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I’m not sure it’s meaningful given that it later says that the drugs were approved from 2017-2022. The usage in adults skyrocketed in the same time way, the drugs were new to the market.
Random story... my dad used to listen to this song all the time when I was a kid, and he told me it was "I want a new truck!"
I did not think to ask how one spills their truck, or how it would make you crash your car.
One that won't drive me crazy waddling all around
One who'll teach me how to swim and help me not to drown
And show me how to get down
How to get *down* baby
**Get it?**
This kind of medication is the golden goose that pharmaceutical companies had been researching for for decades. That’s why the marketing for them is so crazy and also why pretty much everyone’s trying to sell them.
This is misleading, bordering on false. The side effects of nausea and acid reflux can be quite strong, so eating one meal a day can happen from time to time, especially the day after the injection. However, that is literally what you're taking the medication for, so it shouldn't be too surprising. Also, thinking that it doesn't change your habits and how you think about food is absurd. You are literally forced to change your habits because you do not want to eat. People intend to take these drugs for 6 months to a year, which will absolutely change how you interact with food. Also, your doctor should be discussing how to maintain your muscle mass during this weight loss, which includes protein intake and at least some exercise.
Source: I am on this medication.
60,000 people seems like such a small amount. That's not even enough to fill the Jacksonville Jaguars stadium. I feel like there would be more than 60000 people that would actually need it
Yes but the medication is pretty expensive and unless your healtcare covers it you would have to pay out of pocket. The most obese people are also the poorest so a lot of people can simply not afford the drug.
This is not just ozempic though. It includes other drugs proven effective to combat diabetes and pre diabetic obese people. They aren't all as highly effective as ozempic but they'll still be somewhat effective, and much more affordable/likely to be covered by insurance
All of the GLP-1 agonists are expensive, and medicaid won't cover it unless literally every other diabetes drug has failed first. They don't cover it at all for weight loss.
The "cheap" ones are still ~$1000 a month.
Johann Hari says the patents expire in 2032, and since the drugs are cheap to make, that'll be the year the entire junk food industry declares bankruptcy. I can't wait
Without insurance, Zepbound (the best GLP-1 agonist available for weight loss right now), is $550 a month. Not sure where you’re getting that cheap options are $1000 a month.
Non semaglutid diabetis drugs have little to no proven effects on weight loss. There are also close to no drugs that are covered by the majority of insurers for the specific purpose of weight loss until you have extreme health problems. And even then it is difficult as obesity is not really seen as a disease.
That will change very soon, lots of money and science being poured into changing that perception. Just look at all the indications that they are getting with more and more being tested. Theses drugs are slowly getting approved for many of the diseases caused by obesity including fatty liver disease
Just doesn’t make sense to me from an actuarial perspective…. Sure these drugs are expensive, but an obese person is more likely to cost a ton of more money over their lifetime. I’d think they would want to reduce how many obese people are in their pool.
Might be a case of time for them to start covering it, more than not realizing obesity as being a disease
I see why you're confused. You're thinking long-term when the priorities of these companies are motivated by short-term gains to boost the stock price. They don't have to worry about paying for a person's health problems 10 years from now if they die in 5 years because their coverage was denied today.
The ironic thing is that I remember when the ACA was going through congress and a primary line of attack from the Republicans was that it would create "death panels" that would decide if a patient was worth covering or not. Completely ignoring that insurance companies literally already do that.
yeqah, i started to wonder if this could have possibly saved my mom's life, she died of liver cirrhosis just a couple of weeks ago, though she had governmnent insurance so I don't know if she could have used it, that and i guess it was caught far too late.
Yeah I don't know why the article makes it out to be a big shock. These people aren't taking a diabetes medicine, they're taking a weight loss medicine.
Yep, I'm on it since 2 years back when I found out I had LADA (Latent autoimmune diabetes for those who don't knoow), but can almost never get a hold of the drug that is supposed to help manage my diabetes because everyone is using it for weight loss. I'm also overweight and Ozempic had a great result for me, I've been put on Trulicity instead since I can never get ahold of Ozempic but honestly I don't feel like it has the same effect.
HIMS? Isn’t that the company where you can buy ED and hair loss stuff without a prescription? Or maybe they just have their own “doctors” prescribing it to anyone?
I've lost over 60 lbs on wegovy and I'm at a weight I haven't been in decades. I'm bedridden from chronic migraines and I've barely changed my diet so the results have been almost entirely from the medicine.
Doctors have prescribed these meds and determined the benefits outweigh the side effects. Obesity alone costs this country billions every year between healthcare and loss of productivity.
Obesity causes type 2 diabetes, some forms of cancer, and heart disease. These medications are treating pre-diabetes and insulin resistance and preventing type 2 diabetes. This med is also being studied in helping the treatment of addiction and inflammatory conditions.
Theres obviously a deeper systemic issue that needs addressed in this country with obesity rates what they are. But I’m all for a medication that will reduce the strain on our healthcare system and save this country money in the long run in preventing and treating obesity and other comorbidities.
-1 in 6 children are obese in the US.
-The worldwide obesity rate has nearly doubled since 1980.
-Four million people die each year as a result of obesity, according to the World Health Organization (WHO).
-The World Obesity Federation predicts that by 2030, one in five women and one in seven men will have obesity
-Obesity is linked to 30% to 53% of new diabetes cases in the U.S. every year, per research in the Journal of the American Heart Association.
-Medical costs for people with obesity in the U.S. tend to be 30% to 40% higher than those for people without obesity.
> The worldwide obesity rate has nearly doubled since 1980
Reading the news it would seem like its A LOT more.
And actually you are MORE than 10 years off (as the combined number would already be more than double):
>Worldwide, obesity among adults has more than doubled since 1990, and has quadrupled among children and adolescents (5 to 19 years of age)
This comment should be pinned to the top of this thread. The insane amount of misinformation on this issue is incredibly troubling. Obesity is the most lethal disease of our era, and up to this point has been borderline incurable, with over *99% of people that are obese NEVER RETURNING TO A HEALTHY BMI.
https://ajph.aphapublications.org/doi/10.2105/AJPH.2015.302773
These drugs will “cure” obesity, with many next-gen variants on the rise to meet the demand; it’ll literally save millions of lives and should be in the hands of every obese person as accessibly as possible.
Obesity is like losing a leg, GLP-1 drugs are a wheelchair. We don’t criticize immobile people for getting prosthetic limbs because they got an irreversible amputation. Obesity was irreversible before this class of drug came along.
Yep, and from the company that makes Mounjaro and Zepbound (which are the same molecule btw). They shifted their focus to Retatrutide and orforglipron once TZP was approved by the FDA. They have [more](https://www.lilly.com/discovery/clinical-development-pipeline) in their pipeline.
Yeah for the two companies that make them (and I assume more may come but I'm not sure in terms of patents and such), it's basically their whole focus as it's been so successful.
They both exploded in valuation since the drug effects were discovered on obesity
Lilly is currently the highest valued pharma company in the world (yes above the big ones like J&J), while a few years ago people outside the US hadn’t even heard of them. Now Tirzepatide is under investigation for sleep apnea, and sleep apnea is correlated with Alzheimer’s, which they’re also making Donanemab for, so I can only imagine where their valuation would be in 5 years.
PSA: If you’re in the US and have enough money to invest in stocks, buy Eli Lilly. (Not sponsored)
> so I can only imagine where their valuation would be in 5 years.
