[HN Gopher] GLP-1s Are Breaking Life Insurance
___________________________________________________________________
GLP-1s Are Breaking Life Insurance
Author : alexslobodnik
Score : 204 points
Date : 2025-07-13 18:31 UTC (4 hours ago)
(HTM) web link (www.glp1digest.com)
(TXT) w3m dump (www.glp1digest.com)
| toomuchtodo wrote:
| It sounds like aligning incentives here is requiring the weight
| stay off for the policy to remain in effect with an annual
| physical for monitoring, similar to what employers require for
| health insurance premium reductions. Point in time underwriting
| is suboptimal considering current state of the art of GLP-1s
| (unless newer protocols that can update metabolic profiles are
| delivered soon).
| prasadjoglekar wrote:
| Or life insurers paying for ongoing GLP-1s instead of
| potentially the health insurer.
|
| But to your broader point, at least in the US, incentive mis-
| alignment on all healthcare and health insurance is possibly
| irredeemably broken.
| toomuchtodo wrote:
| Nailed my broader point. Could we go through contortions to
| see who is going to pay unreasonable costs for GLP-1s (health
| insurance, life insurance)? We could, but that's silly
| accounting to see who still gets to make the profit and who
| has to end up with the bill for empowering the human to fix
| their reward center. The shortcut is to provide GLP-1s to
| everyone who needs them at scale, as inexpensively as
| possible (to pull forward the improvement in health and
| quality of life outcomes until improved protocols arrive).
| The semaglutide patent is about to expire in Canada, China,
| India, and Brazil, for example.
|
| https://www.labiotech.eu/in-depth/novo-nordisk-
| semaglutide-p...
| jgalt212 wrote:
| I guess, but this is sort of the same as going on a statin to get
| your cholesterol down for a better insurance rate. Then going off
| because of reasons...
| arn3n wrote:
| Obesity is highly correlated with other medical conditions, from
| cancer to diabetes to heart disease. I wonder if there is a point
| at which it is cheaper for health insurance companies to offer
| subsidized or even free GLP-1s to patients than pay out for other
| specialized medications. For example, my insurance covers flu
| shots in my community every year because it's presumably less
| expensive to pay for the shots compared to the increased rate of
| hospitalization that the flu causes.
| aqme28 wrote:
| You're thinking too highly about the incentives of the US
| healthcare system. Since insurance is tied to your employer
| (and therefore changing every few years), and most people die
| on Medicare, there's not much incentive for insurance companies
| to pay for preventative care that won't actually help you for
| several decades.
| ethbr1 wrote:
| That's one reason the ACA shifted it to a mandatory (in most
| cases) category: https://www.healthcare.gov/preventive-care-
| adults/
|
| Minimal, but minimal progress in the US was/is still
| progress.
| helicalmix wrote:
| hmm...doesn't this possibly incentivize ozempic subsidies
| even more?
|
| If you know a "customer" of yours (an individual employee) is
| only going to be with you until they either change jobs or go
| on Medicare, then it seems the name of the game then is to
| make sure that nothing catastrophic happens to them until you
| can hand them off to someone else.
|
| In which case, they should definitely go on ozempic. Even if
| the effects of ozempic immediately come off after usage, it's
| a short-term enough solution that benefits the insurance
| company, no?
| vrc wrote:
| Yes. For very high risk patients, payers do want this. I've
| even heard of some paying pharmacies $100/fill if done on
| time for select people.
|
| The problem is, prediabetic and folks who may have crossed
| 7.0 A1C once, and just overweight folks with docs who are
| willing to play fast and loose are demanding it. Skipping
| metformin and other first line treatment options that are
| way cheaper. For those folks, complications might be the
| next guys problem.
| Aurornis wrote:
| > You're thinking too highly about the incentives of the US
| healthcare system. Since insurance is tied to your employer
| (and therefore changing every few years)
|
| Most people don't change jobs or insurance companies every
| few years. When they do, it's often within similar regions
| and industries so the chances of ending up right back under
| the same insurance company are significant.
|
| Regardless, the issue is more complicated than your line of
| thinking. Insurance companies have very small profit margins.
| Current GLP-1 drugs are expensive, around $1,000 per month.
|
| So each patient on GLP-1 drugs costs an extra $12K per year
| (roughly) or $120K per decade. That would have to offset a
| lot of other expenditures to break even from a pure cost
| perspective, which isn't supported by the math. So the only
| alternative would be to raise everyone's rates.
|
| I know the insurance industry is the favorite target for
| explaining everything people dislike about healthcare right
| now, but at the end of the day they can't conjure money out
| of nothing to cover everything at any cost demanded by drug
| makers. These drugs are super expensive and honestly it's
| kind of amazing that so many people are getting them covered
| at all.
| idontwantthis wrote:
| You presume incorrectly. The flu vaccine has been covered for
| free because the federal government required it. RFK Jr. fired
| the entire CDC panel that created the requirement and replaced
| them with antivaxers. There's a good chance it won't be covered
| soon.
| hammock wrote:
| Covered for the patient yes. For free, no.
| idontwantthis wrote:
| Are you disputing that the patient with insurance does not
| have to pay anything or raising a non sequitur about
| "someone" needing to pay for it?
| dragonwriter wrote:
| > For example, my insurance covers flu shots in my community
| every year because it's presumably less expensive to pay for
| the shots compared to the increased rate of hospitalization
| that the flu causes.
|
| In the US, insurance companies are generally _legally mandated_
| to cover ACIP recommended vaccines at no cost to the insured,
| which includes flu vaccines for everyone six months or older
| without contraindications.
| jameshart wrote:
| We have no idea what the long tern actuarial numbers are of 30
| year GLP-1 use though.
| alvah wrote:
| Well no, obviously not, but we do have 20 years of data, and
| aside from a still-tiny-but-slightly-elevated thyroid cancer
| risk, there's really not much showing up in that data.
| petesergeant wrote:
| > I wonder if there is a point at which it is cheaper for
| health insurance companies to offer subsidized or even free
| GLP-1s to patients than pay out for other specialized
| medications.
|
| That the NHS is getting to a place where it'll provide it, I'd
| say yes.
| Aurornis wrote:
| Everyone likes to bash the US healthcare system, but at the
| same time it's remarkable how much subsidized GLP-1 access
| Americans are getting compared to much of the world. The
| paradox of discussing healthcare online.
| michaelbuckbee wrote:
| Add heart disease and blood pressure meds to the list of "we'd
| be better off as a group if more people took them as
| preventatives".
| massung wrote:
| I don't know if your topic switch was intentional - if so, my
| apologies and this is just for people outside the US who don't
| know...
|
| The article is about life insurance, which is very different
| from medical insurance.
|
| Medical insurance companies often already go out of their way
| to pay early to save in the long run (e.g. free preventative
| care, checkups, etc.). I can't speak to GLP-1s, but it's
| possible that right now there are still active patents when
| used for obesity that make them crazy expensive for a few more
| years.
|
| Life insurance is all about models and predictions about when
| you're going to die. Any sudden change that massively impacts
| those models suck, because life insurers are basically gamblers
| with gobs of historical data they use to hedge their bets.
| silotis wrote:
| > Medical insurance companies often already go out of their
| way to pay early to save in the long run
|
| Literally LOLed when I read this. Health insurance companies
| might pay lip service to this and make some token gestures
| like free preventative care, but in my experience health
| insurance companies frequently shoot themselves in the foot
| by denying care that later ends up costing them even more
| when the patient's untreated condition worsens.
| GLdRH wrote:
| It's not a gamble, it's an application of the law of large
| numbers. But yes, changes in the underlying assumptions (e.g.
| mortality rates) can make the whole calculation untenable.
| terminalshort wrote:
| Medical insurance in the US is not incentivized to save
| money. In fact it's just the opposite. The ACA requires that
| 80% of premiums be paid out to medical expenses. If an
| insurance company encourages people to get preventive care
| and lowers its expenses, that means they also have to lower
| premiums. So they actually want costs to be as high as
| possible since they get to keep 20%.
| paulpauper wrote:
| After it goes generic it will be cheaper. right now, it's not.
| DrillShopper wrote:
| > I wonder if there is a point at which it is cheaper for
| health insurance companies to offer subsidized or even free
| GLP-1s to patients than pay out for other specialized
| medications
|
| Some do. My insurance requires a prior authorization due to the
| previous shortage, but it's $12/mo
|
| Medicaid in my state also covers it for $3/mo
| Jach wrote:
| I don't think GLP-1s are particularly expensive, so my top
| preference would be to just see them easily available. While
| not quite the same, it's a win that Rogaine/Minoxidil were once
| prescription-only but for a long time now can be bought at any
| grocery store and taken to the self-checkout. Still, I think
| the subsidy approach has been done for smoking problems via
| nicotine products before, and e.g. nicotine gum cost never
| seemed that high to me (especially compared to cigarettes).
|
| But it's also worth remembering the relative risks involved.
| Obesity isn't quite the ticking time bomb / public menace it's
| often made out to be... For smoking, you'll find studies with
| relative risk numbers for lung cancer over 5 for casual 1-4
| times a day smokers, and the number quickly exceeds 20 for
| heavier smokers. In contrast, with obesity, the most severe
| relative risks for things like heart disease or diabetes you'll
| find _topping out_ around 4 to 5 for the most obese, even then
| often under 3, with milder 1.1 to 2 for the bulk of obese
| people. (Here, ~31% of the US has BMIs between 30-40, and ~9%
| have BMIs over 40.) For other harms, like there was a study on
| dementia a few years back, you 'll also find pretty mild
| (1.1ish) relative risks, but these end up being similar with
| other factors like "stress", "economic status", or "low
| educational attainment". Just some thought for people thinking
| about subsidizing or providing free stuff, the cost tradeoff
| with paying for other things later might not work out so
| neatly, and there's reason to not focus solely on obesity but
| also do the same sort of analysis with other factors and
| severity of a factor as well.
