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community weblog
GLP-1's may help a variety of conditions unrelated to obesity
Within days of starting on Zepbound last February, Ms. Schmidt felt her concussion symptoms finally begin to ease. "the survey respondents were enthusiastic. Sixty-five percent of current or past GLP-1 users said they were "very interested" in continuing to take the drugs. More remarkably, 63 percent said that if their GLP-1 failed to help the condition it was initially prescribed to treat, they would either "definitely" or "probably" keep taking it for other benefits."
This experimentation is also driven by how the drugs seem to cut across the familiar borders of illness in ways that doctors haven't seen before. "What we've come to realize," said Dr. DiMarchi, who was a vice president at Eli Lilly and involved in GLP-1 research there, until he left the company in 2003, "is that many diseases may share the same root causes, even though we label them and treat them as distinct: This is an endocrine disease, this is a cardiovascular disease, this is a brain disease."
posted by mecran01 on Apr 16, 2026 at 3:31 PM
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A friend of mine had an ozempic baby within months of starting (and after years of struggling with hormone related infertility). Such a joyful surprise.
posted by St. Peepsburg at 3:46 PM
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We were literally just taking about this today at lunch. Not the article, just the things people had experienced or heard were improved by a GLP1.
posted by jacquilynne at 4:03 PM
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Obesity has historically been a difficult topic on MeFi. However, I'd like to say a few things about these medications.
I first started taking tirzepatide (Zepbound/Mounjaro) for weight loss after a lifetime of fighting with my body. Two days after my first dose, something had markedly changed in my body. I have had all-over body pain forever, like since puberty. I have polycystic ovarian syndrome, PCOS, and that is a thing that some people with PCOS experience, due to inflammation. One day, I woke up to no pain at all. As the first dose waned, the pain returned. After the second dose, there was relief again.
My wife and I share a primary care doctor. She (wife, not doctor) has an autoimmune disorder that causes great, great pain, especially in her back and hips. She's had a tough time with medications to help, and those medications have huge downsides. She also started tirzepatide and while it has not been a miracle, it has markedly helped.
This is anecdotal, of course, but people's stories and early studies encouraged our doctor to give her that chance, which has surpassed what her rheumatologist has been able to do.
posted by Miss Scarlet with the Candlestick in the Lounge at 4:08 PM
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There's an odd thing that's been noted in various fragrance subreddits where people have realized that their sudden interest in scents at the level of a hobby coincided with starting semaglutides. I'm not sure it's that widespread or that there's a direct causal effect, but it's anecdotally interesting.
posted by figurant at 4:20 PM
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I take care of a diabetic patient who also has rheumatoid arthritis. When she started her GLP-1 she was able to stop her most immune-suppressing RA medication, rituximab.
There are some patients who have troubles with continuous nausea or constipation, as the article mentions. Their survey result of 60% or so of GLP-1 users being willing to continue the medication even if it didn't help their primary indication seems like it's about right, though.
posted by Emmy Noether at 4:20 PM
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I'm old enough to remember the fen-phen craze and subsequent market withdrawal. So I'm suspicious about another diet wonder drug, even if things like "all cause mortality" effects should produce cautious optimism.
posted by pwnguin at 4:40 PM
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I'm not suspicious, I'm just jealous. I got a prescription for one of these two months ago, and have not yet managed to get it filled. My insurance is supposed to cover it (thanks, comorbidities!) and yet, it has not, and I don't know what the magic words are to make that happen.
The blindness side-effect is kind of scary. I wish we had a better understanding of that risk.
If I were a mouse with epilepsy (or, say, a person who has been waiting two weeks for a neurology referral for seizures), I'd look forward to the lessened seizure severity GLP-1s may offer.
posted by mittens at 4:48 PM
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It does seem like there are a surprising variety of things that are helped by GLP-1s. I'm a healthy weight at the moment and not diabetic so I'm not a candidate to try them, but I'm really interested to see how their use evolves. I'm hopeful that what we learn from them will have broader implications for other medical approaches and that I'll get to reap the benefits as I get older.
posted by potrzebie at 5:02 PM
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Fen-phen was basically organic speed, so not exactly comparable methods of effect.
posted by funkaspuck at 5:02 PM
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I'm old enough to remember the fen-phen craze and subsequent market withdrawal
so is virtually everyone here, sorry to say you don't have some access to unusual wisdom
posted by sickos haha yes dot jpg at 5:04 PM
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The wide-ranging, unexpected effects really do expose how little we know about so much of the body's functioning. It's bananas.
