[HN Gopher] GLP-1 drugs linked to lower death rates in colon can...
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GLP-1 drugs linked to lower death rates in colon cancer patients
Author : gmays
Score : 212 points
Date : 2025-11-12 19:50 UTC (1 days ago)
(HTM) web link (today.ucsd.edu)
(TXT) w3m dump (today.ucsd.edu)
| bicx wrote:
| Maybe I'm just an aging cynic, but I'm waiting for the other shoe
| to drop when it comes to GLP-1s. There have been so many claims
| of positive benefits that it almost seems too good to be true.
| With them being so expensive, the producers have every incentive
| to upsell using any study they can get their hands or money on.
|
| If it's all upside, then I'm happy to be wrong.
| bitwize wrote:
| Haven't you been reading Hackernews for the past 10 years?
| Sugar has been implicated in pretty much every major late-life
| disease, and the closest thing to a cure before GLP-1 agonists
| was fasting.
| phantasmish wrote:
| ... and the mechanism by which GLP-1s cause weight loss is,
| more or less, by making fasting really easy.
| lm28469 wrote:
| That's such a lazy and unimaginative take that basically
| skips 99.999% of human history during which sugar wasn't a
| problem at all.
| tengbretson wrote:
| The baseline lifestyle of 99.999% of human history would,
| by modern classifications, be considered intermittent
| fasting.
| jimbokun wrote:
| That was the part of history when humans didn't have much
| access to cheap sugar.
| Der_Einzige wrote:
| You're the lazy one.
| pessimizer wrote:
| Hacker News has extreme orthorexia and endorses all sorts of
| quackery.
| robbomacrae wrote:
| There have been some. I've heard about eyesight related issues.
| A quick google found this article [0] where results showed that
| people using GLP-1 drugs were 68.6 times more likely to develop
| certain types of vision problems.
|
| [0]: https://www.aao.org/newsroom/news-releases/detail/do-
| glp-1-d...
| phantasmish wrote:
| A lot of the issues are hydration-related, and I wouldn't be
| surprised if the eye ones are, too. Some water intake is from
| food, so if you eat less, you need to drink more. If you also
| tend to drink with food, and you're eating less, you may
| drink less instead of the _more_ that you need to be. Add in
| a generally dulled "I crave something" sense and you've got a
| recipe for not just going all day without eating, but also
| without _drinking_.
| mock-possum wrote:
| I'm not a doctor but iirc water consumed along with a meal
| is absorbed slower and therefore results in longer-lasting
| hydration - than just a bare glass of water on an empty
| stomach. Of course, eating might add more material that
| encourages dehydrating, so I don't know if you'd get a net
| benefit from a bag of teriyaki beef jerky say.
| azinman2 wrote:
| This is also an extremely rare vision problem. So absolute
| numbers are very tiny. The absolute numbers for diabetes,
| weight related problems, etc far dwarf this.
| robbomacrae wrote:
| Right. On the whole I think these things are incredible..
| looking to try myself after reading here in HN the other
| day about it working for all sorts of distractions. Just
| wanted to point out it's not all sunshine and rainbows
| which would certainly be suspicious.
| azinman2 wrote:
| Literally too much water or aspirin can kill you. Some
| people are allergic to avocados. Driving kills huge
| numbers of people daily. Everything is about risk/reward,
| and looking at the macro picture. And right now the
| comorbidities for obesity are terrible in huge absolute
| numbers... something that GLP-1's can take down in
| significant magnitude. Unless we learn that the majority
| of users end up with something worse than obesity,
| they're a huge win for public health.
| asmor wrote:
| A large drop in HbA1c does cause early worsening of diabetic
| retinopathy. Regardless of how it's achieved. So expect some
| noise in generalized data.
|
| Personally, I went from mild background retinopathy to PDR
| and getting laser treatment in about 3 months. My
| ophthalmologist (who has an academic background) didn't
| really know if this diagnosis had the same "quality" of
| someone who "naturally" progresses to PDR, but some studies
| say it's transient.
| projektfu wrote:
| It's a little suspicious... 68x risk with semaglutide, no
| significant risk with tirzepatide. Case-control studies that
| merely search these databases are only really useful for
| hypothesis generation.
| bpodgursky wrote:
| GLP-1s are just showing what people always knew to be true but
| was not clinically actionable -- most of our health problems
| come from eating too much and being fat.
|
| Well, now it's actionable. No magic, just adherence.
| degamad wrote:
| We don't quite have the data to say "most" yet, but it's
| certainly looking like "many" is justifiable.
| infecto wrote:
| I don't know. Having listened to a number of interviews with
| some of the founders in this area of drug research I came away
| with a much higher respect and significantly less cynicism
| toward big pharmaceutical. Novo Nordisk is run by a nonprofit
| even.
| gwbas1c wrote:
| Some people stop using it due to personality changes.
| matthewdgreen wrote:
| Say more?
| ilikecakeandpie wrote:
| Yeah I stopped because I didn't like the way it made me feel.
| I needed it because my blood sugar was way too high and it
| helped me drop close to 60 pounds in 6-8 months, but I did
| not like how it made me feel and I lost more muscle than I
| was happy with.
|
| I've gained about 15-20 pounds back, but I'm now much
| healthier overall.
|
| I like how my brain works and I didn't like something
| affecting or changing that because I couldn't put the fork
| down. Easy decision for me
| AndrewDucker wrote:
| I'd be interested to know how it changed you.
| CoastalCoder wrote:
| Is it possible that some of that personality change was
| because you were running a calorie deficit?
|
| I'm not dismissing your overall point. I minimize my use of
| Adderall for that very reason.
| helicalmix wrote:
| I think it's totally fair to be skeptical, but it's also not
| rare to have interventions that are astoundingly effective.
|
| Antibiotics and vaccines may not be completely free lunches,
| but they're very good at what they do.
| piker wrote:
| The fact is though that but-for taking the drugs a lot of the
| folks that take these things would be long dead before, say,
| the GLP-1 induced cancer kicked in.
| ecshafer wrote:
| GLP-1s have been peescribed for like 20 years, but have been
| limited more to diabetics and extreme cases. So there is pretty
| good data. Not to say there isnt going to be side effects in
| some population sample, but we need to compare that with
| obesity and diabetes (which is a very bad disease).