| Aurornis wrote:
| > I don't think GLP-1s are particularly expensive
|
| On-patent GLP-1s (all of them right now) are actually
| extremely expensive. Right around $1000 per month.
|
| I don't want to discourage anyone who needs them from seeking
| treatment, but their discontinuation rate can be somewhat
| higher than you'd think from a life-changing drug because
| many people don't like certain effects or even encounter side
| effects.
|
| Weight loss drugs are also a challenging category for OTC
| because they're a target of abuse. People with eating
| disorders and body dysmorphia already seek out black market
| GLP-1s at a high rate and it would be a difficult situation
| if they could pick them up impulsively from the medicine
| aisle. It's also common for people to misuse OTC medications
| by taking very high doses hoping for faster results, which
| has to be considered.
|
| There's a libertarian-minded angle where people say "Who
| cares, that's their own problem. Medications should be free
| for everyone to take." I was persuaded by those arguments
| when I was younger, but now I have a very different
| perspective after hearing about the common and strange world
| of OTC medicine abuse from my friends in the medical field.
| Just ask your doctor friends if they think Tylenol should
| still be OTC if you want to hear some very sad stories.
| fnord77 wrote:
| I pay about $40/month for mine, grey market from china
| bananapub wrote:
| > On-patent GLP-1s (all of them right now) are actually
| extremely expensive. Right around $1000 per month.
|
| what does that mean? in the UK it's for sale from numerous
| national-chain pharmacies on a private prescription (ie the
| pharmacy is selling it commercially and customers are
| paying cash, no insurance and no state subsidy) for less
| than $US270/month. it seems unlikely to me that the
| pharmacies or the manufacturers are taking a loss on this,
| and the UK has at least as strict drug quality standards as
| the US.
|
| sounds like the US monopoly-holders are just charging a lot
| more because they can, because the insurance system
| obfuscates prices and gives everyone involved cover to rip
| off patients?
| terminalshort wrote:
| People who want to misuse the medication are going to be
| the ones most willing and able to jump through the
| bureaucratic hoops. Increasing the difficulty to get the
| medication will only make it more difficult for legitimate
| users and won't decrease abuse. In 1920, 1970, and now,
| heroin was legal, illegal with minimal enforcement, and
| illegal with harsh enforcement (except in SF), and the same
| percentage of the population was addicted at each time.
|
| Doctors' jobs are to deal with the cases that go wrong.
| These anecdotes have no relevance without actual data on
| how often these problems occur.
| interestica wrote:
| Fluoridated water? Nah. GLP water.
| llm_nerd wrote:
| This is a fun read, however-
|
| "Life insurers can predict when you'll die with about 98%
| accuracy."
|
| This conclusion isn't supported by the linked document. The
| document instead is talking about expected vs actual deaths among
| demographic groups as a whole, not individual people. And that
| expected vs actual is just history + trends. This doesn't mean
| that insurance can say that Joe Blow is going to die in June of
| 2027 with "98% accuracy", obviously.
| PaulDavisThe1st wrote:
| Put a little differently, they can predict that of your cohort
| (defined somehow), after June 2027, only X percent of you will
| still be alive.
|
| Will you be one of them? Click here to find out!
| etothepii wrote:
| For mortality tables age and sex are pretty much sufficient
| to get to 98% accuracy.
| astrange wrote:
| > This doesn't mean that insurance can say that Joe Blow is
| going to die in June of 2027 with "98% accuracy", obviously.
|
| Pretty easy to predict if you're willing to make it happen.
| GLdRH wrote:
| Life insurance is just another word for bounty
| crazygringo wrote:
| Yeah that was a bizarre line in the article. Not to mention
| it's meaningless because it doesn't say within what time
| interval. But even if you assume a year (i.e. predict your age
| of death) it's obviously false. Life insurers are very much not
| predicting the year an individual will die and getting it right
| 98% off the time. That would be absurd.
| ks2048 wrote:
| I can predict pretty well "Will person X die this year" by
| saying "No". Yeah, this number seems meaningless without more
| context.
| paulpauper wrote:
| They can predict it in the sense most people will die within
| some specified window in which the insurer makes a profit. This
| is why its so profitable for the insurer. They have a very wide
| window where it's profitable and the vast majority of people,
| 98%, fall within this window. .
| vslira wrote:
| I've always felt that there's some trade to be done here, with
| life and health insurers basically giving glp-1 et all for free
| bc they lower the cost of everything else
|
| edit: and then Big Annuity lobbying to oppose this
| lesam wrote:
| Aren't "Big Life Insurance" and "Big Annuity" pretty much the
| same companies?
| hiAndrewQuinn wrote:
| They are, they're basically mathematical inverses of the same
| product.
|
| Big Annuity can charge you more, in fact, if it has reason to
| believe you're going to live unusually long, so playing the
| GLP-1 dance with them would only be profitable in reverse.
| Pretend to be the unhealthiest person on the planet, lock in
| an annuity, then get on the drip stat.
| meltyness wrote:
| Well I guess a GLP-1 pacemaker would address this. A lifetime of
| doses weighs at much as a nickel?
| MPSimmons wrote:
| I believe it has to be kept at refrigerated temperatures over
| its relatively short shelf-life (1 year, I believe).
| foota wrote:
| I realize this is a fraught question, because not everyone is
| overweight by choice (whether due to a subsisting on whatever
| they can afford, time, genetics, injury, etc,.) but I believe
| that insurers are able to consider whether someone smokes
| cigarettes when setting premiums for ACA based healthcare. With
| the above caveats that would make this difficult, it would be
| nice if we could treat "voluntary" obesity similarly.
| etothepii wrote:
| I think the article is making the point that that is what they
| have traditionally been able to do but they no longer can.
| Since the magic drugs are giving people the will power to be
| able to make these changes.
| foota wrote:
| The article is about life insurance, not health insurance (I
| should have made it clear I was talking about health
| insurance).
| romaaeterna wrote:
| The problem (not new with GLP-1s) is that people lose weight, get
| life insurance, and then regain.
|
| The biggest part of that equation is regain part. Most people
| quit GLP-1s because of costs. Let's fix that.
| beepbopboopp wrote:
| Get ready for health/weight based credit scores, Its probably a
| genuinely good idea.
| paulpauper wrote:
| I think they quit also because they see it is working and no
| longer feel like they need to use it
| apwell23 wrote:
| i have hard time believing ppl go through all that only to sign
| up for cheap life insurance.
| cm2187 wrote:
| I don't know, I tend to notice the effect wears off over time.
| Not sure it's a good idea to consume it permanently. Perhaps a
| better use would be for short periods to course correct.
| romaaeterna wrote:
| Anecdotally, the dose required to maintain a stable weight
| seems to be lower than the dose required to lose weight. Most
| people tend to regain some weight when going cold turkey.
|
| The safety profile of the drugs with diabetics, and the
| health benefits that come from the associated weight loss may
| make permanent use a net benefit for most people. There
| appears to be little, if any, "course correction" effect from
| taking it for short periods of time.
| cm2187 wrote:
| It depends how you define "short period of time". When I
| started, I lost 40kg in a matter of 5 months. Is that
| short? If you develop a tolerance to the product, then it
| doesn't protect you long term from gaining back weight,
| combined with you losing the option to do a rapid descent.
|
| I am not saying that those variations are great from a
| health point of view, but they are certainly not as bad as
| staying obese.
| jstummbillig wrote:
| Can you explain what you mean? What you say seems to strictly
| contradict how the meds are supposed to work.
| firesteelrain wrote:
| People find they need to increase to higher tolerable doses
| to ensure their hunger is satiated. But also, you need to
| increase your protein and fiber intake to maintain that
| satiation. I tried going up to 10mg and I had such a sick
| feeling. 5mg I could tolerate. Some people are up 15mg.
| rrrrrrrrrrrryan wrote:
| According to all the studies, this is absolutely the worst
| thing that you can do. GLP-1s are revolutionary, but when you
| go on them, you should intend to stay on them for life. When
| patients first go on them, they lose both muscle and fat, and
| when they go off them, they regain _just_ fat, and in many
| cases they 're in a worse situation than they would be if
| they hadn't gone on them in the first place.
|
| Letting your weight fluctuate up and down in giant swings is,
| in many ways, harder on the body than just staying at a
| steady weight, even if it's overweight.
| nwienert wrote:
| This is nearly perfectly wrong.
|
| There's nothing in these drugs that makes you lose more
| muscle than fat, you don't lose any more muscle than if you
| do a regular diet, not even slightly.
|
| Second, the drugs don't do anything to cause you to gain
| back mostly fat, and people going off them have more
| success, not less, than your average person who loses
| weight rapidly whether through diet or other means.
|
| The average person who is 50lbs overweight because they
| gained 5lbs a year for a decade will lose all of that
| weight within 6 months with nearly entirely positive side
| effects, and if they stop taking it, will regain a bit less
| than they did before, meaning it would take another decade
| to get back to where they were. That is unequivocally a
| huge net positive.
|
| It's not like Testosterone which does have dramatic
| negative effects when taken long term and can cause
| dependency.
|
| It also happens to be extremely effective at reducing bad
| habits, and yes those habit changes persist after quitting
| - not perfectly, but surprisingly so. This even works for
| smoking, drinking, and gambling.
| cjbgkagh wrote:
| I've been on it for years, at a lower dose though, the
| counter action by the body is probably dose dependent so my
| theory is lower for longer is more sustainable. I think
| people get attached to the rapid weight loss, coupled with
| the high expensive, incentivizes higher doses. I take gray
| market supply and it's rather cheap.
|
| Also it should be mostly used as an adjunct to strict diet
| and exercise.
| msgodel wrote:
| "Measuring" people for the sake of insurance just sounds hard.
| Partly because people are complex but also because people just
| hate being measured.
| arp242 wrote:
| Are the long-term (>20 years) effects of taking GLP-1s really
| all that well understood? Because that's kind of what you're
| suggesting here.