My mother-in-law has Crohn's and some other things and is considering a GLP-1. Nobody knows if it would help with all her many symptoms, but there's a pretty good chance it would. She's sort of concerned about losing interest in eating, which I totally understand. Food is for FUN! Especially for someone who's spent so much of her life dealing with difficulty with so many foods.
posted by uncleozzy at 5:18 PM
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Anecdotal data: some years back when GLP-1's had just hit the market, I was trying really hard to lose enough weight to be eligible for a major surgery, and had hit a bad plateau where I simply wasn't dropping no matter what I did. It was an off-label use at the time but my doctors arranged for me to get on the injections for a year- I have absolutely never been as nauseous as I was on that stuff, 24/7, it was like chemically induced IBS or chemo. I am talking full on empty-your-guts-and-pray-for-death nausea, once or twice a month, every month. But I really wanted that weight off, and it was working, so I just gritted my teeth and powered through it. Over the course of a miserable year I lost 90 pounds, I started running again, I got my surgery done, it was great! Then the uninsured price of the meds got jacked through the roof, like 1500 a month, and I had to stop it- I easily put half of that weight back on in very short order. 3-ish years later I finally bit the bullet and went through Hers to get on it again, knowing it might suck but being willing to take the risk. And what's really interesting to me is that whatever formulation they use has like, one-tenth the nausea impact of the stuff I was getting before. I'm losing more slowly this second time around but I am losing it, so maybe it was just a concentration thing? I do not know. But for getting weight off when no amount of diet or exercise would, I am eternally grateful. It has been such a life changer for me.
posted by Seven Deadly Gins at 5:31 PM
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[This isn't a huge deal or anything, but please do not snipe at other users unnecessarily, thx.]
posted by mod_adrienneleigh at 5:37 PM
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I'm not on GLP-1 but have multiple family members and colleagues on it and one thing that has consistently come up in conversations is the challenge with muscle loss (and potentially future bone density loss). Most of the folks I know using these drugs are older and prediabetic so while the intended effect is definitely helpful to their long term health this side effect is too. Lest this become a "wonder drug" conversation I wanted to weigh in that there are side effects, some of them not fully understood because of their effects over long periods of time. Most of the uses of GLP-1 involve continued use over a lifetime so this is something to think about.
posted by q*ben at 5:52 PM
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If you lose a lot of weight, it is never all fat. Some of it is your organs shrinking because they don't have so much load on them, and some of it is muscle. If you were able to lose the same amount of weight through diet alone (which not many people can manage), you would also face these challenges.
Drugs or not, the way to preserve the muscle is some kind of resistance training and a decent protein intake, as the linked article says. So that means the prescription shouldn't be for the drug alone but for the drug and an appropriate regime and support (dietician, trainer, etc) to follow through.
posted by i_am_joe's_spleen at 6:20 PM
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it's interesting to see the 'just asking questions' when it comes to GLP-1s and compare the same to say, COVID mRNA vaccines.
I know why it's that way. Being fat is a personal moral failing, in America at least, and fat-shaming is still en vogue.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 6:27 PM
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No doubt Mr. Spleen! Though both my father and close colleague report the same issue with keeping muscle mass up while on the drug - my colleague compared it to trying to run up a down escalator. I am seeing these in my genetic future for blood sugar control and it's freaking me out a little.
posted by q*ben at 6:30 PM
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I was on Zepbound for two years, until my insurance excluded it (and all GLP1 drugs prescribed for weight loss) as of January 1st.
Yes, I lost 70 lbs, but I also lost the all over chronic pain I'd had for more than 15 years (following a vehicle accident). Overall the inflammation in my body went down, and I can bend my knees normally. Having now been off the drug for three and half months, I've gained back 20 lbs, the inflammation is back, and I've now gotten really serious eczema, which I did not have previously.
I can't afford $500 a month to stay on it, so I've started to figure out other things that could maybe qualify me, including abandoning my low glycemic index diet to drive my blood sugar up.
Which, I get, sounds stupid, but my quality of life is so much worse in the past three months (just physically, the horror show of the world aside) that it actually seems like a fair trade.
posted by anastasiav at 6:46 PM
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I know why it's that way. Being fat is a personal moral failing, in America at least, and fat-shaming is still en vogue.
It feels like there's a little bit of an GLP-skepticism horseshoe, with fat acceptance sort of folks also putting them in the lineage of questionably healthy weight loss drugs, or at least presuming them to be in that category until proven innocent.
I think drugs are cool and I like the idea of a drug that makes everybody mad because it works too well so I guess I'm rooting for them.
posted by atoxyl at 6:53 PM
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If GLP-1s reduce inflammation they probably help all sorts of conditions that are limiting to people's ability to engage in the kind of movement that is right for their body and their brain. My partner has been losing 2-3 lbs a month (similar rate as Ozempic!), at 30 lbs now, from getting on a steroid inhaler for asthma, doing literally NO intentional exercise or any conscious change to their nutrition, because their ability to do things they enjoy without suffering immensely went way up. So they do more things that are good for their body physically and mentally, which happens to coincide with some weight loss for them.
I am personally curious if we would see similar effects if we just prescribed Advair to a bunch of random people, because anecdotally a lot of adults are walking around with undiagnosed asthma, which exacerbates all sorts of other conditions. Is it a magic wonder drug, or is it the first drug that addresses common underlying disorders that are often underdiagnosed or undertreated, and we've created a market demand and a willingness to prescribe that briefly made it easy for millions of people to get on it (before everything fucking imploded and now a bunch of the people who need it most can't get it)?
