GLP-1 pills are coming, and they could revolutionize weight-loss treatment
cnn.com
cnn.com
Anyway. Food cravings gone, I was eating like 10 times a day before that. At least, but sometimes even more. Now I'm on intermittent fasting/OMAD and has 0 problems. No hunger, no cravings. Feeling significantly better.
Lost 43 pounds so far (rougly 3 pounds per week)
Personally, I’ve had success with intermittent fasting and HGH therapy. I started HGH treatment due to a deficiency, and it’s made a huge difference for me, especially in terms of energy levels, recovery, and muscle tone. Combining fasting with HGH therapy has really helped me stay on track with my fitness goals, and I feel much more in control of my body and my health.
If you're curious about how hormones like growth hormone and testosterone compare and impact your health, you might find this link helpful: https://medzone.clinic/growth-hormone-vs-testosterone-the-di...
Bupropion acts as a norepinephrine–dopamine reuptake inhibitor. Importantly it doesn't directly raise your serotonin. If you are a night owl, have trouble falling asleep etc you might have low serotonin to start and this could be bad for you.
Both of these are associated with suicidal thoughts. There is a reason HIMS requires your health info before suggesting drugs. I would flag the parent as providing dangerous information.
I don't know how to feel about the idea that we need treatment for being overweight in general.
https://recursiveadaptation.com/p/the-growing-scientific-cas...
> The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,' - Dr. Gitanjali Srivastava, Vanderbilt Medical Center
GLP-1s allow us to poke at the human to see what happens. Gene therapy will, hopefully, allow us to implement a permanent fix vs a hotfix (once the risk profile of such a genetic modification is better understood).
Engineer for the way the world is, not the way we wish it was. From your comments, you appear to operate under the belief that people can free will their way to success ("The better option seems to be face the appetite head on rather than putting it on a temporal cage"). That is not what the evidence shows, and I wouldn't ask anyone with a brain chemistry imbalance or dysfunction to attempt to will the condition away when proven interventions are readily and inexpensively available.
TLDR We are improving agency in humans using bioengineering, broadly speaking.
https://www.who.int/news-room/fact-sheets/detail/obesity-and...
https://www.cdc.gov/obesity/php/data-research/adult-obesity-...
You seem to imply that people have no self-control and are unable to power through difficulties. Because this is what is all about at the end of the day: self-control, one of the main things that separate us from the rest of the animal kingdom. It is the ability to regulate one's emotions, behaviors, and impulses in the face of temptations and urges.
What your parents taught you, your teachers taught you all those years during compulsory education lies on a solid foundation of self-control. Civilisation as we know is built upon it. Depends on it.
Yet your language implies that this is not the case. That humans are effectively, like toddlers, unable to use their self regulating powers to reign upon their emotions for the sake of a much better outcome in the long term. Fully unable to choose healthier foods or foods with lower calories. Fully unable to engage in free physical activities such as walking, jogging or running.
Truly makes you wonder how civilisations exist at all.
The idea that you can improve an individual's agency by having to temporarily disable a part of their brain is nonsensical. Surely, you can temporarily improve a specific decision making outcome (do I eat now?) by doing this. But you are not improving their agency anymore than you can by putting a gun on their head. In both cases, there is an external force temporarily suppressing a part of their normal decision making so they decide not to eat.
The underlying problem: lack of self-control is still there. You just tackled a symptom. There are others (deciding not to engage in physical activity for example).
A better solution would tackle the lack of self-control rather than some of the symptom. There is already some research on this area and some potential suggestions that if further investigated could help provide a better solution. But unfortunately, the solutions are virtually free and don't involve a lifetime subscription (could very well end up like diabetes medication which is arguably more critical for affected people yet with companies endlessly increasing the patents Disney style) to a drug.
They're absolutely not free. They fail at a high rate, which incurs medical costs. And when they work, they require--in practice--a lot of follow-up and coaching.
It's fairy-tale level mindblowing that we can look at the status quo where nearly half of the industrialised world is obese and get haughty about a drug that medically, demonstrably improves patient outcomes.
It's fairy-tale level mindblowing that we can look at the status quo where nearly half of the industrialised world is obese and get haughty about a free method (see physical exercise) that medically, demonstrably improves patient outcomes with no negative side effects.
That drug is the medical equivalent of a goldberg machine.