|
| Making millions of people dependent on a drug to maintain basic
| health does not strike me as the best of ideas regardless. I
| understand why it's a good idea for many from an individual
| perspective and I'm not judging anyone, but from a societal
| perspective it does not seem like a reasonable solution.
| Spivak wrote:
| Why not? We have an overweight and obesity epidemic that has
| persisted through everything else we've gotten enough
| political capital to try thus far. The "miracle" drug is the
| most promising direction we've had in a long time. Whatever
| possible adverse long term effects have to be (plausibility
| they actually happen) x (harm they cause) > known harms of
| being overweight.
|
| The scale of the solution is allowed to match the scale of
| the problem which is on the order of 2/3 of adults or
| 200,000,000 people.
| arp242 wrote:
| Well, don't say you weren't warned when it turns out the
| miracle is not such a miracle after all and it all
| massively backfires in a few decades, at which point you're
| still going to have to actually fix the real underlying
| causes.
| paul7986 wrote:
| I believe AI along with smart glasses that shows and calculates
| your daily caloric intake will be a SUBSTITUTE (another option)
| to the Ozempics.
|
| With AI glasses doing this automatically for you upon seeing what
| your eating without u having to do anything some people may be
| shocked to learn how many calories they consume daily.
|
| Currently, it's too time consuming now for the majority to do (i
| use GPT via texting it or talking to it to keep track as I eat
| out daily at healthy chains) but if it was done automagically I
| believe it definitely would be a substitute to Ozempic. I bet
| some or more would use that easily captured data that's shown to
| them (in the glasses or on their mobile device) to strive, make
| and possibly compete with their friends/family to eat less
| calories and carry less weight on them (be healthier). You can
| train your body to eat less to a lot less and for some that would
| definitely help them shed weight. The glasses could as well
| deduct calories burned from your daily walk, jog, etc.
|
| *Being downvoted hmmm do you think AI by seeing it can't via an
| image calculate the calories of a burrito bought from Chipolte
| and other chains? All chains have nutrition information on their
| websites now that GPT goes and fetches. As for home cooked
| prepared meals I have taken pics of my food via GPT and it seemed
| to come close.
| __turbobrew__ wrote:
| I don't think awareness of caloric intake is the problem, there
| are standardized labels on most foods (especially the bad
| ones). Most people who are obese know that the calories make
| them overweight, but they still have the need to eat food --
| which is what makes obesity a result of addiction. Similarly
| meth addicts know that meth is bad for them, but they still do
| it anyways.
| astrange wrote:
| How often do people control their own diets? That assumes
| they buy and cook all their own food, which is only true if
| you live on your own.
| __turbobrew__ wrote:
| > How often do people control their own diets
|
| Maybe I live in a bubble, but I don't put stuff in my body
| unwillingly, so yes I control my diet.
|
| It also isn't rocket science, I know doughnuts have a shit
| ton of calories and vegetable shortening which will clkg
| your arteries, so I don't eat doughnuts. I don't have to
| look at the packaging.
|
| Maybe the missing part is a proper education on nutrition
| in school, but we live in the age of the internet. All the
| information is there, you can get meal plans, you can
| figure out what foods are more likely to put you at risk.
|
| Again, I don't believe awareness is an issue. People know
| that chips and doughnuts are bad, but they eat them anyways
| because they are addicted to food which is engineered to be
| addictive.
| astrange wrote:
| > Maybe I live in a bubble, but I don't put stuff in my
| body unwillingly, so yes I control my diet.
|
| The example I'm thinking of is cultures with near-
| religious obligations to listen to their parents. Like
| Italian-Americans all act like they'd die if they ever
| ate less than all of their grandmother's cooking or ever
| changed any of the traditional recipes. Even though the
| recipes were all invented in 1970 in NYC and have
| inhumanly large amounts of carbs.
| paul7986 wrote:
| Sure and I didnt say it would replace Ozempics rather it's a
| substitute that would help a portion of the population.
|
| Yet majority of all people have no idea the amount of
| calories they eat daily. Im sure being shown this
| automagically will be valuable data to all people just how
| they choose to use this optional feature to make changes or
| not.
| dragonwriter wrote:
| > which is what makes obesity a result of addiction.
|
| Obesity is not (in general) a result of addiction.
| lbrito wrote:
| People with poor restraint will remain unfazed.
|
| If what you're suggesting worked, then the horrible cancer pics
| on cig packs would have long eliminated smoking.
| paul7986 wrote:
| I did say it will be a substitute to the Ozempics not a
| replacement.
|
| For those who don't have the will power there's the Ozempics
| to utilize at their discretion. For those who do have some or
| a lot of will power to change their lifestyle forever then
| this is going to be extremely helpful and those types wont be
| using Ozempics as Im sure such types are using it now.
| ChadNauseam wrote:
| I agree with you. However, smoking rates have gone down,
| probably in part because of those pictures and awareness
| campaigns in general
| GLdRH wrote:
| I can't support this with data, but I'd think the increase
| in price and compounding effect of more and more people
| quitting, plus absence of smoking in the media, has had
| more of an effect
| arp242 wrote:
| I knew several people for whom the pictures were the
| "final push" to really quit back when they were first
| introduced. Not sure if it's easy to get good data to
| separate out all the factors such as cost, in-your-face
| warnings, etc. because they all happened more or less at
| the same time.
|
| As an aside, I watched _Poor Things_ this afternoon, and
| it came with a "Contains Tobacco Depictions" warning at
| the start. Never seen that before. No warning for the
| nudity, sex, or profanity.
| paul7986 wrote:
| well for those mid level to have strong restraint this is
| going to be helpful!
|
| I already do this with chatGPT but i have to do something vs.
| just living and glasses doing it automatically.
| lumost wrote:
| You're being downvoted as many people who try to count calories
| fail to achieve meaningful results. From my own experience,
| weight gain follows a simple progression.
|
| 1. Expected high stress work day -> Coffee w/ food item in the
| morning
|
| 2. Stress during the day -> No exercise + large lunch.
|
| 3. Post-day -> door dash due to not feeling up for cooking.
|
| 4. Sleep -> Get 6 hours of sleep due to not having the energy
| to maintain bedtime discipline, getting paged, or late night
| meetings + childcare obligations.
|
| 5. Repeat.
|
| This cycle continues for a few months leading to 10-20 pounds
| of weight gain, followed by a year long push to rebalance life
| and lose the weight. There is nothing that a magic calorie
| counter could do for this cycle other than guilt me over my
| door dash order at the end of the night.
| pmg102 wrote:
| People seem to be taking it as given that "someone else
| preparing the food for you" == "the food is more likely to
| lead to weight gain".
|
| Why should that be? Is it not possible to order healthy food
| in? If not this would surprise me as it seems a number of
| people would be seeking this.
|
| I'm asking as I don't have personal experience.
| paul7986 wrote:
| Everyone lives and enjoy life as they choose as they
| should!
|
| For those who are not interested cutting down daily on what
| they eat this data would not be valuable to them just as
| the data their phone captures now how many steps you walked
| in a day.
|
| Myself I eat Cava bowls for lunch that are less then 600
| calories, drink 70 percent water (not consuming calories
| from what I drink) and unsweet tea (zero calories in tea)
| with some lemonade to sweeten it a bit as the remainder.
| Other chains you can find similar meals that are less then
| 600. If you eat as such and keep at (change ur lifestyle
| for good) it some weight will be lost if the person wants
| to as well go for a walk on their lunch break. But again
| all about to how people want to live and enjoy their lives!
| lumost wrote:
| The ordering out tends to correlate with someone not having
| the energy or discipline to make what they want themselves.
| That lack of energy leads to caving on food cravings and
| overeating.
|
| I recently switched from a major tech company to an
| academic position and lost 5 pounds in the first month.
| Simply due to lower stress making the healthy habits seem
| "easy."
| hiAndrewQuinn wrote:
| So... There's a miracle drug powerful enough to robustly lower
| people's all cause mortality, but since health insurance and life
| insurance are industries with vastly different time preferences,
| this is _not_ a good thing for the life insurers because people
| just keep getting off the magic longevity drug and screwing up
| their predictions. Because, admittedly, it kind of sucks in the
| moment to be on.
|
| And I'm guessing just based on my own experience paying for term
| life that the actual premia differences aren't actually enough in
| most cases for the life insurer to simply pay out of pocket
| themselves; the differences probably add up to a few hundred per
| year per customer, whereas a year's worth of a GLP-1 agonist
| probably costs a couple thousand (for now, in 2025, and probably
| dropping rapidly).
|
| Huh. Second order implementation details aside, this is an
| extremely fortunate turn of events for us.
| ramoz wrote:
| Can you explain what sucks about being on the prescriptions?
| hiAndrewQuinn wrote:
| I'm just reporting my cached knowledge of people saying they
| experienced some adverse side effects. Also injections are
| not fun, even though they are probably a lot less annoying
| than they look.
| nwienert wrote:
| In the 10 or so people I know who are on it, nearly all
| actually seem to enjoy it - reduced addictive
| tendencies/bad habits, appetite control, and reduced
| allergies seem to pretty well outweigh the minor side
| effects.
| ChadNauseam wrote:
| A once-weekly subcutaneous injection is not a big deal for
| most people I think, outside of those who are very afraid
| of needles. It's a tiny needle and you don't even feel it.
| I've given injections to people who are afraid of needles,
| and they sometimes close their eyes in fear and are begging
| me to "just get it over with" without even realizing that
| I'm already done. Anyway, all this to say that outside of
| needle-phobic people I think the annoyance of the
| injections is probably not the reason people stop taking
| GLP-1 agonists.
| loeg wrote:
| > It's a tiny needle and you don't even feel it.
|
| I'll add that while it isn't a big deal, I definitely
| feel the needle; sometimes worse than others. (I'm using
| 8mm 30 gauge needles.)
| swat535 wrote:
| You have to inject it correctly, it needs to be injected
| in the fat and with the right angle.
|
| If you have very little body fat, your glutes are
| probably a better place.
|
| Source: I take HCG and have to use injection 2x a week.
| 27G is my favorite..