I especially wonder this because of how many goddamn years doctors told my partner they just needed to lose weight, before they found someone willing to listen and test them for asthma and upon being diagnosed and mentioning this to their family they found out THEY HAD BEEN DIAGNOSED WITH EXERCISE INDUCED ASTHMA AS A CHILD AND EVERYONE JUST FUCKING FORGOT! So, you know, if that hadn't happened I guarantee they would have ended up on a GLP-1 because the doctors have always diagnosed the problem as "you're too fat" and now suddenly they have a drug that will "fix" this "problem" and they're willing to prescribe it instead of telling them to work harder to lose weight. And nobody is looking to closely at the visibility of being fat and the willingness to prescribe based on fatphobia versus having to fight tooth and nail to get treatment for literally anything else inflammation-related that people may suffer with and be dismissed about.
posted by brook horse at 7:01 PM
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I've decided I'm going to be unabashedly and unreservedly happy that there is a new class of drugs that are dramatically improving folks' lives in countless ways.
posted by flamk at 7:57 PM
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I have my reservations, but I think one of the biggest ones keeping me from inquiring about this to my GP is "What happens when I have to go off the drug?" Because of the people I've personally known who have been put on a GLP-1, about a fifth have had bad reactions and had to go off the drug, and the other four-fifths have had to quit as it was no longer covered by their insurance (or that even with insurance, their co-pay spiked to over $500 a month).
One thing that seems to pop up again and again is that it's a very useful drug that is intended for lifetime use, and that if you have to go off of it, the weight comes back on and is even harder to lose. If I lived in a world where I knew that my treatment would continue unabated by profit-hungry shareholders...I might not be so shy.
(But then I think of all the other medical treatments that I've considered over the years, and how many of them I've dismissed because I've seen how much friends and family struggle when their treatments inevitably gets torn away from them...I just don't know if I can take those hits.)
posted by Rudy_Wiser at 8:18 PM
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I think the economics of GLP-1 drugs (meaning the reduction of add-on healthcare costs) are going to eventually make them accessible to everyone. It's like solar power. Expensive at first, but the long-term benefits are impossible to argue against. (I've lost 65 pounds, and you can pry 'em out of my cold, feeling-healthy hands.)
posted by flod at 8:27 PM
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These things are super fascinating. I'm with uncleozzy above: the big lesson so far is how little we know about how the body works.
I do really feel like either there's some "other shoe" that will eventually drop, revealing the hidden downside to these, or else they're the opening of a door that leads to much finer tuning down the road as they figure out how the drugs are helping all these different maladies. Or, you know, possibly some mix of both.
Regardless, whatever's happening with these drugs, it feels like the first chapter of a much longer story. I look forward to seeing how it develops! And in the mean time I'm very happy for all the people who are being helped.
posted by Smedly, Butlerian jihadi at 8:32 PM
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It's like solar power. Expensive at first, but the long-term benefits are impossible to argue against.
Weeps in USAmerican
posted by Rudy_Wiser at 9:11 PM
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I've watched basically my entire family get on one of these or another, for diabetes and then connected issues. Chances are super high I will end up on them too but I really don't want to be because I've also watched my family struggle greatly with food after starting the drugs, all in different ways, and food is profoundly important to me. My mental health has always been a challenge and engaging with a wide variety of foods every day has been absolutely key to wanting to keep myself alive long term. When I've struggled with wanting to cook or eat I've been at my worst mentally, and had no energy to do anything else either. So I'm worried that starting a glp-1 for my genetic predisposition to diabetes will trigger my genetic predisposition for depression because I won't be able to rely on such a vital component of my self care. (And for those wondering, my diet is really quite good, I'm one of those people who actively craves vegetables, I cook for variety and texture and freshness. Despite this my blood sugar goes up every year. Sigh.)
There are two angles that I approach thinking about and learning about this class of drugs. One angle is scientific - hopefully they are studied meticulously in people with all types of bodies and all types of concerns so that we can begin to chip away at our ignorance. The other is cultural - if there is a pill you can take that not just magically makes you thin but also reduces inflammation and even does wacky stuff like repair fertility or keep migraines at bay, but there are still people with fat bodies or who struggle with chronic pain (or whatever issue glp-1s will fix next month), then the societal tendency will be to judge and ostracize those people even more than they already are. Ideally, studies of these drugs will take into consideration these cultural affects and concerns, and discussion of their use will include their drawbacks and unknowns, conflicts and complications. I never want to hear the term "ozempic face" ever again. But there is no way we will get even close to that ideal. Fatphobia is entrenched like a tick and the manufacturers of glp-1s are making money hand over fist, people love any chance they get to tell someone else they know better about their own health and autonomy than they do, and science is still barely done for bodies other than white men. Harrumph. The best I can ask for is nuance, I suppose.
posted by Mizu at 9:28 PM
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A cursory search for "glp depression" suggests it has positive effects on that, too, though I haven't spent a single second trying to decide how reliable any of those headlines are - I just typed that into duckgo and skimmed the first page of results.
