[HN Gopher] Ozempic drug supresses desire to smoke, drink and more?
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       Ozempic drug supresses desire to smoke, drink and more?
        
       Author : explosion-s
       Score  : 60 points
       Date   : 2023-05-19 16:18 UTC (6 hours ago)
        
 (HTM) web link (www.theatlantic.com)
 (TXT) w3m dump (www.theatlantic.com)
        
       | mym1990 wrote:
       | A drug that promotes weight loss, lessens the desire to smoke,
       | drink, etc...sounds too good to be true?
       | 
       | From what I have heard, all of these issues come back as soon as
       | someone comes off the drug. So either a person is committing to a
       | lifetime of being dependent on this drug, or a person is
       | committing to some period of time of ideal living, followed by a
       | possible time of depression after reverting to the status quo.
        
         | justinbaker84 wrote:
         | This is exactly what happened to me. The clinic I went to
         | recommended starting out with 1/10 the normal dose for the
         | first month to make sure I would tolerate it. Then we would
         | move up each month.
         | 
         | It worked so well I didn't want to move up so for month 2 I
         | stuck with 1/10th the amount. During that month the effects
         | wore off so I had to take more to get the same impact. I chose
         | to just quit.
         | 
         | 2 months after quiting I am 7 pounds fatter than I was when I
         | started with the drug. I suspect that most people will need to
         | keep taking more and more of it to get the same benefits they
         | got from the recommended dose. I am really concerned this is
         | going to lead to a bigger health crises than the one it
         | purported to solve.
        
           | spondylosaurus wrote:
           | > I am really concerned this is going to lead to a bigger
           | health crises than the one it purported to solve.
           | 
           | A lot of diabetics taking it to regulate blood sugar
           | (particular the feedback loop with insulin and hunger) have
           | said it's changed their life... but for people who are merely
           | overweight I think the benefits may not always be worth the
           | side effects. IMO the correlation between weight and health
           | is not as strong as people often assume.
           | 
           | Anecdotal, but if you looked at me and my partner, you'd
           | probably assume I was the "healthier" one based on our
           | respective body types. But they're strong, fit, and rarely
           | get sick (knock on wood); meanwhile I'm a lifelong wimp with
           | a host of autoimmune issues. I outsource all of the heavy
           | lifting to them, literally--if the trash is too heavy for me
           | to take to the dumpster, they get to do it instead :P
           | 
           | So to your point about health crises, yeah. It seems foolish
           | to put my partner on a weight loss drug just so they could
           | "look" healthier while nursing a bunch of unpleasant side
           | effects that would make them far sicker than they were
           | before.
        
             | HDThoreaun wrote:
             | Obesity is the number one cause of heart disease, which is
             | the number one killer in this country. No, its health
             | effects are not being overstated.
        
               | spondylosaurus wrote:
               | Sure, but that doesn't mean everyone who's overweight has
               | high blood pressure and therefore should go on "shit your
               | brains out" medication.
               | 
               | EDIT: Also, to my previous anecdote, despite being the
               | skinny one compared to my partner, I actually _do_ have
               | several heart problems! (Thank you inflammatory
               | diseases.) But you wouldn 't guess that by looking at me,
               | because weight is not a 1:1 indicator of health.
        
             | mym1990 wrote:
             | I think weight is the wrong thing to target for gauging
             | health, but it is the thing that is in everyone's face and
             | easy to see. Undernourishment is just a big of a problem as
             | over-nourishment. Targeting the four horsemen(t2 diabetes,
             | Alzheimer's, heart disease, cancer) is a better use of time
             | and money, but they are relatively much harder to identify
             | early.
        
               | spondylosaurus wrote:
               | > Undernourishment is just a big of a problem as over-
               | nourishment.
               | 
               | Having been recently diagnosed with Crohn's I 100% agree.
               | Getting skinnier during a bad flare makes people _think_
               | I 'm in better health, because I look a certain way that
               | aligns with their expectations, but it really just means
               | my gut isn't absorbing any nutrients. Turns out being at
               | my lowest weight in years was a Very Bad Thing and not a
               | sign I was doing anything right.
               | 
               | Which, again, is an interesting juxtaposition with my
               | partner who weighs more than me but whose body functions
               | correctly and whose biomarkers come back normal, unlike
               | mine.
        
         | karaterobot wrote:
         | For a lot of people, it's kind of a choice of which substance
         | you are going to be dependent on. It's all expensive and sad,
         | but between Ozempic and cigarettes, alcohol, or overeating,
         | Ozempic has got to be healthier, and quite possibly cheaper in
         | the long run.
        