Exercising your willpower will have more benefits than physical exercise alone: mental health, cardiovascular and strength fitness and you could go on. And it is free. No big farma making money from you
Are you serious? How is "taking time" meaning that is not free? And you can't possible use that as a side effect. Brain fog is not even a common side effect. In fact, doing exercise is actually one of the recommended ways to tackle brain fog.
No no no. Obesity is very high in the US, but it's a big problem for lots of the world. It's a hard one to compare because different places use different cut-offs, but bringing this back to the UK: "64.0% of adults aged 18 years and over in England were estimated to be overweight or living with obesity [of which 40% are obese]"[0].
0: https://www.gov.uk/government/statistics/update-to-the-obesi...
I suppose, but that assumes you are viewing them as temporary weight loss interventions rather than lifestyle.
The key is to want to be healthy, and to arrive at a sustainable balance of nutrition and exercise level that works for you to stay at a healthy weight. Fad diets where you are denying yourself pleasures, or going hungry are not sustainable, nor is any extreme exercise regime that you find unpleasant or does not comfortably fit in with your routine.
slide 5: https://www.fractyl.com/wp-content/uploads/2024/10/DGVS-2024...
> You can take it indefinitely, but you must take it indefinitely in order for it to keep its effectiveness because the body isn't producing enough of the hormone.
I don't think we consider this (weight gain due to overeating) to be a GLP-1 deficiency, although I'd be interested to see research on that.
No negative long term effects have been observed in humans yet, but some animals in trials were at a higher risk of cancer.
We haven't observed any evidence that the addiction-suppression effect reduces over time yet. However, we haven't been studying that effect for very long.
It's more accurate to say that if you're depending on the appetite suppression to eat a sustainable amount of calories, you will begin to gain weight again after stopping the drug.
It's possible to use a GLP-1 agonist to lose weight and then keep it off with a proper diet. I took tirzepatide (Mounjaro) for 6 months, lost ~45 lbs., and have not gained any back after stopping the drug in July.
Notably a wide array of food either make them sick to their stomach or have colon related issues (diarrhea or constipation).
I suspect i do observe reward changes as well, but especially in the first few weeks it felt like i was observing weight loss strictly because they struggled to eat so much food without getting sick. So many of the foods they still wanted would just make them sick immediately or hours later.
I think they read that much of this is temporary to the ramp-up time, though. So hopefully in ~6 months they'll be on the full dose and won't have so many nausea/diarrhea issues.
Can you name some of the foods? Never been on GLP-1 drugs. But a good amount of fast food leaves me feeling lethargic and, if I eat it too quickly, nauseated afterwards.
On top of that, fatty meals, larger meals, and iirc fast carb heavy meals would all cause either nausea or diarrhea. Interestingly their mother is on the identical same generic GLP-1 shot, and has mostly the same side effects. It's kinda difficult to enumerate all the foods that went poorly, and it doesn't always feel logical. We eat a lot (entirely?) home cooked meals, so it's not like i'm even talking fast food here.
Off the top of my head a lot of dark green vegs have been working well. Brassicas and the like.
I should note that they're still quite happy on the drug. They still eat normally enough that it's not like they're only eating broccoli or something. We just have to plan meals very purposefully. It's also a lot of trial and error to find the subset that works.
It's worth pointing out that it's a minority of people who get any side-effects. I felt weird the first few days, but after that I only got myself into trouble if I'd forgotten to eat all day and then was faced with a hyper-satiating food with no natural portions -- an on-table buffet, someone placing endless bowls of chips and dips in front of me at a party, etc.
Before I started taking mine, I had to spend a whole month living the diet I'd be on (I lost 10lbs just with that diet change alone) to prepare. Lots of water, lots more fiber. Avoiding certain foods.
When I started taking the meds, my weight started to drop further and it was a minimal change to eat smaller portions (I felt full earlier). No side effects at starting dose.
Usually the 2nd/3rd tier of dose increases are where people get worse symptoms so your SO may be in for a more difficult time.
Some people don't tolerate the meds. Hopefully your SO is giving feedback to the doctor to course correct.
That's not really my experience. For myself, and the ten or so people I've persuaded to start taking them, nobody has really done much different other than listening to their body. I'd strongly encourage people to count calories to make sure they're eating enough, but I'd strongly encourage that of anyone who can't trust the hunger signals their body is throwing out in either direction.
