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Comment by Barrin92 | Hacker News Reader

if you're losing it as a weight loss drug and that's a side effect of the rapid weight loss that otherwise wouldn't occur it's a side effect of the drug in any practical sense, or are you trying to establish the 'guns don't kill people' for pharmaceuticals?

It's a side effect of the treatment regimen that many people in all likelihood aren't even aware of so it's good to report it like this

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Idk, i think its important to distinguish between side effects that would also happen via diet and exercise vs side effects that do not happen when losing weight via other means.

Diet and exercise have not caused any of that ever.

It sounds more like malnutrition and starvation.

I'll concede it may still be better than being fat, though.

malnutrition and starvation is technically a diet change.

That said, based on googling telogen effluvium seems to have lots of causes not related to malnutrition, even if insufficient protein is one of the causes.

People losing hair through "exercise" are using supplements.

If you shoot someone in the face, generally speaking that person will die. Not everyone who takes GLP-1s actually lose weight. A decent fraction of people are non-responders. Those people also tend to not lose their hair or have their sleep apnea and knee problems go away. Your analogy isn't as clever as you might think.

no listed side effect on every drug, or effect for that matter applies to all people. Anti-Depressants don't work for a fairly large amount of users, that doesn't mean we don't list those effects.

it feels like you are being deliberately obtuse so I may be wasting my time, but I'll attempt to assume the best and try one more time. This is very basic correlation vs causation stuff. The side effect is related to rapid weightless of any kind. Weightloss is a "side effect" of the drug. Hairloss is a side effect of rapid weight loss. There is a chain of effects there but it's not X causes Z, it's X might cause Y, which causes Z. This distinction matters less for negatives - still good to tell people but for positives it is disingenuous. If you don't lose weight, your sleep apnea doesn't go away. Your joint pain doesn't get better. Your blood pressure doesn't go down - because the drug doesn't cause those things, the weight loss does.

If you’re drunk and bump your head into a lantern, would you say that haematomas are a side-effect of alcohol consumption?

FDA trials follow this approach. If something bad happens it’s logged as an adverse event; if they croak it’s a serious adverse event (SAE).

So if you have a treatment for moles, and a patient (trial participant) has a mole on their back treated and then falls down the stairs or is run over by a trolley the agency wants you to do an analysis to see if the treatment might have had something to do with getting run over or not taking the lift.

Note: this is not an exaggeration. I have written phase I and phase II clinical trial protocols earlier in my career.

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