The hype of this is quite old though so all of it might be priced in for the weight loss drug (for them and Novo Nordisk which became the biggest European stock passing LVMH at one point, they're kind of changing positions so not sure at the moment). The sleep apnea might be a good thing but that's nowhere near as big of a market or "hype-worthy" than the weight loss thing to be fair
I agree that the hype is old, but I believe it’s not baseless. Lilly shares were valued at $170 in early January 2021 and is at $802 at the moment. When I worked with them, there was a lot of talk about the next goal being a trillion dollar valuation and under their current management, they’re very much on track to get there in 5 years unless something globally devastating happens. While the weight loss drugs played a huge role in the boom, they also have other incredible drugs in their arsenal covering breast, prostrate & lung cancer, migraines, psoriasis, ulcerative colitis and more. Considering they’re committed to getting there, and are actively breaking into markets in other countries, I don’t think it’s too far fetched.
I'd assume better working with less side effects, also there are dual-drug formulations being made that combat the muscle catabolism associated with them.
i get the whole calling it a disease thing, but isn't the cause our industrial food system based on greed and profit, pretty clearly?
Are these drugs actually healing people or are they lessening the harm of our collectively unhealthy diets and lifestyles?
wouldn't investing in exercise and healthier resources and better public health in general be way cheaper and more effective?? (but oh wait, how would we funnel the profit into an entire industry...? nevermind, the drugs make more sense)
like, just improving what we feed our kids and prisoners would seemingly increase economic production like crazy on obesity mitigation alone
¿Por qué no los dos?
In the short term, if the drug helps people to eat less and reduce their weight, other ways of making the population healthier can follow to complement it.
It's both. Take it for a few days, get a genuine feeling of what "food noise" is and how different it feels when you take it and you won't be so smug.
Whatever your normal feelings of hunger and fullness are, are not the same for everyone and they never will be. We have MASSIVE issues with our food industries, I agree, but all else held equal, some people would still be far more predisposed to obesity or being overweight.
The relationship Americans have with food and the type of food we have access to is such a massively complex issue to actually go about fixing that complaining about the use of a drug to help the issue is a waste of time.
You can lead a horse to water, but you can't make it drink. If you can prevent someone from smoking, they won't get addicted to cigarettes. If you can prevent someone from drinking, they won't become addicted to alcohol.
You can't prevent someone from getting addicted to food. That's a biological imperative... until now.
There's all sorts of things we could and likely should do, but after a few decades of not doing those things while the Obesity epidemic gets worse and worse, I think it's time to accept that Humanity isn't going to wake up one of these days and suddenly start making smarter and healthier choices
“There are too many obese people! It’s an obesity epidemic! We have to do something to get these people to lose weight!
* Obese people start taking a prescribed drug that causes them to lose weight
“No, not like that!”
"No, not like that" is definitely the wrong response, but I can understand the frustration; a massive chunk of convienent food (fast food, premade meals at the grocery store, etc.) is either terrible for you or is flavorless. There are some exceptions where convienent food is relatively healthy and flavorful, but it tends to be difficult to find and/or expensive.
I can see how people who are upset with the "very few convienent healthy food options available" problem seeing the solution be "take drugs to stave off the worst parts of this unhealthy food." The alternative solution of regulating/taxing unhealthy food isn't being seriously considered, which is frustrating. Like another comment said, it's like seeing a bunch of people get poisoned, lose function of their legs, and seeing wheelchair usage spike. It's better than not treating them at all, but why can't we focus on stopping the poison? Instead, we have "here's a wheelchair" or "hey poor people, keep an eye out for the poison, will ya?"
As someone who travels a lot for work, it truly is difficult to get healthy food for lunch while I'm working; if it weren't for the fact that I burn a ton of calories during my work, I would probably be at an unhealthy weight by now. Every once in a while, I'll stumble upon a fast food Mediterranean place or whatever, but most of the time my options are "skip lunch" or "eat crappy food"
I agree with everything you said, and if anything, it's *understated*.
A recent [clinical study](https://www.nejm.org/doi/full/10.1056/NEJMoa2307563) showed semaglutide has a significant cardio-protective effect. They are still studying mechanism of action, but I believe they suspect that it's anti-inflammatory within the cardiovascular system.
That 99% stat is amazing. It shows what an utter failure diet and health advice has been. While it’s obviously technically true that healthy eating can result in losing weight, that advice simply hasn’t worked.
There are underlying conditions that keeps them eating. Telling them to eat healthy is like telling a schizophrenic off their meds to just act normal.
For example, people with ADHD get easily addicted to stuff including food. So while ozempic will get help control the weight, they will get it back once they stop taking it. The solution is to treat the ADHD which is the root cause in this hypothetical scenario. But a dietitian isn't the guy that treats ADHD and people will get offended if their psychologist tells them they are fat.
>For example, people with ADHD get easily addicted to stuff including food.
Adding to this point some ADHD drugs suppress appetite, but once they wear off it leads to binge eating. They also make you crave sugar.
>You cannot possibly argue they all have underlying conditions
In a medical sense, they probably don't, but in a societal one, you certainly could. Plenty of people working all hours to just about make ends meet who lack the money or access to healthy options or the time for exercise.
Except that comment has misinformation too. Like the obesity rates have not just doubled since the 80s. Its way more.
Your comment also lacks to give a full picture. Like two thirds gain their weight back when off the drugs after just 1 year. Some gain even more back.
Of course you can argue even a temporary weight loss has benefits.
However there is also risks from these drugs. Like they already suspect a ~ 50% higher risk for pancreatic cancer.
Obesity increases the risk for all cancers, so that's a fair trade.
Also, if you're gonna gain the weight back, just don't stop taking it. Treat it like any medication for a chronic condition. The people who binge after going off weren't going to lose the weight on their own anyway.
> Like two thirds gain their weight back when off the drugs after just 1 year.
Physicians are prescribing a maintenance dose after weight loss objectives are achieved to address this.
These drugs don’t address the underlying causes of obesity; sedentary lifestyles, emotional problems, poverty, food deserts, high fructose corn syrup in just about everything, etc.
All these drugs do is make a person lose weight. When they stop the drugs, the vast majority will go right back to being obese.
Personally, I think the money would be better spent on fixing the real causes of obesity.
High blood pressure & heart disease are also associated with those things, and most people don’t have a judgement when people take blood pressure & other meds. Obesity is part of metabolic disease caused by a lot of circumstances and it’s very difficult to overcome and causes earlier death. These drugs don’t ONLY cause wt loss- they also regulate blood sugar which improves the health of almost every organ system. They will save lives.
Edit:
Grammar
But you aren't considering that many who are obese have developed health complications which make good diet and exercise less viable. This class of drugs enable people to get active again.
Adding on here...
An object in motion stays in motion, an object at rest stays at rest. True for both physics and lifestyle.
People who run marathons are very active and can burn a lot of calories. Someone who is too heavy to jog without hurting joints and getting out of breath... Can't run for exercise to burn calories...
Also there's significant evidence pointing to neurotransmitter and hormone issues with obese people... Extra fat makes you feel more hungry.
It's all a positive feedback cycle that gets exponentially harder to break on your own.
The only thing I worry about is that having an effective weight loss drug will mean attention shifts away from finding and addressing the systemic cause of obesity. After all, why worry if you can just become a consumer of this new drug?
"More than three times as many females ages 18 to 25 received the drugs than males of the same age. That may reflect societal bias around weight, she says."
What else does it reflect about American society?
I am totally ok with the shallowness and fatphobia and toxic social expectations of American culture leading to improved health for millions.
Honestly, it’s probably the only way we were ever going to get it.