|
| https://medneedles.ca/products/1ml-27g-x-1-2-sol-
| care%E2%84%...
| cjbgkagh wrote:
| It's mostly random and some people do feel it more than
| others.
|
| It's a rapidly absorbed peptide suspended in water, it
| could even be used with a transdermal patch, so it
| doesn't matter that much where it gets in or how deep.
| Best to avoid painful areas though.
| loeg wrote:
| It is correct (belly). :-) I think I remember it being
| less painful when I was fatter? The 30G/8mm needles I'm
| using are smaller than your 27G/13mm needles in both
| dimensions; should be better, if anything. Again, it's
| not a big deal, but I feel it.
| randallsquared wrote:
| As someone who is mildly needle-phobic, I'll agree it's
| no big deal, but you definitely can feel it, and if you
| hit a blood vessel by accident, there's a (mostly
| painless) bump and 2-3 week bruise at the injection site,
| which might be a major issue for some.
| sroussey wrote:
| Be sure to pull back on the plunger and ensure there the
| needle is not in a blood vessel (pulling back will draw
| blood into the thing and you will see).
|
| You do not want the drug meant to subcutaneous to go into
| the blood steam. This is true for GPL-1s (all peptides
| for that matter), as well as insulin, and definitely mRNA
| vaccines.
| cjbgkagh wrote:
| You don't feel it most of the time, it's actually random
| with the sparse placement of nerves. Maybe 1 in 5 still
| sting a bit.
| Spivak wrote:
| Subcutaneous shots with insulin needles are basically
| painless. You don't even feel a prick, it's just a little
| pressure and then it slides in. When you get a shot at the
| doctor it's painful because they're intramuscular.
| toomuchtodo wrote:
| Once daily pills will very likely replace injections in the
| near future.
|
| _Eli Lilly will soon release key data on its weight loss
| pill orforglipron_ -
| https://news.ycombinator.com/item?id=43465346 - March 2025
|
| https://en.wikipedia.org/wiki/Orforglipron
| gedy wrote:
| I've taken these and self injected, and it was surprising
| that I really felt nothing - no pain at all. I suppose
| because they recommend in stomach, and it's not in muscle,
| etc.
| dooglius wrote:
| There's an auto-injector mechanism, at least with my brand;
| you don't need to needle yourself
| DrillShopper wrote:
| Hi there - Mounjaro user here. I've been using it for about a
| year at this point.
|
| I feel sick for three days in a row after taking it. Even
| after several months on the same dose. I get horrible gut
| cramps, sour stomach, near constant nausea, and occasionally
| vomiting and diarrhea. I have to take my shot on Thursday
| night because I'll feel bad the next day and supremely sick
| the next two days. If I took it earlier or later in the week
| it would absolutely impact my ability to work during the work
| week.
|
| It has had amazing effects. I've lost about 60 lbs in the
| last year and my A1c is now around 6.2.
|
| It's a very effective drug, but it is brutal on my body. I'm
| not sure anything in the medication is causing the weight
| loss. It just makes me feel so sick that even if I'm hungry I
| don't feel like eating.
| jstummbillig wrote:
| I mean no offense, but you have a fairly substantiated body
| of evidence that something in the medication is causing the
| weight loss. The side effects do sound really shitty
| though.
| dboreham wrote:
| These medications don't work in the way many people
| think. The drug doesn't make you "lose weight" in the
| sense that it causes the body to excrete fat. Rather it
| interferes with the constants in the gut/brain
| signaling/programming system such that your brain doesn't
| want to eat as much. That in turn leads typically to
| weight loss.
| schwartzworld wrote:
| I'm curious what your diet is like, especially at the end
| of the week when the medicine is weakest. If I eat dairy,
| sugar, etc in the day or two before my semaglutide, I feel
| similarly.
| make3 wrote:
| I don't know how overweight you are, but could you not just
| reduce the dose to get fewer side effects & still have
| reasonable weight loss? & Did you try other GLP-1s?
| phil21 wrote:
| These are pretty extreme side effects for being on the drug
| thus long.
|
| What dosing are you on? If you're still doing 2.5mg
| (smallest available in the auto injectors) perhaps try a
| compounding pharmacy for a month or two and you can
| experiment with lower doses and a different dosing
| schedule?
|
| During my peak weight loss period I found that matching my
| injection schedule to the 5 day half life of Tirzepatide
| and adjusting the dose downwards to match this schedule
| helped with any side effects - including the "fading" of
| effects those last 2 or 3 days for me. There are half life
| calculator spreadsheets available on the internet that can
| help dial it in and keep your theoretical concentration
| more flatline vs peaks and valleys.
|
| The current dosing regime is based on the single FDA trial
| that LLY did and is certainly not going to be the common
| practice a decade from now. It's largely designed around
| patient compliance than anything else.
|
| That said - everyone responds to this drug much
| differently. My little group I'm in is all over the map.
| Some folks lose weight consistently with tiny doses every 2
| weeks, some are going above the recommended maximum weekly
| dose.
|
| I also found food choices matter. A lot. The best part of
| tirz for me was being given mental space to stop eating
| shit food and start eating "clean" consistently. When on
| high dosing I absolutely would have a bad day if I decided
| to take my shot and then eat a typical American diet later.
|
| The primary mode of action from the drug is simply you eat
| less. But it shouldn't be due to you feeling too sick to
| keep anything down. That sounds pretty horrible.
| jiveturkey wrote:
| For a single person, perhaps fortunate. What about in
| aggregate? What if the math is so bad that your life insurer
| goes bankrupt?
| hiAndrewQuinn wrote:
| ... I just switch life insurance providers?
|
| Seriously, that's just not that big of a deal. It takes like
| a few days at most for simple term life. Can't speak to the
| other policies, which I understand are mostly tax vehicles
| anyway, but it's not hard to simply get a new life insurance
| policy if your current one goes kaput.
| FabHK wrote:
| ... and the question was about the aggregate effect. What
| happens if all life insurers go bankrupt?
| hiAndrewQuinn wrote:
| Every single life insurer? All at once?
|
| Jeez.... I guess in that scenario I become a billionaire
| because it will be very easy to scoop up some VC money to
| snoop up some of those newly unemployed actuaries to
| monopolize the market at a profit margin an order of
| magnitude larger than any of my now non-existent
| competition, because this is a financial product and
| doesn't require months of building a factory or something
| to offer.
| ecb_penguin wrote:
| If you think it's that simple, you have no idea what
| you're talking about.
|
| How many years experience do you have in the insurance
| industry that you're so confident to talk like this?
|
| > because this is a financial product and doesn't require
| months of building a factory or something to offer.
|
| How many financial instruments have you launched? If the
| answer is zero, you should refrain from any conversations
| on the topic because your opinion literally means
| nothing.
| hiAndrewQuinn wrote:
| I do actually think it's that simple, yes. Term life is
| just not that complicated a product at heart.
|
| Onus is on you to prove that if every single life
| insurance provider was suddenly Thanos snapped out of
| existence tomorrow, we wouldn't see a swarm of hungry
| financial professionals swoop right back in to recreate
| the service within weeks. That seems like a laughable
| claim to me, but maybe you know something I don't.
|
| (Edit, for future readers: ecb_penguin seems to have
| missed the question earlier in the thread I was
| responding to:
|
| >... and the question was about the aggregate effect.
| What happens if _all_ life insurers go bankrupt?
|
| Emphasis mine. This was to clarify that yes, the original
| commenter meant literally all providers.)
| ecb_penguin wrote:
| Ok, so you have no experience and you're just making
| things up.
|
| > Term life is just not that complicated a product at
| heart
|
| Sure, it's easy if you don't know what you're talking
| about and just make stuff up!
|
| > Onus is on you to prove that if every single life
| insurance provider was suddenly Thanos snapped out of
| existence tomorrow
|
| Literally nobody said that would happen. Now you're
| arguing points that nobody made.
|
| You have no experience in the area, arguing things nobody
| said. You're perfect for VC money, lmao.
|
| > That seems like a laughable claim to me
|
| Nobody made that claim. Why are you laughing at things
| nobody is saying? That's weird.
|
| > That seems like a laughable claim to me, but maybe you
| know something I don't.
|
| I would 100% guarantee people that have worked in an
| industry know more about it than you do.
|
| Textbook demonstration of the Dunning-Kruger effect. You
| have no knowledge or experience in an area, but you're
| confident you know how it works, moreso than the actual
| experts. https://en.wikipedia.org/wiki/Dunning%E2%80%93Kr
| uger_effect
| ecb_penguin wrote:
| "the Dunning-Kruger effect is the thesis that those who
| are incompetent in a given area tend to be ignorant of
| their incompetence, i.e., they lack the metacognitive
| ability to become aware of their incompetence. This
| definition lends itself to a simple explanation of the
| effect: incompetence often includes being unable to tell
| the difference between competence and incompetence."
|
| I think this very accurately sums up your comments.
| hiAndrewQuinn wrote:
| Well jeez, that sounds awful. Thank goodness I've always
| been great at everything I've done so I never gave to
| face this.
| carlosjobim wrote:
| That is great, they are by definition a net negative on
| the economy as a whole? You shouldn't gamble on your own
| health.
| GLdRH wrote:
| Oh come on, you can't be serious.
|
| It's not a gamble, you transfer your risk to a
| collective.
| eclipticplane wrote:
| Perhaps some life insurance products fall into that
| category. For many families, though, term life insurance
| plays a big part into ensuring financial security if one
| income earner dies prematurely.
| DrillShopper wrote:
| If you want to gamble on your health then you want a
| tontine, not life insurance.
| A_D_E_P_T wrote:
| Life insurance, in the past, was frequently illegal.
|
| I'd argue that it should be illegal again, as a moral
| hazard (directly contributing to countless murders and
| other schemes) and as a particularly morbid form of
| gambling.
