For a start, it does not appear to be psychoactive to any large degree, which is a huge difference. Of course there will be psychological effects from anything that changes your weight or lifestyle rapidly, but that's not the same as being psychoactive.
I think the largest issue will be sorting out the genuine side effects of the drug from the side effects that would happen from any major change in lifestyle/weight.
Here's the list of side effects from wikipedia:
> Possible side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion/heartburn, dizziness, abdominal distension, belching, hypoglycemia (low blood glucose) in patients with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease (GERD).[26] It can also cause pancreatitis, gastroparesis, and bowel obstruction.[27]
https://en.wikipedia.org/wiki/Semaglutide
How many of the things in that list would you say a person who undergoes massive weight loss in short time without drugs would experience? Or massive changes in the amount and type of food that they eat? Especially if they also have complications with diabetes or pre-diabetes.
And also, how do these compare to the inevitable health problems that long term obesity will cause the same person if they don't take the drug?
These questions will not be easy question to answer. I expect to see a lot of arguments from both sides in the coming years.
Did you know that being in the BMI “overweight” category is healthier than any other category, including “healthy” and “underweight”?
https://www.sciencealert.com/the-healthiest-weight-might-act...
Now you might say well that’s interesting but i was talking about obese people taking this drug.
“The study also found that those in the 'obese' category ended up having the same risk of death as those in the 'normal' range, even when factors such as age, sex, family history of disease, socio-economic status, and smoking were taken into account.”
So there are plenty of justifications and reasons to take a drug like this - some good, some bad - but hand waving at the obvious dangers of being overweight or obese doesn’t hold up as well as you might think.
I think we don't believe this anymore? I am linking to some Hacker News discussions as this is the only website I use (lol).
https://news.ycombinator.com/item?id=34930641
https://news.ycombinator.com/item?id=35121904
> Key Takeaways:
> Epidemiology researchers repeatedly have found that being overweight or obese is not as much of a mortality risk as conventional wisdom would suggest.
> Critics have contended that this "obesity paradox" is the result of poor methods. Using body-mass index (BMI) to measure obesity is likely the most problematic factor.
> Recent research that adjusts for the flaws inherent in BMI show that there is no paradox. The more body fat a person has, the more likely it is that they will die.
The study that you link to that suggests this makes absolutely zero attempts to control for wealth. I don’t think I need to take a health study in the USA seriously if it doesn’t consider the potential for wealth (access to healthcare, leisure time, poverty stress, etc) to be the cause of what it’s seeing.
All large scale observational studies are subject so such biases, and the one you linked to also seems a likely suspect there. The hidden confounders are pretty much infinite. The users of many of the worst of sorts of drugs, such as heroine and amphetamines, tend to be average to lower weight. They will die disproportionately young, which will drag their weight cohort substantially down. Another could be increases in things like body building, which show increases in BMI without the corresponding increase in body fat that it's supposed to represent.
I'm not saying any of these are the silver bullet, but rather that when you see a big observational study like this, that sort of skepticism should be the first thing to enter into your mind, as it's extremely often the case when you read about a [shocking discovery] based on big observational studies. Correlation is not causation, even with really big population sizes.
> The users of many of the worst of sorts of drugs, such as heroine and amphetamines, tend to be average to lower weight. They will die disproportionately young, which will drag their weight cohort substantially down.
Right so this study was skewed by meth use, something that there’s a good chance they controlled for at least where they could, but other studies couldn’t possibly be skewed by drugs that cause weight gain and shorten lifespan.
My takeaway from this and similar studies is that body fat (especially as categorized by BMI) is mostly orthogonal to health. It’s possible to be fat + healthy, fat + unhealthy, slim + healthy, and slim and unhealthy.
And if that’s the case, burdening fat people with my own assumptions about their health is misguided, and dumb.
And most often that answer is eventually found to be that [shocking discovery] was just reporting on a false correlation, driven by a confounding variable. It's the exact same here. There are countless extremely negative factors that being overweight weighs strongly into, yet somehow being overweight is good for life expectancy? There needs to be an explanation for why and, absent some revolutionary new discovery, by far the most likely explanation is a confounding variable.
[1] - https://jamanetwork.com/journals/jama/fullarticle/2520627
But the overarching point is: why is your default that fat is unhealthy and you must have bulletproof data to believe otherwise? My default is i don’t know one way or the other and I think health is probably way more complex than what % body fat you have and I don’t understand why so many people are determined to use it as a proxy for health.
Very good things do happen in this field!
This led to a dramatic drop in drug use. Big Pharma, in the quest to restoe its profits, pivoted to children.
Child fidgety? Can't pay attention? ADDERALL!
The episode is based on the author's first-person experience. I won't spoil the big reveal.
At least it was a step up 1940s ads:
Child fidgety? Can't pay attention? LOBOTOMY![0] https://www.reuters.com/investigates/special-report/health-o...