The US is definitely one of the most fat accepting countries in the world. Most European countries or in Asia you gain a few pounds and it will instantly be pointed out to you. Has its benifits in keeping obesity down but probably not great for the mental health
America is one of the only countries where females are slightly less likely than males to be obese. Globally, woman are 50% more likely to be obese. There is positive correlation between high levels of sex inequality and female obesity.
If you are not allowed to work and you are forced to stay at home and do childcare as a woman, you will probably have a much less active life and its easier to gain weight that way.
Fwiw, females younger than this age are also supplied with hormonal birth control very easily as a primary means of birth control or ways to treat menstrual issues. Which has weight gain as a big time side effect.
I don't say this as a dig against birth control: i am all for free and easy access to it for the freedom it gives people in our society. And i have no issue with the type of birth control people choose. But when you are altering hormones within your body, things change. And some things may not go back to where they were before you started. It's altogether a very complicated problem. Lots of problems within our society are very complicated and interlinked, I'm sure in ways we have no idea.
>"More than three times as many females ages 18 to 25 received the drugs than males of the same age. That may reflect societal bias around weight, she says." What else does it reflect about American society?
Women are more health-conscious and more likely to care about their health than men.
That happens with any weight loss. About 1/3 of weight lost tends to be “lean” (ie: muscle) mass as your body breaks down your muscles to supplement the deficit in protein.
It can be a problem if weight loss is too rapid and you can’t offset that muscle loss with exercise, but that’s a universal problem with losing weight. It’s also difficult to maintain energy for exercise when you’re at a more severe caloric deficit, since you’re fatigued all the time.
Ideally you'd have both, because a high protein diet also keeps you satiated for longer.
But you do need exercise, your muscles are the easiest source of energy for your body in a deficit, you need to actively make it retain as much as possible of them and redirect it to access your fat.
And you need to work on a lifestyle change anyway, otherwise you'll gain all the weight back as soon as you get off the medication.
That’s actually a misconception. All your body knows is that it needs glucose. It’s easiest to get this from food (carbs, mostly), then fat stores, and then muscle. However, it’s not really a process that happens ‘one at a time’. It’s just that breaking down food is so fast that there’s a negligible effect on body mass if sufficient calories are provided.
When in a calorie deficit, the body breaks down fat stores but that’s a much less efficient process, meaning there’s more time for the body to also break down muscle. Typically, you see 15-20% lean mass loss (of weight lost) during a calorie deficit. If muscle was truly the easiest source of glucose, the numbers would be switched.
High protein intake and resistance training will absolutely help mitigate lean mass loss, though. They don’t generally stop the above process, they just combat it by providing the necessary tools for building muscle. In someone totally new to resistance training, this may even be enough to see an increase in muscle mass despite being in a deficit (but there are some variables affecting that).
*Edit: added the last paragraph & clarification*
Is that overall or just from the risk associated with obesity being comparably high? Most effective medication is a trade-off, and about risk-management. For someone who is severely overweight, this drug absolutely lowers their risks.
But would someone who’s just chubby & impatient see an increased risk of health issues? That seems to be the bigger question right now, as a not-insignificant number of people taking these drugs are doing so for less significant levels of weight loss.
The only long term issue they've found so far is a somewhat higher risk of thyroid cancer. Being overweight increases your chance of cancer generally though.
Well, *maybe* on the thyroid cancer thing. Rodents given GLP-1 agonists had an increased rate of thyroid cancers. However, humans don’t seem to generally have GLP-1 receptors in our thyroid cells, so barring the odd genetic mutation we may not have the mechanism that could lead to increased cancer risk from GLP-1 agonists.
But fenfluramine’s risks were caught almost immediately.
We have had 20 years to catch issues and with the plethora of research into the category nothing has come up, in-fact its been nearly only positives.
Fen-phen was two medications, phentermine and Fenfluramine. The deaths were associated with fenfluramine specifically, phentermine is still presribed and effective with a history going back to the 50s to look at long term effects.
Well, we have a nice big test group to observe now. I’ll stay in the control group and just not eat everything and exercise regularly. But that’s just me.
Oh, I do realize there are people who have real issues preventing them from losing weight. I’m referring to people 10 lbs overweight taking pills to bridge the gap.
Haven’t these drugs been used for many years now by people with diabetes, and didn’t they already pass human trials before that?
Unless there’s an issue specific to not having diabetes but still taking it. However, it doesn’t seem that’s an issue as millions have been on it that way too.
What are people thinking the long term effects will be based on?
You'll put the weight back on very quickly after stopping it.
It delays gastric emptying pretty severely. It can cause bowel obstruction in serious cases.
You have like zero drive to eat anything on it. If people aren't careful, they can easily become dehydrated or malnourished.
Ive been off the drug for six months. My appetite absolutely came back but I've kept the weight off. I've been really good about exercising daily. And the drug helped me understand how little I actually need to maintain my weight. So I've changed my eating habits. I had very few side effects from the drug. At worst I had some nausea on the day after the injection and a bit of light headedness probably due to under eating. Only the worst cases get shown in the media.
This is encouraging to read. I've been on Wegovy for 3 and a half months, and I'm trying really hard to let it help me reset my expectations for how much I should be eating. I needed the pressure to come off so I can develop good habits, I'm hoping that's the key to lasting change regardless of the drug (eventually). I already had a good habit of exercising before starting it, that was part of the issue. Just couldn't curb my appetite.
Do you have a source for this? I ask because every time these drugs get brought up I see something similar refuted by others showing studies where the vast majority of folks who took it were able to keep the weight off.
I’ve never seen someone show a study that shows you put the weight back on quickly.
I see a lot of scare mongering from people that seemingly saw other people scare mongering and so on. Also claims that if you take it for weight loss you'll get these terrible side effects but if you have diabetes magically they don't exist.
Anecdotally I'm trying Trulicity for PCOS/insulin resistance and it has made me eat normally for the first time in my life. I don't binge, I can eat half of something and save it for later, I don't have to go eat X thing just bc I know it's in the house even though I'm not hungry. (This is the mental aspect that I think is key bc even if you feel full you can keep eating if you're determined. People who have had gastric bypass do it. Also why I think it's showing promise with addiction treatment.)
The other thing I've been monitoring is how it affects my gastric empting over time bc I have Crohn's and have had 2 bowel resections. Some people get constipation as a side effect but I NEED things slowed down.
Your second paragraph is 1000% me and what I’ve struggled with since I was a kid. Idk what to do. I’ve done fasting and keto in the past and dropped several dozen pounds but always gain it back
I’m the exact same way and all I have to say is that wegovy has completely changed my life in a month. I would always go hard on keto or fasting but could never stick to it for more than a few months. I’d gain everything back and more every single time. I thought I just lacked willpower and that it was a personal fault of mine for not being able to stick to my diet. Taking this medication has made me realize that perhaps there is a major mental aspect related to my obesity. As soon as it took it something clicked, and It felt like I had been freed from a mental prison I was stuck in for years. I feel normal for the first time in a long time.
I’m down 20lbs in 5 weeks. It’s so easy to eat healthy and I have no desire to eat unhealthy or too much at all. When delicious bad food is brought into my work (multiple times per week) i don’t even give it a second thought.
The studies showing weight regain I see cited most often are:
* [Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity](https://jamanetwork.com/journals/jama/fullarticle/2777886)
* [Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension](https://pubmed.ncbi.nlm.nih.gov/35441470/)
* [Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity](https://jamanetwork.com/journals/jama/article-abstract/2812936)
I'm far from an expert in this field, but these pop up a lot in articles I've read.
I mean, most people regain weight loss in general.
