[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 : 255 points
Date : 2023-05-19 16:18 UTC (1 days 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.
| chriscappuccio wrote:
| > 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.
|
| All of these diseases have significant input from bad
| diet and metabolic disorder. Alzheimer's is considered a
| variation of t2d in some circles.
| atchoo wrote:
| What if the greatest harm is that the easy path of modifying
| our biology prevents us ever needing to gain the self-knowledge
| and build the fulfilling lives that lets us thrive in a world
| surrounded by potential addictions?
|
| I consider myself a much wiser and stronger person in recovery
| than I was before addiction. Who would I be if I took a magic
| pill and was still the person that sought oblivion? What will
| humanity be if it doesn't need such self-knowledge and
| resilience? What impact will that make in say, our future
| politics?
| chadlavi wrote:
| This feels like the same logic as "I had to pay off my
| student loans, so other people should have to suffer like
| that too." Suffering does not make you better later despite
| what millennia of Christian theology has told people about
| its supposed purgative effects. It seems pretty rad to me to
| be able to just not suffer through the bad part of getting
| over a major life problem, and I for one am happy that people
| will be able to skip that part and get on to the part where
| they live well.
| atchoo wrote:
| This is not an argument that suffering is valuable, it's
| that drug-seeking behaviours are a symptom of poor
| psychology / life-fulfilment.
|
| The fear is that by removing symptoms, we no longer find it
| important to address the root cause. The symptoms should be
| treated as a warning signal. It sounds dystopian to make
| poor psychology and poor life-fulfilment a consequence free
| norm.
| AnIdiotOnTheNet wrote:
| Could be worse. Omeprazole not only stops working after you get
| off it, your issues actually become much more severe. Once
| you're on it, you are unlikely to ever be able to get off of
| it.
| lost_tourist wrote:
| do you have stats to confirm your assertion about this drug
| because it seems as speculation as saying "well maybe if I was
| 100lbs less I would have more energy, be happier with myself
| and therefore have more willpower to have a more healthy
| relationship with food".
| 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.
| jasonfarnon wrote:
| do you know what tolerance effects are acknowledged by the
| makers/doctors? I was thinking this was more like insulin;
| is it more like an opiate?
| 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.
| aorloff wrote:
| Read Gary Taubes
| 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.
| htag wrote:
| To pile on other popular theories on smoking guns, there
| is a widespread decrease in physical activity levels.
| Physical activity can delay or prevent type 2 diabetes,
| as well as having widespread benefits on almost every
| system of the body. Physical activity also improves
| mental health, which impacts some behaviors around
| emotional/addiction driven over eating.
| 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.
| reaperman wrote:
| Reports from people using this don't indicate that they feel
| depressed at all. They either get a ton of nausea if their
| dose is too high, or they just don't get cravings to eat tons
| of "bad" food. Most people I've talked with on low doses
| report they can still eat large meals, but it has to be a
| pretty conscious, determined decision.
|
| No one's been reporting depression that I've seen. And these
| groups ('fitness enthusiasts') experiment with enough other
| things that do cause depression that they're quite sensitive
| to changes in "well-being", "outlook on life", "mood", and
| "energy levels". It would be more widely reported in these
| circles if it did resemble depression.
| 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.
| akiselev wrote:
| _> The only intervention that does reliably work is bariatric
| surgery._
|
| My understanding is surgery only works reliably because
| failure to comply with life style changes post-op is easily
| fatal and ethical doctors only perform the operation after
| patients have demonstrated that ability. In all but the most
| extreme patients, about a fifth to a third of the target
| weight loss has to happen pre-op for doctors to even consider
| the procedure. The surgery is essentially a sword of Damocles
| hanging over patients, reminding them that they'll die much
| faster than normal if they over eat.
| jasonfarnon wrote:
| " failure to comply with life style changes post-op is
| easily fatal"
|
| My understanding is naive but I always thought it was no
| longer possible to fail to comply after this intervention?
| confoundcofound wrote:
| You can rupture your GI sutures if you do not adhere to
| the post-op diet, and risk death.
| SamoyedFurFluff wrote:
| No, you can seriously damage your stomach, which is now
| already severely scarred.
| wcfields wrote:
| New addictions post bariatric surgery is fairly common.
| Gambling for instance [1] replaces food.
|
| [1] https://www.researchgate.net/publication/332884264_Gamb
| ling_...
| fosk wrote:
| Clinically, what causes the urge to have an addiction?
| Like in your statement, replacing food with gambling. I
| would assume that these are fundamentally two different
| reward systems for the brain, or maybe not?
| paulpauper wrote:
| best to read the study before commenting on it
|
| _In the addiction literature, the development of
| gambling dependence after bariatric surgery is limited.
| Mitchel et al. reported that 2 cases presented with post-
| operative gambling addiction in their 3-year screening
| study in 201 post-op case (5). In our case, the presence
| of genetic background may be a risk factor for the
| develop-ment of gambling_
|
| 2 out of 200 cases is not that common and close to
| baseline level
| jjeaff wrote:
| Failure to comply with the post op diet might be fatal
| within the first few months of recovery (although I haven't
| heard of that happening, I'm sure someone has died from
| eating too much), but after that, you are going to be
| mostly healed up. And its the long term that will determine
| if the weight loss sticks. It certainly isn't just because
| the surgery selects for people with willpower. Because
| almost everyone who has it has gone through years of losing
| and gaining back their weight over and over.
|
| Bariatric surgery usually works for 3 reasons. First and
| most obvious is that it reduces your stomach size so you
| simply can't eat as much. Second, in most cases, reducing
| the surface area of the stomach reduces the amount of
| hunger hormones that get released thus making you less
| hungry all the time. And the third is malabsorption.
| Meaning that of the food you do eat, you absorb less of the
| calories than you did before. So if it were possible, you
| could potentially eat the same amount as before but still
| lose weight.
| paulpauper wrote:
| Diets fail because ppl lose willpower. These new drugs in
| theory make this easier
| rolisz wrote:
| Isn't that the case for every diet? You can lose weight on
| diets and then gain it back when you start eating the way you
| used to.
| 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.
| hombre_fatal wrote:
| The same could be said even for interventions like "don't eat
| surplus calories" and "life weights". Once you stop, you
| don't get the benefits and you'll regress.
|
| "But you have to do it forever" shouldn't be a convincing
| dismissal after 10 seconds of thought.
| mcntsh wrote:
| By completely changing your lifestyle and retuning your
| habits your health isn't hinging on one single point of
| failure (a drug you need to take).
|
| If I stop going to the gym for a couple of months, I'm
| probably not going to gain any weight because I still eat
| healthy and stay active.
| 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.
| SOLAR_FIELDS wrote:
| Yeah, I honestly don't see a problem with taking a drug for
| life, as long as the side effects are minimal and the
| logistics are simple. I'm in my early 30's and have a family
| history of bad cholesterol. So once a day I will take a
| statin for the rest of my life. Not a problem, little to no
| side effects and pretty easy to manage, and not the end of
| the world if I miss one day every so often. Twice a day is
| not so easy to manage and plan but once a day is definitely
| manageable for a lot of people
| joedevon wrote:
| Imagine being 250 lbs and feeling like you are starving
| constantly, despite eating a lot every day. You decide to lose
| weight. You do something you hate, like calorie restriction and
| working out like a dog. You lose 80 lbs in 1 year. Bravo.
| Everyone tells you how great you look. You feel great. All that
| hard work was worth it. The fatness and a million other things
| really motivated you to do the hard work. I've done this a
| couple of times.
|
| Next day after hitting your goal, the starvation is still
| there. The desire to eat is still there. Hating working out is
| still there. But now you have to do this herculean effort every
| day not to get better. Not to lose weight. Just to maintain.
| Your brain wants you to gain 80 lbs and will never stop nagging
| you. Not on a good day. Not on a bad day.
|
| Then something really shitty happens in your life. Like it does
| for everyone. You slip. Eventually you start to gain back the
| weight. You just want to die. You feel like a failure. You hate
| yourself.
|
| That's the trick. Hitting goal weight the first time or two is
| relatively "easy". But you've achieved nothing if you aren't
| able to maintain weight loss. That's the failure of all
| approaches prior to these GLP1 and similar drugs.
|
| Having set the scene, now compare it to semaglutide. You have a
| drug that regulates your brain. Gets rid of the constant
| nagging to eat. You get normal brain. You lose weight.
|
| Now you have to pick, take a once a week drug for life to
| maintain, or do a herculean effort to fight the brain urges and
| work out to maintain.
|
| Which do you think will be more successful?
| 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?
| Ginden wrote:
| > 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.
|
| Medicine tried this. It's extremely hard to actually to do
| it in practice. Obviously, it's better solution, but we are
| living in real world, where we have to choose "good enough"
| solutions over those deemed "better, but infeasible for 90%
| of patients".
| 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.
| 0zemp2c wrote:
| How dangerous is it to have a new $1k/month bill you need
| to pay forever?
|
| So far there is no indication insurance companies are
| going to pay for 100 million Americans going on Ozempic
| who aren't diabetic...
|
| Anecdotally, another danger is people confusing less
| eating with a healthy diet. I know someone on
| Ozempic...eats less but what is eaten is the same old
| junk...
| lotsofpulp wrote:
| Given a significant percent of voters are overweight and
| obese, it would be very politically popular to legislate
| that health insurance must pay for GLP-1 antagonists.
| Atsuii wrote:
| Wouldn't this cause insurers to have to raise their
| premiums for everyone substantially?
| ouid wrote:
| No. The additional costs to the healthcare system due to
| people being overweight probably exceed
| 12000/person/year, but if not exceed it, they certainly
| come close. Moreover, it's not unheard of to mandate
| cheaper drug prices, and now that we understand how these
| drugs work, there will be more of them in the pipeline.
| nwiswell wrote:
| > The additional costs to the healthcare system due to
| people being overweight probably exceed 12000/person/year
|
| This is a big claim to assert without evidence. If it was
| the case then insurers would already be adding the drugs
| to their formularies.
|
| There is undoubtedly a cost associated with obesity but
| you are suggesting that simply being overweight doubles
| the average cost of care[1], a figure that already
| includes overweight and obese people (which are of course
| a huge population in the US).
|
| A quick Google search turned up a report[2] that suggests
| that
|
| > This estimated public cost equates to an average
| marginal cost of $175 per year per adult for a one unit
| change in BMI for each adult in the U.S. population.
|
| So, even for the extreme case of a very obese person that
| has a very successful treatment and goes from 40 BMI to
| 25 BMI, you are only saving a hypothetical $2,625 per
| year (perhaps an underestimate due to inflation and the
| age of the paper).
|
| Therefore it would appear that unless insurers strike a
| deal with the drug companies (lower the price, make it up
| in volume), such a law would dramatically increase
| insurance premiums. A better compromise would be a law
| which requires insurance companies to offer co-insurance
| on these drugs up to the expected savings.
|
| [1] https://www.pgpf.org/blog/2023/01/why-are-americans-
| paying-m....
|
| [2] https://vinecon.ucdavis.edu/wp-
| content/uploads/2019/04/cwe12...
| Ginden wrote:
| > If it was the case then insurers would already be
| adding the drugs to their formularies.
|
| American healthcare system has perverse incentivizes.
| Most unhealthy groups are generally least likely to be
| privately insured, so insurers are incentivized to
| prioritize health issues affecting working-age adults,
| while neglecting those which will be someone's else
| concern in future.
| atchoo wrote:
| You can also factor in that all those obesity related
| heart complications will turn into an extra decade of
| cancer treatments.
| c0m wrote:
| Why would a $1k/month drug increase costs more compared
| to the status quo of expensive bariatric surgeries and
| complicated heart failure/joint
| issues/osteoarthritis/sleep apnea etc. cases that arise
| from obesity? Massively reducing obesity rates seems like
| a good thing from the POV of an insurer.
| AnIdiotOnTheNet wrote:
| > Anecdotally, another danger is people confusing less
| eating with a healthy diet. I know someone on
| Ozempic...eats less but what is eaten is the same old
| junk...
|
| There is anecdotal evidence that eating less is, in
| itself, so much more healthy that it doesn't really
| matter what you eat. Nutrition professor Mark Haub ate
| nothing but "convenience store food" for 10 weeks at a
| caloric deficit and _all_ of his health metrics improved
| while he lost 27lbs.
|
| http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.profess
| or/...
| ed_elliott_asc wrote:
| Move country, it costs about a tenth of that in the UK.
|
| One month supply us about PS135 which is about $170 at
| todays rate.
| prepend wrote:
| > So far there is no indication insurance companies are
| going to pay for 100 million Americans going on Ozempic
| who aren't diabetic...
|
| What's the cost/benefit of weight loss and diabetes
| control vs $12k/year? I would expect people with high
| obesity are very expensive to insure and insurance can't
| drop people any more. It may be cheaper to pay for
| ozempic (especially at whatever negotiated rate insurance
| pays) than to pay for the alternative negative health
| outcomes.
|
| That and ozempic goes generic in 2031 and mounjaro in
| 2027 so soon this won't be a question of $1000/month but
| maybe $1000/year at which point insurers will probably
| force customers to take it or pay higher rates.
| 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
| CapstanRoller wrote:
| >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
|
| It sounds like you're realizing what it's like to really
| depend on a medication.
|
| The anxieties and risks you're describing are what people
| with diabetes, cancer, HIV, bipolar disorder,
| schizophrenia, depression, ADHD, etc. deal with on a
| daily basis for their entire life.
|
| Yeah, it _is_ frightening! Sometimes a guy like this[0]
| comes along and makes your life even worse!
|
| https://en.wikipedia.org/wiki/Martin_Shkreli
| reaperman wrote:
| That sounds like the lesser of two evils to me. Get
| healthier now and maybe sometime later lose access to the
| thing that helps you be healthier...or don't get
| healthier now? Yeah, there are other, orthogonal, choices
| but I don't think they're part of this particular
| decision matrix.