| Cthulhu_ wrote:
| But also do long-term studies; one thing I gathered
| (anecdotal through the internet so take it with a grain of
| salt) is that people revert to their old habits when they
| stop taking it. Not always, of course, and I think using it
| should always be done with guidance of a dietician etc to
| make lifestyle adjustments if needs be, but it did imply that
| long term usage is a factor that needs to be considered.
| hollerith wrote:
| SSRIs have been prescribed for 37 years, and society is just
| starting to understand that under current prescribing
| protocols, they do more harm than good.
|
| Also, isn't the dose used to treat obesity 3 times higher
| than the dose used over those 20 years to treat diabetes?
| OptionOfT wrote:
| Even with an increased risk of mortality, at least right now I
| can live. The voice in my head that is constantly telling me
| I'm hungry is quiet.
|
| Without it I'd die sooner anyway.
| stavros wrote:
| It's not even "I'm hungry", it's just "must have more food".
| What a nuisance.
| rootusrootus wrote:
| Exactly. Food noise is a terrible nuisance. "Go eat." "Umm,
| I don't feel hungry." "Doesn't matter, eat anyway."
|
| Having that on a repeat loop is no fun. Getting rid of it
| is worth all of the mild side effects and cost.
| stavros wrote:
| 100% agreed. It would be nice if I lost some weight, but
| just not having the food noise is worth it.
| radial_symmetry wrote:
| Most medications have negative side effects because otherwise
| our bodies would already have whatever changes they make
| through evolution. My personal theory (based on nothing but my
| own intuition) is that GLP-1s are an adaptation to the modern
| world that evolution hasn't caught up with yet.
| ammon wrote:
| And we know what the adaptation is: calorie constraint. We
| evolved in a calorie constrained environment. We don't live
| in one now. Our set point for desire to eat is clearly too
| high. None of this means that glp-1 inhibitors don't have
| other side effects, of course.
| lm28469 wrote:
| > Most medications have negative side effects because
| otherwise our bodies would already have whatever changes they
| make through evolution.
|
| That's not what evolution is, at all
| dillydogg wrote:
| This sounds like the argument during the pandemic, "If
| masks work, then why didn't we evolve permanent masks?
| Checkmate atheists." Though I do understand the impulse
| that evolution is working towards some unknowable
| perfection because of how I was taught evolution during
| high school, that is, of course, not how it works.
| viking123 wrote:
| lol
| gedy wrote:
| At this point I view the risks/downsides as akin to vaccines.
| Sure things happen, the overwhelming positives greatly outweigh
| this.
| unsupp0rted wrote:
| Not everything has another shoe to drop.
|
| Getting people to eat more broccoli is almost entirely upside.
| Sure a handful of people will be allergic or whatever, but on a
| population level some interventions are just one positive after
| another, and there's no reason it has to be a deal made with
| the devil.
| cerved wrote:
| Well glp1 doesn't make you want to eat broccoli. Just less in
| general
| daedrdev wrote:
| sure but it definitely makes carbs specifically disgusting
| in my case
| stavros wrote:
| I can confirm that. On GLP-1s (when they worked for me,
| anyway), I'd routinely think "pizza? Bleh, so fatty, I'd
| really like some chicken breast with roast potatoes
| instead right now".
| dfc wrote:
| You can confirm that GLP1s make "carbs specifically
| disgusting" and an example of this reaction is that you
| would have a desire to eat potatoes?
| stavros wrote:
| Oh no, you have torn through the flaws in my argument
| like bullets through paper, however will I live this
| down? Unless I clearly meant "it makes previously-
| desirable food undesirable", anyway.
| dfc wrote:
| I was not trying to tear your argument down. The comment
| you replied to was about carbs being specifically
| disgusting and in my head potatoes are the runner up to
| bread for classic examples of carbs. I was simply asking
| about what seemed like a contradiction. I have been
| looking into GLP1s and have not seen/heard people mention
| that GLP1 make carbs gross.
| stavros wrote:
| I think it varies per person. For me, it didn't
| specifically make carbs gross, but it did make unhealthy
| food less palatable. I think that's what the GP was
| talking about as well, they were just a bit more
| specific.
|
| It really depends on the person, though. They worked for
| me for a while and don't work now, but I'm a small
| minority, from what I've heard from people. When they
| worked, they were great.
| rootusrootus wrote:
| Actually there is a very real effect on which foods you
| find appealing and which ones are kind of gross. It's a
| thing the food companies have been studying, and their own
| studies show that people on GLP1s tend to skip the junk
| food aisle and head towards the produce section instead.
| 01100011 wrote:
| Oddly enough semaglutide is making me crave sugar more.
| It might be the frequent sensation of having low blood
| sugar. Idk.
|
| It does make me choose more dense meals though since I
| know I can't eat that much due to delayed gastric
| emptying. But I have to budget some room for prunes to
| counteract the constipation. It definitely makes you
| think about what you eat.
| skissane wrote:
| Tirzepatide somehow gave me a craving for apples. I used
| to occasionally eat them, now I eat them every day.
| CalRobert wrote:
| I do get a bit gassy if I binge on broccoli...
| jesse_dot_id wrote:
| Same. I think that pharmaceutical industry is lot more bleak
| now than it was when Fen-Phen became popular. GLP-1 usage is
| largely off-label as far as I know, but I wouldn't trust them
| even if it wasn't. There is a mountain of precedent for these
| companies to choose profit over health, and for our
| government(s) to aid them in covering up evidence of negative
| effects on the latter for the sake of the former.
| topato wrote:
| The popularity of these drugs is specifically from the FDA-
| approved "weight loss" indication. You're at least a few
| years behind. I would also think the many many years when it
| was only prescribed for diabetes would have yielded some data
| about negative effects, (other than the ocular issue) if
| there were any. Glp-1s were so unprofitable, Novo Nordisk let
| their Canadian patent lapse almost a decade ago, rather than
| pay the upkeep fee lol. So I dont think anyone is protecting
| them from bad press.
| CyanLite2 wrote:
| Its not upside per se, more like avoiding the downsides of
| diabetes and obesity.
|
| Healthy, non-obese individuals likely aren't seeing these
| "benefits"... But I'm not a doctor, I just pretend to be one on
| the Internet.