Problem is i don't know what we could have predicted. The only thing the doctor predicted was the protein, which we did prepare on.
The other things have largely been a surprise and most importantly erratic.
> Usually the 2nd/3rd tier of dose increases are where people get worse symptoms so your SO may be in for a more difficult time.
I believe they're on the 3rd tier atm and the symptoms are lessening, though it's difficult to say if it's that or our successful adjustments.
And yea the doctor is aware - both my SO and their parent had doctors that planned to only increase tiers when they get reduced symptoms. So the doctor was planning for it at least, even if we weren't prepared on the specific foods they'd have issues with.
I see this said all the time about GLP-1 agonists, and it's a mischaracterization. It is true that when you stop taking the drug, your appetite is no longer suppressed, but you can still keep the weight off by eating a sustainable amount of calories.
Usually, the biggest challenge with weight loss is sticking with it, since it's normally miserable and takes a very long time. Taking a GLP-1 agonist speeds the process and makes it much more tolerable. I lost ~45 lbs. (~205 to ~160) in 6 months by taking tirzepatide (Mounjaro), and if I had done it without the drug it would have taken at least twice as long and been much more difficult.
This was always true and we know this is not the reason why people are overweight
I'm perfectly capable of maintaining my weight at ~160 lbs, but losing a large amount of weight to get there was difficult enough that I didn't try. A friend did pretty much everything to lose weight after she had children but couldn't, went on GLP-1 agonist for a few months, lost it all and kept it off since.
People always lament that, like most drugs, the effects of a GLP-1 agonist stop when you stop taking it. What I'm saying is it doesn't necessarily matter. Some people will need continued support, some won't. Taking the drug isn't a "life sentence" and you aren't guaranteed to re-gain the weight after you stop.
Notably it also slows digestion though, so you feel full earlier and for longer.
Semaglutide is a GLP-1 agonist only. Retratutide is a newer drug that is triple-action.
Generally on these drugs the action does not induce more "calorie burning", they are used mostly to modulate caloric intake.
>I don't know how to feel about the idea that we need treatment for being overweight in general.
Obesity is by orders of magnitude the worst public health issue facing humanity. Obesity makes every disease worse. Obese people are more likely to develop cancer, cardiovascular issues, respiratory issues, dementia, diabetes, and other afflictions. Obesity often leads to depression, lack of motivation, lower libidos, overall worse moods in general.
Of course there are "levels" to it, it's not to say everyone has to be a bodybuilder to be happy and healthy. Of course not. This is not about being slightly overweight, or "wanting to lose 15 lbs for summer"... But in almost every way, being fat makes life worse for the majority of people.
On the one hand, obesity is associated with many other ailments such as heart disease, diabetes, etc. that cost the system a lot of money.
On the other hand, well, longer life spans impacting Social Security, Medicare, etc.
but i think if you think it thru, 1 should dominate 2, and 2 should be reduced as well.
If somebody wants to live an obese lifestyle, I really think that’s up to them. But I’d be much happier about it if it didn’t cost me so much money.
Your perspective is frankly disgusting. I hope you don't have any vices. The point of a society is to pool resources together to improve the collective. Different people in different positions of power and ability have different needs. Hopefully you don't personally have any power to exclude people from that group. I hope that the powers that be don't decide that you deserve less for some reason.
Your opinion is that of a petulant child. Many years of research has shown that obesity is not this simple. Many chemical processes take place that influence one's ability to make better health choices, and many external factors put constraints on those choices as well. This is the exact same thing as hard drugs. Being obese is not a moral failing. When you say things like this, you show your true colors. You are not extending humanity to obese people, and it is very obvious.
I sincerely hope you reconsider your opinions. I hope you don't have any obese people in your life, or at least hope they don't read these messages. I think they would be disappointed to hear what you think of them.
And again, I hope you don't have any vices and are the perfect model of health, otherwise this would be a quite silly opinion to have.
EDIT:
I've been rated limited on comments so I'll post my last response here instead:
I have nothing further to say to this other than that you should consider talking to someone about your clearly deep-seated hatred for those who don't fit your model of participant in society; it doesn't seem healthy. Find an obese friend and show them your comments and watch their face as they read them. I wonder if you will find the humanity in their response that you are lacking here.
The fact that an obese person is harming other people as well as themselves might be an uncomfortable truth for them to hear. But ignoring it doesn’t make it go away.
Granted. But why does it need to be said?
