[HN Gopher] Ozempic shows anti-aging effects in trial
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       Ozempic shows anti-aging effects in trial
        
       Author : amichail
       Score  : 157 points
       Date   : 2025-08-05 14:28 UTC (8 hours ago)
        
 (HTM) web link (trial.medpath.com)
 (TXT) w3m dump (trial.medpath.com)
        
       | xeromal wrote:
       | I can't open this link but I wonder if the weight loss or the
       | medicine itself is performing the anti-aging
        
         | declan_roberts wrote:
         | I was just researching this myself before investing in LLY.
         | 
         | For cardiovascular health, they see benefits even with people
         | who are at a healthy BMI, which suggests therapeutic effects
         | beyond just losing weight.
        
           | xeromal wrote:
           | Very interesting! Thanks for chiming in.
        
           | jjtheblunt wrote:
           | it could also suggest that BMI isn't a great metric, though,
           | as has been in the news often lately.
           | 
           | regardless, thanks too.
        
             | Tade0 wrote:
             | It isn't. Waist-to-height ratio is a much better predictor
             | of cardiovascular issues - you want to stay below 0.5.
             | 
             | I never went above 25 BMI but I wouldn't call myself a
             | healthy person as it's obviously like that only due to low
             | muscle mass.
        
       | riku_iki wrote:
       | what would be reversing biological age from regular running and
       | eating chicken breast + veggies with olive oil.
        
         | HarHarVeryFunny wrote:
         | You can tell if that regime reverses aging when you instead
         | start wanting to eat chicken nuggets and mac & cheese.
        
         | amanaplanacanal wrote:
         | Wish I could run. Knee says no.
        
           | avoutos wrote:
           | Do you have an injury? Knees over toes exercises can do
           | wonders for rehab. From a form perspective, it also helps to
           | avoid heel-striking.
        
       | lurking_swe wrote:
       | This isn't really surprising at all IMO, but it's nice that it's
       | been confirmed.
       | 
       | > "The researchers believe semaglutide's anti-aging properties
       | stem from its effects on fat distribution and metabolic health.
       | Excess fat around organs triggers the release of pro-aging
       | molecules that alter DNA methylation in key aging-related genes.
       | By reducing this harmful fat accumulation and preventing low-
       | grade inflammation - both major drivers of epigenetic aging -
       | semaglutide appears to create a more youthful biological
       | environment."
       | 
       | In other words, being medically obese ages your body quite a bit,
       | its stresses out your body with inflammation, etc. Taking Ozempic
       | helps people lose weight, which also reduces inflammation. This
       | is sort of like saying we proved rain (usually) increases
       | humidity lol. A very obvious finding.
       | 
       | The article even says " Randy Seeley from the University of
       | Michigan Medical SchoolView company profile expressed little
       | surprise at the findings" :)
        
       | morninglight wrote:
       | There is another study that comes to mind.
       | 
       | https://www.pnas.org/doi/abs/10.1073/pnas.2420092122
        
         | readthenotes1 wrote:
         | I have no idea why you're down voted. The replication crisis is
         | real, and it is well known that fraud is a part of it
        
           | pie_flavor wrote:
           | Because it's a content-free dismissal. No attempt is made to
           | link it to this study in particular.
        
           | aswegs8 wrote:
           | Maybe because that is a whole different topic that is only
           | tangentially related to this thread?
        
       | V__ wrote:
       | Any study which uses epigenetic clocks can be discarded. There is
       | to my knowledge no test which produces reliably measurements
       | which don't have big error bars. The only conclusion this study
       | can really make is: Ozempic changes the 'thing' which the
       | epigenetic clock test also measured.
        
         | metalman wrote:
         | it does seem that there is no reliable connection with
         | "epigenetic clocks" where people are shown to be dying at the
         | same bio age, regardless of calender age......all of the
         | mortality estimating calculations rely on many "factors", so
         | the "ozempic" effects will be just part of a puzzle, where I
         | will bet anything that attitude, demenour, , basic personal
         | conduct will weigh in as the hinge pins that everything else
         | pivots around..........stress, and how that is delt with, and
         | anyone who thinks that one compound is going to reset the whole
         | clock on a complex organism is kidding themselves, which if
         | done right, works ;) so....it's all for the good
        
       | taeric wrote:
       | It remains eye opening to see how much losing weight does to
       | people.
        
       | pitpatagain wrote:
       | This is specifically a study on people with HIV-associated
       | lipohypertrophy, which is associated with accelerated aging. Not
       | clear what this would mean for people generally.
        
         | kjkjadksj wrote:
         | People on ozempic certainly look more like the crypt keeper
         | than a younger version of themselves. You lose all that buccal
         | fat that defines your young adult face.
        
           | radiofreeeuropa wrote:
           | Any means of attaining weight loss at a similar rate will
           | tend to do the same thing. Especially if you're starting from
           | quite-heavy, not just dropping 20lb or something.
        
           | YokoZar wrote:
           | It varies. People are often thinner in their twenties than
           | their thirties and forties. If you browse some before and
           | after pictures the ones who have had their skin tighten tend
           | to look younger for that reason alone.
        
           | pitpatagain wrote:
           | Or that's who you notice. My husband takes ozempic for type 2
           | diabetes and it completely fixed his blood sugar while
           | causing very moderate weight loss.
           | 
           | What the people in this study have causes abnormal visceral
           | fat accumulation in the belly and back and itself causes
           | disturbing changes in body shape and appearance, does not
           | respond or normal weight loss, and hasn't had real treatment
           | options. That ozempic has beneficial effects for it in an RCT
           | is actually awesome, it's the framing given by the headline
           | that is bad.
        
           | angmarsbane wrote:
           | I notice it in people who have never been the weight that
           | they're suddenly walking around as, with them it often looks
           | overdone, too thin for their features etc, but in those who
           | have used it to get back to weights where I've seen them
           | before...I didn't guess. They had to tell me.
        
             | hinkley wrote:
             | I wonder how much of that is losing weight too fast and
             | having floppy skin because of it.
        
             | snug wrote:
             | I've lost weight the natural way and people will tell me
             | the same thing. People are just rude to fat people
        
           | const_cast wrote:
           | That's just what happens when you get skinny. People who have
           | always been skinny just look sickly always so we don't
           | notice.
        
       | some_random wrote:
       | I find it fascinating how much a pretty large group of people
       | just hate semaglutides and seemingly need to believe that it's
       | some kind of Faustian bargain. I'm not talking about the people
       | who are cautious or suspicious, that's more than reasonable, but
       | it's clear that it's not cautious optimism in many.
        
         | jbentley1 wrote:
         | Naturally skinny people hate Ozempic for the same reason I know
         | many talented engineers who hate AI coding.
        
           | kmeisthax wrote:
           | As a talented engineer, I hate AI coding because it doesn't
           | do what it says on the tin. If GLPs made people hallucinate
           | weight loss that wasn't actually happening, I'd be angry
           | about them too.
        
             | thaumasiotes wrote:
             | Ever seen "Shallow Hal"?
        
           | amelius wrote:
           | It is not fun when your superpower becomes a commodity.
        
           | stronglikedan wrote:
           | I'd wager that you can only call an engineer talented _if_
           | they know enough to hate AI coding.
        
           | zer00eyz wrote:
           | > I know many talented engineers who hate AI coding.
           | 
           | People whos primary skill is coding, hate AI coding. No
           | talented engineer hates AI coding. The distinction is this: a
           | coder knows how to use their tools, an engineer knows how to
           | work with people, understands product, process, users, and
           | knows how to use their tools.
           | 
           | Talented engineers hate the HYPE around AI. And those of us
           | old enough to remember sigh and think "This is just
           | dreamweaver all over again". It is ESB's with "drag and drop"
           | workflow tools. AI is just another useful tool that a good
           | engineer can pick up and put down where appropriate.
        
           | eddythompson80 wrote:
           | Thank you for your service
        
           | devmor wrote:
           | I think those engineers don't like you because you find
           | unrelated subjects to justify your favorite scam.
        
         | qgin wrote:
         | There were even people who felt this way about anesthesia too.
         | To survive in that era, they had to believe that suffering was
         | somehow good for healing (or at least good spiritually) and
         | talked about anesthesia as if it were cheating the natural god-
         | given order.
        
           | readthenotes1 wrote:
           | Are you talking about MMother Teresa? She wasn't that long
           | ago...
        
           | zoeysmithe wrote:
           | I think this might be revisionism. A lot of people feared
           | early anesthesia because it was far more dangerous than
           | today.
           | 
           | I also notice people will make note that 'eccentrics' from
           | the 1940s-1950s hated air conditioning but it helps to
           | understand it was a dangerous technology that regularly
           | injured and killed people back then, especially in its
           | earlier days the adults of that period were children during.
           | AC didn't get safe until fairly recently in the 70s, 80s and
           | 90s. It would catch fire or leak poison that killed people in
           | their sleep. Some people just saw it as an unnecessary risk.
           | Same with early fridges. When they leaked, that leak could be
           | fatal as poison or explosion.
           | 
           | It wasnt until later that these technologies got safer and
           | even now today, we consider full anesthesia a last resort and
           | will always try to get away with local or twilight anesthesia
           | because full anesthesia does regularly injure, disable, and
           | kill people. Evolution didnt design us to be trivially "shut
           | off" like this. Injecting us with substances like that will
           | always come with risk.
           | 
           | In other words, a lot of those people weren't mindless
           | luddites, but people who assessed their personal risk and
           | said "nope, not worth it." I think that's perfectly fine.
           | 
           | I'd argue the revisionism of today and the ego justifications
           | of the time were just that, ego protection. Its far easier to
           | say "Well, I'm tough, I don't need that," then "I'm scared of
           | that." The former is rewarded in our individualist capitalist
           | society. The latter is vulnerability and honestly which is
           | often only punished in a society like ours. We see it today
           | with people with limited access and affordability to
           | healthcare in the USA putting off care or engaging in various
           | home remedies, alt-medicine, supplements, or conspiracy-
           | culture-esque pharma drugs gotten cheaply via the gray
           | market.
        
