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dirtbagskier 5 hours ago [-]
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.
faangguyindia 2 hours ago [-]
>my body and mind are no longer is in starvation mode
What does it mean? If a drug reduces your desire to eat food, wouldn't it also decrease your desire to eat food beneficial for your body?
I think the effect most people want is to stop craving junk food but still eat nutritious food required for muscle growth and health.
ceejayoz 1 hours ago [-]
What if you could intentionally eat good food?
I've heard it widely described as reducing mental noise around food.
dmayle 39 minutes ago [-]
I had the same experience, but not with GLP-1 drugs, but by upping my protein intake to about 0.7g per pound of body weight.
Night and day, stopped always being hungry... I've tried Noom before (eating highly filling, low calorie foods, but filling, not satiating), but that only worked while I was tracking (and always forcing myself to keep it up)...
Losing weight required work on top of that, but the protein just made my hunger response start working properly again.
sublinear 9 minutes ago [-]
I had a similar experience bringing down my A1C.
People talk a lot about meat, but not enough about dairy. My prayers were answered at the altars of feta, greek yogurt, half and half, butter, cottage cheese, etc. They made salads not suck. They opened up a ton of lower carb dessert options. My gut health improved. All of my health improved.
I no longer treat these humble foods as optional extras. They perfectly fill the gap in my daily protein needs. They were never unwelcome, just forgotten.
barake 4 hours ago [-]
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
faangguyindia 1 hours ago [-]
I remember reading the Hazada paradox, where they found these Hadza tribe members who live an active life, walking miles, hunting, and doing all physical labour, have the same maintenance calories as a Western person.
So where does the energy burn in a sedentary population come from vs highly active Hadza tribe members?
Pontzer’s research showed that while the Hadza were highly active, they actually demonstrated lower baselines of certain markers of metabolic and physiological stress over time compared to Western populations.
Don't quote me on this; I am paraphrasing things I remember from.
spbaar 2 hours ago [-]
Thirst affects me in a different way too. My throat doesn't feel dry and uncomfortable because before it reaches that point I almost get naseous.
npunt 4 hours ago [-]
oh say more?
cjbgkagh 4 hours ago [-]
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.
emmelaich 1 hours ago [-]
Interesting! Is it possible that you're just eating less of whatever triggers the autoimmune symptoms?
cjbgkagh 1 hours ago [-]
No, if that’s all it was then ME/CFS would be a cake walk and it isn’t. I have such a crazy restrictive diet and have had for a long time that one of my issues was being kicked out of doctor's offices for looking too healthy. The diet is necessary but not sufficient.
taurath 24 minutes ago [-]
As a counter example, I found myself unable to eat anything at all even with anti nausea meds, and my head utterly in a fog that felt like I was becoming ill.
diggerboy 5 hours ago [-]
Did you have to reach a certain dose for such effects?
chadd 4 hours ago [-]
the minimum dose of monjaro (2.5mg injection once/week) can often be enough
joshuamcginnis 4 hours ago [-]
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.
wpm 4 hours ago [-]
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.
htk 1 hours ago [-]
No, the symptom is being treated, not the underlying issue.
And that's ok, but treating the underlying issue, when possible, is better, as the problem ceases to exist.
crooked-v 1 hours ago [-]
For many people, the "underlying issue" is fundamentally just being too hungry for how they live. GLP-1s absolutely treat that.
faangguyindia 1 hours ago [-]
for many people the underlying issue is serious lack of education when it comes to nutrition.
Not understanding calorie balance, not understanding calorie density of the food they eat.
How many people know 1kg fat = 7700kcal that if they could create deficit of 7700kcal they could potentially lose 1kg bodyfat? Ofc, i know the relationship isn't that simple but for most people this roughly holds true.
If you are eating granolas in breakfast, it may come across as a shock how many calories they pack, go ahead look it up many people believe that's a low calorie health breakfast option.
Many people don't know
1g of carb or protein = 4kcal
1g of fats = 9kcal.
dgabriel 43 minutes ago [-]
I understand calorie balance. I've been on a diet since I was 12 years old, and am now approaching 50. I've lost and regained the same 60lbs about 4 times now. I have logged every bite that goes into my mouth, and lived with a constant hunger for as long as I could take it. Then I ate until I felt satisfied and gained it all back. I know how many calories are in anything, and I can eyeball any serving size. I've been doing it for decades. When I take GLP-1s, I can just stop. My appetite and body maintains itself at a healthy weight, and I don't cry myself to sleep from either hunger or shame.
I think I'm not the ignorant one.
faangguyindia 34 minutes ago [-]
I have no personal animosity toward you, but I've heard all this many times, so I'll respond accordingly.
>I've been on a diet since I was 12 years old, and am now approaching 50. I've lost and regained the same 60lbs about 4 times now
You can lose weight by crash dieting, which does not prove much. The first thing that comes to mind for people is simply: "I'll just eat very little and lose weight." It even works, but people quickly get results; it makes them miserable, and they gain it back.