This stuff effects a scarily large amount of conditions.
posted by egypturnash at 9:58 PM
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Glp1s and cancer. After I asked my question about Glp1s and endo I found an article that showed that when taken with progestrins they show a possible link to reducing uterine cancer. The American cancer society shows that it's more than just one type it may help with.
posted by Higherfasterforwards at 10:56 PM
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Ozempic, within a few weeks, cured my debilitating and untreatable IBS. I went from probably 90% of my bowel movements being diarrhea for 40 years to nearly none of them. Add me to the crowd of "I would take this forever even if I had never lost a pound."
It also, randomly, completely erased my appetite for alcohol. I was never a problem drinker, I just enjoyed a beer or glass of wine a few times a week. I still like the idea but when it comes down to it I realize that, nah, I'm good without. I wasn't expecting that to happen and I hope we can add alcoholism to the list of problems glp1s miraculously cure.
posted by BuddhaInABucket at 11:02 PM
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I feel conflicted about these drugs.
On the one hand, there's no doubt they they are providing great benefits to very many people.
On the other hand, the hormones in our bodies have evolved over millions of years to have a certain balance. Maybe that balance is a bit wrong for our current world of abundant high-energy-density food and limited physical activity. But it wouldn't be surprising if changing that balance turns out to have unwanted trade-offs as well as unexpected benefits.
I think people sometimes underestimate the indirect benefits of excess-fat loss. If you spent all day every day wearing a 5kg or 10kg backpack, you'd eventually stop noticing it. But when you took that backpack off: suddenly you'd have a load more energy, a lot less fatigue. The second order effects are that you can go more places and do more activity which also can increase your sense of wellbeing. Some of the beneficial side-effects people report seem to happen immediately before any weight loss. But others might just be byproducts of getting to a healthy weight.
It kind of bugs me that as a society we seem to have decided to not bother trying to fix our obesogenic environment, and now we've just decided it's easier to put huge numbers of people on medications to let them thrive in a world of ubiquitous junk food where cars are the default transport option.
posted by TheophileEscargot at 11:55 PM
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A possible outcome is, if significant numbers of people start eating less and moving more, the obesogenic environment could change, in that maximising palatability will be a less successful marketing strategy for food companies, while at the same time demand for safe ways to move around will increase...
But I agree it's very frustrating that the power of Big Food and Big Oil and other Bigs makes effective regulation almost impossible. Instead we have The Invisible Hand Of The Market bringing us the drugs. Which is shit, even if the drugs are good and useful for those who need them and can afford them.
posted by i_am_joe's_spleen at 12:34 AM
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I have commented here before on my own use of a GLP-1 medication and its benefits and drawbacks.
I'm glad it is becoming more accessible and socially accepted to use it. It has changed my life in significant and positive ways, and I hope it becomes more accessible to others to gift them with similar changes in their own lives.
My long-term fear is that it will help too many with treating serious, life-altering diseases, to the extent that doctors and government will work hand in hand to make it illegal or significantly proscribed and controlled, and even more expensive than it is now.
I'm convinced of this by my own experience in how difficult doctors, particularly, have made it to access this medication, and how the current regime seems to want to actively make and keep the majority of people sickened. We have been a captive market for a very long time, in numerous ways.
posted by They sucked his brains out! at 1:33 AM
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I wish insurance/French social security would approve this for inflammation related illnesses, I would love to be able to try one.
posted by ellieBOA at 3:12 AM
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Fully agree that a drug that is helpful for too many people with too many different problems will quickly expose the class and racial prejudices inherent in the system.
Incredibly frustrating that this bends so quickly toward conspiratorial thinking, but equally difficult to square the actions of our economic and political elite with any other reasonable explanation.
To be clear, it doesn't have to be a top down grand conspiracy. It can just be a quick recapitulation of the typical snobbery and racism of the multi-generational Harvard/Yale/Princeton/Stanford set plus the markedly toxic culture of American medical education. As I've said for awhile, there is a broadly eugenicist/neo-Malthusian vibe to our current moment in history, and i have no doubt that many of these people would happily see the general population sharply reduced. Certainly they produce policies and take individual actions that are consistent with those values. One can easily imagine a dystopian world where wonder drugs exist, but are only available to the few.
posted by Smedly, Butlerian jihadi at 4:15 AM
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Everything has a price.
I was put on GLP-1 when my numbers went off the rails last October. I carry some extra weight but nothing that has ever slowed me down.
After the standard therapies failed, My GP—himself a diabetic who uses it—spent serious time convincing me that Mounjaro was nothing short of a miracle. His advice to "eat what you feel like" just sounded wrong to me. Everything about starting the drug set off personal alarm bells, and just working through insurance issues was stressful and took time to resolve.
For the first month, I paradoxically could think of nothing but the worst possible foods—sugary, rich, carb-heavy treats haunted my thoughts even as my system slowed to a crawl. I had cramps at night and became strangely fixated on textures. Shopping was torment—I denied myself the treats I craved.