| dillydogg wrote:
| This isn't true, the heart and kidney benefits appear
| independent of weight loss. I would encourage you to let the
| physicians speak to these effects instead of making educated
| conjecture; it is tough to keep ahead of all of the claims
| about these medications with my patients.
|
| https://www.science.org/doi/10.1126/science.adn4128
| toomuchtodo wrote:
| Many Americans drive a car every day, even though ~40k people a
| year die in car accidents. Why? Because the benefits outweigh
| the risk.
|
| (my partner is on a GLP-1, and lost ~25 lbs in 3 months)
| culi wrote:
| > Why? Because the benefits outweigh the risk
|
| Many of us wish we didn't have to drive a car. Many of us
| also wish we didn't live in a world where hyperprocessed
| foods weren't the norm
| toomuchtodo wrote:
| Agreed, but we must operate and decision in the world we
| live in, not the world we wish we lived in.
| thefz wrote:
| > Many Americans drive a car every da
|
| Coincidentally also a factor of why many Americans take GLP-1
| frugs
| chrisco255 wrote:
| Not really, Americans have been driving cars for over 100
| years but the obesity epidemic cropped up in the last 30
| years.
| atherton94027 wrote:
| Per-capita volume of miles traveled went up by 5x since
| 1950: https://enotrans.org/article/americans-
| drove-1-0-percent-mor...
| WithinReason wrote:
| It's still a factor
| kshahkshah wrote:
| I'm a huge proponent of GLP's, but with respect to cars I
| would say that the privatized incentives outweigh the risk to
| the public
| JumpCrisscross wrote:
| > _I 'm waiting for the other shoe to drop when it comes to
| GLP-1s_
|
| We know there are downsides. They're just irrelevant compared
| to being obese. (Or alcoholic. Or, potentially, overweight.)
|
| It might be a vitamin, where there literally aren't any
| downsides. I'm sceptical of that. But to the degree there is
| mass cognitive bias in respect of GLP-1s, it's against them. (I
| suspect these are sour grapes due to the drugs being
| unreachable for many.)
|
| My frank concern is we're separating into a social media
| addicted, unvaccinated and obese population on one hand and a
| wealthy, insured, disease free and fit one on the other. Those
| are dangerous class and physical divides to risk becoming
| heritable (socially, not genetically).
| zemvpferreira wrote:
| GLP-1's should make you less concerned in that case, they're
| poised to become extremely affordable very soon. Ending the
| obesity epidemic will do more to bridge the class divide than
| anything I can practically imagine. Not to mention the other
| compulsions these drugs help moderate - alcohol, tobacco,
| gambling etc. It's my best hope for worldwide quality of life
| improvement in the next 10 years.
| JumpCrisscross wrote:
| > _Ending the obesity epidemic will do more to bridge the
| class divide_
|
| My hope is the "waiting for the other shoe to drop" folks
| are just expressing sour grapes.
|
| If it runs deeper and merges with the anti-vaxers, we've
| got a behavioural problem fuelling a class divide. _That_
| is my fear.
| phil21 wrote:
| I've thought about this a decent amount.
|
| My opinion has shifted over the years. At first I also
| thought it was largely just sour grapes re: accessibility
| and fear of the unknown, but now I'm thinking that a
| large number of people are going to be so far deep into
| anti-GLP opinions and hot takes they can't backtrack out
| of it. Much like political or social beliefs you make
| into your identity. Too embarrassing to admit you might
| be wrong.
|
| I know you're alluding to the same thing, it's just
| interesting to me someone else in the world seems to
| share these thoughts. I also think it may really
| delineate a multi-generational class divide that is hard
| to break.
|
| Or all the folks on GLP-1s will develop some rare form of
| cancer and die early leaving the world to the so-called
| haters.
| DharmaPolice wrote:
| I'm sure there will be negative side effects but the main
| outcome of these drugs is that you eat less. Many of us have
| trained ourselves to eat at a frequency and volume way beyond
| what is really required to keep our body functioning. This
| leads to weight gain in most people and thus is the focus but
| even independent of weight there are effects of continuously
| eating poor quality foods which are unlikely to be good. So I'm
| not surprised that there are all these miraculous sounding
| positive side effects to drugs which prevent most people from
| putting their metabolic system under near constant load.
|
| When the side effects are better understood I suspect for the
| average person, eating less would be a net benefit to their
| overall health - _even if they don't lose any weight_.
| coffeebeqn wrote:
| I'm sure some negative effects will be found but from what I
| understand lowering your weight outweighs (no pun intended) a
| lot of possible side effects. Closest thing to a miracle cure
| and quality of life improvement
| 45764986 wrote:
| These drugs have been around for more than 10 years. If there
| were significant downsides, we probably would have seen them
| already.
| bossyTeacher wrote:
| Given all the potential money, if they are issues, I expect it
| to go down like tobacco companies back in the days actively
| suppressing undesirable research by harassing researchers,
| influencing peer review journals or/and funding research
| casting doubt on the benefits of this drug. Chances are that
| any negative effects won't be obvious until it's too late. Look
| at microplastics, they have been around for just over a century
| and it's only now that we are starting to realize that they
| have several negative effects.
| CoastalCoder wrote:
| I agree. I think it's _unlikely_ that negative effects can go
| unnoticed for very long, but in the short term I 'm only like
| 97% sure we're getting the full story.
|
| That said, it's probably certain enough for me to be open
| enough to using them now, if my doctor recommends it.
| xtracto wrote:
| Several members of my family are into glp-1 both for glucose
| control and for weight loss. Taking different brands (wegovy,
| ozempic and others.) They all mention.th terrible secondary
| effects when you eat something "forbidden" (tacos, cake or
| icecream e.g.) . Also It causes constipation
| apparently, which for most of them is not that much of an
| issue, but given that I've IBS-C, I'm happy to not have to take
| it.
| tssva wrote:
| I take a glp-1 and suffer no ill effects when I eat something
| "forbidden".
| icebergonfire wrote:
| More anecdata, my spouse and I have been on Mounjaro since
| Jan 2025 guided by private health insurance.
|
| I have suffered almost the entire gamut of side effects
| from the beginning until I tried split dosing twice a week,
| and even then there's still the occasional instance of me
| learning that I should not have eaten _that_ and the
| following 9 hours are going to revolve around stomach pain.