         | hollerith wrote:
         | The drug companies are very good at making new drugs with high
         | profit potential look better than they are. I'm worried
         | semaglutides are another fen-phen, Vioxx, Quaaludes,
         | Trovafloxacin or OxyContin.
         | 
         | One thing to watch for is effect size: how big of an anti-aging
         | effect does Ozempic confer relative to other good
         | interventions? Were the subjects doing other solid anti-aging
         | interventions like the Fasting Mimicking Diet (FMD)? If not,
         | the 2 interventions might affect the same pathways with the
         | result that if you are doing FMD, you get no additional benefit
         | from Ozempic.
         | 
         | Fen-phen is particularly interesting here because people
         | reported that not only did it help them lose weight, it gave
         | them more willpower and changed their personalities for the
         | better.
        
           | some_random wrote:
           | I think that's a completely reasonable concern to have, it
           | doesn't seem to be the case wrt obesity but for the myriad of
           | other potential effects it's important to keep in mind.
        
             | hollerith wrote:
             | I'm not even ready to concede that it is a good weight-loss
             | drug -- but then I haven't really investigated much, so I'm
             | just repeating what I heard from researcher Ben Bikman and
             | maybe other researchers. I heard that most people choose to
             | discontinue it after 4 or 5 years or less, regain most or
             | all of the weight, then refuse to go back on it.
        
               | throwforfeds wrote:
               | I've had a few friends on it. They definitely lost
               | weight, but the GI issues were too much and when they
               | went off of it they gained it all back.
        
               | alistairSH wrote:
               | I've read (anecdotes from people in the fitness/body-
               | building space) that the default dosing could be too high
               | for many people. And the side-effects seem to ramp up
               | with the dose.
               | 
               | IE, if you're getting weight loss at 1/2 the default
               | dose, you might want to stay there, even if your MD wants
               | you to increase to the default.
               | 
               | [default uses loosely here - people build up from a low
               | dose over the span of weeks/months]
               | 
               | And the weight gain is due to a lack of lifestyle change.
               | The drug just numbs your appetite, so you don't eat as
               | much. If you go off the drug and return to over-eating,
               | yep, you gain the weight back.
               | 
               | I also suspect many people lose the weight too fast and
               | go too far. "Ozempic butt" is a joke for a reason -
               | people loose a bunch of fat, but the massive calorie
               | deficit also means they aren't exercising (no energy, and
               | they probably weren't before the drug either), so they've
               | probably crashed their metabolism.
        
               | n8cpdx wrote:
               | I tried it. I started down about 80 lbs from my heaviest,
               | but a good 40 lbs from ideal/20 lb from healthy weight.
               | 
               | The first time I tried it I followed dosing guidelines
               | for ramp up; side effects were horrible, didn't lose much
               | weight, and it just kept getting worse.
               | 
               | Second time, after a few months off, I started at lowest
               | dose and stayed there. Side effects were better to start
               | but ramped up again. Eventually my digestion stopped
               | entirely and I couldn't eat without pain; that actually
               | was good for weight loss but very unhealthy (e.g. despite
               | being hungry and lightheaded the pain kept me from eating
               | more than 400 calories). Eventually it passed but I
               | couldn't justify taking it after that.
               | 
               | Basic side effects: exercise intolerance (higher starting
               | rate, much faster increase exertion, chest pain after
               | ~150bpm when previously I could run nearly an hour and go
               | up past 180 without issue), fatigue in the morning
               | (despite essentially maintaining my pre-ozempic
               | nutrition), significant increase in resting heart rate,
               | significant decrease in HRV, and digestive upset
               | (basically alternating diarrhea and constipation).
               | 
               | Many of these side effects are well known, others less
               | so.
               | 
               | Ozempic, when micro dosed, did help reduce hunger and
               | make a weight loss diet easier to sustain, until the side
               | effects got so bad I wanted to comfort eat. But
               | mindfulness and healthy lifestyle are similarly effective
               | without crippling side effects.
        
               | alistairSH wrote:
               | Have you looked into Tirzepatide? Basically a combo of
               | ozemspic plus a GIP drug. Again, anecdotes from bro-
               | science, but appears to allow lower dosing and reduced
               | side-effects.
        
               | mapontosevenths wrote:
               | Try Zepbound. You lose more weight with far fewer side
               | effects.
               | 
               | Although, you may still have issues. It does just sound
               | like there's something unique about your chemistry. I
               | don't think that many of those side effects are even in
               | the ballpark of normal.
        
               | n8cpdx wrote:
               | I would like to try it, but I don't think it is available
               | from shady internet doctors and insurance won't cover it
               | because I'm not diabetic. Shady internet ozempic passes
               | the cost-benefit test (barely, considering I can
               | successfully lose weight without it it's just hard). Full
               | cost out of pocket it does not. Maybe in a few years.
               | 
               | I would worry that the side effects I care about are not
               | the side effects that others report being improved on
               | zepbound.
        
               | mapontosevenths wrote:
               | Protip: Get an ultrasound on your liver. Almost every
               | obese person has (what used to be called) fatty liver,
               | and that's usually enough to justify the prescription to
               | your insurance company.
        
               | cjbgkagh wrote:
               | Very much the default is too high and the bro-science was
               | indeed early on this. I'm super sensitive and had the bad
               | negative reactions at 1/10th the starting dose. It's been
               | a wonder drug for me though, finally able to put my life
               | back together after ME/CFS all but destroyed it.
        
               | mapontosevenths wrote:
               | > when they went off of it they gained it all back.
               | 
               | To make matters worse, even ibuprofen is a scam. I
               | stopped taking it and my headache came right back!
               | 
               | More seriously, if you stick to it the GI issues go away
               | after the first month for most people.
        
               | smiley1437 wrote:
               | Tirzepatide (and likely other GLPs) have limitations that
               | are rarely brought up in the general media
               | 
               | - Patients have about 72 weeks to reach maximum loss,
               | they don't lose any more weight after 72 weeks even on
               | the highest dose.
               | 
               | - Patients appear to immediately gain the weight back as
               | soon as they stop taking it.
               | 
               | It's right in the phase 3 trial outcomes paper:
               | 
               | https://pmc.ncbi.nlm.nih.gov/articles/PMC10667099/
               | 
               | I suspect that this info is intentionally down-played so
               | that it doesn't affect sales.
        
               | kion wrote:
               | I've been on Zepbound for ~25 weeks now and one of the
               | first things my doctor told me was that this was a
               | lifetime drug. He pointed out that I had a choice, of
               | lifetime drugs. I needed to do something to get my
               | cholesterol under control. That meant start statins now
               | and likely add blood pressure meds and diabetes meds in
               | the next 2-5 years. Alternatively I could start Zepbound,
               | which would likely address all 3 and result in better
               | quality of life in the next year. So far it seems like it
               | is doing exactly that.
               | 
               | I'm sure some people are going into this without that
               | knowledge, but people are being told this is a lifetime
               | commitment. What you don't see a lot of is why people
               | stop taking it. There's some cases of people losing and
               | then stopping, but the majority are because insurance is
               | forcing people off of it. Just look at the recent CVS
               | Caremark forced switch from Zepbound (2nd Gen) to Wegovy
               | (1st Gen) in July.
        
               | mapontosevenths wrote:
               | I'm fairly certain that literally every doctor tells
               | literally every patient this. Mine sure did. It's also on
               | the handout your pharmacy gives you, the website for the
               | drug, and in fine print at the bottom of most
               | commercials.
               | 
               | Nobody expects a single does of ibuprofen to cure your
               | headaches for life. Similarly, this doesn't "fix" your
               | biochemistry for life, you have to take it in order for
               | it to work.
        
               | themafia wrote:
               | > I suspect that this info is intentionally down-played
               | so that it doesn't affect sales.
               | 
               | Yea, hard to figure out why drug companies keep producing
               | "Faustian bargains" in our current system. What galls me
               | is people assume the best for new drugs instead of
               | forcing the _for profit_ entity to prove it's actually
               | safe and useful.
               | 
               | To the extent that, reliably, the first comment on these
               | posts on Hacker News are some wishy washy anecdotal
               | emotional blackmail garbage that completely obfuscates
               | the point and runs direct interference for these large
               | profitable organizations.
               | 
               | To the extent that it's hard to believe that these posts
               | even on this tiny corner of the internet aren't bought
               | and paid for. We live in a society that cherishes
               | organized crime and denigrates hard work. I would not
               | look forward to "new drugs" in this regime.
        
