[HN Gopher] A new class of drugs for weight loss could end obesity
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A new class of drugs for weight loss could end obesity
Author : bumbledraven
Score : 14 points
Date : 2023-03-05 20:26 UTC (2 hours ago)
(HTM) web link (www.economist.com)
(TXT) w3m dump (www.economist.com)
| bumbledraven wrote:
| https://archive.fo/4eE2y
| pedalpete wrote:
| It seems like we never learn.
|
| There are definitely a group of people who truly need this drug
| (diabetics), but the obesity epidemic is the result of poor diet
| and a lack of exercise.
|
| So rather than solving for the problem at the source, we're
| suggesting a "quick fix" which has some known side-effects, and
| potentially many more unknown. Historically we look at the drugs
| that have promised weight loss in the past, and they have all
| been pulled from the market, or shown to have negative
| consequences.
|
| Taking the drug likely still doesn't solve the other side of the
| obesity epidemic, which is exercise. So are we going to pop a
| pill that exercises for us as well?
|
| What will life look like for future generations when they can eat
| like gluttons, laze around with robot servants bringing us our
| every wish, and AI that can think for us?
|
| That's not a future I want to live in. I already see parts of it
| with the UberEats/DoorDash, etc - where people think they are
| just too busy to go and do something themselves, then I find out
| they are watching 3 hours of television and tiktok per day.
|
| I'm tempted to downvote myself for this rant, but I do find this
| a very worrying state.
| exfatloss wrote:
| Obesity is unsolved. If you know what dietary intervention will
| cause significant long-term fat reduction in a majority of
| people, please demonstrate and you'll win the Nobel peace
| price.
|
| We just don't know. Trust me, this is kind of my thing.
|
| That said I am also naturally skeptical of quick fixes. The
| known side effects of these drugs seem meh, but I worry about
| hidden ones. E.g. I've heard these described as "chemical
| starvation" - doesn't exactly sound healthy long term to starve
| your body?
|
| I strongly disagree exercise has anything to do with the
| obesity epidemic. Exercise is great but not related to obesity.
|
| edit:
|
| let's debate this guy and not just downvote, plz?
| renewedrebecca wrote:
| Obesity is one of those areas where if you don't suffer from
| it, solving it seems easy... "just" eat better. "just"
| exercise.
|
| Problem is, once the body's mechanisms get out of whack, it
| just doesn't work that way. When you try to lose weight via
| calorie restriction, especially if insulin resistance has set
| in, hunger is going to catch up to you. Study after study has
| shown this.
|
| Drugs like ozempic, metformin, even wellbutrin... They act on
| those mechanisms, and that's why they result in weight loss. If
| you think people are taking those medications and then binging,
| that's honestly not what's going on. Once those feedback
| mechanisms are under control, you're simply not controlled by
| hunger anymore. That naturally leads to weight loss.
| exfatloss wrote:
| 100% agreed.
|
| Diet advice from naturally thin people is like dunking advice
| from Shaq. "Just walk up and put it in" won't cut it for
| those of us who have a screwed up metabolism.
| bberrry wrote:
| I'd be lying if I said I wasn't excited by the discovery of
| semaglutide. I'm not particularly heavy (BMI of 26.5) but I would
| happily pay for it if it was available over the counter.
|
| I wonder how long that will take, if ever.
| exfatloss wrote:
| Don't know about OTC but patents last 20 years. So the generics
| will be out then. And you could get it prescribed by your
| doctor w/o a big deal like blood pressure meds or something
| now. I got a CGM prescribed just cause I wanted one. No biggie.
| thatguy0900 wrote:
| Honestly not sure how I feel about people being able to be
| absolute gluttons then just take a pill and have no consequences.
| I can't imagine a move to healthier eating or lifestyle
| afterwards.
| Enginerrrd wrote:
| That's not how the pills work. They act by reducing hunger and
| creating satiety at lower caloric inputs. They also often have
| nausea and vomiting as side-effects.
| anonuser123456 wrote:
| You misunderstand the mechanism of action.