| DavidPeiffer wrote:
| You will be going through underwriting again, your new rate
| will be based on starting at an older age, and you'll have
| a new exclusion period begin (unless there are some
| provisions which prevent these in the event of a company
| failure). Hopefully you haven't had any significant health
| conditions present themselves since the original policy
| went into effect.
| darth_avocado wrote:
| Insurance companies will find any and every reason to not
| insure you. A slight change in lifestyle could mean you
| are no longer covered.
| sethhochberg wrote:
| With term life insurance specifically the lifetime policy
| premiums are typically so low relative to the value of
| the policy that there's a natural bias towards insuring
| generally healthy people. Its not uncommon to see
| policies that are something like $40/month for 20 years
| ($9600 in premiums) for a $1mm death benefit, for
| example.
|
| People with more complex medical conditions often can get
| life insurance from smaller, specialized providers... and
| at much higher rates. But the big mass-market players
| offering inexpensive term life products are only offering
| them that cheaply because they really control the risk
| profile during underwriting.
| Marsymars wrote:
| That's a pretty bad deal if you're 10 years into a 20-year
| term, and your rates were determined prior to a decade of
| inflation and new pre-existing conditions.
| hiAndrewQuinn wrote:
| I admit that's unfortunate. I don't think that was a "bad
| deal" in the sense that anyone grievously misled you or
| anything.
|
| I would feel bummed out, but not angry or like I actually
| got ripped off, in other words. When I signed up for the
| 20-year term, part of what I was being asked to do was
| estimate how likely I think it is for this firm to
| actually be around for that full 20 years. That's just
| part of the game.
| petesergeant wrote:
| > admittedly, it kind of sucks in the moment to be on
|
| I don't think that's a typical experience for most people,
| other than the price
| mattmanser wrote:
| There's often side effects, including nausea, diarrhea,
| headaches, bloating, discomfort, etc.
|
| As far as I can tell from forums, it's not like 5% have the
| side effects, it's like 80-90%.
|
| But for the first time in decades, I felt full. I didn't want
| to finish a meal, it was too much.
|
| My body regulated my food intake in what felt like a natural
| way.
|
| I hadn't even realized my body had somehow lost that
| fundamental mechanism of appetite control. It made me realize
| I wasn't weak willed, something is different about my body
| than other people.
|
| But it comes with a price. The side effects I had were quite
| bad and so I stopped (though I now read that if I switch to a
| different brand, I might be ok).
|
| I often didn't want to leave the house due to a dicky tummy.
| It could come/go in waves. But often can last a whole week.
|
| Plus you've got to inject yourself every week. Often you
| can't drink as it makes you sick. Even when you're doing
| everything 'right' you can feel a bit off.
|
| If you do over-indulge (with food or drink) the side effects
| can sometimes be massively amplified and you feel terrible
| for days.
|
| So amazing in some ways, but it's not like taking a vitamin
| tablet. There are costs and making one slip up can result in
| suddenly feeling awful for a day or two.
|
| Perhaps I was just particularly prone to the side effects,
| but it seems to happen to a lot of people (I found Mumsnet
| threads about it useful, they are quite revealing as they
| seem to be fairly honest and willing to share their
| experiences)
| loeg wrote:
| I had more side effects ramping up the dose than after a
| while at the same dose. But they were all fairly mild. (I'm
| on 5mg/week of Tirzepatide; higher doses probably have more
| side effects.)
|
| > If you do over-indulge (with food or drink) the side
| effects can sometimes be massively amplified and you feel
| terrible for days.
|
| Never had anything like that.
| DrillShopper wrote:
| The one thing that helped blunt the side effects for me was
| cannabis. Just a few puffs at night on the three nights
| after my injection made a huge difference.
|
| I wouldn't recommend that to everyone, but it helped a lot
| for me.
| JoshTriplett wrote:
| > As far as I can tell from forums, it's not like 5% have
| the side effects, it's like 80-90%.
|
| Happy people with no issues are less likely to post, or
| post as often.
|
| That said, much sympathy for the people who _do_ experience
| particularly bad side effects.
| sroussey wrote:
| From the people I know on trizepitide, side effects were
| strongest when upping the dosage in the protocol,
| particularly two days after. The advice I have received
| while considering it:
|
| - change your diet. you can't eat the same food at the same
| volume. or even is smaller volume if the food is a burger,
| etc.
|
| - watch your drinking, your tolerance for alcohol is reset,
| and again on the volume thing
|
| - drink a lot of water. apparently opposite to all the
| volume warnings above, lol
|
| - split dosage and inject twice a week. (i dunno, talk to
| your doctor. also this only works when you have a vial and
| not the auto-injectors, though apparently the autoinjectors
| are way more expensive)
|
| On the other hand, when i ask about what happens if you go
| on a bender and eat two burgers and lots of fries and drink
| a six pack?? From people that used to gladly do that:
| "gross, why would i do that?" That there is the real
| change.
| linsomniac wrote:
| >There's a miracle drug powerful enough to robustly lower
| people's all cause mortality
|
| Did I misread the article, my TL;DR of the article is that
| GLP-1 reduce the indicators or mortality _without_ modifying
| the actual mortality (because most users return to normal
| indicators within about 2 years).
| yumraj wrote:
| > because most users return to normal indicators within about
| 2 years
|
| Because they stop taking GLP-1s after 1-2 years, not, it
| seems, because the meds stop working.
| readthenotes1 wrote:
| "If we assume about 65% of people who start GLP-1 medications
| _quit_ by the end of year one, that creates a big problem.
| When someone stops the medication, they 'll usually regain
| the weight they lost, and in two years, most of those key
| health indicators (like BMI, blood pressure, blood sugar and
| cholesterol) bounce back to their starting point. "
|
| So in addition to the quitters returning back to normal after
| they got life insurance underwritten when they were healthy,
| we have the unknown of the longevity of people on the glp-1
| drugs.
| refulgentis wrote:
| Subtly different: you read "most...return to normal...within
| 2 years", it says "When _someone stops the medication_ ,
| they'll [return to baseline]"
|
| Then from there, I click through the 65% #, assuming they
| have a good study on 65% of people stop after a year. Nah,
| they don't. It's super complex but tl;dr: specific cohort,
| and somehow the # getting on it in year 2 is higher than the
| # of people who quit in year 1.
|
| I have a weak to medium prior, after 10m evaluating, that the
| entire thing might be built on more sand than it admits.
|
| Lot of little slants that create an absolute tone - ex.
| multiple payout _s_ over the "lifetime" of a life insurance
| policy. (sure, it's technically possible)
|
| Also there's no citation for the idea this mortality slippage
| happened because of GLP-1, and it's been out for...what...a
| year? _Maybe_ two?
|
| That's an awful lot of people who were about to die, saved in
| the nick of time by...losing weight? Again, possible, I'm
| sure it even happened in some cases.
|
| Enough to skew mortality slippage from 5.3% to 15.3%?
|
| I thought they were 98% accurate?
|
| Wait...is the slippage graph _net life increase_ slippage? Or
| _any_ slippage?
|
| Because it's very strange this explosion happened in exactly
| the year of a global pandemic that had sky-high mortality
| rates for older people.
| samus wrote:
| Since it's so new, of course there aren't any long-term
| data on GLP-1 takers. However, relying on prior knowledge
| about people who are good on the metrics, it can be
| presumed that they will do fine. And won't create financial
| risk for the insurer due to passing on earlier than
| expected. But only if they keep taking their meds and/or
| fix any underlying behavioral and health issues that made
| them obese in the first case!
|
| Regarding the graph about slippage: yes, that looks like
| the Covid peak. However, even assuming this recent trend is
| an anomaly, the industry is in a changing landscape and
| needs to adapt. New metrics and criteria, and the fastest
| mover will capture the market. Business as usual.
|
| I don't feel sad except for the people who managed to bring
| their health issues under control and now can't get life
| insurance.
| alvah wrote:
| GLP-1 isn't new - the first trials were 20 years ago &
| there's a lot of long term data from its use in diabetes
| management, prior to the weight loss application.
| pie_flavor wrote:
| No, it's a miracle drug that drops mortality by a ton. The
| indicators aren't being faked. The weight causes the
| mortality, and the weight loss reduces it, and the weight
| regain reintroduces it. GLP1RAs introduce _some_ noise to the
| indicators but not enough to cause what you 're implying.
| dragonwriter wrote:
| It's a maintenance medicine, not a cure, so if people stop
| taking it, they return to the same problems they had without
| it.
| aetherson wrote:
| And it's under-commented upon because it's
| counterintuitive, but most people stop taking it. Like, two
| year continuation of use is about 25%.
|
| That's kinda wild, because it seems like holy shit if
| you're taking a drug that lets you drop 10-20% of your body
| weight from obese down to normal why would you stop taking
| it, but people do.
| catdog wrote:
| Side effects? Also many might not be able to afford it
| long term as it's quite expensive.
| AndrewDucker wrote:
| Cost is a big factor. When it becomes generic then I
| suspect people will stay on it for a lot longer.
| decimalenough wrote:
| Because they're now "normal", so why would they continue
| paying for it, taking unpleasant injections, and enduring
| the side effects?
|
| In this sense it's like any diet: they "work", but if you
| don't permanently modify your food intake, the weight
| comes back as soon as you go off the diet.
| sroussey wrote:
| Another way of putting it is that people achieve their
| goals and wind down the usage of the drug that got them
| there.
|
| I think that in a few more years the number may stay at
| 25% (or whatever) but that the makeup of the 25% may be
| different. That is, people will go off it and back on it
| if they see their progress reverse but that will happen
| to different people at different times.
| subscribed wrote:
| Because the pharmacy will refuse to sell it to you.
|
| Source: UK based friend who says the pharmacy will refuse
| to sell them once they fall under BMI 25 (still
| overweight). They'd prefer to be on the tiny maintenance
| dose but it seems to be very hard to achieve (unless
| you're going off the market completely).
| JumpCrisscross wrote:
| > _if people stop taking it, they return to the same
| problems they had without it_
|
| Source? Everyone I know who stopped taking it rebounded a
| bit, but not to where they were. And no literature shows
| 100% rebound to my knowledge.