People get stuck between "eating too little" and "binge eating".
>I have logged every bite that goes into my mouth, and lived with a constant hunger for as long as I could take it
This proves you are sincere in calorie tracking, but it doesn't tell us much about what kind of deficit you were in. What were your maintenance calories, and how did you calculate them?
What kind of deficit did you run over what time period?
In my experience, while people know all these things, execution still requires knowing all the "gotchas".
Going from 2700kcal calories to 1000kcal a day diet will make anyone hungry and miserable.
crooked-v 47 minutes ago [-]
Being aware that there are deceptively calorie-dense foods doesn't help the basic equation there. Anecdotes are not data, but my anecdotal experience is that if I ate nothing but bulk vegetables whenever my hindbrain wanted food, I would still be eating over my maintenance calories every day.
faangguyindia 43 minutes ago [-]
What's your maintenance calories and how did you calculate it?
Most people calculate it wrong.
ajross 52 minutes ago [-]
> No, the symptom is being treated, not the underlying issue.
That's a semantic argument. The "issue", medically, to most people viewing this as a health problem, is excess body fat and not eating behavior.
I mean, you're not wrong, but this seems silly. YES, it would be better to have developed a cure for disordered and unrestrained eating. We didn't. And we don't really even know how. Oops, as it were. But we do have a treatment that avoids the most significant impacts of those problems.
Medicine is harder than software engineering. Not all bugs are shallow even with all the eyes in the world.
fwip 37 minutes ago [-]
Additionally - GLP1 drugs work by changing those eating patterns.
joshuamcginnis 4 hours ago [-]
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).
ceejayoz 4 hours ago [-]
> 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.
applfanboysbgon 3 hours ago [-]
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.
ceejayoz 3 hours ago [-]
> 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.
applfanboysbgon 3 hours ago [-]
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.
ksenzee 1 hours ago [-]
What evidence do you have that it is a cultural shift, rather than, say, a chemical in the environment that wasn't there before, or a difference in the food supply?
faangguyindia 46 minutes ago [-]
Are food options today not more calorie-dense than they were back in time? More easily accessible? Calories have become increasingly cheap and dense to come by. You've lots of processed food being engineered to be highly palatable and calorie dense at an industrial scale.
Plus, cars and all "comforts" eating into your physical activities?
ceejayoz 3 hours ago [-]
> 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?
applfanboysbgon 3 hours ago [-]
> 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.
cflewis 2 hours ago [-]
Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
PaulHoule 32 minutes ago [-]
America is more obese than many nations but obesity is increasing the world over.
The timing is just about right to blame it on Reagan, either the theory that neoliberalism leads to "structured stress" or than some environmental chemical got approved in that time frame.
thereisnospork 3 hours ago [-]
>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?"
applfanboysbgon 3 hours ago [-]
> 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.
ceejayoz 1 hours ago [-]
> especially if there are unforeseen longterm side effects
GLP-1s have been used widely for 20+ years now.
crooked-v 4 hours ago [-]
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.
buck746 3 hours ago [-]
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.
throwatdem12311 1 hours ago [-]
Why would exercise use help? Burning calories makes your body want to eat, obviously - this is how our bodies are supposed to work.
untrust 20 minutes ago [-]
Exercise absolutely helps as it helps regulate blood sugar more effectively. A surprising effect of building muscle and exercising is that your body becomes more insulin sensitive and your blood sugar stabilizes instead of having drastic swings.
habinero 3 hours ago [-]
Yeah, I posted elsewhere about it, but GLPs instantly switched that feeling off like it was throwing a breaker. It's wild.
saberience 4 hours ago [-]
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.
hackingonempty 3 hours ago [-]
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.
Aaargh20318 3 hours ago [-]
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.
buck746 3 hours ago [-]
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.
Aaargh20318 2 hours ago [-]
> 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.
hackingonempty 2 hours ago [-]
> 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.
Obviously not a practical solution as you say but they do exercise enough to offset the food when eating as much as they can.
phil21 2 hours ago [-]
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.
SpaceNugget 3 hours ago [-]
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.
crooked-v 3 hours ago [-]
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.
habinero 4 hours ago [-]
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.
9x39 4 hours ago [-]
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.
MPSimmons 2 hours ago [-]
Oh hi, I'm a heart attack survivor who had GLP-1 prescribed by my cardiologist for its heart-protecting benefits. I told my cardiologist that I wasn't losing weight as fast as I thought I would, and he said, quote, "I don't care about you losing weight. That's not why I prescribed you this."
So I'm not sure your first sentence is universally accurate.
Aaargh20318 3 hours ago [-]
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.
SubiculumCode 2 hours ago [-]
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.
MPSimmons 2 hours ago [-]
It doesn't take away joy. It does cause me to be slapped in the face with the "full" feeling while I am in the middle of eating, which is like 15 minutes earlier than I used to get it. I don't overeat anymore because I would be literally miserable if I did. It would be like force-feeding myself. But before I get that full feeling, food is excellent.
