I wonder how Ozempic will change this? I really do expect we will all be on this soon and maybe we can resume the increase in lifespan that has been stalled by obesity, lack of exercise, and processed food.
replies(4):
When antibiotics were first invented some people thought we'd be taking them daily as a vitamin. Turns out that's not such a good idea despite them being life saving in some scenarios
And there are potential bad side effects too.
It has a side effect of reducing muscle gains from exercise.
As for life extension by GLP-1 active drugs, it's much more of a guess. Mechanism is relatively similar. Side effects might not be...
If a doctor tried to push that on me I would fire that doctor.
Life expectancy is a weighted average (no pun intended), and so it's unusually sensitive to outliers. People who die early drag the average down much more than people who live close to the mean life expectancy. The biggest premature killers of Americans are obesity, drugs, car accidents, and suicide. Anything that addresses one of those causes of death has an outsize effect on life expectancy. There are 100M+ obese Americans. There are about 100,000 overdose deaths per year. Obesity, while not as lethal as drugs or suicide, afflicts 1000x as many patients, and so a treatment for it can have a large effect on the numbers.
I'm all for getting rid of sleep, but given how society is structured I worry that the extra time will just end up being used for longer commutes and more zoom calls. Hardly advancement.
Sure, if all the weights are 1. Where i come from, we just call that an average.
>People who die early drag the average down much more than people who live close to the mean life expectancy.
This is true of all averages where all weights are the same.
The information that something stopped or slowed down is still useful without having to think it was going to go on eternally. It allows you to adjust your plans for the future.
It's not binary I guess (sleep "once a week" is less than "sleep once a day"), but even some incremental improvements seem very far off.
One also has to wonder if it's actually desirable to have less sleep and be "on" with fewer or no breaks.
While in practice, what would happen is that we’d be doing more of the same. Bosses would be demanding more time in the office, people would be spending more time doomscrolling, nothing would change. It’s a pipe dream to think that if we had more time in the day we’d suddenly start using it more respectfully and responsibly.
People are asking if we should be surprised by the headline but are missing this. As suggested in the article by the researchers, there is something dragging down the average since the 2010s. Not even hitting the general expectation of ~75 years. We don’t have solid answers yet, only theories.
So yes, generally while going up against the process of aging is going to create barriers (eg can we get to 130 years old), we are also failing to raise the baseline which is the bigger issue that people might not grasp when it comes to “life expectancy rates”.
The exact quote you gave had a pretty solid answer, certainly not just "theories".
"Millions long for immortality who don't know what to do with themselves on a rainy Sunday afternoon." — Susan Ertz, Anger in the Sky (1943)
This is the great future the visionary OP envisions for us.
https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-...
> According to the CDC, 9.4% of adults in the United States were severely obese between August 2021 and August 2023. This is higher for women (12.1%) than men (6.7%). The prevalence of severe obesity varies by age group, with the highest rates in adults aged 40–59 (12.0%)
Only 9.4% of people are severely obese. Moderately obese people have only a ~4% shorter life-span than healthy weight individuals - much of which can probably be attributed to other lifestyle issues besides simply being overweight.
This will move the needle, but I doubt as much as you think.
There's a lot more smokers than there are severely obese people.
> did you expect her to live forever?
(To reproduce exactly the scenario being discussed, you fit a constant-only model to the data using least squares: that gives the average as the best fit. Then, you measure the leverage of each point of interest.)
I understand some tech billionaire want to live forever by eating hundreds of pills a day for nutrition, anti-aging, disease control etc. Their life may be "great" for some definition of great.
But do billions of people on earth think that their life will become great in another 50 years even if it is rather miserable right now? I just live under rock to not know the desires of modern human.
Which, I recognize is a pretty privileged way of putting it—people struggle with weight, mental health, and drugs, and those are real struggles that shouldn’t be ignored. I just also want to see where things are developing on the upper-bound for reasonably plausible lifespans.
Huh, I was going to argue this, but you're right (in the US). 19.5% of the population smokes, so there's about twice as many smokers as severely obese people.
I was sure it had dropped to 5-10%. I guess I'm in a bubble (of fresh air).
We have research on what can affect heart health, like what things might be linked to it, such as smoking and alcohol. We also know genetics plays a huge role.
So we don't actually have solid answers, actionable answers as to the rise of heart health issues. Look at this analysis[1] regarding how dietary guidelines specifically for fats (saturated, trans) have very little substantial evidence supporting it. Yet this gets repeated by the average person, that fats are the ultimate evil you must avoid. In another study[2] we find that reducing your fat intake still resulted in the same rates of mortality as those who ate more. This is also why more in the space are shifting away from these sort of claims ("only eat x amount of saturated fat per day") and more to general food composition (eg who cares if a fish has saturated fats, eat the fish with vegetables).
It's quite challenging to figure out, everyone has their theories. All I'm saying is we don't actually have the answers yet.
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
I don't know why is this even a question. Do people really think being overweight is a net positive?
I find that when I point this out, people often get mad. They feel they aren't obese. But the research doesn't support them, if you are anywhere outside of the "healthy" categorization you are at the same risk (that we know of so far) as "clinically obese" people.
The real and staggering excellence of the series is the speculation - it's not such hard SF that it explains the mechanisms by which everything happens, and there are real characters who do more than stand as cardboard observers to technology, but it's crunchier than most.
https://www.wired.com/story/the-benefits-of-ozempic-are-mult...
> Known as GLP-1 agonists, these drugs were originally developed to help control diabetes. But there's increasing evidence that they have other health benefits, beyond controlling weight. They seem to boost heart health, protect the kidneys, improve sleep apnea, and lower the risk of certain obesity-related cancers.
Perhaps there are other shared variables besides genes? For one thing, blindness is associated with higher mortality [1]. And even within a country, life expectancy can vary dramatically by region, city, and even neighborhood. Or perhaps the people you know happen to be more likely to share certain occupations, mindsets, levels of physical activity, or diets?
Or maybe it's just coincidence.
[1] https://www.thelancet.com/journals/langlo/article/PIIS2214-1...
We’re really flying in the dark there.
We really don’t know and have made it nigh impossible to study. Obviously governments are trying to hide something.
We’ve normalised being fat.
I guess we’ll soon be able to measure the impacts on what it does to the children of parents that take it.
How have McDonalds Happy Meal sales been looking lately?
The gist is that this isn't quite as cut and dry as it may seem.
We also paid to make the Nature Aging paper open access.
Our economic system is incompatible with the next 200 years irregardless of what specifically gets invented.
At 5%/year, that's a factor (not percentage) of 17292 growth; in energy terms that's not quite boiling the oceans, but it is making the poles the only barely livable zone.
In any sense besides energy, this kind of growth implies automation that makes the meaning of work radically different than today. Human or superhuman AI would be an example of that, but the successful creation of that has other complications that we can currently only guess at with less awareness than the Victorians had of climate change or biodiversity loss.
That’s awesome! Did you make a deal with the authors to pay for the fee during publication or is this something anyone can do by approaching the journal itself?
seems decent to me. I hate sleeping, the problem is i get tired and cant avoid it.
Edit: if you need to know I would just ask the editor if it's an option
To show that we are hitting a limit on our ability to extend lifetime, we really should look at having reached 95, how many people reach 105 or something like that.
To say that the average life expectancy is dropping and therefore we have reached our limit on their ability to extend the lifetimes ignores the fact that much of the reason for a stage life expectancy drop in my country is lifelong maltreatment, often self-inflicted--death-oriented decisions on drugs, nutrition, and activity.
That doesn't mean obese people are "to blame" for any medical complications they might suffer from obesity. It also doesn't mean that obesity is a death sentence; people's bodies function differently and we've all heard stories of pack a day smokers that lived into their 90s. But there is absolutely a connection between the two.
By doing so, historical events outside of the study period don't have a major effect. In this study, they deliberately avoided the covid pandemic as it would have caused a significant drop in life expectancy that is not representative of a general trend. Of course, the future is not taken into account either. Despite what the name may suggest, life expectancy is like a snapshot of the studied period (1990-2019 here), not a prediction.
Huh? Statins are a medication type in which increases in life expectancy are extremely hard to point to all. I think they're almost a "poster child" for medications that correct a problem to an extent but whose overall benefit is quite dubious.
(and given that these medications were highly prescribed before any long term studies were finish - creating considerable incentive for people to find benefit - I'd personally wager they are overall harmful but that's me guessing - the main point is they definitely aren't boost-life-expectancy-by-years drugs but probably aren't reduce-life-expectancy-by-years drugs either, given the studies)
Link from google: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/
Let's give a few decades of strict control over food suppliers a try, and if that doesn't work, maybe we could look into alternatives.