| dragonwriter wrote:
| I mean roughly in reference to the underlying mechanism
| it directly addresses, not all the downstream effects.
| And even that was, admittedly, sloppy, because there's
| some complex feedback loops involved. I guess it would be
| more accurate to say it is a maintenance medicine and not
| a _complete_ cure, and so stopping taking it unmasks the
| continuing condition that is treating.
| JumpCrisscross wrote:
| > _stopping taking it unmasks the continuing condition
| that is treating_
|
| Some of the prediabetics I knew who stopped taking it (N
| = 2) stopped being prediabetic (N = 1).
| loeg wrote:
| They aren't even that awful in maintenance -- just expensive.
| The unpleasant part is when you're increasing the dose. After a
| while at the same dose, it's more or less unnoticeable IMO.
| gregw134 wrote:
| Unnoticable meaning doesn't have any effect at all, or just
| no bad side effects?
| zer00eyz wrote:
| > And I'm guessing just based on my own experience paying for
| term life that the actual premia differences aren't actually
| enough in most cases for the life insurer to simply pay out of
| pocket themselves; the differences probably add up to a few
| hundred per year per customer, whereas a year's worth of a
| GLP-1 agonist probably costs a couple thousand (for now, in
| 2025, and probably dropping rapidly).
|
| I wonder why life insurance isnt funding more research into
| things like metformin, where we have amazing long standing data
| but haven't done the real research. See:
| https://www.afar.org/tame-trial
| firesteelrain wrote:
| I was on Mounjaro for two months. I was also dieting and walking
| 10k steps a day. I lost 25 lb and my A1C went down to 5.0 from
| 5.7. All my cholesterol numbers were in range. I stopped taking
| it and lost 25 more. I haven't regained the weight. People who
| gain it back did not learn the lesson and did not effectively
| change their habits. You need the discipline - and a good support
| system. But if you don't have that and continue old habits then
| you will gain weight back. The original problem isn't solved.
| Sparkle-san wrote:
| Giving people the magic cheat code drug seems antithetical to
| helping them develop the habits and discipline for long term
| lifestyle change.
| 44520297 wrote:
| Why is obesity the only disease that taking medicine for is
| "cheating"? Which is more important: instilling your
| particular version of "discipline" into people, or saving
| billions in healthcare costs and millions of lives from
| suffering?
| Group_B wrote:
| It's usually a self inflicted disease. Your own actions
| cause it most of the time
| 44520297 wrote:
| Which other self-inflicted medical conditions do we deny
| medical care for?
| animal_spirits wrote:
| We prescribe alcoholics with medicine to help them curb
| their alcohol intake, but if they do not learn the
| discipline to not drink then they can end up back where
| they started after getting off the medicine. But I don't
| think either drugs for alcoholism or obesity should be
| denied to anyone. However there are other tools to
| supplement with to help learning discipline.
| 44520297 wrote:
| >However there are other tools to supplement with to help
| learning discipline.
|
| The current FDA guidelines support your assertion that
| GLP1s should be prescribed in addition to other tools to
| help people change their eating habits.
|
| What the FDA does not prescribe is moralism, which is
| what "help learning discipline" tends to imply. If you
| didn't intend to frame your argument in terms of
| moralism, you might consider a different word choice.
| animal_spirits wrote:
| Not sure how else to word it. "help people change their
| habits" vs. discipline to change their habits - what's
| charged about the word 'discipline'?
| 44520297 wrote:
| In English, we "instill discipline" in children. When we
| talk to and about adults, we talk about the confluence of
| factors that influence habits and help people change
| them. Discipline implies that an adult, who is otherwise
| fully functioning and subject to the demands of the
| world, is lacking an essential attribute. Whatever you
| might feel about this explanation, we already observe
| from science and medicine that "instilling discipline" on
| its own has not stalled the obesity epidemic.
| Group_B wrote:
| Good point. The main root cause of obesity is too many
| calories. Usually, obesity and the symptoms / diseases
| that come with it improve / go away when eating less
| calories. Does any human technically need medication to
| eat less calories?
| 44520297 wrote:
| > Does any human technically need medication to eat less
| calories?
|
| Chronically obese people, who are prescribed GLP1s to
| enable them to eat fewer calories. Are you interested in
| the reasons why people are unable to eat fewer calories
| without medication? It's a pretty fascinating problem,
| one that intersects genetics, environment, and culture.
| mikhailt wrote:
| Yes. Gut microbes has already been shown to have a great
| impact on how we metabolize by what med we take, what we
| eat or drink and intake from our environments (micro-
| plastics, etc).
|
| There is no single main root cause for obesity. We just
| combine it as one because there isn't a lot of long term
| research or funding for it right now. There is a lot of
| sigma against obesity and people keep blaming other
| people instead.
|
| Thyroid hormone disorders have been linked to cause
| weight gains. This can't be fixed by simply eating less,
| it can literally do far more damage.
|
| Medications have been linked to cause weight gain as side
| effects. This wouldn't do anything to eat less until they
| stop taking meds and for some, they cannot do that.
|
| Americans' increasing desire for sweets have increased
| the sugar content in all of our food including the fruits
| and vegetables over time. We've intentionally bred our
| healthy stuff to be sweeter. So eating less can make us
| even more hungrier because we go into sugar crush without
| realizing it. Changing diets is difficult without us
| doing all sorts of calculations of finding the right
| cheap healthy food at the right store and that is you are
| lucky enough to have any.
| bryant wrote:
| People grew up making fun of others for being overweight.
| Suddenly a medication making it treatable (and possibly
| providing an explanation for why the prevalence of obesity
| skyrockets in developed countries) validates the idea that
| it's a medical condition.
|
| Relatedly: it validates that people are assholes for making
| fun of others who are overweight. And not many people like
| feeling like an asshole.
|
| Edit: starlevel004 is right.
| Starlevel004 wrote:
| Correction: Lots of people like feeling like an asshole.
| They don't like being called out for it or being wrong.
| Sparkle-san wrote:
| Cheat code was probably not the best term for it, I'll
| admit. I don't fault anyone for chosing to try GLP-1s and
| the cause of obeseity isn't particularly on the individual
| given the prevailance of ultra processed foods and car
| transportation in our society. That all being said,
| regaining most, if not all, the weight has been a
| historical issue around weight loss treatments because
| they're not durable. The way we're proceeding with GLP-1s
| feels short-sighted and potentially unethical if we're
| setting people up for rebound failure to line the pockets
| of big pharma.
| 44520297 wrote:
| Would you say the same about blood pressure medications,
| diabetes medications, cholesterol medications, thyroid
| hormone replacement, antidepressants, mood stabilizers,
| antipsychotics, anti-anxiety medications,
| immunosuppressants, DMARDs, corticosteroids,
| anticonvulsants, Parkinson's medications, multiple
| sclerosis treatments, blood thinners, and heart failure
| medications? All of them set people up for rebound
| failure if they stop taking them for the chronic
| condition they started them for.
| Sparkle-san wrote:
| I wouldn't group those together at all for the sake the
| argument. Take antidepressants for example. We're at the
| point of reexamining if we actually understand the
| consequences of long term usage of them. My personal
| experience was that my long term usage definitely came
| with issues and it's taken me a few years to feel like my
| emotional range has returned to a stabe baseline after
| going off them. I likely would have been better off using
| them short term. Depressiom is also quite similar to
| obesity in the sense that helping people develop the
| durable non-medical interventions while being treated
| with drugs would go further than just treating them with
| drugs alone.
|
| Contrast this with Parkinson's which is a
| neurodegenerative disease with no known non-pharmacutical
| treatments and even the pharmacutical ones lose
| effectiveness as it progresses as they only treat
| symptoms, not the disease itself.
| 44520297 wrote:
| > go further than just treating them with drugs alone
|
| This is precisely what the FDA guidance contains: that
| GLP1s be mixed with lifestyle modifications.
| kbelder wrote:
| It's not. I'd put most addictions in that category. And
| instilling discipline in people is a _good_ thing that
| benefits them in myriad ways.
| 44520297 wrote:
| You are free to put addictions in whichever category you
| prefer. The medical community does not: we treat
| addiction with medication as well.
| jchw wrote:
| A lesson often learned painfully: in most cases there isn't a
| reward for doing things the hard way. You could argue that a
| magic weight loss drug will prevent people from making
| important lifestyle changes, but all else equal, a magic drug
| that helps you lose weight with seemingly no other downsides
| is an obvious net win for health. Losing weight once you put
| pounds on is hard, for both mental and physical reasons, and
| even just being able to lose weight is probably a huge help
| as it puts in reach what many consider to be intangible after
| years of failure.
|
| I haven't tried a GLP-1 agonist myself because I'm not
| exactly severely overweight, but I do absolutely struggle to
| keep weight off. It's amazing how easy it is to re-gain
| weight and how hard it is to keep it off. If the worst side-
| effect of GLP-1 agonists is that it makes life insurance
| quotes harder, whatever; I think it's totally acceptable that
| some people will still struggle with improving their habits,
| I don't think it's likely to make it any worse. In my opinion
| I suspect it is likely to make it a bit better, by helping
| you break out of the cycle.
|
| P.S.: since there is some neighboring discourse about whether
| being fat is a disease or a lifestyle choice, I'll just say
| this: I don't personally think it matters. I don't think
| arguing this distinction will actually help anyone. I don't
| really care for body positivity and I don't make excuses for
| my poor habits or being overweight, but I still don't think
| it makes losing weight much easier.
| saturneria wrote:
| You could apply this same stupid logic to many medications.
|
| Blood pressure medication comes to mind.
| padjo wrote:
| People have to believe in free will or they go crazy.
| Admitting that we're just a bag of hormones and electric
| signals means our whole system of morality is built on sand
| and that's a scary door to open.
| mikhailt wrote:
| That's a great idea!
|
| Can you show me what we're doing in USA to help children and
| people develop the habits and discipline for long term
| lifestyle change?