JumpCrisscross 3 hours ago [-]
> 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.)
cflewis 2 hours ago [-]
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.
JumpCrisscross 26 minutes ago [-]
My friends who have been on it can genuinely enjoy food more now. There is no guilt. The portions make restaurant budgets more manageable. And they’re trying more of the menu. They liked food before. I think they can genuinely love it now, and that’s really great to experience with them, even aside from the massive lifestyle benefits losing weight brings.
cflewis 15 minutes ago [-]
Yes!
I was able to drink an Italian soda this week and not feel like "oh God I'm drinking my calories I'm going to be punished for this on the scales later".
SubiculumCode 2 hours ago [-]
So many misconceptions in these threads; your take is spot on and accurate.
phil21 2 hours ago [-]
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!
thereisnospork 3 hours ago [-]
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.
buck746 3 hours ago [-]
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".
9x39 3 hours ago [-]
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.
JumpCrisscross 3 hours ago [-]
> 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.
9x39 3 hours ago [-]
The evidence of where their fat stores came from?
JumpCrisscross 2 hours ago [-]
> 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.
faangguyindia 1 hours ago [-]
>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.
The average person does not understand how weight loss works; many people do not know the concept of maintenance calories, and don't know how calorie surplus or deficit works.
Simply putting them on drugs for life isn't a solution. The average person does not have metabolic syndrome, yet the average person is increasingly becoming obese or perhaps already is obese in many countries.
crooked-v 1 hours ago [-]
> Simply putting them on drugs for life isn't a solution.
Plenty of people are on drugs for life for a variety of things that have less health impact than being overweight.
s1artibartfast 46 minutes ago [-]
Third party private healthcare decisions are almost non-existant in the US due to the payment systems. People are on the hook for the decisions of others either through their premium, taxes, or both. Of course, this is non-central and rarely the concern people present.
That said, 2026 US GLP-1 healthcare sales projections run between 60 and 100 billion [1]. it will be interesting to see if these miricle drugs can really provide that much benefit/offset that much cost.
> Third party private healthcare decisions are almost non-existant in the US due to the payment systems
The payment part is almost entirely pushing against GLP-1 agonists. Nobody has a long-term financial stake in patient costs to care that lifetime costs will likely be lower; insurers are just looking at the next couple years against expected churn. Another cost of tying health insurance to employment.
phil21 2 hours ago [-]
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?
faangguyindia 1 hours ago [-]
>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?
Why we should not care about putting people on drug who do can benefit from making lifestyle changes, being less sedentary and leaning about maintenance calories and how calorie surplus and deficit works?
if there is no resistance, simply prescribing GLPs to average person may become a new normal.
hamhock666 1 hours ago [-]
If you can find a way to use your own free will and self-discipline to stop the bad condition then that seems preferable to using a drug. Maybe someone doesn't have the willpower in which case it's good that we have the drug.
With regards to omeprazole, I changed my diet a bit and no longer needed the omeprazole. I don't know exactly what it was, but if you can get off of a drug because you don't need it anymore that seems ideal.
paulddraper 1 hours ago [-]
I mean…that’s just like depression medication.
It’s possible to ignore sadness as well as hunger.
hamhock666 1 hours ago [-]
There are usually ways to fix the problems in your life, like sadness and hunger, without resorting to using drugs. Maybe not everyone but it is something we should strive for.
dmayle 32 minutes ago [-]
The issue isn't food addiction, it's a broken hunger response (broken by Howard Moskowitz intentionally in the name of profits)...
You have to change your food regimen completely (higher fiber, more protein, less sugar, less carbs, less fat), and that's tough to do when you're surrounded by options that aren't...
I think the real problem is that the symptom we're trying to treat is "overweight", and it's actually a two-stage problem... Fix the hunger response... and only then work on fixing the weight... Fixinig the latter without fixing the former means you'll always gain the weight back, fixing the former doesn't guarantee you lose weight (and is only temporary, if you're using drugs for it)... You have to go after both problems.
basch 8 minutes ago [-]
We shouldn’t ignore grocery stores and marketing.
Aisles and aisles of sugar drinks and colorful sugar packaging.
The way society leaves it up to people to make their own decisions creates the problem at scale.
Society essentially has to take weekly injections to avoid the temptation of coca cola.
rfv6723 9 minutes ago [-]
The only underlying issue is an evolutionary mismatch: human evolution is too slow to keep pace with the modern abundance of food.
What we now call food addiction is exactly what kept our ancestors alive during famines.
PaulHoule 35 minutes ago [-]
It's not like anything else in terms of drugs, surgery, or lifestyle changes has been proven safe and effective. A person who is dependent on opiates or caffeine or cannabis can possibly live without those substances, you can't go "cold turkey" from food.
Funny I just shot myself with a Zepbound autoinjector for the first time! My primary care doc told me he thought I was a good candidate a year ago but that he had trouble getting insurance to pay for it, it took me a year to get in with a specialist, insurance approved it right away, and now I am supposed to keep a food an exercise log.
