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Comment by cjbgkagh | Hacker News Reader

I think modern diets are quite damaging, even stereotypically 'healthy diets' that don't incorporate regular fasting. I've tried low doses of semaglutide and the effect to me feels very similar to fasting without the strong hunger cravings.

I know people are worried about the 'something for nothing' aspect of the medication and wonder what the cost is, but it's entirely possible, and I think probable, that the mechanism for action is reversing some of the damage of modern diets. I also think it's important to use semaglutide as a fasting aid and not as a cure all that would enable continuations of bad habits.

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Were you on Rybelsus? I think that one has one of the biggest potentials to be really widespread in use. It's a low dosage (which looks high just because you lose so much of it in your body) -- pills are easy to take.

The costs are very well known (about as well known as ever for any pharmacological weight loss option) -- GLP1 RAs don't work for everyone, and they cause gastro-intestinal issues and can have other complications.

They're actually quite amazing (well I might be biased, I spend a lot of time looking them up).

I buy the semaglutide as a research peptide and manage my own dosing based on symptoms and ended up at 0.25mg per week which is a low dose but also makes it very cheap. I appear to be much more sensitive than most and I consider it a very strong drug. I was researching it for personal use before the ozempic craze but it was hard to get dosing and safety data - additionally if I had worrisome complications it would be hard to find a doctor that understood the medication. Now those issues have been fixed. I think more people would benefit from much lower doses for longer - alongside diet and lifestyle changes. Chronic GI issues are definitely something that should be avoided and I think lower dosing helps with that.

I think this is one of the reasons that Rybelsus will do really well. It ends up being quite a low dose because of how much of it is lost in the ingestion process, but a pill is certainly much easier.

> Chronic GI issues are definitely something that should be avoided and I think lower dosing helps with that.

This simple/obvious take is really quite often left out of the common objections to the drug on side-effect grounds. I wasn't sure it was necessarily true but it certainly makes intuitive sense -- if you're having a strong reaction, take a lower dose and plan your weight loss around that.

Yeah, quite a lot is lost via oral, I do worry with the dosing being uncertain with different stomach conditions resulting in different effective doses. Due to the cost savings I'll stick with injecting but totally understand that most people are adverse to that.

Permanent gastroparesis is nightmare fuel and I worry about people assuming ozempic a safe drug and being cavalier with the higher doses. There is a risk/trust dynamic between doctors and patients where doctors want to keep doses on the 'known path' and patients trust their doctors a bit too much.

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