         | noah_buddy wrote:
         | Many people (will only speak to America), view being fat as a
         | literal moral failing. Gluttony or overeating are not the sin,
         | but being fat.
         | 
         | (From that perspective:)a miracle cure that allows someone to
         | stop being fat is like an indulgence (in the Roman Catholic
         | sense). It's a cheat, a shortcut that allows the unworthy to
         | reach a state they do not deserve.
         | 
         | My opinion is to wait long enough to validate there are no long
         | term harms, but beyond that, yeah, adjust the priors, it could
         | be a modern aspirin.
        
           | NoMoreNicksLeft wrote:
           | >My opinion is to wait long enough to validate there are no
           | long term harms,
           | 
           | What's your threshold on that? How many years is "long
           | enough"? Trying to calibrate my own sense of risk.
        
             | dexwiz wrote:
             | Not OP but 10-15 years for most drugs. Took about a decade
             | for the general consensus around Oxy to change.
        
               | 2OEH8eoCRo0 wrote:
               | Haven't these been out for a very long time, just not for
               | weight loss?
               | 
               | A quick Wikipedia search shows Exenatide was FDA approved
               | in 2005 for diabetes.
        
               | mapontosevenths wrote:
               | Ozempic itself has been in use for almost a decade now
               | (originally approved for type 2 diabetes in 2017). Many
               | millions of people have taken it, without much in the way
               | of serious complication.
               | 
               | Exenatide had been in use since about 2005, and by 2019
               | had more than a million people on it. Some of those
               | patients have literally been on it for 20 years. It does
               | have a worse side-effect profile than Ozempic (or the
               | more modern GLP-1's like zepbound), but even then the
               | benefits outweigh the risk for those diabetics.
               | 
               | Today it is hard to argue the benefits of modern GLP-1s
               | don't outweigh their risks. They've been extensively
               | tested, the class of drug has been around for decades,
               | and they are used by many millions of people.
               | 
               | I personally lost 120 pounds on Zepbound in a little less
               | than a year. It's been life changing, and anyone who
               | thinks I might be less healthy now is very clearly wrong.
               | Literally every aspect of my life has been greatly
               | improved.
        
             | gryn wrote:
             | I'm a late adopter to most things.
             | 
             | my estimate would bigger than others and I would put it at
             | 30-50years.
             | 
             | I take smoking as a cautionary tale, in the beginning it
             | was pushed as not just a recreational thing but a healthy
             | activity that bring benefits with papers published to sing
             | praises about it. my parents were even nudged by their
             | teachers/doctors/etc when they were young to try smoking.
             | 
             | now we all know that smoking is beyond bad and all that
             | early "research" was just people paid off by big companies
             | to promote it.
        
               | daedrdev wrote:
               | I think a lot of people share similar concerns, but the
               | benefits of a successfully therapy are so extreme it
               | would take quite a lot to derail ozempic. People easily
               | gain 5 or more years of lifespan by not being obese,
               | avoid myriad related health conditions, and are truly
               | much better off. It would take a lot to reduce someone's
               | life expectancy by a comparable amount and we haven't
               | seen that much besides gastrointestinal issues.
               | 
               | We performed the surgical options like stomach reduction
               | before this which come with serious danger for comparison
        
               | radiofreeeuropa wrote:
               | Under-discussed benefit: being able to have all your
               | clothes actually fit at the same time (no wardrobe
               | scattered between your "skinny" weight and your "fat"
               | weight and rarely being in the right place for more than
               | a handful of pieces to fit entirely correctly) so you can
               | spend up a little on nicer clothes without worrying
               | you'll only be able to wear them part of the time. Worst
               | case, you start to pack on a little too much and they
               | start getting tight, you increase the dose or go back on
               | the drugs for a week or three (or just do it the old
               | fashioned way--hey, it works some of the time,
               | temporarily) and ta-da, right back where you want to be--
               | you're not going to pack on weight and find yourself
               | _unable_ to lose, so buying  "skinny clothes" isn't
               | mortgaged against your future success at forcing yourself
               | to eat less.
        
               | krisoft wrote:
               | > I take smoking as a cautionary tale, in the beginning
               | it was pushed as not just a recreational thing but a
               | healthy activity
               | 
               | While i agree the gist of what you are saying, also
               | important to mention that humans started cultivating
               | tobaco when mamoths still roamed the Earth. There was
               | indeed a concentrated pro-smoking publicity campaign by
               | tobaco manufacturers in the 1930s, but it was hardly "in
               | the beginning" of our tobaco use.
        
             | bradleyjg wrote:
             | There's two sides to that coin. Obesity has known long term
             | harms. So what we are looking for in a deal breaker can't
             | be a small but statistically significant increase in some
             | cancer or other. We'd need something as bad as smoking to
             | outweigh the benefits.
        
           | stronglikedan wrote:
           | > Many people (will only speak to America), view being fat as
           | a literal moral failing. Gluttony or overeating are not the
           | sin, but being fat.
           | 
           | As an American with a sister with thyroid issues, I can say
           | that is absolutely not true for the majority of Americans.
           | People are mostly sympathetic to those who are not obvious
           | slobs.
        
             | drowsspa wrote:
             | People are mostly sympathetic when it's physical issues.
             | Psychological issues are treated as diseases of the soul
             | that you only need God or willpower or whatever to fix. And
             | most fat people are fat because of the incentives in our
             | society, but admitting that also goes against certain
             | political ideologies...
        
               | jfim wrote:
               | What are the incentives for people to be fat, out of
               | curiosity? Do you mean farm subsidies for corn, for
               | example?
        
               | const_cast wrote:
               | At a low level, yes, corn, but at a high level: more
               | consumption = more money.
               | 
               | Everyone benefits from you being fat. Your doctors, your
               | car manufacturer, food manufacturers, everyone. Except
               | maybe health insurance. But they're not hurt too too
               | much.
        
               | XorNot wrote:
               | There is no doctor on Earth who goes to work and thinks
               | "thank god for fat people or I wouldn't have a business".
               | 
               | There's _plenty_ of doctors and surgeons who wish there
               | were less fat people, because they enormously complicate
               | doing surgery on and managing in hospitals.
        
             | guizadillas wrote:
             | How would you even know the cause of obesity of a stranger?
             | This is why viewing being fat as a moral failing is mistake
             | regardless of the cause. I'm pretty sure a lot of people
             | view your sister the same way just because they have no
             | idea she has thyroid issues
        
             | jvanderbot wrote:
             | With respect, neither of you are qualified to speak for
             | majority of Americans, but given the amount of effort,
             | money, ink, and television dedicated to looking better and
             | losing weight _combined_ with the fact that there 's even a
             | thing called _fat phobic_ that even _requires_ definition
             | _just to push back on all that_...
             | 
             | I think there's sufficient reason to believe that
             | "Overweight = bad" is a common standard that at least
             | people hold _themselves_ to.
        
               | blitzar wrote:
               | We must live on different timelines. Pre ozempic America
               | was the proudest nation of fat people I have ever
               | encountered (excluding the costal elites of course).
        
               | jvanderbot wrote:
               | It's weird because I agree with you, but also have to
               | acknowledge that the "pushback against fat phobia" was
               | for some reason a thing.
        
               | davorak wrote:
               | Third American here, and the push for fat acceptance was
               | so little of my media consumption that it surprised me so
               | many people spent so much time and energy on the topic.
        
           | cm2187 wrote:
           | And also the idea that it is "easy" to lose weight is
           | completely out of touch. If it was there wouldn't be millions
           | of people trying hard, spending money on trying and failing
           | for decades, and entire businesses addressing that.
           | 
           | RFK Jr's "let them eat less" is paradoxically the modern
           | version of "let them eat cake"!
        
             | kulahan wrote:
             | I think many people confuse simple with easy.
             | 
             | It IS simple to reduce your weight. There are like, two
             | things you need to do. It is, however, VERY hard to
             | actually _do_ those things.
        
               | morkalork wrote:
               | Even then, limiting calorie intake isn't all that
               | difficult; there's a reason why intermittent fasting took
               | off and so many people were getting results from it.
        
               | nosignono wrote:
               | It is that difficult, otherwise everyone would do it.
        
               | tsol wrote:
               | Not necessarily. Some people respond well too
               | intermittent fasting but not everyone. Some people
               | respond to keto but not everyone. And just because you
               | respond doesn't mean it's gonna take you to where you
               | need to be.
               | 
               | I've always been skinny but for some reason I've gained
               | weight recently. Even with keto, intermittent fasting,
               | tirzeptide, and workouts twice a week I have only lost 5
               | lbs in months. When I was skinny and forgot to eat, I
               | would feel a little crappy but still could function. Now
               | I begin to feel incredibly depressed, I can't sleep nor
               | focus. This solidified it to me that there's a circuit in
               | your brain that controls feeding and if it's out of whack
               | it'll punish you until you eat. Dieting takes months and
               | no one can go that long without sleep. So it's still a
               | practical problem, its just hard to see if your system is
               | well calibrated.
        
               | Aurornis wrote:
               | > Even with keto, intermittent fasting, tirzeptide, and
               | workouts twice a week I have only lost 5 lbs in months.
               | 
               | If you're combining a ketogenic diet AND intermittent
               | fasting AND a GLP-1 inhibitor AND exercise and you're
               | still losing less weight than observed in the Ozempic
               | studies, it's likely that there's more to this story.
               | 
               | Ketogenic dieting does not automatically translate to
               | weight loss. Keto simply makes it easier to reduce
               | caloric intake. It's actually very easy to gain weight on
               | a keto diet due to the high caloric density of consuming
               | that much fat.
               | 
               | > Now I begin to feel incredibly depressed, I can't sleep
               | nor focus.
               | 
               | Honestly if you're having these dramatic negative effects
               | from minor caloric restriction with GLP-1 inhibitors,
               | something else is going on.
        
