Semaglutide does an incredible job of keeping my autoimmune issues in check. The only side effect I've had is needing to drink more water or else I feel like I've got the flu. Minimal tradeoff IMO
Studies show almost all subjects regained the weight and reversed gains within 2 years. This means underlying issues (e.g., food addiction) aren't being addressed. Short of changing habits, the only maintenance solution is lifelong drug use and that doesn't sit well with me.
Why not? People take depression meds, blood pressure meds, all kinds of meds for their whole life. I'll be on omeprazole for reflux my whole life. It doesn't solve the underlying problem of my gut being prone to overpumping acid into my stomach. So omeprazole is problematic?
The underlying issue is being treated, it's treated by taking the drug. It works. It's doing its job.
I'd be curious as to how you came to this conclusion.
If they were a normal weight they would not have been prescribed the drug. The underlying issue is they're overweight because they eat too much. Anything more is speculation.
There is usually no free lunch when it comes to pharma, and extrapolating long term or lifetime dependence as being equivalent to short term interventions is an unsupported leap.
That’s the problem with these new weight loss drugs. Ultimately they work by reducing food intake.
For many people food is one of the few things in life that gives them some form of joy. I won’t ever take any drug that will take that away from me. Life is depressing enough as is.
What we need is a weight loss drug that lets you eat unlimited amounts of food, preferably even suppressing the feeling of fullness, without gaining weight.
Have you taken this drug? Because they don't reduce my enjoyment of food. Quite the opposite; I enjoy it more...its just that I get full feeling much quicker, and am less likely to go graze in the kitchen. But enjoy? No, I enjoy my food quite a bit.
They don’t stop eating, just overeating. Getting joy from food is different from self medicating with overconsumption. (For the record, I love food. I also don’t have an issue maintaining a healthy weight and physique.)
I am on GLP-1 (Zepbound). I have done Weight Watchers multiple times. I'd lose the weight for a little bit, then it would come back. The reason was _I was hungry all the time_. It's not sustainable. As someone else in WW told me: "The easy bit is losing the weight. The hard part is continuing to eat that way your whole life."
It's simply a faulty hunger sensor in my body. It was not what I was eating, simply how much.
GLP-1s fix the sensor. It's really simple. Nothing else to it.
I still enjoy food (although my palette has turned away from anything greasy, which is for the better anyway), but I can finally understand why someone would eat half a plate of something and say "I'm good" and actually mean it rather than trying to diet/starve themselves.
I dunno. It’s not universal, but I have a newfound joy when it comes to food after being on a GLP-1 and losing about 100lbs.
Sure, I don’t get the instant giant dopamine spikes from binge eating $30 worth of Taco Bell or a couple large pizzas. Once in a while I do miss that, but I can still do it now that I’m a few years into the weight staying off. It’s just not worth how shit I feel the next couple days afterward.
But healthy Whole Foods? What was once kind of meh for me is now something I look forward to and explore. Both going out to foodie type spots, and cooking at home. Both gourmet and basic. Just tasting the nuances and everything in some well prepared veggies or whatnot is great and not something I used to appreciate.
I also don’t constantly feel like crap with stomach issues either. I suppose there is less “addictive” type vice enjoyment in my life in some way, but the tradeoff has been life changing. I certainly still get plenty of joy from many of my meals when I feel the need!
Nonsense, one not just as easily say they are overweight because they aren't taking enough GLP-1 agonists. A patient with scurvy is proscribed vitamin C - they might even need to take it for the rest of their lives to stay healthy.
Woe is them I guess for their chemical dependence.
One could even argue food is a lifetime chemical dependance. An assortment of chemicals really with the amino acids, lipids and sugars involved. People who are against these medications typically draw arbitrary lines for what treatments are "acceptable".
Until starting tirzepitide I always thought about food, now I don't. Had depressive issues since I was a teenager as well. I took Wellbutrin for 20 years and had an interruption in the last six weeks due to an insurance issue. Payed for the tirzepetide out of pocket, take that once a week, my depression is manageable without the Wellbutrin for the first time in my life. I'm still going thru depression, but that's due to my husbands death in early March. If I wasn't taking my weekly shot I would easily be morbidly obese and probably suicidal. The cost isn't an issue either, I would spend more on food that I'm not buying or eating each month than it costs to buy the medication.
Just because something might not be interesting to someone doesn't mean it has no value. I have no interest in sports, but that doesn't mean they shouldn't exist. I could argue they shouldn't be as prominent in society but that's a different argument.
If you have struggled with your weight, depression, have early warning signs of cardiac problems and a range of other conditions it can be worth considering semaglutide or terzepitide. As long as you stick to the lowest dose that's effective the side effects are minimal to non existent. Categorically dismissing these drugs is as silly as refusing pain meds because "god designed us to experience pain".
I think you dislike the personal responsibility angle, which is fine but separate from caloric intake being the source of obesity. The fat is stored energy from food, it would violate conservation of energy otherwise.
There's metabolism, food density, food availability, psychology, culture, economics, etc in play, but it's important not to lie to ourselves that the proximal cause of obesity isn't from over consumption.
Why I ate too much is uninteresting to me. I also don’t have some moral hang up over it. Give me that easy button all day long so I can focus on shit in my life that actually matters.
If it makes someone feel better about themselves to believe in woo-woo science that violates the laws of physics and ascribe magical properties to GLPs, why do you care?
I dislike the rejection of evidence. These drugs solve a problem. Preaching personal responsibility does not. In that way it almost reminds me of drug prohibition and abstinence-only rhetoric.
Yes. Specifically, how basal metabolism is not a consciously-controlled rate that modifies itself against diet and exercise to the point that in some people with serious metabolic syndrome it may be impossible for them to lose weight through diet and exercise without suffering nutritional shortfalls.
Also, the clinical evidence around what works for people losing weight and getting healthier and what doesn’t. Like, I get we have a powerful fast-food and sugary-drinks lobby in America, but wow is it wild seeing people get uppity about third parties’ private healthcare decisions like this.
I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).
We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
> That's why they could stop being fat, if only they chose to.
This seems like one of those "replication crisis" claims.
> That's why they could stop being fat, if only they chose to.
So they're pre-ordained not to?
I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be.
> You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control.
> What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
>This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug.
I fail to see the need for additional analysis or consideration?
Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
> I fail to see the need for additional analysis or consideration?
Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
Terzepitide took me from always wanting food to actually being able to focus on other things fully. I was concerned with being able to inject myself weekly, but it's easy and worth the 1-2 minutes a week. If you start, the dosage schedule is more a suggestion than an absolute. I noticed side effects getting worse so I dropped back to a lower dose and have held there for a couple months now. Only real drawback has been from a friend giving me a hard time after seeing the vial in my fridge, but he seems to be coming around after seeing obvious results.