|
| My partner's journey on the other hand has been smooth
| sailing the entire time.
|
| YMMV, do your own research but definitely double check any
| search results with your doctor first... lots of urban
| myths going around.
|
| I do recommend it though, I am the healthiest I've been in
| literally 10 years.
| CoastalCoder wrote:
| I'm surprised that tacos are a big deal. I'd have thought
| that the filling (meat, cheese, veggies, maybe beans) would
| mostly outweigh the carbs from the shell.
| m463 wrote:
| I wonder if you could ask: are there downsides to losing
| weight?
| MangoToupe wrote:
| Hey some of us struggle to eat enough and/or remember to eat
| in the first place
| PeaceTed wrote:
| I am sort of in your boat in seeing what may come. There are a
| few very rare conditions but the benefits seem to out weigh
| (ha, I will take the pun!) The down sides.
|
| While it might mean the incident rare of some things goes up,
| those that it reduces are far more impactful and where far more
| likely to have mortality issues. Sort of like how Chemotherapy
| is poisonous but potential has better long term odds, only
| chemo is far more extreme than GPL1.
|
| Time will tell but so far it is looking kind of good with a few
| lesser issues.
| CoastalCoder wrote:
| > chemo is far more extreme than GPL1.
|
| Which is ironic because someone at Microsoft once called the
| GPL "cancer".
| thefz wrote:
| > Maybe I'm just an aging cynic, but I'm waiting for the other
| shoe to drop when it comes to GLP-1s. There have been so many
| claims of positive benefits that it almost seems too good to be
| true.
|
| Well, read up the testimony of those who stopped taking it for
| adverse effects, such as nonexistent intestinal transit and
| -yuck- sulfur burps.
| 01100011 wrote:
| I was in that boat too but with NAFLD and now liver fibrosis
| despite not eating all that much sugar and having a BMI that is
| high but partially due to muscle I finally gave in to see if
| semaglutide will help.
|
| Only on week 3 but it's been a rollercoaster. It seems to have
| quite a broad spectrum of effects. I'm still not sure I'll be
| able to stay on it but losing 10 pounds is a nice counterpoint
| to the side-effects.
| mannanj wrote:
| Right. This is what we heard about the COVID therapies. And we
| all know how that turned out to be little more effective than
| placebo for healthy non-comorbid people.
| glp1guide wrote:
| Basically, the gastro-intestinal side effects are the biggest
| issue, along with CVS (not the store) and possibly eye
| problems.
|
| That said, the negative side effects look to be incredibly rare
| and manageable (including via stopping treatment) -- and the
| positives are quite tremendous.
|
| It's not a magic drug, but it is the first of it's kind with
| such a skew to the positive on side effects.
| brazukadev wrote:
| > It's not a magic drug
|
| It actually is a magic drug. The same way ultra-palatable
| food is also not natural.
| Der_Einzige wrote:
| This kind of "it's too good so it must be bad" thinking is a
| cancer in our species.
| hollerith wrote:
| I agree. A better response is, "maybe GLP-1 drugs are really
| great or maybe the drug companies, which spend most of their
| time and money trying to manipulate opinion (i.e., by bribing
| researchers and clinicians, which is not illegal) are at it
| again."
| agentifysh wrote:
| is there an extract or can you get it from natural food? which
| have it ?
| phantasmish wrote:
| GLP-1 agonists? Well they derived them from a lizard, so, uh...
| sort of? But no, no foods you eat are really going to have
| GLP-1 agonists in them, not to any meaningful degree anyway.
| Plus if you're eating them they have to survive at least part
| of the digestive tract, which means you need even more since
| some of it'll be lost.
|
| Your body produces GLP-1, but it lives in the blood for like
| minutes. The innovation was finding a chemical that tickles the
| same receptors but survives in the body for days at a time.
| cstrahan wrote:
| There may be some herbal supplements that impact GLP-1 release
| to some extent, but what is being talked about here are
| synthetic GLP-1 receptor agonists.
| mrtesthah wrote:
| https://www.sciencedirect.com/science/article/pii/S221112471...
|
| L-tryptophan > Indole > Raises GLP-1
| fleetwood wrote:
| Resistant starch
| https://pmc.ncbi.nlm.nih.gov/articles/PMC10085630/
| https://pmc.ncbi.nlm.nih.gov/articles/PMC4030412/
| ck2 wrote:
| no GLP-1 generics until 2030
|
| lots of people will miss out on benefits, like oh preventing
| death
|
| our drug system is weird
| exabrial wrote:
| Private people invested a lot of money to develop this and get
| it through testing. Allowing them to reap the benefits from
| their investment for a limited time is just fine.
|
| It's not people couldn't also: Diet, exercise, choose veggies,
| eat more fiber, etc
| isoprophlex wrote:
| "Sorry bro gonna let you die because, muh investments, you
| see"
|
| Your closing remark is overly simplistic and offers a
| contradiction: if those things would work for these obese
| people, they wouldn't need GLPs.
| exabrial wrote:
| The laws of thermodynamics apply to everyone equally.
| asdff wrote:
| Where in thermodynamic principles does it suggest money
| ought to flow into the pockets of the few?
| phantasmish wrote:
| The standard for medical interventions usually isn't
| "could it work?" or "should it work?" but "does it work?"
|
| This is why the efficacy of every single contraceptive
| method isn't way higher than it is. Lots of them _should_
| work almost perfectly... but the harder they are to use
| correctly, the less effective they in-fact are.
| exabrial wrote:
| Eating less, exercising more, has worked for the entire
| existence of human race. In fact, it worked for me just
| fine too. GLP-1s are a safe and proven tool and should be
| used wherever appropriate to assist people. Both of these
| are simple facts that aren't in contradiction with either
| other.
|
| But saying the patent owners shouldn't be allowed to reap
| the benefits of their investment is ridiculous,
| especially when it's completely possible to lose weight
| in other ways. 6 years isn't that long to wait anyway.
| ck2 wrote:
| just want to point out it's not just for obesity
|
| GLP-1 has been demonstrated to even cure some types of
| long-covid in some people in some cases
|
| and various other diseases
|
| but it's priced way out of reach even for micro-doses until
| it becomes generic
|
| so all those cases suffer until 2030, if they make it that
| far, five years is a long time
| asdff wrote:
| The public also invested a lot of money.