In spite of this, my numbers improved dramatically and my dose was doubled. ("Odd," observed my MD about my food issues.) I've been on this increased amount for two weeks now, and have noted a huge shift.
Yesterday at the market, I told myself it's okay—if I want something, I can treat myself, it won't hurt me. But when I approached an item once craved (there's a saffron-cardamom ice cream made locally that is out of this world) I felt a weird, queasy aversion. Not quite nausea, but definitely no desire. I returned home with a bag full of admirably healthy purchases but no real joy.
Not sure how I feel about this. Mizu's musings above strike familiar chords. Enjoyment of food has always been central to my life, and sharing things I've made has been one of the rare ways with which I can express social connection. Without this, I feel untethered. My poor husband, who always enjoyed my cooking, sadly noted that meals have become spartan affairs focused on nutrition—eating as basic maintenance.
The benefits of these drugs, many still emerging, are awe-inspiring, and I am cautiously grateful that this thing exists. I am, however, also grateful that my advancing age (68) limits the amount of time I'll have to be on it, as the idea of it being permanent is horrifying. "The rest of your life" does feel different at this point.
The struggle continues and, in view of stigmatization and complicated family dynamics, I have chosen to keep my Mounjaro use a secret—even more isolating. Much gratitude to Metafilter for this thread, and those sharing their experiences, as it has been helpful. Thank you everyone.
posted by kinnakeet at 4:21 AM
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Thanks for sharing that, kinnakeet. That's exactly what my mother-in-law is worried about, although she is likely to benefit from a GLP-1. It's a difficult calculus and she's struggling with it, in particular because she's been on and off so many different treatments during her life.
posted by uncleozzy at 4:28 AM
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It's weird that we're just these wet bags of chemicals shuffling around having consciousness and making "societies" and that we can make little microadjustments to the chemicals in our bags and they can have effects that are both large and unclear. Being alive is so strange and involves so much luck that you would think that just considering that would flood us with compassion for one another. But maybe we need better chemicals for that, too.
posted by rikschell at 5:02 AM
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My husband is on one of these, and it's been beneficial for him because hunger previously affected his mood... a lot. When he got hungry he'd also get very angry and irritated, which made it difficult for him to change his diet; and his father has issues with anger so he would work extremely hard to mask how he felt which was draining for him.
I currently have a lot of excess weight from my second pregnancy and breastfeeding, and it would be nice to join him in losing weight. The idea that you can do something easily that used to be a struggle, it's very tempting. I don't mean to disparage anyone here for their choices, because I think the calculus is different for everyone.
But for me, I guess I want to exhaust all other routes before going down this path, because it is permanent. Do I really want to make a permanent decision about the way my body operates, without trying other non-permanent options first. That's where my head's at these days.
My husband is doing well on these drugs though. He wanted to be less of a slave to his moods and his hunger and these drugs have allowed him to be the version of himself that he wants to be.
posted by subdee at 5:19 AM
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And heh, I just read a puff piece about how much trouble the US booze industry is in, because Americans are drinking less (and foreigners are buying less US booze for political reasons). I wonder if these drugs have something to do with it.
posted by subdee at 5:21 AM
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American alcohol consumption has been declining for years, and the biggest drivers of that trend have been young adults - not the demographic that is the heaviest user of glp-1s.
What I can find attributes it mostly to changing attitudes towards alcohol, but I wouldn't be surprised if another reason is that a lot of people only drink socially and it's become more difficult and expensive to be social.
posted by Kutsuwamushi at 5:46 AM
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The Cut had piece on how GLP-1s made the writer's life boring. Anhedonia seems to be a feature for most, but not all.
posted by fiercekitten at 8:18 AM
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I really want to try it and my doctor agrees - I have IBS - C and GERD and a 4 cm hiatal hernia and losing the weight would if not fix than significantly impact all of those in a good way. I know this because every other year or so i lose 30 pounds (I need to lose way more than 30 pounds) in seven miserable months of deprivation and obsessive point / calorie counting, thanks weightwatchers. Then I can't stand it any more and gain back 35 pounds in 5 months of good bread and pasta and all the things that make me happy.
This cycle is not making me happy or doing any part of my body any favors. So yes, I want to try it. Great idea, enthused my doctor! Yes! Agreed the weird foregut (no really it's a thing)
surgeon. Haha no, said my insurance. We only cover any part of it if you have diabetes and you, miraculously, do not. Try the internet, said my doctor. $180 a month, said the internet, and it may go up and by the way, we need three months of that upfront.
So I guess its back to weight watchers for me. They're pushing Wegovy as well; it costs more than Hers, the site my doctor recommended. But this is the US and the lines are strict and getting stricter: glp-1s are not for poor people unless they have diabetes and I'm sure they'll get rid of that exception as soon as they can. Edited to add: i am not even really that poor! And if I cant afford it, then there are legions who also cannot.
posted by mygothlaundry at 10:00 AM
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The Wegovy patent expires this year in Canada, and I expect that will soon(ish) bring the price down substantially on all the GLP-1s here, because they will suddenly be competing with an available generic in the face of broad-based refusal by insurance companies to pay for this class of drugs at all.
posted by jacquilynne at 10:19 AM
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Just a warning for anyone with GERD - taking wegovy has triggered absolutely horrific acid reflux, to the point where I was taking several pepcid ac a day (I couldn't even care what the recommended dose was), plus drinking baking soda water. I did manage to get it under control by taking a betaine hcl supplement and making sure I am actively managing constipation on a daily basis in case that helps anyone.
