Of all things my taxes go to, I would love it the United States Government would buy the patent for this drug and make it freely available to anybody who wants it.
The number of things it apparently just cures is staggering.
The number of things it apparently just cures is staggering.
I have been reading obsessively about this drug since going on it. I have been fortunate enough not to suffer side effects on it, save for one -- frustration with the cynicism around it. A cynicism I shared prior to experiencing its effects.
I am convinced that, barring any life threatening long term side effects, this is the most important drug of our lifetime (from a first world perspective) or until a silver bullet cancer drug is found. The potential to be the tide that lifts so many boats and alleviates so much physical and emotional pain and suffering on a population level is almost overwhelming to think about.
It reminds me of the British reaction to the famine in Ireland - the good ministers were concerned about the moral health of the Irish. If they were provided with charity food, it would be a terrible tragedy if they became dependent. Just let them starve to death, with a clean soul.
The strange thing about GLP-1s effect on my desire to drink is how it manifests: I just don't care about drinking. I actually _could_ drink and be fine I think, I haven't tested it. I don't go through life with the burden of the knowledge of my own addiction. I don't have to be vigilant about triggers and self-assess my actions. I just don't drink.
I noticed that I did not want to drink the day after my first shot. It was that fast. If anything the closest I came to drinking came from routine, not desire. That is to say, what is an afternoon watching football if not with a beer in hand? But I was able to move past that.
One thing I should make clear, no matter how heavy a drinker I have been at times in my life, including with liquor, I have never had a physical addiction. A person deep in the throws of physical addiction will need to approach this carefully.
If you are interested in this topic, I highly recommend reading this newsletter: https://recursiveadaptation.com/
There is a lot of great writing on this subject and some real world testimonies in there. Also happy to answer any more questions here.
My sleep has been pretty hosed up since I started but it wasn't like it was great before. I am also probably suffering from sleep apnea and I'm hoping to address that soon as I probably have another 4-6 months at the current weight loss rate before I am at a normal BMI.
Edit: oh, I see you describe it elsewhere in the thread. Thank you for sharing.
There's the rub. We have not been prescribing semaglutide very long, and I won't trust it until we've had enough time to suss out long term side effects.
My father was on a long-term maintenance dose of immunosuppressant (I think prednisolone, but I could be misremembering) following his kidney transplant. When it was first prescribed to him, the long term side effects were either not known at all or not widely known. By the time these side effects were more widely known, it was too late, as he was already losing his vision (cataracts) and mobility (cartilage was being destroyed). He spent his last few years in pain.
I am very cautious about the potential for damaging long-term side effects.
We've been prescribing GLP-1s for almost 20 years now. Not to say they all should behave identically, but from a Bayesian inference perspective these things really do appear to be quite safe.
This adds literally zero information.
It occurs in a small number of patients, sure, but maybe that just means I am more risk averse than you. My calculus is simple. I don't need wegovy. I can lose (and am losing) weight without it. Sure, it would be easier with wegovy, but it is not necessary. I am not going to take an unnecessary drug that has a nonzero chance of killing me.
Excellent! A huge chunk of people try and fail to do this for a wide variety of reasons.
If you can lose weight without the help of a GLP-1 drug, then yeah, that is likely the safest option. But most people aren't choosing between using a GLP-1 drug to lose weight or losing weight without it - they're choosing between staying fat and using the GLP-1.
> As of March 31, only 4 cases of gastroparesis were recorded for semaglutide—the active ingredient in Ozempic and Wegovy—in the FDA Adverse Event Reporting System (FAERS), a surveillance database updated by healthcare professionals, consumers, and manufacturers. For tirzepatide—the active ingredient in Mounjaro and Zepbound—there is just one case logged.
I don't have more recent numbers, but these seem pretty low.
I don't think anyone is saying that there is no chance of significant side effects in people, but when measured against the risks of being obese, they'd have to be very bad and impact a significant number of people taking the drug.
The dosage though for losing weight is 3 or 4 times the dosage for diabetes.