           | mym1990 wrote:
           | Healthier in what sense? There is little knowledge of long
           | term side effects and it isn't even approved for weight loss,
           | it is specifically for people with diabetes.
        
             | iwanttocomment wrote:
             | Semaglutide, the active ingredient in Ozempic, is
             | absolutely approved in the US for weight loss. Ozempic is
             | the trade name for the diabetes medication, Wegovy is the
             | trade name for the weight loss medication. They are the
             | exact same medication, in the same formulation.
        
               | mym1990 wrote:
               | Ah, good to know!
        
           | justinbaker84 wrote:
           | I took it and started out with a small dose. The impact of
           | that dose wore off eventually and the plan at my clinic was
           | to raise it over time.
           | 
           | I am concerned that maybe there isn't a dose where you can
           | stop taking more and keep the results. I am worried that
           | everybody will need to keep taking more as they build up more
           | tolerance to it. The study that showed how effective the drug
           | is was 60 weeks long.
           | 
           | That is a long time, but it doesn't show what happens if
           | somebody plans on staying on the drug for years.
        
           | nancyhn wrote:
           | Is a drug or drug-like-food (ie, sugar) dependency really the
           | only option?
        
             | oniony wrote:
             | No, there's also badmington.
        
             | deegles wrote:
             | What do you suggest otherwise? Clearly whatever we're doing
             | now has led us to this point.
        
             | karaterobot wrote:
             | Versus, like, "just suck it up"? No, but empirically that
             | strategy has had poor results across the wider population.
             | It seems like it would work, but usually doesn't. At some
             | point people look for more effective strategies.
        
             | yamtaddle wrote:
             | It's that, or dropping out of modern life, as far as I can
             | tell.
             | 
             |  _Everyone 's_ on something and/or coping in unhealthy
             | ways.
        
             | acjohnson55 wrote:
             | Most research indicates "yes", conditioned on the consensus
             | of what comprises the modern lifestyle.
             | 
             | I've been trying to understand what changed to create the
             | obesity epidemic. Many things contribute, but it's hard to
             | identify the smoking gun. My understanding is that one
             | major lever seems to be the advent of snacks,
             | refrigeration, and microwaves. Drastically reduced food
             | prep overhead has radically alerted eating patterns.
        
               | mym1990 wrote:
               | It seems pretty obvious that the massive injection of
               | sugar in the 60s and 70s into diets paved the way for
               | pretty much everything else that followed(snacks, fast
               | food, convenient food, etc). I guess we can all ignore
               | that diabetes is driven by insulin resistance and the
               | body's inability to process glucose, which is
               | conveniently also the predominant thing in our food
               | today, because we would rather look the other way and
               | continue living in a fairy tale...that is until we are
               | disease ridden in our 40s, at which point we can live out
               | the rest of our lives on meds and in the hospital.
        
         | thomascgalvin wrote:
         | > A drug that promotes weight loss, lessens the desire to
         | smoke, drink, etc...sounds too good to be true?
         | 
         | It does sound too good to be true. However, it's possible that
         | the drug is working on all of these through the same mechanism:
         | by altering the brain's reward system.
         | 
         | If that's true, the drug doesn't make you not want to eat, it
         | makes you not want _stuff_ , in general. That could potentially
         | suppress a wide array of addictive behaviors. I also wonder if
         | that suppression might look a lot like clinical depression,
         | though.
        
         | 015UUZn8aEvW wrote:
         | >From what I have heard, all of these issues come back as soon
         | as someone comes off the drug. So either a person is committing
         | to a lifetime of being dependent on this drug, or a person is
         | committing to some period of time of ideal living, followed by
         | a possible time of depression after reverting to the status
         | quo.
         | 
         | This is true of every weight loss intervention: Weight
         | Watchers, low-carb, keto, Whole 30, etc. Once people stop
         | complying with them, they gain the weight back.
         | 
         | Most people don't realize how dismal the stats on long-term
         | weight loss are. Almost no one maintains a substantial amount
         | of weight loss for many years by following "just eat healthy
         | and exercise" advice. The only intervention that does reliably
         | work is bariatric surgery. The jury is still out on the new GLP
         | drugs.
        