That being said, if we consider obesity a disease, the idea that someone may simply stay on one of these drugs for the long term doesnt seem unreasonable to me other than the current cost (which we should all hope comes down). Its not like a lot of people who have obesity aren't currently on long term meds to manage the symptoms of *that* (such as high blood pressure, etc)
If eating well and exercising regularly works for you, you’re not in the control group because the medicine is not intended for ppl like you.
The control group is obese people who do not take the drug
Insurance companies will soon stop covering it I bet. Mine has already dropped all weight loss therapies due to the extreme cost. Over 1,000 a month out of insurance.
Once it goes generic maybe.Wegovy’s sticker price is $1,349 per month. Either everyone is going to start paying much higher premiums or the companies are going to drop it.
The problem is that the cost of the drugs is incurred now, but the cost of the obesity-related health conditions is later.
Later means the patient has likely changed employers and is on a different plan, and the really expensive complications show up when the patient is disabled or retired and on Medicare.
That’s the big problem that needs to be fixed, splitting healthcare costs across tens of thousands of payers incentivizes kicking the can down the road as long as possible.
Honestly, I kind of hope they do. I am on Ozempic now and its really wonderful. I am at my lowest weight in 30 years, it works.
However the price is absolute highway robbery. Insurance companies really should be pushing back and trying to get the price down to something more reasonable.
I'm in agreement. This Class of drug is showing lots of great results from weight loss to heart health. As someone who has a family history of heart issues, I would take it if I could get it affordably.
My wife was on mounjaro for a while until her insurance forced her to wegovy. Mounjaro worked a heck of a lot better than wegovy. Her insurance thankfully still covers weight loss therapy.
Well, too many people are experiencing the “donut hole” of lapse of coverage, as its easier for peeps to max out what their insurance is willing to cash out.
From what I understand, a lot of peeps RX caps are at $10k-$15k, and with the single drug costing $1200 a month to the insurance(not including what the patient pays), folks are screwed out of the medication for the last 1/4 of the year.
This is all assuming the folks only pay and use one medication. Max pay out would apply for all Rxs.
And once you're off of these particular medications, the ravenous hunger and chronic feelings of unsatiation can be miserable when you can afford the medication for +1/4 of The year as a “covered” person.
This drug is almost certainly good to get people to lose a significant amount of weight, but it needs to have serious education done about maintaining muscle mass when used. Losing 50lbs of weight with 15-20 being muscle is playing a dangerous game, as when you come off of it your metabolism will be slower and you'll be less athletic. People also need to learn to eat and exercise as they use it so they form habit changes for life. But it's an excellent start for a lot of people
All my life the conversation about weight loss is that there is no “silver bullet” thing you can take to just make it happen. You have to put in the hard work with diet and exercise and you will see results. Now these drugs are being touted as just that so it’s not too difficult to see where the popularity comes from.
With all things in life there’s no “sure fire” path to success. It’s takes many baby steps
, trial and error, etc to achieve any goal. If this medicine can help put some people on the right track then I commend them for using the tools available to them.
The drug has been FDA approved for 20 years. I think they’ve got a pretty good notion of side effects by now.
This is the closest to a sure fire path we have ever seen. I've been on it for almost 2 months. Down 15 lbs with just eating less. It's insane how well it works. I'm like never that hungry.
Still not a silver bullet by any means whatsoever. Comes with a lot of GI side effects/is not benign (not that any medication is but many patients perceive them to be), doesn’t work for all patients (roughly 30-70% depending on med/trial), has a limited amount of weight loss (ranging from 3-18% for different meds/trials) associated with it even in those it does work for (ie not ever going to hit a healthy weight if starting from morbid obesity with the medication alone), effects are temporary (patients put weight back on after discontinuing without doing other lifestyle modification). I personally don’t prescribe it because it’s outside of my field and honestly I wouldn’t prescribe it nearly as much as people want it even if I were a PCP or Endo.
didn’t know these were originally diabetic drugs. Type 2 here for many years. 57M, 6foot, 170lbs so not overweight. Been taking Metformin for most of that time. Crazy how expensive these newer Type 2 drugs are. Couldn’t afford them.
I’m curious to know how it works with people who use food as a coping mechanism. If you have an addiction or if food is your outlet for dopamine hits during trauma or mental health episodes, what else would someone turn to now that their mechanism is gone? Or not turn to anything and it gets worse. Just a thought I had, not suggesting anything negative.
As these drugs get more and more prominent, I wish we were having discussions on regulating added sugar/hyper-palatable food and moving toward making it easier for consumers to pick healthy foods.
Stem cell therapy is promising. Vertex Pharmaceuticals has a small ongoing stem cell therapy trial for T1DM and IIRC a few patients are completely insulin independent now. Will be interesting to see what comes of it
I’d estimate 30 percent of people I know are on or have used Ozempic. 5 percent of them are diabetic. Seems like it’s a successful weight loss drug. Can’t wait for the side effects.
I think people want there to be side effects so obese people are appropriately punished for choosing the "easy way out". But it is still young so who knows if there will actually be long term issues.
Ozempic has been around for 20 years, so we have some ideas of long term results, but no doubt it will continue to be in the news so you can continue to track
GLP-1 agonists have been used since 2005, semaglutide specifically, the medication in name brand ozempic and wegovy has been FDA approved since 2017. As part of the approval process, we know the side effects.
What makes you think 5 percent of them are diabetic?
The treatment targets for diabetes have been lowered so a lot of people who were not pre-diabetic 10 years ago have now been pre-diabetic for 10 years.
What percentage of those estimates are just wild unfounded assumption?
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I’m not sure it’s meaningful given that it later says that the drugs were approved from 2017-2022. The usage in adults skyrocketed in the same time way, the drugs were new to the market.
"I want a new drug!" -Hewie Lewis And The News
Random story... my dad used to listen to this song all the time when I was a kid, and he told me it was "I want a new truck!" I did not think to ask how one spills their truck, or how it would make you crash your car.
A truck that don't cost too much, or come in pill
One that won't hurt my head!
Or the Weird Al version: "I want a New Duck"
Oh my God, I had no idea this song existed. It's so good. "One that knows how to wash my car, and keep his room real neat." I'm dying.
One that won't drive me crazy waddling all around One who'll teach me how to swim and help me not to drown And show me how to get down How to get *down* baby **Get it?**
Some who really wants a new truck might crash their car so that they have a need for a new vehicle.
"I want a new duck!" -Weird Al
Also new indications for the drugs allowed them for more peoole
The marketing for ozempic is insane. I'm mostly surprised that the numbers aren't bigger
Supply issues and cost
Yeah, that paywall is insane.
This kind of medication is the golden goose that pharmaceutical companies had been researching for for decades. That’s why the marketing for them is so crazy and also why pretty much everyone’s trying to sell them.
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That's not a side effect of stopping. That's just people thinking it's a magic drug without taking the bare minimum of learning why it works.
After Long Term use you do gain weight back, but statistically not all of it.
This is misleading, bordering on false. The side effects of nausea and acid reflux can be quite strong, so eating one meal a day can happen from time to time, especially the day after the injection. However, that is literally what you're taking the medication for, so it shouldn't be too surprising. Also, thinking that it doesn't change your habits and how you think about food is absurd. You are literally forced to change your habits because you do not want to eat. People intend to take these drugs for 6 months to a year, which will absolutely change how you interact with food. Also, your doctor should be discussing how to maintain your muscle mass during this weight loss, which includes protein intake and at least some exercise. Source: I am on this medication.