Fat positivity? It's not really a popular position, and is in fact regarded as a loathesome movement.
You think every fat kid, especially those bullied, don't want to be thin?
You think shaming is going to work? That's an uphill battle, especially against the human body and the urges it generate, the causes we do not fully understand.
Normal healthy humans are supposed to be able to self regulate their weight at a healthy level. I have seen at least one friend who has an atrocious diet, poor eating habit, and yet remain rail thin.
If shaming did work, then it would have been implemented widely and obesity is solved. But it's not. We don't have anything that works as well as ozempic.
I am all for taking responsibility, but we ought to be cognizant about the current limitations of our tools and flexible at how we would solve problems, rather than sticking to dogma or trying the same thing over and over again and expecting different results.
For example, I found a psychological trick that enables me to work long hours. Tricks for eventually getting rid of bad food addiction(sadly, I am at it again).
There is no lobbying like the lobbying for massively selling classes of drugs of dubious effect.
edit: you really think insulin prices don't have an effect on the lifespans of diabetics?
I'm a good example of how it fails. I have long arms and legs which causes my BMI to be fairly low. However, my body fat is fairly high. I need to lose fat but were I to rely solely on BMI I'd think I'm fine.
What I'd want instead of BMI is body fat percentage. I think that gives a much better measure of health problems.
Since everyone knows smoking is bad for a long time now, we’re going to eventually need to categorize stuff like lung-cancer as a death of despair, similar to other deaths caused by alcoholism, opioids, or suicide.
A lot of people who otherwise might quit smoking are probably looking at impossible dreams of home ownership or retirement, and thinking consciously or unconsciously that there is more dignity in a death at 50-60ish than one at 80ish when you’re unemployable and the thin promises of social safety nets have fallen through.
Smoking (or other high risk activities) might be a dirty habit but it’s still more socially acceptable than suicide.
"Overweight" is longer-lived than "Normal," and "Grade I Obesity" isn't significantly less longer lived than "Normal." So what you're pointing out is misinformation, which is why people are annoyed by it. There is a case that "Normal" includes more sick and dying people because sick people often lose weight, but the difference still can't be as stark as reddit knowledge makes it out to be.
https://pubmed.ncbi.nlm.nih.gov/23280227/
Conclusions and relevance: Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
Most of them are smoking primarily because they're addicted.
A few of them actually like smoking.
75% American are overweight..
Just let it sink a second, they speak about how many baby born after 2000 will reach 100 years old, how we are reaching the absolute limit of human survival.
75% overweight... Everyone know fat people don't live long. I bet all the studies done in the 90's that predicted we would easily be able to reach 100 years old didn't take that into account.
What kind of reasoning is this? This is only true if you believe good policies always get implemented. You'll notice other countries like Japan don't require every man and child to be drugged to stop eating food, and they have a much stronger sense of shame for being an undue burden on society.
King County in Washington State, which contains the Seattle metro area, has a life expectancy of 86.3 years. This is higher than any country in the world. If you move one county south (Pierce), it is 75.7 years, slightly worse than the US average currently. Not surprisingly, there are many obvious factors that may contribute to this e.g. the obesity rate in Pierce County is 50% higher and the obesity rate in King County is roughly half the US obesity rate. The Seattle metro is a relatively walkable city and people do, Pierce County is not. As a matter of demographics, King County is significantly more Asian than Pierce County. And so on.
Both counties are geographically large and contain many municipalities. It is difficult to come up with a theory where pension fraud in King County is so high relative to Pierce County that it explains a >10 year difference in life expectancy.
I've been hearing this complaint (that the guidelines claim fat are the worst) for way too long, when in (my) reality, all the guidelines I've seen in the last 25 years has put more emphasis on carbs than on fats (i.e. too many carbs is evil).
I know "low fat" diets were the craze a long time ago. And sure, advertisers still like to slap "low/no fat" labels. But I believe the actual recommendation has been to lower carbs since around the 90's.
This is ultimately a strawman.
I saw more grossly obese people at that airport in the first ten minutes than I had back home in probably the previous year. It really stood out to me.
It must be your general dietary makeup and lifestyle. All that corn syrup. Also, I don't see any reason why it would have gotten better since then.
Just calling a spade a spade from an outsider's perspective..
https://doi.org/10.4158/endp.19.1.50042678317gx698
The evidence that being overweight is healthier is a bit dubious, but the evidence that having a "normal" BMI is healthier than "overweight" is nonexistent.
studies estimate that moderate obesity takes about 2-3 years of life expectancy (defined as having a BMI of 30-35), only people with severe obesity (BMI of 40-45+) lose on average 6-13 years, comparable to smoking.
Given that severe obesity is still uncommon even in the rich world it only has a small impact on life expectancy overall.
Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis
> Conclusions and Relevance: [...]overweight was associated with significantly lower all-cause mortality.
That is to say, I'm not clear that "beating aging" is what is required for "long life." Is that definitionally required and I'm just being dense?
I'm assuming this is a tiered discussion? In that nobody thinks we should freeze aging at baby stages for someone. Such that we would still want some aging, but would then try and fix a point where all aging can be stopped?
It is so pervasive though it is hard to tell until you go on a really boring and restrictive diet. It is just hard to not gain weight on average when the food tastes this good with such incredible variety.
That is even if you buy something at the store. With our "foodie" culture, restaurants are an entire other level of choice and taste on top of that.
We dance around it and call it 'obesity' but the real medical cause of obesity is an addiction to unhealthy food.
This is compounded by the fact that it is completely legal for people to make their food more addictive and therefore unhealthy and advertise it to addicted people with underhanded marketing techniques that take advantage of their addiction.
Until we recognize this as an addiction issue that is compounded by dealers being able to operate with impunity we won't make any headway -- short of technological advancements like Ozempic that allow people to side step their addiction.
The accepted view is a lot like the accepted views to mono-cultures for crops. In that they are bad. The practiced take, though, is quite the opposite? Crops are dominated by mono-cultured fields. And though antibiotics are known not to be used constantly, farms seem to use them at an amazing rate.
I'd love to see a longer exploration of this. Why is it farms seem to be full of practices that we are taught are bad?
Fair that I don't expect to be as strong in my 60s as I am now. Or when I hit 70+. If I get that far. Light weight training is plenty to get to be in good physical shape, though? Get to where you can do 10-30 pushups and run a continuous mile, and you are probably doing fine?
Depends. All cause mortality is notoriously lower for "overweight" people than "normal weight" people.
I think we need to distinguish between longevity and health though. Lots of people live with chronic disease and giving them more quality of life counts for more than longer life IMO.
i.e. the benefits of the weight loss almost certainly outweigh any side effects that are likely to manifest.
Why not? Humans have been pursuing immortality for time immemorial. "The Epic of Gilgamesh", one of the first known stories, features such a pursuit.
This is all my THEORY, a speculation that I would like someone to study or to find a study about.
Theory / speculation:
Humans evolved with natural sugars, fats, proteins/meats; primitive cooking, probably some grains (more recently). That's what our bodies know how to process, to react to.
All the fake sugars, modified foods that lack the components our bodies use to regulate internal processes; highly processed foods which also lack those components we need to feel satiated and to produce the messengers to digest correctly: those are likely the causes of obesity (not feeling full, so more eating) and bodies behaving poorly.
'Food Deserts' and corporations that are geared around selling large portions of tasty but unsatisfying food, or only offering huge sizes rather than also offering adults a tasty portion that's not intended for take home leftovers also contribute.
Also: my main vice for this topic. Can I _please_ have lightly caffeinated + carbonated water that isn't outrageously expensive?
Everyone already dies.
So, if you limit aging to "getting frail," I am fully there. But there are other things that happen as you age.
It is expensive to live a healthy lifestyle in the US.
Hunched over old people do not have the muscle mass to help keep them upright, I guess amongst other things.
If obesity is supposed to be the other main candidate for why life expectancy is down, you can do a similar analysis there. Is life really good enough to prolong or attempt to improve for people that are in at-risk categories? That’s the question people are looking at when they choose to move towards or away from self-care. For someone who makes minimum wage and already has to choose between paying for a date or paying for rent, it makes less sense for them to care much about losing weight, because it makes a bad life longer but won’t help their love life.
This is how practically all population-level analysis of health is just economics in disguise, even without directly looking at costs of medicine/services
So, what does it mean to "beat aging in a medical sense?" If it is just definitionally to not have any of the bad effects of aging, then sure. Of course I would want that. What are the names for the good things that are generally along for the ride with aging?