The way I feel about taking one of these drugs is so, so complicated. It's such a mindfuck. On the one hand, my back pain reduced by 70% the first week. I feel looser and less stiff. I used to drink water and feel like it was just hanging out in my body, neither hydrating me nor travelling through my system. Now I pee an hour after I drink a glass of water. My skin tags are drying up. Fewer heart palpitations, fewer hot flashes. I end up googling and googling why semaglutide might cause these improvements, but I get no real answers.
On the other hand, I haven't lost any weight yet (it's still early days). I'm having awful fatigue at least a couple of days a week and some anhedonia - both of which combined make it harder to do physical activity. Prior to going on wegovy, I was so proud of my healthy diet. I'd been basically following what I think is the most reasonable eating advice - food, not too much, mostly plants. I focused on fiber and plants and variety. Now I'm being told to eat 100 grams of protein a day, which I find disgusting and nearly impossible. My breakfast today? A glass of protein milk. When you're not very hungry, there's no desire to make that nice bowl of steel cut oats with a couple of eggs, onions and some bean puree. It's not possible to down more than a third of it. It wouldn't be enjoyable. Why would I go to that trouble? Is it healthier not to eat 'healthy'? How can that be true? Maybe it is true. Because when I was eating that way, my blood sugar was still creeping up and overall health was worsening. It's just so confusing.
posted by kitcat at 10:36 AM
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I started taking this at the beginning of March. The first week hit hard, with a complete lack of energy to the point where getting out of bed was difficult; I may have also coincidentally had the flu at the same time. I honestly don't know, but it hit me as hard as any illness ever has. Thankfully I was back to normal by the end of week two or I would have had to quit.
Over the course of the first month, I lost 10 pounds, but that progress has stopped. I'm still eating much smaller meals and I feel full on what I would have normally considered a half portion. Getting enough protein and fiber has been a challenge. I also have to remind myself to drink water, I don't get thirsty like I used to. I haven't noticed any other side effects for good or ill.
It's early days for me, but the only time I've made this much change to my weight was when I was jogging 4 times a week. That ended when I stepped off a curb and destroyed my ankle. I only ever lost 25 pounds running, and that took a year. To lose almost half that in a single month without exercise is crazy.
posted by Eddie Mars at 11:01 AM
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Incredibly frustrating that this bends so quickly toward conspiratorial thinking
My experience with primary care physicians has been the very definition of gatekeeping. I don't say it lightly when I believe, with the exception perhaps of some specialists who are already well-paid, that most doctors would prefer their patients not be able to access this medication for the very simple reason that it can mean fewer visits for chronic ailments.
posted by They sucked his brains out! at 11:40 AM
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I don't think there's any drug which has so varied a psychological profile.
To the skinny people, it seems to bifurcate half between those who rejoice at their fat friends and family finally being able to eat like a normal person, and those who have moralized their fat friends and family's inability to eat like a normal person as failures of character, and now think they are "cheating."
To the fat people on the shot who are not, for want of a better way of saying it, constitutionally fat ... your dad bods, your hard-to-shake-the-baby-weights, your jocks who packed it on after an injury, your speedy metabolisms hit the wall of middle age ... the appetite and satiation impacts are a somewhat discomfiting alien presence. They like being able to eat less but they don't really like feeling chemically forced to do so.
To your constitutionally fat people on the shot, the appetite and satiation impacts are a revelation ... like someone putting on glasses for the first time after a lifetime of astigmatism. "This is how skinny people think about food! It wasn't a moral failing or incurable disease after all!"
The weirdest feeling has got to be the fat people who aren't (yet) on the shot. The sense of sheer inevitability, that every late night snack or second serving at dinner is close to the last one before it never happens again.
posted by MattD at 11:41 AM
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I'm spooked by the anhedonia aspect--I (fat, no GLP-1) already have low mental health days that are plagued by "nothing is food" feelings, when eating is a real struggle. I don't want that to be my life (and I don't want lower libido or other joy-seeking drives either). It seems like turning down those desire drives is an intrinsic part of the way it works and not a side effect that can be solved for. But who knows, maybe science will find a way to target the effects more precisely?
posted by rivenwanderer at 12:03 PM
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(Though, a medication that drastically cut my doomscrolling down would honestly be welcome!)
posted by rivenwanderer at 12:16 PM
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Everyone's mileage may vary. Ozempic gave me sporadic nausea and occasionally the slow emptying resulted in my regurgitating a bit of food when I was asleep and using my CPAP machine, so that was it for CPAP that night. Switched to Mounjaro and it's been smooth sailing ever since and I actually got taken off one of my other diabetes meds because my A1C dropped that low. Food noise (a term that I only found out about on GLP-1s) is diminished but not completely absent. Lost some weight, not a lot but it was still welcome. The only major side effect is that I can't go on bike rides longer than about a metric century (about 62 miles), so no more RAGBRAI, but if it lets me keep my eyes, kidneys, and legs, I'll take it.
posted by Halloween Jack at 1:09 PM
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922257033c4a0f3cecdbd819a46d626999d1af4a: it's interesting to see the 'just asking questions' when it comes to GLP-1s and compare the same to say, COVID mRNA vaccines.