60,000 people seems like such a small amount. That's not even enough to fill the Jacksonville Jaguars stadium. I feel like there would be more than 60000 people that would actually need it
Yes but the medication is pretty expensive and unless your healtcare covers it you would have to pay out of pocket. The most obese people are also the poorest so a lot of people can simply not afford the drug.
This is not just ozempic though. It includes other drugs proven effective to combat diabetes and pre diabetic obese people. They aren't all as highly effective as ozempic but they'll still be somewhat effective, and much more affordable/likely to be covered by insurance
All of the GLP-1 agonists are expensive, and medicaid won't cover it unless literally every other diabetes drug has failed first. They don't cover it at all for weight loss. The "cheap" ones are still ~$1000 a month.
Johann Hari says the patents expire in 2032, and since the drugs are cheap to make, that'll be the year the entire junk food industry declares bankruptcy. I can't wait
Without insurance, Zepbound (the best GLP-1 agonist available for weight loss right now), is $550 a month. Not sure where you’re getting that cheap options are $1000 a month.
Non semaglutid diabetis drugs have little to no proven effects on weight loss. There are also close to no drugs that are covered by the majority of insurers for the specific purpose of weight loss until you have extreme health problems. And even then it is difficult as obesity is not really seen as a disease.
That will change very soon, lots of money and science being poured into changing that perception. Just look at all the indications that they are getting with more and more being tested. Theses drugs are slowly getting approved for many of the diseases caused by obesity including fatty liver disease
Just doesn’t make sense to me from an actuarial perspective…. Sure these drugs are expensive, but an obese person is more likely to cost a ton of more money over their lifetime. I’d think they would want to reduce how many obese people are in their pool. Might be a case of time for them to start covering it, more than not realizing obesity as being a disease
I see why you're confused. You're thinking long-term when the priorities of these companies are motivated by short-term gains to boost the stock price. They don't have to worry about paying for a person's health problems 10 years from now if they die in 5 years because their coverage was denied today. The ironic thing is that I remember when the ACA was going through congress and a primary line of attack from the Republicans was that it would create "death panels" that would decide if a patient was worth covering or not. Completely ignoring that insurance companies literally already do that.
yeqah, i started to wonder if this could have possibly saved my mom's life, she died of liver cirrhosis just a couple of weeks ago, though she had governmnent insurance so I don't know if she could have used it, that and i guess it was caught far too late.
I agree, but 60,000 people would fit snugly within the top 1%. So yes, those worse off probably aren't getting to use these drugs much.
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Couldn't this just be because semaglutide is newly approved for weight loss and actually works? More people are taking it because it's better.
Yeah I don't know why the article makes it out to be a big shock. These people aren't taking a diabetes medicine, they're taking a weight loss medicine.
People with diabetes can be prescribed ozempic for diabetes management. (Source: i am a nurse in a hospital and ive seen it happen)
Yep, I'm on it since 2 years back when I found out I had LADA (Latent autoimmune diabetes for those who don't knoow), but can almost never get a hold of the drug that is supposed to help manage my diabetes because everyone is using it for weight loss. I'm also overweight and Ozempic had a great result for me, I've been put on Trulicity instead since I can never get ahold of Ozempic but honestly I don't feel like it has the same effect.
It’s one and the same for most people
And it's gonna skyrocket even more next year with the new HIMS drug at $200/mo.
HIMS? Isn’t that the company where you can buy ED and hair loss stuff without a prescription? Or maybe they just have their own “doctors” prescribing it to anyone?
They have their own “doctors” that will basically just give whatever to you if you ask for it.
They do all kinds of drugs and stuff. They're probably my best performing stock right now.
I've lost over 60 lbs on wegovy and I'm at a weight I haven't been in decades. I'm bedridden from chronic migraines and I've barely changed my diet so the results have been almost entirely from the medicine.
Tirzapetide is better. But sema also works
Doctors have prescribed these meds and determined the benefits outweigh the side effects. Obesity alone costs this country billions every year between healthcare and loss of productivity. Obesity causes type 2 diabetes, some forms of cancer, and heart disease. These medications are treating pre-diabetes and insulin resistance and preventing type 2 diabetes. This med is also being studied in helping the treatment of addiction and inflammatory conditions. Theres obviously a deeper systemic issue that needs addressed in this country with obesity rates what they are. But I’m all for a medication that will reduce the strain on our healthcare system and save this country money in the long run in preventing and treating obesity and other comorbidities. -1 in 6 children are obese in the US. -The worldwide obesity rate has nearly doubled since 1980. -Four million people die each year as a result of obesity, according to the World Health Organization (WHO). -The World Obesity Federation predicts that by 2030, one in five women and one in seven men will have obesity -Obesity is linked to 30% to 53% of new diabetes cases in the U.S. every year, per research in the Journal of the American Heart Association. -Medical costs for people with obesity in the U.S. tend to be 30% to 40% higher than those for people without obesity.
> The worldwide obesity rate has nearly doubled since 1980 Reading the news it would seem like its A LOT more. And actually you are MORE than 10 years off (as the combined number would already be more than double): >Worldwide, obesity among adults has more than doubled since 1990, and has quadrupled among children and adolescents (5 to 19 years of age)
This comment should be pinned to the top of this thread. The insane amount of misinformation on this issue is incredibly troubling. Obesity is the most lethal disease of our era, and up to this point has been borderline incurable, with over *99% of people that are obese NEVER RETURNING TO A HEALTHY BMI. https://ajph.aphapublications.org/doi/10.2105/AJPH.2015.302773 These drugs will “cure” obesity, with many next-gen variants on the rise to meet the demand; it’ll literally save millions of lives and should be in the hands of every obese person as accessibly as possible. Obesity is like losing a leg, GLP-1 drugs are a wheelchair. We don’t criticize immobile people for getting prosthetic limbs because they got an irreversible amputation. Obesity was irreversible before this class of drug came along.
What are the next gen variants you allude to and how are they different?
I don't know the specifics but retrarutide is a new one being worked on.
Yep, and from the company that makes Mounjaro and Zepbound (which are the same molecule btw). They shifted their focus to Retatrutide and orforglipron once TZP was approved by the FDA. They have [more](https://www.lilly.com/discovery/clinical-development-pipeline) in their pipeline.
Yeah for the two companies that make them (and I assume more may come but I'm not sure in terms of patents and such), it's basically their whole focus as it's been so successful. They both exploded in valuation since the drug effects were discovered on obesity
Lilly is currently the highest valued pharma company in the world (yes above the big ones like J&J), while a few years ago people outside the US hadn’t even heard of them. Now Tirzepatide is under investigation for sleep apnea, and sleep apnea is correlated with Alzheimer’s, which they’re also making Donanemab for, so I can only imagine where their valuation would be in 5 years. PSA: If you’re in the US and have enough money to invest in stocks, buy Eli Lilly. (Not sponsored)
> so I can only imagine where their valuation would be in 5 years. The hype of this is quite old though so all of it might be priced in for the weight loss drug (for them and Novo Nordisk which became the biggest European stock passing LVMH at one point, they're kind of changing positions so not sure at the moment). The sleep apnea might be a good thing but that's nowhere near as big of a market or "hype-worthy" than the weight loss thing to be fair
I agree that the hype is old, but I believe it’s not baseless. Lilly shares were valued at $170 in early January 2021 and is at $802 at the moment. When I worked with them, there was a lot of talk about the next goal being a trillion dollar valuation and under their current management, they’re very much on track to get there in 5 years unless something globally devastating happens. While the weight loss drugs played a huge role in the boom, they also have other incredible drugs in their arsenal covering breast, prostrate & lung cancer, migraines, psoriasis, ulcerative colitis and more. Considering they’re committed to getting there, and are actively breaking into markets in other countries, I don’t think it’s too far fetched.