         | coffeebeqn wrote:
         | If something affects so many basic functions of the body, the
         | side effects must be intense as well
        
         | trasz4 wrote:
         | >From what I have heard, all of these issues come back as soon
         | as someone comes off the drug
         | 
         | Same as with drugs for hypertension, depression, hyperglycemia
         | and many, many others. Not every drug is supposed to somehow
         | permanently cure you.
        
         | aplusbi wrote:
         | A lot of addiction is caused by social issues or mental health
         | issues, but it's really hard to deal with those issues when
         | someone is also dealing with the effects of addiction. A drug
         | like this could provide an opportunity to fix the underlying
         | issues causing addiction in the first place.
         | 
         | And for some people they will have to take this for life, which
         | isn't so different from many other medications.
        
         | jameshart wrote:
         | > A drug that promotes weight loss, lessens the desire to
         | smoke, drink, etc...sounds too good to be true?
         | 
         | What other desires does it lessen? Does it suppress every
         | hedonistic impulse? What does it do to creativity? Impulsivity?
         | Does it make you more susceptible to or resistant to
         | persuasion? Feels like reporting 'oh it has these other
         | unintended psychological/behavioral responses. Neat!' is
         | ignoring a whole can of worms that that opens.
        
           | mym1990 wrote:
           | I think the body of work around what this drug does outside
           | of its impact on patients with diabetes is pretty limited,
           | which is what is scary about everyone jumping on this one.
        
         | iwanttocomment wrote:
         | I'm not sure why "it stops working when you stop taking it" is
         | used as an argument against these new peptides. This is the way
         | almost every medication we encounter works.
         | 
         | Tylenol might get rid of your headache, but that headache can
         | come back tomorrow. Stop taking birth control and you might get
         | pregnant. Stop taking Claritin and your allergies return. Stop
         | taking insulin, and, as with these new peptides, you lose
         | control over your blood sugar. Stop taking Adderall, and not
         | only will your ADHD symptoms come back, you'll also experience
         | withdrawal.
         | 
         | Almost no medications are "one and done", and I'm not sure why
         | Ozempic or Mounjaro are being held to needing to be a cure when
         | it's clear that they're effective, repeatable treatments for
         | blood sugar control and (likely related) weight gain.
        
           | iwanttocomment wrote:
           | (If the answer is "because you'll learn to eat less or eat in
           | a more healthy fashion", it may well be that the metabolic
           | issues that are creating heightened blood sugar or appetite
           | issues _may not be able to be resolved by diet alone_ in
           | those who respond well to these peptides.)
        
           | mym1990 wrote:
           | I am not holding Ozempic to needing to be the cure for
           | anything. My point is that people without diabetes are
           | looking to this drug for weight loss, at which point they
           | create a dangerous dependency, with no hard evidence that
           | their actual health improves. This is opposed to coming up
           | with long term solutions that involve re-evaluating daily
           | decisions that lead to some of these diseases in the first
           | place. If Ozempic is a good treatment for blood sugar
           | control, which could be a good factor to consider in weight
           | fluctuation, maybe reduce the amount of sugar one eats?
        
             | iwanttocomment wrote:
             | Is it _really_ a _dangerous dependency_? There 's been no
             | evidence of anything happening once individuals go off of
             | semaglutide or tirzepatide other than the tendency of
             | gaining weight to the original levels and/or blood sugar
             | readings returning to the pre-medication levels. This is
             | the most common outcome anyone has trying literally any
             | calorie-reducing diet, medication or not. There's no
             | evidence that people are ending up _worse_ for having been
             | on the medication, except for some who experience gastro
             | effects early on and can simply quit.
             | 
             | Also, yes, you can absolutely advocate for a low-carb/low-
             | sugar diet for those with poor blood sugar control. The
             | issue there is that virtually every medical professional
             | has advocated for similar diets for diabetics or those with
             | blood sugar control issues for centuries, or even millennia
             | - there is evidence of recommended diets for those with
             | diabetes since BCE. This does not mean that those diets are
             | easy or pleasant to follow, whereas all evidence indicates
             | that common issues with appetite and energy on a limited
             | calorie or low-carb diet are less prevalent with these new
             | peptides than those trying to go it alone.
        