|
| Because I've never learned anything about nutrition, macros,
| high sugar content and all of the healthy food I should learn
| to eat on my own.
|
| We did not have home classes in any of my education in US at
| all, they were a thing in the past but that wasn't a thing in
| my middle hs or hs or college at all in NY in 90s/2000s.
|
| All of my bad habits were from my parents and they were not
| good eaters.
| firesteelrain wrote:
| Yep, that's key. That's the lesson I learned as I commented
| above as GP.
|
| My work offered me five visits with a dietician and then I
| got a health coach and a nurse all paid for and monitoring
| me on the side through the Vida service. Not everyone has
| that
| DrillShopper wrote:
| I'd be okay with that so long as nobody can have Nicorette,
| the birth control pill, or Viagra. I don't have a problem
| refraining from smoking, I've never gotten pregnant, and my
| dick works, so it must be some innate discipline in me that
| others must learn, so no meds for them.
|
| See how ridiculous that sounds?
| pfdietz wrote:
| Giving people the magic antibiotic cheat code seems
| antithetical to helping them develop habits and discipline to
| avoid bacterial infection.
| arp242 wrote:
| Depends on your circumstances. If you're a bit overweight and
| want to lose weight: it's perhaps not helpful. If you're
| obese and everything just seems hopeless: fuck it - do
| anything that will bring your weight down to a manageable
| level first, and _then_ start working on habit and lifestyle
| changes. Energy levels, the motivation of seeing progress,
| and that type of thing are _hugely_ important.
| petesergeant wrote:
| > People who gain it back did not learn the lesson and did not
| effectively change their habits. You need the discipline
|
| This is deeply misguided. I'm glad that the little assist was
| enough for you, but if "healthy habits" were enough then people
| who'd lost weight the traditional way would keep it off.
|
| Further, unless you've been off it for more than six months,
| I'd hold your judgement on this one.
| firesteelrain wrote:
| I have been off since Oct 2024. Also, I did continue to lose
| weight the traditional way.
|
| After I stopped, a coworker told me about Vida which my work
| offers as a health benefit.
|
| Using the Vida service where I got a registered dietician to
| show me what to eat, I tracked my food and water intake and
| tracked my exercise. I had protein and fiber goals to hit.
|
| You can't do it all on the medicine - it is a lifestyle
| change. The medicine was the catalyst but not the reason I
| kept the weight off. I wanted it. But because I wanted it, I
| wanted to use the support system that my work paid for.
|
| I think there is a lesson to be learned here
| mschuster91 wrote:
| > but if "healthy habits" were enough then people who'd lost
| weight the traditional way would keep it off.
|
| That's because a lot of the "traditional way" methods are
| pseudoscience at best, outright quackery that's going to send
| you into serious malnutrition issues or eating disorders at
| worst. Every two or three months you see a new diet fad
| pushed through the yellow press rags, and none of it anywhere
| near being considered scientifically valid - usually it's
| some VIP shilling some crap story to explain how they lost
| weight, of course without telling the people that they have
| the time for training and the money to pay for proper food,
| 1:1 training and bloodwork analysis.
| GLdRH wrote:
| I would have thought the "traditional way" would simply be
| eat less, move more (by changing your habits of course).
| firesteelrain wrote:
| GLP-1 makes you want to eat less. So you are correct.
| vkazanov wrote:
| I know some serious cases where there were non-habitual
| problems but... "healthy habits" is nothing to laugh about.
| People literally are what their habits are. All of our
| behaviour is habits, and changing behaviour takes time and
| effort.
|
| The good news is that it is not impossible, and it really is
| possible to change bit by bit for most people suffering from
| obesity.
|
| I don't think somebody who walks 10k+ a day, maybe goes to
| gym a couple of time a week, limits calorie intake to a
| comfortable and reasonable 2000 kcal per day, would suddenly
| bounce back to 130kg!
| furyofantares wrote:
| How long ago was this?
| firesteelrain wrote:
| I started in Aug 2024 and stopped in Oct 2024. I paid for it
| from one of the pharmacies that made it in Florida. I
| injected myself with insulin needles that they send you.
| consp wrote:
| Depends on your ultimate high's. That's a pretty good
| indication of diabetes (any form).
|
| I've had pretty good hb1ac's when my blood sugar's were all
| over the place and in no way healthy.
| apwell23 wrote:
| suprised your a1c was only 5.7 despite being obese .
| firesteelrain wrote:
| From what I understand you don't have to be obese and have
| type 2 diabetes. In my case, I was obese and did not have
| diabetes but I might have been going down that road
| nerevarthelame wrote:
| This is akin to saying a severely anxious person should be able
| to take an SSRI for a few months, learn how to change their
| thinking, and stay off antidepressants for the rest of their
| life. So simple. Must be their fault if they can't pull it off.
|
| Perhaps that works for some people. I'm glad it seems to have
| worked for you. But the facts of the world we live in show that
| it doesn't work for most. "Learn the lesson and be
| disciplined!" is not effective advice.
| firesteelrain wrote:
| The analogy to your example is that someone who has to take
| Mounjaro for diabetes will always have to take it even after
| losing say 100 pounds. Or Metaformin even.
|
| GLP-1 in those cases helps manage the problem better.
|
| But for those who are not in those cases where Type 2
| Diabetes has sunk in, then they need to use the opportunity
| to get better while on it and kick themselves into high gear
| or they will have learned nothing from the experience
| treyd wrote:
| That _is_ the _ideal_ model for treatment of those types of
| mental health disorders. Often patients have blockers that
| prevent them from resolving underlying issues. But through a
| drug they can get into a headspace that allows them to work
| through them with talk therapy, and then learn new habits and
| eventually go off the drug.
|
| In practice, this doesn't happen that often, no, but it's a
| theoretical goal. Probably because we're in the pre-GLP-1 era
| with regard to mental health meds. Maybe that will change.
| make3 wrote:
| I feel like your example shows the inverse of what you want.
| SSRI are actually great at helping the person develop healthy
| mechanisms (compared to GLP-1s), because they reduce the mood
| swings & negative thoughts, allowing the person to be more
| productive & be more involved in their therapy, in reading,
| journaling, doing sports, etc. It's just that it might take
| two or three years and not months, which is fine because SSRI
| also have much more limited side effects than GLP-1s.
|
| GLP-1s don't do that directly.. but at least they might help
| people move more, and give them confidence to do more for
| their health instead of seeing it as a lost cause.
| jstummbillig wrote:
| > People who gain it back did not learn the lesson
|
| Considering it took you a miracle drug to learn the lesson,
| that seems like a humorously arrogant take.
| arp242 wrote:
| I lost almost 15 kg (~33 lbs) over the last two months and I
| didn't even try that hard. I never had problems with my weight,
| but over the last few years it slowly crept up to ~107kg (at
| ~1.95cm), at which point I realised I had to do something.
| Reasonably sure I could do a The Machinist Christian Bale if I
| wanted to.
|
| I also quit smoking with relatively little effort twice (once
| in my early 20s, and then again a few years ago after I picked
| up smoking again during COVID). It wasn't easy-easy, but if I
| hear the struggles some other people go through, it was
| relatively easy.
|
| Some people are just wired different. I have plenty of other
| issues, but on this sort of thing, for whatever reason I seem
| to be lucky.
| almosthere wrote:
| so surreal reading comments... a month after non-stop threads
| about glp causing a billion issues, everyone is talking about how
| wonderful they are again.
|
| humanity
| brokensegue wrote:
| billion issues? i saw some reporting on rare cases of
| blindness. what else?
| paulpauper wrote:
| 1-2 years ago there was considerable skepticism about "taking
| the easy way out" or unforeseen risks like like with
| Fenfluramine/phentermine. Now sentiment has changed given
| that more people realize these drugs are safe and effective.
| octo888 wrote:
| Pancreas issues and hair loss IIRC?
| nwienert wrote:
| It's a once in a generation drug with less side effects than
| most OTC, likely net positive even for healthy weight people.
| I'd bet within the decade it'll be approved for a whole basket
| of other benefits - at the least a whole array of immune system
| disfunctions and a cure-all for addiction.
|
| Likely protective of a wide array of internal organs, likely
| life extending.
| saturneria wrote:
| What is well studied and has a billion issues is obesity.
|
| Imagine that, people make up bullshit that isn't grounded in
| reality. Who would have thought!
| throwaway019254 wrote:
| Is there any research on whether GLP-1s are also beneficial for
| generally healthy and not overweight people?
| paulpauper wrote:
| More sensationalism. Insurers can simply adjust the policy
| accordingly to account for patients discontinuing the drug. They
| can also raise premiums if patients go off the drug, and there
| can be a cluse that stipulates this. This is literally the job of
| an actuary to reprice premiums . Insurers take a short-term hit
| and then adjust premiums to ensure it never happens again. This
| happened with California fire risk for example. Moreover, this
| drug will not increase life expectancy by that much even with
| lifetime patient compliance. The majority of obese people
| ,especially men, who take these drugs will still be overweight or
| obese, but just not as much as before.
| wjnc wrote:
| The article is missing some key points about insurance. An ideal
| book balances mortality and longevity risks. This cancels out the
| risk GLP-1s or many other actuarial shifts in mortality. Insurers
| swap risks, reinsure risks etc to move towards an ideal book.
| Nice products to balance are pensions and longevity. Problem is
| that the scale is quite different on a per policy basis, and also
| very location specific.
|
| The article also misses regarding slippage is that Swiss Re in
| the link calls it a modest increase And that is mainly due to
| insurers Not performing the same level of medical intake
| (accelerated versus full underwriting). Increased competition
| leads to less profits. That's pretty straightforward and not per
| se GLP-1s related.
|
| And then the kicker. For not diversified portfolios of mortality
| risks. Those have been massively profitable for decades, in line
| with the general increase in age and health. GLP-1s just expands
| on that profitable aspect. Did I mention that the long term
| expected rate of return on an insurers book is quite good?
