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Comment by boloust | Hacker News Reader

Semaglutide is a new drug that results in ~20% weight loss. Previously, only surgery could accomplish that kind of reduction in a single intervention.

It's going to be an absolute revolution in the fight against obesity.

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Speaking as a T2 diabetic that relies on Semaglutide, I'm really pissed that doctors are prescribing it "off label" for weight loss to the point that it is becoming difficult to get for its primary use.

Have you tried nutritional ketosis to reduce your need for medication?

https://www.virtahealth.com/reversediabetes

There is a form of semaglutide that is not off-label for weight loss called Wegovy.

A person in my direct environment has been on that (Ozempic) for 2 years. While at first the results were very decent, longer term (> 9 months) things seemed to reverse. Now, about 2 years in, weight-wise things seem back to the original starting position.

Unfortunately, there literally does not seem to be a free lunch.

Unfortunately I'm confident that the FDA will make it hard enough to prescribe (need to get it through a GP, only after you've tried diet and exercise, only for a limited duration) that it's only ever used by a tiny fraction of the target population.

thats fucked up. they should just prescribe it to anyone.

Medication doesn't work like potions in a role playing game, there are usually side effects.

Fewer and less severe than obesity, in the case of semaglutide.

Enough weed turns you into some version of a deadbeat. Alcohol has a hangover and a lot is bad for your liver. Most nicotine delivery mechanisms are expensive and really bad for you. Caffeine creates a dependency.

If people are ok with the tradeoffs they should be able to go for it. It's not like this is back alley drug dealing. If people are getting these drugs from their GP or over the counter then they can be informed.

"It's not like this is back alley drug dealing."

Honestly, I feel the more you delve into the pharma business, the less it seems to differ from back alley drug dealing, apart from the marketing & lobbying budgets.

The three-party (patient, doctor, drug company) drug selling relationship is fraught with a lot of conflicts of interest that two-party relationships (buyer and seller) are not, unless you have a really good doctor. Too bad there is no way to find them!

There's heaps of ways. For a starter, don't live in a country where doctors can get kickbacks.

No, the way it works is they don't prescribe to people that need it. Meanwhile, the weekend party people can get whatever they want.

Easy not to look like you're drug seeking when you don't actually need the meds.

Do you have actual evidence that doctors are refusing to prescribe? Usually they're only concerned with drug seeking in the case of controlled substances.

I was talking about controlled substances, but the principle is the same, except in the authors example, doctors hesitate to prescribe because of off-label interest.

The principle isn't even remotely the same. Most physicians won't hesitate to prescribe.

The principle is exactly the same. Physicians missprescribe med, and society follows up by under-prescribing meds.

This is the principle I as talking about and it lines up just fine. The difference is that you're saying it's different "because controlled substances". Yes this is a difference, but as far as I'm concerned this is simply arbitrary, as it's a different authority making decrees (vs. doctors just deciding on their own)

I'm talking about the policy as a whole. I'm not interested in asking the various stakeholders why, only to have them point fingers at each other.

You're just making up nonsense. There is no such policy.

No, I'm not. You aren't reading my comments. Policy as a whole encompasses the way Doctors prescribe meds, generally. People are routinely cut off from medication for bogus reasons by clueless doctors.

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