Going back to my earlier quip, if you could turn off aging for babies/toddlers, how would that be a good thing?
Get an apartment on at least the third floor, in a building without a lift.
Get a pet dog which needs to be walked several times a day.
Eat lots of chili peppers[0]:
"The analysis included data from more than a half a million people in multiple countries. When compared with people who never or rarely ate chili pepper, those who ate it regularly had lower rates of death due to cardiovascular disease (by 26%), cancer (by 23%), or any cause (by 25%)."
[0] https://www.health.harvard.edu/blog/will-eating-more-chilis-....
A little bit of high-intensity workout each week?
I know people who are incapable of eating lunch or any meal without a large can/bottle of full-strengh coca cola or such, ever single day. Most of whom complain about not being able to lose weight.
The science is pretty clear. Breaking out of old habits is much more challenging.
EDIT: Typos: whole -> whom, mean -> meal
https://www.medicalnewstoday.com/articles/how-the-brain-flus...
IIRC mostly they had to do with seasonal sicknesses like the flu, the theory being that your body can burn the extra fat during periods you aren't able to eat well.
So the heart of my question is why do we view "defeating aging" as the same as "living longer?" Or is this something where the target age that people would want to be generally coalesces on a common number?
The modern lifestyle is incredibly sedentary and every civilisation is built on staple foods that can feed hours of manual labour (with modern snacks thrown on top).
Calling a major food group evil is just a good scapegoat because it’s much more palatable than telling people that they don’t move enough and eat too much food.
As I said down thread, this could just be a potato/potahto thing? If this is just definitionally beating getting frail, then that makes sense. But I don't know that I could pin down an age that I would want to freeze progress at. Nor do I think I expected that there would be a general age to freeze aging at. Let me keep my strength longer, but I expect I will be/look/appear older and older the older I get.
Now, granted, I'd be delighted if I have the same strength my 90 year old grandfather in law did. In his 70s, I'm pretty sure the only thing I could beat him at was a race. Lifting things or doing manual work outside, and he was far beyond what I was in my 30s.
Regarding other factors, American culture is fairly similar to Canadian culture. However Canadians have free healthcare, meaning more Canadians see doctors than Americans. So I wonder if they have lower levels of obesity, heart disease and diabetes, and if their lifespans have also been decreasing.
"Although nuts are high in fat, it’s mainly healthier unsaturated fat. They contain protein, B vitamins, vitamin E and minerals, including iron, potassium, selenium, magnesium, zinc and copper."[0]
[0] https://www.bhf.org.uk/informationsupport/heart-matters-maga....
A book on sleep and how important it is to learning and health: https://en.wikipedia.org/wiki/Why_We_Sleep "Walker spent four years writing the book, in which he asserts that sleep deprivation is linked to numerous fatal diseases, including dementia. ... The values of sleep and the consequences of sleep deprivation are also brought up in the book. One particular research conducted in the past, where people volunteered themselves to sleep for only six hours in a span of 10 nights, is brought up by Walker. This resulted in the volunteers being "cognitively impaired" along with their brains being heavily damaged, regardless of the three week eight-hour sleep schedule they received later."
At any rate, I'll be reading more on this some. I have real work I should be doing, after all. :D
Whether that leads to actual heart disease is iffier, but not terribly controversial among cardiologists as far as I can tell. It's only doubted on the Internet where everyone wants to be a galaxy brain with some answer the doctors don't want you to know.
But nobody ever demonized fat in general, and demonizing carbs is just as stupid. Eating enormous amounts of carbs is fine as long as you actually use them. My daily calories right now are around 3,900 with carbs at 650 grams a day, a fair amount being syrups I eat early in the morning while running. If you listened to the Internet, you'd believe I was diabetic already, yet basically every remotely serious endurance athlete eats like this and is fine. Glucose that is continuously and immediately shuttled into muscle cells to power mitochondria and provide energy for movement does no harm whatsoever. It's roughly the entire point of animal metabolism. Glucose that sits around in your blood forever because you're sitting around staring at a screen for 16 hours a day while stuffing your face is what causes problems because of all the oxidizing effects of glucose when it isn't taken apart quickly and turned into ATP.
My BMI is 21.6 for what it's worth. As far as I can tell, the whole "mystery" behind why no diets work is because no diet can magically make people eat less when they spend the overwhelming majority of their time not moving and hunger decouples from energy expenditure. If you're sufficiently active as a lifelong athlete, every diet works. I ate super sized McFlurries, entire boxes of Entenmann's donuts, and Little Debbie's treats as a teenager as staples of my diet. As an adult, I've tried paleo, zone, mediterranean. Right now, I pretty much just eat the standard American food pyramid. None of these has managed to magically poison my brain or destroy my metabolism because metabolic function can be trained just like any other bodily function and it is trained by doing regular athletic activity with a high energy demand. Just like your muscles atrophy if you never do any resistance training, your metabolism atrophies if you never do any aerobic exercise.
I can't claim to know the secret to weight loss but I know how to never get fat in the first place. On every team I was ever on from middle school to college to my time in the Army, whether that be cross country, track, volleyball, basketball, tennis, or general outdoor adventurism and long-haul hiking with a weighted pack, the overweight rate was never 0 but it sure as shit wasn't 70%. And we were all eating the same "poisons" and manufactured foods from evil Nestle that the rest of you were eating.
Wrinkling skin, graying hair, loss of muscle mass and bone density, loss of mental acuity, decline of libido, late-life diseases (eg: cancer, Alzheimer's, type-2 diabetes), and so on.
It's scientifically proven that our bodies spend enormous amounts of energy up into our 20s when we reach sexual maturity and then glide through on momentum through our 30s into our 40s when we are raising our children.
Once we're in our late 40s to early 50s we're done spawning new life and our bodies throw in the towel, starting the slow but inevitable deterioration culminating in death.
It's that whole physical process that we as a species want to overcome, we want to defy being just machines for spawning more machines. Life is fucking evil.
Growing wiser from more and more life experiences is also part of aging, but it's not what we refer to when we say "defeat aging".
Curiously, however, for a system apparently stultified by the dead hand of government, Australia’s health system far outperforms the free market-based US healthcare system, which spends nearly twice as much per capita as Australia to deliver far worse outcomes — including Americans dying five years younger than us.
Source: https://www.crikey.com.au/2024/10/16/pubic-private-healthcar...
Bypass: https://clearthis.page/?u=https%3A%2F%2Fwww.crikey.com.au%2F...
Overall, we now have the fourth-highest life expectancy in the world.
This is contrary to the narrative that pervades the media about our health system — one in which our “frontline” health workers heroically battle to overcome government neglect and inadequate spending, while the population is beset by various “epidemics” — obesity, alcohol, illicit drugs.
In fact, Australian longevity is so remarkable that in August The Economist published a piece simply titled “Why do Australians live so long?”
The Economist: https://www.economist.com/graphic-detail/2024/08/23/why-do-a...
AU Gov Report: Advances in measuring healthcare productivity https://www.pc.gov.au/research/completed/measuring-healthcar...
Ageing is not a perfectly understood process, so what it would mean to overcome aging wasn’t clear, and there was some hope decades ago that maximum human lifespans would just keep going up indefinitely as medicine slowly eliminated the various causes of death.
But now this research concludes what has been suspected for a while - that even under perfect conditions the average human lifespan isn’t going to hit 100. Even if you eat and exercise well and have the best medical treatment, and avoid all the other things that might kill you, ageing will get you.
The medical term for this is “mortality compression”, the idea that as we remove all the ways people die early, the ages of death for everyone end up being squashed up against a limit.
It will take significant breakthroughs in technology (probably some combination of gene therapy, cancer treatments and nanotechnology) to actually stop, or reverse aging.
market, maybe, "free" market? I doubt it.
It's not a very free market when there is such a large power differential between the buyer and the seller. You can't exactly shop around for the ambulance or the hospital when you need it, nor can you realistically circumvent the artificially constrained supply [1] of doctors to get cheaper healthcare (unless you live next to the border).
When the alternative is a one-sided market like this, government becomes rather more appealing.
1. https://en.wikipedia.org/wiki/American_Medical_Association#R...
It’s not just America [1].
Norway’s obesity rate runs at roughly half America’s [2]. But the trend across the world is increasing rates of overweightness, obesity and--most worryingly--child obesity.
[1] https://news.ycombinator.com/item?id=41634611
[2] https://en.m.wikipedia.org/wiki/List_of_countries_by_obesity...
So dangerous to extrapolate from anecdotal observation like this. If I see old people smoking, doesn't mean smoking is safe. It just means it doesn't kill at 100% effectiveness.
