The Hacker’s Diet Online is the Web-based application companion to my diet book, The Hacker’s Diet. It allows users from any modern Web browser or Web-enabled mobile device to maintain weight and exercise logs, produce custom charts, analyse trends, plan diets, and import and export data to spreadsheets, databases, or other applications.
The Hacker’s Diet Online was launched in August 2007, and now has more than 33,000 user accounts on the Fourmilab server. The software is written in Perl, with browser support code in JavaScript, and is written in the Literate Programming methodology with source code both available for downloading and readable as a Literate Programming “book of the program” [PDF, 610 pages] with all code and embedded documentation.
To provide easier access to the code, visible version control, and to permit those who work with it independently to keep track of changes and submit contributions to the project, the complete source code is now available as a repository on GitHub. This repository contains everything you need to set up your own server with all of the capabilities of the one at Fourmilab, and can serve as a “code mine” for developing similar Web applications.
GLP-1 agonist are all the rage right now, with pharma pushing hard through celebrities, Hollywood, Elon Musk, etc. However, it seems like the mechanism is fraught with risks.
I came across this earlier in Michael Eades blog post (source) discussing a paper that looked at semaglutide (original paper link)
Granted, Mounjaro (tirzepatide) is based on a different GLP-1 agonist that Ozampic or Wegovy (semaglutide). But to this correspondent, the underlying mechanism proposed seems risky. Anything that results in an increase in adipocytes does not seem to be consistent with longer term weight loss. Once the fat cells are there, our bodies will find a way to stick fat in them.
If one decides to roll the dice on GLP-1 agonists, it seems like tirzepatide is more effective than semaglutide (here is one paper that looked at this).
There may be other risks associated with promoting cancer cell development. Seems to be an area of active research, just a few random papers on either side of the argument.
Do GLP-1 Receptor Agonists Increase the Risk of Breast Cancer? A Systematic Review and Meta-analysis (source)
Glucagon-like peptide-1 receptor activation by liraglutide promotes breast cancer through NOX4/ROS/VEGF pathway (source)
Weight-loss in a pill (or shot, as with -tide based drugs) may not be quite in reach yet. I guess the Hacker’s Diet relevance remains strong.
The chart seems to show the classic weight loss during treatment with the just as classic regaining it all when treatment ends. The medicated cohort has a much steeper loss curve and total loss to the minimum, but also a correspondingly steeper regain off-treatment. It would have been interesting to see another 60 days to see if the pill poppers gained it all back eventually.
Would I be too cynical if I suggested that a one-time weight loss pill that permanently kept the weight off is a lot less attractive to the pharma company than a treatment that one takes for the rest of one’s life?
A magic pill that causes precipitous weight loss without hunger is 100% compatible with The Hacker’s Diet. Just replace the “Losing Weight” chapter with “Take this pill until you arrive at your target weight” and then use the monitoring, calorie balance adjustment, and feedback tools to maintain that weight without further medication.
He is now a weekly columnist for the Daily Mail. His first article was on trying and failing to get on the ozempic bandwagon.
I first thought that something was up when I saw that a certain member of the Cabinet had miraculously changed his appearance. He had acquired a new jawline. His neck emerged without effort from his collar. When he rose from his chair at the Cabinet table, that chair no longer tried to cling longingly about his hips.
I got it! He had lost weight, stones and stones of belly and dewlap; and I immediately thought of Julius Caesar, and his preference for well-fed colleagues.
‘Let me have men about me that are fat,’ said the Roman dictator, shortly before his assassination. ‘Yond Cassius has a lean and hungry look.’
As it turned out, Caesar was right to be worried about Cassius. Then I noticed another colleague whose silhouette was shrinking visibly; and another. By this time my spider senses were jangling.
If an otherwise healthy middle-aged man displays sudden weight loss, I reasoned, there are only two possible explanations. Either he has fallen hopelessly in love, or else he is about to mount a Tory leadership bid.
We used a random sample of 16 million patients (2006-2020) from the PharMetrics Plus database (IQVIA), a large health claims database that captures 93% of all outpatient prescriptions and physician diagnoses in the US through the International Classification of Diseases, Ninth Revision (ICD-9) or ICD-10. In our cohort study, we included new users of semaglutide or liraglutide, 2 main GLP-1 agonists, and the active comparator bupropion-naltrexone, a weight loss agent unrelated to GLP-1 agonists. Because semaglutide was marketed for weight loss after the study period (2021), we ensured all GLP-1 agonist and bupropion-naltrexone users had an obesity code in the 90 days prior or up to 30 days after cohort entry, excluding those with a diabetes or antidiabetic drug code.
[…]
Results
Our cohort included 4144 liraglutide, 613 semaglutide, and 654 bupropion-naltrexone users. Incidence rates for the 4 outcomes were elevated among GLP-1 agonists compared with bupropion-naltrexone users (Table 1). For example, incidence of biliary disease (per 1000 person-years) was 11.7 for semaglutide, 18.6 for liraglutide, and 12.6 for bupropion-naltrexone and 4.6, 7.9, and 1.0, respectively, for pancreatitis