               | mym1990 wrote:
               | I don't necessarily mean dangerous in the health aspect,
               | although long term affects of these drugs are not know
               | yet...I mean the dependency on needed the drug to keep a
               | certain lifestyle, and then having an "oh shit" moment
               | when you're in a place that you can't access it, whether
               | that be traveling or the supply of it becomes scarce, or
               | it gets banned, etc
        
         | standardUser wrote:
         | The first days, weeks and months are often the hardest time
         | when quitting a substance. If this drug helps a smoker not
         | smoke for 3 months, by that time the nicotine addiction has
         | weakened considerably. They've gotten past the hardest part. I
         | see no downside to that.
         | 
         | Similarly, if a person loses 30 pounds on this drug, then stops
         | using the drug and reverts to normal habits, it will take a
         | while to regain those 30 pounds. And the long term shift of
         | maintaining the new body weight doesn't require any radical
         | changes (unlike losing 30 pounds, which does require sustained
         | radical changes).
        
           | justinbaker84 wrote:
           | That is not what happened to me. I took it for 2 months and
           | then I wanted to get off. I did not go back to normal.
           | Mentally I felt like I needed more food and more junk food
           | than I ever did before using the drug.
           | 
           | My hypothesis is that it supressed my body's natural
           | production of whatever chemical in my brain helps me not go
           | overboard with food. With that supressed by the drug I had an
           | uncontrollable desire for food and currently I am fatter than
           | I was before taking the drug in the first place.
        
             | 1123581321 wrote:
             | An interaction with leptin? Or are you just feeling hungry
             | after the side effects wore off?
             | 
             | You also said it stopped working while you were taking it
             | in another post; are you just talking about satiety or one
             | of the other effects like insulin production or glucagon
             | release? Are you diabetic or just overweight?
        
             | yamazakiwi wrote:
             | This same thing happened to me when I quit smoking without
             | assistance from a drug.
        
           | mym1990 wrote:
           | This is what I thought as well, that the habits that drive
           | some of these activities would be dramatically weakened, but
           | it looks like the body is not actually re-aligning to a new
           | homeostatis level, so when a person gets off the drug, the
           | body is trying to get back to the old level. I don't think it
           | all comes back to habits, often your body is working really
           | hard against you to get back a level it feels is
           | right(whether that level is 'healthy' or not).
        
           | raducu wrote:
           | > The first days, weeks and months are often the hardest time
           | when quitting a substance. If this drug helps a smoker not
           | smoke for 3 months, by that time the nicotine addiction has
           | weakened considerably.
           | 
           | I love(d) nicotine and it was the only substance that I ever
           | was addicted to. I tried dozens of times to quit and the only
           | thing that helped was getting treatment for my ADHD. Quitting
           | nicotine was easy for me on methylphenidate. I only tried
           | combining them and nearly went to the ER, so I quickly learnt
           | that I can't take them both. But when I'm on methylphenidate
           | I just don't crave nicotine that much. It took 2-3 years to
           | completely not get any nicotine cravings at all.
        
       | throwaway5959 wrote:
       | Wasn't this the plot of the Firefly movie? It didn't work out
       | well for them.
        
         | pixl97 wrote:
         | I mean the opposite where we're fattening up ourselves like
         | lambs for the slaughter isn't working out great either. We've
         | had recent downward trend in longevity.
        
       | myshpa wrote:
       | Psilocybin too.
        
       | rektide wrote:
       | I'm surprised Ozempic gets all the press. Supposedly Mounjaro is
       | all that and more.
       | 
       | The wonderful Paul Ford has the best writeup I've seen that
       | discusses these more meta levels, the post-human implications of
       | a drug we can genuinely widescalely reprogram ourselves with.
       | Paul's so great. https://www.wired.com/story/new-drug-switched-
       | off-appetite-m... https://news.ycombinator.com/item?id=34660232
        
         | HDThoreaun wrote:
         | Ozempic has been around longer and there were a bunch of
         | celebrities taking it and talking about it on twitter so I
         | think it has more cultural cachet. Most people probably don't
         | know about mounjaro, I don't even think it's approved for
         | weight loss yet.
        
         | kristofferR wrote:
         | Massive text: "People taking Mounjaro lost up to 25 LBS"
         | 
         | Small text underneath: "Mounjaro is not a weight loss drug."
         | 
         | Man, the US pharma industry/marketing is so weird.
         | 
         | https://www.mounjaro.com/#:~:text=mounjaro%20is%20not%20a%20...
         | .
        
           | iwanttocomment wrote:
           | Mounjaro is not yet approved for weight loss in the US even
           | though there is strong evidence that it will be, and there's
           | little question that there has generally been weight loss in
           | those taking it for diabetes.
           | 
           | Recent studies have very clearly shown it's effective for
           | weight loss even in those without diabetes, but there's a lag
           | as the FDA reviews those studies. Until then, Lilly simply
           | can't advertise it as a treatment for obesity.
        