"The idea that saturated fats cause heart disease, called the diet-heart hypothesis, was introduced in the 1950s, based on weak, associational evidence"[0]
( Describing various systems in various countries as either communist of free market capitalist is pretty simplistic, it's not much as a linear spectrum either )
I'd also argue that the foundation for a high life expectancy doesn't start with good health care for seniors .. unless the metric is "life support via artificial means" .. life expectancy is grounded in healthy living and excerise from an early age well maintained with good health programs.
0: most kids, I just got the disease instead and the vax later
> she will have a much higher chance of survival in the US.
Without a deep dive it looks ballpark the same, to be honest.
AU Cancer Survival Rates:
The 5-year survival for cancer in 1991–1995 was 55% and by 2016–2020, the rate had increased to 71%. Even with decreasing mortality rates and increasing survival, the number of deaths from cancer has been increasing.
US Cancer Survival Rates:
Five-year survival rates have also been increasing for an even longer period of time. The overall cancer survival rate was 49 percent in the mid-1970s. It currently sits at 68 percent
https://en.m.wikipedia.org/wiki/Fat_acceptance_movement
Online there's tons of content encouraging fat gain - for example Tiktok women celebrating "BBW" as a sexy thing and the r/PlusSize subreddit, where members encourage each other to remain "big and beautiful" and post anti-science content claiming that being fat is healthy. I saw for example a post by a 20-something woman who was morbidly obese and had had a blood clot in her leg but everyone was still insisting she was a "healthy" type of fat person, herself included.
Of course you will find very few doctors who will endorse this movement or its ideas. And the vast majority of us understand that obesity is unhealthy. But the fat acceptance movement has almost certainly played some role in making people believe that obesity is less dangerous than the research shows.
I won't be shy about my view here, obesity is a terrible disease and if you have it you must take steps to cure it. If you don't your quality of life will be lower in dozens of ways and you will die younger, probably not in a comfortable way. (Not to mention that its economic cost is enormous... a principal way that you can reduce health care costs personally, is to not be fat.)
First and foremost we must renew society's understanding that this is a disease, acceptance is not an option, and it must be prevented, treated and cured.
The US has massive government regulation and dysfunctional state intervention in healthcare if not directly then vicariously with rules around Medicare. The US government helps make the dysfunction that private equity later exploits.
So I’m not sure that it would be correct to use Aus and the US as examples of the either end of the private / public continuum.
I would use UK or France as an example of a public system and Singapore as a light touch private, and perhaps India or Turkey as a laissez-faire system.
The UK and France systems appear to be degrading and do not appear long term affordable and I think they will soon be adopting Canadian style Maid systems to cut cost.
Germany is a weird one because it seems like half the doctors there are homeopaths and the Germans love their insurance but I’m not sure if they get value for it.
Personally I’d prefer the Australian or Singaporean style systems but I’d classify those as mostly private.
What do you mean by this? Fatalities among the young will have a much larger impact on lowering nationwide life expectancy than fatalities among the elderly.
The government can work to provide the medication that its citizens require to stay alive. Under such a system, those who are able and willing to work can, via taxes or other contributions, provide medications that some citizens require to stay alive. Many such systems seem to cost less overall than the system currently existing in the United States, so the average man who will work will have to work fewer hours to pay for an average dose of average quality anything required to stay alive.
Alternatively or in tandem, the pharmaceutical companies can sell such medications at cost, with rebates and coupons for no/low-income patients, while still making plenty of profit on reasonably priced pharmaceuticals that patients do not technically require to survive.
https://www.mayoclinicproceedings.org/article/S0025-6196(19)...
Weightlifting can improve mobility by:
- strengthening muscles around joints allowing for more controlled movement.
- increasing flexibility: Dynamic movements in weightlifting, like squats, lunges, and overhead presses, can stretch and strengthen muscles simultaneously, improving flexibility over time.
- improving joint health because loading the joints with resistance can increase the production of synovial fluid, which helps lubricate joints and promote better movement.
- promoting balance and coordination because exercises often challenge stability and coordination, which can help improve motor control and range of motion in everyday movements.
The current system grew out of a more fully public system under a many years past Whitlam government, people like the universal health for all aspects and wanted additional private services in the mix. It's evolved from there, with government oversight directed towards keeping things accessable and fair.
The US appears to have "massive government regulation and dysfunctional state intervention" as the end result of a lot of fingers in the pie bending regulation toward "middlecare" providers that don't apply splints or save lives, just diddle about with insurance schemes. (Admittedly that's just an impression from afar).
> The US government helps make the dysfunction that private equity later exploits.
My feeling is the US government is largely an arm of private interests in many matters.
Health Care in Australia embraces public policy such as Food Regulation to ban and limit additives, parks and sports grounds to encourage exercise, limiting access to tobacco, and some interesting national level drug acquisition deals to keep pharmacy costs low.
These cause a flow on of less per capita input into the medical side; lower heart disease, less smoking related issues, etc.
Back in the 1970s the AU Government was running campaigns such as Life. Be In It: https://www.youtube.com/watch?v=GNjEge3Awl8 (many short segments airing with commercials on TV).
Planning requirements typically require open spaces, walking paths, sporting facilities, etc.
A "healthcare system" needs to be more than simply "immediate care for the injured, sick, and|or dying".
I'm assuming the rational behind drawing the distinction between the US and Aus systems is to somehow inform what the US should do, I don't think giving an already corrupted government system more power will help. It's very hard to uncorrupt things and because of that reason I think the US would benefit from a more laissez-faire system.
Additionally Australia has many advantages that the US does not and the US could not emulate Australia even if they wanted to. I don't know how long that'll last either - mathematically I would assume a country could not get rich and stay rich repeatedly selling houses to each other but it does seem to have lasted a very long time. I assume at some point the Aus government will run out of ways to prop up the housing market. The combination of negative gearing and all sorts of first home buyer grants is just insane.
> Part of the Australian national, state, and local health care system is policy to encourage healthy life styles and to discourage, limit, or ban food additives, tobacco, etc.
Quick Google search:
> what percent of australians are overweight?
> Over the last decade, the proportion of adults who were overweight or obese has increased from 62.8% in 2011–12 to 65.8% in 2022.
US NIH says: 73.1% are overweight (includes obese). Ref: https://www.niddk.nih.gov/health-information/health-statisti...
Sure, 73.1% > 65.8%, but Australia is still plenty overweight. Both are appalling.
> However Canadians have free healthcare
Also, Canadians are pretty fat. It looks like 65% are overweight, which includes obese. Ref: https://www.statista.com/statistics/1317268/overweight-obesi...
Also, I agree with your general sentiment: Framing carbs are evil is lazy. First, calories matter. Second, if your calories are general under control, most people need fewer calories as they age. Many choose to restrict carbs to maintain weight.
Since when are polyunsaturated fatty acids considered unhealthy? As I recall, the real enemy is saturated fats.
>These studies have two main messages: When you eat saturated fat in moderation (contributing 10% or fewer of your daily calories), it has little effect on cardiovascular disease. When you cut back on saturated fat, replacing it with unsaturated fats or whole grains is good for your heart and arteries, while replacing it with easily digested carbohydrates isn't.
> It is extremely hard in a highly advanced economy to provide quality healthcare at less than 10% of GDP.
In the US we pay 17% of GDP towards healthcare and tons of people still can’t afford it.
A quote from another comment here is:
Australia’s health system far outperforms the .. US healthcare system, which spends nearly twice as much per capita as Australia to deliver far worse outcomes — including Americans dying five years younger than us.For non-seniors, the medical insurance system certainly sometimes doesn’t feel like a free market from the consumer perspective, but the insurance companies are private for-profit institutions, and the medical providers are too, so it may well fit the definition.
Could this also (partially) be explained by the cost of healthcare? Something like a downwards spiral where average people end up poor either due to direct costs of healthcare or neglecting their own healthcare due to cost?
- greater usage of surgeries and prescriptions, leading to greater exposure to medical malpractice (the 3rd leading cause of death in the US.)
- higher birthrate. more pregnancies.
- less cultural tolerance of abortion. Greater willingness to take on risky pregnancies
- single parent homes (people with less family support)
- ethnicities which are more susceptible to certain disease and lifestyle risks
- greater exposure to crime in impoverished areas
- more life time spent traveling in cars
- more restricted access to health insurance (as you said only accessing healthcare in dire emergency)
The US is a different world than most countries which tend to be geographically tight and culturally homogenous. It's very difficult to make comparisons, not to mention differences in data collection and reporting ethics.