I'm a skiier. That lifestyle choice alone probably has a higher risk-adjusted cost to our healthcare system than if I were fat. I'd still miffed if prior to setting a bone my doctor decided to lecture me on the risks of skiing. I'd be positively furious if I got that from my health insurer.
> fact that an obese person is harming other people as well as themselves might be an uncomfortable truth for them to hear
Why do they need to hear it? There isn't a need. What they need is to not be obese anymore. That's treatment. My point is skipping the lecture and going straight to treatment is how we solve most medical problems.
Source?
Based on what? The reward pathways are remarkably similar. And unlike heroin, you can't go cold turkey on eating.
You're assuming everyone who tries heroin becomes an addict. At first glance it looks like "approximately 1 to 12 months after heroin onset, an estimated 23% to 38% of new heroin users have become dependent on heroin" [1]. By coincidence, that seems to mirror American obesity prevalence [2]. (Obviously heroin is more addictive than food. Don't do heroin.)
[1] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
[2] https://www.cdc.gov/obesity/php/data-research/adult-obesity-...
The bigger difference though is that we all eat food, and for most of us includes at least some absolutely delicious food that would be incredibly unhealthy to eat in large quantities. We’re all (more or less) exposed to the “addictive substance”, it’s just some people have the ability to deprive ourselves constantly indulging that impulse, while others don’t. We don’t however, need to take small doses of heroin every day to survive.
What gives you the confidence to overrule medical professionals on this? (Note: I am not a doctor and have zero medical training.)
> We’re all (more or less) exposed to the “addictive substance”, it’s just some people have the ability to deprive ourselves constantly indulging that impulse, while others don’t
One, I’d challenge we’re all similarly exposed. I grew up in a house with no sugary sodas and plenty of leafy greens with each meal. Many people did not.
Two, we know from drug addiction that there is no global measure of addictiveness. Some people can smoke a cigarette or cigar or two, on average, per year. Others get hooked after their first draw. There is no reason to suspect something similar isn’t happening with obesity.
By this criteria, I’m sure you’ll be able to find at least one eating glass addict somewhere in the world. But if we can stretch the definition to include glass as an addictive substance, then it kinda stops meaning anything at all.
And when I say these innovative addiction diagnoses are controversial, I mean within the community of clinical experts, which they are.
It would be interesting to see this information, but would not be useful to act on. If the answer was "it costs more to keep more people alive" (hint: it does, that is why we let so many die of preventable illness), should we keep less people alive and healthy? The pursuit of economic growth at all costs is a disease far more dangerous than anything you would treat in a hospital.
Humanity’s GDP is around $100 trillion per year. There is plenty of money for healthcare with many orders of magnitude to spare for other endeavors.
Bean counting here feels like Google in the early ‘00s proposing to make office supply expense reduction a business priority.
Putting infinite value on anything is a great way to incentivise a system that delivers little to none of it.
No it's not. Every doctor triages. And every medical system has internal cost limits, whether implicit or implict, universal or variable, past which it will not treat. Sometimes that's enforced by gatekeeping entire categories of treatments; in other cases we have patients individually reviewed, e.g. for organ transplants.
If managing obesity is less expensive than treating it, there is a legitimate question around how the cost of that treatment should be split between the public and the individual. (Whether that cost be an explicit split or gatekeeping the treatment to only the most morbidly obese.) Thankfully, that's not the case--treating obesity, even chronically with super-expensive drugs, is still cheaper than the status quo.
Yes, every medical system does this. (It's almost the defining difference between medicine and healthcare.)
America does it individually (and inefficiently). Europea by restricting access to expensive treatments. If you don't do this at some level, you'll wind up with edge cases constantly running up bills the economy can't pay for and a collapse of the healthcare system's solvency.
Savings on the order of $100bn per year [1].
> longer life spans impacting Social Security, Medicare, etc.
An obese person dying early may well wind up costing the system more than a healthy person dying old. (Most medical costs are incurred terminally. The obese have more-complicated terminal paths.)
[1] https://healthpolicy.usc.edu/research/benefits-of-medicare-c...
My regime for informational puprposes, consult your doctor before you try anything obviously: 3 restorafiber gummies in the morning, 3 in the evening a half teaspoon of allulose in the morning and evening (tastes sweet, I just dissolve it on my tongue).