Part of the difference, I think, is that mRNA vaccines were designed to (and seemed to achieve?) a narrowly targeted response. GLP-1 treatments appear to do all kinds of interesting stuff.
posted by clawsoon at 1:18 PM
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For those who are struggling to get insurance to cover it, Hims and Shed will pretty much rubber-stamp it as long as you pay them and profess your deep unwavering love for GLP-1 compounded with B-12 self-injected subcutaneously. $200/m is not cheap, but it's not $1000 to $ 500/m and give them a weight and height outside of a 'healthy'* BMI.
I haven't read every comment, but I would like to speak from experience, having lost 70lbs over 8 months. GLPs DO NOT MAKE YOU LOSE WEIGHT. FULL STOP. They make it easier to enact significant lifestyle changes. But when you're eating 1.5 meals a day, it makes you feel like absolutely bloated shit, and your stomach fucking hurts for an hour, now you are on your way.
That entire time, I never felt actual tummy-rumbling hunger, but I still had emotional hunger. Anti-depressants and/or therapy can help there but GLPs won't. Thankfully, I had both.
*BMI is horsepucky, and doctors should know better than to use it to discuss health issues. Scales that rudimentarily measure fat/muscle ratio aren't expensive.
posted by MiltonRandKalman at 1:45 PM
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I guess there's also the route of scoring some free Narcan and making DIY Contrave.
posted by mittens at 1:55 PM
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So, I took Lexapro for years and I told anybody who'd listen that it was a great, life-changing drug that had done wonders for my anxiety. Then it stopped working for me, and it started to screw up my mental clarity and made my heart wonky. (Not just the Lexapro, in fairness, but it turns out longstanding autonomic issues + Lexapro + beta blockers can fuck you up real good.) Getting off of it has been a nightmare, with brain fog, panic attacks, migraines, etc. I'm like five months into this crap, and every time I think I'm getting better it comes around to kick my head in again. I wouldn't tell anybody to not take SSRIs, but I'd tell them to be extremely cautious and to not stay on any one drug too long. SSRI discontinuation syndrome is a hell of a thing.
From a lifetime of being on many, many meds, I know what tricksy, dangerous things they are. Take them if you need them, but take the minimum dose you can get away with and get off that stuff as soon as you can. Even the drugs that actually help you are probably doing other stuff that is not good. Medicine is a genie in a bottle, a monkey's paw. Maybe it'll save your life, or maybe it will mess you up in ways you can't even imagine.
As somebody who is sick all the damn time, of course I was tempted to ask my doctor about this stuff. But then I remind myself that it's basically brand new on the market and breathless announcements about a Miracle Cure are how zombie movies start. I really don't want to be a guinea pig for the Umbrella Corporation. The people taking this stuff now may see lots of amazing benefits from it... and I sure hope it doesn't give them tumors in 15 years.
(This rambling post brought to you by a brain thoroughly addled by Lexapro.)
posted by Ursula Hitler at 3:43 PM
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(prozac has a much longer half-life than lexapro and can really help with symptoms of discontinuing shorter half-life ssris.)
posted by mittens at 4:11 PM
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Count me as another happy GLP-1 user. I have been oversized since literal infancy, >99% on height and weight on the growth charts as a kid and plenty fat as an adult. It's been very helpful with weight loss though not as dramatic as many other people have experienced.
I had a lot of enduring success with losing weight via a keto diet starting maybe 12 years ago--say 50 lbs have stayed off. Years of experimentation since have confirmed that if I eat even a fairly low carb diet of whole foods--I'm talking fruits and starchy veg and legumes and literal whole grains (wheat berries, steel cut oats)--I will first put on water and then gain fat. It is hard to adhere religiously to less than 20 g net carbs each day. I tracked my intake for years and it can make me absolutely crazy so for mental health reasons generally I avoid it. Bottom line is that my weight has varied over the years in my lower weight, low-carb register. I have always been in the "obese" category by BMI.
If you list out all of the "bad", "obesogenic" stuff blamed for obesity in America (fast food, sweets, baked goods, chips, booze, restaurant meals, ultraprocessed food, soda, sugary "health foods" like flavored yogurts and smoothies, whatever): I haven't eaten that shit in literal decades. I eat plenty of vegetables and since my mid 30s have worked out vigorously a few times a week. Still fat. Despite a high quality diet and plenty of exercise my body's innate sense of what is enough is clearly out of whack and I can easily eat more than what my body plainly needs. Without these drugs I also can only eat less than what my body needs with a lot of suffering. It so weird to be toting around many lbs of extra fuel and to get so hungry that I feel gnawingly miserable and light headed. I'm a PhD biochemist and I have to believe there's some mechanism that gets in the way of fuel being released into the bloodstream. The "eat less, move more" chorus can kiss my ass.