I am well in the obese BMI range but I've been active my whole life (e.g. I can't see how people can get through the day without going to the gym or something) so I have a high lean mass and don't look that fat with my clothes on. I've struggled for years with various conditions associated with "metabolic syndrome" and I'm on numerous maintenance medications already and may be able to delete some of them.
I am currently around 250 lbs which has been my usual for the past 20 years or so. Had some luck with Zone, ketogentic and bean plan diets but couldn't stay on any of them indefinitely. Got my weight down to about 208 lb in six months when I quit taking antidepressants at my doctor's suggestion (never went back), had something like a manic episode where I manifested an "evil twin" who was vain highly motivated [1] and worked out like... a maniac and I also discovered I had TMJ dysfunction and took load off my jaw by throwing comically random food (cashews, seaweed, celery, potatoes, carrots, pork, ...) into a pot and grinding it with an immersion blended. Not sustainable, not least because my evil twin's antics got me kicked out of the gym.
[1] as-a-fox one axiom is that "I never push on a string" and have a hierarchy of goals, non-goal goals and non-goals; my non-goal goals are his OKRs
flextheruler 4 hours ago [-]
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.
mukbangpervert 36 minutes ago [-]
What facts do you have that make you certain that the underlying issue is "food addiction" rather than, say, a difference in body chemistry that changes perceived hunger levels?
JumpCrisscross 3 hours ago [-]
> 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.
SOLAR_FIELDS 2 hours ago [-]
Statins are a well understood mechanism of action for controlling cholesterol. We generally understand that people with cholesterol problems leverage statin therapy to address those, and there is a well audited corpus of placebo controlled double blind trials that demonstrate the efficacy of the solution for statin therapy. If you discontinue the statins, you lose the benefit to some extent. How is this situation fundamentally different?
vidarh 4 hours ago [-]
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.
brazukadev 4 hours ago [-]
changing habits do have lasting effects, I'm not part of this "we" that doesn't know that.
topgrain2 4 hours ago [-]
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”.
yakz 4 hours ago [-]
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.
topgrain2 2 hours ago [-]
Even with extensive assistance (which is way too expensive to widely deploy) outcomes are weak.
Last I checked, researchers in the specific area of high-touch weight interventions were excited that they finally had a tool that might more-than-barely work… in glp-1 agonists.
yakz 2 hours ago [-]
I didn’t mean to suggest that GLP-1s don’t count as assistance.
Informing people that they can avoid pregnancy and STDs if they’d just stop fucking each other doesn’t work at scale either.
vidarh 4 hours ago [-]
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.
PeterHolzwarth 4 hours ago [-]
A couple years of reduced weight, and all the benefits that entails, doesn't sound bad.
SubiculumCode 4 hours ago [-]
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.
nihonde 3 hours ago [-]
The idea that appetites are assigned at birth is a bold claim. Is there evidence to support it?
9x39 3 hours ago [-]
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:
I think there is much stronger evidence that it is metabolic damage from overconsumption in an earlier stage in life.
Not unlike if you shatter your legs, your recovery may be long and incomplete.
SubiculumCode 2 hours ago [-]
Genetics and epigenetic factors.
LaurensBER 4 hours ago [-]
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.
coffeemug 4 hours ago [-]
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.
faangguyindia 54 minutes ago [-]
lifting weight isn't efficient for weight loss.
Without calorie deficit, you'll not lose much weight by lifting alone.
kolinko 4 hours ago [-]
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.
3stacks 4 hours ago [-]
It’s the food equivalent of declaring bankruptcy. If you don’t fix the behaviours you’ll just end up in debt again.
kolinko 4 hours ago [-]
This assumes underlying behaviours are core reason. Research (tein, adoption) suggests otherwise
yakz 4 hours ago [-]
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.
shadowpho 1 hours ago [-]
Practically speaking any person cannot maintain that for significant length of time.
Dieting has like a 99% fail rate by year 2.
It’s hard to maintain that for many people — your body will keep you in starvation mode, keep you hungry and hang on to every calorie received.
crooked-v 4 hours ago [-]
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.
joshuamcginnis 4 hours ago [-]
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.
mukbangpervert 27 minutes ago [-]
Joshua McGinnis -- if I were you, I would be more disciplined about the words that came out of my mouth.
m1keil 4 hours ago [-]
Why this has to be all or nothing?
You can use the drug to loose weight while trying to understand the underlying problem.
kolinko 4 hours ago [-]
“be more disciplined” - did you read any studies about the sources of obesity? Or do you struggle with weight since childhood yourself?