This is fair. But I'll ask you this: how long would it take for you to trust it? Assuming there are no side effects beyond what we know now, which are:
* gastroparesis is a small number of patients
* elevated thyroid cancer risk in mice
* nausea and general uncomfortableness when taking it (some percentage, not all)
* muscle and bone loss which seems to be roughly on par with any rapid weight loss approach
* a small percentage of people develop malaise, anhedonia and suicidal ideation
* a propensity to gain some percentage of weight back and/or relapse in addictive behavior when going off the drug
These are the side effects we know about with over a decade of prescribing GLP-1 agonists. Assuming these continue to be the primary side effects, how long would you wait until you are comfortable in trusting they are the only ones?
These things we already know are dangerous, and we also already know they're the most prevalent. We're not treating mesothelioma here.
Purchasing NN Would cost roughly 0.2 Iraq wars.
The EU loves to ransom US tech companies for budget money. It's very clear that this is an opportunity for the US to similarly damage a big EU company by threatening its patents in the US, or otherwise hitting Novo for tens of billions of dollars in ransom money. The US market is by a huge margin the most important drug market in the world, and especially for Novo.
Find an abusive excuse to invalidate their patents if all else fails. Let Europe learn a valuable lesson in trade wars.
Lol. I can think of dozens of worse things. Drinking. Cocaine addiction. Meth. Winding up in prison for some reason. Riding a motorcycle without a proper helmet. Getting into a plane flown by Harrison Ford. Even simple unprotected sex can lead to massive medical problems. Ever looked up the average life expectancy of professional athletes, especially the NFL? It isn't great.
Being obese is probably worse for you. NAFLD has long eclipsed alcohol related liver issues.
> Even simple unprotected sex can lead to massive medical problems
Even treated HIV is probably less of a risk to your long term health than obesity, but I'm not a doctor.
> Cocaine addiction. Meth
OK, yes, there are illegal drugs that are going to be worse for you than being fat.
I'll rephrase:
Being obese is basically the worst possible thing you can do to yourself that affects a huge portion of the population of the western world.
Very very few people are riding motorcycles without a helmet, even fewer are getting into planes flown by harrison ford, only a tiny tiny tiny fraction of the population even has the option of being a professional athlete.
Ozempic treats all of those too.
GLP-1 solves this too
> Cocaine addiction
GLP-1 solves this
> Meth
GLP-1 solves this
> Prison ... no helmet
Okay, GLP-1 don't solve these but these aren't medical issues. This is just danger
> Even simple unprotected sex can lead to massive medical problems
Mmm... not really. People overblow this. Pretty much all STIs are completely harmless to your health if treated. One shot of penicillin and you're good to go. Your average flu is probably much worse than syphilis or chlamydia. HIV is the "biggest" risk, but HIV doesn't even impact your lifespan anymore.
DNP is an extremely effective drug for weight loss, but no one who knows anything about how it works would think that it would be reasonable to compare it to the GLP-1s, and anyone who knows how it works would also plainly see the dangers around its use.
GLP-1 type drugs have been on the market for decades now as well, and while they are not perfectly safe, we've got a good amount of data around the short to medium term side effects.
We have the data.
And I don't care about votes up or down. But I appreciate your theory on how they're playing out!
One of the most commonly consumed drugs on the planet seems to indicate there is no such thing - caffeine in reasonable quantities is tolerated by the overwhelming majority of human beings and research indicates that even outside of the stimulant effects that humans use it for, it is beneficial. We have significant evidence that caffeine in the 100-400mg per day range decreases risk of heart disease and stroke, and smaller but still compelling evidence that it is protective against diabetes.
Irregular use does seem to cause a small increase in heart rate and blood pressure, but this fades in the overwhelming majority of users as they make the usage more regular.
Too much can cause adverse outcomes, such as anxiety, and in some people timing might be important for maintaining sleep quality, but the vast majority of us would see positive impact from consuming a cup or two of coffee in the morning with little to no concern around side effects.
I think this is the part where the argument falls apart, though. My relationship with food is vastly different now than it was when I was a teenager or in the front half of my 20s. It was easy for me to eat a healthy amount of food and exercise. I never struggled with it. It didn't take any particular amount of willpower to avoid overeating. I even was able to fairly easily bulk and cut because I was focused fairly heavily on lifting weights - the bulking was harder for me than the cutting!