               | const_cast wrote:
               | Ive heard this same sentence, verbatim, repeated
               | throughout the course of decades for particular fad
               | diets. _Decades_.
        
               | pessimizer wrote:
               | The irony is that all that
               | 
               | "it's so easy"
               | 
               | "it's just calories in, calories out"
               | 
               | "if you eat according to this plan and make sure to get 8
               | hours of sleep a day, you won't even feel the cravings"
               | 
               | Is stuff that fat people say. They totally buy into it
               | and buy all of the products to help them convince
               | themselves this is true. Then they get disillusioned when
               | it doesn't work, have a crisis of faith, then go to the
               | next fad to get over the self-hatred caused by their
               | failure at sticking to something _so easy._
               | 
               | Intermittent fasting is great. It got me from 225 to 165,
               | kept it off for the past few years with no effort (my
               | entire metabolism recalibrated to 165-175, I guess.) I
               | also know people who cry actual tears when they're very
               | late for a meal, or panic. Those people need therapy
               | and/or maybe an injection to artificially lower their
               | appetites to the level _where I also artificially lowered
               | my own appetite._
               | 
               | Intermittent fasting is no more natural than injections.
               | Dieting is modernity.
        
               | kulahan wrote:
               | I'm certain IF more closely resembles how humans ate for
               | millions of years, not knowing when our next meal would
               | come before becoming an agrarian society, and we haven't
               | had much time to evolve since then.
               | 
               | So, yeah, dieting is modern, but so is an abundance of
               | food. Both are equally unnatural.
        
               | blitzar wrote:
               | Limiting calorie intake is easy. Consuming near unlimited
               | calories is even easier and a lot more fun.
        
               | leidenfrost wrote:
               | But it's not.
               | 
               | What you're referring to, is the basic concept of
               | thermodynamic calorie in/calorie out. Yes, you can "just"
               | reduce food and lose weight if you hit deficit numbers.
               | 
               | But if you don't do it correctly, you'll feel like trash,
               | you'll suffer bad cravings, and put yourself in a
               | stressful mental situation for days, possibly putting
               | your job at risk.
               | 
               | You have to:
               | 
               | - Eat less than what you're already eating
               | 
               | - But enough to nourish yourself so you keep being in
               | good shape for your work and hobbies
               | 
               | - Manage hunger
               | 
               | - Make the change sustainable so you can keep doing it
               | for the rest of your life.
               | 
               | It's specially hard when your work is entirely sedentary,
               | you live alone and, ironically, when you have a salary
               | that let's you order food every day.
               | 
               | A lot of people don't have it hard. Maybe because they
               | have someone cooking for them at home, because they meal
               | prep the entire week, or because their work is so
               | physically intensive they can just wing it and burn
               | everything with what they need to do for a living anyway.
        
               | kulahan wrote:
               | Right, so exactly like I said, it's very simple. If you
               | want to lose weight, reduce calories.
               | 
               | If you add extra modifiers like "I want to feel great
               | while doing it" and "I want to lose weight while
               | sedentary" and "I want to continue eating whatever stupid
               | thing I want" and "I need to be able to scroll tiktok for
               | at least 3 hours, leaving no time for cooking", it gets
               | much more complicated.
               | 
               | Side note: LOL at "but if you're craving food you might
               | get fired!!1!" - this is professional victimhood at its
               | finest.
        
               | throwawaylaptop wrote:
               | Inaccurate in my opinion. Let's say you eat 2500 calories
               | a day usually. But you want to lose weight so you reduce
               | it to 1800.
               | 
               | Except your calories are from pop tarts.
               | 
               | If you ate 100 calories of pop tarts every hour you're
               | awake for total of 1800 calories... At the end of the
               | month you'd be fatter.
               | 
               | If you ate 1800 calories of pop tarts once a day in 1
               | hour, you might maintain weight or loose a little. Maybe.
               | 
               | If you had 3600 calories of pop tarts in a few hour
               | window, and then didn't eat again for 48 hours, you'd
               | lose weight in a month.
               | 
               | Insulin control is 99% of losing weight. Yes
               | thermodynamic blah blah, but unless you pay attention to
               | hormone control that controls metabolism in general, it's
               | not going to work without insane willpower to keep your
               | 'calories out' higher than your body wants.
               | 
               | If you repeated the 3600 calories every 48 hours with
               | beef instead, you'd lose weight like never before.
        
               | XorNot wrote:
               | > If you ate 100 calories of pop tarts every hour you're
               | awake for total of 1800 calories... At the end of the
               | month you'd be fatter.
               | 
               | This is thermodynamically impossible unless your daily
               | calorie use is less then 1800 calories.
        
               | throwawaylaptop wrote:
               | Are you saying raising your insulin levels hourly, 18
               | times a day, will not do anything to your metabolism? Did
               | you even read my post, or did you just instantly reply
               | with the same pedantic reply which my post was
               | specifically meant to address?
        
               | leidenfrost wrote:
               | Insulin control is about managing hunger more than a
               | direct cause for weight.
               | 
               | You don't even need to do keto or wacky "just meat" diets
               | to handle insulin. Protein consumption prevents insulin
               | spikes for around 1-2 hours after eating. Also, proteins
               | and fats slow down digestion.
               | 
               | Turns out, the good old Mediterranean diet is spot-on for
               | a healthy lifestyle.
        
               | throwawaylaptop wrote:
               | ? Insulin is not about management of hunger. I think you
               | got your hormones mixed up.
               | 
               | But yes, meat and vegetables is basically what I'd
               | recommend. Never pasta or bread or sugar unless you need
               | help gaining weight.
        
               | dawnerd wrote:
               | That's exactly why I liked being on keto. Never felt
               | hungry, had way more energy, mental health improved a
               | lot. No other diet had those effects. I've been off it
               | for a while and I feel gross again.
        
             | Aurornis wrote:
             | > And also the idea that it is "easy" to lose weight is
             | completely out of touch. If it was there wouldn't be
             | millions of people trying hard, spending money on trying
             | and failing for decades, and entire businesses addressing
             | that.
             | 
             | This is a touchy topic, but I would like to point out that
             | you're missing the obvious confirmation bias that comes
             | with this observation.
             | 
             | There are many people who modulate their weight by changing
             | what they eat, how much they eat, reducing snacking, meal
             | planning, and changing their shopping habits.
             | 
             | You don't see them among the millions of people failing to
             | lose weight or paying for expensive solutions because they
             | quietly solve their problem.
             | 
             | I'm also not suggesting it's easy, but we should
             | acknowledge that many people _do_ successfully control and
             | modulate their weight through dietary and habit changes.
             | There 's a survivorship bias problem that occurs when you
             | only look at the remaining sub-group who has the most
             | difficulty with this.
        
               | cm2187 wrote:
               | and there are people who don't get fat no matter what
               | they eat. Not sure what difference it makes to the
               | millions of people I am refering to. Not even sure what
               | is your point.
        
               | XorNot wrote:
               | With 40% of US adults overweight, that is a substantial
               | plurality though. It's not confirmation bias when it's
               | more then 1 in every 3 people.
        
           | naravara wrote:
           | The weight loss mechanism largely just comes from suppressing
           | appetite though, so it still lines up with the penance for
           | sin narrative. It's not that different from wearing a hair-
           | shirt and whipping yourself if you find yourself having
           | lustful thoughts. Only instead of a whip you just feel kind
           | of uncomfortable and nauseous if you eat too much.
        
             | cheald wrote:
             | That's true of semaglutide, but newer peptides like
             | tirzepatide (a dual-agonist) and retatrutide (a triple
             | agonist) have additional effects like improving insulin
             | sensitivity, and simultaneously slowing the release of
             | glucagon and activating glucagon receptors, which directly
             | increases fat oxidation and thermogenesis.
        
             | radiofreeeuropa wrote:
             | I'd describe the effects as basically the opposite of self-
             | torture. Self-torture is dieting/fasting without the drugs.
             | With them, it's great. No afternoon light-headedness and
             | difficulty concentrating, no hunger pangs, no "hangry"
             | effect, no cravings you have to keep suppressing. Just
             | smooth sailing. (though experiences do seem to vary--as do
             | dosage levels)
        
           | thaumasiotes wrote:
           | > Gluttony or overeating are not the sin, but being fat.
           | 
           | This is a strange thing to say. If you do something normal,
           | and you end up in a normal state, why would that be a moral
           | failing? There's no such thing as "overeating". Different
           | people eat different amounts. The same person eats different
           | amounts at different times.
           | 
           | > (From that perspective:)a miracle cure that allows someone
           | to stop being fat is like an indulgence (in the Roman
           | Catholic sense). It's a cheat, a shortcut that allows the
           | unworthy to reach a state they do not deserve.
           | 
           | This is incoherent. If you believe that being fat is a sin,
           | but that the things you do that make you fat are not sins,
           | then a miracle cure that makes you thin removes the only sin
           | you were committing. You can't be unworthy if you're not fat.
           | In order for a miracle cure to be "cheating", it is
           | _necessary_ that the sin is in the behavior and not the
           | result.
        