|
| You cannot be a glutton on this class of drugs. They make you
| not want to eat, and that's how weight loss is achieved.
|
| Think back to a time when you had a gastroenteritis. There is a
| period after vomiting where you are fine pain wise, but have a
| mental opposition to eating. That's the sensory feedback these
| drugs give to your HPA axis.
| halfjoking wrote:
| Sounds horrible. Why don't people just learn how to fast?
|
| Prebiotic fiber while fasting feeds gut bacteria so you won't
| feel overwhelming hunger. Electrolytes/mineral-salt stop
| "fasting headaches." With prebiotics and drinking tea my
| stomach doesn't even growl while fasting, and I'm more
| productive. Most people just need to try and they'll find
| it's easier than they thought.
| exfatloss wrote:
| I've fasted a ton including every sort of IF and up to 7
| days water/10 days fat fast. Didn't do anything for fat
| loss. Read here if you care:
| https://exfatloss.substack.com/p/19-fat-loss-experiments-
| ive...
| exfatloss wrote:
| Haha hopefully without the disgust ;) edit: oh wait, is this
| why they sometimes cause vomiting? Like you literally feel
| sick?
| exfatloss wrote:
| Will be interesting to see how that dynamic acts out. I'm also
| kind of dumbfounded. E.g. will we just make food even
| unhealthier and just counter it with more of these drugs? Where
| eventually we're just chugging soybean oil laced with high
| fructose corn syrup? :D
|
| I mean could the drug counteract that or is there a limit?
|
| Guess we'll find out.
| _aavaa_ wrote:
| The real money quote is: "A bigger drawback, however, is that
| those who start taking the new drugs are likely to depend on them
| for life. Stop, and the weight piles back on, just as with most
| conventional diets."
| thomascgalvin wrote:
| This _is_ a drawback, but I 'm not sure how terrible it is.
|
| If you go off the drug, you regain your weight. If you go off
| your diet, you also regain the weight. That, then, is a wash.
|
| These drugs currently cost a fortune, so lifelong dependence is
| an expensive scenario, especially since most insurances refuse
| to cover them. On the other hand, this is preventative
| medicine, which might significantly reduce costs from obesity-
| related health issues down the road, including heart disease,
| cancer, and arthritis.
|
| Compliance with a weekly injection is also likely to be higher
| than compliance with a long-term dietary change. Of course,
| since something like 95-plus percent of diets fail long-term,
| almost anything would have a higher compliance.
|
| I don't know that we have enough data on long-term use of these
| drugs to be confident about long-term side effects, either.
|
| I don't love the idea of being dependent on a medicine for the
| rest of my life, but there are plenty of other lifelong
| medicines that we just sort of accept as normal now. Insulin-
| dependent diabetics and people with high blood pressure are
| just two examples.
|
| I guess for now I'm putting these in my "cautiously optimistic"
| bucket.
| exfatloss wrote:
| 100% agreed. I currently wouldn't take it just because it
| seems to have pretty drastic effects, and we don't seem to
| quite understand on what or how.
|
| The reported side-effects like 5% have nausea or whatever,
| don't seem too bad. Prices will inevitably come down if these
| go mainstream.
|
| Would I snap my finger like Thanos and obliterate obesity in
| natural ways if I had the 7 rings or whatever?
|
| Yea, but I don't. This is a decent alternative, it seems. If
| there are no serious long-term side-effects.
| dsfyu404ed wrote:
| "Like dieting but easy, just pop a pill" still seems like a
| huge net positive for society.
| exfatloss wrote:
| Not even pop a pill - take an injection weekly, at home. Zero
| stigma, nobody will even know you're on it.
| thomascgalvin wrote:
| If these drugs prove workable over the long term, pretty
| soon everyone will suspect you're on it, because the
| majority of people will be. There would be no more of a
| stigma about this than taking a medication for blood
| pressure.
| exfatloss wrote:
| 100%.
|
| I've heard the theory that once we discover the cure for
| obesity, it'll be over in 2 years and nobody will miss
| it. What, like 40% of Americans are currently dieting at
| any given time? And that's with a ~0% success rate.
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