Exercise will help. It's Physics, it's not an opinion based thing that works for some people and not others. It's energy in vs energy out. If you simply eat less calories then you exercise/use, you WILL lose weight.
I don't get this weird thing people do where they act like their bodies don't follow the laws of conservation of energy.
It is of course true that caloric input is a thermodynamic limit and restricting it sufficiently relative to caloric expenditure will cause you to lose weight. (Lisa, in this household we obey the laws of thermodynamics...)
However, not all calories are the same, metabolism is dynamic, and the brain is complex and exerts a powerful influence over behavior.
Increasing exercise will make you hungrier and most people are simply unable to resist this and end up not losing weight. It is why there is a common saying that "you cannot outrun your fork." Restricting calories generally is difficult in today's environment with plentiful calorie dense food everywhere. People don't cook as much as they used to and restaurant meals have more calories than ever.
AFAIK GLP-1 drugs work because they calm the minds desire to eat which is baked in deeply from millions of years of our ancestors struggling to get sufficient food.
The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn.
You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.
More importantly we have decades of irrefutable evidence that diet and exercise alone are about as effective as abstinence only sex education. It's great there are people that can just decide to eat less, but it's foolish to assume that can work for everyone.
It's odd how people act as tho there's a "moral argument" against using a tool to help reach the goal. It feels a lot like the argument that "morals are from religion", as if you need god to know that murder isn't really a productive activity (unless you work in a slaughterhouse).
I wish American money could go back to having "mind your business" printed on it instead of "in god we trust", it was a huge loss to all of us when that garbage was passed. It was also a huge loss when everyone just decided to go along with saying "taxpayer money" instead of saying "public funds/money", but slippery psychological slopes are everywhere.
> You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
People racing the Tour Divide, a 2700 mile solo unsupported bikepacking race through the Rocky Mountains, lose weight when riding their bikes 18 hours a day for 2-3+ weeks straight. They describe being unable to choke down enough food even though what they are eating is very calorie dense. Hotdogs, burritos, burgers, pizza, a pound of gummies every day, chocolate milk and ice cream when resupplying, McDonalds where they fill their hydration bladders with PowerAde, anything they can get their hands on quickly when they arrive at a small mountain town which frequently has nothing more than a gas station.
Great? When I worked landscaping I would plow through 2-3 double quarter pounder meals every lunch break. And then a dominos pizza or three when I got home for dinner. Plus a gallon or two of full sugar soda throughout the day, and snacks.
It’s not practical in the least for the average office worker to outrun the fork. It’s just silly advice and pointless to even bring up. When it takes an hour or more of treadmill work to cancel a single donut you don’t need to think about it any longer than that.
You exercise for health. Not to lose weight. Until you are at the margins and can consistently create an extra 100-200 calorie deficit by walking for an hour every evening or whatever.
My three gym days a week don’t do much for the scale. Those are for physical and mental health. The weight part is in the kitchen.
They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
Exercise will burn calories, yes. But my life doesn't fit the several hours of exercise a day, every day, forever, that would be needed as an already-small person to burn the 1000+ excess calories a day my body is constantly hungry for.
Unfortunately for a lot of people with weight issues it stems from becoming overweight during puberty which is uniquely bad. Your body's appetite signals are permanently impaired if you become overweight during puberty because during this window your fat cells don't just increase in size, but also in number and this increased quantity does not go away once created. Fat cell shrink as weight is loss, but they are not destroyed and they are responsible for appetite signaling. It's one of the reasons that childhood obesity is actually leagues worse than it first appears and I think should be considered child abuse in extreme circumstances.
Practically speaking, any person could starve themself (short of death) and lose weight. In almost all cases there is no magic to storing more energy than you need.
Given that we know that diets and changing habits doesn't have lasting effects, what doesn't sit well with me is to risk my health to avoid taking a drug that helps.
People talk past each other on this because for an individual it technically can work, and sometimes does, but on a population level, as extensively studied by people whose job it is to study that, it definitely does not work. Even with tons of regular attention from professionals and a cohort selected to have above-average motivation, it’s surprisingly poorly-performing (and that’s a crazy expensive level of intervention)
Think about how we describe contraceptives, medically speaking: a failure rate is tracked and promoted that’s the in the wild rate of failure, not the ideal-use rate of failure (which can be effectively zero!). The diet and exercise equivalent of a contraceptive couldn’t be sold, because its failure rate would be way higher than its success rate.
So “we” (people who’ve paid attention to the science on it) know it doesn’t work (on a population level), like for-sure definitely does not work, but a person reads this assertion of fact and goes “but wait it worked for me, this person must be dumb or something” but that’s not it. It’s two different perspectives on what it means for it to “work”.
I think it'd be more accurate to say that informing people that they should change their behavior doesn't work. A person changing their behavior can escape obesity. The reality is that most people won't be able to change their behavior without some other kind of assistance.
However, all the evidence is that the vast majority of people fail at changing their habits in ways that produce lasting weight loss, so it does not generally work as advice for reducing your weight.
So you're technically right, but it is irrelevant, because we don't know how to actually get people to change habits with any meaningful rate of success.
At this point it is downright harmful and wildly unethical to recommend it when we now have a far more successful option.
I've gained and lost 10kg twice in my life. Maintaining the weight loss isn't that hard once you've a rhythm dialed in.
In my case I just weight myself daily, track the weight and scale my food consumption with the current trend. If I'm gaining weight I'll skip a meal.
It takes a while to figure out what works for you but I can tell you that making small lifestyle changes to maintain your weight is fairly easy compared to figuring out how to lose 10 kg.
When I was lifting weights I went from 170lbs to 210, and back to 170. Doing that isn’t technically hard, and maintaining is even easier. But I had to think about it _all_ the time. Maybe it’s because I’m older now, but I just don’t want to spend that much effort thinking about food.
Just because it wasn’t hard for you doesn’t mean it isn’t hard for the others. Grom what you said it seems you just had some bad habits you had to fix and that’s it.
Plenty of people have lifelong drug use of, say, caffeine, or aspirin as a blood thinner, or various antihistamines. Why is this somehow worse? Particularly keeping in mind that it's very easy to make, so once the patents expire, it's going to be dirt cheap as generics everywhere.
I'm just sharing my personal preference and not trying to tell people how to live their lives. I don't like personally like the idea that I'll only be healthy if I take this drug for the rest of my life when I could (again - speaking for me), be more disciplined about the food I put into my body.
The "underlying issues" are not all moral failings as you hint. In my case, as I've aged my appetite due blood sugar/insulin resistance/etc means I'm basically hungry all the time if I restrict calories to maintain lower body weight. Yes - even if I exercise frequently. Yes - even with healthy food and snacks. My wife tells me my stomach is growling at night.