4 hours ago [-]
gedy 4 hours ago [-]
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.
anon291 4 hours ago [-]
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
fragmede 4 hours ago [-]
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.
aaron695 4 hours ago [-]
[dead]
storus 5 hours ago [-]
Metabolic theories of mental illnesses and cancer are seriously understudied.
hellzbellz123 5 hours ago [-]
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.
buck746 2 hours ago [-]
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.
declan_roberts 31 minutes ago [-]
It's not just anecdotes. Eli Lilly is actively in trials with a glp-1 peptide brenipatide for treatment for certain kinds of addictions, such as alcohol, smoking and opioid addictions.
zhivota 5 hours ago [-]
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.
tapoxi 4 hours ago [-]
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.)
zhivota 3 hours ago [-]
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.
rossdavidh 19 minutes ago [-]
Might be worth trying live yogurt in the meantime, per the article?
zhivota 11 minutes ago [-]
Yep one thing I did as part of going off tirzepatide was go immediately on a high fiber and fermented foods diet. It has helped a lot actually.
It's quite hard to maintain over time is all, I have a lot of social occasions where healthy choices are not really available, and from experience I know that over time I'll slowly drift back towards an unhealthy eating pattern. The modern world is just geared that way, unfortunately.
y-curious 5 hours ago [-]
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.
taurath 21 minutes ago [-]
It’s so funny, because they did well for you you’re now incredibly on board for all of society.
I tried them and my health got massively worse and I couldn’t eat at all, on a sub minimum dose.
SubiculumCode 2 hours ago [-]
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.
api 2 hours ago [-]
A central flaw in the Nobel is that it rewards one or two people for what is often the work of teams.
PeterHolzwarth 5 hours ago [-]
That's quite admirable to correct yourself in public. Good on ya.
nubg 4 hours ago [-]
Yes. I wonder if taking GLP-1 made him have higher morals as well!
SubiculumCode 2 hours ago [-]
its possible.
sph 4 hours ago [-]
Very weird (or funny?) to use statins as an example of a ‘good and effective’ drug.
incognito124 4 hours ago [-]
Why do you say that? My first exposure to statins was in https://myticker.com and they seem somewhat important
HedonicEscal8r 3 hours ago [-]
GLP-1s are far more effective than statins.
9x39 4 hours ago [-]
That says more about the harmful effects of obesity than anything.
PeterHolzwarth 15 minutes ago [-]
That's kind of the point.
4 hours ago [-]
devcatapult 4 hours ago [-]
What about the reports of bone density loss? Any downsides to this?
pitaj 34 minutes ago [-]
From what I've seen it's mostly related to just losing weight in general (less weight -> less musculoskeletal stress -> weaker bones and muscles). Weightlifting can counteract it.
kolinko 4 hours ago [-]
What reports?
OptionOfT 4 hours ago [-]
My insurance stopped covering, now I'm looking at $450 for Zepbound / month. Just the weight coming back is making me more depressed...
declan_roberts 28 minutes ago [-]
Gray market peptides are excellent. You can do you own independent lab testing, buy with a group who's testing, or buy from a reputable vendor who pre-tests before sales.
Even after all that it comes down to like $50 a month at the highest dose.
cjbgkagh 4 hours ago [-]
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.
declan_roberts 26 minutes ago [-]
GRAY market is way undercounted in peptide use. Go to the gym and there's like 25% of the people there taking gray market peptides (some for weight, some for injury repair, etc)
faangguyindia 1 hours ago [-]
Without long term positive dietary changes most people are unlikely to keep the weight off unless you want to take this stuff for life.
declan_roberts 27 minutes ago [-]
I have to exercise and go to the gym for life already?
jzkdroid2 4 hours ago [-]
You can probably use some coupons like goodrx to get it for $300 a month.
crooked-v 4 hours ago [-]
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.
buck746 2 hours ago [-]
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.
nonethewiser 4 hours ago [-]
Why shouldnt it?
SubiculumCode 2 hours ago [-]
And it surely did. Like clockwork. And it is annoying.
sp527 4 minutes ago [-]
A lot of people have had to accept that they've wasted a considerable amount of time and energy on something that is being heavily devalued by GLP-1's. They've also lost an important vector for status signaling. This particularly offends narcissists and the hyper-competitive.
They desperately need to restore status, and one easy option is, in effect, "oh you're still ugly on the inside."
By way of analogy, it has the same underlying motivation as the various sumptuary laws that arose in response to the mass-manufacture of silk.
> The Elizabethan Restrictions: In 1574, Queen Elizabeth I passed strict sumptuary laws to curb "unprecedented social mobility". The Crown decreed that no woman could wear silk cloaks unless her husband was at least a knight, and restricted fabrics mixed with gold or silver to Earls and above.
> Income Thresholds: In 14th-century England, if an esquire or merchant wanted to wear silk, they had to legally prove they made at least £100 a year. If they didn't meet the financial threshold, wearing the fabric was a criminal offense.
jbird99 5 hours ago [-]
Could be related to endorphins and BDNF, similar to the effect from fasting.
replwoacause 4 hours ago [-]
Hasn't done jack shit for my depression.
Also worth mentioning GLP1's are known to cause anhedonia. So there's that...
declan_roberts 19 minutes ago [-]
I can say the things I like, I like the same or even more (higher sex drive is one noted example). I can sit and program for hours now without thinking about other things. I assume this is what people who took Ritalin felt.