One of the most interesting observations about eating keto it that it dramatically changes my experience of hunger and satiation--much less hungry, much more easily sated. Seems in line with the lower insulin = increased fat release hypothesis of why keto works. When I heard about GLP-1 drugs having the same effect, especially since they were originally developed as diabetes drugs (e.g., affecting blood sugar/insulin systems) I was really curious about whether they would let me eat wholesome higher carb foods like fruit and legumes. I started Wegovy about two years ago and enjoyed eating those foods. I lost about 10% of my body weight on Wegovy before plateauing at the highest dose--still well in the obese range.
I moved to Zepbound last fall. It has a higher effective dose and I'm losing weight again, very slowly, like a pound a month. I have recently started experimenting with getting diligent about being in the keto zone again--lord, I hate tracking--and so far it does seem to be synergistic. I'm at 12.5 mg and my doc is holding the highest dose as a last option if and when I stop losing weight on the current dose.
I don't have a "goal weight" because that way lies madness. There seems to be no imminent danger of me ever being underweight so I'm just happy to be able to move better and am rolling with it however it goes.
I'm not noticing any other big "off label" effects. Depression and suicidal ideation are a known side effect of Wegovy and I did notice that I was in an atypical black mood each time I upped the dose on that drug. Doesn't seem to be the case with Zepbound, thankfully.
I'm not bothered by the fact that the mechanism of action isn't fully understood. That's true of other common and accepted drugs too (like acetaminophen.) However much humankind has learned about bodies there is much, much more we still have to learn.
I am so grateful that these drugs are available and that they seem so broadly effective and am very curious to see how they evolve over time. The biologic/injectible/cold chain aspect is a big part of why they're so expensive. Shit is going to really get real when GLP-1 oral formulations are improved, and/or drugs that affect obesity through completely different mechanism are developed.
posted by Sublimity at 8:27 AM
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MiltonRandKalman: "For those who are struggling to get insurance to cover it, Hims and Shed will pretty much rubber-stamp it as long as you pay them and profess your deep unwavering love for GLP-1 compounded with B-12 self-injected subcutaneously. $200/m is not cheap, but it's not $1000 to $ 500/m and give them a weight and height outside of a 'healthy'* BMI.
$200/m is well outside of the budget of most people in the US. Nearly 4 in 10 Americans lack enough money to cover a $400 emergency expense, Fed survey shows That's a single $400 expense, not $200 every month for the rest of your life.
I currently take a biologic drug to treat my inflammatory arthritis. The co-pay for that is $300/m. I can only afford that because the manufacturer reimburses me the full cost. If I had to pay $300/m, I would have to start driving Door Dash or something. And I have "good" health insurance as a state employee.
What's happening in the US is that wealthy people will be able to get GLP-1 drugs, and no one else will. Being fat will just become an even clearer marker of the already stigmatized poor even more than it already is.
posted by hydropsyche at 2:38 PM
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As part of their "new strategy for weight loss care treatments" (i.e., not getting sued into oblivion), Hims is no longer doing compounded GLP-1's, with some small exceptions.
posted by mittens at 3:36 PM
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What's happening in the US is that wealthy people will be able to get GLP-1 drugs, and no one else will.
Wealthy people will be able to get full-price, FDA-approved, name-brand GLP-1 drugs. For the rest of us, there are mail-order pharmacies in India, greymarket Chinese biosimilars and an increasing array of biohacker "peptides" to inject ourselves with.
At least until something finally snaps and the political situation in the US changes dramatically, we'll have a two-tier system: one supply chain for people who can afford (or have luxe enough insurance to cover) brand-name FDA-approved drugs, and another supply chain that exists in the grey areas of international commerce, ranging from having your well-traveled friend pick you up generic versions of your prescriptions in a civilized country, to sending Monero to some guy on WhatsApp and hoping whatever shows up in a brown envelope a few weeks later is what you think it is.
posted by Kadin2048 at 12:25 AM
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Kadin2048: "Wealthy people will be able to get full-price, FDA-approved, name-brand GLP-1 drugs. For the rest of us, there are mail-order pharmacies in India, greymarket Chinese biosimilars and an increasing array of biohacker "peptides" to inject ourselves with."
On my most bleak days, I hope that all the rich folks injecting themselves with unregulated complete bullshit supposed "peptides", from RFK Jr to your favorite podcaster to apparently every wealthy person in the US, suffers permanent damage to their health, is no longer able to work, and suddenly has to deal with just how much this country hates the chronically ill and disabled.
posted by hydropsyche at 5:57 AM
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sending Monero to some guy on WhatsApp
if the collapse of american healthcare makes me have to learn about crypto i'm gonna be so mad
posted by mittens at 7:06 AM
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