| mym1990 wrote:
| But given that the actual health benefits of ozempic(for
| me weight loss is not indicative of better health) have
| not actually been seen yet, you are quite possibly just
| taking on both evils at the same time.
| reaperman wrote:
| On the contrary: GLP1 agonists show broad health benefits
| across the board.
|
| Check this 24-month clinical trial with >3000
| participants[0]. It showed improvements in rates of:
|
| - Cardiovascular death
|
| - Non-fatal Myocardial Infarction
|
| - Non-fatal Stroke
|
| - Revascularisation
|
| - HbA1c
|
| - Fasting Plasma Glucose
|
| - Body Weight
|
| - Lipid Profile ( total cholesterol, LDL cholesterol and
| triglycerides)
|
| - Urinary Albumin to Creatinine Ratio
|
| - Systolic blood pressure (mmHg)
|
| - "overall health related quality of life namely bodily
| pain, general health, mental component summary, mental
| health, physical component summary, physical functioning,
| role-emotional, role-physical, social functioning and
| vitality." (each of these categories were
| "quantitatively" measured using a calibrated
| questionnaire - - and they all showed a dose-response
| relationship -- 1.0mg semaglutide made a bigger
| improvement than 0.5 mg, vs. two different placebos)
|
| 0: https://clinicaltrials.gov/ct2/show/results/NCT0172044
| 6?term...
| [deleted]
| nwienert wrote:
| Yep. I lost 30lbs on it in 3 months. It took me 10 years
| to gain that weight.
|
| So I guess if it takes me 10 more years to gain it back I
| can look into taking it again.
| 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).
| sneak wrote:
| Nicotine physical addiction is over with in less than a week.
| The remainder is psychological habit and classical
| conditioning.
| 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?
| rolisz wrote:
| Did you quit cold turkey? Or did you slowly taper it off?
|
| I'm taking Rybelsus (pill form of semaglutide) and there
| are 3, 7 and 14 mg versions. My plan is to take 14 mg for a
| couple more months, then switch to 7 mg for 1-2 months and
| then 3 mg for a month before stopping taking it completely.
| Ginden wrote:
| > Mentally I felt like I needed more food and more junk
| food than I ever did before using the drug
|
| This is consistent with hungry brain hypothesis. Your
| hypothalamus detects that you have less body fat than
| amount set on "lipostat" and it tries to get fat content
| back to this set amount.
| 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.
| sirsinsalot wrote:
| Makes sense given the mechanism of action.
|
| I describe my adhd as being addicted to nicotine and
| stopping cold turkey. Except you're not addicted to
| nicotine, what you're addicted to is a stimulus that is
| inconsistent and changes constantly. Your cigarette is a
| constantly changing thing.
|
| Methylphenidate really messed me up, I found
| Lisdexamfetamine much much more effective.
|
| I still use nicotine, though in vape form these days.
| tonyarkles wrote:
| >I only tried combining them and nearly went to the ER
|
| Could you elaborate on that? I'm currently still a smoker
| (working on it...) and on Concerta. Your note alarms me :)
| y-curious wrote:
| Not the person you're replying to, but what helped me
| quit was the book "How to stop smoking" by Alan Carr.
| Highly recommend working through it and taking his point
| about cold turkey in good faith. Good luck!
| 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.
| clementmas wrote:
| Is this mostly a US drug? I never heard about it in France. I
| can't believe people love it so much without thinking about the
| actual source of their problem.
| throwawayadvsec wrote:
| The source of the problem is that animals are wired to eat as
| much food as possible as quickly as possible. You can't blame
| half of the population for something that is deeply wired into
| our brain and bodies.
| prawn wrote:
| I think you _can_ ultimately blame them, but you can also
| accept that for many it 's a very difficult problem to
| overcome and that finding other ways to tackle it has value
| to the individual and community.
| benrapscallion wrote:
| No, it is approved by EMA. https://www.has-
| sante.fr/jcms/c_2906429/fr/ozempic-semagluti...
| myshpa wrote:
| Psilocybin too.
| tremere wrote:
| [flagged]
| HDThoreaun wrote:
| Why do you assume other people's experiences match yours?
| CapstanRoller wrote:
| >just by deciding to
|
| Congratulations. You were blessed with some very convenient
| brain chemistry. Many others are not so lucky, and literally
| cannot even begin to commit to decisions you find trivial.
|
| It's probably impossible for you understand what it's like
| (which is good!) but for many people it's completely
| ineffective to use their free will to try and overcome the pull
| of their brain's reward system. That's when exogenous chemical
| assistance is needed.
|
| Addicts know what needs to be done, can see the harmful effects
| of not doing it, but no amount of internal force can make it
| happen. Addiction is horrible.
| sibeliuss wrote:
| I think a healthy dose of compassion is in order here.
|
| It is well known that compulsive tendencies are, in some
| people, literal demons that want nothing more than to destroy
| your life, and do. There are degrees to things and 'willpower'
| is not so simple.
| jacobrussell wrote:
| Congrats -- many people cannot do that, and would like to be
| able to.
| mattpallissard wrote:
| I'm a former alcoholic. I quit cold turkey years ago.
|
| Had a drug problem before that. Cold turkey as well.
|
| While I agree with you somewhat, I too don't like the
| narrative, I also realize that some people actually can't do
| that. Some people are faster, some smarter, some stronger, and
| some of us are better at sticking to a resolution. Everyone has
| things they're good at and things they struggle at despite the
| effort. Gotta find what works for you personally.
| Gud wrote:
| Couldn't agree more. Although I never suffered from obesity,
| I've lived a generally unhealthy lifestyle for most of my life.
| Slowly I've gotten my diet in order - not perfect, but a lot
| better. I haven't had a smoke for three days, and frankly, it
| was easier to quit than I thought. I still get the impulse to
| go buy a pack, but I hold out and 20 minutes later that
| intrusive thought is gone.
|
| I don't believe a pill would do much, in the end I needed to
| change
| aww_dang wrote:
| Even if a pill were the right solution, it wouldn't give you
| the personal growth that you are experiencing. Exercising
| your willpower in this way may allow you to increase your
| ability to make changes. These things can become easier with
| practice.
| sneak wrote:
| No pill is as effective as having finally had enough of what
| you don't want.
| Eumenes wrote:
| Pharma is big money. This drug can cost 800-1400/month. Average
| American can't even run a mile. Patients dont want to hear how
| they need to eat less or exercise. Doctors have long queues of
| people to get through. Easier to prescribe the pill and move on
| vs address lifestyle choice.
| 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.
| refurb wrote:
| It's not weird at all if you're aware of the regulations.
|
| Drug companies can't promote a drug for something it's not
| FDA approved for (off-label promotion). Companies face multi-
| billion dollar penalties for doing so.
|
| Mounjaro is approved for type 2 diabetes. And weight loss is
| a great way to help get your type 2 diabetes under control.
|
| So highlighting that it helps type 2 patients lose weight,
| while having an FDA mandated disclosure that it's not
| approved for weight loss alone, makes perfect sense.
| shrimp_emoji wrote:
| My favorite Linux distro; it's basically a user-friendly Arch
| with goodies like a GUI kernel switcher thrown in.
| ec109685 wrote:
| How is it for weight loss?
| reaperman wrote:
| Semaglutide gets all the press because it's a lot cheaper and
| _actually available_ (barely available, but available).
| Tirzepatide is much more difficult to get access to, though IMO
| it should be the one that people default to if they 're going
| to take this class of drug.
|
| Semaglutide will probably have the most side effects because it
| only has one action (GLP-1 agonist). Tirzepatide has slightly
| lower side effects because it adds a dual action (GLP-1 agonist
| + GIP analogue) so it can act at a lower magnitude on the GLP-1
| receptors to avoid strong side effects, while still having
| higher efficacy due to its additional, separate, GIP action.
|
| LY3437943 looks even more promising, with fewer side effects.
| LY3437943 retains both the actions of Tirzepatide but adds a
| third action, glucagon receptor agonist. So it should be able
| to have higher efficacy at a lower equivalent dose than the
| other two (less action on GLP-1 and GIP mechanisms, fewer side
| effects).
| mchannon wrote:
| Eli Lilly's scientific name for LY3437943 is retatrutide.
| Eumenes wrote:
| Congrats, you're now a lifetime subscriber to big pharma
| ingenika wrote:
| maybe useful to treat drug addiction ?
| jshaqaw wrote:
| It's interesting to me how much of the hostility to this drug has
| a moral dimension. I am quite fit for my middle age. It's a
| relative superpower which confers a degree of status in this
| world. It's not why I originally became fit 5 or so years ago but
| it's something I increasingly notice or to be clear others notice
| and comment on.
|
| I think the "fit" of the world get inherently uncomfortable that
| our relative social currency is being "devalued" if everyone can
| be like us with an "unearned" pill. And it comes out as hostility
| and skepticism.
|
| I admit haven't done much research on this particular topic.
| History should caution us that serious medication like this often
| has serious side effects which are not apparent early on. I get
| that. But unlike many others I don't "hope" that happens like
| some kind of moral balancing. I get that reaction. In my gut I
| have that "I did it with willpower and lifestyle and sweat and
| these people shouldn't just get it at CVS." But that's just the
| primate status brain talking.
|
| Not that it impacts the outcome but I sincerely hope these drugs
| can improve people's lives without significant negative problems.
| I can find my relative status elsewhere or better yet try to grow
| up past such impulses.
| joedevon wrote:
| Well said. I believe you are right. That and ignorance of how
| Leptin works, setpoint or lipostat theory of bodyweight
| regulation...once you've gotten fat, your setpoint goes up and
| the hunger signals are far greater than folks who have never
| gotten fat. You can have 2 athletes with identical weight
| height and BF%, but if one had been fat once, their hunger
| signals from the brain will be far greater than the athlete who
| was always slim.
| EdwardDiego wrote:
| From my experience of addiction, suppressing the sensation of
| pleasure derived, is only the start.
|
| People who are addicted will repeat the behaviour even without
| the neurochemical response. Consider the ritual of the addiction
| as a form of self-soothing.
|
| You have to treat the patterns we've trod in our own minds, as
| well as removing that biological reinforcement.
| TeeMassive wrote:
| I am taking Contrave to lose weight. Lost 30 lbs in 4 months. It
| is a drug that's composed of an anti-depressant and an opioid
| antagonist. Together they have a synergistic effect that
| represses binging envy and cuts appetite.
|
| It also has a repressive effect on drinking and smoke, to my
| great surprise. And it also has had an effect on my addiction to
| video games.
|
| Drugs companies get a lot of slack (most of the time deserving)
| but sometimes they create miracles pills.
| jmpman wrote:
| I've been on Mounjaro since August. Down almost 60lbs, and it's
| been a life changer. Have I had some gastrointestinal issues,
| sure, but expected. I feel great and my brain seems to be
| functioning as well as when I was in my 20's. Now, when I go to
| the bar with friends, I end up having maybe 2 beers and although
| enjoyable, I don't feel that light switch turning on which
| encourages me to drink more. Can I force myself to keep drinking,
| say if my good friends are in town and we're going out all night?
| Sure, but there's some reward center that's no longer lighting
| up. I just get drunker, but it's not more pleasurable. I was
| never a big drinker at home by myself. Maybe a glass of wine or
| two with dinner if my in-laws are coming over. Now I've literally
| had zero drinks at home by myself. Seems to have started changing
| about 3 month in.
|
| Work also seems more interesting, but my untreated ADHD seems to
| be getting worse.
| helsinkiandrew wrote:
| > but there's some reward center that's no longer lighting up.
|
| Do you find other pleasures (non food and drink) as enjoyable?
| Interesting to hear if it's selective or dampens everything.
| jmpman wrote:
| Sex, sure. Video games - maybe.
| yieldcrv wrote:
| the most surprising thing to me is how you're describing normal
| behavior that I can relate to all my life, but the community of
| strugglers is so big that this is a whole testimonial people
| feel comfortable and exalted to share
|
| like thats not something I'm deriding its just news to me
|
| makes me wonder what this drug actually does, flush gut
| bacteria? just the right ones?
| ramraj07 wrote:
| For a long time we have known the existence of a network of
| hormones controlling our apetite on the gut brain axis, with
| names like ghrelin, leptin, glp-1, orexin, somatostatin, list
| goes on [1]. Issue was the network was tres complice and hard
| to perturb without getting the opposite effect than what we
| wanted. Finally with glp-1, sglt2 and pcsk9 inhibition we are
| starting to be able to correct in the right way.
|
| To answer your question, yeah turns out it was never about
| will power. Some people just had hormone drive to be
| healthier than others and finally we can pharmacologically
| start to level the field.
|
| 1. https://www.cell.com/cell/pdf/S0092-8674(14)01503-7.pdf
| imtringued wrote:
| People talk about willpower but they ignore social
| influences like children learning habits from their parents
| or simply being forced by their parents to become obese
| (all it takes is a portion size that is slightly too big
| and demanding that you eat the full plate). No amount of
| willpower is going to end that unless you want to blame
| children for not running away from home.
| yieldcrv wrote:
| can we do this for working out and exercise?
|
| I'm lean but dont do that and can recognize the benefits.
| It would be cool if we could pharmacologically make that
| appealing too.
|
| What if we could just continually swap in states.
|
| Executive work mode, ah it feels so good to think and
| focus.
|
| Empath mode, ah it feels so good to build relationships.
|
| Brolic mode, ah it feels so good to think about working
| out, and actually work out!
| [deleted]
| Red_Leaves_Flyy wrote:
| Do you want to live in the world of we happy few? This is
| what you're suggesting with your rose colored glasses.
| What would really happen is companies would get the drug
| legalized so they can pump into their employees.
