glp1guide

We think obesity is basically going to be gone in <7 years. GLP1s don't work for everyone, and the side effects can be severe, but this these drugs are basically safe, and incredibly effective.

This is going to accelerate when every one and their mother (with industrial capacity) starts making generic Ozempic/Wegovy (Semaglutide) next year due to Canada's patent protection lapse[0].

https://glp1.guide/content/novo-nordisk-patent-protections-l...

Note that these results probably apply to Mounjaro/Zepbound as well, because they are the most effective GLP1s on the market right now:

https://glp1.guide/content/semaglutide-vs-tirzepatide-clinic...

My bet is on the reduction in inflammation -- it's a notoriously beneficial positive side effect of GLP1 Receptor Agonists, along with the obvious reduction in weight or HbA1c.

Yes, we should, and eventually those who need to will be.

Pill forms of the drug are currently uninspiring (see: Rybelsus), but as different formulations (triple agonists, etc) that are more effective also get their own pill forms, it is even more likely that this class of drugs may become as common as aspirin.

Not everyone needs to take GLP1s, but they are as close to a miracle drug as has recently been seen.

That said, most people can't stay on them forever:

https://glp1.guide/content/if-glp1-is-so-great-why-dont-peop...

And once off them, most people do not regain the weight:

https://glp1.guide/content/do-people-regain-all-the-weight-l...

Given the relatively rare negative side effects, it's an amazing class of drugs.

Retatrutide looks to be very effective, but it's not possible to get legally/safely at this point. TONS of experience/knowledge in the r/retatrutide subreddit though, a lot of pretty conscientious consumers in there that have done their research, but obviously impossible to recommend outside of finding a sanctioned study to join.

That said, Reta is a triple agonist[0] and it seems to be quite amazing with good muscle retention as well -- it's unclear if this is just the people who are taking it being more likely to be gym goers. Up until now the only formulation I've seen that specifically targets preserving muscle is GLP1s in combination with bimagrumab[1].

[0]: https://glp1.guide/content/a-new-glp1-retatrutide/

[1]: https://glp1.guide/content/preserving-muscle-glp1s-with-bima...

Ah -- the linked research trial contains evidence that it is not the best, Tirzepatide is more effective.

Unless you mean that Semaglutide worked best for you, right now the research points at Tirzepatide being most effective for weight loss (says nothing about t2d though).

Oh also, the side-effect category is a good place to watch:

https://glp1.guide/tag/category-side-effects/

https://glp1.guide/tag/category-risks/

I try to tag all the new news of negative side effects there

Let me try again:

1. People do not stay on GLP1s for long, despite how effective they are

2. People often rebound harder from other forms of weight loss (dieting, temporary lifestyle changes, etc)

3. GLP1 reduces a LOT of health risks linked to obesity (heart disease being the most important IMO)

4. Older people are taking GLP1s in droves

5. Once these drugs are everywhere (they will be soon IMO in < 7 years obesity will probably be ~gone), the effects will get "priced in" to actuary tables.

No social commentary or dark humor intended -- GLP1s aren't miracle drugs but the effects (and relative lack of side effects) is miraculous.

It varies case by case, but just want to point out that the research agrees with you here, Tirzepatide is more effective than Sema!

Liraglutide is now available as a generic, but it is the least effective of the big 3 (Semaglutide, Tirzepatide, Liraglutide):

Basically, Tirz > Sema > Lira

https://glp1.guide/content/semaglutide-vs-tirzepatide-clinic...

https://glp1.guide/content/semaglutide-liraglutide-continue-...

https://glp1.guide/content/another-generic-liraglutide-launc...

> For semaglutide, the newest and most potent GLP1.

Tirzepatide is the most potent GLP1

https://glp1.guide/content/semaglutide-vs-tirzepatide-clinic...

That's an insane cost reduction -- $250/month is a common gray market price in the US.

Tried to list them all here:

https://glp1.guide/content/are-glp1-side-effects-all-the-sam...

It was a while ago, but IMO the list still plays

Note that right now there's a problem with people staying on GLP1s[0] so it's not quite clear how this could go any other way. Considering the rate of rebound from other lifestyle methods, GLP1 is among the most effective alternatives we have.

GLP1 significantly reduces the risk of many mobidities and is increasingly prescribed to older people.

Also, this is incredibly likely to resolve itself once the drugs become common place after patent expiries, the actuaries will update their tables and the curve will smoothe out.

[0]: https://glp1.guide/content/if-glp1-is-so-great-why-dont-peop...

[1]: https://glp1.guide/content/patent-expirations-for-glp1-recep...

Also relevant, compounders are being sued by Eli Lilly right now. The compounding loophole is being welded shut:

https://glp1.guide/content/eli-lilly-suing-glp1-compounders-...