Our world in data hasn't updated life expectancy past 2021.
I've half wondered if it's because the article is optimistic but life expectancy has stalled since 2020. Coild also be the underlying data hit a snag. Would love to see an update
Overall, the study found that children born since 2010 have a relatively small chance of living to 100 (5.1% chance for women and 1.8% chance for men). The most likely cohort to see a full century are women in Hong Kong, with a 12.8% chance.
If this is going to be an exception, it'd be truly interesting.
Only fools would convince themselves a drug has no sideeffect.
The worst is that these drugs were created for legitimate use but are now being abused by what I would call lazy fat who can't get their finger out of their arse and start eating healthy.
When there is a natural, effective and no side effects alternative, why go the medication way.
Most people still have a car but you wouldn't think about taking the car to go buy bread for instance.
Everything is, before it gets invented. 200 years ago, radio, cars, skyscrapers, anaesthesia, transplants, space travel, plastics, and bioprinting were all scifi. Aluminium was almost exactly 200 years ago.
Voice-to-voice translation and cheap synthetic gem quality diamonds were too, even when I was a kid.
I'm not saying any of this will be easy — from what I've heard, it's sufficiently hard that one would need to do a PhD in the subject just to really understand how hard and I've not done that — but you are made of atoms, and the atoms in your body can be rearranged into a younger form.
That the only mechanism to do so today is called "cannibalism" is an (enormous and repugnant!) implementation detail, even though it's also an existence-proof of the possibility of such a re-arrangement.
Do you know what's not science fiction? People are already experimenting with genetically modifying themselves, because of things as simple as "they don't enjoy lactose intolerance".
> I don’t see what solving aging does to solve any of these problems.
Then you don't understand the actual problems.
Most of the costs we have today from an aging population are that old people are physically weak, get sick a lot, have many expensive complications, and 30 years ago they collectively didn't have enough kids for the next generation to be able to afford to look after them so well.
When you write:
> we can’t deal with the amount of humans we already have at the ages they live to
That's because (1) it's their kids (us) doing the "dealing with", and they didn't have so many; and (2) our natural aging process is awful.
Anti-aging's biggest promise is that it makes age-related degeneration much easier to manage.
(And all that's assuming "you’ll start to see jobs requiring 100+ years experience" isn't obviated by AI).
The upside was that if you needed, say, a brain transplant for ten million Euros, as long as it was medically necessary they would pay for it.
Now I have a policy elsewhere that is cheaper, still covers me when I go to Europe, and has a much better copay structure while being 100% private. Downside is I can’t afford that brain transplant, but I’ll probably be OK for everything else.
I do not understand how some of the conclusions about reaching the limitations of reducing aging or reached given this simple data. not to mention a direct quote that is very inspirational in the article itself
"if we cannot imagine it today, does not mean it is not possible"
The worst life expectations are in underweight category.
Not to downplay the malpractice problem, but this doesn’t sound remotely plausible. Do you have some sources to back up this claim?
I googled around a bit and it appears to come from some sloppy misuse of statistics in a journal one time, plus internet amplification.
A few years after graduation, for unrelated reasons, I was on antidepressants. I massively over-ate, became obese, gained stretch marks that will likely remain for life.
There was no voice in my head telling me I was even over-eating, there was no awareness of what I was doing to myself even when I felt the weird tingle in my belly that in retrospect was the tearing flesh that has the outward sign of a stretch mark — I ate without thought.
There is no "natural, effective" solution, because our natural instincts are at odds with our unnatural world.
Disordered eating is a norm and being ashamed is a norm.
For example, Medicare.
As in, inability to keep them long term is biological defense of organism that does not have genetic predisposition toward anorexia.
The vast bulk of health care is by appointment, not a dash in the ambulance.
When you move toward obese or into underweight category, health problems kick in.
This is my main argument against private healthcare: there's no real choice involved. Without even getting into what a free market is and perfect information etc, the main advantage of a capitalist society is you get to choose what you like. Nobody chooses healthcare (at least, not the super expensive part).
It’s not shopping for a tv. You can’t choose not to buy. It’s often time sensitive even if by appointment. Pricing is incredibly complex as are the details of the product. Your average person does not have the information necessary to navigate the market.
Ozempic is exactly the type of drug Unilevel/Nestlé would create if they were tasked with reducing obesity. I wonder if they'll include a free 7 day dose of it with Mars bars.
https://www.crikey.com.au/author/bernard-keane/
Bernard is well across many aspects of US, UK, and AU political views, government systems, media etc. with his own particular views as we all have.
In context he's writing for an Australian audience about a conservative Australian trope that the Australian health system is weighed down with government meddling and would do better with, for example, a "US free market" approach.
I think we all appreciate that's an illusion, a myth spun for children.
The underlying source of 86.3 matches San Juan county from other sources. Seattle metro areas are a bit over 83, and King County is somewhere between 81-82 from sources that seem more primary.
Internet search is straight garbage these days.
> No copay/deductible/coinsurance bs.
The opioids thing is hardly comparable. Everybody clearly knew the risks (for the past 100+ years) and chose to ignore them. This is an almost entirely new type of drugs.
That's pretty much the exact opposite of what you seem to think it does, and is exactly the kind of thing that will hurt Nestlé's junk food line. (Though probably not their bottled tap water line).
Seriously — the US and Europe have not been in a remotely "natural" condition since over a century before I was born. Even the air we breathe is significantly different from its natural condition.
Why do you think I gave that example?
How did we collectively decide that it's okay for insurance companies to overrule medical professionals?
So the line between normal and overweight is somewhat blurry. e.g. someone who is 6'3" and weighs 200 pounds is overweight. Which might or might not be the case (but you certainly don’t need to a body builder or invest a lot of time to maintain at least reasonably healthy 18-20% body fat ratio).
Similar to zero-calorie sugar substitutes, "too good to be true" isn't always the case. Sometimes new inventions really are just better.
There's likely at least one other major factor, and I would assume that it's some variation of "inability to access high-quality care for financial reasons" given how much of a wealth disparity there is in various healthcare outcomes.
It is a carefully constructed plan that will ensure rich people get a whole lot richer and poorer people get worse care. It’s not an accident or nice story. It’s class warfare
Why not just use a preprint server like Medrxiv?
Arxiv is now the default place to publish papers in physics -- and, with that established, it seems to me that it would be for the best if more institutions, researchers, and organizations in biology, medicine, chemistry, and other areas also use preprint servers.
A few years back my Mum in Australia was diagnosed with stage 4 lung cancer, given 12 months to live.
For just shy of 3 years she had radiation, chemo, trial drugs worth nearly a million a pop all in a brand new cancer Center. Because she lived a couple of hours away she got free transport to and from and free hotel. Not pay and claim it back, fully free.
She was on an enormous cocktail of drugs that dad would get at the pharmacy that raised a lot of eyebrows for the strength of the opiates among other things.
For three years they never paid a cent. They never paid a cent of health insurance, never had private cover, never had a deductible. That would all be the same if they had never worked or took a decade off to pursue some hobby.
Trust me when I say it was stressful and emotional enough without adding money or paperwork or insurance into the equation
The comparison to my friends in the US who couldn’t get a separated shoulder fixed because it was “out of network” or had to move hospitals the day after a C section because the insurance didn’t want to pay anymore is downright disgusting.
For real people living their lives the two systems are vastly different.
While they do have a competitive market, the government very much does pick and choose winners and loosers here like Huawei, resulting in consolidation into a few large conglomerates like every other country. Their (software) tech scene certainly dosen't like more particularly "capitalist" than Big Tech, nor is the Fed pumping subsidies to Tesla like BYD, if anything they're sidelining Elon Musk.
Having read (well, listened to) Attia's excellent OUTLIVE, I've reversed my own (slowly turned bad) trajectory by switching my diet to the basics - all home made meals, making my own breads, lots of milk and eggs, meats (not in excess), exclusively extra virgin oil and pure butter in my cooking (zero blends/veg oil etc), and not buying any (sugar) snacks - combined with exercise. Oh and no alcohol for the past few years either - sacrifices had to be made. :-)
Luckily my own kids are showing zero signs of obesity, they are very healthy.
I'm not noticing people eating more healthily, so it only makes sense that life expectancy isn't going up anymore.
[1]: https://ourworldindata.org/causes-of-death [2]: https://www.who.int/news-room/fact-sheets/detail/cardiovascu...
That does not seem likely to result in a stable and productive society, particularly when many working people would have below average housing in order that government beneficiaries could have average housing provided to them.
>market, maybe, "free" market? I doubt it.