| yieldcrv wrote:
| Then some people would feel there is a lopsided power
| dynamic in their choice to take them.
|
| In the meantime I would like that choice from a purely
| self preservation interest in being good at other bodily
| health and resource appropriations
| kika wrote:
| Empath mode is oxytocin injection. Joking? Or not?
| Earw0rm wrote:
| Find the right exercise/workout for you and it'll be its
| own reward.
|
| Shouldn't take more than a bit of caffeine to get you
| moving at that point.
|
| As to empath mode, you've just described MDMA. But it'd
| be nice if there were something a little less intense.
| That you could take weekly without frying your brain &
| was mild enough for family/work social situations. (And
| no, alcohol doesn't fit the bill).
| yieldcrv wrote:
| > Find the right exercise/workout for you and it'll be
| its own reward.
|
| appreciate the perspective but I want to be like the
| people that feel pulled to "find" it at all.
| Earw0rm wrote:
| That's not so easy, but also not as hard as you think.
| Won't take a lot of time on any one thing to see if it
| clicks for you. Pick a couple of activities, do each from
| absolute beginner level, twice a week for four weeks.
| Once if you're pushed for time. Keep the one that sucks
| less after a month. You don't need to hear the voice of
| God to download the Couch to 5K running app, grab a basic
| weights set and watch a few vids on simple exercises, or
| sign up for a local yoga or spin session.
|
| The high can be way better than you'd believe possible
| before you try. Or if you don't believe personal
| anecdote.. /something/ must be keeping all those people
| coming back to it at considerable expense, hassle and
| time.
| tick_tock_tick wrote:
| > yeah turns out it was never about will power.
|
| What a completely silly take away. It's like nature vs
| nurture it's not 100% one thing only.
| beebmam wrote:
| Free will has not been shown to exist. Everything is
| nature.
| leroy-is-here wrote:
| Reality does not need to be peer-reviewed to be true.
| pasquinelli wrote:
| how could you separate actually will power from the
| illusion of will power?
| 0cVlTeIATBs wrote:
| You know the conversation has strayed once you start
| debating epistemology.
| AndrewKemendo wrote:
| This is the opposite of straying it's actually a real
| conversation
| rblatz wrote:
| I always thought that it's uncertain if free will exists,
| but you have to behave as if it does otherwise the world
| falls into chaos.
| [deleted]
| reaperman wrote:
| Any effects on gut bacteria will be _very_ downstream of its
| primary effects, which are on:
|
| - GLP-1 (semaglutide)
|
| - optionally, that and also GIP (tirzepatide)
|
| - optionally, both of those and also glucagon receptor
| (retatrutide)
|
| But these hormones directly make you not hungry, among other
| things. They are probably some of the things that your gut
| bacteria manipulate to commandeer your behavior.
| andbberger wrote:
| it's a GLP-1 agonist
| 015UUZn8aEvW wrote:
| Ozempic/Wegovy is a GLP-1 receptor agonist, but Mounjaro is
| a GLP-1 and GIP receptor agonist
| usernew wrote:
| If you're interested - not pushing an agenda. Here's what
| worked for this weird dude to not drink and stay fit.
|
| I used to lift and be real fit till about 40. Like bulky-lean
| looking, bench 400 10x with a 6pack. Had a lot to do with being
| on the road for work all over the world, and you sit at the gym
| at the hotel for an hour every night because of nothing else to
| do, and there are girls there also on business who you'll never
| see again. I drank A Lot, ate anything I wanted, and did lots
| of blo on weekends.
|
| It was getting out of control, so I did months of google-foo,
| went to a pharmacy in eastern europe, got like a thousand 150mg
| disulfiram pills under the counter for fifty bucks, and took
| one pill every morning for 2 years. You don't drink, you can't
| drink or you die, you forget drinking exists and after a couple
| of months don't even think about it, yet still do all the same
| stuff you used to - like dancing and clubs if that's your
| thing. And it's even more fun. There were no side effects.
|
| Then things changed with age, testosterone went to crap, joints
| hurt. I got married and settled down. Can't work out too much
| now - just a couple of hours per week, and no heavy weights.
| Within 2 years I couldn't fit into my clothes and had high
| blood pressure and high cholesterol.
|
| I realized I don't eat because I'm hungry, but because it keeps
| away sadness. So I changed my diet so I could eat however much
| I want. I now have a 4-pack instead of 6, fit into my pants,
| and eat however much I want.
|
| I cut out fat completely. No oil when I cook besides a light
| spray on the frying pan. No nuts. Tuna - not salmon. Real
| expensive lean filet if I want cow in my mouth. Only white meat
| from birds. All the pasta, rice, and potatoes I want, but zero
| sugar added to anything. Lots of splenda and sweet n low. Fat
| free fairlife milk (lactose filtered out = less sugar
| calories). I eat normal sized meals.
|
| Then, I have fruit and berries, and I eat as much of that as I
| want. I'm stuffing my face the whole day. Today, I had a pint
| of blueberries, 5 medium apples, 2 mangoes, and a pound of
| grapes.
|
| Speaking of gastrointestinal issues, my poo is now soft and
| gentle, and smells delicious.
| tremere wrote:
| > I stopped using cocaine and for some reason gained weight,
| the post
| usernew wrote:
| Not at all, the two events are clearly separate in my
| account of history, and are actually about a decade apart.
| The weight gain, as with 99% of people, comes from a
| testosterone change once you approach 40yo.
|
| It's really strange how you and a few other people just
| keep making up weird scenarios, then attacking those to
| make yourself feel superior. I don't get it. It was 1/4
| book page of simple text. How is it possible to read
| something that simple, that short, and then make up
| something completely different in your head. This explains
| a lot of politics, but I don't get what people with that
| mental illness are on HN. Please stop. You are not superior
| - you have reading comprehension problems.
| tysam_and wrote:
| That last line does not belong on most respectable websites
| on the internet.
| prepend wrote:
| Just imagine all the testing he had to get to reach this
| conclusion. GP has suffered enough.
| water9 wrote:
| If he hasn't learned by now, your post isn't going to teach
| him
| [deleted]
| gateorade wrote:
| This is kind of weird because there's a lot more data to
| suggest now that dietary fats are almost never the problem
| when it comes to obesity, and in fact dietary fats are really
| important for a lot of critical processes (brain function,
| neuroprotection, hormone synthesis). I get it for caloric
| restriction though since fat is denser than protein or carbs.
| vore wrote:
| This is such a "one weird trick your doctor doesn't want you
| to know!" anecdote. Mounjaro and Ozempic are generally
| prescribed in instances where dietary interventions are
| insufficient and perhaps one of the last resorts before
| bariatric surgery. If your dietary interventions worked for
| you -- great! But there is only a certain class of people for
| which they work for, and it is rude to assume the OP hasn't
| tried these methods already (it would be surprising if they
| hadn't, since so many people can't help themselves from
| offering this kind of advice unsolicited).
|
| With regards to cutting out fat, if you are advocating for a
| weight management plan for the general person, it is really
| too prescriptive and doesn't take into account that someone
| following your diet should not be accidentally increasing
| your carbohydrate intake (fruit sugars are still sugars!),
| resulting in the diet being a total wash. The gold standard
| for diet-based weight management is food journaling, and not
| cutting out an entire group of macronutrients without
| holistic consideration of your diet.
| rblatz wrote:
| I was slightly overweight, 22% body fat 6'2" 220, and was
| suggested semaglutide (generic ozempic) all other standard
| health metrics in the healthy range. It's not some crazy
| last resort drug, it's basically everywhere and readily
| available to anyone that want it.
| jmpman wrote:
| I'm 6'1", and my goal weight is 210. In theory I should
| get down to 180, but expect I'd be too skinny. Currently
| 246, so I have 6-8 months for my personal goal, and at
| $1200/month, I may self fund for the remaining 3-4 months
| to hit that goal. Not sure if I'm willing to drop another
| $6k to hit 180lbs.
| andy_ppp wrote:
| The gold standard for diet is whatever people can maintain
| longer term!
| vore wrote:
| That is of course more correct :) But the first step is
| building intuition about what and how you're eating!
| usernew wrote:
| and... this person now takes these last-measure pills
| forever? or here in the real world, do they use the pills
| to lose weight, and then maintain that normal weight
| forever with... perhaps a diet trick that works?
|
| people who have to take last-measure medication usually
| don't stop eating when they are full. i know, it's weird to
| tell someone who doesn't stop eating when they're full, how
| to still maintain weight if they... don't stop eating when
| they're full. i'm a weird guy with ADD and get side-tracked
| easily. I got an appointment with the florist about that
| next week, hopefully he can recommend a medication.
|
| yes, a doctor will not tell you diet tricks. if you are
| asking your doctor for diet tricks, we need to step back a
| minute. when you're done grocery shopping at jiffy lube,
| drive home, sit down, and carefully read this link.
|
| this is what a doctor is. a doctor will give you general
| health guidelines, but knows very little about diets.
| https://en.wikipedia.org/wiki/Physician
| jmpman wrote:
| I'm hopeful that it's more like 3 months out of the year.
| Looking back over the years, I've gained roughly
| 5lbs/year since I hit 30. Now in my late 40's, during
| Covid, it seems like that went to 10lbs/year. The first 3
| months on mounjaro, I lost 20lbs, so that cycle should be
| sufficient. I'd stay on it permanently, if it weren't for
| the $1200/month.
| usernew wrote:
| Here's something I tried that's a 5-year max type of
| solution. If my suggestion for "stuff your face with
| fruit" isn't for you, maybe this is. If you absolutely
| Have to eat fatty foods, there's Alli. It clumps about
| 1/4 of your fat intake into large balls, so you poo it
| out. For small weight gain like yours, perhaps it's
| enough reduction to maintain current weight. You can't
| take it longer than a few years, because you'll have
| vitamin issues. Oil-soluble vitamins dissolve in the
| clumped fat and don't get absorbed.
|
| I tried this a few years before going with my "apple
| diet." It works, but my bloodwork after a few years said
| I need to stop. There is a catch. The first year, you
| Cannot pass gas. That clumped oil that comes out, comes
| out very easily, and unfortunately Alli makes you gassy
| too. This side-effect goes away in about a year if you
| power through it.
|
| Not a dietician or a doctor, but perhaps your mounjaro
| treatment can be cycled with Alli (cheap, OTC) every few
| years to save some cash. Invest in a large bottle of Dawn
| dishsoap. Put it in a spray bottle and spray the bowl
| after you do your stuff. You'll have to, just trust me.
| vore wrote:
| Obesity is often a chronic medical condition that's not
| solely controllable by willpower. There is no difference
| between taking pills for treating obesity as a chronic
| condition vs any other chronic condition, like type 1
| diabetes. Decades of treating obesity as a personal
| failing have resulted in worse and unsustainable health
| outcomes.
|
| And again, you are being far too presumptuous about OP's
| interventions. And I certainly don't know what this
| business about ADD appointments at the florist or grocery
| shopping at Jiffy Lube you're talking about is.
| rblatz wrote:
| I suspect a chat bot, maybe not got-4, but maybe Bard?
| It's close, but there was no point and the references
| were off but weirdly close. Like florist could be
| psychiatrist.
| usernew wrote:
| I suspect someone who lacks social interaction in life,
| so does not understand subtle satire. Like a problem that
| could be solved by a florist. By talking to the florist,
| making friends with the florist, and having some bbq
| outings with the florist and her friends on the weekends.
|
| but before one would do that, which may be an
| insurmountable long-term goal, someone should compare
| going to a florist for pills, to going to a doctor for
| making up diets.
| usernew wrote:
| >not solely controllable by willpower
|
| so, would you say a solution to the problem that lets you
| eat as much as you want, so you don't have to use your
| willpower, be an appropriate solution to suggest? There
| is a difference between taking last-resort medication for
| the rest of your life, and eating apples.
| vore wrote:
| Your experience is not universal. Many classes of obesity
| CANNOT be treated by "eating apples". Don't just take my
| word for it:
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/
| (2019) Substantial weight loss is
| possible across a range of treatment modalities, but
| long-term sustenance of lost weight is much more
| challenging, and weight regain is typical1-3. In a meta-
| analysis of 29 long-term weight loss studies, more than
| half of the lost weight was regained within two years,
| and by five years more than 80% of lost weight was
| regained (Figure 1)4. Indeed, previous failed attempts at
| achieving durable weight loss may have contributed to the
| recent decrease in the percentage of people with obesity
| who are trying to lose weight5 and many now believe that
| weight loss is a futile endeavor6.
|
| Again, great that your regimen works for you! But a lot
| of these purely behavioral interventions are really not
| sufficient.
| usernew wrote:
| where in the world from what I wrote, did you get the
| idea that I was saying the obesity in all cases can be
| treated by eating as many apples as one likes. I also
| don't remember saying that apples are sufficient. I'm not
| taking your word, but you should take my words. Take my
| words with your eyes, have the brain process my words,
| and respond to my words and only my words. If you hear
| other words that your eyes do not see, don't respond to
| those.
| AnIdiotOnTheNet wrote:
| People like you are the absolute worst to deal with when
| struggling to lose weight. I managed to lose 150lbs, and
| it had very little to do with will power, at least the
| way people like you mean it.
|
| I had to reconfigure my entire life around it. I kept
| barely enough food in the house to meet my calorie target
| for the week. I once fell asleep while driving home from
| work and ran off the road because my blood sugar was so
| low. I spent 9 hours a week doing intense exercise and
| pretty much any time I wasn't doing that or working I was
| just sleeping. I basically had to have no social life,
| because socialization around here pretty much mandates
| large quantities of food.
|
| Is something physically wrong with me? Probably, but good
| luck getting an American doctor to give a flying fuck. My
| thyroid stopped working when I was a child and it went
| undiagnosed for two years because doctors just keep
| telling my mother I was lazy. Ultimately a toll booth
| attendant diagnosed it because her dog had similar
| symptoms and my mother had to go full Karen to get the
| simple blood test to happen. American physicians are
| fucking useless.