But as I got busier with other aspects of my life, it became easier and easier to just grab some fast food, or swap over to eating almost entirely uber eats during the pandemic. Before I realized it, it was suddenly very hard to eat less. It was still possible - I would lose weight, manage my eating, exercise, etc. - but something would always happen that caused me to lose track and backslide. A huge project at work, a bad breakup, tearing my meniscus while lifting. But all of these attempts took significant effort and willpower from me, something that I had never struggled with before. It wasn't my metabolism slowing down - I was always hungry in a way that I had never faced when I was a slimmer person, and fighting it caused significant impact to my mood, ability to focus, stress levels, etc. Tirzepatide has put my relationship with food and hunger back to being much closer to how it was when I was younger.
There are tons of feedback loops that are well documented that makes it more and more difficult to lose weight once you've put it on and kept it on for a while. It's certainly true that there's no magical situation where people can eat fewer calories than they use and not lose weight, but for a huge amount of people, these GLP-1 medications are a far simpler solution.
> Hope it works out for everyone and it's a smashing success!
Me too!
You're grossly underestimating the problem.
40+% of the population are obese.
This isn't just a few pounds to lose. This is 60, 70, 100lbs.
The task is to lose the weight forever.
For which long term weight loss success numbers are abysmal.
For me, a month in on 2.5, I was still struggling to force myself to eat enough. Zero need to move up. Some people don't feel anything at all until they're on 7.5mg, though.
There's also a lot of people seeing better success with smaller doses more frequently, too. Instead of moving up to 5mg, I'm doing 2mg every 3-4 days. Loss is still steady and I'm not seeing any indication I'll need to bump up any time soon.
- Higher rates of cardiovascular disease
- Type 2 diabetes
- Sleep apnea and breathing problems
- Osteoarthritis due to excess pressure on joints
- Multiple types of cancers (colon, breast, endometrial)
- Depression and anxiety from social stigma
- Reduced mobility and quality of life
- Higher medical costs (~$1,429 more annually per person)[1]
- Decreased workplace productivity
- Shorter life expectancy (can reduce by 5-10 years)
Oh no wait, sorry, those are the effects of obesity.
We already know the side-effects of the alternative because Western society as a whole has been living them.
It's bad. The obesity epidemic causes pretty much everything bad. This drug doesn't just solve one thing, it solves hundreds or thousands of things all at once.
https://www.perplexity.ai/search/does-exenatide-lower-or-ext...
There is an enormous amount of biotech work to develop next-gen versions that have better half-lives, lower adverse events, and most importantly, have long patent lives. But it seems base GLP-1 are good enough that we should see massive societal change starting next decade.
We already know what can go wrong.
We already did that decades and decades ago. Sugar, for example. Aside from so many foods being laced with it, you can now simply walk into a store and buy a kilogram of sugar and eat it. So many other examples. That ship sailed a long long time ago. All we can do now is nudge the dial the other way.
This style of condescension does grow tiring.
He's saying we already have completely fucked our reward system.
That's why 75%+ of American are literally eating themselves to death. And they can't stop. And no, "discipline" isn't a solution.
If anything, I'd say Ozempic brings our reward systems to be more in line with modern reality. Monkey brain doesn't work when you have the unhealthiest food available constantly at your finger tips.
Regardless of your stance on anything, it should be obvious we have a HUGE problem. I'm sorry, but a "do nothing and hope it works" approach is now off the table. We need real, tangible solutions. Not moral grandstanding.
You aren't making compelling points by pretending the OPs are stating things they are not.
It cures behavior, not directly disease. I see red flags. Firefly did a movie about a drug that interfered with people's motivations to do things.
Nothing is being healed, we are just helping people cope with excess
This drug in a nutshell partially paralyzes the stomach and upper intestine causing food to move through slowly. This has the effect of reducing food cravings as you literally stay full longer.
However slowing down the stomach muscles has many risks and many side effects.
Yes this drug is great for people who have struggled with weight loss and may not realistically be in a position to work on diet and exercise.
However this drug is not a substitute for the larger issue at hand. Many (possibly most) Americans are not living healthy lives in terms of mind, body (maybe spirit).
Improving physical activity leveled.. learning to eat less and to eat healthy should be a national priority. If anything the US government lack of addressing the elephant in the room and the underlying cause of many of these metabolic orders should outrage all Americans.
Just my two cents
No it isn't. Stop trying to make fetch happen.
> Improving physical activity leveled
It doesn't appear that this is the issue. You can't explain a recent trend (obesity) using something that hasn't changed recently. And exercise is not very effective for weight loss compared to diet (it's something like 20%/80%).