The consumer of healthcare is doubly removed from the price of healthcare. This is the opposite of a free market.
The patient did not pay the doctor, the insurance company does. In most cases the patient does not pay for insurance their employer does.
So the normal pricing forces of a free market are removed.
Then we need to talk about certificate of need laws which restrict the supply...
OxyContin was marketed to be the safe alternative to all opioids that came before it, impossible to become addicted to and extremely difficult to overdose from. This was a lie.
The figure I see thrown around is America has a 40% rate of obesity.
Australia looks like it's 32%.
European countries look like 20-30%.
I think these rates alone could explain life expetancy regardless of health care system.
> The US is a different world than most countries which tend to be geographically tight and culturally homogenous
I am not sure how much you know about Australia, but homogeneity and geographically tight is definitely not how you would describe it.
If you’re poor, you’re fucked. If you’re old you’re ok. If you work for the government or certain companies, you have access to world class care. Everyone else is on a spectrum from high quality PPO to the shittiest Cigna plan.
In the US, government is elected by people. You can't blame a gvt for not doing what it hasn't been mandated to do.
The healthcare system in the US is far, far from a free market. Most people would describe it as a crony capitalist market. There's a lack of transparency, lack of competition, and lobbyists of established players have too much say in the lawmaking process.
More people die of Suicide than Malaria aparently.
Somehow what actually kills people, is different from what you think kills people.
Australians have a weird sense of humour - it's clear from here that most aspects of US economics are decidedly not free markets but so many US citizens never shut up about "free markets" and have such a bicameral Capitalist v. Communist view of the world that it makes sense to just deadpan nod along.
Maybe reread https://news.ycombinator.com/item?id=41856242 and ask yourself if the article really thinks the US health system is a proper Adam Smith free market .. or just a "US free market" with extra heavy air quotes.
Says who? Are you implying that true societal shame is still being enforced right now, without hundreds of refuges in the form of safe spaces and social justice advocacy groups? I'm pretty sure that such shame worked pretty well in the past, and still does in countries like Japan.
In the end, you'll just have to realize that the root issue you're facing is decadence, and that's there's no fighting it.
Ozempic's mechanism of action is not "ramp up your metabolism" or "make you absorb fewer calories from food." It's "make the desire to eat less intense, making it easier to remain on a diet plan." That diet plan could be, "eat exactly the same things but less of them," but it will often be, "cut out unhealthy snacks" or whatever.
When I am psychotic I cannot exactly choose which psychiatric hospital I want to check into and ponder about the price to put it off for another day.
And this is what the free market did to psychiatric hospitals: https://www.wral.com/holly-hill-hospital/21507953/
All the medicines they prescribe are merely to manage symptoms. I have GERD and reflux. I was given PPI after many many tests. How does taking PPI extend my lifespan. Whatever has gone wrong with my body is still there.
How is this not obvious to ppl making this absurd correlation between hospital care and lifespan.
Medicine doesn't have shit of new breed of diseases and disorders ppl are dying from. Doctors don't have answers to any of modern illnesses so how does it matter if access to a useless person is govt funded or 'free market'.
Same thing is happening in Europe and other developed nations. UK considering giving ozempic to unemployed? How about subsidized or free gym memberships instead? Things are going to get alot worse before getting better. The established intuitions will continue to double down no doubt.
"less likely to die from drug overdoses. Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries, except among American men aged over 65. And Australians are also less likely to die in road accidents than other countries"
Looks like you conflated two unrelated things ?
Right up until the moment that the CCP decides to purge your entire sector, sure. I don't know if it counts as "free" if the government stands ready to nuke the sandbox they so generously let you play in.
https://www.reuters.com/technology/beijings-regulatory-crack...
less likely to die from drug overdoses. Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries, except among American men aged over 65. And Australians are also less likely to die in road accidents than other countries
So, if this was the issue, you'd probably expect outcomes to be better in less diverse, physically smaller US states. Looking at, say, life expectancy by state (https://commons.wikimedia.org/wiki/File:Life_expectancy_map_...) doesn't seem to bear this out, really; on your theory you'd probably expect, say, West Virgina to be handily beating California or Texas.
Also, of course, _Australia_, which started the thread, could hardly be called either geographically tight or culturally homogenous. Australia is roughly the size of the contiguous United States.
Older age groups are also less likely to die from chronic diseases such as circulatory problems and heart disease. Cancer mortality rates are lower in Australia than they are in all other Anglophone countries
wealth disparity there is in various healthcare outcomes.
Why would it depend just on one factor like hospital access?
It's hard to take seriously the aversion especially Americans seem to have against overweight and obesity
Funny the land of the free is so incredibly intolerant on this one point
I was an employee so this didn’t apply to me, but for my freelancer friends it seemed very unfair that they had to use private.
Both are also largely meaningless because they're based on BMI, which is literally just mass/height^2. No measure of percent body fat, no measure of any other aspect of health, just mass by the square of height.
If you're comparing the BMI of two countries with very similar gene pools it's not a bad point of comparison (though the raw number still doesn't tell you much without more context about build types), but when you're comparing Australia to the US the gene pools of the non-European minority groups are sufficiently different to make BMI pretty worthless as a point of comparison for public health.
It's a pretty straightforward formula, and even though the cutoffs might be arbitrary, there's undoubtedly a u shaped mortality curve centered somewhere around 20-25. At a population level I don't think any of that is a relevant factor. No one thinks that your risk of death hinges on crossing an arbitrary line, but being fatter definitely isn't good for your health.
If people can't be convinced to eat carrots over chips, what makes you think they're going to suddenly eat carrots over chips after eating medication that makes them want to eat less?
It can potentially extend your life by reducing your probability of developing esophageal cancers, improve your quality of life in the meantime, and there are other complications from untreated GERD I can't recall but would negatively impact your life.
Unless Ozempic causes significantly more muscle loss than other ways of losing weight, that news isn't really news.
Bone density, muscle mass, torso height relative to leg height—none of these things are factored into BMI and all of these vary wildly depending on genes.
When you're very sick you hardly have time, money and energy do deal with a lawsuits so that you can get the care you desperately need. By the time you win your lawsuit you could be dead or your condition worse from the stress.
Ignoring risk and consequences doesn't make them go away.
see: https://theconversation.com/why-isnt-dental-included-in-medi...
, realise that mental health services also had poor inclusion at times and that "gambling" is being implied to fall under mental health services (and hence not addressed).
On a more serious note, gambling in Australia has some serious industry influence that's preventing it being properly addressed - see: (for example) Media Watch -s2024e31- Monday 2024-09-09 They're Addicted
Yes N=2, small sample sizes, but I could also see how being less snacky makes one less likely to eat chips. (Why I almost pathologically don't keep easy to eat food in my pantry, granted this can also backfire too).
Well.. no since you cant really win anything. With pharmaceuticals on the other I hand I think 1 Oxycontin/etc. like “situation” would be a reasonable price to pay for let’s say 4 major successes.
You were talking about decades. Surely you noticed the advancements in treating cancer, HIV and a multitude of other conditions since the 90s?
> This was a lie.
Sure. But it’s on the same level as saying that filtered cigarettes don’t cause cancer. If a doctor actually believes that he’s just too dumb to be a doctor… (although I assume most safety claims were relative to other opioids and not in absolute terms?)
Are there any signs that the situation with Semaglutides is that similar? Yes they are new and not well understood drugs (well not really but sort of..) and it’s not inconceivable that their longterm cost might end up outweighing the benefits but I don’t really see any signs of an actual conspiracy yet.
My washing machine isn't going to make me suicidal if I start or stop using it.
This is really hard to believe. Moderate obesity has to shave at least 10 years off life expectancy.
A 70 year old man 6' tall with a BMI of ~35 weighs 260 lbs. That is pretty overweight.
Anecdotally, I just don't see many people that overweight or heavier making it into their 80s.
This says it's <20% there[1][2]
1: https://en.wikipedia.org/wiki/Average_human_height_by_countr...
Would you also tell people suffering from depression to just cheer the fuck up instead of going the medication way?
Similarly, cancer risks may scale with the amount of tissue or the surface area for things like skin / colon cancer but it’s hard to see how being taller is beneficial.
I still think calling this "defeating aging" is an odd framing. But it makes sense in the standard context here.
Obviously, we need some way to not completely lose genetic data and such. If there is a "throwing in the towel" moment, as it were, find a way to prevent that. But living forever doesn't equal forever young, to me. Mayhap I'm just too old for that to have meaning anymore? :D
I'm not sure what angle you are getting at. There is tons of data that shows that yes, people lose weight on it.