|
| Even treated, to this day I have to eat well under the
| caloric requirement that I "should" be eating and
| constantly feel like shit in order to lose weight, which
| makes me perform worse at work and apparently require 3-4
| hours extra sleep every day.
|
| I can guarantee you "willpower" people aren't doing that.
| Your body isn't fucked up and constantly demanding more
| calories than you need, so it comes easy to you and you
| probably just take any excuse to feel like you are better
| than other people.
| usernew wrote:
| I don't know how you can take a response that says "don't
| fight the willpower war, just give in and adjust your
| life so you don't need willpower" and interpret that as
| the polar opposite of what was written.
|
| It is people like you who are the absolute worst to deal
| with. You take a specific example which probably does not
| not apply to your body, completely and completely twisted
| what was said so you can both be a victim and feel
| superior.
|
| I specifically stated a diet that for a person who is
| working out a couple of hours per week, there is a way to
| constantly eat and minimize the caloric intake despite
| large amounts of food. I did not remotely suggest
| stuffing your face all day is a willpower-based solution
| to a thyroid problem.
|
| I'm 5'11. In my early 30s, I was a 31 waist, 170lb,
| benched a full set of 400lb, ran cross country, and had
| 6% body fat. In my late 30s, I was a 34 waist with high
| blood pressure. I made the change in my diet, and a few
| years later, I'm a 31 waist, 170lb, normal blood
| pressure, and 10% bodyfat, and I eat as much as I feel
| like, just not whatever I feel like.
|
| This is a solution for maintaining a healthy weight in an
| active lifestyle, that uses zero willpower, because my
| willpower is bad. This is not a solution for someone with
| a thyroid problem who needs to lose almost the weight of
| my whole body.
|
| I don't know what it is with you and this other guy. You
| read very simple basic text, and you reply to something
| you've completely made up. It's like your brain paints a
| virtual world for yourself where you can feel constantly
| offended. No one's out to get you. No one's making fun of
| you. People are talking about something that clearly
| wasn't for you, so you inject yourself into the
| conversation so you can feel attacked. Stop that.
| code_duck wrote:
| I believe "grocery shopping at JiffyLube" is a reference
| to consuming oils in one's diet.
| orhmeh09 wrote:
| What's your bloodwork and cardio like now and what does your
| doctor say? No fat + high carbs flies in the face of
| everything I've read that was published in the last 20 years.
| Maybe you've found another path to health?
| cesnja wrote:
| You're confusing complex carbohydrates with sugar.
| tsimionescu wrote:
| Pasta, rice, and fruit have huge amounts of simple
| sugars.
| orhmeh09 wrote:
| How complex are pasta, rice, pint of blueberries, 5
| medium apples, 2 mangoes, and a pound of grapes?
| rblatz wrote:
| I've been a fan of the keto diet (low carb high fat) for a
| while. But I suspect any diet that cuts a very large group
| of foods like carbs or fats out forces you to be more
| mindful of what you're eating. And that's a large part of
| the weight loss on those diets.
|
| Elsewhere in this thread it was stated that food journaling
| was the gold standard in weight loss, which also I'd expect
| to increase mindfulness around eating.
| tempestn wrote:
| I believe there's a fair bit of evidence to the effect of,
| any "diet" that restricts one's food options - be it
| calorie restriction, low fat, low carbs, low protein,
| intermittent fasting, no sugar, whatever - will result in
| weight loss as long as it's stuck to. Which makes sense
| logically; if normally you'd eat whatever you felt like,
| and then you restrict what (or when) you're "allowed" to
| eat, some substitution will be done, but you'll likely also
| just eat less.
|
| And then when you go off the diet (either intentionally, or
| more likely, by just slowly drifting back to the norm),
| you'll return to eating what you were before, and will
| return to your original weight. Which is why the only diet
| that works is one you can stick to indefinitely. So, if the
| parent can stick to a no fat, high complex carbs diet for
| life, it will probably work for them.
| usernew wrote:
| After 2 years, my blood pressure went back down to a steady
| 110/75, heart rate about 55-60, bad cholesterol is on the
| low of normal range. I do about 2 hours of cardio with
| light weights per week, no longer lift. That's not a lot,
| but it's enough to stay at the same blood pressure for many
| years now.
|
| I don't do high carbs - fruit are not high in carbs you
| actually process. I eat normal portions of complex carbs
| like bread and pasta, normal sized meals. I eat a
| ridiculous amount of fruit, and that has some sugar in it,
| but it's actually not that much. What that does is increase
| my fiber intake to ridiculous levels - and that has many
| benefits.
|
| My issue was that I use food as an anti-depressant, and to
| deal with stress. The solution had to involve eating a lot,
| but minimizing calories. That's why the fat had to go - I
| can eat twice as many carbs as fat for the same weight.
| When you look at things like fruit - a lot of those "carb"
| calories you don't even metabolize since it's fiber.
|
| I don't think I have discovered some magical solution, but
| it works for people like myself, who have what I consider a
| minor mental illness called 'self-medication with food.'
| Mental problems are a lot harder to fix than just not using
| oil and replacing nuts and chips with fruit. My solution to
| win the war was not to fight it and learn to live w/ the
| fact that I'm not perfect, and adjust the lifestyle to
| that.
|
| High carb diets are a bad idea. I eat normal balanced
| meals, just with no fat. Long-term high fat diets are for
| people who want liver damage, and stop eating when they're
| full. A little bit of fat makes you full, unlike carbs. But
| keto is terrible for your health if you do it for decades.
|
| The tiny amount of fat I do get, is from things like red
| tuna and other low-fat fish. It's amazing how little good
| fat you actually need in your diet, if you look that up.
| Literally one can of chunk light canned tuna is all you
| need for the day.
|
| Now here's something groundbreaking that's pretty good -
| thin and wide no sugar no fat pancakes: 1 cup flour, 3/4
| cup fat free fairlife milk, 2 packets splenda, 1/2 cup Egg
| Beaters. mix real well so it's runny with no flour chunks.
| no need for baking powder. real short spray of oil to just
| get some drops on a teflon pan. no need to spray when you
| flip.
|
| Now my diet is not high carbs, but let's address the "no
| fat+high carbs = bad." the reason that's everything you've
| read in the last 20 years, is because that's what you chose
| to read. there are different diets for different causes of
| fatness in people.
|
| fat makes you full faster so helps you eat less calories.
| carbs make you work out harder, so you burn more calories.
| if you have an active lifestyle - carbs and no fat. if you
| sit on the couch after sitting at the office, you want fat
| and no carbs. dietary fiber isn't something you should
| count as carbs.
|
| if the reason you're overweight is because you like to
| constantly eat, and it has zero to do with hunger - you
| don't want any fat. you want the most amount of food for
| the least calories, and fat is double of carbs per gram.
| you want lots of indigestible fiber a normal amount of
| carbs, and eating the potatoes with that thick rough skin,
| with the skin.
| raincom wrote:
| I heard Mounjaro is even more effective than Semaglutide.
| paulpauper wrote:
| Good job, nice to see it works on reducing alcohol consumption
| too. I do not need this drug but it's nice knowing the option
| exists it need be. It gives hope to others too.
| rblatz wrote:
| I started taking it in November and I'm down 30 pounds and my
| retina has detached 2x for no apparent reason since then. My
| drinking is unchanged, except I get full sooner and drink
| slower. Because of the discomfort.
| ShadowBanThis01 wrote:
| "my retina has detached 2x for no apparent reason since then"
|
| I'd say that's a pretty huge deal. Did you report that?
| eshack94 wrote:
| Oh my, is retinal detachment a known potential side effect of
| the drug? Or is that a complication of diabetic retinopathy
| or some other condition that you already had? This sounds
| frightening. Hope they were able to reattach it, and hope
| you're doing alright.
| rblatz wrote:
| Thanks, I am stable for now. There is some vision loss but
| only in the periphery, my most recent surgery was on
| Tuesday so it's not clear how much is permanently lost and
| how much will continue to return as the eye heals.
| c0m wrote:
| I can't find the specific study this website cites, but it
| mentions:
|
| > In a 2-year trial among patients with type 2 diabetes and
| high cardiovascular risk, patients treated with this drug
| experienced a great incidence of diabetic retinopathy
| complications (3% vs 1.8%). The absolute risk was greater
| in patients with a history of diabetic retinopathy at
| baseline (8.2%[drug] vs 5.2%[placebo]) than those without
| (0.7%[drug] vs 0.4%[placebo]).
|
| https://www.drugs.com/sfx/semaglutide-side-effects.html
|
| Would be very interested in knowing the commenter's
| diabetes status.
| rblatz wrote:
| Non diabetic, didn't/don't have diabetic retinopathy. I
| had assumed that the detachments were unrelated to
| Semaglutide but just happened as a freak coincidence in
| time.
|
| The no apparent reason was a bit of hyperbole, since my
| vitreous was pulling away from the retina and brought
| some pieces with it during the process. But as to why
| that was happening at my current age is unknown. Second
| was likely related to stress in the eye from healing from
| the first surgery. But the point was I didn't take any
| blows to the head or eye, or any other common cause of
| retinal detachments.
| nwienert wrote:
| Were you prescribed it? What strength?
| c7DJTLrn wrote:
| Based on what you've said it sounds like the drug may have an
| effect on release of dopamine, though I'm sure the trials would
| have caught that if so.
| CapstanRoller wrote:
| >I feel great and my brain seems to be functioning as well as
| when I was in my 20's
|
| >but my untreated ADHD seems to be getting worse.
|
| I had very similar results after taking ketamine for treatment-
| resistant depression. It eliminated all my compulsive
| tendencies for getting cheap dopamine hits (food,
| doomscrolling, etc), reset my tolerance to everything
| (caffeine, ADHD meds, alcohol), and made my ADHD worse while
| improving throughput and ability to Get Shit Done.
|
| I wonder if they affect the same parts of the brain in a
| roundabout way? Ketamine is also used to treat addiction
| (opioids, primarily).
|
| Do you experience any anhedonia while using Mounjaro? Did your
| overall pleasure response get blunted?
| 36933 wrote:
| Ketamine treatments help people, because ketamine is a
| dissociative drug. It makes you not feel your suffering, also
| makes you not feel the positive feelings. That's why you're
| not eg doomscrolling. It doesn't feel good for you anymore.
| If you're not getting treatments regularly, you will be back
| to suffering in a few months likely. In my opinion, there are
| better alternatives and more effective treatments than living
| a life of disassociation.
| CapstanRoller wrote:
| This isn't true. I am not dissociated when not actively
| undergoing the treatment.
|
| If anything, the after-effects of ketamine treatment
| alleviate my lifelong dissociation and other symptoms
| depression and PTSD. Something about the induced
| dissociation "wraps around" and snaps people back into
| fully being present.
|
| Have you ever had ketamine treatment? Where are you getting
| these conclusions?
| 36933 wrote:
| Yes I did have two treatments. After the first treatment
| I really liked it and I thought I had my life back. All
| my debilitating symptoms were gone. Weeks after the
| second treatment I noticed that my depression and trauma
| is not gone. It just made me not constantly aware of it,
| if that makes sense. I was not clinically dissociated as
| well, just dissociated from the things that caused my
| suffering. I didn't think that was a healthy way of
| living, so I stopped getting treatments. Luckily I found
| forms of treatments to actually heal after that. I'm
| incredibly glad I did.
|
| Ketamine didn't heal me, my perspective just changed,
| which can be valuable though.
| valec wrote:
| this is not true at all. the dissociative effects only last
| a few hours. the clinical benefit is because ketamine
| stimulates neurogenesis in the mPFC and hippocampus,
| restoring plasticity lost in depressed patients.
|
| don't make unsubstantiated leaps :-)
| 36933 wrote:
| Yes the immediate effects last for a few hours. I didn't
| say otherwise. The current scientific literature paints a
| mixed picture of ketamine. While it can stimulate
| neurogenesis, there is a definite potential for
| neurotoxicity. Not to mention that there are no long term
| studies out there. There are countless people reporting
| being anhedonic after treatments. Only a few people have
| been reported to not relapse before 24 weeks.
|
| I'm not making unsubstantiated claims. Don't accuse me of
| that, because you don't like my answer.
| CapstanRoller wrote:
| >Only a few people have been reported to not relapse
| before 24 weeks.
|
| So what? Ketamine is a treatment, not a cure.
|
| Would you apply the same logic to insulin for T1
| diabetes?
| 36933 wrote:
| You are comparing apples to oranges my friend.
| [deleted]
| jmpman wrote:
| > anhedonia
|
| Possibly slightly, but not life impacting.
| remote_phone wrote:
| I heard that 2/3 of the weight loss is muscle, do you find that
| to be the case?
| paulpauper wrote:
| this is likely incorrect because people are confusing lean
| body weight loss for muscle loss. lean body weight loss does
| not mean only muscle loss. lean weight includes non muscle
| like skin, organs, etc.
| adamduren wrote:
| Drugs that target the GLP-1 and GIP pathways can suppress
| appetite, potentially leading to a significant caloric
| deficit.
|
| This can lead to the body to break down muscle tissue to
| obtain protein for energy which could lead to a loss of
| lean muscle mass
|
| However, maintaining regular exercise and consuming
| sufficient protein can help to minimize the impact of lean
| muscle mass loss
| sjtgraham wrote:
| Protein is not what the body reaches for first in the
| absence of glucose/glycogen.
| pasquinelli wrote:
| not just lost muscle mass, but also lost organ mass?
| imtringued wrote:
| If that means visceral fat then it would be a godsend.
