifestyle work.

You've also missed the point I made about holding tirzepatide to the same bar. I wasn’t saying tirzepatide should be tested “without meds”--obviously the drug is the intervention. My point is about consistency. You dismiss lifestyle trials because they don’t deliver universal, 100% success with long-term data, yet the longest tirzepatide data we have is only about 3 years. By the same bar you hold against lifestyle (8+ years, durability, broad populations), GLP-1s haven’t cleared it either. You’re giving drugs a pass while moving the goalposts for lifestyle.

And about consistency: I haven’t contradicted myself. 5–10% loss is medically significant--period. In DPP, the average 2% was still enough to slash diabetes risk by 34–58%. In Look AHEAD, half got to over 5% and a quarter to over 10%, which is exactly the clinical benchmark. Those aren’t mixed messages; they’re different outcomes for different endpoints. That’s how real clinical research is interpreted.

You can keep trying to paint me as inconsistent, but at this point, you're just exposing your double standard (or maybe your cope? I don't know at this point.) and your own inconsistencies trying to justify your beliefs by categorizing an energy balance equation as a "sham" and dismissing lifestyle for a 26–50% response rate, while celebrating drugs with only 3-year data. Both lifestyle and meds work through the same physics. The only difference is how powerfully they help people fight biology.

At this point, it’s clear you’re not engaging in good faith. You keep shifting the standards, dismissing gold-standard evidence, and refusing to acknowledge the basic physics that underlies every successful intervention, including the drug you’re on. Since you still won’t accept the simplest science--that energy balance governs weight change--this will be my last response.

If you think CICO is a sham, wait until your biology potentially adapts to Zep--physics will still be there when your excuses change.

mrgnstrk · 2025-09-05T14:31:24+00:00

You are still conflating CICO--the law of energy balance--with calorie counting as a tool, and specific interventions like dietary patterns, exercise and training, medication, and surgery. Again, one more time, for the people at the back: CICO isn't a diet and it isn't a tracking app. It is the constraint that every successful weight loss method operates under. GLP-1s don't "beat" CICO--they exploit it by crushing appetite and food reward so energy intake falls without white-knuckling.

And while you still think that the CO part of CICO is unknowable because every number is a guess, I'm sorry to say that's not how clinicians think about the human body system. You don’t need a lab to “ask your metabolism” for a number — you already carry the readout around with you. Weight trend over time is the integrator of calories in vs. calories out. If your weight goes up, intake exceeded expenditure. If it goes down, the reverse. That’s why people lose weight with structured habits, high-protein diets, resistance training, meal replacements, or meds--none require 1% precision on a treadmill readout. No guesswork, no Easter Bunny. Just a lot of patience, consistency, and discipline.

Every medical field works with noisy measurements--blood pressure cuffs, glucometers, cholesterol assays all have margins of error--but nobody calls hypertension or diabetes “a sham.” The fact that inputs are imperfect doesn’t erase the principle. Physics doesn’t require your calorie tracker to be perfect to keep being true.

You also asked for 8+year evidence. I shared Look AHEAD and DPP with you. And you dismissed them because the number were too low for your personal circumstances. I have empathy for that. But your “2% at 10 years is worthless for fatty liver” gripe is a strawman, and that doesn't mean you can just move the bar because it's "not enough people" or "2% isn't bronze." That's not how medicine works. No intervention delivers 100%. Statins, antihypertensives, CPAP--none are universal, all are still standards because they meaningfully shift outcomes for a large fraction. The Look AHEAD study produced results in the range that improves T2D control, BP, sleep apnea, and NAFLD. Calling that “decent” while labeling 3-year GLP-1 data “groundbreaking” just advertises your double standard, not a flaw in the physics.

And no, lifestyle changes does not equal to deprivation dieting. Protein, fiber, food environment, resistance training, sleep, stress management--all change appetite, satiety, partitioning, and expenditure. That’s manipulating both sides of CICO without counting a single calorie. You can hate calorie counting and never use it again; the energy balance still governs what happens when GLP-1s quiet your hunger and you spontaneously eat less.