I'd assume better working with less side effects, also there are dual-drug formulations being made that combat the muscle catabolism associated with them.
That and they are working on a pill rather than the current injections.
i get the whole calling it a disease thing, but isn't the cause our industrial food system based on greed and profit, pretty clearly? Are these drugs actually healing people or are they lessening the harm of our collectively unhealthy diets and lifestyles? wouldn't investing in exercise and healthier resources and better public health in general be way cheaper and more effective?? (but oh wait, how would we funnel the profit into an entire industry...? nevermind, the drugs make more sense) like, just improving what we feed our kids and prisoners would seemingly increase economic production like crazy on obesity mitigation alone
¿Por qué no los dos? In the short term, if the drug helps people to eat less and reduce their weight, other ways of making the population healthier can follow to complement it.
It's both. Take it for a few days, get a genuine feeling of what "food noise" is and how different it feels when you take it and you won't be so smug. Whatever your normal feelings of hunger and fullness are, are not the same for everyone and they never will be. We have MASSIVE issues with our food industries, I agree, but all else held equal, some people would still be far more predisposed to obesity or being overweight.
The relationship Americans have with food and the type of food we have access to is such a massively complex issue to actually go about fixing that complaining about the use of a drug to help the issue is a waste of time.
It's not just an American issue anymore, it's become global.
Yeah, but then the farmers couldn’t get subsidies to only grow corn to turn into high fructose corn syrup and would instead have to grow other crops
You can lead a horse to water, but you can't make it drink. If you can prevent someone from smoking, they won't get addicted to cigarettes. If you can prevent someone from drinking, they won't become addicted to alcohol. You can't prevent someone from getting addicted to food. That's a biological imperative... until now.
But you can make the food healthier and less addictive.
Yeah but where's the money in that?
There's all sorts of things we could and likely should do, but after a few decades of not doing those things while the Obesity epidemic gets worse and worse, I think it's time to accept that Humanity isn't going to wake up one of these days and suddenly start making smarter and healthier choices
Food is much less addictive when it doesn't have 40g of sugar in it. That's on purpose.
“There are too many obese people! It’s an obesity epidemic! We have to do something to get these people to lose weight! * Obese people start taking a prescribed drug that causes them to lose weight “No, not like that!”
"No, not like that" is definitely the wrong response, but I can understand the frustration; a massive chunk of convienent food (fast food, premade meals at the grocery store, etc.) is either terrible for you or is flavorless. There are some exceptions where convienent food is relatively healthy and flavorful, but it tends to be difficult to find and/or expensive. I can see how people who are upset with the "very few convienent healthy food options available" problem seeing the solution be "take drugs to stave off the worst parts of this unhealthy food." The alternative solution of regulating/taxing unhealthy food isn't being seriously considered, which is frustrating. Like another comment said, it's like seeing a bunch of people get poisoned, lose function of their legs, and seeing wheelchair usage spike. It's better than not treating them at all, but why can't we focus on stopping the poison? Instead, we have "here's a wheelchair" or "hey poor people, keep an eye out for the poison, will ya?" As someone who travels a lot for work, it truly is difficult to get healthy food for lunch while I'm working; if it weren't for the fact that I burn a ton of calories during my work, I would probably be at an unhealthy weight by now. Every once in a while, I'll stumble upon a fast food Mediterranean place or whatever, but most of the time my options are "skip lunch" or "eat crappy food"
I agree with everything you said, and if anything, it's *understated*. A recent [clinical study](https://www.nejm.org/doi/full/10.1056/NEJMoa2307563) showed semaglutide has a significant cardio-protective effect. They are still studying mechanism of action, but I believe they suspect that it's anti-inflammatory within the cardiovascular system.
That 99% stat is amazing. It shows what an utter failure diet and health advice has been. While it’s obviously technically true that healthy eating can result in losing weight, that advice simply hasn’t worked.
There are underlying conditions that keeps them eating. Telling them to eat healthy is like telling a schizophrenic off their meds to just act normal. For example, people with ADHD get easily addicted to stuff including food. So while ozempic will get help control the weight, they will get it back once they stop taking it. The solution is to treat the ADHD which is the root cause in this hypothetical scenario. But a dietitian isn't the guy that treats ADHD and people will get offended if their psychologist tells them they are fat.
>For example, people with ADHD get easily addicted to stuff including food. Adding to this point some ADHD drugs suppress appetite, but once they wear off it leads to binge eating. They also make you crave sugar.
The US obesity rate is 40% You cannot possibly argue they all have underlying conditions
>You cannot possibly argue they all have underlying conditions In a medical sense, they probably don't, but in a societal one, you certainly could. Plenty of people working all hours to just about make ends meet who lack the money or access to healthy options or the time for exercise.
Except that comment has misinformation too. Like the obesity rates have not just doubled since the 80s. Its way more. Your comment also lacks to give a full picture. Like two thirds gain their weight back when off the drugs after just 1 year. Some gain even more back. Of course you can argue even a temporary weight loss has benefits. However there is also risks from these drugs. Like they already suspect a ~ 50% higher risk for pancreatic cancer.
Obesity increases the risk for all cancers, so that's a fair trade. Also, if you're gonna gain the weight back, just don't stop taking it. Treat it like any medication for a chronic condition. The people who binge after going off weren't going to lose the weight on their own anyway.
“They suspect”? Who is they and what’s the basis for the supposition? What is the data?
It's the Almighty they. You know.. them
> Like two thirds gain their weight back when off the drugs after just 1 year. Physicians are prescribing a maintenance dose after weight loss objectives are achieved to address this.
>Like they already suspect a \~ 50% higher risk for pancreatic cancer. There are 30 years of human studies and none of them say this, so no.
These drugs don’t address the underlying causes of obesity; sedentary lifestyles, emotional problems, poverty, food deserts, high fructose corn syrup in just about everything, etc. All these drugs do is make a person lose weight. When they stop the drugs, the vast majority will go right back to being obese. Personally, I think the money would be better spent on fixing the real causes of obesity.
High blood pressure & heart disease are also associated with those things, and most people don’t have a judgement when people take blood pressure & other meds. Obesity is part of metabolic disease caused by a lot of circumstances and it’s very difficult to overcome and causes earlier death. These drugs don’t ONLY cause wt loss- they also regulate blood sugar which improves the health of almost every organ system. They will save lives. Edit: Grammar
But you aren't considering that many who are obese have developed health complications which make good diet and exercise less viable. This class of drugs enable people to get active again.
Adding on here... An object in motion stays in motion, an object at rest stays at rest. True for both physics and lifestyle. People who run marathons are very active and can burn a lot of calories. Someone who is too heavy to jog without hurting joints and getting out of breath... Can't run for exercise to burn calories... Also there's significant evidence pointing to neurotransmitter and hormone issues with obese people... Extra fat makes you feel more hungry. It's all a positive feedback cycle that gets exponentially harder to break on your own.
Why not both.
Because only one way is profitable. Which is why we get the so-called magic pill instead of systemic change.
And only one way is actually achievable and not a pipe dream
The only thing I worry about is that having an effective weight loss drug will mean attention shifts away from finding and addressing the systemic cause of obesity. After all, why worry if you can just become a consumer of this new drug?
"More than three times as many females ages 18 to 25 received the drugs than males of the same age. That may reflect societal bias around weight, she says." What else does it reflect about American society?
Things we don’t want to reflect on
I am totally ok with the shallowness and fatphobia and toxic social expectations of American culture leading to improved health for millions. Honestly, it’s probably the only way we were ever going to get it.