| voldacar wrote:
| Obese people do not have enough muscle mass for 2/3 of their
| weight loss to be muscle
| EatingWithForks wrote:
| Obese people can actually be pretty muscular in my
| experience, due to their need to heft around their size.
| It's their endurance that isn't there since their hearts
| are quite weak.
| travisjungroth wrote:
| It still won't get you to the 2/3 point making sense. If
| someone is 250 lbs and 35% BF and they lost 50 lbs, 2/3
| of which was lean, they'd end up 200 lbs and 35.5% BF.
| That's possible, but I don't know if anyone would be
| recommending it at that point.
| hombre_fatal wrote:
| That's not what the research says though. Just FUD that some
| influencers like Attia are spreading for some reason.
| paulpauper wrote:
| the reason is to buy diet programs and coaching, this drug
| threatens their business model.
| reaperman wrote:
| In an actual study of this with published results on
| clinicaltrials.gov ...
|
| Semaglutide users lost 16% bodyweight overall but only 3.4%
| of their lean mass.
|
| This is study NCT03548935 if you'd like to look it up, there
| are other statistics of interest in it as well.
| rblatz wrote:
| Yeah that was some dude on TikTok selling some diet scam
| stuff saying that. Or at least that's where I saw it.
| jmpman wrote:
| I don't have any quantifiable data, but although I'm certain
| the majority of the weigh has been fat, I'm sure I've lost
| quite a bit of muscle too.
| tomcam wrote:
| Ozempic did nothing for me
| MagicMoonlight wrote:
| I was always of the opinion that being fat was a moral failing.
| Trying the drug really changed that.
|
| Normies have it so easy. They take one bite and feel full. My
| brain would scream at me continuously to try and make me eat and
| would never be satisfied.
| thegreenswede wrote:
| "they take one bite and feel full"- I strongly disagree with
| this as the reason some people are just lean.
|
| As someone who's bounced around weight a lot and also had long
| periods where I had to basically control it (wrestling in
| college), the main difference I've seen with people who are in
| shape and people are overeat is that the former group
| understands that it's 'ok' to not feel full all the time. As in
| like learning the TRUE difference between appetite and hunger.
|
| I've had periods where I gained 50lb in like 4 months (start of
| pandemic) and all I had to do to basically get back to baseline
| is remind myself that I'm not going to die just bc I'm not
| constantly full.
|
| But i definitely don't get 'full' after a few bites. I can keep
| eating and eating for sure. It's more that being what we call
| traditionally "full" is actually just wayyyyy overeating.
| gerbilly wrote:
| When I'm on vacation my stress is reduced to the point where
| my 'appetite' drops, and this is despite the fact that I'm
| increasing my exercise load enormously (surfing, hiking,
| etc...)
|
| I've noticed that stress causes me mild stomach pain, which
| can register as hunger. It also causes dry mouth which
| registers as thirst. If you're satisfying that thirst with
| sugary drinks long term, then you're going to be in trouble.
|
| There is also so much novelty and more interesting stuff
| going on while on vacation that I don't find myself poking
| through the fridge out of boredom.
| thegreenswede wrote:
| I also lose so much weight on vacation it's weird. I once
| lost weight when visiting Japan for two weeks but I swore I
| was going crazy with the food, so I was confused. But I
| still managed to eat less than at home (I must have).
| Definitely a busyness thing.
|
| Im the opposite when it comes to stress. I lose my appetite
| when I'm stressed but get super super hungry when bored.
| The lockdowns really messed up my eating habits but
| thankfully I've shed all the weight now that I can actually
| do stuff again.
| MagicMoonlight wrote:
| Oh buddy... you're not normal. If you're yoyoing 50 pounds
| then you also have the eating disorder.
|
| Trust me on this. I also thought it was a self-control thing.
| It's not at all. When you're normal you actually get full. I
| don't mean telling yourself you are full, actually full. You
| do not want to eat anymore. You don't want chocolate straight
| after eating dinner. You don't go to the fridge randomly to
| get snacks. You actually have no desire for food. You
| voluntarily stop eating during meals because you don't want
| to eat anymore.
|
| It's something you can't really comprehend without
| experiencing it because you've experienced a lifetime of the
| hunger constantly telling you to eat. The idea that you could
| just... not want to eat is just absurd. But that's how it
| feels. When a normal person eats a small meal and says they
| are full, they are actually full. There's no self-control for
| them, no screaming voice or impulses.
| thegreenswede wrote:
| Miswrote: I don't yo-yo 50lb normally. Only once during the
| pandemic gained that much and I was purposely eating like
| shit bc I was angry with the lockdown situation and had
| nothing else to do. Just used that as an example that if I
| actually just eat as much as I want (like eat till I'm
| full-full 3x a day) with no control, I'd be 50lb heavier.
| But 95% of my adult life post college (9+ years), I hover
| around the same weight.
|
| I guess I understand what you mean that you'd think that
| every skinny person must actually be full after eating and
| that's why they're like that, but everyone I know who is in
| shape (like really in shape, either ex college athlete or
| lives the gym life now and would be considered top 5% of
| the population), they absolutely do not feel full every
| meal/day. I mean talking about planning cheat meals and
| fantasizing about certain foods is super common in the
| fitness lifestyle.
|
| I've met maybe 3 people in my entire life who have what
| you're describing: they truly don't care about food and can
| forget to eat meals if distracted. All the others have some
| form of habit/routine and wish they could eat more and stay
| lean.
|
| I'm not discounting that some people really struggle with
| eating habits and literally cannot stop thinking to eat
| more (I have family members like that) but I do heavily
| disagree that 'normal' people are always full quickly and
| that's why they are 'normal' weight.
|
| If it was a simple normal/not normal appetite wiring then
| why do most major cities contain way more skinny people and
| places like Mississippi are almost 50% obese? Or the fact
| that obesity was pretty rare 100 years ago. I think there's
| a lot more going on than just 'normal people get full
| quicker'.
| sourcecodeplz wrote:
| It's the same for me. I resorted to just eating yogurt,
| vegetables and fruits in between meals. Give it a try.
| MagicMoonlight wrote:
| I'd rather take the medication that stops the addiction. You
| can't eat your way out of an eating disorder
| caycep wrote:
| it's funny in that a few years ago we were (and still are)
| excited by the potential cellular protective properties of GLP1
| agonists, not just in the pancreas but in brain glial cells or
| whatnot. So much so that it seems to be the most neuroprotective
| of recent candidates for Parkinson's disease disease-modifying-
| therapies (DMTs).
|
| to whit, (like botox), all the initial promises of the stuff have
| been waaaay overshadowed by...cosmetic value.
|
| (I'm oversimplifying a bit...for those who are morbidly obese,
| yes, the weight loss really helps, but then they also have
| diabetes most likely which is the primary indication of the drug)
| xvilka wrote:
| I tried Ozempic for two months but wasn't able to continue - the
| gastrointestinal side effects are unbearable. I can confirm lack
| of desire to eat and drink alcohol. The hunger didn't go away but
| after a few bites of anything it quickly evaporated. After
| dropping the drug the hunger steeply increased, even higher than
| before, that was hard to contain.
| jamesfisher wrote:
| https://archive.is/BUo29
| PostOnce wrote:
| Exercise is free and the side effects are you get stronger, more
| energetic, and better looking.
|
| Ozempic costs money and its side effects include cancer, kidney
| failure, and ruining your eyes.
|
| https://www.ozempic.com/faqs.html
|
| edit: many point out calorie intake is the real problem, it's
| true: buy a kitchen scale, weigh your food, count your calories,
| and you will lose weight. Exercise is optional compared to that.
| Still, both are free and have more benefits.
| shadowpho wrote:
| >Exercise is free and the side effects are you get stronger,
| more energetic, and better looking.
|
| And that works for what, 3% of the people that try it?
| pton_xd wrote:
| > And that works for what, 3% of the people that try it?
|
| Exercise is medicine!
|
| Far too few people understand that unfortunately. Something
| is wrong with our culture when the majority have the attitude
| that exercise isn't worth doing.
| Danjoe4 wrote:
| Exercise is not an effective weight loss intervention. It's
| something you should do for your cardiovascular health,
| strength, and cardiovascular health.
| hombre_fatal wrote:
| You did it. You solved obesity.
| caymanjim wrote:
| Exercise does nothing for weight loss if you're eating too
| much. Exercise has health benefits, but weight loss is not one
| of them for the vast majority of people. People wildly
| overestimate how many calories they're burning.
| tuatoru wrote:
| Yeah, you can exercise enough for weight loss.
| Ultramarathoning, the Tour de France, digging canals by hand.
|
| It only takes ten or twelve hours of high-output exercise per
| day. Everyone's got that time to spare, right?
| tehjoker wrote:
| Exercise can help control hunger and insulin levels so it's a
| good idea to pair moderate exercise with diet. I find it
| harder to resist snacking when I'm not regularly exercising.
| justsomehnguy wrote:
| > People wildly overestimate how many calories they're
| burning.
|
| And people wildly _underestimate_ how many calories they
| need. Just by limiting the one portion to 50g of pasta,
| instead of my preferred 150+g, I can go under 100kg in less
| than a week. My 'how much should I cook' habits formed when
| I was young and spent at least a couple of hours commuting,
| but nowadays I'm quite literally just sit on my ass all day.
| It's bothersome and isn't _fulfilling_ to use scales cut down
| on the food (especially if it 's tasty) but...
| dmix wrote:
| s/calories/carbs
|
| Calories can still be a useful metric as a proxy but low
| calorie ("diet") foods tend to compensate with more carbs. At
| least the ones I see regularly at my grocery store.
|
| As a side note: It's actually difficult to find pre-packaged
| low carb food at regular grocery stores sadly. It requires
| effort to make yourself, just like going to the gym. Like
| most good things in life.
| tuatoru wrote:
| Low glycemic index carbs are available. I find I eat
| smaller portions and feel full for longer with low GI rice
| vs ordinary rice, for example.
| uranium wrote:
| Lots of grocers will have hard sausages, cheeses, olives,
| and nuts. It's not as easy as chips and food bars, I'll
| grant you, but it's doable.
| chaostheory wrote:
| It's just like intermittent fasting. Nearly everyone can afford
| it, but only a few people are willing to pay.
|
| While aerobic exercise is more for a healthy circulatory
| system, anaerobic exercise has proven effective in weight loss.
| nwienert wrote:
| Exercise has many side effects too, including a risk of injury.
|
| Meanwhile GLP-1 protects and even improves the function of
| brain, lungs, heart, muscles, bones, and kidneys, it improves
| sleep quality and reduces sleep duration, it definitely
| decreases addictive behavior, and even seems to help with some
| immune issues (anecdotally, but the effect is so strong it's
| remarkable).
|
| https://en.m.wikipedia.org/wiki/Glucagon-like_peptide-1#/med...
| htag wrote:
| > Exercise has many side effects too, including a risk of
| injury.
|
| This feels like saying chocking is a side effect of eating
| vegetables.
|
| Most negative side effects from exercise come in a few camps.
|
| * The exercise of choice comes with a risk of accidents.
| Accidents happen everywhere, but they happen to skiers more
| frequently than mall power walkers.
|
| * The exercise of choice is well known to put strain on
| certain body parts. Usually this is a joint or tendon.
| Pitchers and arms. Power lifting and knees.
|
| * The exerciser did not prepare well for exercise. Do they
| have proper equipment? Did they stretch? Did they warm up?
| Did they drink enough fluid? Are they attempting a goal they
| aren't ready for? Are they over training? Did they get
| training to establish proper technique? Are they distracted
| when they should have been focused?
| nwienert wrote:
| > This feels like saying chocking is a side effect of
| eating vegetables.
|
| That's actually my point. HN not getting anything that
| isn't straightforward though is expected.
|
| The side effect profile of these modern drugs is actually
| shockingly minimal so I felt the GP post was doing much the
| same as people who would claim exercise has side effects -
| missing the forest for the trees. Everything has side
| effects but if something has an overwhelmingly positive
| effect profile with seemingly minor side effects the
| discussion shouldn't be misdirected like they were trying
| to do.
| [deleted]
| lexandstuff wrote:
| They're not mutually exclusive. You can exercise regularly and
| still have a substance abuse problem. In fact, substance abuse
| is a major problem amongst high-performing athletes [1]
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140700/
| 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?
| tetrep wrote:
| > 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?
|
| That sounds like stimulants. You wouldn't be motivated to do
| things if you were satisfied, so any drugs that motivate
| people would seem to need to have to have such an effect.
| Dylan16807 wrote:
| > So it doesn't dull all pleasure just almost all
|
| That is not what that quote says.
| 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.
| Jun8 wrote:
| So, instead is suppressing the _desire_ to eat, how about
| inventing a drug that blocks the absorption or breakdown of
| carbohydrates in the gut? Or maybe control the gut biome so that
| growth of bacteria that breaks down high calorie food is
| minimized.
|
| Is this faster-than-light-like impossible daydream or is there
| any plausible path to it?
| TeaBrain wrote:
| Your first proposal is what acarbose does. It is widely used in
| Asia, but is much less popular in Western countries. It
| inhibits alpha glucosidase and alpha amylase, which has the
| effect of decreasing the rate that complex carbohydates are
| broken down and absorbed.
| coke12 wrote:
| Consider Alli, the drug that blocks fat absorption in the body.
| It already exists and works reasonably well for weight loss.
| The side effects can be gross and unpleasant though.
| AuryGlenz wrote:
| I don't know if I want a drug to exist that allows people to be
| gluttons without consequence. It's like a modern (and real)
| vomitorium.
| cromulent wrote:
| Some people will tell you though that they can eat anything
| and not put on weight - this is simply allowing others to do
| the same, right.
|
| A vomitorium is simply the large exit pathway in stadia for
| rapid egress of many people. The idea that ancient Romans had
| facilities dedicated to vomiting has been debunked.
