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Comment by jaco6 | Hacker News Reader

I’m just as curious as to why some people are so willing to take numerous medications, while others go to any lengths to avoid them. Some people are happy to be on an SSRI, sleeping pill, statin, low dose aspirin, and a few others, and aren’t bothered by this. Other people seem instinctively revolted by prescription drugs, seeing toxins pushed by evil corporations. Is it a trust issue?

I personally detest and avoid all medicines other than antibiotics and vaccines. Pharmaceuticals have a long track record of harboring “side effects” that only become apparent years later.

In general, why are we surprised that the chronic use of any substance has negative effects? Humans evolved for thousands of years eating food and drinking water. Regularly consuming anything else is an abberration and self-experiment.

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I think the answer to your question is that people who avoid drugs understand that drugs do not fix anything permanently, in 99% of cases. They only treat symptoms. The people who avoid drugs attempt to treat the underlying problems.

of course it’s not always practical. For example, some skinny people are simply genetically predisposed to high blood pressure, even if they work out and eat pretty healthy. It’s rare, but these things happen.

Nobody ever gets sus about needing to take heart medication every day to stay alive but the moment it becomes about how I take Lexapro every day they get real preachy.

Maybe we can find a medication people will take that solves the preachy problem instead. That might achieve significant population-wide improvements.

Which is sorta funny because some antihypertensives are known to decrease anxiety.

I'm curious why you include antibiotics in your trusted medications list.

Over the past several years we've found that antibiotics have a huge impact on beneficial microbes in your body which then has downstream impacts on your health [0]. Oddly enough for the topic in this article exposure to antibiotics as a child may be linked to obesity[1]. They are also extremely over prescribed for things like viral illnesses [2].

I personally wouldn't take an antibiotic unless whatever malady I was suffering from was proven to not only be bacterial in origin but likely to progress without treatment.

Regarding your larger point some of the distrust of medications can be related to the fact that people know that medication producers' goal is to be profit for the most part.

Because they are for-profit the medicine producers can't be trusted to produce quality products or to produce products which resolve a problem rather than just reducing symptoms as long as the patient continues to pay for the medicine.

As with other problems we have a low trust society because it's a society built on for-profit enterprises rather than enterprises focused on doing the best thing for society.

0: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756738/ 1: https://www.nature.com/articles/ijo2014180 2: https://pubmed.ncbi.nlm.nih.gov/37876436/

> I'm curious why you include antibiotics in your trusted medications list.

Because bacterial infections can be horribly lethal?

Can be, sure, but most are just unpleasant and you'll eventually recover. Why not just do it the natural way?

Most clicks of the revolver in Russian Roulette are just unpleasant and not lethal too. Why take the chance?

He is not shooting the gun at all. He's advocating waiting it out. You're the one taking risk and playing russian roulette. He'll take the gun out at the first sign sign of danger.

To address the question in your first paragraph, I think it's due to whether you think your locus of control is internal or external.

You can have an internal locus of control and still believe the benefits of taking something like an SSRI far outweigh the costs of attempting to address depression/anxiety more "naturally." I'd rather take an SSRI if it means more motivation to live healthily, positively, productively for myself and family. If anything, the drug could very well help someone discover their sense of agency.

> seeing toxins pushed by evil corporations. Is it a trust issue?

That sounds a lot like the divide between people who see conspiracies everywhere and those who do not. In that case I would suggest it is just personality, not logical and not solved by improving trust.

> Other people seem instinctively revolted by prescription drugs, seeing toxins pushed by evil corporations.

You can advertise drugs on TV in the USA. This certainly opens the door for bad drugs to get pushed out and marketed to people who don't have the technical skills to examine the claims and the risks of side effects objectively.

> avoid all medicines other than antibiotics and vaccines

Just because it's been such a hobby horse lately I would have to add pain killers. There is absolutely a large potential for abuse but they also serve an incredible utility to modern medical care.

> Regularly consuming anything else is an abberration and self-experiment.

Ozempic should be for people who are obese and have thoroughly demonstrated that they are not physically capable of exercising themselves enough to lose weight naturally.

Otherwise, this drug gets marketed as an obesity cure, but it's mostly dispensed for cosmetic purposes. If there are any side-effects, it will be a double tragedy for these people.

I'm with you, it's a little revolting, this specific drug.

Ozempic and similar drugs are being used by many to get rid of the food noise and insatiable hunger that have stood in the way of sustainable progress. These drugs are being used as catalysts for healthy living. The fact that they seem to work thus far is evidence that obesity is on some level driven by powerful hormonal forces that influence impulse control and willpower, which addressed, can give people the freedom to make better decisions and effectively pursue a lifestyle they've struggled to maintain.

The cosmetic narrative you're pushing is actually quite disgusting.

> These drugs are being used as catalysts for healthy living.

You have some evidence for this claim?

> is evidence that obesity is on some level driven by powerful hormonal forces

It's suggestive. It's nowhere near evidence.

> the freedom to make better decisions

As long as they're on the drug.

> The cosmetic narrative you're pushing is actually quite disgusting.

No it isn't. It's a valid concern about how this medication is _marketed_ and _dispensed_. It's also an obvious concern to have. Pretending that I'm disgusting because I'm actually worried about the future outcomes for these patients is bullying highroad nonsense. Come off of it.

I've been on Zepbound since July and have lost 40lbs in that time through calorie restriction, intermittent fasting, and resistance training 3x per week, which all felt like impossibly herculean tasks before starting the medication. I know others who've had similar experiences. Sorry I haven't published a paper on it.

> You have some evidence for this claim?

The obvious evidence is the result of the drug, i.e., overweight people losing weight because they're eating less.

The obvious countertpoint is that obesity rates have not been constant for the last few decades.

So there are clearly multiple factors here and those should be taken into consideration before uncritically deciding this is a "good thing" that we should "all be on."

> that we should "all be on."

Who, exactly, has claimed that?

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