I will slowly gain about 10-15lbs a year due to excess calories if I try to maintain weight at < overweight BMI. GLP-1 drugs have been great to take that edge off.
Why? If you have too much help or whatever being produced such that your body eats too much, just take a drug. The harm of being fat is worse than anything ozempic does
The drug stops working if you stop taking it? Shocking! Heart medication for hypertension also stops working if you don't take it. Sure there's a vast conspiracy by the pharmaceutical industry to hook us all on drugs because we can't learn to exercise, but that's hardly Ozempic's fault. Now if you were looking at brain surgery that zaps the reward center of the brain causing permanent changes so the patient was less addicted to food, but the patient kept needing to have brain surgery, then you'd have a point, but "drug stops working if you don't take it" is hardly the gotcha some make it out to be. Insulin also stops working for diabetics if they don't take it. That's kind of medication's whole deal.
Now that we know obesity can be controlled via medication, and it'll cost $foo over the lifetime of the patient, the next step is to optimize. If there is a treatment involving ultrasonic brain surgery that costs less than $foo, the expectation is for the market to find that. Ultrasonic brain surgery is in its infancy, but it's already showing utility for Alzheimer's and addiction. The real question is if the pharma companies are going to be able to keep it from going mainstream because it's less profitable for them.
And this morning, I cut another hole in my belt. Turns out, losing weight and being thin was never about willpower or laziness in the face of absolute food abundance. It was mostly about whether a person was born lucky enough to have a moderate appetite, or was born burdened by exaggerated appetite.
The underlying issue is physiological food cravings, not some personal failing or lack of willpower, and GLP-1 absolutely addresses those "underlying issues". That it isn't some one and done pill is hardly a realistic expectation as that would require probably genetic and epigenetic reprogramming.
Well, not assigned by the hospital or your parents, but being a DNA-based lifeform a genetic baseline is a safe assumption. Experiences vary after that:
There's anecdotal accounts of GLP meds helping with a range of addictions. Of course in science anecdotal accounts are the lowest tier of evidence, that's only top shelf in law.
Tirzepatide at 1mg/week reduced my muscle soreness. I felt less depressed but this might just have been situational because I've been plagued by bad soreness after working out for years.
Unfortunately after twelve weeks I had to stop because I felt a lot of nausea and tenderness in my upper abdomen, and was worried it might be pancreatitis developing. I'm not sure why it would happen at such a low dose but the symptoms reduced pretty quickly as it wore off.
I may go back on later with a dose spread over a longer period with the hypothesis that the drug has a longer half life in my body and what I experienced was a gradual build up. Considering I lost 15 pounds over 3 months as well, I believe this to be very plausible.
I got pancreatitis from Zepbound, but it was indirect.
Turns out rapid weight loss can cause gallstones, especially if you're genetically predisposed to them. I had one that ended up stuck in the bile duct, causing acute pancreatitis. I had to get my gallbladder removed shortly after and hundreds of stones were found.
I would consider getting an ultrasound since the stones don't just go away when you stop taking the drug.
(Gallbladder removal aside I had no lasting issues and kept the weight off.)
Thanks for sharing, it makes sense. Even before taking Tirzepatide I have had issues my whole life with greasy / fatty stool, and now that I've had reason to research the gall bladder, it does make me wonder if perhaps I also have stones.
I get mine on the black market, 50c/mg for semaglutide, $3 per month at my current rate of usage. I’ve been on it for years, I was getting gray market at $12/mg for 3 years before RFK clamped down on that market. It’s exactly the same stuff (for me, no guarantee for others), had it tested in a lab and as the side effect profile is on point. It massively relieved my ME/CFS, back when I started there was no way I could have gotten a prescription let alone insurance to cover it.
I got severely downvoted in the past for badmouthing GLP1s here. Then I did my research, got on them and I take it all back. These things are on par with statins in terms of potential societal impacts.
GLP1s are one of today's real, true, modern miracles. It deserves a Nobel, but not to one person, but the teams upon teams upon teams that made it possible to get here.
Nothing in this world is free, GLP-1s have their downsides (excluding cost).
Mostly it's nausea and gastrointestinal distress side effects. These tend to cool down over time, but it'll put a ceiling on how big a dose you can tolerate. Some people can't tolerate a dose at any level.
The fact that GLP-1 seems to have roles not just in satiety but that agonists seem to reduce other types of impulsiveness (e.g. gambling, shopping) is interesting. That's not something you'd predict as a consequence, and perhaps is downstream of some gut-brain connection.
Of course we already manipulate brain chemistry in other more direct ways with antidepressants so perhaps any unwanted second-order effects could be minor in comparison to the profile of existing antidepressants .
I've been watching developments on how GLP1s seem to go beyond just hunger/insulin response, even how they may affect symptoms of polycystic ovarian syndrome (PCOS), which is difficult on women who have it:
I'm curious if this post will also have the same phenomena I've seen before of people springing out of the woodwork to post moralizing comments about people shouldn't rely on drugs, about how actually GLP-1s are bad because they don't fix problems indefinitely with a single dose, about how people should fix their problems by just having more willpower, talking about 'but what about the unknown side effects?' of drugs that have been in use for twenty years already, etc.
Semaglutide has been used for diabetics for roughly 20 years. The FUD angle is just people rambling against something that doesn't affect them personally. Everyone knows the only things that matter are what effects "you", everything else is just fantasy. If we could rid ourselves of that mindset we could build a much better world.
I'm on GLP-1 and it's completely stopped my urge to online shop. I used to browse/shop for fun and out of habit or when I was stressed out or wanted a treat etc. Entirely resolved! I've also lost 40lbs on it.
To the others on this reply, I take 1/4 dose of the "clinical dose" and it has been life changing. I've lost 30 lbs. I've done that in the past, but for me that was harder than ranger school in the army.
I LOVE food. Eating out and family dinner were always important to me. I was very worried that I would lose my pleasure in this.
I haven't.
But now I can just eat 1/2 slice of pie. Or 1 scoop of ice cream, etc etc. I don't have the crazy urge to EAT IT ALL.
Also I loved drinking. I actually still love drinking. But I get done at 2.5 drinks. And once a week.
It adds up. Makes you wonder what free will is.Variance in GLPs are naturally occuring. I find the people who say "I forgot to eat" relatable now. Our bodies were not designed for abundance. At least not mine.
I've been on Mounjaro for a couple of years. Unfortunately this effect seems to plateau somewhat and you have to bump your dose. I've changed doses 3 times now, so I'm pretty familiar with how long each increase lasts. It still provides some appetite control, but those initial gains, or the honeymoon phase, definitely tapers. Still, I'm better off being on it versus not and I think it allows me to maintain a healthy weight easier. Plus reap all the other benefits we're learning more about.