| piyh wrote:
| I don't know about you but I don't want to be shitting loaves
| of bread everyday
| refurb wrote:
| That's what lactose intolerance is.
|
| Does gas, painful cramping and diarrhea sound like a good
| approach?
| hombre_fatal wrote:
| Imagine the side effects of food passing through the gut
| without being broken down.
|
| Reminds me of Olestra, the zero calorie oil substitute that
| failed because of similar sounding side effects. Olestra wasn't
| consumed/absorbed in the gut so you'd just shit out oil and
| your half digested food would glide out with it since it didn't
| block stomach emptying like real food.
| paulpauper wrote:
| this is what gastric bypass tries to do. it bypasses part of
| the digestive process
| SamoyedFurFluff wrote:
| How long is the research info ozempic and other hormonal weight
| loss drugs? Remember the last miracle drug that went to the
| market for weight loss had to be retracted for killing people or
| damaging their hearts to the tune of over 10 billion dollars in
| damages paid out.
| ESTheComposer wrote:
| These types of medications have been around since the 2000s,
| semaglutide (ozempic) specifically since 2012.
| dillydogg wrote:
| At least in this case GLP-1 antagonists have been in clinical
| use for diabetes since around 2010
| reaperman wrote:
| Drugs acting on GLP-1 (ozempic), GIP, and glucagon receptors
| are largely shown to help hearts and cardiovascular health
| specifically (and independently of weight loss). They also
| improve lipid profiles (HDL/LDL), and have a multitude of other
| benefits.
|
| Whether they, for example, increase the rate of glial brain
| cancer ... they really haven't been out long enough to know.
| jjeaff wrote:
| While I am not saying that this drug is definitely safe, I
| think the fact that Fen-phen turned out to be more dangerous
| doesn't really implicate these new drugs because while the
| desired outcome is the same, the class and type of drugs seem
| to be entirely different. My understanding is that fen-phen is
| a stimulant and increased blood pressure and heart rate. It
| also includes some other drugs that affect serotonin levels.
|
| These new drugs are peptide analogs that affect your body's
| digestion and how it deals with sugar and fat production and
| insulin.
| aaron695 wrote:
| [dead]
| 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.
| cameronh90 wrote:
| As a counterpoint, I've been using it for several months and
| have had no side effects to speak of other than occasionally
| some mild reflux.
|
| If anything, my energy levels actually went up immediately
| after starting it. Normally I was pretty sluggish but it felt
| like some extra firepower was unlocked.
|
| Everything has risks and benefits, and might harm some people.
| I hope your family member gets better soon.
| mgarfias wrote:
| I've been on it (at 1mg, then 2mg doses) for 3-4 years now.
| Worst side effect for me is the tendency to have sulfur
| smelling burps if I have any kind of stomach upset.
| desmosxxx wrote:
| did the weight stay off? Do you notice tolerance
| mgarfias wrote:
| Didn't lose weight at 1mg. Down about 20# since the 2mg
| was approved.
|
| But, also doing CrossFit 3D/wk. and now have a CGM so I
| can easily track blood glucose.
| runsWphotons wrote:
| Second the question about tolerance! Wondering why this
| doesnt happen it is interesting. Most everything else
| causes some tolerance over time but no one mentions it for
| this
| etchasketch wrote:
| I know this isn't your family member, but if they were a
| 500-pound alcoholic smoking two packs of cigarettes a day, I
| suspect they probably felt like crap before the ozempic.
| ESTheComposer wrote:
| I started Wegovy about 5 months ago. The first couple months
| you feel sick but after it passes your appetite is extremely
| curbed (in a good way). Would highly recommend people to try it
| as it's made me healthier in pretty much every way.
| transcriptase wrote:
| Bold move to name their pharmaceutical like a Chinese Amazon
| "brand" of AliExpress-sourced electronics.
| 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.
| jjeaff wrote:
| Ya, rapid weight loss is one of the most common triggers of
| gall stones. Lots of weight loss surgery patients get them
| as well.
| winocm wrote:
| Happened to me too from just generally not eating much at
| the time.
|
| Ended up getting acute cholecystitis and a dead
| gallbladder plus sepsis after. Not too pleasant of an
| experience.
| 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...
| HyperSane wrote:
| That is pretty unrealistic with 10% odds but I wonder what
| the odds would actually have to be for a drug like that to
| get so popular.
| Dan42 wrote:
| Thank you, thank you so much for sharing that. It's been a
| while since the last time my mind was blown away that much.
| ennasila wrote:
| Great story. There were parts that made me think the pill was
| a metaphor for the covid vaccine, but this story was written
| several months before the vaccine was released
| hayst4ck wrote:
| I have to admit, I would probably have taken the pill
| depending on how gruesome (or mitigatible) the death is. I've
| been obese and I've been thin, and life is not worth living
| when obese.
|
| 10 years ago, I was reading about nootropics and ran across
| an interesting piece on the ethics of drugs (that has
| probably been lost to time). The question it was asking was
| "why can we take drugs to bring us to normal, but we can't
| take drugs that make us better than normal?"
|
| The interesting consequence is that it de facto forces people
| who don't need drugs to take them or be at a disadvantage.
| (think adderall at a competitive college or testosterone for
| lifting).
| crooked-v wrote:
| > why can we take drugs to bring us to normal, but we can't
| take drugs that make us better than normal?
|
| Consider caffeine, which is probably entirely responsible
| by itself for a significant sliver of the world's total
| GDP.
|
| We just don't have a lot of drugs like that because it's
| hard to find stuff that's performance-enhancing without
| serious side effects.
| grugagag wrote:
| > The question it was asking was "why can we take drugs to
| bring us to normal, but we can't take drugs that make us
| better than normal?"
|
| Because ultimately drugs make you pay one way or another,
| eg dependency, liver toxicity, numbness of some other facet
| and so on. When none of those will be true it's the day
| they become the new norm
| Earw0rm wrote:
| True, but the price vs the amount of effect varies
| hugely.
|
| Some drugs are a bargain. Caffeine. E-nicotine. Some are
| hellishly expensive. Solvents will destroy your health
| without even giving much in the way of a high.
| taneq wrote:
| Sounds a little bit like the "fatkins diet" in Makers by Cory
| Doctorow.
| kennyloginz wrote:
| How does this remind you of this strange story.
| renewiltord wrote:
| [flagged]
| TeMPOraL wrote:
| Not helpful. Drugs are drugs. Side effect happens. Sometimes
| not even related to the drug.
|
| I don't know how you folks do it in the US, but I imagine
| there is a leaflet attached to the medication, and somewhere
| in it should be a phone number, physical address and/or an
| e-mail address of an institution that tracks drug side
| effects. If you're unlucky enough to have some weird reaction
| to a drug, it's good to let them know.
| rafaelero wrote:
| Right? For god sake folks, trust the randomized trials, not
| Internet nocebo screamers.
| dasfdslj wrote:
| [flagged]
| 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.
| reaperman wrote:
| > I wasn't informed I needed to slowly ramp up.
|
| In a fair world that would be considered severe malpractice
| :-( It's nearly common knowledge. A huge number of people are
| suffering under these medications because of starting at a
| dose to high or raising doses too quickly / too much at a
| time.
|
| LY3437943 looks even more promising, with fewer side effects.
| Semaglutide will probably have the most side effects because
| it only has one action (GLP-1 agonist). Tirzepatide has
| slightly lower side effects because it adds a dual action
| (GLP-1 agonist + GIP analogue) so it can act at a lower
| magnitude on the GLP-1 receptors to avoid strong side
| effects, while still having higher efficacy due to its
| additional, separate, GIP action.
|
| LY3437943 retains both the actions of Tirzepatide but adds a
| third action, glucagon receptor agonist. So it should be able
| to have higher efficacy at a lower equivalent dose than the
| other two (less action on GLP-1 and GIP mechanisms, fewer
| side effects).
| SystemOut wrote:
| My story / anecdata.
|
| About 6 months ago there was a posting about Ozempic and I had
| said something to the effect that it wasn't worth it watching
| some of the side effects my wife had from it. And then I went
| to the doctor for a check-up and lo and behold I had diabetes.
| Asymptomatic, but an A1C of 11. My doctor re-ran the test
| because he didn't believe it and it doesn't run in my family.
| My cholesterol had also jumped and he said he was going to put
| me on a statin after the initial 3 months of adjusting to the
| diabetes medication.
|
| My Dr. puts me on Ozempic and I grumble about it but with that
| test results I had, I knew I had to do something. Fast forward
| 3 months, I dropped 20 pounds, and every other measurement is
| back in the green, including my A1C. Now, I made some serious
| lifestyle changes and ate a diabetic diet (limiting carbs, the
| types of carbs, etc), and have been keeping up with being more
| active but my entire relationship with food has changed because
| of Ozempic. Before I had a near compulsion to eat more than I
| should. Now, I don't because one, I feel fuller quicker and
| two, I know I'll feel horrible for hours if I over-eat. It only
| took one of those events to never want to do that again. I
| can't really explain why but I also don't have as strong of a
| desire to eat foods that are bad for me. I really thought I'd
| battle the cravings more after going cold turkey from "bad"
| foods. I can't say why it is but it's true. Side note, going to
| the grocery story was really difficult at first....there is so
| much sugar in the American food supply.
|
| Energy wise I will say that I did struggle with low energy
| initially as my body adapted to lower calorie intake but I also
| learned that when I found the right balance of protein/complex
| carbs for me that my energy levels came back up and I now feel
| better than ever.
|
| My doctor was shocked. I've never seen him that animated when I
| came back in for the 3 month follow-up. I didn't need to add
| any additional medications and they're slowly adjusting me back
| towards a single medication.
| r00tanon wrote:
| I have had a nearly identical experience. Thanks for sharing.
| justinclift wrote:
| Out of curiosity, do you drink much water each day?
|
| I'm kind of wondering if the people having a bad result don't
| drink enough water each day to clear out their systems? Yeah,
| that's a simplistic take... but still, curiosity. :)
| SystemOut wrote:
| Yeah, most of the time I think I do. I suspect it has to do
| more with diet and maybe water as well. Since Ozempic slows
| down your digestive process my current thought is that
| fiber / gut bacteria might have more affect on things but I
| haven't done a food diary to try and track what impacts me
| more.
| riceart wrote:
| Has nothing to do with it. A1c measures the percentage of
| hemoglobin A1 in red blood cells bound to sugars (glycated
| hemoglobin). Since red blood cells normally circulate for
| months this gives a surrogate marker for average blood
| glucose levels over 3-6 months.
|
| Dehydration is not a confounder for an A1c test since the
| percentage is relative to the hemoglobin present. The
| primary confounder to A1c are blood disorders such as
| hemolytic anemias that lower the normal lifetime of RBCs or
| proportion of HbA. And this tends to falsely lower the A1c.
|
| A person with an 11% A1c is also likely drinking quite a
| bit (whether they notice it or not) because at that point
| the chronically elevated glucose is elevating serum
| osmolality to increase urination.
| rblatz wrote:
| Dehydration and kidney damage is a common side effect of
| Semaglutide, and they regularly test for that if you are
| on it. Drinking plenty of water is the way to prevent
| that from happening.
| riceart wrote:
| Perhaps I misunderstood what the GP was asking.
| Nevertheless GLP-1 medications appear to be kidney
| protective from a long term standpoint with an increased
| short term risk of AKI likely primarily related to GI
| losses with additional risk conveyed by concomitant use
| of "depleting" (diuretics) and nephrotoxic meds. Once on
| a stable dose there's no current recommendation to
| monitor kidney function beyond what would normally be
| indicated for diabetes (usually yearly).
| 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.
| vrc wrote:
| The risk of pancreatitis is also increased substantially [0].
| And for people who may already be predisposed to pancreatitis
| but haven't had an attack, severe pancreatitis has a 10-30%
| mortality rate [1]. But even mild acute pancreatitis will make
| you want to crawl out of your own skin in pain.
|
| [0]
| https://www.hopkinsmedicine.org/news/media/releases/johns_ho...
|
| [1] https://www.aafp.org/pubs/afp/issues/2007/0515/p1513.html
| nullc wrote:
| I'm somewhat dubious of the severe pancreatitis mortality
| rates-- the issue is that most cases of severe pancreatitis
| are caused by very severe alcoholism, and by the time the
| pancreatitis shows up everything else is already failing.
| mattzito wrote:
| So I was able to find an aggregate of the study results:
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294388/
|
| out of an n of >3000 patients getting medication, 34 ended up
| having some form of pancreatitis. At least 12 people on
| placebo got pancreatitis. That's a much higher rate, but the
| odds are still pretty low.
| 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
| etchasketch wrote:
| You want to know what's even crazier, you can literally but
| it over the counter. I was at kroger the other day and I saw
| it next to the vitamins and I did a double take.
| 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.
| User23 wrote:
| My favorite fat loss drug along these lines is dinitrophenol.
| It is the true miracle fat burning drug. It interferes with
| cellular metabolism in such a way that the body just nonstop
| oxidizes fat. Fat mass loss in the order of a pound a day or
| more is entirely possible and some bodybuilders use it to get
| to a ludicrously low bodyfat percentage. Unfortunately
| oxidizing that much fat generates a lot of heat, so much that
| an overdose can be lethal because your body literally roasts
| itself to death and titration is extremely difficult. Oh and
| blindness is a common side effect. And for added fun it's an
| high explosive. Needless to say it's not FDA approved.
| reaperman wrote:
| Honestly GLP-1 agonists will save lives just by being the
| go-to replacement for people who previously would have used
| DNP. GLP-1 agonists are effective enough that everyone in
| those circles basically stopped using DNP suddenly a couple
| years ago.
| desmosxxx wrote:
| Also when you eat on it you are punished by heating up even
| more.
| TylerE wrote:
| > And for added fun it's an high explosive
|
| Better not tell that to all the cardiac patients on
| nitroglycerin.