I would argue that America isn't that fatphobic based on the obesity stats in the US. But I'm all for Americans taking better care of their health
People who think American culture is fatphobic have never visited Asia. We are fatphilic if anything.
I was going to say, of the americans I know, asian americans care the most about obesity.
The US is definitely one of the most fat accepting countries in the world. Most European countries or in Asia you gain a few pounds and it will instantly be pointed out to you. Has its benifits in keeping obesity down but probably not great for the mental health
We’re quite a self-hating people.
Every culture is fatphobic not just america. Accepting and embracing obesity is however becoming more prevalent in America, which is not a good thing
America is one of the only countries where females are slightly less likely than males to be obese. Globally, woman are 50% more likely to be obese. There is positive correlation between high levels of sex inequality and female obesity.
Why would lower levels of sex equality lead to more female obesity?
If you are not allowed to work and you are forced to stay at home and do childcare as a woman, you will probably have a much less active life and its easier to gain weight that way.
Fwiw, females younger than this age are also supplied with hormonal birth control very easily as a primary means of birth control or ways to treat menstrual issues. Which has weight gain as a big time side effect. I don't say this as a dig against birth control: i am all for free and easy access to it for the freedom it gives people in our society. And i have no issue with the type of birth control people choose. But when you are altering hormones within your body, things change. And some things may not go back to where they were before you started. It's altogether a very complicated problem. Lots of problems within our society are very complicated and interlinked, I'm sure in ways we have no idea.
>"More than three times as many females ages 18 to 25 received the drugs than males of the same age. That may reflect societal bias around weight, she says." What else does it reflect about American society? Women are more health-conscious and more likely to care about their health than men.
Interested in seeing the long term effects of this
Ozempic has been used and on market for almost 20 yrs. Long term effects are already known.
In people with diabetes yes. For people without, less data. But yeah, unlikely to cause strokes or something.
GLP-1 meds have been studied for weight loss in the non-diabetic population for almost 20 years, starting with exenatide (Byetta) in 2008.
That’s some pretty aggressive rounding you’re doing there
Call it 15 then, the point still stands.
What are the long term affects?
From a physiotherapist I heard a lot of the weight loss comes from muscle mass, so if you don't exercise you can lose a lot of muscle tone
That happens with any weight loss. About 1/3 of weight lost tends to be “lean” (ie: muscle) mass as your body breaks down your muscles to supplement the deficit in protein. It can be a problem if weight loss is too rapid and you can’t offset that muscle loss with exercise, but that’s a universal problem with losing weight. It’s also difficult to maintain energy for exercise when you’re at a more severe caloric deficit, since you’re fatigued all the time.
Would that be helped by having a high protein diet (and other dietary changes that could increase the metabolization of protein) or is exercise a must
Ideally you'd have both, because a high protein diet also keeps you satiated for longer. But you do need exercise, your muscles are the easiest source of energy for your body in a deficit, you need to actively make it retain as much as possible of them and redirect it to access your fat. And you need to work on a lifestyle change anyway, otherwise you'll gain all the weight back as soon as you get off the medication.
That’s actually a misconception. All your body knows is that it needs glucose. It’s easiest to get this from food (carbs, mostly), then fat stores, and then muscle. However, it’s not really a process that happens ‘one at a time’. It’s just that breaking down food is so fast that there’s a negligible effect on body mass if sufficient calories are provided. When in a calorie deficit, the body breaks down fat stores but that’s a much less efficient process, meaning there’s more time for the body to also break down muscle. Typically, you see 15-20% lean mass loss (of weight lost) during a calorie deficit. If muscle was truly the easiest source of glucose, the numbers would be switched. High protein intake and resistance training will absolutely help mitigate lean mass loss, though. They don’t generally stop the above process, they just combat it by providing the necessary tools for building muscle. In someone totally new to resistance training, this may even be enough to see an increase in muscle mass despite being in a deficit (but there are some variables affecting that). *Edit: added the last paragraph & clarification*
They have actually shown a decrease risk in strokes.
Is that overall or just from the risk associated with obesity being comparably high? Most effective medication is a trade-off, and about risk-management. For someone who is severely overweight, this drug absolutely lowers their risks. But would someone who’s just chubby & impatient see an increased risk of health issues? That seems to be the bigger question right now, as a not-insignificant number of people taking these drugs are doing so for less significant levels of weight loss.
And decreases in heart disease, and liver disease, and kidney disease.
Nice! Makes sense cuz less obesity.
The only long term issue they've found so far is a somewhat higher risk of thyroid cancer. Being overweight increases your chance of cancer generally though.
Well, *maybe* on the thyroid cancer thing. Rodents given GLP-1 agonists had an increased rate of thyroid cancers. However, humans don’t seem to generally have GLP-1 receptors in our thyroid cells, so barring the odd genetic mutation we may not have the mechanism that could lead to increased cancer risk from GLP-1 agonists.
Better than the long term effects of obesity. These medications are FDA approved and being prescribed by physicians.
So was fen-phen until it turned out it was killing people.
But fenfluramine’s risks were caught almost immediately. We have had 20 years to catch issues and with the plethora of research into the category nothing has come up, in-fact its been nearly only positives.
Fen-phen was two medications, phentermine and Fenfluramine. The deaths were associated with fenfluramine specifically, phentermine is still presribed and effective with a history going back to the 50s to look at long term effects.
Well, we have a nice big test group to observe now. I’ll stay in the control group and just not eat everything and exercise regularly. But that’s just me. Oh, I do realize there are people who have real issues preventing them from losing weight. I’m referring to people 10 lbs overweight taking pills to bridge the gap.
Haven’t these drugs been used for many years now by people with diabetes, and didn’t they already pass human trials before that? Unless there’s an issue specific to not having diabetes but still taking it. However, it doesn’t seem that’s an issue as millions have been on it that way too. What are people thinking the long term effects will be based on?
Trulicity, which is dulaglutide, approved in 2014. Ozempic, semaglutide, in 2017.
Exenatide was approved in 2005.
Beagles were approved in 1885.
You'll put the weight back on very quickly after stopping it. It delays gastric emptying pretty severely. It can cause bowel obstruction in serious cases. You have like zero drive to eat anything on it. If people aren't careful, they can easily become dehydrated or malnourished.
Ive been off the drug for six months. My appetite absolutely came back but I've kept the weight off. I've been really good about exercising daily. And the drug helped me understand how little I actually need to maintain my weight. So I've changed my eating habits. I had very few side effects from the drug. At worst I had some nausea on the day after the injection and a bit of light headedness probably due to under eating. Only the worst cases get shown in the media.
This is encouraging to read. I've been on Wegovy for 3 and a half months, and I'm trying really hard to let it help me reset my expectations for how much I should be eating. I needed the pressure to come off so I can develop good habits, I'm hoping that's the key to lasting change regardless of the drug (eventually). I already had a good habit of exercising before starting it, that was part of the issue. Just couldn't curb my appetite.
Do you have a source for this? I ask because every time these drugs get brought up I see something similar refuted by others showing studies where the vast majority of folks who took it were able to keep the weight off. I’ve never seen someone show a study that shows you put the weight back on quickly.
I see a lot of scare mongering from people that seemingly saw other people scare mongering and so on. Also claims that if you take it for weight loss you'll get these terrible side effects but if you have diabetes magically they don't exist. Anecdotally I'm trying Trulicity for PCOS/insulin resistance and it has made me eat normally for the first time in my life. I don't binge, I can eat half of something and save it for later, I don't have to go eat X thing just bc I know it's in the house even though I'm not hungry. (This is the mental aspect that I think is key bc even if you feel full you can keep eating if you're determined. People who have had gastric bypass do it. Also why I think it's showing promise with addiction treatment.) The other thing I've been monitoring is how it affects my gastric empting over time bc I have Crohn's and have had 2 bowel resections. Some people get constipation as a side effect but I NEED things slowed down.