             | frumper wrote:
             | Everyone defines normal differently and people are quite
             | good at judging those that are not their normal.
        
           | falcor84 wrote:
           | I'm not a Catholic, but wasn't the idea of an indulgence that
           | God intentionally allowed an alternative path to redemption,
           | such that if you buy an indulgence, you are (at least by
           | their definition) worthy and deserving?
           | 
           | I always thought of this as essentially the same idea as with
           | Civ allowing you different paths to victory.
        
             | swat535 wrote:
             | Yes indulgences mean something different in Catholicism,
             | they remit the "temporal effects" of Sin ie its spiritual
             | consequences but don't "forgive" it like "Sacrament of
             | Reconciliation" would..
             | 
             | I think that parent is perhaps confusing it with the sin of
             | Gluttony.
        
             | noah_buddy wrote:
             | My point was that many people view ozempic and other drugs
             | like Martin Luther viewed buying an indulgence: a cheat for
             | the undeserving.
        
               | j2bax wrote:
               | I thought Martin Luther's issue was more with the
               | organization selling indulgences than the undeserving
               | buying them. He preached justification by faith alone.
               | Not some org selling justification.
        
           | Aurornis wrote:
           | > Many people (will only speak to America), view being fat as
           | a literal moral failing. Gluttony or overeating are not the
           | sin, but being fat.
           | 
           | I feel like I've seen and heard more of the opposite: The
           | trend is to avoiding anything that might make someone feel
           | blame for arriving in their situation.
           | 
           | With obesity the trend is to blame some combination of "our
           | food supply", trending science topics like microplastics or
           | the microbiome, and genetics.
           | 
           | I've heard countless people explain to me that dieting
           | doesn't work for them. It's not hard to find people claiming
           | they ate <1000 calories per day and still gained weight. Even
           | Eliezer Yudkowsky, a figurehead of the "rationalist"
           | movement, has written about "metabolic disprivilege" and
           | claimed that his genetics do not allow him to lose weight
           | through dieting. This thinking runs deep.
           | 
           | What's interesting about GLP-1 inhibitors is that they
           | modulate the intake portion of the diet, which shatters these
           | previous notions that some people had "metabolic
           | disprivilege" and simply could not lose weight by reducing
           | caloric intake. They just make it easier to reduce food
           | intake.
        
             | nxobject wrote:
             | > I feel like I've seen and heard more of the opposite: The
             | trend is to avoiding anything that might make someone feel
             | blame for arriving in their situation.
             | 
             | > I've heard countless people explain to me that dieting
             | doesn't work for them.
             | 
             | I think you're being a tad reductive - "dieting right now
             | doesn't work for me for reasons I can't control" and
             | "reducing calorie intake will help me reduce weight" aren't
             | necessary contradictory, and don't imply "I'm going to
             | attribute it all to biology/blame it on something general".
             | 
             | Anyway, let me assert the opposite: as a partner of a
             | nutritionist who's talked (with anonymity) about her
             | clients, the majority of the people she's worked with, who
             | struggle with sustainably reducing calorie intake over the
             | course of years, come to dieting with that logic, and
             | _then_ struggle against specific barriers, and _then_ blame
             | themselves. (A recent example: "because of my work schedule
             | I don't get enough sleep, which leads to weight gain and
             | time only for frozen food - on top of my predispositions".)
             | 
             | In that case, GLP-1 inhibitors as an intervention
             | _complements_ the way her clients think about dieting.
        
             | davorak wrote:
             | > Even Eliezer Yudkowsky, a figurehead of the "rationalist"
             | movement, has written about "metabolic disprivilege" and
             | claimed that his genetics do not allow him to lose weight
             | through dieting. This thinking runs deep.
             | 
             | I thought EY's point was different. Am I misremembering? I
             | thought it was about not being able to do mental work
             | productively when dieting enough to loose weight(maybe
             | maintain a low weight too, though I do not remember that
             | being mentioned explicitly).
        
             | tuesdaynight wrote:
             | I agree with you, but it's important to remember that
             | "dieting down" is way harder for a lot of people. I am and
             | always was skinny through my life. Whenever I need to eat
             | less, I can do it without much effort. However, I have
             | friends who would faint if they tried to diet down the way
             | that I do. I don't know why that happens, but I've seen
             | happening and it changed my perspective about this subject.
             | If Ozempic can help with that, I will never criticize
             | someone who uses it.
        
             | snek_case wrote:
             | Genetics do factor. It's not just a question of genetics
             | affecting metabolism. People literally don't feel hunger
             | with the same intensity as one another. It's like sex
             | drive. There are both very horny people and asexuals out
             | there. There are also people who routinely forget to eat.
             | For many people though, the notion of "forgetting to eat"
             | seems completely alien, because those signals are much
             | stronger for them.
        
           | trhway wrote:
           | >My opinion is to wait long enough to validate there are no
           | long term harms, but beyond that, yeah, adjust the priors, it
           | could be a modern aspirin.
           | 
           | it can be more than aspirin. Such an effect on glucose
           | should, among other things, be affecting cancer, probably in
           | a very positive way.
        
           | throwawaylaptop wrote:
           | You can be gluttonous and still thin. I eat 2 lbs of ground
           | beef a day, with tons of cheese on it. For breakfast I have
           | 6-8 eggs, with cheese. I have my morning coffee with heavy
           | whipping cream. For desert, I whip up some of the heaving
           | whipping cream and have it with frozen berries thawed out. It
           | drives gfs nuts but they're too anti fat to try it.
        
         | gameman144 wrote:
         | I think there's a justifiable fear/dread when things that used
         | to demonstrate virtues no longer do so.
         | 
         | For instance, being in shape used to (usually) demonstrate
         | discipline. Art or music used to demonstrate attention to craft
         | and practice. Knowledge demonstrated time devoted to study.
         | 
         | This isn't to say that the world is worse with these advances
         | (I'd be hopeless without search engines, and I am grateful that
         | people get to live longer and healthier with semaglutide), but
         | I think a little bit of mourning is understandable: what used
         | to be the fruits of hard work are now a dime-a-dozen commodity.
        
         | Barrin92 wrote:
         | >seemingly need to believe that it's some kind of Faustian
         | bargain
         | 
         | I mean, that's because that's literally what they need to
         | believe. A majority of people has been brought up on an
         | incredibly moralized account of human behavior, and if it turns
         | out you can just pour some GLP-1 drugs into the drinking water
         | and basically fix a whole bunch of issues it will become
         | obvious that a therapeutic framing is the appropriate way to
         | look at these things.
         | 
         | For people who live in a world of vices and sinners who have to
         | swear off the devil, this throws a pretty big wrench into the
         | whole story, it's much more than just a drug.
        
           | losvedir wrote:
           | I think it's a similar thing to those who are morally
           | invested in human overpopulation and not consuming resources
           | for climate change reasons and such.
           | 
           | The techno-optimist GLP analogs like solving these things
           | with clean energy and other modern marvels throws a wrench
           | into that story.
        
         | cm2187 wrote:
         | I agree, and I am a consumer of those myself, which did
         | absolute wonders. And of course I will assign vastly more
         | weight to my own experience, than to the opinion of some random
         | guy on the internet who only read about it.
         | 
         | However, we also need to be conscious that this is a very very
         | big business, and given the size of the market, is happy to
         | pour billions into some studies that will demonstrate that it
         | has all the benefits in the world and cures everything.
         | Addressing obesity is a humongous benefit in itself, and helps
         | with all the medical conditions that result from it (which in
         | balance makes most mild side effects irrelevant). I am a lot
         | more skeptical about those dozens of claims that it improves X
         | by Y% (often low single digit). Most medical studies in general
         | are dodgy, show minor benefits on small samples in a massively
         | multivariate environment, which more often than not are
         | statistical noise carefully selected, when the approach don't
         | have outright flaws or fraud.
        
         | jjice wrote:
         | I was kind of scared of these when Ozempic starting picking of
         | steam for weight loss. I was worried that this would be having
         | more negative effects. Turns out, generally speaking, if used
         | with you doctor, these things are pretty safe, especially
         | comparatively to some of the negatives of being overweight.
         | 
         | And then I saw some of the stories on HN about how it's changed
         | peoples lives for the better. And then people in my life
         | started taking it and singing its praises. I'm very bullish on
         | GLP-1s now and I've very excited to see all the lives it
         | improves. I'm not saying this thing is 100% miracle with no
         | downsides, but this seems to be a generally large net positive.
         | 
         | It's a bit hard for me to comprehend how big of an impact this
         | can have for someone since I've been very fortunate to never
         | struggle with my weight, but I'm (slightly embarrassingly)
         | tearing up writing this because of how many people I've seen
         | have huge positive effects on their physical and mental health
         | (due to body image).
        
           | radiofreeeuropa wrote:
           | It's great because _we had no other way_ to address this
           | problem at a population level. Not any realistic ones,
           | anyway.
           | 
           | Like, I figured we were just never going to solve it, given
           | the two possibilities were "radically re-engineer US culture
           | such that moving to the US doesn't make previously-skinny
           | people fatter" (with other countries heading the same
           | direction as us needing to make similar moves, one supposes)
           | or "find a miracle drug". Neither seemed likely. Turns out,
           | decent odds we've managed the latter! Which was always the
           | more likely of the two, but I still wouldn't have rated it as
           | very likely.
        