Costco sells 2 large 140 gummie jars for 29 bucks (46 servings) where I live and the "wholesome, non-gmo pure allulose" brand is available from iherb for 19 bucks for 80 daily servings, which puts the cost of this regime ~86 cents a day.
With GLP-1 medications, it is considerably easier to do the first part of "eating less". An obese person can lose over 20% of their body fat in a year, which will reduce the probability of injury when they begin working out. There is hardly any downside to developing medication to help people manage their weight to below obesity, and incredible upside.
Maybe another example would be: why do you use VSCode to do your programming? Hell, why do you use a computer at all? You should probably do it the hard way, on a sheet of paper... there is no reason to use a keyboard when you could just use your hands, right?
GLP-1 agonists are just tools like anything else. They make difficult tasks easier.
There are lots of problems with drug reliance still to be worked out, but I'm excited for the chance to rebuild my habits into something good and work my way off to something normal.
Related, exercise is awesome but has little impact on long term weight loss! Check this out: https://www.youtube.com/watch?v=vSSkDos2hzo
If it was there wouldn't be so many suffering from obesity...
Plastic surgeons, I expect, are especially concerned about a large reduction in volume of lipo & related procedures, and are eager to get the message out that “no, you still need to come pay us to cut on you!”
There was a large amount of skepticism in the original HN thread, but it strikes me as weird and dangerous, along the same lines of COVID-19 deniers.
I’m not even sure this is a capitalist solution. Sure, Novo Nordisk is making a ton of money with these pills at the moment, but at least externally it seems like their decisions are controlled by the foundation (of course, money talks and no one is immune).
I know plenty of people who are scared of needles and I’m not sure they should have to suffer from diabetes if they should develop it.
Separately, and I’m not an expert but slightly more knowledgeable than a layperson, but food scarcity is rarely because of overconsumption in the global West. The blame usually lies with corrupt local organizations working with NGOs and poor quality transmission routes rather than global food markets.
I used to think people just needed to "eat less", CICO and etc. Just like i thought people needed to just get off drugs. I think that's wrong, now.
These days it seems more apparent that some people are just more prone to addiction. The fact that i don't struggle with drinking or drugs is not due to my own will. Neither do i struggle with food, i'm frankly indifferent to food. So just as much as i seem gifted by nature to not be addicted to these things, others are innately pulled towards addictive substances.
Combine that with forever chemical use in packaging, pesticides in non-organic produce, our food supply chain is killing us.
I buy eggs from reputable regenerative free range, non-vegetarian fed chickens. I order my poultry and beef from regenerative farms across the country who are verified organic + grass fed + grass finished.
I bake my own bread and cook 95% of the meals I eat at home.
It costs an arm and a leg and isnt convenient but I feel much better.
Huh, apparently this originates with Joe Rogan [1].
In any case, I'm happy you found something that works for you. But you can find the quality you're looking for in restaurants in any Tier 1 city and most wealthy suburbs. (We absolutely have an issue with poorer communities having a choice between canned and fast food, in essence.)
It's not just America.
"Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country's population" [1]. (It's about 7% in America [2].) Meanwhile in China, "the incidence of overweight and obesity among school-age children...was 15.5% in 2010, rising to 24.2% in 2019 and soaring to 29.4% in 2022" [2]. Same story in Vietnam: "The prevalence of overweight among children aged under 5 years increased from 5.6% in 2010 to 7.4% in 2019. For overweight and obesity among children aged 5 to 19 years, prevalence rose from 8.5% and 2.5% in 2010 to 19% and 8.1% in 2020, respectively" [3].
[1] https://en.wikipedia.org/wiki/Obesity_in_India
While you may interject that privileged classes used to have larger portions and better quality food without having to work so much at all times, it somehow coincides with fatty bellies being a status symbol in many locales. Being obese used to be a sort of privileged class mark.
https://news.ycombinator.com/newsguidelines.html
Edit: we've had to ask you this before.
This has nothing to do with being nationalistic or not. It’s a statement of fact.
It just looks like at least in the US, if you go to the nearest grocery store to buy food or you eat out, and your goal is to decrease caloric intake, you’re playing against a stacked deck, is all I’m saying. You either need to spend extra time, effort, and money to find better places, or overcompensate by exercising extra time.
If you had posted something more like what you wrote here, I don't think I would have referred to it that way or posted a moderation response. (Btw this is a not-uncommon phenomenon: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...)