         | shrimp_emoji wrote:
         | My favorite Linux distro; it's basically a user-friendly Arch
         | with goodies like a GUI kernel switcher thrown in.
        
       | Avshalom wrote:
       | "Semaglutide does not dull all pleasure, people taking the drug
       | for weight loss told me. They could still enjoy a few bites of
       | food or revel in finding the perfect dress; they just no longer
       | went overboard. Anhedonia, or a general diminished ability to
       | experience pleasure, also hasn't shown up in cohorts of people
       | who take the drug for diabetes, says Elisabet Jerlhag Holm, an
       | addiction researcher at the University of Gothenburg."
       | 
       | So it doesn't dull _all_ pleasure just _almost all_ so it 's not
       | _technically_ anhedonia...
       | 
       | I dunno, still seem pretty fucking bleak to me.
        
         | contravariant wrote:
         | I'm not sure it is pleasure driving people to go overboard. I'm
         | pretty sure it is dissatisfaction that is driving excess. In
         | which case a drug that means you're more easily satisfied is
         | far from bleak.
         | 
         | If anything the _opposite_ is far more bleak. Imagine if there
         | was a drug that meant you 're less easily satisfied, who on
         | earth would want that?
        
         | kevviiinn wrote:
         | Our experience exists on a series of spectrums, some people
         | experience pleasure _way too intensely_ and it actually causes
         | problems which is why this might be a good thing
         | 
         | Obviously there are people who like the pleasure given to them
         | by food a bit too much and they consistently overindulge, it
         | can be that way for many things as well. I'm not saying that
         | the cause is always related but for many it may be
        
         | Taywee wrote:
         | Addiction is often extremely distressing. Dulled pleasure can
         | be far better than drinking yourself into a stupor every single
         | night.
        
       | lumb63 wrote:
       | I'm glad people are enjoying Ozempic. My experience from seeing a
       | family member on it, is I would not touch it if I were a
       | 500-pound alcoholic smoking two packs of cigarettes a day. That's
       | an exaggeration since it probably outweighs the health issues
       | there, but only slightly.
       | 
       | The person I know taking Ozempic has only lost weight (35 lbs)
       | due to the fact that eating now makes her sick. She has been
       | sapped of all energy and has developed issues with her bladder,
       | circulatory system, joints, thyroid, and digestive system since
       | starting Ozempic. I'm not saying it's due to Ozempic, but I am
       | saying all these issues have cropped up in the few months since
       | she started taking it, and she never had any chronic health
       | issues prior. At least she lost some weight, I guess.
        
         | ikekkdcjkfke wrote:
         | Same experience here, gallstone attacks
        
           | shrimp_emoji wrote:
           | You can get those from rapid weight loss, I thought. Maybe
           | it's working TOO well if that's the case.
        
         | MandieD wrote:
         | Your relative's sad story reminds me of a short story I read a
         | few years ago about a miracle pill that leaves about 90% of its
         | takers perfectly slim and able to stay that way eating
         | anything, after a few truly disgusting initial days of
         | elimination, but kills the other 10% gruesomely.
         | 
         | Because it's so wonderfully effective for the majority, there
         | ends up being a ton of social and economic pressure for anyone
         | even slightly overweight to take it, despite said 10% risk of
         | death.
         | 
         | (Edited to add):
         | 
         | "The Pill," by Meg Elison
         | 
         | https://escapepod.org/2022/11/03/escape-pod-861-the-pill-par...
         | 
         | https://escapepod.org/2022/11/10/escape-pod-862-the-pill-par...
        
         | ex3ndr wrote:
         | Super weird since once you get thyroid problems, you have to
         | drop this medication.
        
         | burnte wrote:
         | I take it, and when I started I got violently nauseous and had
         | GI issues. I wasn't informed I needed to slowly ramp up.
         | 
         | I still have pretty big appetite suppression, and only minimal
         | nausea sometimes if I eat too much, but what it's done to my
         | blood glucose is AMAZING. And I lost some weight when I started
         | which was a great bonus. It can be hard to start but it's truly
         | worth it, just adjust the dose. I take 0.5mg as I can't handle
         | the larger 1.0mg dose.
        
         | kristofferR wrote:
         | While others have none or barely any side effects, it is a drug
         | after all.
         | 
         | For those people who tolerate the drug well, it can be
         | revolutionary in their lives, but it's unfortunately not a good
         | fit for everyone.
         | 
         | I hope your family member gets better soon.
        