I do notice it makes it harder for me to get up and do certain harder, outdoor chores.
jfaat 54 minutes ago [-]
Known to who? I just did a quick search didn't see anything that like a scientist or physician said about this. Someone who describes himself as a 'biohacking educator' said it without citing sources though.
dyauspitr 4 hours ago [-]
What’s the downside to this magical drug. There has to be a downside…
declan_roberts 22 minutes ago [-]
Some downsides:
1. They make you stop eating, which for most of human history kills you.
2. They are a life-long treatment and kind of expensive unless you go gray market.
3. Gastrointestinal issues especially when titrating up.
pandaman 2 hours ago [-]
Even if there are zero effects other than the advertised weight reduction, one downside is obvious from the comments here - some people will stop exercising.
While exercise has many positive effects, which I'd argue are more important than the weight loss, the latter is the primary reason many people exercise and likely to stop when given the weight loss by other means.
subtlejellyfish 54 minutes ago [-]
We should stop telling people that exercise is a primary driver of weight loss.
That said, exercise has a direct impact on metabolic health which is pretty necessary to maintain a healthy weight.
cflewis 2 hours ago [-]
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.
ceejayoz 4 hours ago [-]
Why does there have to be a downside?
What was the downside of washing hands before surgery?
OscarCunningham 47 minutes ago [-]
One argument would be that Ozempic doesn't give your body any additional resources. It just triggers your body to behave in a different way. But if the changes it causes are universally good, why didn't evolution already make your body work that way?
I suppose the counterargument would be that modern life is different from the evolutionary environment, and so it's possible for a change to be beneficial now that wasn't beneficial then. But it would still be good to understand better the mechanism of the effect of Ozempic on things like addiction.
9x39 4 hours ago [-]
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.
> 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.
krackers 3 hours ago [-]
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 .
9x39 3 hours ago [-]
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:
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:
And downsides of penicilin? There are some but they are massively offset by not having alt consequences
culi 15 minutes ago [-]
There are massive downsides to any antibiotic. A single dose of a broad-spectrum antibiotic can permanently alter a kid's gut microbiome and make them more likely to develop a variety of mental health issues like depression
The downside is that they make you eat less thereby taking away one of the few things that make life worth living.
SubiculumCode 2 hours ago [-]
That is the silliest take ever. I am on GLP-1s, and I still enjoy my food..maybe more than ever before.
vladmk 5 hours ago [-]
Mice are not people, but interesting link
randycupertino 5 hours ago [-]
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.
meetingthrower 4 hours ago [-]
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.
replwoacause 4 hours ago [-]
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.
declan_roberts 17 minutes ago [-]
Did it still plateau on the highest dose?
replwoacause 12 minutes ago [-]
I’m at 7.5mg now so can’t speak to any doses higher than that. But I’m assuming each step up would reintroduce more appetite control and reduce food noise and then level back off a bit. Not saying the effects go to zero, just that they start off more pronounced.
SubiculumCode 2 hours ago [-]
Exactly my experience.
sandcat_ 5 hours ago [-]
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.)
SubiculumCode 2 hours ago [-]
First, I eat...but seem to get full fast. Its like before, my body would really delay sending me the "you're full now" signal while eating, but now it starts to come half way through my plate. But did I enjoy the food? Hell yeah. It might even taste better. And because I get full quicker, I eat slower so I can enjoy it more.
Outside of eating, I drink less, but do have occasional beers. I enjoy them.
And my relationships are not less fulfilling, and I don't find my life and work less interesting. All in all, the only thing I don't like is the occasional "egg" burps I get from it.
vidarh 4 hours ago [-]
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.
randycupertino 3 hours ago [-]
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.
habinero 4 hours ago [-]
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.
rubicon33 5 hours ago [-]
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?
randycupertino 3 hours ago [-]
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.
tsol 3 hours ago [-]
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
rubicon33 2 hours ago [-]
Interesting point… and I suppose for the most part, I agree. A rare case of a mostly free lunch.
bawolff 5 hours ago [-]
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.
kolinko 4 hours ago [-]
The point of modern mefivine is that we have drugs that have benefits that outweigh risks and downsides.
api 2 hours ago [-]
Why is this a hard rule?
I know people who have had miraculous benefits from psych meds. No downside. Using them for years. Or if there is a downside it’s massively outweighed by the upside.
crooked-v 4 hours ago [-]
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.
cyberax 3 hours ago [-]
> 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.
metalman 4 hours ago [-]
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.
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.
What does it mean? If a drug reduces your desire to eat food, wouldn't it also decrease your desire to eat food beneficial for your body?
I think the effect most people want is to stop craving junk food but still eat nutritious food required for muscle growth and health.
I've heard it widely described as reducing mental noise around food.
Night and day, stopped always being hungry... I've tried Noom before (eating highly filling, low calorie foods, but filling, not satiating), but that only worked while I was tracking (and always forcing myself to keep it up)...
Losing weight required work on top of that, but the protein just made my hunger response start working properly again.