I'm curious, has it affected pleasure at all in other areas of life? Are things you used to enjoy still as enjoyable? Is it more the "addictiveness" of things that has dropped, as opposed to how enjoyable they are?
(Never tried them myself, but very intrigued by them.)
I definitely used to use food as a source of joy, so I had try to and find things to replace that. I got really into getting my nails done, nail art and perfume/fragrances to help fill the joy gap. Also exercise and audiobooks.
I had to conscientiously try and find new "fun" things in my life to replace food, which used to be my treat/highlight of my life lol.
I notice a little less joy, pizza used to make me soooo happy lol. Now even if I have pizza- which I still totally can, I just accommodate for it, but it's just like... okay, whatever here's some pizza, cool. I can have 1 or 2 slices and feel fine and not go hog on the entire thing and have it be this amazing fantastic binge.
I went on them because I started boomeranging back after a long and very successful diet. It was pretty much the plan - I wanted to get as far as I could "naturally" and then use GLP-1's to bring me the rest of the way and keep me there, but I was surprised at just how rapidly I started adding weight again.
It stopped me cold and has gotten me almost back down at the lowest I was at after my diet so far and I keep losing at a slower pace but basically without effort.
In terms of pleasure, I'd say mostly no with some caveats. I have fewer snacks, and drink less coke, and I enjoyed both. I don't find chocolate or baked goods as enticing any more, but it's not stopped me from enjoying them on occasion.
It's more that it's stopped me from wanting them as often. I find it easier to tell myself not to grab a snack when I'm already full in particular. Before I might overeat to the point of discomfort.
So when I now actively choose to enjoy those things, I'm more likely to actually enjoy the whole experience.
I'd say the exception is probably coke, which I do find less enjoyable.
It's more like...you just don't want them? It's kind of wild. The first week I took them, I discovered there was a loop in my brain that was constantly thinking about food, and I never realized until it got switched off.
That's the best way I can describe it. I could basically always eat before and now I just...don't feel like it lol.
I will say, they are rough when you first start out on them. During the 1st 6-8 weeks I had several instances of maaaaaybe five seconds of warning between feeling nauseated and vomiting.
It settles down after a couple months and it was never bad enough to be a dealbreaker, but it's a fun time.
Do you honestly believe in the so called “free lunch”? I mean there are MANY substances you can presently take that make you feel way better, but always come with a cost or a downside. Why should we believe GLP-1 class drugs are any different?
It definitely has downsides- it's $$, you have to take a shot every single week, I need to make sure to eat enough fiber now or I will not be regular. But that's a positive lifestyle change anyways- essentially am diligent now to ensure I get fiber every single day!
For me the pros outweigh the cons, I don't obsess over food constantly, my belt size went down and my watch band closed a few notches and even my dental hygienist mentioned last week my face was thinner. Overall it's a huge win.
I pay out of pocket $450 a month for it and it's worth it. The money I saw from no more online shopping habit and no more doordashing or drinking probably breaks even.
Antibiotics are pretty much a free lunch but they exist. Completely stops deadly disease without causing any long term damage. They exist it's just rare
All drugs have side effects and downsides. The question should be if the benefits outweigh the costs, not if the drug is pure magic. Obviously its not pure magic, nothing is, but its still a useful drug.
We already know the downsides (https://pmc.ncbi.nlm.nih.gov/articles/PMC5397288/). The family of drugs has been in use since 2005 for controlling glucose with diabetes. The only new thing is the mass-market use when it turned out to also reduce the physio-mental effects of cravings (food but also apparently other things) in general.
> Do you honestly believe in the so called “free lunch”?
Yes. Why not? A body is a complex biomechanical system, that can be influenced by certain chemicals. Some of them can solve the underlying problem.
Why everything has to be a morality play?
> Why should we believe GLP-1 class drugs are any different?
Why are they any different from, say, antiretroviral drugs? Or from something like statins?
I started the GLP-1 drugs with liraglutide, a predecessor of Ozempic. It works similarly but its half-life is just several hours, so you had to get a daily injection. It has been in use for two decades by now with great results.
I'd take them even if they didn't make me lose weight - and I'm the type of person that doesn't like takeing Tylenol unless absolutely necessary.
The best way I can describe it: my body and mind are no longer is in starvation mode. I plan, do, act and sleep well.
Semaglutide does an incredible job of keeping my autoimmune issues in check. The only side effect I've had is needing to drink more water or else I feel like I've got the flu. Minimal tradeoff IMO
oh say more?
This is why I took it, auto immune related ME/CFS. Works great. I still get PEM but outside of that I get to live a normal life.
Did you have to reach a certain dose for such effects?
the minimum dose of monjaro (2.5mg injection once/week) can often be enough
Studies show almost all subjects regained the weight and reversed gains within 2 years. This means underlying issues (e.g., food addiction) aren't being addressed. Short of changing habits, the only maintenance solution is lifelong drug use and that doesn't sit well with me.
Why not? People take depression meds, blood pressure meds, all kinds of meds for their whole life. I'll be on omeprazole for reflux my whole life. It doesn't solve the underlying problem of my gut being prone to overpumping acid into my stomach. So omeprazole is problematic?
The underlying issue is being treated, it's treated by taking the drug. It works. It's doing its job.
I'd be curious as to how you came to this conclusion.
If they were a normal weight they would not have been prescribed the drug. The underlying issue is they're overweight because they eat too much. Anything more is speculation.
There is usually no free lunch when it comes to pharma, and extrapolating long term or lifetime dependence as being equivalent to short term interventions is an unsupported leap.
That’s the problem with these new weight loss drugs. Ultimately they work by reducing food intake.
For many people food is one of the few things in life that gives them some form of joy. I won’t ever take any drug that will take that away from me. Life is depressing enough as is.
What we need is a weight loss drug that lets you eat unlimited amounts of food, preferably even suppressing the feeling of fullness, without gaining weight.
Have you taken this drug? Because they don't reduce my enjoyment of food. Quite the opposite; I enjoy it more...its just that I get full feeling much quicker, and am less likely to go graze in the kitchen. But enjoy? No, I enjoy my food quite a bit.
> that will take that away from me
They don’t stop eating, just overeating. Getting joy from food is different from self medicating with overconsumption. (For the record, I love food. I also don’t have an issue maintaining a healthy weight and physique.)
This is it.
I am on GLP-1 (Zepbound). I have done Weight Watchers multiple times. I'd lose the weight for a little bit, then it would come back. The reason was _I was hungry all the time_. It's not sustainable. As someone else in WW told me: "The easy bit is losing the weight. The hard part is continuing to eat that way your whole life."