> The CDC’s published mortality statistics, however, count only the “underlying cause of death,” defined as the condition that led a person to seek treatment.
Because of this political choice the information comes from 3rd parties digging into the accidents category.
https://www.propublica.org/article/study-urges-cdc-to-revise...
The entire system only works if healthy 30 year olds are putting in somewhat similarly (it will be cheaper regardless). Insurance is based on the idea of spreading risk. Without it insurance cannot function.
West Virginia is extremely poor.
I have a suspicion that something is being miscommunicated between you and many others here. (I admit that I might be wrong. But hear me out.)
It sounds like you are thinking about the visual signs of aging. Like wrinkling of the face, or salt-and-pepper hair. That kind of thing. And sure, there is a lot of vain people who would like to stop that from happening.
But in general the aging people want to defeat is not the wrinkled face. It is things like our immune system demonstrably going to crap as we turn older. Or losing muscle mass. Or becoming senile. Or our bones becoming more fragile.
For young people the flue is basically an inconvenience (by and large). But as we age things like seasonal flue becomes huge issues. People's immune system used to work for decades without a hitch, and then suddenly it decides to crap out. Why?
I can also put it into a more mathematical framework. If maybe that helps? Imagine plotting the probability of a human dying in their x'th year assuming that they have survived before x-1 years. If you plot this now you would see a sort of bath-tub like curve. There is some chance a newborn dies in their first few years of life due to birth defects. Because of that the first few years have a higher probability of death. Then the plot plateaus, and the probability remains basically constant low number for multiple decades. People can still die due to violence, or accidents, or random health issues, but the chance of that doesn't really change much from year to year. And as you approach the other "side" of the bath-tub you see that the probability starts climbing again. And this climb is quite rapid. By the time you are 100ish (plus minus a few years) you have fairly good chances of dying in any given year. And then around 105ish you have about even chances of dying or staying alive in each year. And then we don't have anyone who ever lived to 130.
On this kind of plot if we were to defeat aging what you would see is that the plateau remains constant. That is the chances of a 35 year old dying in the next year where the same as the 135 year old dying in the next year.
Which is why I balk at the framing of "defeating aging." We want to defeat the decline that comes with advanced age. But this doesn't necessarily mean we have to freeze the clock at some age, as it were. May be that that is the way it happens.
“The analysis looked at the period of 1990 to 2019, to avoid the distorting impact of the COVID-19 pandemic.”
At least life expectancy was still growing before COVID. Now after the introduction of dirty (mass production was not the same quality as the small batches used in leading studies) COVID vaccines, plus the virus itself which caused some trouble to not fully healthy people, we will see a life expectancy decline. Excess deaths did already rose worldwide.
Meanwhile they want you to get more dirty vaccines..
Edit: typo
I’ve had to make very few compromises to still enjoy life while staying alcohol free - I can even have a decent bottle of wine, or a rum and Coke should I be in the mood for one.
https://theconversation.com/youth-drinking-is-declining-myth...
The point about less diverse is that’s it’s easier to operate health programs which match the values of the population.
Not that small ethnic group = healthy.
Not really true, as the employer could otherwise pay that money to the employee who would then shop for his own insurance. So the employee pays, but doesn't have a choice.
A lot of people struggle with intense cravings for foods that they know to be unhealthy. These cravings stack up against their willpower and sometimes overcome that willpower and they eat in ways that they know are unhealthy.
If the cravings are less intense, willpower wins more often, cravings win less often.
I think that you will indeed see that some people on ozempic eat much the same mix of foods as before, but less so. But others will in fact change their dietary mix. And I'm pretty sure that the empirical evidence supports me on this.
Is your argument that there is choice involved in public healthcare? Or simply that it's not even a question?
a basic heart ultrasound cost me over $1k while my vasectomy cost me a $60 copay. i was expecting those prices to be flipped.
and don’t get me started on labs. i’ve gotten bills for basic screens years later for thousands of dollars.
you can’t shop around if you don’t know what you’ll pay until months after it happens. if you call the insurance company beforehand you wait on a static filled line with a call center in india, and even with the CPT code they can’t give you a straight answer.
https://www.cms.gov/marketplace/private-health-insurance/mar...
There's a deeper philosophical question here about how we should spread risks and costs across society. Like should some plan members pay more because they have a history of cancer, or because they engage in risky activities like flying light airplanes?
Some states have recently passed laws which limit the authority of health plans to conduct medical reviews or deny payment for services that providers deem medically necessary. This will reduce hassles and expenses for some patients, but it will also accelerate the inflation of insurance premiums paid by everyone else.
To put it into more technical, economic terms: why should the individual tobacco consumer bear the full cost of their externalities while the tobacco company does not?
They proactively forced interconnectivity and limited the ability for companies to make "walled-garden peudo-monopolies", as we have in the US with Apple and Google.
If the same happens here (through act of congress, or legal outcomes), you can expect their market caps to decline as well. A decline in market cap doesn't speak at all to whether it's beneficial to the industry or consumers
Yes, I believe people should have food and water sufficient for survival regardless of their ability to work.
WeChat is the inspiration for the idea of the "everything app" that so many US companies want to create but have always failed to. Has it somehow been newly limited in its ability to control an absurd percentage of all Chinese internet-connected activity?
It depends on what your goals are. The reasoning behind why the ACA ("Obamacare") is the way it is:
> Suppose you want to make health coverage available to everyone, including people with pre-existing conditions. Most of the health economists I know would love to see single-payer — Medicare for all. Realistically, however, that’s too heavy a lift for the time being.
> For one thing, the insurance industry would not take kindly to being eliminated, and has a lot of clout. Also, a switch to single-payer would require a large tax increase. Most people would gain more from the elimination of insurance premiums than they would lose from the tax hike, but that would be a hard case to make in an election campaign.
> Beyond that, most Americans under 65 are covered by their employers, and are reasonably happy with that coverage. They would understandably be nervous about any proposal to replace that coverage with something else, no matter how truthfully you assured them that the replacement would be better.
> So the Affordable Care Act went for incrementalism — the so-called three-legged stool.
> It starts by requiring that insurers offer the same plans, at the same prices, to everyone, regardless of medical history. This deals with the problem of pre-existing conditions. On its own, however, this would lead to a “death spiral”: healthy people would wait until they got sick to sign up, so those who did sign up would be relatively unhealthy, driving up premiums, which would in turn drive out more healthy people, and so on.
> So insurance regulation has to be accompanied by the individual mandate, a requirement that people sign up for insurance, even if they’re currently healthy. And the insurance must meet minimum standards: Buying a cheap policy that barely covers anything is functionally the same as not buying insurance at all.
> But what if people can’t afford insurance? The third leg of the stool is subsidies that limit the cost for those with lower incomes. For those with the lowest incomes, the subsidy is 100 percent, and takes the form of an expansion of Medicaid.
* https://archive.is/HzS1G / https://www.nytimes.com/2017/07/10/opinion/obamacare-repeal....
* https://thehealthcareblog.com/blog/2023/02/15/all-three-legs...
The goal of the ACA in the US was getting closer to universal coverage, and that means 'subsidizing' bad behaviour to a certain extant.
Certainly smokers and such should practice more (so-called) 'personal responsibility', but there are a lot of situation where the pre-existing condition is not smoking or other lifestyle choice, but something genetic / congenital. So unless we want to get into (social) Darwinism and leave those folks on the sidelines, the lifestyle folks can end up coming along for the ride when society decides to protect other non-lifestyle pre-existing people.
https://asia.nikkei.com/Business/Technology/Beijing-asks-Ten...
"Beijing asks Tencent to lower WeChat's mobile payment market share"
https://www.forbes.com/sites/zennonkapron/2022/11/09/chinas-...
https://www.business-standard.com/world-news/china-may-impos...
"China is planning to introduce a new mobile payment regulation aimed at reducing the market share of Tencent Holdings' WeChat app, similar to efforts made by the National Payments Corporation of India to curb Google Pay and Phone's growing dominance in the market"
China's methods are more authoritarian than are viable in the west. But the general premise of a competitive market being better for society than dominance by a small number of firms is supported well by history
Those are 2 different things.
Monopoly doesn't mean "more powerful than the government". I'm not sure what that means, since the CCP disappears or coerces anyone who might threaten the supremacy of the CCP (or Pooh Bear) in any way.
Capitalism results in a single winner, for many industries. CCP prefers kingmaking in various industries, because it's easier for the government to control a few players than a multitude. This isn't what "fair market" means, in context. It's modern communism. State owned companies that are directed by government, rather than direct investment or day to day management. China learned from Russia's failures, I would say. I would also concede it's less regulated, under a political lens.