| cess11 wrote:
| Kind of weird to assume other people think it's fine to
| exchange human lives for money.
|
| Is it ethical for me to pay someone to murder you? Does it
| matter if it costs me a large amount of money or not?
| exabrial wrote:
| This is a great example of a straw-man attack.
| cess11 wrote:
| No, it is not. They said that since someone, which is
| typically a fictive person, had spent a lot of money,
| they deserve to restrict physical persons' access to
| supposedly life saving substances.
|
| I would like to know how far they take that position.
| WillPostForFood wrote:
| How many people do you feel liek you are personally
| responsible for killing because you haven't given 100% of
| your disposal income to food relief? Hundreds? Thousands?
| CobrastanJorji wrote:
| This isn't "I could use my money to acquire food for the
| poor." It's "I'm going to prevent anyone else from
| selling food, and that will let me charge 100x as much
| for food."
| ashdksnndck wrote:
| Why do we pay doctors? Are they evil if they refuse to go
| to work for free?
| k_roy wrote:
| Protecting it before generic is fine, but the pricing doesn't
| make sense.
|
| If it's $1000 per month cost per person when it's the name
| brand, how many people are on it? At this point just the
| diabetics and people with really good insurance?
|
| Wouldn't they make a hell of a lot more money selling it for
| $100 during their protected period to 1000x the people.
| kube-system wrote:
| They have direct discount programs where they sell at ~
| half price.
| pretzellogician wrote:
| True, but also still absurdly high. Novo Nordisk and Eli
| Lilly cost roughly $500 monthly... but the price is
| almost the same regardless of the dosage (from say 0.5mg
| to 2.4mg).
| MangoToupe wrote:
| > Allowing them to reap the benefits from their investment
| for a limited time is just fine.
|
| Or we could just move to a sane economic system where we
| don't have to beg the rich/reward people for having money
| km144 wrote:
| Those things also require more willpower than taking a
| medication. Willpower is generally determined by your
| particular psychology which is determined by genetics and
| environmental factors. People don't have a choice in the
| matter as much as your comment seems to imply. Getting GLP-1s
| to everyone who could benefit from them is extremely
| important for overall health.
| mrtesthah wrote:
| In theory you could supplement with L-tryptophan which is
| metabolized into indole which then raises GLP-1 production
| within enteroendocrine cells.
|
| https://www.sciencedirect.com/science/article/pii/S221112471...
| matthewdgreen wrote:
| Or anything that boosts Akkermanskia.
| Bender wrote:
| I use that to help me stay asleep. I also feed large amounts
| of it to horses and deer before, during and after 4th of July
| since everyone here launches mortars from their fields. Helps
| them chill.
| degamad wrote:
| It's not obvious that there is a benefit here - the third
| sentence of the summary at the top says:
|
| > Indole increased GLP-1 release during short exposures, but
| it reduced secretion over longer periods.
| kube-system wrote:
| Compounded GLP-1s are still floating around in the US
| ck2 wrote:
| if you saw the 60 Minutes on compounding pharmacies, which
| are completely unregulated and never inspected, and sometimes
| contaminate products out of lack of care/repercussions
|
| you'd never touch a compounded pharmacy product ever again
|
| people have died from contamination
| kube-system wrote:
| Compounding pharmacies are regulated by section 503 of the
| FD&C act, and also subject to inspection.
|
| Are you referring to the fact that the FDA does not inspect
| all facilities because they have limited resources? This
| applies to pharmaceutical companies as much as it does to
| compounders. If you think the FDA posts inspectors at every
| pharmaceutical company in India, you'd be wrong.
| ACCount37 wrote:
| People are straight up buying black market "research use
| only, not to be used in humans" GLP-1. Compounding
| pharmacies are reliable, safe and well regulated compared
| to that.
|
| Clearly, there's an entire spectrum of tradeoffs between
| safety/shadiness, availability and price. I think that's a
| good thing.
| kshahkshah wrote:
| I compound tirz with glycine and B12. I honestly think these
| are miracle drugs.
|
| I've never been extremely overweight but I hit a point where
| I had 30 pounds to lose, despite my height, and I can't deal
| with the hunger amidst all my other life stresses.
| pretzellogician wrote:
| There are already GLP-1 generics available like liraglutide;
| they're just not as effective as the newer ones.
|
| (This refers to the U.S. Some other countries have more
| generics available.)
| glp1guide wrote:
| Like others have mentioned, liraglutide already exists as a
| generic! It's not as good as Semaglutide or Tirzepatide, but.
|
| Also, a lot of people are still getting compounded GLP1, to the
| chagrin of Eli Lilly and Novo Nordisk.
|
| Separately, 2026 is about to completely change the pricing of
| this stuff, not even taking into account the Trump
| administration's recent efforts. The price of injected GLP1 is
| going to implode due to patents lapsing in Canada and other
| places -- and for the pill forms that come out soon it looks
| like the Trump administration is keen on keeping prices for
| that low as well.
| jl6 wrote:
| > However, the study authors emphasize that more research is
| needed to confirm these mechanisms and determine whether the
| survival benefit observed in this real-world analysis represents
| a direct anti-cancer effect or an indirect result of improved
| metabolic health
|
| Given it's an observational study, I would bet on the latter.
| It's really hard to know you've controlled for all confounding
| factors, and there's a strong null hypothesis because we know
| that losing weight can have huge and wide-ranging health
| benefits.
| stavros wrote:
| Yeah, most GLP-1 benefits (or even adverse effects, like muscle
| loss) seem to be caused by the weight loss. We already knew
| obesity massively increases risk from a host of diseases, but
| GLP-1s are still treated with scepticism of the "oh but what
| about the side-effects we don't know about?!" variety?
| ed wrote:
| Source?
|
| There's growing evidence of cardioprotective effects
| independent of weight loss.
|
| Eg https://www.thelancet.com/journals/lancet/article/PIIS0140
| -6...
|
| > The cardioprotective effects of semaglutide were
| independent of baseline adiposity and weight loss and had
| only a small association with waist circumference, suggesting
| some mechanisms for benefit beyond adiposity reduction.