         | ortusdux wrote:
         | >>due to the fact that eating now makes her sick.
         | 
         | Reminds me of the first FDA approved weight loss drug, Alli,
         | that basically just gastrointestinally punishes you if you eat
         | more than a few grams of fat.
         | 
         | https://en.wikipedia.org/wiki/Orlistat#Side_effects
        
           | vrc wrote:
           | Never trust a fart on orlistat. The horror stories I've read
           | of people soiling themselves after eating seemingly normal
           | meals is nuts. On par with Olestra/Haribo sugar-free stories.
           | Also it makes absorbing fat soluble vitamins a huge issue.
        
           | spondylosaurus wrote:
           | > The manual for Alli makes it clear that orlistat treatment
           | involves aversion therapy, encouraging the user to associate
           | eating fat with unpleasant treatment effects.
           | 
           | Christ. This is like Crohn's disease in pill form. One too
           | many teaspoons of olive oil and you're in for an unpleasant
           | evening...
        
             | ortusdux wrote:
             | I remember grabbing a pamphlet when it was new and reading
             | their recommendation to wear dark colored pants and bring a
             | change of clothes to work.
        
               | op00to wrote:
               | If shitting your pants in the break room is what gets
               | people who can't control their weight any other way to
               | get to a healthy level, I think that's worth it.
        
               | aidenn0 wrote:
               | I want to frame this comment as an example of (the
               | generalized form of) Poe's law.
        
               | znpy wrote:
               | Jesus Christ on a bike, that's beyond dystopian, that's
               | completely f---ked up.
               | 
               | Does the fda allow that?
        
       | crakenzak wrote:
       | Now if only it didn't cost so damn much every month even under
       | insurance =(
        
         | toomuchtodo wrote:
         | Going to be huge when it goes off patent off exclusivity. I'd
         | also expect you'll be able to get it when it's made in
         | jurisdictions that will ignore the patent. Up to you to get it
         | from those places, either via mail or travel runs.
        
           | tboyd47 wrote:
           | They will find some way to prevent people from acquiring it
           | and promote some other in-patent drug.
        
             | toomuchtodo wrote:
             | Lots of ways around jurisdictional regs. Consider how many
             | people live near a national border, or have access to the
             | postal service.
             | 
             | https://www.usnews.com/news/best-
             | states/articles/2018-11-01/...
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523158/
             | 
             | https://www.cnn.com/2023/03/07/health/fda-drug-shipments-
             | khn...
             | 
             | https://www.usatoday.com/story/news/health/2022/12/14/state
             | s...
             | 
             | Also, I expect CRISPR or gene therapy to be the long game
             | wrt this and updating the body's GLP-1 regulation, versus
             | maintenance doses of a pharma product. This is a shim.
             | 
             | https://benmay.uchicago.edu/crispr-gene-therapy
             | 
             | https://www.creative-biogene.com/crispr-
             | cas9/solution/glp1r-...
        
             | HDThoreaun wrote:
             | It is not possible to stop people from getting mail order
             | pills from China. Especially with the abortion restrictions
             | the market already is pretty large and it will be easy for
             | them to throw these drugs in too.
        
               | trasz4 wrote:
               | We used to believe it was not possible to stop people
               | from getting their funny movie clips from China.
        
               | pseudo0 wrote:
               | The solution to that was a $10 per month subscription via
               | Netflix and clips for free on YouTube. Meanwhile Ozempic
               | is around $1,000 for a month's supply. That is a margin
               | on par with illegal hard drugs, which already have a
               | smuggling supply chain from China to North America (eg.
               | Fentanyl and variants).
        
           | justinbaker84 wrote:
           | A lot of clinics are administering the generic form and it is
           | still very expensive.
        
         | BizarroLand wrote:
         | You can buy it as a "research chemical" and save money, but
         | then the potential consequences of diy medicine and all that
         | that entails are all on you.
         | 
         | Hopefully the price will come down more as it becomes more
         | prevalent or as generics become available.
        
           | rektide wrote:
           | I'm not that afraid of swallowing random chemicals but self
           | injecting is a bit hardcore for me.
        
             | EthicalSimilar wrote:
             | FWIW, SubQ injections are pretty much completely
             | unnoticeable in terms of pain / feeling at all. It's more
             | the mental barrier of doing it to yourself but once you've
             | done it for the first time you soon realise it's fine.
        