|
| Insurers can weather a bit of slippage. Reinsurers will kick the
| worst offenders back in line with their AUC performance, because
| without diversification Or reinsurance it's hard to stay in the
| market. (Capital requirements strongly favor diversification.
| Mono line is very hard.) That's why Swiss Re is bringing out such
| rigorous studies of detailed policy events. Signaling to the
| reinsurance markets and the insurance companies and their
| actuaries!
| mcherm wrote:
| If insurers are suffering from "mortality slippage" because some
| of their customers purchased insurance while on GLP-1s then later
| discontinue the medication, then there must also be "mortality
| slippage" in the opposite direction. There must be customers who
| were not on GLP-1s when they purchased insurance, but could go on
| them, extending their lives in a way that is very profitable to
| the life insurance companies.
|
| Furthermore, there are more people not on GLP-1s than on them
| (even with the recent surge in popularity) so this population
| that can give life insurance companies "excess" profits must
| outnumber those the article describes where the insurance company
| takes a loss.
|
| Why can't they focus on this profit opportunity?
| poulpy123 wrote:
| cry more
| jakubmazanec wrote:
| > When someone stops the medication, they'll usually regain the
| weight they lost
|
| Source? I agree that _some_ people will regain the weight, but
| "usually" is an unfounded (without some data) generalization.
| paulpauper wrote:
| It's variable. some regain all, other regain less. But they
| basically all regain some.
| catdog wrote:
| It probably depends if they also change eating habits. If they
| change nothing regaining the weight is no surprise.
| arp242 wrote:
| It's linked in the article.
| jamesgill wrote:
| In 2023, the life insurance industry took in >$3 _trillion_
| dollars in premiums.
|
| That same year, it paid out roughly $800B in claims.
|
| TL;DR: there's no violin tiny enough for me to play for the life
| insurance industry's 'woes'.
| paulpauper wrote:
| yes, there is a reason why BRK.A/B stock has done so well ,even
| while sitting in tons of cash. Geico is a cash cow.
| kylecordes wrote:
| Seems like insurers should be rating based on your worst health
| markers, including weight, over the last N years rather than just
| a current point-in-time snapshot. Someone who somehow has no
| medical records over the last few years at all that would capture
| any of that data would be priced on the assumption the past was
| possibly worse than current.
| GLdRH wrote:
| I don't know the situation in the USA, but in Europe you
| wouldn't find many young (up to ~35) people who have data on
| any health markers. And these are the main market.
| refulgentis wrote:
| Is the slippage graph just for _net life increase_ slippage?
|
| Or any slippage?
|
| It caught my eye this explosion in slippage happened years before
| GLP-1s, and exactly in the year of a global pandemic that had
| sky-high mortality rates for older people.
| loeg wrote:
| I think it's unlikely that the quoted 65% of GLP-1 users will go
| off the drug and resume their unhealthy lifestyle as the drugs go
| off patent and become more affordable. It's not super
| inconvenient to stay on, just expensive (today, using the name
| brand formulations). Users benefit from good health more than
| they benefit from deceiving life insurers.
| stego-tech wrote:
| Now expand this to other treatments: HIV, PreP,
| depression/anxiety, ADD, ADHD, you name it. We've had data for
| decades that adherence is the key factor in successfully lowering
| mortality and increasing quality of life, which in turn increases
| duration of _productive_ life, which in turn lowers costs in the
| long run as more people live healthier, longer, more productive
| lives.
|
| The problem continues to be the pharmaceutical and health
| insurance industries, particularly in the West. Under pressure to
| deliver infinite growth forever to shareholders on a quarterly
| basis, companies have a vested interest in making _less_
| medication at a _higher price_ , and lobbying the government to
| prohibit price negotiations while mandating insurance coverage
| for many of these drugs.
|
| GLP-1s might be the proverbial straw that broke the camel's back,
| but there's decades of research - and bodies - saying this over,
| and over, and _over_ again.
|
| Which reminds me: I need to call my new health insurance company
| to get them to cover my medication, and hopefully extend it to 90
| day supplies. Because god forbid that just be an automatic thing
| for someone who's taken the same medication daily in some form
| for a decade without adherence issues.
| jeremynixon wrote:
| This blog post is flawed. "Life insurers can predict when you'll
| die with about 98% accuracy." Is not even properly framed and is
| found nowhere in the cited report.
|
| Predictions of when you will die need a range in order to be
| attached to a number like accuracy. The attached report is not
| about this but about population-level mortality trends.
| dzhiurgis wrote:
| Yeah was skimming that report too and it doesn't look even
| related to that claim.
| Jimmc414 wrote:
| If GLP-1s are working for people, why do they quit taking them?
| 44520297 wrote:
| Cost.
| technocratius wrote:
| They are very expensive
| degamad wrote:
| It is well known that people are bad at taking drugs that work
| for them. This is particularly well studied when it comes to
| heart medication, the kind where you take it regularly or you
| die, and yet adherence is often around 50%.
|
| From a quick search, Jarrah et al. (2023) "Medication Adherence
| and Its Influencing Factors among Patients with Heart Failure:
| A Cross Sectional Study" [0] discusses some of the relevant
| details.
|
| [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10224223/
| theideaofcoffee wrote:
| And nothing of value was lost. These industries, insurance in
| particular, pharma coming in a close second, are just parasites,
| sucking the vitality out of everything by their sick rent seeking
| and giving crumbs, if that, in return. The faster they can be
| torn down and liquidated, the better. Maybe helping the overall
| population boost their wellness with more-or-less miracle drugs
| like GLP-1s can hasten that.
| fnord77 wrote:
| > Life insurers can predict when you'll die with about 98%
| accuracy.
|
| I saw this:
|
| https://media.nmfn.com/tnetwork/lifespan/index.html#0
|
| is there anything better?
| arp242 wrote:
| Looking at the link they give for it, the 98% accuracy isn't
| for individuals but for aggregate data. That is: they can't
| predict with 98% accuracy when you or I will die, but they can
| with a sufficiently large group which averages out all the
| noise. The phrasing in the article is somewhat unfortunate.
| jtrn wrote:
| Clinical psychologist here in Norway, and just my subjective
| experience: People stop GLP1 agonists for the following reasons,
| in descending order: - They want to enjoy eating again. -
| Medications are a hassle. - Worry about long-term effects, even
| if there is no alarming evidence for now. - Price (we are a
| spoiled/rich country). - Other (like hating needles, feeling bad
| for taking medications that others need more, being aggressively
| lazy).
|
| Often, I think that it's a bad move, as the clinical effect of
| losing around 20 kg would have to be matched by some extremely
| high frequency and severe side effects. Overweight is still not
| sufficiently appreciated for how dangerous it is, especially
| after they ramped up production so much that there isn't a real
| shortage anymore.
|
| Ironically, most of the people who respond well to Ozempic and
| stay on it have few psychiatric problems. But those who almost
| desperately want to get off it after a while might be those who
| have a psychological component to their overeating. The obvious
| suspect then is eating as emotional regulation. So one could
| extrapolate, at least as a hypothesis, that the ones who have
| worse life expectancy due to regained weight after a year of
| usage are the ones who have a double set of problems stacked
| against them: overweight and emotional problems. That would have
| a huge effect on longevity.
|
| This is PURE free association though, no deep analysis behind it.
| k__ wrote:
| How much does it cost right now?
|
| Are there any alternatives coming out soon or generics?
| jtrn wrote:
| For semaglutide, the newest and most potent GLP1.
|
| United States: The main patent is expected to expire around
| 2032. Monthly Price: $950 - $1,350+ (cash price without
| insurance)
|
| Norway: The main patent is expected to expire around 2031.
| Monthly Price: $109 - $301 (cash price equivalent in USD)
| thatnerdyguy wrote:
| I'll note that in the US that 1000+ is the "list price".
| For those paying out of pocket, both zepbound and wegovy
| offer coupons available to anyone taking it down to $500
| (and I'll note that discounted price keeps coming down,
| slowly, as well)
| chhxdjsj wrote:
| Grey market from China is around $250/year for tirzepatide
|
| There are group chats with tens of thousands of people and I
| havent seen any issues with the drug
| OptionOfT wrote:
| Did you see a decrease in people gambling / drinking when on
| the medication?
|
| N=1, I'm on ZepBound and in general my brain is less likely to
| give in to things that give instant satisfaction.
| jtrn wrote:
| Actually yes. Not as much as with ADHD medication, but
| obvious subset of addictive personalities that have relief
| from addictive behaviors (beyond eating addiction) with
| semiglutide.
| Neywiny wrote:
| No mention of Common Side Effects in the discussion? It was
| pretty predictable (at least for someone healthcare-field
| [discovery + regulation]-adjacent all my life), but touched on
| the notion that the miracle wonder drugs are a provider's worst
| nightmare. It's a business
| aredox wrote:
| Mortality slippage has also exploded since the COVID pandemic
| started... And again, nobody seems to wonder if somehow, a virus
| that invades the whole body (not just a respiratory virus),
| repeatedly, is causing death by a thousand cuts...
|
| The blind spot related to COVID is huge. There are lots of health
| data going haywire since 2020 and everyone seems to find any
| other reason but COVID for it.
| brap wrote:
| Just want to share my own experience since were doing it:
|
| Took Wegovy (Semaglutide) for about 6 months. Barely lost any
| weight, would occasionally get nauseous.
|
| Then the doc switched me to Mounjaro (Tirzepatide) + Phentermine,
| and holy shit, I just don't feel like eating, almost ever. Lost
| 20kg in 6 months, which is all I needed to lose, never had any
| side effects. None.
|
| I did feel a little weird/buzzed the first time I took
| Phentermine, but it went away the next day.
|
| I feel like for many people it's not really the physical hunger
| that makes them fat, it's that annoying voice in your head
| telling you to snack something for no reason at all. It sometimes
| felt almost like drug addiction.
|
| Tirz+Phent are great for that.
| twilo wrote:
| "mortality slippage" coincides with Sars2 circulating within our
| population so I bet it has a lot to do with it
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