It's simply a faulty hunger sensor in my body. It was not what I was eating, simply how much.
GLP-1s fix the sensor. It's really simple. Nothing else to it.
I still enjoy food (although my palette has turned away from anything greasy, which is for the better anyway), but I can finally understand why someone would eat half a plate of something and say "I'm good" and actually mean it rather than trying to diet/starve themselves.
So many misconceptions in these threads; your take is spot on and accurate.
I dunno. It’s not universal, but I have a newfound joy when it comes to food after being on a GLP-1 and losing about 100lbs.
Sure, I don’t get the instant giant dopamine spikes from binge eating $30 worth of Taco Bell or a couple large pizzas. Once in a while I do miss that, but I can still do it now that I’m a few years into the weight staying off. It’s just not worth how shit I feel the next couple days afterward.
But healthy Whole Foods? What was once kind of meh for me is now something I look forward to and explore. Both going out to foodie type spots, and cooking at home. Both gourmet and basic. Just tasting the nuances and everything in some well prepared veggies or whatnot is great and not something I used to appreciate.
I also don’t constantly feel like crap with stomach issues either. I suppose there is less “addictive” type vice enjoyment in my life in some way, but the tradeoff has been life changing. I certainly still get plenty of joy from many of my meals when I feel the need!
Nonsense, one not just as easily say they are overweight because they aren't taking enough GLP-1 agonists. A patient with scurvy is proscribed vitamin C - they might even need to take it for the rest of their lives to stay healthy.
Woe is them I guess for their chemical dependence.
One could even argue food is a lifetime chemical dependance. An assortment of chemicals really with the amino acids, lipids and sugars involved. People who are against these medications typically draw arbitrary lines for what treatments are "acceptable".
Until starting tirzepitide I always thought about food, now I don't. Had depressive issues since I was a teenager as well. I took Wellbutrin for 20 years and had an interruption in the last six weeks due to an insurance issue. Payed for the tirzepetide out of pocket, take that once a week, my depression is manageable without the Wellbutrin for the first time in my life. I'm still going thru depression, but that's due to my husbands death in early March. If I wasn't taking my weekly shot I would easily be morbidly obese and probably suicidal. The cost isn't an issue either, I would spend more on food that I'm not buying or eating each month than it costs to buy the medication.
Just because something might not be interesting to someone doesn't mean it has no value. I have no interest in sports, but that doesn't mean they shouldn't exist. I could argue they shouldn't be as prominent in society but that's a different argument.
If you have struggled with your weight, depression, have early warning signs of cardiac problems and a range of other conditions it can be worth considering semaglutide or terzepitide. As long as you stick to the lowest dose that's effective the side effects are minimal to non existent. Categorically dismissing these drugs is as silly as refusing pain meds because "god designed us to experience pain".
I think you dislike the personal responsibility angle, which is fine but separate from caloric intake being the source of obesity. The fat is stored energy from food, it would violate conservation of energy otherwise.
There's metabolism, food density, food availability, psychology, culture, economics, etc in play, but it's important not to lie to ourselves that the proximal cause of obesity isn't from over consumption.
Who is lying? I was fat because I ate too much.
Why I ate too much is uninteresting to me. I also don’t have some moral hang up over it. Give me that easy button all day long so I can focus on shit in my life that actually matters.
If it makes someone feel better about themselves to believe in woo-woo science that violates the laws of physics and ascribe magical properties to GLPs, why do you care?
> dislike the personal responsibility angle
I dislike the rejection of evidence. These drugs solve a problem. Preaching personal responsibility does not. In that way it almost reminds me of drug prohibition and abstinence-only rhetoric.
The evidence of where their fat stores came from?
> evidence of where their fat stores came from?
Yes. Specifically, how basal metabolism is not a consciously-controlled rate that modifies itself against diet and exercise to the point that in some people with serious metabolic syndrome it may be impossible for them to lose weight through diet and exercise without suffering nutritional shortfalls.
Also, the clinical evidence around what works for people losing weight and getting healthier and what doesn’t. Like, I get we have a powerful fast-food and sugary-drinks lobby in America, but wow is it wild seeing people get uppity about third parties’ private healthcare decisions like this.
I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).
> things you can fix on your own (diet + exercise)
We have decades of research showing this is more in the "excess acid production" realm of things.
We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
> We also know there's a replication crisis in psychology and medicine…
It seems unlikely to extend to bariatric surgery outcomes.
> This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
This idea that Americans are genetically pre-ordained to lack willpower seems like fanciful thinking.
Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
> That's why they could stop being fat, if only they chose to.
This seems like one of those "replication crisis" claims.
> That's why they could stop being fat, if only they chose to.
So they're pre-ordained not to?
I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be.
> You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
> So they're pre-ordained not to?
No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control.
> What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
>This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug.
I fail to see the need for additional analysis or consideration?
Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
> I fail to see the need for additional analysis or consideration?
Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
Terzepitide took me from always wanting food to actually being able to focus on other things fully. I was concerned with being able to inject myself weekly, but it's easy and worth the 1-2 minutes a week. If you start, the dosage schedule is more a suggestion than an absolute. I noticed side effects getting worse so I dropped back to a lower dose and have held there for a couple months now. Only real drawback has been from a friend giving me a hard time after seeing the vial in my fridge, but he seems to be coming around after seeing obvious results.
Yeah, I posted elsewhere about it, but GLPs instantly switched that feeling off like it was throwing a breaker. It's wild.
Exercise will help. It's Physics, it's not an opinion based thing that works for some people and not others. It's energy in vs energy out. If you simply eat less calories then you exercise/use, you WILL lose weight.
I don't get this weird thing people do where they act like their bodies don't follow the laws of conservation of energy.
It is of course true that caloric input is a thermodynamic limit and restricting it sufficiently relative to caloric expenditure will cause you to lose weight. (Lisa, in this household we obey the laws of thermodynamics...)
However, not all calories are the same, metabolism is dynamic, and the brain is complex and exerts a powerful influence over behavior.
Increasing exercise will make you hungrier and most people are simply unable to resist this and end up not losing weight. It is why there is a common saying that "you cannot outrun your fork." Restricting calories generally is difficult in today's environment with plentiful calorie dense food everywhere. People don't cook as much as they used to and restaurant meals have more calories than ever.
AFAIK GLP-1 drugs work because they calm the minds desire to eat which is baked in deeply from millions of years of our ancestors struggling to get sufficient food.
The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn.
You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.
More importantly we have decades of irrefutable evidence that diet and exercise alone are about as effective as abstinence only sex education. It's great there are people that can just decide to eat less, but it's foolish to assume that can work for everyone.