               | rektide wrote:
               | The actual doing it seems wild/absurd, but I don't think
               | that would hold me back.
               | 
               | This is ignorant/uniformed, but, taking research chemical
               | by ingestion feels like I have some natural barriers
               | still. Where-as I feel like there's a much more raw
               | exposure to risk with injection. Also there's dumb risks
               | like infection, if I don't attend well enough to
               | injections.
               | 
               | In spite of these protests, I think you are probably much
               | closer to the truth here. Thanks for writing. These
               | reactions I have are, I suspect, not really significant.
        
             | opportune wrote:
             | Steroid users do it all the time and I haven't heard of
             | steroid users dealing with infections much.
        
           | scheme271 wrote:
           | GLP-1 agonists are a bit more tricky since they are
           | temperature sensitive and need to be injected. You'll really
           | need to be careful to keep it sterile and handle it properly.
           | Whether the "research chemical" will receive the proper care
           | until it gets into your hands is something that you're
           | literally gambling your health on.
        
         | scheme271 wrote:
         | It's not the only GLP-1 agonist out there. Victoza is another
         | GLP-1 agonist and should be going generic in the US in a little
         | over a year. It might already be available as a generic outside
         | the US. There might be other GLP-1 agonists that are going
         | generic soon as well.
        
       | glonq wrote:
       | What happens when you reach your target weight with drugs like
       | this?
       | 
       | After having learned _potentionally nothing_ about nutrition,
       | exercise, and self-control, are you stuck on these meds for life
       | out of fear of binge-eating back to your original weight?
       | 
       | FWIW I'm on a hundred-pound roller coaster ride from 300lbs to
       | 200lbs; currently ~215. I've learned a lot about discipline and
       | sustainable habits along the way.
        
         | op00to wrote:
         | What happens when someone who was previously deeply depressed
         | but feels better goes off an antidepressant? They learn to
         | handle life, or they return to the drug if further treatment is
         | needed. It's not a moral failing.
        
         | opportune wrote:
         | I've never been obese but after losing 30+ lbs of weight I
         | found it a lot easier to live an active lifestyle and keep the
         | weight off. Partly it was just that moving around was
         | physically easier and less strenuous, but also that I was less
         | self conscious and had higher self esteem.
         | 
         | I imagine Ozempic will help with this even if people don't
         | learn about nutrition per se. Though I think basically
         | everybody knows nutrition, it's more about self control IME.
        
       | beefman wrote:
       | https://archive.is/MfXlm
        
       | NickC25 wrote:
       | My neighbor is on Ozempic. Guy was slightly chubby previously but
       | has dropped like 30 pounds in record time. Now he looks pencil-
       | thin.
       | 
       | I guess that's a success, but he would be much healthier if he
       | just didn't eat like crap and took an hour each day to exercise.
       | 
       | Sad that the obvious route (diet and exercise) is skipped by so
       | many people, who just want to continue their unhealthy lifestyles
       | but not suffer the physical consequences of it.
        
         | renewiltord wrote:
         | Sometimes I see people have written a bug in code and I wonder
         | why they didn't just do the obvious and write it without the
         | bug.
         | 
         | Personally, every time I'm about to introduce a bug I just
         | choose to not do it.
        
           | moonchrome wrote:
           | I mean if you know ahead of time the thing you're doing is
           | going to produce buggy code then yep your analogy holds.
        
             | renewiltord wrote:
             | Yeah, it's weird, right? But people keep putting use-after-
             | free bugs everywhere. Like, do the OpenBSD guys not know
             | that this is a bug (and worse, a security bug)? They keep
             | putting them everywhere. A few years ago they stuck one in
             | OpenSMTPD.
             | 
             | Theo de Raadt would benefit from reading some Hacker News.
        
               | moonchrome wrote:
               | That's like saying obese people are the same as
               | bodybuilders because they both eat surplus calories and
               | have high BMI.
        
         | furyofantares wrote:
         | > Sad that the obvious route (diet and exercise) is skipped by
         | so many people
         | 
         | Many people also try it repeatedly for several years or even
         | decades, failing all the while. There's also psychological
         | issues that make this hard (possibly among other issues), and
         | no pithy remedy like "try diet and exercise" for that (well,
         | ok, sometimes people say "try therapy" this way, but we can
         | include people who've included that for several years too.)
        
         | amanaplanacanal wrote:
         | Unfortunately, suggesting that people eat less and exercise
         | more doesn't seem to actually work that well. We've been trying
         | that for decades and the obesity epidemic just keeps getting
         | worse.
        