People talk a lot about meat, but not enough about dairy. My prayers were answered at the altars of feta, greek yogurt, half and half, butter, cottage cheese, etc. They made salads not suck. They opened up a ton of lower carb dessert options. My gut health improved. All of my health improved.
I no longer treat these humble foods as optional extras. They perfectly fill the gap in my daily protein needs. They were never unwelcome, just forgotten.
So where does the energy burn in a sedentary population come from vs highly active Hadza tribe members?
Pontzer’s research showed that while the Hadza were highly active, they actually demonstrated lower baselines of certain markers of metabolic and physiological stress over time compared to Western populations.
Don't quote me on this; I am paraphrasing things I remember from.
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.
Not understanding calorie balance, not understanding calorie density of the food they eat.
How many people know 1kg fat = 7700kcal that if they could create deficit of 7700kcal they could potentially lose 1kg bodyfat? Ofc, i know the relationship isn't that simple but for most people this roughly holds true.
If you are eating granolas in breakfast, it may come across as a shock how many calories they pack, go ahead look it up many people believe that's a low calorie health breakfast option.
Many people don't know
1g of carb or protein = 4kcal
1g of fats = 9kcal.
I think I'm not the ignorant one.
>I've been on a diet since I was 12 years old, and am now approaching 50. I've lost and regained the same 60lbs about 4 times now
You can lose weight by crash dieting, which does not prove much. The first thing that comes to mind for people is simply: "I'll just eat very little and lose weight." It even works, but people quickly get results; it makes them miserable, and they gain it back.
People get stuck between "eating too little" and "binge eating".
>I have logged every bite that goes into my mouth, and lived with a constant hunger for as long as I could take it
This proves you are sincere in calorie tracking, but it doesn't tell us much about what kind of deficit you were in. What were your maintenance calories, and how did you calculate them?
What kind of deficit did you run over what time period?
In my experience, while people know all these things, execution still requires knowing all the "gotchas".
Going from 2700kcal calories to 1000kcal a day diet will make anyone hungry and miserable.
That's a semantic argument. The "issue", medically, to most people viewing this as a health problem, is excess body fat and not eating behavior.
I mean, you're not wrong, but this seems silly. YES, it would be better to have developed a cure for disordered and unrestrained eating. We didn't. And we don't really even know how. Oops, as it were. But we do have a treatment that avoids the most significant impacts of those problems.
Medicine is harder than software engineering. Not all bugs are shallow even with all the eyes in the world.
We have decades of research showing this is more in the "excess acid production" realm of things.
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.
Plus, cars and all "comforts" eating into your physical activities?
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.
The timing is just about right to blame it on Reagan, either the theory that neoliberalism leads to "structured stress" or than some environmental chemical got approved in that time frame.
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?"
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.
GLP-1s have been used widely for 20+ years now.
I don't get this weird thing people do where they act like their bodies don't follow the laws of conservation of energy.
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.
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.
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.
More importantly: I don’t want to eat less. I want to eat more. There is so much amazing food.
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.
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.
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.
So I'm not sure your first sentence is universally accurate.
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.
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 was able to drink an Italian soda this week and not feel like "oh God I'm drinking my calories I'm going to be punished for this on the scales later".
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!
Woe is them I guess for their chemical dependence.
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".
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.
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.
The average person does not understand how weight loss works; many people do not know the concept of maintenance calories, and don't know how calorie surplus or deficit works.
Simply putting them on drugs for life isn't a solution. The average person does not have metabolic syndrome, yet the average person is increasingly becoming obese or perhaps already is obese in many countries.
Plenty of people are on drugs for life for a variety of things that have less health impact than being overweight.
That said, 2026 US GLP-1 healthcare sales projections run between 60 and 100 billion [1]. it will be interesting to see if these miricle drugs can really provide that much benefit/offset that much cost.
For comparison, Medicare part D is ~150 billion in its entirety. https://evolvancemarketresearch.com/reports/glp-1-weight-los...
The payment part is almost entirely pushing against GLP-1 agonists. Nobody has a long-term financial stake in patient costs to care that lifetime costs will likely be lower; insurers are just looking at the next couple years against expected churn. Another cost of tying health insurance to employment.
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?
Why we should not care about putting people on drug who do can benefit from making lifestyle changes, being less sedentary and leaning about maintenance calories and how calorie surplus and deficit works?
if there is no resistance, simply prescribing GLPs to average person may become a new normal.
With regards to omeprazole, I changed my diet a bit and no longer needed the omeprazole. I don't know exactly what it was, but if you can get off of a drug because you don't need it anymore that seems ideal.
It’s possible to ignore sadness as well as hunger.
You have to change your food regimen completely (higher fiber, more protein, less sugar, less carbs, less fat), and that's tough to do when you're surrounded by options that aren't...
I think the real problem is that the symptom we're trying to treat is "overweight", and it's actually a two-stage problem... Fix the hunger response... and only then work on fixing the weight... Fixinig the latter without fixing the former means you'll always gain the weight back, fixing the former doesn't guarantee you lose weight (and is only temporary, if you're using drugs for it)... You have to go after both problems.