| rickydroll wrote:
| They also help with slowing the progression of CKD
|
| https://www.kidneyfund.org/treatments/medicines-kidney-
| disea...
| anovikov wrote:
| Someone has to start a study where they give GLP-1 to skinny
| people and see what happens. Why it hasn't been done yet?
| stavros wrote:
| Because they lose weight and it's too dangerous.
| anovikov wrote:
| They won't, GLP-1 has almost no direct effect on skinny
| people. Many women with BMI around 22-23 are trying them
| to lose weight to match beauty standards and usually end
| up disappointed, not able to drop more than 1-2 kilos.
| cyrusradfar wrote:
| Agreed.
|
| I'm a big fan of intermittent and water fasting. Have seen
| things in my blood work that doctors would require me on meds
| to reverse. Outside of that, I can't speak to the positive
| impacts on my mood, and general ability to focus.
|
| The simplest solution to a lot of problems is consuming less
| with the assumption that, most of us (maybe not you), have a
| lot of spare energy sitting around.
|
| A lie that we don't unlearn as we grow up is we "require" three
| meals a day. This is true for children who need obscene amounts
| of energy to grow, but, not for us desk-bound adults.
|
| In the end, giving the body a break to heal by fasting or just
| consuming significantly less is going to leave more resources
| for the body energy to deal with other things.
| trallnag wrote:
| Awesome insight. It's not the disability I have, it's that I
| have never tried healing by fasting. Of course. Because my
| body was always busy trying to eat food instead of fixing and
| regrowing all the malformed tissue. Because that's how it
| works. When a person without legs starts to fast, the legs
| will suddenly develop.
| amenhotep wrote:
| It would be sensible for you to examine and interrogate why
| reading a general and fairly anodyne opinion about what
| might be a solution to a problem some people have led you
| to interpret it as a prescriptive and judgemental
| suggestion about the specific problem you specifically
| have.
| cyrusradfar wrote:
| Appreciate the thoughtful retort. Have a good one.
| trallnag wrote:
| In my mind it is a slippery slope that leads to a sickly
| Steve Jobs eating kilograms of raw carrots.
|
| Obviously a healthy lifestyle is good. And this includes
| not eating over your requirements. But sometimes there is
| actually something wrong. And in these cases, first
| trying out to just eat healthy can worsen the situation
| by delaying proper treatment. And proper treatment does
| equal a bunch of pharmaceutical drugs.
| mock-possum wrote:
| I disagree, I think it's fairly easy to read this passage
| in particular
|
| > The simplest solution to a lot of problems is consuming
| less with the assumption that, most of us (maybe not
| you), have a lot of spare energy sitting around.
|
| as energy-woo / thanks-I'm-cured material.
|
| You can weasel your way around criticism by calling it "a
| general and fairly anodyne opinion about what might be a
| solution to a problem some people have," but consider -
|
| It does make sense that someone who's struggled with a
| chronic condition would be tired and embittered by the
| endless snake oil evangelizing they've had to endure, _on
| top of_ already struggling with their health.
|
| (Not that fasting doesn't work for some people, as you
| say! it's more the grandiose claim that it's "The
| simplest solution to a lot of problems" coupled with some
| vague anecdote about blood work and knowing better than
| doctors that waves a red flag)
| itchyouch wrote:
| An interesting FYI is a comment made by Peter Attia on his
| podcast.
|
| He had a patient with metabolic markers that were not
| improving and they had exhausted all the typical avenues.
| Presumably they were things like weight loss.
|
| They put the patient on GLP-1 but injected into the thighs
| (or butt, I don't recall) for the metabolic benefits without
| the hunger blunting effects.
|
| It seems like GLP1, even in skinny patients (implied by Attia
| in this particular case), has metabolic benefits.
|
| The longevity community seems to be hinting that there may be
| geroprotective aspects of GLp1 as well, so we may be looking
| at the benefits beyond weight loss for metabolism.
| asmor wrote:
| (Outer) Thigh, upper arms and stomach are the on-label
| injection sites for these drugs.
| ifwinterco wrote:
| It shouldn't make any difference where you pin it, it's
| systemic it just has to be administered subcutaneously
| because it's a peptide and it isn't orally active.
|
| Don't listen to these YouTubers about health and fitness,
| most of them are clueless
| avgDev wrote:
| Pseudoscience scares me. There are so many people that
| believe this nonsense and basic understanding of medicine
| disproves many of those claims.
| op00to wrote:
| It shouldn't, and yet for me it seems to make a
| difference! I don't think it's placebo, because I am
| really losing weight. My anecdata: When I start with a
| particular dose of GLP-1, I inject in thigh. I get strong
| appetite suppression, heart rate increase, digestion slow
| down etc. After some time, the effect decreases as my
| body adjusts. I then move injection to abdomen, and I get
| a huge bump in suppression, systemic effects, etc. No
| idea why this happens, but I've seen it with Zepbound and
| 5, 7.5, and 10mg. It's allowed me to stay on each dose
| for far longer than my doctor expected.
| itchyouch wrote:
| There were no recommendations.
|
| Usually this type of anecdata becomes the basis of
| legitimate, controlled studies and over time can inform
| and/or adjust.
|
| It would be premature to simply write off all influencers
| or limiting to only accept the medical profession as the
| immutable truth.
|
| The reality tends to exist somewhere in the middle,
| outside of a formal proof.
|
| I've listened to many health influencers and among the
| legitimate and balanced tend to be Rhonda Patrick and
| Peter Attia.
|
| Attia provides guidelines for how to think about items,
| but usually it's the fan base that tends to sully the
| messaging as the base tends to be far more polarized and
| dogmatic over bits.
|
| It is interesting to see that there is another poster
| confirming a slightly different effect though. Regardless
| of things being "systemic", just understanding that
| fluids dynamics are complex, I imagine diffusion of a
| systemic molecule like GLp1 could possibly be variable?
| Or perhaps there is a localized tissue fatigue?
|
| Many potential options do exist to propose as hypothesis.
| itchyouch wrote:
| While the area under the curve for glp1 administration
| may be the same, good chance that the story is informing
| us of a mechanism such as the absorption rate between two
| different sites.
|
| Slower absorption in the thigh may blunt the immediate
| peak dosing and the acute hunger effects.
|
| As always, the small details matter. I'd guess that
| pharmacology also has their own thundering herd problem
| with the dosing of certain drugs.