           | shagymoe wrote:
           | Have we though? I seriously doubt doctors are aggressively
           | pushing eating well and exercising. Has anyone ever received
           | a workout plan from their doctor besides some generic PT
           | exercises? Do they develop nutrition plans tailored to you?
           | Do they track your progress? Do they have any incentive for
           | you to actually get better? Do they require regular blood
           | tests and include all the tests that might actually tell them
           | something?
           | 
           | The answer is a resounding no. None of that. Even if you
           | request a blood test, they will include the absolute bare
           | minimum and fight you when you request something like vitamin
           | D or testosterone. General healthcare in the US is farce. You
           | must be your own doctor, do your own research and fight for
           | the care you need and also tolerate doctors telling you that
           | you don't know what you're talking about. Besides being
           | prescribed antibiotics, no doctor has ever fixed any problem
           | I've ever had. I had to do it myself.
        
             | iwanttocomment wrote:
             | _I seriously doubt doctors are aggressively pushing eating
             | well and exercising._
             | 
             | Have you ever... been to a doctor when you've been obese? I
             | assure you that they will indeed push eating well and
             | exercising to obese people. Even when you've already been
             | eating well and exercising. This will not be an
             | intervention by the PCP themselves - your primary can
             | really just refer people to substantial interventions - but
             | they will try to refer you to one of three things.
             | 
             | First, they will recommend a book on healthy eating and
             | exercising.
             | 
             | Second, there is behavioral weight loss, which generally is
             | a combination of an appetite-suppression medication like
             | phentermine and a Very Low Calorie Diet through a pre-made
             | controlled calorie diet (such as Medifast or Optifast). A
             | program like this will absolutely require weigh-ins and
             | blood tests.
             | 
             | Third, they will recommend surgical weight loss, most
             | likely gastric bypass, such as Roux-en-Y. There are
             | guaranteed to be medical follow-ups after the surgery.
             | 
             | If you are not clinically obese, and that's great, no, your
             | PCP will not provide that type of advice. They're not there
             | to help you with subclinical concerns with weight. There
             | are plenty of dietitians out there who can.
             | 
             | Anyway, that's not a resounding no - it is extremely common
             | to be referred to these programs if you have any
             | substantial level of obesity. If you're obese, and you
             | haven't been referred to these programs by your PCP, that
             | might be an issue with your primary.
             | 
             | What's exciting about these new peptides is that a simple
             | once-a-week injection might be able to be prescribed by a
             | primary with limited intervention or without outside
             | specialists or surgery and still have good results in terms
             | of weight-loss, as opposed to the truly exhausting
             | requirements of a medically-assisted VLCD or weight loss
             | surgery.
             | 
             | Finally, I have no idea what you're talking about Vitamin
             | D. I've both been diagnosed with a Vitamin D deficiency by
             | my primary (through blood tests!), and Vitamin D
             | supplements are easily available over the counter without a
             | prescription.
        
           | NickC25 wrote:
           | Probably because people aren't acting on it, or sticking with
           | it long enough to actually see results.
           | 
           | Especially in today's world when they can just take a pill
           | and loose 10-15 pounds, nobody wants to do something they
           | probably don't like doing (consistent exercise or healthy
           | eating) as part of a short-term or long-term process.
           | 
           | A lot of people, especially those in food deserts or without
           | access to adequate nutrition on a consistent basis (or those
           | who cannot afford quality food, or those unable to prepare it
           | properly) are not going to undergo something where change is
           | gradual versus taking a magic pill, side effects be damned.
           | Sad, but that's the world we live in.
        
       | akiselev wrote:
       | https://archive.ph/1waP9
        
       | omgmajk wrote:
       | I was on ozempic for a bit but it raised my resting pulse from
       | 65ish to 95ish just sitting at my computer so I had to stop
       | taking it.
        
       | bitwize wrote:
       | The cure for everything and secret to longevity is still fasting.
       | These miracle diabetes drugs (including Metformin) have turned
       | out to be mostly fasting with extra steps.
        
       | tboyd47 wrote:
       | [flagged]
        
         | roywiggins wrote:
         | Wegovy- semaglutide- is approved for weight loss "in adults
         | with obesity or overweight with at least one weight-related
         | condition (such as high blood pressure, type 2 diabetes, or
         | high cholesterol)":
         | 
         | https://www.fda.gov/news-events/press-announcements/fda-appr...
        
         | trasz4 wrote:
         | One works, the other doesn't.
        
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