Aisles and aisles of sugar drinks and colorful sugar packaging.
The way society leaves it up to people to make their own decisions creates the problem at scale.
Society essentially has to take weekly injections to avoid the temptation of coca cola.
What we now call food addiction is exactly what kept our ancestors alive during famines.
Funny I just shot myself with a Zepbound autoinjector for the first time! My primary care doc told me he thought I was a good candidate a year ago but that he had trouble getting insurance to pay for it, it took me a year to get in with a specialist, insurance approved it right away, and now I am supposed to keep a food an exercise log.
I am well in the obese BMI range but I've been active my whole life (e.g. I can't see how people can get through the day without going to the gym or something) so I have a high lean mass and don't look that fat with my clothes on. I've struggled for years with various conditions associated with "metabolic syndrome" and I'm on numerous maintenance medications already and may be able to delete some of them.
I am currently around 250 lbs which has been my usual for the past 20 years or so. Had some luck with Zone, ketogentic and bean plan diets but couldn't stay on any of them indefinitely. Got my weight down to about 208 lb in six months when I quit taking antidepressants at my doctor's suggestion (never went back), had something like a manic episode where I manifested an "evil twin" who was vain highly motivated [1] and worked out like... a maniac and I also discovered I had TMJ dysfunction and took load off my jaw by throwing comically random food (cashews, seaweed, celery, potatoes, carrots, pork, ...) into a pot and grinding it with an immersion blended. Not sustainable, not least because my evil twin's antics got me kicked out of the gym.
[1] as-a-fox one axiom is that "I never push on a string" and have a hierarchy of goals, non-goal goals and non-goals; my non-goal goals are his OKRs
Source? I thought it was 2/3rds of the weight regained, which is still a substantial long-term loss.
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”.
Last I checked, researchers in the specific area of high-touch weight interventions were excited that they finally had a tool that might more-than-barely work… in glp-1 agonists.
Informing people that they can avoid pregnancy and STDs if they’d just stop fucking each other doesn’t work at scale either.
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.
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.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3052625/
Not unlike if you shatter your legs, your recovery may be long and incomplete.
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.
Without calorie deficit, you'll not lose much weight by lifting alone.
You can use the drug to loose weight while trying to understand the underlying problem.
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.
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.
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.
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.
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.)
It's quite hard to maintain over time is all, I have a lot of social occasions where healthy choices are not really available, and from experience I know that over time I'll slowly drift back towards an unhealthy eating pattern. The modern world is just geared that way, unfortunately.
I tried them and my health got massively worse and I couldn’t eat at all, on a sub minimum dose.
Even after all that it comes down to like $50 a month at the highest dose.
They desperately need to restore status, and one easy option is, in effect, "oh you're still ugly on the inside."
By way of analogy, it has the same underlying motivation as the various sumptuary laws that arose in response to the mass-manufacture of silk.
> The Elizabethan Restrictions: In 1574, Queen Elizabeth I passed strict sumptuary laws to curb "unprecedented social mobility". The Crown decreed that no woman could wear silk cloaks unless her husband was at least a knight, and restricted fabrics mixed with gold or silver to Earls and above.
> Income Thresholds: In 14th-century England, if an esquire or merchant wanted to wear silk, they had to legally prove they made at least £100 a year. If they didn't meet the financial threshold, wearing the fabric was a criminal offense.
Also worth mentioning GLP1's are known to cause anhedonia. So there's that...
I do notice it makes it harder for me to get up and do certain harder, outdoor chores.
1. They make you stop eating, which for most of human history kills you.
2. They are a life-long treatment and kind of expensive unless you go gray market.
3. Gastrointestinal issues especially when titrating up.
While exercise has many positive effects, which I'd argue are more important than the weight loss, the latter is the primary reason many people exercise and likely to stop when given the weight loss by other means.
That said, exercise has a direct impact on metabolic health which is pretty necessary to maintain a healthy weight.
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.
What was the downside of washing hands before surgery?
I suppose the counterargument would be that modern life is different from the evolutionary environment, and so it's possible for a change to be beneficial now that wasn't beneficial then. But it would still be good to understand better the mechanism of the effect of Ozempic on things like addiction.
Typically, if something "works", there often appear to be side effects. A free lunch is rare.
https://www.uclahealth.org/news/article/understanding-medica...
Unless it’s literally a deficit. There isn’t a downside to treating vitamin C deficiency with vitamin C.
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 .
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
https://theconversation.com/how-childhood-infections-requiri...
https://www.scientificamerican.com/article/a-single-course-o...
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.
(Never tried them myself, but very intrigued by them.)
Outside of eating, I drink less, but do have occasional beers. I enjoy them.
And my relationships are not less fulfilling, and I don't find my life and work less interesting. All in all, the only thing I don't like is the occasional "egg" burps I get from it.
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.
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.
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.
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.
I know people who have had miraculous benefits from psych meds. No downside. Using them for years. Or if there is a downside it’s massively outweighed by the upside.
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.