It's odd how people act as tho there's a "moral argument" against using a tool to help reach the goal. It feels a lot like the argument that "morals are from religion", as if you need god to know that murder isn't really a productive activity (unless you work in a slaughterhouse).
I wish American money could go back to having "mind your business" printed on it instead of "in god we trust", it was a huge loss to all of us when that garbage was passed. It was also a huge loss when everyone just decided to go along with saying "taxpayer money" instead of saying "public funds/money", but slippery psychological slopes are everywhere.
> It's great there are people that can just decide to eat less, but it's foolish to assume that can work for everyone.
More importantly: I don’t want to eat less. I want to eat more. There is so much amazing food.
> You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake.
People racing the Tour Divide, a 2700 mile solo unsupported bikepacking race through the Rocky Mountains, lose weight when riding their bikes 18 hours a day for 2-3+ weeks straight. They describe being unable to choke down enough food even though what they are eating is very calorie dense. Hotdogs, burritos, burgers, pizza, a pound of gummies every day, chocolate milk and ice cream when resupplying, McDonalds where they fill their hydration bladders with PowerAde, anything they can get their hands on quickly when they arrive at a small mountain town which frequently has nothing more than a gas station.
https://www.facebook.com/groups/tourdivide/posts/24754803527...
Obviously not a practical solution as you say but they do exercise enough to offset the food when eating as much as they can.
Great? When I worked landscaping I would plow through 2-3 double quarter pounder meals every lunch break. And then a dominos pizza or three when I got home for dinner. Plus a gallon or two of full sugar soda throughout the day, and snacks.
It’s not practical in the least for the average office worker to outrun the fork. It’s just silly advice and pointless to even bring up. When it takes an hour or more of treadmill work to cancel a single donut you don’t need to think about it any longer than that.
You exercise for health. Not to lose weight. Until you are at the margins and can consistently create an extra 100-200 calorie deficit by walking for an hour every evening or whatever.
My three gym days a week don’t do much for the scale. Those are for physical and mental health. The weight part is in the kitchen.
They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
Exercise will burn calories, yes. But my life doesn't fit the several hours of exercise a day, every day, forever, that would be needed as an already-small person to burn the 1000+ excess calories a day my body is constantly hungry for.
Why? They both get you to the same place, and one is vastly more likely to work. I don't get the weird moralizing around this.
Unfortunately for a lot of people with weight issues it stems from becoming overweight during puberty which is uniquely bad. Your body's appetite signals are permanently impaired if you become overweight during puberty because during this window your fat cells don't just increase in size, but also in number and this increased quantity does not go away once created. Fat cell shrink as weight is loss, but they are not destroyed and they are responsible for appetite signaling. It's one of the reasons that childhood obesity is actually leagues worse than it first appears and I think should be considered child abuse in extreme circumstances.
> almost all subjects regained the weight and reversed gains within 2 years
Source? I thought it was 2/3rds of the weight regained, which is still a substantial long-term loss.
It’s the food equivalent of declaring bankruptcy. If you don’t fix the behaviours you’ll just end up in debt again.
This assumes underlying behaviours are core reason. Research (tein, adoption) suggests otherwise
Practically speaking, any person could starve themself (short of death) and lose weight. In almost all cases there is no magic to storing more energy than you need.
A couple years of reduced weight, and all the benefits that entails, doesn't sound bad.
Given that we know that diets and changing habits doesn't have lasting effects, what doesn't sit well with me is to risk my health to avoid taking a drug that helps.
changing habits do have lasting effects, I'm not part of this "we" that doesn't know that.
People talk past each other on this because for an individual it technically can work, and sometimes does, but on a population level, as extensively studied by people whose job it is to study that, it definitely does not work. Even with tons of regular attention from professionals and a cohort selected to have above-average motivation, it’s surprisingly poorly-performing (and that’s a crazy expensive level of intervention)
Think about how we describe contraceptives, medically speaking: a failure rate is tracked and promoted that’s the in the wild rate of failure, not the ideal-use rate of failure (which can be effectively zero!). The diet and exercise equivalent of a contraceptive couldn’t be sold, because its failure rate would be way higher than its success rate.
So “we” (people who’ve paid attention to the science on it) know it doesn’t work (on a population level), like for-sure definitely does not work, but a person reads this assertion of fact and goes “but wait it worked for me, this person must be dumb or something” but that’s not it. It’s two different perspectives on what it means for it to “work”.
I think it'd be more accurate to say that informing people that they should change their behavior doesn't work. A person changing their behavior can escape obesity. The reality is that most people won't be able to change their behavior without some other kind of assistance.
If you succeed at changing your habit, it works.
However, all the evidence is that the vast majority of people fail at changing their habits in ways that produce lasting weight loss, so it does not generally work as advice for reducing your weight.
So you're technically right, but it is irrelevant, because we don't know how to actually get people to change habits with any meaningful rate of success.
At this point it is downright harmful and wildly unethical to recommend it when we now have a far more successful option.
I've gained and lost 10kg twice in my life. Maintaining the weight loss isn't that hard once you've a rhythm dialed in.
In my case I just weight myself daily, track the weight and scale my food consumption with the current trend. If I'm gaining weight I'll skip a meal.
It takes a while to figure out what works for you but I can tell you that making small lifestyle changes to maintain your weight is fairly easy compared to figuring out how to lose 10 kg.
When I was lifting weights I went from 170lbs to 210, and back to 170. Doing that isn’t technically hard, and maintaining is even easier. But I had to think about it _all_ the time. Maybe it’s because I’m older now, but I just don’t want to spend that much effort thinking about food.
Just because it wasn’t hard for you doesn’t mean it isn’t hard for the others. Grom what you said it seems you just had some bad habits you had to fix and that’s it.
Plenty of people have lifelong drug use of, say, caffeine, or aspirin as a blood thinner, or various antihistamines. Why is this somehow worse? Particularly keeping in mind that it's very easy to make, so once the patents expire, it's going to be dirt cheap as generics everywhere.
I'm just sharing my personal preference and not trying to tell people how to live their lives. I don't like personally like the idea that I'll only be healthy if I take this drug for the rest of my life when I could (again - speaking for me), be more disciplined about the food I put into my body.
Why this has to be all or nothing?
You can use the drug to loose weight while trying to understand the underlying problem.
“be more disciplined” - did you read any studies about the sources of obesity? Or do you struggle with weight since childhood yourself?
The "underlying issues" are not all moral failings as you hint. In my case, as I've aged my appetite due blood sugar/insulin resistance/etc means I'm basically hungry all the time if I restrict calories to maintain lower body weight. Yes - even if I exercise frequently. Yes - even with healthy food and snacks. My wife tells me my stomach is growling at night.
I will slowly gain about 10-15lbs a year due to excess calories if I try to maintain weight at < overweight BMI. GLP-1 drugs have been great to take that edge off.