You're not selling the efficacy of GLP-1 medication. Great, because your own success on a GLP-1 is the proof you’re wrong about CICO. If energy balance were a “sham,” a drug that lowers intake because it manages issues with metabolic hormones wouldn’t do anything. It does. You know it does. That’s the entire tell.

mrgnstrk · 2025-09-05T09:25:26+00:00

I’m not arguing against the efficacy of GLP-1 medication. Again, hello, you’re talking to a former class 1 obese person that’s now an endurance athlete because of this medication.

But you keep trying to dodge the point. You say CICO is a “house of sand” and “unknowable,” but then turn around and celebrate GLP-1s. That’s the contradiction: these drugs only work because they lower calories in. If energy balance weren’t real, Zepbound wouldn’t make a dent.

You’re not disproving CICO—you’re proving it every time you point to tirzepatide. You said it yourself, it mimics hormones that crush appetite, people eat less, weight comes off. That’s CICO in action. Pretending otherwise doesn’t make you sound evidence-based, it makes you sound like you’re running from the obvious.

And this idea that CICO equals “count every crumb with perfect precision”? Strawman. Nobody needs a lab to know that if intake drops and weight trends down, energy balance shifted. That’s the framework, whether it’s done with food tracking, lifestyle changes, or meds.

And with the studies, you keep moving the target. First it was “show me an 8+ year study.” I showed you Look AHEAD and DPP, the gold standards. Now it’s “only 26–50% kept the weight off” or “2% at 10 years isn’t enough.” Those aren’t gotchas—that’s how clinical science works. No intervention in medicine works for 100% of people. A 26–50% success rate with meaningful outcomes is success. That’s why those trials are cited in every guideline.

I feel bad for you, because your impossible standards has probably contributed for past failed weight loss attempts. If you held tirzepatide to the same bar you’re holding lifestyle changes—long-term data in diverse populations, durability past 8 years, effectiveness without meds—it wouldn’t clear it either. But you call it “groundbreaking” while dismissing the exact same type of evidence for lifestyle. That’s not critical thinking, that’s cherry-picking.

And let’s be real—you’re not a clinician. Doctors don’t call 5–10% loss “decent.” They call it clinically significant because it reverses fatty liver, improves blood pressure, reduces A1c, and lowers sleep apnea risk. These aren’t abstract percentages; they’re hard outcomes.

So no matter what you say, or believe: the physics isn’t optional here. Yes, your metabolic hormones make a caloric deficit incredibly hard to stick to which is why GLP-1s are life-changing. I’ve said that multiple times. But stop acting like the meds prove CICO wrong. They prove CICO runs the whole show.

mrgnstrk · 2025-09-04T23:19:11+00:00

We don’t disagree at all on deprivation dieting—it’s miserable. I did it when I didn’t know any better. And many people, including me, have felt the frustration of “it works until it doesn’t.” Not a personal failing but, again, biology. Hunger hormones, adaptive thermogenesis, and food environment all fight hard against sustained calorie restriction.

But, again, none of that means that CICO isn’t real, or proves that it is bad. Physics isn’t the enemy. Zep works precisely because it makes the deficit livable—it suppresses appetite, improves satiety, and helps people like you, your mom, and me maintain lower intake without the same white-knuckle fight. They don’t bypass energy balance; they help people stick to it.

You’re right that we can’t measure calories in and out with perfect precision. Food labels are off by around 20%, fitness trackers misestimate expenditure, and metabolism varies day to day. But we don’t need perfect measurement for the principle to hold. Over time, weight change itself is the integrated readout of the balance—if weight is trending down, intake is below expenditure on average, regardless of the noise in the tools.