Because people are well aware that smoking is dangerous and can freely choose to smoke or not.
All you gotta do is ask.
> Nobody chooses healthcare
Yeah, they do. Root canal vs implant vs dentures, for example. Ozempic vs diet+exercise, for another.
Thankfully you can often get denials reversed after the fact by calling and complaining, but that takes an hour and is another roll of the dice. The only people who like the US system are wall street people who own stock in the companies.
Or its a ticking time bomb: 39.6% of Americans are Obese(BMI 30 or higher). Fast forward 15 years and this will probably collapse the country. It certainly will be the No 1 issue in the country bar none. Ozempic may actually give the country a chance of some sort of future.
Yes, therefore separating people's lifestyle choices from the plainly obvious risk and consequences involved.
But if you can socialize your losses (banks) or bad decisions (people) and avoid some of the consequences, I get it.
Then you get into the wonderful world of getting receipts for every procedure and manually submitting them, only for them to be rejected so you have to call and tell them to provide the service they promised you. The insurance isn't even cheap! My monthly deduction would be close to the same price as an Obamacare plan, and that doesn't include the employer contribution. Healthcare is such a racket.
All of that cost savings makes US healthcare cost double what it does anywhere else in the world.
and salaries are stagnant. why would they pay extra? at least they're obligated to provide insurance, even if it's terrible and impenetrable
Last year, my wife died from a recurrence of metastatic melanoma. By your standard, that suffering was her “fault”, because she failed to use sunscreen as a teenager. If insurance was rated like general liability insurance, she would have been dropped 8 years ago when the original cancerous lesion was removed. Fuck that noise.
I would have bankrupted the entire family to fight for the 60% survival rate in a few months, and she would have suffered even more without adequate care at the end.
We have Medicare “socialism” because social security was allowing the elderly to support themselves and live longer. Many were neglected and dying in inhumane ways, or saddling families with the burden of being a full time caretaker. It’s gross that we live in a society drowning in riches, but we take a principled stance to avoid taxation for rich people, at an incalculable human cost.
It works every time I asked.
The entire reason health insurance got so mixed up with employment was as a workaround to WW-II era wage freezes. Employers couldn't pay more salary, so they offered other benefits including insurance to attract and retain employees. Now we're stuck with that.
'Normal weight loss' here refers to eating the same amount of calories without taking Ozempic. You should lose weight at the same speed as with Ozempic, because it's the calories that matter when it comes to fat loss.
Many demographic trends like fertility rate are treated the same way. While it is not a very accurate prediction for how long a current young person will actually live, it's a consistent metric that doesn't rely on a particular model of future events. It's good for discussions like this where we're more interested in how the value is changing than the actual value itself.
If we want to hold down costs then we'll have to put a greater focus on preventative care, stop expensive treatments for terminal patients, impose price controls on providers, and stop subsidizing drug development for the rest of the world. None of those measures are politically popular.
Do you currently see jobs demanding 50+ years experience?
Even if we ignore the fact that most jobs won't require any more experience to do than they take now just because we live longer, longer periods of time won't seem as costly to us either. Right now 100+ years of experience is absurd because the only way they could ever have that much experienced is if they worked from the day they were born until the day they died, and even then they would need to live an exceptionally long life. If we lived to 200, you could start your career in your 30s, get those 100 years experience, and still have 70 years - an entire current lifetime - to reap the rewards afterwards.
Being more realistic, there is some finite amount of money you need to put away to live indefinitely off interest at any given level of comfort. Right now reaching that threshold in the 50ish healthy adult years we have is a difficult but achievable goal for most people. But with more time you can reach that threshold on a less aggressive trajectory and enjoy retirement for substantially longer (all while being healthier to boot).
As a thought experiment, if you want to imagine how you would feel about your doubled lifespan, consider your current lifespan doubled from some previous threshold. Would you prefer to live only 35 years on average with 50 being advanced old age? Sure there might be some benefits, perhaps some jobs might lessen their experience requirements, but would this be overall a more pleasant world with higher quality of life? We did not choose a 75-100 year lifespan to optimize human happiness, it is just the number we happened to wind up at as a result of a process that did not consider human happiness at all.
That doesn’t seem like it will have broadly popular support.
When you're old, setbacks that cause you to lose your appetite are much more common and much bigger threats to the health of skinny people.
I don't know where you live, but I've met tons of moderately fat people in their 70s and 80s.
This is certainly possible because it already happens now with the current setup.
https://www.reuters.com/business/retail-consumer/mcdonalds-p...
I don't know what they based "normal" bmi weight on, but it's not by setting the middle of the range to max longevity.
Americans walk the least out of all, followed by Australians. When I visit the the US for work. People sometimes stop and asked me if I'm ok because I'm carrying my groceries home from the store. People would say: "What are you doing? do you need help?" lol
Virtually nowhere is designed for walking outside of say New York, parts of San Fran etc.
These definitions are arbitrary anyway. In india they define a bmi of 25 as obese. The same indian after moving to America is not obese until a bmi of 30.
Meanwhile, the average height is also going up, which also correlates with lower life expectancy.
Cardiologists already had to back off their blood pressure guidelines when they defined the average middle aged man as hypertensive in the past.
Actually it's much worse than that. The tobacco company is not just selling tobacco products, it's marketing them and actively encouraging their use!
People tend to over-estimate the impact of both smoking and obesity.
Depending on your priors, This may be a lot or not
Also in Asia, average bmi is 23, and average bra size is B. In the usa, average bmi is 29, average bra size is DD. Probably same thing applies for men in relation to bench press and deadlift numbers.
I do recognise though that it’s an unsolved problem, and will lead to some form of regulation as our understanding is lacking.
I think only harmful monopolies should be broken up by force, since they’re a legitimate market force. I’m conceding some ground on that because I’m not prepared to claim that monopolies aren’t always harmless.
If anything, healthcare and insurance have almost completely perpendicular incentives. No wonder then we have the world's most inefficient system.
The only people who don't are people who lose weight through resistance training. Which is a small minority - because we have a HUGE diet culture!
Being born with worse attributes doesn't mean those attributes are out of the equation. A lot of people die much younger than they should just by poor luck, with little or no control on their end.
If you happen to have higher bone density and higher muscle mass just because you have higher testosterone, you're still better off. Sometimes people just get the short end of the stick. That doesn't necessarily mean BMI doesn't work.
I've even met smokers, smokers! Who have better cardiovascular health than me and are skinnier. Which really fucking sucks for me.
If you don't care much for food then you don't mind eating the carrots and you don't mind losing the chips. If your entire life is food, then you do mind.
Well the ozempic helps you do the discipline and hard work. You don't take ozempic, eat everything, and get skinny. No, it makes it easier to diet and exercise.
For some they don't need the "motivation". For others, their mind is constantly under attack and pushed to eat, like an addict. For them it can be very helpful.
if you ask the insurance company you’ll never get an answer. providers are usually more helpful about what “should be covered”, but that’s not guaranteed.
seems like prior authorization is the only way to really make sure charges are covered but takes forever. but even then, if your insurance covers $x and they bill $y, you might get a balance bill in the mail.
point is, the market is heavily skewed against the consumer.
How would that even work? Any such tax would be priced in into the price of the product. It doesn’t really matter if the government is collecting it directly or through the tobacco companies.
Or if we wanted tobacco companies to pay for all the damage they did retroactively they would just go bankrupt, since they don’t have even remotely enough cash/assets to cover it.
What the fuck do you guys think GLP-1 inhibitors do? Why even bother posting if you don't understand the most surface level of what I'm saying.
> drinking habits
GLP-1 inhibitors have also been shown to reduce drinking and smoking. It's essentially an anti-addiction drug.
It's very easy to sit on a throne when you don't have a food addiction. For those who do, it's not as simple as "durrr eat better". Come on guys we have to start putting that meat sack between our ears to use.
We've been trying, and ONLY been trying, the "discipline" approach for the entirety of the obesity epidemic. And it is not working. Point blank, this is not an effective method of treating obesity or diabetes.
If that's your suggestion, it's obvious you don't actually know what's going on. Which is fine, but then perhaps silence would do you some good. Less embarrassment that way.
You think that 33% of deaths are caused by addictions? I don't understand why you brought addictions up.
> It's very easy to sit on a throne when you don't have a food addiction
Yeah, I don't. I'm mindful every day of what I eat and drink.
> We've been trying, and ONLY been trying, the "discipline" approach for the entirety of the obesity epidemic
Except that most overweight people are not food addicts. They are just normal people with bad nutrition, and that's it.