Why? If you have too much help or whatever being produced such that your body eats too much, just take a drug. The harm of being fat is worse than anything ozempic does
The drug stops working if you stop taking it? Shocking! Heart medication for hypertension also stops working if you don't take it. Sure there's a vast conspiracy by the pharmaceutical industry to hook us all on drugs because we can't learn to exercise, but that's hardly Ozempic's fault. Now if you were looking at brain surgery that zaps the reward center of the brain causing permanent changes so the patient was less addicted to food, but the patient kept needing to have brain surgery, then you'd have a point, but "drug stops working if you don't take it" is hardly the gotcha some make it out to be. Insulin also stops working for diabetics if they don't take it. That's kind of medication's whole deal.
Now that we know obesity can be controlled via medication, and it'll cost $foo over the lifetime of the patient, the next step is to optimize. If there is a treatment involving ultrasonic brain surgery that costs less than $foo, the expectation is for the market to find that. Ultrasonic brain surgery is in its infancy, but it's already showing utility for Alzheimer's and addiction. The real question is if the pharma companies are going to be able to keep it from going mainstream because it's less profitable for them.
[dead]
And this morning, I cut another hole in my belt. Turns out, losing weight and being thin was never about willpower or laziness in the face of absolute food abundance. It was mostly about whether a person was born lucky enough to have a moderate appetite, or was born burdened by exaggerated appetite.
The underlying issue is physiological food cravings, not some personal failing or lack of willpower, and GLP-1 absolutely addresses those "underlying issues". That it isn't some one and done pill is hardly a realistic expectation as that would require probably genetic and epigenetic reprogramming.
The idea that appetites are assigned at birth is a bold claim. Is there evidence to support it?
Well, not assigned by the hospital or your parents, but being a DNA-based lifeform a genetic baseline is a safe assumption. Experiences vary after that:
https://pmc.ncbi.nlm.nih.gov/articles/PMC3052625/
Genetics and epigenetic factors.
As a habitual habit developer, Im keeping my hopes up that in 5 or 10 years, this is something that can help me and many others.
I've read experiences from people on illicit substances that claimed they helped them quit.
It would be beat if this carried over to things like caffeine/nicotine/thc/etc.
There's anecdotal accounts of GLP meds helping with a range of addictions. Of course in science anecdotal accounts are the lowest tier of evidence, that's only top shelf in law.
Tirzepatide at 1mg/week reduced my muscle soreness. I felt less depressed but this might just have been situational because I've been plagued by bad soreness after working out for years.
Unfortunately after twelve weeks I had to stop because I felt a lot of nausea and tenderness in my upper abdomen, and was worried it might be pancreatitis developing. I'm not sure why it would happen at such a low dose but the symptoms reduced pretty quickly as it wore off.
I may go back on later with a dose spread over a longer period with the hypothesis that the drug has a longer half life in my body and what I experienced was a gradual build up. Considering I lost 15 pounds over 3 months as well, I believe this to be very plausible.
I got pancreatitis from Zepbound, but it was indirect.
Turns out rapid weight loss can cause gallstones, especially if you're genetically predisposed to them. I had one that ended up stuck in the bile duct, causing acute pancreatitis. I had to get my gallbladder removed shortly after and hundreds of stones were found.
I would consider getting an ultrasound since the stones don't just go away when you stop taking the drug.
(Gallbladder removal aside I had no lasting issues and kept the weight off.)
Thanks for sharing, it makes sense. Even before taking Tirzepatide I have had issues my whole life with greasy / fatty stool, and now that I've had reason to research the gall bladder, it does make me wonder if perhaps I also have stones.
Metabolic theories of mental illnesses and cancer are seriously understudied.
What about the reports of bone density loss? Any downsides to this?
What reports?
My insurance stopped covering, now I'm looking at $450 for Zepbound / month. Just the weight coming back is making me more depressed...
I get mine on the black market, 50c/mg for semaglutide, $3 per month at my current rate of usage. I’ve been on it for years, I was getting gray market at $12/mg for 3 years before RFK clamped down on that market. It’s exactly the same stuff (for me, no guarantee for others), had it tested in a lab and as the side effect profile is on point. It massively relieved my ME/CFS, back when I started there was no way I could have gotten a prescription let alone insurance to cover it.
You can probably use some coupons like goodrx to get it for $300 a month.
I got severely downvoted in the past for badmouthing GLP1s here. Then I did my research, got on them and I take it all back. These things are on par with statins in terms of potential societal impacts.
GLP1s are one of today's real, true, modern miracles. It deserves a Nobel, but not to one person, but the teams upon teams upon teams that made it possible to get here.
That's quite admirable to correct yourself in public. Good on ya.
Yes. I wonder if taking GLP-1 made him have higher morals as well!
its possible.
GLP-1s are far more effective than statins.
Very weird (or funny?) to use statins as an example of a ‘good and effective’ drug.
Why do you say that? My first exposure to statins was in https://myticker.com and they seem somewhat important
That says more about the harmful effects of obesity than anything.
Could be related to endorphins and BDNF, similar to the effect from fasting.
What’s the downside to this magical drug. There has to be a downside…
Nothing in this world is free, GLP-1s have their downsides (excluding cost).
Mostly it's nausea and gastrointestinal distress side effects. These tend to cool down over time, but it'll put a ceiling on how big a dose you can tolerate. Some people can't tolerate a dose at any level.
The downside is that they make you eat less thereby taking away one of the few things that make life worth living.
That is the silliest take ever. I am on GLP-1s, and I still enjoy my food..maybe more than ever before.
Why does there have to be a downside?
What was the downside of washing hands before surgery?
Because our bodies are delicate systems of networks, and inputs in one area can have complex/unpredictable outputs elsewhere, it seems.
Typically, if something "works", there often appear to be side effects. A free lunch is rare.
https://www.uclahealth.org/news/article/understanding-medica...
The fact that GLP-1 seems to have roles not just in satiety but that agonists seem to reduce other types of impulsiveness (e.g. gambling, shopping) is interesting. That's not something you'd predict as a consequence, and perhaps is downstream of some gut-brain connection.
Of course we already manipulate brain chemistry in other more direct ways with antidepressants so perhaps any unwanted second-order effects could be minor in comparison to the profile of existing antidepressants .
Yeah, that's a good point. I hadn't heard about impulsiveness. I had read that taste preferences changed - e.g., salty, sweet, savory, fatty:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7105351/
I've been watching developments on how GLP1s seem to go beyond just hunger/insulin response, even how they may affect symptoms of polycystic ovarian syndrome (PCOS), which is difficult on women who have it:
https://academic.oup.com/ejendo/article/194/3/S25/8488941
> Typically, if something "works", there often appear to be side effects
Unless it’s literally a deficit. There isn’t a downside to treating vitamin C deficiency with vitamin C.