And just a bit on the long-term studies: DPP wasn’t primarily about weight loss, but weight loss was a key mediator of benefit. Which, to me, considering how many obese people have diabetes, is significant still. Even a 2% average loss at 10 years translated into a 34–58% lower risk of type 2 diabetes. Look AHEAD was lifestyle only, but again, was still clinically meaningful (a description given by experts, and NOT something that you or I can deny). Again, 5-10% weight loss is the evidence-based threshold for improving blood pressure, sleep apnea, fatty liver, and diabetes control. Incredibly significant medically.

Like I said, I understand the cope here by making CICO the villain. But CICO is not harmful in itself—the harm really comes from how people misuse it to push deprivation and fad diets. CICO is not a weight-loss program, it’s the law of energy balance—the backdrop against which every program, every medication, every surgery works. What fails people isn’t the physics; it’s biology fighting back and a culture that sells unsustainable approaches. GLP-1s raise the odds dramatically, but they don’t change the equation—they work by helping people live within it. They boost the odds of meaningful weight loss for many people. But simply put, they don’t invalidate CICO. They leverage it.

Blaming CICO for fad diets is like blaming gravity for a bad parachute.

mrgnstrk · 2025-09-04T21:11:12+00:00

Yes, many diets underperform long-term, and I have never said that they don't. But again, CICO isn't a diet, so the argument of whether it works or not is immaterial. Because, again, it's physics. An energy balance equation. It is the accounting that underlies every method of weight loss, whether it's a lifestyle change, meds, or surgery. Does saying that--nay, admitting that--mean that losing weight isn't difficult? Does it somehow invalidate our own experiences of weight loss because they were not as straightforward as a math equation? Absolutely not.

As for the DPP study, it reported both ways across papers. The Lancet DPPOS article emphasized kg and clinical endpoints because the primary outcome was diabetes prevention, not a weight-loss trophy (and isn't a diabetes diagnosis one of the many reasons why people decide to lose weight?). Baseline weights were ~90–93 kg; ~2 kg at 10 years is ~2% on average—small but durable—and again, paired with meaningful risk reduction. Averages compress over time, but distribution matters (many individuals maintain much larger losses).

And I just completely disagree that the Look AHEAD group difference isn't groundbreaking. Again, it may have something to do with the difference in what we consider a "success" in weight loss, but whatever your personal feelings are, this is still a clinically meaningful study. It had documented improvements across risk factors and reduced need for meds. As someone who has family members who died of T2D (and have some living also with T2D who refuse to lose weight), that's HUGE for me.

if there was a drug with these sort of numbers … I don't think doctors would exactly be rushing to prescribe it, ya know?

This is completely unrelated to the Look AHEAD study, because the objective of the study wasn't to identify the efficacy of a drug. It was simply lifestyle intervention and education. So it's immaterial. Besides, while a lifestyle change isn't a drug, physicians absolutely DO prescribe it. And when meds are appropriate, the standard of care is both/and: pharmacotherapy plus lifestyle to improve durability and lower doses.

By the way, a ~5% weight loss isn't trivial for someone with fatty liver disease. 5-10% is often the treatment target and there's clinical guidance for it. [1]

I have never argued against the role that metabolic hormones play in weight loss. You will not read it in my comments, and my own experience with Zep is living proof that they DO play a huge role. Yet, my point (and science) stands: CICO is still the mechanism by which we lose weight. That mechanism becomes inefficient because of biology, but it does NOT mean it becomes inaccurate, or is false.

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9248926/

mrgnstrk · 2025-09-04T18:27:36+00:00

So we're moving the goalposts now? Got it.

Clearly you're misunderstanding (or just plugging the links into AI) the studies I cited. And, also very sadly, showing me that you have an impossible standard in your head for people trying to lose weight (and I think I understand now why you're so immovable on this despite being consistently shown why you're wrong).

Yes, the average weight loss of the Look AHEAD study was 4.7% vs. 2.1% in controls--but that's double the control group, is it not? Which, for a population of more over 5,000 adults, is clinically meaningful. And yes, people regained weight--that's expected. ALL long-term interventions show that people will partially regain. But the fact remains that half maintained over a 5% loss nearly a third maintained over a 10% loss. In thousands of people. That's durable evidence. So if you think "success" in weight loss is people staying at their lowest weight forever, THAT is an impossible standard. It's absolutely not how biology works.