             | throwawaylaptop wrote:
             | I helped my dad lose 50 lbs by finally, after 10 years,
             | getting him to give up bread, sugar, potatoes. It took
             | buying him 2 months of a bluetooth glucose monitor. Once he
             | saw what certain foods do, he believed me finally. At 65
             | years old, healthier than I remember since he was 40 and I
             | was a teen. It doesn't require some weird injection.
        
               | XorNot wrote:
               | No but its a lot easier for people who've had trouble and
               | gets results, which is all that matters.
        
               | radiofreeeuropa wrote:
               | There's anecdotes, and there's science.
               | 
               | Individually, there's (previously) been nothing better to
               | suggest than "try harder (and, maybe, smarter)".
               | 
               | Statistically it was almost useless, but it's the best we
               | had. It's not _bad_ advice exactly, it 's just extremely
               | unlikely to work for long-term, sustained weight loss.
               | 
               | It also very much appears to be the case that weight gain
               | and loss are heavily influenced by environmental factors.
               | Skinnier countries aren't skinnier because the people
               | there have more willpower, it seems, but because _they
               | live in a skinnier country_ and are surrounded by the
               | culture, laws, physical layouts of the created world, et
               | c., that come with that. It 'd be kinda weird if we
               | expected "just try harder" to work very well when that's
               | evidently not the mechanism by which skinny countries
               | _are_ skinny. Alternatively, if it _is_ willpower doing
               | it, we 're just adding a step, because then it appears
               | that environment strongly influences willpower, instead,
               | since the same observations hold.
               | 
               | Sure, sometimes it works for individuals. In fact, it
               | _often_ works temporarily, causing a yo-yo effect. It
               | _can_ work for long periods (many years without a slip)
               | but that 's rare.
               | 
               | If your solution to the obesity crisis is "people need to
               | try harder" your solution is demonstrably not helpful.
               | Can it work for one person? Yes. Over a population, will
               | it? No, it won't, it's _amazingly_ ineffective, even very
               | expensive high-touch interventions involving multiple
               | experts aimed at weight loss and lifestyle change and
               | such are wildly less effective than  "inject GLP-1
               | agonists" or "move somewhere skinnier".
        
               | throwawaylaptop wrote:
               | My dad was never told by a single doctor to cut out all
               | processed carbs/grains, and even potatoes, by a single
               | doctor in his life.
               | 
               | So "try harder" isn't going to work when the doctors
               | don't even know what they're talking about.
               | 
               | I'm losing faith in this forum. People would prefer to
               | give people pharma bs because no processed carbs is too
               | much of an ask. Pathetic.
        
               | radiofreeeuropa wrote:
               | Run a study of your approach and show good results over a
               | cohort for 2+ years and you'll make an entire sub-field
               | of medical scientists very happy.
               | 
               | [EDIT] It's not that your approach _can 't_ work, it's
               | that if (for example) people had as hard a time following
               | the directions for condoms as they do following diet &
               | workout plans, we'd never allow condoms to be sold as
               | contraceptives, they'd not even be _close_ to being OK to
               | promote as useful for that purpose. It wouldn 't matter
               | if a few people _could_ follow the directions and it
               | worked 100% of the time for them.
        
               | throwawaylaptop wrote:
               | I assure you, not buying bread and pastries for your
               | family is a lot easier than correctly using a condom in
               | the heat of the moment. Which is why most people don't
               | use them and use pull out instead. Because even that is
               | easier and better if done right. (I know when to pullout,
               | I don't know if a condom broke before it's too late).
               | 
               | Anyway, it does work, people just aren't told to do it
               | firmly. Doctors dance around it.
        
               | tuesdaynight wrote:
               | Just scale that solution to millions of people and the
               | comparison will be relevant.
        
               | throwawaylaptop wrote:
               | If you told millions of people that bread, sugar, pasta
               | and bread are basically killing them, and to flat out
               | stop eating them.. you probably would help people lose
               | weight (and save many lives too).
               | 
               | My dad has finally understood that grains are for people
               | that need help maintain weight or gaining weight.
               | 
               | No fat person should ever be eating them.
        
               | parineum wrote:
               | If I told you billions of people eat bread, sugar and
               | pasta and it wasn't "basically killing them" (whatever
               | that means)...
               | 
               | It's strange to make the culprit of a modern epidemic
               | foods that have been with us for millenia.
        
               | stavros wrote:
               | I helped my dad lose 50 lbs by finally, after 10 years,
               | getting him to give up bread, sugar, potatoes. It took
               | buying him 2 months of Ozempic. Once he saw what stopping
               | the cravings for certain foods can do, he believed me
               | finally. At 65 years old, healthier than I remember since
               | he was 40 and I was a teen. It doesn't require some weird
               | bionic arm implant.
        
           | matwood wrote:
           | And not just weight loss, but the people I know on GLP-1's
           | have also significantly cut back on alcohol. I think there
           | are ongoing trials around GLP-1's and general addiction.
        
             | nosignono wrote:
             | I find my compulsion towards videogames is decreased. Not
             | eliminated, but I feel much less _compelled_ to be playing
             | all the time.
        
               | CoastalCoder wrote:
               | I'm curious if this affects smartphone usage. E.g.,
               | "compulsive" feed-checking and doom scrolling.
        
               | garbawarb wrote:
               | I wonder how it compares to Adderall.
        
               | nosignono wrote:
               | Adderall produces a very, very different experience and
               | is prescribed to address a very, very different root
               | cause.
        
             | mullingitover wrote:
             | The cynic in my thinks this will its undoing. Some huge
             | fraction of alcohol profits come from a small portion of
             | drinkers. If these G* peptides help these poor people their
             | drinking under control, it would take a huge wrecking ball
             | to the profits, and thus to the taxes. Can't have that.
        
               | quickthrowman wrote:
               | Reduced healthcare, policing, and other costs that are
               | paid for with tax dollars from lower alcohol consumption
               | would almost certainly be a net gain over the piddly tax
               | revenue from alcohol consumption sales.
        
               | mullingitover wrote:
               | So you're saying it's also going to harm the revenues of
               | the health care industrial complex _and_ the police
               | state? That 's not going to help its case.
        
               | snek_case wrote:
               | They're very expensive drugs so it would be one lobby
               | against another. However given that they're so expensive,
               | I would think that broke, uneducated alcoholics just
               | won't have access to them, so those profits are safe...
        
             | jjice wrote:
             | I've heard similar for gambling, and as one of the sister
             | comments said, things like video games. I'm so curious to
             | understand _why_ that effect is there, but I've heard this
             | so many times now that I do believe that it exists in some
             | capacity. Such an interesting world we're opening up here.
        
               | DharmaPolice wrote:
               | Every person I know who tried to give up smoking has the
               | same story - they were successful for a while and then
               | they encountered some stressful moment (exam, work
               | deadline, etc) and they fell off the wagon. One
               | explanation could simply be that normally we have food
               | stresses which manifests in general stress which we
               | relieve via video games or whatever else. If these drugs
               | turn down the volume of hunger then maybe this has the
               | benefit of reducing the need for stress relieving
               | behaviours in general.
        
             | VectorLock wrote:
             | It helped me cut back on my drinking significantly. I'm not
             | an every day drinker but a weekend binge drinker and the
             | amount I drink when I drink is down by I'd estimate by
             | around half or more.
        
           | dawnerd wrote:
           | The same thing with keto. People will swear it's unhealthy
           | but like, the alternative (outside of Ozempic and co) is
           | being overweight...
        
         | y-curious wrote:
         | I am one of those people to some extent. For me, it's the
         | naturalistic fallacy I can't get over. I drink caffeine daily,
         | but the idea of hijacking my hunger with an injectable induces
         | dread. I would like to believe that there are no long-term side
         | effects, but:
         | 
         | 1. We have to trust the data of for-profit pharmaceutical
         | companies and their trials. They are incentivized to produce
         | optimistic results.
         | 
         | 2. It's relatively new (insofar that a lot of people are taking
         | it). Opiates were touted in a similar way until the other shoe
         | dropped. There exists an undefined line in time where I would
         | feel more comfortable.
         | 
         | 3. It is/was made of a poison from an animal.
         | 
         | 4. The extreme benefits are overwhelmingly in obese candidates.
         | Keto is the same way; I tried it and it was not for me because
         | I am not obese.
         | 
         | I'm actually open to any sort of evidence that will change my
         | mind. No name calling please.
        
           | bobsmooth wrote:
           | >It is/was made of a poison from an animal.
           | 
           | Caffeine is an insecticide.
        
         | genewitch wrote:
         | every time in recorded human history when there's be a panacea
         | or cure-all it's generally been snake-oil.
         | 
         | There are a lot of side effects, of this type of medicine -
         | many which were not really prevalent when it was prescribed on-
         | label.
        
           | smt88 wrote:
           | There are lots of miraculous, life-saving drugs that have
           | minimal side effects and aren't snake oil.
           | 
           | Metformin, insulin, many vaccines, some statins, and some
           | antibiotics are clearly on that list.
        
             | genewitch wrote:
             | > panacea or cure-all
             | 
             | specifically, is what i said.
        