|
| One of the interesting bits about pharmacology seems to
| not be the active molecule as much as the innovations in
| delivery mechanism.
| gavinray wrote:
| > They put the patient on GLP-1 but injected into the
| thighs (or butt, I don't recall) for the metabolic benefits
| without the hunger blunting effects.
|
| Thanks for the dumbest thing I've read all day
| l5870uoo9y wrote:
| There is no such thing as water fasting. I would characterize
| it as an eating disorder.
| cyrusradfar wrote:
| Umm.
|
| Sources? -
| https://en.wikipedia.org/wiki/Fasting -
| https://zerolongevity.com/blog/the-history-of-fasting/
| InMice wrote:
| Of course. That's why the nobel prize in medicine in 2016
| was awarded to a cell biolgoist studying cellular autophagy
| for over a decade. It must be why glucose is not an
| essential dietary macronutrient and our liver can
| synthesizie it endogenously from fats and proteins (it just
| felt like doing that one day and stored all those chemical
| pathways in our genes I guess). That must also be why
| ketones produced from our fat stores burn so cleanly with
| less reactive inflammatory byproducts. In fact the cells in
| our brain actually prefer ketones to glucose. There's no
| such as water fasting. It's just random chance that when
| the body is in a state of ketosis it suppresses ghrelen and
| other hunger hormones or that countless other chemical
| pathways (de)activate or change. That's right the body has
| absolutely no design or adaptation for scarcity of food.
| Water fasting is totally foreign to the human body, that's
| why whenever we study ancient cultures...we find they
| practiced purposeful fasting. There's just no such thing as
| water fasting, it must be a modern eating disorder.
|
| There's no chance it has anything to do with the last few
| million years of our evolution. It has no benefit or
| relevance now.
| l5870uoo9y wrote:
| Took "water fasting" to mean fasting even without water,
| apparently it is the opposite.
| InMice wrote:
| LOL total misunderstanding then. No problem.
| Cthulhu_ wrote:
| I for one don't "require" three meals a day, but I'm hungry
| in the morning, ergo, I like breakfast.
|
| It's not so much about how often you eat but what and how
| much. Generally speaking, of course, I can't speak for any
| benefits of intermittent fasting (assuming equal daily
| calorie / macronutrient intake) because I'm uneducated in
| that regard. But TL;DR, I will agree that desk jockeys will
| need less calories than people with a more active job or
| lifestyle, and people need to adjust their lifestyle
| accordingly else they'll gain weight.
| foobarian wrote:
| Maybe this goes away after a while, but when I tried this
| in the past I get so hungry I can't think or work. So
| clearly it's a non-starter for me on work days.
| codr7 wrote:
| It takes time to get used to the feeling, to accept that
| it's not dangerous, quite the opposite.
|
| Also the body gets used to not being full all the time,
| it will stop signalling so hard.
|
| Try it in the weekends first? Once you start enjoying the
| feeling, and you will, it will happen by itself.
| codr7 wrote:
| Yeah, the problem with mornings is that it's probably the
| worst time of day to eat.
|
| Because the body flushes all stored up energy when you wake
| up, likely an evolutionary adaptation as breakfast was
| rarely served on a silver plate.
| InMice wrote:
| ALmost everyone who shares their positive, any length fasting
| experience here gets downvoted. I will always upvote them.
| Ive done two 48 hour fasts and they were so relaxing and felt
| so natural. It just feels great to occasionally go about your
| day and not eat anything. Your gut tries to heal itself in
| between meals. The fact that almost all of HN just cant stand
| anyone mention they fast with positive benefits (and mounting
| evidence) is kidna sad. I guess every community has to be
| exceptionally closed minded about something.
| lazyasciiart wrote:
| If you include as much meta-commentary every time, you're
| certainly going to get downvoted.
| codr7 wrote:
| Yeah, it's been a gradual process for me, feeling comfortable
| with being hungry.
|
| But the less I eat, the better my health gets; I'm down to
| one normal sized meal per day, have been doing that for
| months.
| p00dles wrote:
| Interesting that GLP-1s might have different effects on cancer
| _incidence_ vs. cancer _survival_.
|
| A different study "GLP-1 Receptor Agonists and the Risk of
| Thyroid Cancer" was published in the Diabates Care journal in
| February 2023*
|
| The conclusion of the 2023 study: "we found increased risk of
| all thyroid cancer and medullary thyroid cancer with use of
| GLP-1 RA, in particular after 1-3 years of treatment."
|
| I wonder what the mechanistic hypothesis could be for GLP-1s
| increasing thyroid cancer _incidence_ (the probability of
| thyroid cancer occurring in patients taking GLP-1s) but
| increasing colon cancer _survival_ (the probability of
| surviving in patients taking GLP-1s who have colon cancer).
|
| Of course there are numerous important differences across the
| studies (cancer type, France vs. USA data, etc.), I'm just
| curious about a why this might be the case.
|
| *https://diabetesjournals.org/care/article-
| abstract/46/2/384/...
| mr_luc wrote:
| I'd be cautious for the same reason: thyroid cancers are also
| positively associated with obesity, and people who take
| GLP-1s are often obese.
|
| Below a table, it says "adjusted for social deprivation
| index, hypo- and hyperthyroidism, and use of other
| antidiabetic drugs..." -- but nothing about obesity.
|
| What if the GLP-1-prescribed patients tended to be more
| obese?
| freetime2 wrote:
| The article also says that the effects persist after adjusting
| for BMI:
|
| > After adjusting for age, body mass index (BMI), disease
| severity and other health factors, GLP-1 users still showed
| significantly lower odds of death, suggesting a strong and
| independent protective effect.
|
| The observed reduction in mortality is also quite large:
|
| > Health sites, researchers found that those taking glucagon-
| like peptide-1 (GLP-1) medications were less than half as
| likely to die within five years compared to those who weren't
| on the drugs (15.5% vs. 37.1%).
|
| More research is needed, but if I were diagnosed with colon
| cancer I would definitely be asking my doctor about the risks
| vs. potential benefits of getting on GLP-1 meds based on this
| study alone.
| andy_ppp wrote:
| If you eat less your stomach/whole body gets time to relax and
| repair?