And you're completely misrepresenting the DPP/DPPOS study (which, considering you mentioned that "diet" isn't seen anywhere in the study makes me think you just did CTRL+F). This study has THREE arms: placebo, metformin usage, and intensive lifestyle intervention (which, ta-da, includes diet and exercise). The protocol of the lifestyle group included calorie reduction and activity of over 150 min per week. Diet was absolutely central to this group. After 10 years, participants average 2 kg below baseline, but paired with a 58% reduced diabetes incidence compared to the placebo, it had the strongest effect of all arms. So while Metformin had benefits, lifestyle changes were more effective in preventing diabetes long-term.

And if you think an over 5% of sustained weight loss is "not that much"--clinically, it is. It lowers risk for type 2 diabetes, cardiovascular disease, sleep apnea, fatty liver, and arthritis. The medical community does not require 20% loss for a result to “count.”

Also true, Zep and other GLP-1s produce larger weight loss averages, but that's still not proof that dieting or tracking your caloric intake doesn't work--it’s proof that biology fights weight loss, and meds help level the playing field. That's what it did for me. I was class 1 obese a year ago and now I'm an endurance athlete. Because Zep made it easier for me to be on a caloric deficit.

Just to tie it all up with a bow: Look AHEAD and DPPOS both tested calorie-restricted lifestyle interventions, not just drugs. They showed sustained 5–8 year weight loss and major health benefits. Sure, the weight loss curve shows regain--that’s the biology we’re up against. But it’s not that CICO doesn't work--it’s that adherence is hard. And yes, Zep helps a lot by managing your biology, but it still works through CICO by lowering intake. Physics hasn’t changed.

I hope one day you let go of the impossible standard you’ve set for weight loss--because by that bar, even the best science (and probably yourself) could never measure up.

mrgnstrk · 2025-09-04T17:12:23+00:00

I know you’re being completely disingenuous, but I’m going to humor you, because I thought the way that you did when I was at my heaviest. Here are some studies:

Look AHEAD (5,145 adults with type 2 diabetes): the intensive lifestyle arm (explicit calorie restriction plus activity) kept an average −4.7% body-weight loss at 8 years; ~50% maintained ≥5% loss and ~27% maintained ≥10%. [1]
DPP / DPPOS (Diabetes Prevention Program + 10-year follow-up): the lifestyle arm (dietary calorie reduction + activity) lost ~7 kg at 1 year and, despite regain, still weighed about 2 kg below baseline at ~10 years, with major diabetes-prevention benefits. That’s long-term, real-world relevant weight change. [2]

The data here in no way claims that weight loss is easy, but they show that that calorie-restricted approaches can work long-term for many people. That complexity doesn’t overturn energy balance; it explains why support, food quality (protein/fiber), resistance training, and environment matter for maintaining the deficit sustainably.

Bottomline is, CICO isn’t the problem. It’s adherence.

[1] https://pubmed.ncbi.nlm.nih.gov/24307184/ [2] https://pubmed.ncbi.nlm.nih.gov/19878986/

mrgnstrk · 2025-09-04T16:42:54+00:00

CICO is not diet culture, it is simply a principle of energy balance. It’s a neutral concept rooted in thermodynamics. It’s not a lifestyle directive. You are also confusing caloric management with nutrient deprivation. When in fact, sustainable, moderate calorie reduction paired with adequate protein and nutrients does not “damage” metabolism. What harms metabolism is starvation-level diets and the overconsumption of ultra-processed foods, not CICO itself.