               | smt88 wrote:
               | "GLP-1s are beneficial for many conditions downstream of
               | liver dysfunction and metabolic disease" is a much milder
               | claim than "cure-all".
        
           | const_cast wrote:
           | > every time in recorded human history when there's be a
           | panacea or cure-all it's generally been snake-oil.
           | 
           | That's just not true at all. Like, not even close.
           | 
           | Almost everything we've invented in medicine has been free.
           | As in, little to no downsides and just makes things better.
           | And not just in medicine - look around you, compare it to 100
           | years ago. A lot of stuff is safer, for free.
           | 
           | Think about infant mortality. We went from 1/4 100 years ago
           | to 1/1000s. For free. Surely birth must be more painful now,
           | right? No... we got rid of the pain too. Well surely mothers
           | die more, right? No... They die orders of magnitude less too.
           | Well surely the Vitamin K shot must have SOME downside?
           | Pretty much no, it just pevents bleeding out.
        
             | genewitch wrote:
             | does HN not know what the word "panacea" or the phrase
             | "cure-all" mean?
        
         | Petersipoi wrote:
         | Just about every single adult woman in my wife's extended
         | family is on Ozempic. None of them are obese at all. Or
         | diabetic. They are all using it to "lose a few pounds" (we're
         | talking like less than 20 pounds; Yes, as you might expect,
         | there are some unrealistic beauty/success standards in my
         | wife's family). So I think there are a lot of people who are
         | annoyed by that, because of the message it sends to completely
         | healthy-weight girls/young women who don't look like
         | professional super models in a swimsuit.
         | 
         | Since we have young daughters, that aspect of Ozempic really
         | bothers my wife. Though she would have no issue with
         | obese/diabetic people using it to get healthy.
         | 
         | Personally I do think it is a miracle drug and I'm glad people
         | are getting healthy because of it.
        
           | angmarsbane wrote:
           | I fall into the same category as your wife's extended family.
           | I used it to get to the weight I feel most comfortable and
           | I've gone back on it periodically (like after 5 weeks of work
           | travel) to get back within 5 lbs of that weight (where I can
           | manage the additional weight loss on my own).
           | 
           | When being fat becomes more of a deliberate choice (due to
           | the drug accessibility) I do wonder how society and society's
           | expectations Will change. Will women be even more pressured
           | to "bounce back" during postpartum? Will the "baby fat" we
           | only get to have during adolescence be eliminated and drop
           | out of the shared experience of growing up?
           | 
           | There's also a lot of concern within the eating disorder
           | community about the potential for abuse, because these drugs
           | are so easy to get a hold of by lying on telehealth (could be
           | argued that I've abused them by getting them when they're not
           | truly necessary).
        
         | kulahan wrote:
         | Purdue Pharma created the Opioid Crisis. Martin Shkreli bought
         | AIDS drugs and increased the price 5000% LEGALLY. IG Farben set
         | up a factory next to Auschwitz for slave labor while making
         | Zyklon B and their own personal concentration camp. Bayer sold
         | HIV-contaminated blood in the 80s to developing companies.
         | 
         | Anyone who isn't incredibly cautious of drug companies claiming
         | perfectly safe "holy grail" medicines is insane. The number of
         | crimes committed by this industry is hilarious and depressing
         | simultaneously. The lack of moral guidance in this industry is
         | incredible. The incredible greed in this industry is unmatched.
         | I can't think of a more devil-like industry.
         | 
         | If news came out tomorrow that everyone who's taken GLP-1
         | started bleeding out of every orifice until dead, and that this
         | outcome would've been impossible to miss during trials, I'd
         | STILL be more shocked at the people who didn't see it coming.
        
           | cjbgkagh wrote:
           | Semaglutide is a signaling peptide, these are basically in a
           | different class of medication that has traditionally been
           | largely ignored. Partly due to difficulty defending patents
           | for a class of medication that the body produces naturally,
           | I.e. the instructions are in the DNA. Even if a drug company
           | patents one GLP-1A they can't patent all of them and any of
           | them will work much the same way.
           | 
           | Because it's a naturally occurring signaling peptide there
           | already exist people who have too much of it and too little
           | of it due to normal genetic variation.
        
             | kulahan wrote:
             | We didn't even know what "junk DNA" did until like 25 years
             | ago. We've discovered a couple new body parts in the last
             | 50 years. We don't have any real understanding of how
             | basic, foundational parts of medicine work - things like
             | anesthesia and antidepressants and _even pain differences
             | between men and women_. Tests are regularly performed on
             | highly homogenous groups, or even tested on groups
             | completely different from the target audience. The US
             | allows us to advertise medicines on TV, and this gets
             | people thinking they have some vague understanding of
             | medicine - which they do not. I mean, maybe the
             | unreasonably smart audience of this site may, but for the
             | extreme majority of Americans, they do not.
             | 
             | I think our massive advancement in the computer industry
             | has confused people into thinking other industries which
             | _use_ computers are _also_ advanced, but this is not the
             | case. Pharmacology is an extremely immature field.
             | 
             | Edit: I think the only field more immature than this would
             | be psychology? And I don't think many are silly enough to
             | trust a field who still worships a dude that believed every
             | thought you had was somehow actually about sex, and has
             | made zero advancements beyond borrowing meditation and a
             | few other ideas from other cultures.
        
         | godshatter wrote:
         | I'm not a fan because it's expensive and once you go off of the
         | drug the weight comes back on (at least from what I've read).
         | That's not a trade-off I want to take lightly.
         | 
         | There's also something to be said for gaining the discipline to
         | do it yourself along the way, which may lead to keeping more of
         | the weight off in the long run.
         | 
         | We also don't know what the long term side effects of it will
         | be, if any.
         | 
         | I don't find any of that unreasonable to me. I'm saying this as
         | a type-2 diabetic who could stand to lose a lot of weight.
        
           | Someone1234 wrote:
           | > We also don't know what the long term side effects of it
           | will be, if any.
           | 
           | The first GLP-1 receptor agonist was commercially released in
           | April 2005, meaning 20+ years. People who often repeat this:
           | If 20-years, and tens of trials, isn't long enough to "know"
           | then where is the line exactly?
           | 
           | Thalidomide by contrast was available for 4-years, Vioxx for
           | 5-years, and Rezulin for 3-years by contrast.
           | 
           | > There's also something to be said for gaining the
           | discipline to do it yourself along the way, which may lead to
           | keeping more of the weight off in the long run.
           | 
           | That doesn't work; we know it doesn't work both from small
           | and large scale studies, and population evidence since 1970s.
           | So you're promoting the same thing we've been doing, and
           | failing at, for beyond all of my lifetime. Feels like a
           | religious belief at this point, rather than following the
           | data and what we know from it (i.e. that objectively does not
           | work, and has never worked).
           | 
           | Is there something new you know that health experts haven't
           | known as Obesity as increase up through 40.3%+ (with
           | overweight being 73.6%+)?
        
         | lenerdenator wrote:
         | There are people who are going to hate anything like that,
         | because it makes a very difficult task (losing weight)
         | significantly easier. And we hate it when the damned kids,
         | what, with their Tok-Clock and deadass rizz, have it easier
         | than we did back in the day.
         | 
         | That being said, the fact that we let our society in North
         | America get to the point where something like semaglutides are
         | such a huge deal is something to honestly hate, and I think
         | some of the misdirected hate is really a hatred for that.
        
         | hinkley wrote:
         | You've got a crowd of people raised in a Calvinist society who
         | think nothing good comes without suffering, you've got people
         | who feel this is a cheat where discipline should win out, and
         | you have a bunch of people who are used to all easy solutions
         | coming with either a bad lottery ticket or externalities on
         | other people/the environment.
         | 
         | They can all agree that they're waiting for the other shoe to
         | drop.
         | 
         | That said, we are at a point where people are overweight enough
         | that getting exercise has its own risks, and taking a
         | medication that allows you to be more active is likely to
         | cancel out some of those downsides. As long as you do both I
         | have no problem with people taking ozempic, mounjaro, etc.
         | 
         | I would prefer if we figured out what other than cultural
         | changes is making everyone have symptoms of inflammatory
         | dysfunctions. There is more than one thing going on. Processed
         | foods, contamination, some microbe that doesn't culture in
         | agar. And it's spreading to more of the world.
        
           | rglover wrote:
           | > That said, we are at a point where people are overweight
           | enough that getting exercise has its own risks, and taking a
           | medication that allows you to be more active is likely to
           | cancel out some of those downsides.
           | 
           | And yet we rarely ask or say "maybe I should just eat fewer
           | calories?" Unless you have some other disorder that prevents
           | normal bodily function, that does work (and would be viable
           | I'd imagine for the majority of people being prescribed).
           | 
           | But it requires patience and discipline which are basically
           | non-existent for the majority of the population.
        