| pedalpete wrote:
| My understanding is that it slows the digestive process, so
| there isn't more "empty time to repair or relax".
|
| But my thinking there may be naive.
| andy_ppp wrote:
| I just know someone who skips breakfast and lunch on the
| jabs... maybe he eats dinner I've not checked.
| icebergonfire wrote:
| Anecdotally speaking I can confirm this... it gets easy to
| _just_ skip a meal, and you may end up skipping the entire
| day because the usual hunger signals are just not there.
|
| For anyone tempted by that concept, please don't and
| remember to try to eat your 1000-1500 calories every day.
|
| Quick weight loss won't do you any good if you lose all
| your muscle mass, or if you carve a deeper groove into body
| image issues.
|
| It's cliche but it's true, slow and steady is the way to
| go.
| glp1guide wrote:
| At this point most experts lean more heavily on the effect of
| GLP1s in the brain rather than delayed gastric emptying --
| it's more of a brain drug than anything else which is why it
| works so well.
| Noaidi wrote:
| I do not like the framing. GLP-1 drugs help people lose weight,
| and it is the weight loss that lowers death rates in colon
| cancer[1]. This is making it sound like the drug itself is
| reducing cancer.
|
| [1] https://link.springer.com/article/10.1007/s12672-025-03902-4
| surfsvammel wrote:
| I don't agree. They are not saying that.
|
| It's observational. They are saying they see correlation.
|
| Your suggested mechanism is plausible, and likely, of course,
| but that might only be part of the effect.
|
| I think it's still valuable findings and can help direct
| further studies.
| surfsvammel wrote:
| I am on GLP-1 (very low dose), and I've found that it seems to
| help me moderate my alcohol consumption as well. Maybe some thing
| like that could also be contributing to the effect.
| richwater wrote:
| Is there evidence for addiction tendencies in general? Or is it
| something specific to alcohol?
| surfsvammel wrote:
| I don't know! Think I've seen a headline somewhere, but can't
| remember where. Quick search should help you :)
|
| To me, it's anecdotal, of course, but I have same sense of
| being in control over alcohol intake as food intake.
|
| Basically makes it much easier for me to avoid binging.
| zemvpferreira wrote:
| I'm about to go to the cinema so I can't find you references,
| but there's a lot of anecdotal evidence at least of glp1's
| curbing all sorts of addictive behaviour. I personally
| started Mounjaro last week and my coffee cravings have gone
| way, way down for the first time in my adult life.
| SoftTalker wrote:
| I believe there is, I don't recall the source but have read
| that these drugs work by reducing cravings. So they have
| shown at least hints that they can work on any addictive
| behavior, not just overeating.
| toomuchtodo wrote:
| _A Brain Reward Circuit Inhibited By Next-Generation Weight
| Loss Drugs_ - https://www.biorxiv.org/content/10.1101/2024.12
| .12.628169v1.... | https://doi.org/10.1101/2024.12.12.628169
| - December 17rd, 2024
|
| _Glucagon-like peptide 1 agonist and effects on reward
| behaviour: A systematic review_ - https://www.sciencedirect.c
| om/science/article/pii/S003193842... |
| https://doi.org/10.1016/j.physbeh.2024.114622 - Physiology &
| Behavior Volume 283, 1 September 2024, 114622
|
| _GLP-1 for Addiction: the Medical Evidence for Opioid,
| Nicotine, and Alcohol Use Disorder_ -
| https://recursiveadaptation.com/p/the-growing-scientific-
| cas... - May 14th, 2024
|
| _The central GLP-1: implications for food and drug reward_ -
| https://www.frontiersin.org/journals/neuroscience/articles/1.
| .. | https://doi.org/10.3389/fnins.2013.00181 - Front.
| Neurosci., October 13th, 2013
| CobrastanJorji wrote:
| From my friends on GLP-1s, I'm pretty sure that it's mostly
| that it makes you really sick fairly quickly when you drink
| even in moderation.
| donsupreme wrote:
| I hypothesize that the appetite-suppressing effect of GLP-1
| agonists contributes to the normalization of dopamine signaling
| in the brain. By mitigating the exaggerated dopamine
| fluctuations seen in food and sugar addiction, GLP-1 may
| promote a return to dopamine homeostasis, thereby reducing
| compulsive or addiction-like reward-seeking behaviors.
| foobarian wrote:
| Wonder if it would help compulsive gamblers then.
| basisword wrote:
| I think that's already been shown (at the very least I've
| read news articles with anecdotes).
| fgimenez wrote:
| They have a lot of anecdotal, observational, and emerging RCT
| evidence on their effects on substance consumption and abuse.
|
| The biggest effect and best tested is on alcohol use disorder.
| Mechanistically we don't know if it's through some complex
| reward mechanism, or something simpler like "alcohol is a
| calorie and you consume fewer calories." The JAMA study showed
| that GLP-1 reduce Heavy Drinking Days (>2 drinks/day), but did
| not reduce overall drinking days. This would imply the simple
| mechanism -> it's hard to drink a lot of calories even if you
| do enjoy a drink.
|
| More anecdotal evidence showing this effect in opiates, but
| nothing in an RCT yet.
|
| So far, nothing has worked in stimulants. Cocaine and Meth
| abuse are insanely difficult to manage therapeutically right
| now.
| hexbin010 wrote:
| Same here. There's less wanting it but also, if I do indulge
| even one small glass of wine, the side effects are awful:
| broken sleep, acid reflux and a hangover the next day. It
| really slaps you in the face for indulging
| Cthulhu_ wrote:
| Harsher side-effects to drinking sounds like an effective
| deterrent (although you'd think people would quit after that
| one hangover they'll never forget). Works for me with candy,
| a lot of it gives me tooth pain. My teeth are otherwise
| healthy, no cavities or anything.
| aswegs8 wrote:
| Does the very low dose help with weight management?
| pretzellogician wrote:
| It depends on the person, but for some (including me) a low
| dose is enough.
|
| Conversely, for some (including me) a moderate dose has
| intolerable side effects.
| _1 wrote:
| Same. two drinks and I'm done
| basisword wrote:
| I am 100% a layman here so apologies if this is a stupid
| analysis. But I have read that fasting can improve odds and
| improve side effects during chemo. Would GLP-1 stabilising blood
| sugar be having the same effect?
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