Hacker News Reader

Comment by standardUser | Hacker News Reader

The first days, weeks and months are often the hardest time when quitting a substance. If this drug helps a smoker not smoke for 3 months, by that time the nicotine addiction has weakened considerably. They've gotten past the hardest part. I see no downside to that.

Similarly, if a person loses 30 pounds on this drug, then stops using the drug and reverts to normal habits, it will take a while to regain those 30 pounds. And the long term shift of maintaining the new body weight doesn't require any radical changes (unlike losing 30 pounds, which does require sustained radical changes).

View on HN

That is not what happened to me. I took it for 2 months and then I wanted to get off. I did not go back to normal. Mentally I felt like I needed more food and more junk food than I ever did before using the drug.

My hypothesis is that it supressed my body's natural production of whatever chemical in my brain helps me not go overboard with food. With that supressed by the drug I had an uncontrollable desire for food and currently I am fatter than I was before taking the drug in the first place.

An interaction with leptin? Or are you just feeling hungry after the side effects wore off?

You also said it stopped working while you were taking it in another post; are you just talking about satiety or one of the other effects like insulin production or glucagon release? Are you diabetic or just overweight?

This same thing happened to me when I quit smoking without assistance from a drug.

Did you quit cold turkey? Or did you slowly taper it off?

I'm taking Rybelsus (pill form of semaglutide) and there are 3, 7 and 14 mg versions. My plan is to take 14 mg for a couple more months, then switch to 7 mg for 1-2 months and then 3 mg for a month before stopping taking it completely.

> Mentally I felt like I needed more food and more junk food than I ever did before using the drug

This is consistent with hungry brain hypothesis. Your hypothalamus detects that you have less body fat than amount set on "lipostat" and it tries to get fat content back to this set amount.

This is what I thought as well, that the habits that drive some of these activities would be dramatically weakened, but it looks like the body is not actually re-aligning to a new homeostatis level, so when a person gets off the drug, the body is trying to get back to the old level. I don't think it all comes back to habits, often your body is working really hard against you to get back a level it feels is right(whether that level is 'healthy' or not).

> The first days, weeks and months are often the hardest time when quitting a substance. If this drug helps a smoker not smoke for 3 months, by that time the nicotine addiction has weakened considerably.

I love(d) nicotine and it was the only substance that I ever was addicted to. I tried dozens of times to quit and the only thing that helped was getting treatment for my ADHD. Quitting nicotine was easy for me on methylphenidate. I only tried combining them and nearly went to the ER, so I quickly learnt that I can't take them both. But when I'm on methylphenidate I just don't crave nicotine that much. It took 2-3 years to completely not get any nicotine cravings at all.

>I only tried combining them and nearly went to the ER

Could you elaborate on that? I'm currently still a smoker (working on it...) and on Concerta. Your note alarms me :)

Not the person you're replying to, but what helped me quit was the book "How to stop smoking" by Alan Carr. Highly recommend working through it and taking his point about cold turkey in good faith. Good luck!

I have a fun experience with the Alan Carr book. The first time I read it, I was laughing the whole way through thinking about how much it was written like straight-up brainwashing propaganda, but I had committed to a friend to reading it all the way through. I got to the end where the final bit is something like "now just say out loud 'I am a non-smoker and when I wake up tomorrow I will never have a cigarette again'". I chuckled, thought it was ridiculous, and the next morning I woke up and didn't have a smoke. That lasted about 2 years until I got extremely drunk one night after a rough breakup, had smoked the whole night, and was pretty much instantly hooked again.

Ten years later I went through the exercise again, but sadly it didn't work nearly as well as it had the first time around.

One thing that kind of opened my eyes is his asking the reader "what do you prefer about your cigarette brand?" It made me realize that they all taste like sh*t.

Makes sense given the mechanism of action.

I describe my adhd as being addicted to nicotine and stopping cold turkey. Except you're not addicted to nicotine, what you're addicted to is a stimulus that is inconsistent and changes constantly. Your cigarette is a constantly changing thing.

Methylphenidate really messed me up, I found Lisdexamfetamine much much more effective.

I still use nicotine, though in vape form these days.

Nicotine physical addiction is over with in less than a week. The remainder is psychological habit and classical conditioning.

In my experience, different drugs have different effects on different people, sometimes radically so, and overly-generalizing is less than useless when trying to learn and understand how drugs work, both on an individual level and a societal level.

Reply on news.ycombinator.com