Only a partial patent expiry for Semaglutide in 2026, then full in 2033:

https://glp1.guide/content/patent-expirations-for-glp1-recep...

This is certainly a problem, but there just isn't much that many can do about the laws as they are written (and the whole incentives of the pharmaceutical industry as we know it).

That said, there is some hope on the horizon, some patent expirations have already happened (i.e. liraglutide which is less effective) and some are coming:

https://glp1.guide/content/patent-expirations-for-glp1-recep...

Absolutely! Timing on that is not so great though:

https://glp1.guide/content/patent-expirations-for-glp1-recep...

Again this is not great news but if you zoom out it’s amazing that obesity might be a solved problem basically completely in like 10 years.

Obviously GLP1s don’t work for everyone but they work for a lot of people, maybe we can focus the remaining resources on a smaller group of people with greater struggles

Woops, last link is wrong:

https://glp1.guide/content/patent-expirations-for-glp1-recep...

Sorry a bit late here, but both Tirzepatide and Semaglutide are off the shortage list, and the promise to not seek legal action that is currently allowing some compounders to operate freely will likely end sometime soon.

Literally, the only reason any compounder today (that is brave enough) can produce Tirzepatide or Semaglutide is because the FDA has promised to not pursue legal action for a short period to enable people to find other solutions.

Prices are about to go back up/a bunch of options are about to leave the market. See: Novo Nordisk's share price/related news.

> Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...

This might be my biggest unknown with GLP1s, how does it affect people with reward system issues — it could dramatically worsen a procrastination problem if it dampen the will to reward seek.

Then again it has only seemed to do this for vices so far

No it hasn’t— its well researched and the short to mid term (ish) side effects are well known:

https://glp1.guide/tag/category-side-effects/

I think this is the appropriate response — it’s clear that lack of appetite control is driving purchases a nontrivial amount of the time for junk foods — companies that depend on that revenue have never really had a challenge until now

Yeah unfortunately that’s about to come to an abrupt end

Incredibly excited about these drugs (like everyone else) and have been looking into them for a bit. A few notes:

- Semaglutide just came off the shortage list [0], companies won’t be able to compound it for long

- generic Liraglutide exists, and is about half as effective

- patent expiries vary[1]

[0]: https://glp1.guide/content/semaglutide-removed-from-shortage...

[1]: https://glp1.guide/content/another-generic-liraglutide-launc...

Been writing about this a ton as well -- these drugs are quite possibly the closest things to actual wonder drugs I've ever seen.

One thing that was really interesting was looking at how the side effects differed[0]. It's rare to see a medication so con-free, and we're finding out that weight loss may not even be related to the riskiest part (gut behavior).

[0]: https://glp1.guide/content/are-glp1-side-effects-all-the-sam...

Well of course, the problem is in the mind. As most disorders are.

That said, I wonder if people with those kinds of eating disorders also suffer from the "food noise" phenomenon.

Super tired of seeing this argument. Most people who get on GLP1 Receptor Agonists keep their weight gains.

If someone told you there was a consistent, well researched and studied way to lose 5% of your body weight, would you take it? Of course.

Also, not to mention that the period of time where you're experiencing better HbA1c, etc can be a lifeline.

https://glp1.guide/content/do-people-regain-all-the-weight-l...

GLP-1s aren't con-free, but this ain't it.

Welp, water is wet.

It won't be up to Novo Nordisk to reduce the cost of GLP1 RAs -- it will be up to other entrants into the market (that said, there are worryingly few), and huge companies taking up manufacturing of GLP1s and similar compounds.

At this point, companies partnering with compounding pharmacies might hit mainstream (more than it already has) and be the go-to way to get GLP1 RAs.

There's already a Liraglutide (Victoza/Saxenda) generic:

https://glp1.guide/content/victoza-generic-hits-the-market

Though I've seen some anecdotal reports that the generic was worse than regular Victoza.

While metformin is cheaper, I find that only fairly wealthy "longevity" maximizers have heard of it.

Also, it's far less effective than GLP1 RAs at weight loss, which is what most people want.

A bit late here, but vivid dreaming... that's absolutely a new thing I haven't seen before.

Interesting, this reminds me of the effects of coming off of THC, I wonder if there's some relation.

Another bullet point in the list of benefits for GLP1 RAs -- it's amazing all the areas that it seems to touch.

I've been on the lookout personally for more negative side effects (it's almost suspicious how little there are, though it varies by person to person), but also excited to hear of benefits.

Some of the benefits recently led 23andMe to get into GLP1s:

https://glp1.guide/content/23andme-gets-into-glp1/

They even a paper on some possible benefits with Alzheimers, though I think the research is in it's infancy. I think the plastic story is a bit more compelling though.