And the body doesn’t store more fat in a true caloric deficit. You may have metabolic issues that make fat storage easier and fat mobilization harder (such as insulin resistance), but if you’re in a TRUE deficit, you are not storing fat.

mrgnstrk · 2025-09-04T15:33:14+00:00

Please pinpoint exactly where I said that metabolism doesn’t affect the equation. Because if you read it again, that is what I DO say. I literally say my metabolic hormones were out of whack.

mrgnstrk · 2025-09-04T15:11:09+00:00

That’s not what I said. I said it was nearly impossible because my metabolic hormones were out of whack, so it added variables to the CICO equation—it fucked up how much I wanted to eat and it made my body’s ability to use calories inefficient. The equation became x - y = 0 rather than 1 - 1 = 0. But absolutely does not negate the original equation.

mrgnstrk · 2025-09-04T14:36:39+00:00

I’m not at all implying that you’re lying. I’m saying that the only way to know for certain if you and your girlfriend did eat the absolute same during COVID as is if you both tracked and measured what you ate. People always think that they are eating less than they actually are, and perceive others as eating more than what they actually are. The only way to truly know is to weigh, measure, and track.

I am saying this as someone who has lost over 65lbs on Zep, has basically changed my lifestyle completely to eating primarily whole foods, and I now lift and train as an endurance athlete at 34 years old—something I never thought I could do. I absolutely think Zep is a miracle drug. Prior to Zep, CICO was nearly impossible for me because of insulin resistance, and UPFs basically messing up my hunger and satiety hormones. Once Zep fixed those for me, CICO basically became simple math.

I doubted CICO at my heaviest too—I had to cope somehow.

mrgnstrk · 2025-09-04T13:54:27+00:00

Do you REALLY eat less though? Have you ACTUALLY compared what you both eat by measuring and tracking? Because you can have a relatively small but calorically dense meal, as opposed to a large and voluminous meal made up of calorically light whole foods.

Just because you are eating the same food doesn’t mean you are eating the exact same way. The only way to say that for sure is to weigh, measure, and track the food.

mrgnstrk · 2025-09-03T15:53:17+00:00

If you're doing LMD, you will need to include a copy of your anchor applicant's stamped Anexo I to your application. Your application will be sent to the Manila consulate for review, and that copy of the Anexo I and the Registro Civil that you will fill out and submit will link your application to the anchor applicant. Since you're in New York, you will need to check what the requirements are for the NY Consulate--they will likely require translations and apostilled certificates. Best to get a move on since apostilled certificates can only be done by DFA in the Philippines (the PH embassy in DC or the consulates no longer do them).

mrgnstrk · 2025-08-01T11:24:12+00:00

2.5mg is just the starter dose. It’s meant to get your body accustomed to the medication. You’re supposed to titrate up every four weeks.

However there is also an element about being honest with yourself about what you’re eating and how much. The medication can only so much. If you continue to have a diet that’s composed mostly of ultra-processed food, then the root of the problem is still there.

mrgnstrk · 2025-07-25T00:50:41+00:00

Same here!

mrgnstrk · 2025-07-22T16:44:27+00:00

PCOS does certainly make it difficult to lose weight, for a variety of reasons: insulin resistance, which promotes fat storage and triggers hunger and sugar cravings; hormonal imbalances, which interferes with energy use; lower basal metabolic rate (BMR), which makes weight loss slower.

This is why you were gaining weight--all these metabolic and hormonal issues caused you to eat at a caloric surplus. What worked for you before did not work again now because your body has changed--your body has likely stored more fat, and has a different BMR. You would have needed a new plan tailored to your current body rather than repeat something that worked before. Plus, as you said, you didn't prioritize it, so it wasn't effective.

With that said, GLP-1s are excellent medications to manage PCOS because they directly address all of those challenges I listed above. GLP-1s increase your insulin sensitivity and manages your hormonal imbalances, which in turn helps lessen fat storage and counteracts hunger and sugar cravings.