And downsides of penicilin? There are some but they are massively offset by not having alt consequences
Hasn't done jack shit for my depression.
Also worth mentioning GLP1's are known to cause anhedonia. So there's that...
I'm curious if this post will also have the same phenomena I've seen before of people springing out of the woodwork to post moralizing comments about people shouldn't rely on drugs, about how actually GLP-1s are bad because they don't fix problems indefinitely with a single dose, about how people should fix their problems by just having more willpower, talking about 'but what about the unknown side effects?' of drugs that have been in use for twenty years already, etc.
And it surely did. Like clockwork. And it is annoying.
Semaglutide has been used for diabetics for roughly 20 years. The FUD angle is just people rambling against something that doesn't affect them personally. Everyone knows the only things that matter are what effects "you", everything else is just fantasy. If we could rid ourselves of that mindset we could build a much better world.
Why shouldnt it?
Mice are not people, but interesting link
I'm on GLP-1 and it's completely stopped my urge to online shop. I used to browse/shop for fun and out of habit or when I was stressed out or wanted a treat etc. Entirely resolved! I've also lost 40lbs on it.
To the others on this reply, I take 1/4 dose of the "clinical dose" and it has been life changing. I've lost 30 lbs. I've done that in the past, but for me that was harder than ranger school in the army.
I LOVE food. Eating out and family dinner were always important to me. I was very worried that I would lose my pleasure in this.
I haven't.
But now I can just eat 1/2 slice of pie. Or 1 scoop of ice cream, etc etc. I don't have the crazy urge to EAT IT ALL.
Also I loved drinking. I actually still love drinking. But I get done at 2.5 drinks. And once a week.
It adds up. Makes you wonder what free will is.Variance in GLPs are naturally occuring. I find the people who say "I forgot to eat" relatable now. Our bodies were not designed for abundance. At least not mine.
Exactly my experience.
I've been on Mounjaro for a couple of years. Unfortunately this effect seems to plateau somewhat and you have to bump your dose. I've changed doses 3 times now, so I'm pretty familiar with how long each increase lasts. It still provides some appetite control, but those initial gains, or the honeymoon phase, definitely tapers. Still, I'm better off being on it versus not and I think it allows me to maintain a healthy weight easier. Plus reap all the other benefits we're learning more about.
I'm curious, has it affected pleasure at all in other areas of life? Are things you used to enjoy still as enjoyable? Is it more the "addictiveness" of things that has dropped, as opposed to how enjoyable they are?
(Never tried them myself, but very intrigued by them.)
I definitely used to use food as a source of joy, so I had try to and find things to replace that. I got really into getting my nails done, nail art and perfume/fragrances to help fill the joy gap. Also exercise and audiobooks.
I had to conscientiously try and find new "fun" things in my life to replace food, which used to be my treat/highlight of my life lol.
I notice a little less joy, pizza used to make me soooo happy lol. Now even if I have pizza- which I still totally can, I just accommodate for it, but it's just like... okay, whatever here's some pizza, cool. I can have 1 or 2 slices and feel fine and not go hog on the entire thing and have it be this amazing fantastic binge.
I went on them because I started boomeranging back after a long and very successful diet. It was pretty much the plan - I wanted to get as far as I could "naturally" and then use GLP-1's to bring me the rest of the way and keep me there, but I was surprised at just how rapidly I started adding weight again.
It stopped me cold and has gotten me almost back down at the lowest I was at after my diet so far and I keep losing at a slower pace but basically without effort.
In terms of pleasure, I'd say mostly no with some caveats. I have fewer snacks, and drink less coke, and I enjoyed both. I don't find chocolate or baked goods as enticing any more, but it's not stopped me from enjoying them on occasion.
It's more that it's stopped me from wanting them as often. I find it easier to tell myself not to grab a snack when I'm already full in particular. Before I might overeat to the point of discomfort.
So when I now actively choose to enjoy those things, I'm more likely to actually enjoy the whole experience.
I'd say the exception is probably coke, which I do find less enjoyable.
It's more like...you just don't want them? It's kind of wild. The first week I took them, I discovered there was a loop in my brain that was constantly thinking about food, and I never realized until it got switched off.
That's the best way I can describe it. I could basically always eat before and now I just...don't feel like it lol.
I will say, they are rough when you first start out on them. During the 1st 6-8 weeks I had several instances of maaaaaybe five seconds of warning between feeling nauseated and vomiting.
It settles down after a couple months and it was never bad enough to be a dealbreaker, but it's a fun time.
Do you honestly believe in the so called “free lunch”? I mean there are MANY substances you can presently take that make you feel way better, but always come with a cost or a downside. Why should we believe GLP-1 class drugs are any different?
It definitely has downsides- it's $$, you have to take a shot every single week, I need to make sure to eat enough fiber now or I will not be regular. But that's a positive lifestyle change anyways- essentially am diligent now to ensure I get fiber every single day!
For me the pros outweigh the cons, I don't obsess over food constantly, my belt size went down and my watch band closed a few notches and even my dental hygienist mentioned last week my face was thinner. Overall it's a huge win.
I pay out of pocket $450 a month for it and it's worth it. The money I saw from no more online shopping habit and no more doordashing or drinking probably breaks even.
Antibiotics are pretty much a free lunch but they exist. Completely stops deadly disease without causing any long term damage. They exist it's just rare
Interesting point… and I suppose for the most part, I agree. A rare case of a mostly free lunch.
All drugs have side effects and downsides. The question should be if the benefits outweigh the costs, not if the drug is pure magic. Obviously its not pure magic, nothing is, but its still a useful drug.
The point of modern mefivine is that we have drugs that have benefits that outweigh risks and downsides.
We already know the downsides (https://pmc.ncbi.nlm.nih.gov/articles/PMC5397288/). The family of drugs has been in use since 2005 for controlling glucose with diabetes. The only new thing is the mass-market use when it turned out to also reduce the physio-mental effects of cravings (food but also apparently other things) in general.
> Do you honestly believe in the so called “free lunch”?
Yes. Why not? A body is a complex biomechanical system, that can be influenced by certain chemicals. Some of them can solve the underlying problem.
Why everything has to be a morality play?
> Why should we believe GLP-1 class drugs are any different?
Why are they any different from, say, antiretroviral drugs? Or from something like statins?
I started the GLP-1 drugs with liraglutide, a predecessor of Ozempic. It works similarly but its half-life is just several hours, so you had to get a daily injection. It has been in use for two decades by now with great results.
so, the whole mouse thing is a scam, and now they are openly testing on us, first, and publishing in psychology today to see if we notice.fiendish.