| justinclift wrote:
| Is this the one? :)
|
| https://en.wikipedia.org/wiki/2,4-Dinitrophenol#Toxicity
| xenospn wrote:
| Permanent blindness?! Ffs
| 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...
| reaperman wrote:
| I don't have a colon (but I do still have a functioning
| anus). The effects from orlistat are very similar to what I
| experience 24/7. If you're under 30 or so, eventually your
| sphincter gets much, much stronger and the excess oil stops
| affecting you nearly as much. You can hold it in
| indefinitely until your normal "need to go" timing. This
| takes about a year or so to train, and you'll have quite a
| few accidents in the meantime.
|
| I still can't eat too much salmon in one sitting though :-(
| I don't get diarrhea but I do get stuck on the toilet for
| ages after.
| 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:
| [flagged]
| aidenn0 wrote:
| I want to frame this comment as an example of (the
| generalized form of) Poe's law.
| op00to wrote:
| It's better to not know.
| znpy wrote:
| Jesus Christ on a bike, that's beyond dystopian, that's
| completely f---ked up.
|
| Does the fda allow that?
| stavros wrote:
| Yes, why would the FDA restrict what color pants you
| wear?
| Retric wrote:
| There's huge tradeoffs people rarely talk about in
| Medicine. Significant risk of soiling yourself vs a
| statistically significant reduction in risk of early
| death isn't a big deal for the FDA.
|
| In many cases the hell that is chemo is considered
| acceptable for even moderate increases in expected
| lifespan. That's why people started talking healthy life
| expectancy vs just life expectancy.
| AtlasBarfed wrote:
| Well duh, if you discuss the side effects with patients,
| they won't take the drug and the drug people won't send
| you hookers.
| lazyasciiart wrote:
| Bizarrely enough, the pressure doesn't always go in that
| direction.
| crazygringo wrote:
| Yeah, that's definitely always been my challenge with weight
| loss. I have zero problem with self control -- I can easily cut
| calories in half or less (e.g. 1000-1200 cal/day), but it's
| simply that my body suffers immensely. I lose all energy, can't
| concentrate on anything, and my immune system weakens so I
| start getting colds constantly.
|
| I'm sure I'd easily lose weight with Ozempic but I'd still be
| suffering health issues. Not because of Ozempic itself but just
| because I wouldn't be getting enough calories, despite still
| being above a healthy weight.
| jjeaff wrote:
| That reaction may have to do with too much cutting, as
| another commenter alluded to, but it may also have to do with
| the types of nutrients you are missing when cutting.
| skulk wrote:
| > my body suffers immensely
|
| Does the same thing happen if you slowly wean yourself down?
| Are you cutting out essential nutrients that your body needs
| to function properly rather than the unnecessary carbs/junk?
| The reason I'm asking these things is that people I know who
| have reduced their caloric intake usually report feeling
| better, not worse.
| MagicMoonlight wrote:
| That sounds like a convenient excuse not to change
| [deleted]
| lumb63 wrote:
| You may have better success in a smaller caloric deficit.
| 1000-1200 calories a day is very few and that's a very fast
| pace of weight loss. Try removing 500 calories or 10% of your
| calories. Progress will be slower, but you may feel much
| better.
|
| Also, as a sibling comment alluded to, when you have fewer
| calories to eat, the micronutrients in the few foods you do
| eat matter that much more. The nutritional quality of food
| you need to stay healthy increases greatly when in a caloric
| deficit. Fruits and veggies are great for helping that, and
| multivitamins are cheap insurance policies to make sure you
| aren't deficient in anything important, IMO. YMMV. Best of
| luck with your goals!
| kika wrote:
| Calories are not created equal. They are equal in physics
| sense, but your body is not a "bomb calorimeter" (device to
| measure caloric content of whatever). So maybe instead of
| cutting your calories in half, you cut less and replace carb
| calories with fat calories or protein calories. Or maybe you
| can even cut to 1000-1200 by replacing your calorie source
| with something else. For some weird reason carrots with
| butter work very well for me and I love the taste :-)
| smith7018 wrote:
| I know someone that took it and his gallbladder burst. Doctors
| couldn't say if it was related to the drug, though.
| reaperman wrote:
| As a counter-counter-point I've read _most_ (~90%) of the
| papers that come out of trials registered at
| http://clinicaltrials.gov/ for all GLP-1 agonists, including
| ones that haven't been approved. The vast, vast, vast majority
| of secondary outcomes, for things like
|
| - blood pressure
|
| - lipids (HDL, LDL)
|
| - insulin sensitivity
|
| - blood glucose
|
| - strokes
|
| - cardiovascular events + deaths
|
| - myocardial infarctions
|
| - hemoglobin A1C,
|
| - revascularization,
|
| - etc, etc, etc
|
| _are literally all affected positively_ (to the benefit of the
| imaginary "mean" patient) in bulk.
|
| Note though, that doesn't mean 100% of patients are have
| positive results, just that each of these are, in bulk,
| positive across the tested subjects _when averaged together_.
| There 's little in the data to suggest that cases like your
| family member aren't happening or couldn't happen.
|
| There's also evidence that GLP-1 agonists increase the rate of
| glucose use in the brain, accelerating learning rates. (The
| brain accounts for 2% of body weight but up to 25% of glucose
| consumption, it really is fueled by glucose)
|
| https://clinicaltrials.gov/ct2/show/NCT00256256?term=stroke&...
| atkailash wrote:
| [dead]
| therein wrote:
| [flagged]
| breezingfast wrote:
| [dead]
| LazyMans wrote:
| Yes. On a compounded semaglutide. I can finally control my hunger
| and a nice unexpected effect has been losing a desire to drink
| large quantities of alcohol. I don't drink during the week
| anyway, but it seems to be the volume that turns me off to
| drinking. Thus a few cocktails are all I can tolerate. For
| context, Im 30, male, would be defined as a binge drinker on
| weekends. Oh, and I've given up nicotine entirely. I can't tell
| if the drug is helping or it was just a point in my life that I
| finally decided I accept it makes me feel ill most of the time.
| [deleted]
| rjbwork wrote:
| Can you share this "compounded semaglutide" source? My doctor
| mentioned it but I'm a bit anxious about it. Everything out
| there seems so sketchy.
| chriscappuccio wrote:
| wellsrx is a reliable source
| AtlasBarfed wrote:
| I'd hazard a guess that nicotine is one of the two or three
| most addictive substances known to humanity. Opiates/heroin is
| probably worse, world of warcraft is probably third :-)
|
| The drug probably helped.
| LazyMans wrote:
| Society makes it hard as well. It's unacceptable to be
| falling asleep high on opiates. Hitting a vape on a video
| call with coworkers is considerably more acceptable.
| frankthedog wrote:
| As a fully remote employee for years who now lives in zoom
| I have never seen a coworker hit a vape on a call and it
| would be very off putting if they did, in the same way
| smoking a cig while on a call would be.
|
| Context: work at a big tech co.
| y-curious wrote:
| I've seen coworkers do it accidentally, forgetting their
| cameras are on. It's a super hard habit to quit, too,
| since it's innocuous (except you can't leave home without
| your vape!).
| sergiomattei wrote:
| Factorio is third.
| CapstanRoller wrote:
| The real message of the game is that to win you must
| abandon industrial society and make peace with the bugs.
| SgtBastard wrote:
| The factory must grow...</gollum voice>
| UberFly wrote:
| 18 years later I still freebase WoW on occasion, but I can
| stop any time I want.
| [deleted]
| Waterluvian wrote:
| Don't forget caffeine!
| LazyMans wrote:
| I like caffeine, unfortunately even small amounts tend to
| make me irritable and sick at the end of the day. Wasn't
| always like that
| runsWphotons wrote:
| What changed and when?
| Danjoe4 wrote:
| Caffeine is not that addictive.
| burnished wrote:
| Nicotine was the hardest thing I have ever given up - three
| years later and I still get the occasional craving or dream
| where I have an excuse to smoke. This tracks with the
| experience of other smokes I have known. All else being equal
| and given you have reason to believe the drug reduces cravings,
| I'd guess that it is a strong factor
| 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.
| tsimionescu wrote:
| If a drug is under a patent, the generic form still pays
| royalties to the patent holder, so of course it's still
| expensive.
| chriscappuccio wrote:
| not entirely true. semaglutide is a great example. the
| FDA allows compounding pharmacies to make semaglutide
| because wegovy/ozempic are sold out and therefore have
| limited availability. compounding pharmacies are allowed
| to sell their own royalty-free in this situation! wellsrx
| does just this (probably with chinese sourced
| semaglutide)
| 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.
| idontwantthis wrote:
| Counterpoint: Don't inject yourself with stuff you found
| on the internet because people on the internet told you
| it's ok.
| opportune wrote:
| Steroid users do it all the time and I haven't heard of
| steroid users dealing with infections much.
| pixl97 wrote:
| I'm sure its because most people aren't going to talk
| about illegal drug use and when it goes wrong.
| 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.
| reaperman wrote:
| You ship it as a dry/lypohilized powder, both semaglutide
| and tirzepatide survives long China->Europe shipping in the
| summer just fine, with customs delays. The testing I've
| seen showed 99.965% purity of semaglutide after 22 days in
| shipping from China to Poland during April. Tirzepatide
| shows 99.064% purity after 58 days of shipping in October-
| November. These didn't start out at 100.00% purity either,
| so they likely experienced absolutely minimal degradation
| in shipment.
|
| You reconstitute it with Bacteriostatic Water which is
| available without a prescription in the USA and contains
| 0.9% benzyl alcohol to inhibit bacterial growth.
|
| If you're particularly concerned you buy a 0.22 micrometer
| PVDF "syringe filter" and pump it through that to another,
| fresh/sealed sterile vial which you can get for like $2.00
| from a medical supply company (the syringe, filter, and
| vials are gamma-irradiated to destroy any remnants of
| RNA/DNA). That size filtration will filter out any
| lifeforms (fungal, bacterial, viral) while allowing the
| peptide/drug itself to pass through. So you get a
| guaranteed sterile solution out of the filter.
| quazar wrote:
| Where do you buy it from to ship to Poland?
| reaperman wrote:
| Anything specific would be inappropriate for this forum.
| But the broad answer is a chemicals distributor in China.
| I actually only utilize them for legal "nutritional"
| compounds, but others use them for pharmaceutical
| options, and those are independently tested frequently by
| a variety of stakeholders. Personally I really wish US
| citizens didn't feel forced to go outside of the quality
| protections of the FDA for their medical care.
| scheme271 wrote:
| Nutritional compounds? My understanding is that without a
| lot of special processing, GLP-1 agonists (semiglutide,
| liraglutide, tirzepatide, etc) will be degraded by
| stomach acids into useless fragments. There's an oral
| semiglutide formulation but it looks like it's quite
| inefficient and has some pretty strigent requirements in
| order to be effective.
| reaperman wrote:
| What? No one is taking these orally. Hence the
| bacteriostatic water for injection.
|
| The same distributor sells legal things to import like
| L-Carnitine, Epitalon, Berberine, NAD+, NACET, and
| vitamins at great prices so I was saying I use them for
| things like that.
|
| But others use them for GLP-1 agonists and many do their
| own independent testing.
| Scoundreller wrote:
| > That size filtration will filter out any lifeforms
| (fungal, bacterial, viral) while allowing the
| peptide/drug itself to pass through
|
| 0.22 won't filter out viruses, but time will inactivate
| enveloped viruses (which are usually the ones you want to
| avoid injecting), and source control/proper handling
| should take care of the rest.
| 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.
| reaperman wrote:
| You can get these wholesale from China from "reputable" gray-
| market wholesalers who get the chemicals made at contract
| manufacturing facilities. BYO QA/QC though, as with all non-FDA
| drugs. That's the huge catch, and it sucks for consumers.
| Testing just for active ingredient is >$100 and takes about a
| month. Testing for proper buffering agents, harmful
| contaminants, microbial contamination, etc is essentially
| unavailable at all.
|
| Semaglutide is very, very cheap in the gray market. It's
| somewhat less effective than Tirzepatide and has slightly more
| side effects if you ramp up the dosage too quickly.
|
| If an annual amount is purchased on the gray market, this
| brings the monthly cost down to:
|
| - Semaglutide: $10/month
|
| - Tirzepatide: $60/month
|
| - Liraglutide: $87/month
|
| - LY3437943: I have not yet seen this available, but it looks
| like distributors are notifying manufacturers of latent demand
| and are working to build up a supply chain.
|
| Note that in the USA, it is legal to import certain amounts of
| FDA-approved drugs if you have a prescription for them.
| However, just because something is the exact same chemical as
| an FDA-approved drug does not make it an FDA-approved drug. It
| must be manufactured in an FDA certified facility and be the
| same brand/manufacturer/packaging/labeling/etc as the approved
| drug.
|
| e.g. importing generic Sildenafil/Viagra is legal if you can
| find the Teva(tm) brand generic sildenafil in, say, Mexico or
| Canada for a better price. But it must be the pills
| manufactured by Teva in the appropriate facility with NDC
| #0093-5342-56[0].
|
| If you import generic sildenafil "Cenforce" from the (very
| legitimate but not FDA-approved) Indian pharmaceutical
| manufacturer "Centurion Laboratories"...
|
| ...that would still be potentially criminal smuggling. Even if
| the pills you import show via laboratory test that they
| precisely match your medical prescription, they are not "FDA
| approved" and therefore not legal to import.
|
| A lot of people do though!
|
| 0: https://ndclist.com/ndc/0093-5342/package/0093-5342-56
| crakenzak wrote:
| Wow this is incredible, thanks for sharing! I was quoted
| $800/mo after insurance for a moderately low dose of
| Semaglutide (Ozempic)
| etchasketch wrote:
| Interesting.