           | ninwa wrote:
           | > I would prefer if we figured out what other than cultural
           | changes is making everyone have symptoms of inflammatory
           | dysfunctions.
           | 
           | I personally hope it's just cultural and sugar/hfcs. Because
           | some alternatives might be grim to reckon with just from a
           | humanistic/grief perspective:
           | https://pubmed.ncbi.nlm.nih.gov/34484127/
        
           | nomel wrote:
           | > Calvinist society who think nothing good comes without
           | suffering
           | 
           | Or, some of us older folks have been around long enough to
           | understand that _we_ are, in an uncontroversial and factual
           | way, the long term medical trial, and long term effects found
           | in that trial, along with the eventual market withdrawal, may
           | not show up until 10 to 20 years later, creating a _healthy_
           | distrust in the money /corporations behind the, sometimes
           | outright _crafted_ [1], early medical trials.
           | 
           | [1] https://www.nature.com/articles/d41586-023-02299-w
        
           | Levitz wrote:
           | You've also got the crowd who would argue that there's
           | nothing wrong with being fat in the first place and that are
           | scared of society pressing on this matter again after years
           | of pushback.
        
         | rglover wrote:
         | Well, considering that the drug was originally developed not
         | for weight loss but for type 2 diabetes management, it's not
         | terribly radical to be skeptical or outright dismissive of it
         | as some miracle weight loss drug (even if that _is_ a
         | consistent side-effect).
         | 
         | The whole rush to get people on the thing feels like an
         | opportunistic pharma grab (because it is). The outcome of those
         | sorts of things is never in favor of the individual or their
         | well being.
        
         | bsder wrote:
         | > I find it fascinating how much a pretty large group of people
         | just hate semaglutides and seemingly need to believe that it's
         | some kind of Faustian bargain.
         | 
         | Some of us also remember previous weight loss drugs which had
         | similar levels of hype and later got pulled because of really
         | bad side effects.
         | 
         | If I needed to lose 100+ pounds, I'd be at my doctor tomorrow
         | asking for it. The side effects of 100+ pounds are way worse
         | than anything semaglutide might cause.
         | 
         | For people who are using it to lose 10-20 pounds, the tradeoff
         | isn't as clear.
         | 
         | I am cautiously optimistic and hope that semaglutide lives up
         | to the hype. _lots_ of people will benefit if it does.
        
       | wolfi1 wrote:
       | Is the term "biological age" even well defined?
        
         | sharkjacobs wrote:
         | Presumably it is in the narrow context of the study, since they
         | need something they can consistently measure and compare
         | 
         | > The researchers used epigenetic clocks to assess biological
         | aging - sophisticated tools that identify patterns of DNA
         | methylation, chemical tags that affect gene activity and shift
         | predictably with age
        
         | sharkjacobs wrote:
         | I think you're very correct to identify the gulf between what
         | the average MedPath headline reader understands "biological
         | age" to mean, and the very specific chemical tags being
         | measured and reported
        
       | lysecret wrote:
       | It's so fascinating that we just keep on finding more positive
       | effects.
        
       | thurn wrote:
       | Are we close to having generic semaglutides e.g. available in
       | India? Or locked into high prices for the foreseeable future?
        
         | Someone1234 wrote:
         | Generic Semaglutide is already produced on a massive scale
         | throughout the world. However, it is unlawful to import and
         | sell and will remain so until 2032 in the USA.
         | 
         | In other markets, where it is under patent, it is significantly
         | cheaper than the $500/month or more in the US currently. For
         | example in the UK it is roughly $150/month USD privately (i.e.
         | not through the NHS).
         | 
         | In China it will be out of patent within two years.
        
           | readthenotes1 wrote:
           | Iirc, that pricing will change in the US as Trump will
           | require that the price of drugs to Medicaid patients must
           | match or be less than that of any other developed nation.
           | 
           | Since about 1/4 of the people in the US are on medicaid,
           | close to 90 million, that means the drug manufacturers will
           | probably raise the price for everyone else in the US because
           | they got to get their profits somehow...
           | 
           | https://www.whitehouse.gov/fact-sheets/2025/07/fact-sheet-
           | pr...
        
             | Someone1234 wrote:
             | Unfortunately, per the link, it sounds like a voluntary
             | arrangement. Essentially they're asking drug companies
             | nicely to stop ripping off Americans.
             | 
             | If they're serious about this, they would introduce
             | legislation rather than send strongly worded letters to
             | pharma companies.
        
           | radiofreeeuropa wrote:
           | There's a whole little online subculture of people in the US
           | importing the precursors and making it themselves at home for
           | dirt-cheap.
           | 
           | I gather it's extremely easy and basically fool-proof, as far
           | as producing the desired drug and not producing some other,
           | undesired drug. Much easier than, say, home-brewing beer. The
           | risk is all in contamination, which presents a vector for
           | infection.
           | 
           | [EDIT] I don't mean to downplay the risks or suggest people
           | go do this, only to highlight that there's enough demand for
           | this that we're well into "life, uh, finds a way" territory,
           | and also just how lucky (assuming these hold up as no-
           | brainers to take for a large proportion of the population) we
           | are that these things are so incredibly cheap and simple to
           | make, if you take the patents out of the picture.
        
             | tsol wrote:
             | Not just the current generation of drugs, but they also
             | import and use the next generation that is still in
             | clinical trials and won't be on the market for at least a
             | year. I had it reccomended to me online in a very casual as
             | if it were a supplement. The risk with the is not just
             | contamination but also if you get side effects there's no
             | recourse to sue because you bought it from a chemical
             | factory in China. The new generation of glp peptides is
             | similar to the old one, but still can have unintended side
             | effects as they do work on three receptors rather than the
             | two that the current generation does
        
       | neves wrote:
       | Be very cautious with these miracle drug headlines. There's a
       | strong financial incentive to highlight only the good news.
       | 
       | My mother, a healthy and active 87-year-old, started taking
       | Ozempic because she was overweight and her doctor was impressed
       | by the drug's supposed miracles. She ended up suffering from
       | severe intestinal motility issues, went through a lot of pain,
       | and had to be admitted to the ICU.
       | 
       | The long-term systemic effects of these drugs are still largely
       | unknown.
        
         | jorts wrote:
         | Haven't these types of drugs been in use for ~15 years?
        
           | throw-qqqqq wrote:
           | > Haven't these types of drugs been in use for ~15 years?
           | 
           | The predecessor of semaglutide, liraglutide has been sold
           | since 1998. GLP-1 has been studied since the 70s. The first
           | human was injected with GLP-1 agonists in 1993 IIRC.
        
             | mapontosevenths wrote:
             | Further, Ozempic itself is nearly 10 now and some people
             | have been on Exenatide for 20+ years continuously now.
             | 
             | These drugs are not novel, or new and we absolutely know
             | the long term health impact.
        
         | jsbg wrote:
         | > The long-term systemic effects of these drugs are still
         | largely unknown.
         | 
         | The long term effects of obesity are very well known though and
         | unlikely to be better than any still unknown negative effect
         | semaglutide might have.
        
         | bobsmooth wrote:
         | You don't think her being 87 might have something to do with
         | her complications?
        
       | jsbg wrote:
       | Doesn't biological age normally go down with weight loss? Is it
       | just a corollary of the off-label effects of the drug?
        
       | HocusLocus wrote:
       | I guess maybe I'm one of the few who consider "reversing 3.1
       | biological years" to be a personal insult. Something that polled
       | well in a group of pre-kindergarteners. What happened, some
       | statistical bloodwork metric was tortured to produce such a
       | claim? A mouse population survived the lab a little longer?
        
         | tzs wrote:
         | Here's an article that answers your question [1]. It in the
         | second bullet point near the top.
         | 
         | [1] https://trial.medpath.com/news/5c43f09ebb6d0f8e/ozempic-
         | show...
        
           | HocusLocus wrote:
           | Yes, epigenetic clocks discovered in 2010 and even the
           | researcher who discovered them might feel insulted by the
           | phrase of a prescription drug declaring "reverse biological
           | aging 3.1 years"
        
             | aswegs8 wrote:
             | If you're really interested in that and not just trolling,
             | these are the measures used by the study:
             | 
             | After adjustment for sex, BMI, hsCRP, and sCD163,
             | semaglutide significantly decreased epigenetic aging:
             | PCGrimAge (-3.1 years, P = 0.007), GrimAge V1 (-1.4 years,
             | P = 0.02), GrimAge V2 (-2.3 years, P = 0.009), PhenoAge
             | (-4.9 years, P = 0.004), and DunedinPACE (-0.09 units, [?]9
             | % slower pace, P = 0.01). Semaglutide also lowered the
             | multi-omic OMICmAge clock (-2.2 years, P = 0.009) and the
             | transposable element-focused RetroAge clock (-2.2 years, P
             | = 0.030).
        
       | charlie0 wrote:
       | It it ozempic specifically or just the side effect of eating less
       | (which also has tons of evidence for extending life)?
        
       | getpost wrote:
       | In a recent podcast[0], Ben Bikman explained some of background
       | and pitfalls of GLP-1 drugs. When the drugs were first
       | prescribed, dosages were much smaller than the dosages now
       | prescribed for weight loss. Microdosing might be a better and
       | safer strategy.
       | 
       | The podcast is only 3 hours long! The GLP-1 discussion starts at
       | 2:09:53.
       | 
       | [0] https://www.foundmyfitness.com/episodes/ben-bikman
       | 
       | EDIT: ycopilotFYT version https://www.cofyt.app/search/dr-ben-
       | bikman-how-to-reverse-in...
        
       | scrozart wrote:
       | Lots of anecdotes and opinions in the thread. Read the post and
       | the science.
        
       | heraldgeezer wrote:
       | Fasting is good. I do it without medicines and crap. 24h-48h
       | fast. Skip meals. BMI back to 19 and it feels GOOOOD BABYYY.
        
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