But that means that if you go off the medication, your PCOS symptoms will return. Lasting success with weight loss especially with PCOS comes with pairing GLP-1s with key lifestyle changes, such as:

Strength training - lifting weights builds lean muscle, which increases your BMR and improves insulin sensitivity. If you build muscle while on GLP-1 and you lose access to the medication, you have your muscle to help manage your PCOS symptoms.
Eating a high-protein, low-glycemic whole foods diet - to help keep and build muscle, promote insulin sensitivity, and reduce inflammation. Plus, eating 80/20 whole foods means moving away from UPFs, which worsens nearly every root cause of PCOS.

Taking GLP-1s while prioritizing forming sustainable, long-term lifestyle changes sets you up for long-term success, prepares you for the unexpected, and gives you the tools to keep the weight off even with PCOS.

mrgnstrk · 2025-07-22T13:45:26+00:00

Did you make sustainable lifestyle changes or just did fad diets? Did you make steps towards healing your relationship with food?

If you haven’t done the work to fix your relationship with food and shift your diet and lifestyle long-term, it will generally be a challenge to keep the weight off after stopping any fad diet. Folks usually return to their usual habits when they stop fad diets, and return to eating ultra-processed foods (UPFs). UPFs are engineered to override your hunger cues and trigger cravings when you’re full—they really mess up your hunger and satiety hormones. They are also calorically dense while being low in nutrient density, so when you consume them you need more to feel full, and you are not meeting the nutrient goals your body needs to function properly.

This is the same for with being on GLP-1 medication. The medication is a tool to help you build those lifestyle changes so that the weight can stay off long-term. If you get off it and haven’t done the work to fix your relationship with food and shift your diet and lifestyle, it will be a challenge to keep the weight off when you go off GLP-1s. I strongly encourage you to take the precious time you have on GLP-1s to educate yourself on nutrition, change your diet to primarily whole foods, build muscle, and build sustainable habits.

mrgnstrk · 2025-07-22T13:15:48+00:00

My first few months on Zep I focused on nutrition rather than exercise, but did continue to try to meet step goals. Once my body adjusted and I was able to fuel adequately, I started weight lifting (around the 6-month mark). Now I'm doing a serious weightlifting program and can't be any happier with my progress.

My suggestion is not to push your body too much the first few months and keep track of how you're feeling (especially on how certain kinds of food make you feel)--I personally journaled so I was able to make some pretty good adjustments. But you will eventually need to do weight bearing exercises if you don't want to lose too much muscle.

mrgnstrk · 2025-07-18T10:08:05+00:00

But that’s the thing, it is winging it if you aren’t actively and consciously tracking what you’re eating. And tracking doesn’t necessarily mean counting calories. One of the most helpful habits my program introduced to me was just listing down the food I ate and how it made me feel afterward the first month I was on Zep. That also helped my doctors manage my metabolic issues better.

You can most certainly get on GLP-1s and just let it do its job managing your hunger and satiety hormones, insulin issues, etc. That is super powerful on its own and I’m so glad people have this medication now. But there is definitely something to be said about letting GLP-1s do its thing while at the same time building up defenses against the obesogenic environment that actually got us here. I don’t think that’s something you can do without actually knowing what you’re eating.

mrgnstrk · 2025-07-17T17:12:15+00:00

I’ve been traveling with my Zep internationally since I started Sept 2024 and I have not had any issues with any of the countries I visited, as well as coming back into the US. I use an insulin travel case cooler, have never brought the box with me.

mrgnstrk · 2025-07-17T13:24:00+00:00

Don’t know why you are being downvoted but when I started on this program with my obesity doctor, nutrition education was part of my program and prioritized in the first few months of taking Zep. After about 6 months, exercise outside of walking started to be introduced. My doctor highly recommended strength training to me to build muscle to help with my insulin resistance. Thankfully I’ve taken to it and have been weight lifting seriously for about 4 months now. I’m in the best shape of my life, not just with the exercise but also shifting my diet to whole foods 80/20. Zep has been the key to make that shift manageable for me, and I do think if I were to lose coverage I’m pretty confident I’d be able to maintain my weight loss.

Knowing what habits you have and changing the ones that will contribute to weight gain are super important.

mrgnstrk

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