| chriscappuccio wrote:
| where is this grey market? apparently it's not as simple as
| just searching aliexpress :)
| 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.
| jasonfarnon wrote:
| I don't think you need to bring morality into it. OP is just
| asking, do you develop your own tools to address the problem,
| or rely on another's forever? There are lots of practical
| non-moral answers to that question.
| gnulinux wrote:
| As an anecdote: at my worst (when I was clearly suicidal,
| insomniac and emotionally unstable) I was on antidepressants
| (Prozac) and it helped me _a lot_. It made me very
| emotionally stable. I got off Prozac after a couple years to
| try it out and I felt much better. Over that year, I started
| feeling similarly terrible due to COVID world. Went back to
| Prozac. Once again made me very stable. Stopped using Prozac
| in mid 2022, again to see if I feel good without it. Since
| then have been feeling much, much better. Of course, mental
| health is a constant battle, you fight one day at a time, but
| I consider my depression as close to "cured" as possible
| because over the last year I felt pretty normal without any
| drugs.
|
| Things to note are, along the way I stopped drinking alcohol
| which helped me tons. Before 2020 I was a huge drinker (not
| alcoholic, but every day heavy drinker). Initially, I started
| smoking weed. This helped a ton because I stopped drinking
| completely, but I wasn't getting very high every day and I
| thought THC helped quite a bit too. Eventually, in late 2022
| I stopped using THC too. I'm completely drug free now. I
| believe that both Prozac and THC helped me significantly to
| get out of depression. In addition to drugs, CBT (cognitive
| behavioral therapy), therapy in general and getting a cat has
| been extremely helpful as well.
|
| This is just an anecdote, every brain is different. Never
| self medicate, see a doctor and a therapist!
| sneak wrote:
| Not everyone that is overweight is overweight because of binge
| eating.
|
| There is no data to suggest that those that don't engage in
| binge eating will suddenly begin doing so when ceasing this
| medication.
| [deleted]
| mastax wrote:
| Presumably the dose can be altered such that for a given
| individual their appetite creates a caloric equilibrium at
| close to the target weight. I don't think this is something
| that is done currently.
|
| The side effects of chronic use don't appear to be that
| significant and would need to be weighed against the side
| effects of chronic obesity.
| 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.
| [deleted]
| beefman wrote:
| https://archive.is/MfXlm
| monkeycantype wrote:
| the genetics of obesity are amazing. we all have a unique
| combination of genes, and epigenic features that influece the
| endocrine and neuronal pathways that drive the desire to eat,
| these different genotypes affect our behaviour. Ozempic is
| putting a thumb on the scales of this pathway, but this pathway
| is balanced differently in all of us. Think of the most hungry
| you have ever been, in some people this never stops, in others
| it's dialed up or down.
|
| there are some great papers on fat labradors that hint at how
| these different genotypes are linked to our desire to eat and how
| that shifts our behaiour. Guide dogs are highly selected for
| trainability, and positive reinforcement with food reward plays
| an important role in their training. I think it was Yeo, found
| 22% of pet Labradors and 80% of Labrador guide dogs sampled
| carried a 14 BP deletion in the POMC gene, which forms part of
| this pathway.
|
| https://doi.org/10.1007/s00125-016-4187-x
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873617/
| arcadeparade wrote:
| Some people really love to moralize and cite anecdotes about
| Ozempic.
| armchairhacker wrote:
| Moralizing about weight loss is upsetting, as someone whose
| thankfully considers themselves "naturally thin".
|
| It's 100% true the vast majority (including me) needs to put
| _some_ discipline into eating and exercise: normal people can
| 't just eat whatever they want whenever they feel hungry. But
| normal people don't get fat eating whole foods, working out,
| eating below their demographic's daily intake; and normal
| people don't suffer immense fatigue on tiny calorie deficits or
| even maintenance. People with thyroid and other metabolic
| issues do. Which IMO completely destroys the "moral" argument
| for weight.
|
| (And it's also probably true that most overweight people don't
| eat whole foods and work out daily. That doesn't mean its right
| to call out some random fat person eating a mildly-unhealthy
| meal. You have no idea what else they've eaten that day, what
| else is going on around them, and you wouldn't call out a
| skinny person who eats the same.)
| jjeaff wrote:
| It's also interesting to note that while thyroid and other
| similar issues are not usually the cause of a person's
| initial weight gain, those types of issues are much more
| common in obese people. So it makes it much more likely that
| an obese person has some underlying medical issues making
| their battle to lose weight even more difficult.
| mrcrumb1 wrote:
| I'm a person who has vacillated between being close to normal
| weight and obese. I think people who don't have problems
| controlling their diet tend to underestimate just how hard it
| can be to eat at a calorie deficit or even just maintenance
| when you've lost a large amount of weight. When I'm at my
| lowest weight I literally am thinking about food constantly
| and my maintenance calorie intake drops to about 1500-1800
| calories.
| Danjoe4 wrote:
| [flagged]
| DoreenMichele wrote:
| FWIW, I lost multiple dress sizes without counting calories
| or starving myself by eating a more nutrient dense diet.
| Aloha wrote:
| It's really hard to explain to someone the agony of being
| hungry all the time - without experiencing it, they just
| cant understand.
| [deleted]
| pton_xd wrote:
| > It's really hard to explain to someone the agony of
| being hungry all the time - without experiencing it, they
| just cant understand.
|
| This can easily happen if you eat the wrong food and
| train your gut to prefer the wrong types of food.
|
| And by "wrong food" I mean the typical American diet --
| processed food and soda.
| sneak wrote:
| "processed" food is fine - all food is processed. The
| issue is with huge amounts of fast carbs coupled with
| high fat. It can occur even with "unprocessed" foods such
| ice cream.
| NickC25 wrote:
| [flagged]
| randallsquared wrote:
| > _Sad that the obvious route (diet and exercise) is skipped by
| so many people_
|
| It is definitely true that many people find it difficult to be
| abjectly miserable all the time. The difference with
| Ozempic/Wegovy is (and I know this is hard to believe!) you can
| eat a small portion of something and actually feel satisfied
| and literally just not want more. This is _mind-blowing_ when
| you 've never experienced it before. I've only been on the
| lowest dose for a few weeks, and I'm still in shock about how
| effortless it is to just... stop. I actually can get satisfied
| with food, rather than feeling too full to eat more! I have
| been wondering if this is just what naturally thin people feel
| like all the time?
| nmca wrote:
| It is.
| 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.)
| shusaku wrote:
| I also think the problem is that if you're losing weight,
| you're by definition not eating healthy. If you could skip to
| the fat gone step, and work on a diet that maintains a
| healthy weight, it seems like you would have a easier time
| adjusting.
| AuryGlenz wrote:
| I guess we'll see if that works out once people stop using
| this class of drugs. I bet most rebound.
| 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.
| paulpauper wrote:
| _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._
|
| yeah. If you are losing weight unintentionally, docs will
| care a lot and will run tests. Otherwise, being
| overweight, not so much. Weight loss is a bigger concern
| than weight gain from the perspective of doctors.
| bluepizza wrote:
| [flagged]
| [deleted]
| lazyasciiart wrote:
| Vacuously false. Do you think "eat well and exercise
| regularly" is some kind of magic switch? One day you are
| 120lbs overweight but then you eat well and exercise for
| a week and star in a film?
| bluepizza wrote:
| Not a magic switch, but that's pretty much how the body
| works - a ratio between energy consumed and used. If you
| invert it, your weight will go down.
| SamoyedFurFluff wrote:
| Legally in some states some doctors are mandated to bring
| up weight loss to sufficiently fat patients. But also,
| fat loss isn't covered by insurance generally unless it's
| paired with an existing health condition. So fat people
| who don't have health problems don't get help to lose
| weight but get all the shame. :)
| 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.
| pixl97 wrote:
| Weight has been increasing for nearly 40 years now in the
| US among all groups. Trying to point this out as any kind
| of individual failure just has not, and is not going to
| work. It's tantamount to telling someone to stop smoking in
| 1950. Yes, some people did manage to, but the vast majority
| stopped smoking when their lungs no longer supported them
| living.
|
| When pretty much everywhere you go is plastered in signs
| saying "EAT THIS YUMMY UNHEALTHY BULLSHIT" and said
| bullshit is cheap and highly available don't be surprised
| when we have society wide problems. Add to that our work
| practices commonly have us hold down a computer for 8 hours
| a day, it should be no surprise we are where we are.
| pton_xd wrote:
| > Weight has been increasing for nearly 40 years now in
| the US among all groups.
|
| Although interestingly it's still far lower among Asians
| in the US than any other group. Why is that?
|
| [1] https://www.cdc.gov/obesity/data/adult.html
| pixl97 wrote:
| A small group that's used a different selection mechanism
| than the primary population is really a poor metric to
| judge the majority. It seems likely that we'd find that
| migrant populations that have to a lot of work to get
| where they are have a higher motivation level than the
| general population.
|
| One should look at Asian obesity level growth, then
| compare the populations you're talking about in
| particular
|
| https://www.adb.org/sites/default/files/publication/32041
| 1/a...
|
| Some Asian countries still have rather low obesity growth
| compared to the world average.
| paulpauper wrote:
| _Probably because people aren 't acting on it, or sticking
| with it long enough to actually see results._
|
| Like telling penguins they need to flap harder to fly. The
| literature on diets on abysmal. People lose some weight and
| regain it, probably as willpower runs out. Look at all
| these celebrity weight loss shows over the past 2 decades--
| almost every contestant regains the weight, and these are
| people who have a lot of money and access to top chefs,
| trainers, etc.
| c7DJTLrn wrote:
| >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.
|
| Food has a different effects on different bodies with different
| mental state and neurochemistry. Pleasurable foods can be as
| addictive as recreational drugs. Is it really fair to blame it
| on people? When somebody can't stop using cocaine, we don't
| call them undisciplined, we call them addicts.
|
| It is far better for somebody to use a crutch to lose weight
| than remain fat and significantly damage their health in turn
| reducing their lifespan. Increasing tax on unhealthy foods and
| reducing sugar is still a work in progress. The long term goal
| is to nudge people into healthier foods such that the cycle of
| addiction is harder to start.
|
| With the collapse of traditional gender roles, both the man and
| a woman in a typical family are now working full time. It's
| harder particularly for the lower class to eat healthily when
| there's nobody to prepare meals. If that problem were solved,
| we'd be a big step closer to solving obesity.
| akiselev wrote:
| https://archive.ph/1waP9
| olegious wrote:
| Just a heads up "weight loss" is a poor metric if it comes at the
| cost of lean muscle mass. It seems that 39% of weight loss
| associated with Ozempic comes from lean muscle mass which isn't
| great.
|
| https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
| WheelsAtLarge wrote:
| When you diet to lose weight you lose lean muscle too unless
| you exercise to minimize it. What's the lean muscle mass loss
| from just dieting? I would guess that it's a relatively large
| number too.
| paulpauper wrote:
| _Though a certain amount of lean loss is inevitable with
| significant weight reduction (usually about 25% of total weight
| loss), the goal is to increase the body's overall proportion of
| lean mass - in other words, to improve body composition._
|
| lean loss does not mean muscle loss
| hombre_fatal wrote:
| There's no shortage of people debunking that charlatan.
|
| https://twitter.com/MichaelAlbertMD/status/16470364172503040...
| benrapscallion wrote:
| In 2020, Diabetologia published a body composition analysis
| of 88 volunteers with type 2 diabetes who used semaglutide
| for one year. These participants lost an average of 12.5
| pounds. Of that weight loss, there was a 7.5-pound reduction
| in fat mass and a 5-pound reduction in lean mass.
|
| In 2021, a major trial of semaglutide's weight loss potency
| examined the body composition of a minority of participants.
| These patients did not have diabetes, and they took a much
| larger dose of the drug. The 95 participants to undergo a
| body scan lost an average of 18 pounds of fat -- and 12
| pounds of lean mass.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997246/
| ddlutz wrote:
| Why do you think Peter Attia is a charlatan? Out of all these
| longevity & health influencers he seems most realistic &
| knowledgeable.
| gateorade wrote:
| I'm generally skeptical of pharmaceutical weight loss solutions
| as a bandaid over the underlying problem, but for this
| statement to mean anything you'd have to compare it to
| traditional methods of weight loss.
|
| If you simply eat at a calorie deficit and aren't taking
| specific steps to preserve muscle (resistance training and high
| protein), a lot of the weight you lose will be muscle mass.
| 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:
| [flagged]
| fintechie wrote:
| I was about to get on semaglutide and after extensive research I
| thought "wait, the results won't be much better than the periods
| of IF I've had in the past, and the reported benefits are
| similar", and without side effects. Dropping 30 pounds in 3
| months? easy to achieve with the Warrior Diet or OMAD versions of
| IF.
|
| The results are exactly the same... you fill full eating less
| quantity, cravings disappear after 1-2 weeks, increased focus and
| enhanced mental state. But yeah, you need some self-discipline,
| tons of coffee/matcha and water.
|
| I've concluded that semaglutide is not for me. Just like self-
| discipline in pills, with potential side effects. So better to
| give IF another go... I'm in the 4th week and dropped 10lbs
| already.
| 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...
| tboyd47 wrote:
| I appreciate the reply, really.
| trasz4 wrote:
| One works, the other doesn't.
| hayst4ck wrote:
| Ivermectin did feasibly improve covid outcomes, but _only_ in
| places where worms were common, which is not the US.
|
| So it's true that people like the one you are responding to
| are ignorant and can't really understand nuance and that they
| are also wrong for their lack of trust in institutions, but
| institutions also failed to communicate to those ignorant
| people and that is a problem all of it's own.
|
| Very fun science read that I hope humbles you a little:
|
| https://astralcodexten.substack.com/p/ivermectin-much-
| more-t...
| [deleted]
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