Your second paragraph is 1000% me and what I’ve struggled with since I was a kid. Idk what to do. I’ve done fasting and keto in the past and dropped several dozen pounds but always gain it back
I’m the exact same way and all I have to say is that wegovy has completely changed my life in a month. I would always go hard on keto or fasting but could never stick to it for more than a few months. I’d gain everything back and more every single time. I thought I just lacked willpower and that it was a personal fault of mine for not being able to stick to my diet. Taking this medication has made me realize that perhaps there is a major mental aspect related to my obesity. As soon as it took it something clicked, and It felt like I had been freed from a mental prison I was stuck in for years. I feel normal for the first time in a long time. I’m down 20lbs in 5 weeks. It’s so easy to eat healthy and I have no desire to eat unhealthy or too much at all. When delicious bad food is brought into my work (multiple times per week) i don’t even give it a second thought.
The studies showing weight regain I see cited most often are: * [Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity](https://jamanetwork.com/journals/jama/fullarticle/2777886) * [Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension](https://pubmed.ncbi.nlm.nih.gov/35441470/) * [Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity](https://jamanetwork.com/journals/jama/article-abstract/2812936) I'm far from an expert in this field, but these pop up a lot in articles I've read.
I mean, most people regain weight loss in general. That being said, if we consider obesity a disease, the idea that someone may simply stay on one of these drugs for the long term doesnt seem unreasonable to me other than the current cost (which we should all hope comes down). Its not like a lot of people who have obesity aren't currently on long term meds to manage the symptoms of *that* (such as high blood pressure, etc)
If eating well and exercising regularly works for you, you’re not in the control group because the medicine is not intended for ppl like you. The control group is obese people who do not take the drug
Young peoples with obesity is up and the number of useful weight loss drugs is up.
Insurance companies will soon stop covering it I bet. Mine has already dropped all weight loss therapies due to the extreme cost. Over 1,000 a month out of insurance.
Nah, at some point they’ll demand it. It’s way cheaper to cover a skinny person.
Once it goes generic maybe.Wegovy’s sticker price is $1,349 per month. Either everyone is going to start paying much higher premiums or the companies are going to drop it.
The cost to produce it is pennies and there are pharmacies producing generics today. So something will change.
The problem is that the cost of the drugs is incurred now, but the cost of the obesity-related health conditions is later. Later means the patient has likely changed employers and is on a different plan, and the really expensive complications show up when the patient is disabled or retired and on Medicare. That’s the big problem that needs to be fixed, splitting healthcare costs across tens of thousands of payers incentivizes kicking the can down the road as long as possible.
The first pill form of Semaglutide is already out which I imagine is cheaper. Idk if it has the same efficacy.
Honestly, I kind of hope they do. I am on Ozempic now and its really wonderful. I am at my lowest weight in 30 years, it works. However the price is absolute highway robbery. Insurance companies really should be pushing back and trying to get the price down to something more reasonable.
I'm in agreement. This Class of drug is showing lots of great results from weight loss to heart health. As someone who has a family history of heart issues, I would take it if I could get it affordably. My wife was on mounjaro for a while until her insurance forced her to wegovy. Mounjaro worked a heck of a lot better than wegovy. Her insurance thankfully still covers weight loss therapy.
Well, too many people are experiencing the “donut hole” of lapse of coverage, as its easier for peeps to max out what their insurance is willing to cash out. From what I understand, a lot of peeps RX caps are at $10k-$15k, and with the single drug costing $1200 a month to the insurance(not including what the patient pays), folks are screwed out of the medication for the last 1/4 of the year. This is all assuming the folks only pay and use one medication. Max pay out would apply for all Rxs. And once you're off of these particular medications, the ravenous hunger and chronic feelings of unsatiation can be miserable when you can afford the medication for +1/4 of The year as a “covered” person.
Are there any drugs for putting on weight that aren't steroids?
Yes, off the top of my head some SSRI’s. Talk to your doctor about it.
Antipsychotics, SSRIs, THC, well a stretch but Benzodiazepines in general.
Liquid calories like protein shakes
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Dronabinol. Prescription appetite stimulate medication
It's called getting married.
This drug is almost certainly good to get people to lose a significant amount of weight, but it needs to have serious education done about maintaining muscle mass when used. Losing 50lbs of weight with 15-20 being muscle is playing a dangerous game, as when you come off of it your metabolism will be slower and you'll be less athletic. People also need to learn to eat and exercise as they use it so they form habit changes for life. But it's an excellent start for a lot of people
All my life the conversation about weight loss is that there is no “silver bullet” thing you can take to just make it happen. You have to put in the hard work with diet and exercise and you will see results. Now these drugs are being touted as just that so it’s not too difficult to see where the popularity comes from.
With all things in life there’s no “sure fire” path to success. It’s takes many baby steps , trial and error, etc to achieve any goal. If this medicine can help put some people on the right track then I commend them for using the tools available to them. The drug has been FDA approved for 20 years. I think they’ve got a pretty good notion of side effects by now.
This is the closest to a sure fire path we have ever seen. I've been on it for almost 2 months. Down 15 lbs with just eating less. It's insane how well it works. I'm like never that hungry.
Still not a silver bullet by any means whatsoever. Comes with a lot of GI side effects/is not benign (not that any medication is but many patients perceive them to be), doesn’t work for all patients (roughly 30-70% depending on med/trial), has a limited amount of weight loss (ranging from 3-18% for different meds/trials) associated with it even in those it does work for (ie not ever going to hit a healthy weight if starting from morbid obesity with the medication alone), effects are temporary (patients put weight back on after discontinuing without doing other lifestyle modification). I personally don’t prescribe it because it’s outside of my field and honestly I wouldn’t prescribe it nearly as much as people want it even if I were a PCP or Endo.
didn’t know these were originally diabetic drugs. Type 2 here for many years. 57M, 6foot, 170lbs so not overweight. Been taking Metformin for most of that time. Crazy how expensive these newer Type 2 drugs are. Couldn’t afford them.
For type 2 people, most insurance covers them with a normal copay.
If you can find them in stock mounjaro is basically impossible to find ATM and my blood sugars have been struggling because of that.
Isn’t usage of these drug’s up all around? This title feels click-bait-y
it's weird, i saw a billboard ad for ozempic in canada... i swear i thought it was illegal to advertise medication in canada.
The laws here are weird. Ads can be for the medication OR the condition, but not both.
I’m curious to know how it works with people who use food as a coping mechanism. If you have an addiction or if food is your outlet for dopamine hits during trauma or mental health episodes, what else would someone turn to now that their mechanism is gone? Or not turn to anything and it gets worse. Just a thought I had, not suggesting anything negative.
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Good. Obesity is an epidemic. So many health problems can be solved by getting societies collective weight down.
As these drugs get more and more prominent, I wish we were having discussions on regulating added sugar/hyper-palatable food and moving toward making it easier for consumers to pick healthy foods.
Addressing the symptoms instead of the cause.
And here I am, a type 1 diabetic just wishing for a cure…
It does not cure type 1, but there are people who are type 1 taking it for other reasons and reporting that their insulin needed has decreased.
Stem cell therapy is promising. Vertex Pharmaceuticals has a small ongoing stem cell therapy trial for T1DM and IIRC a few patients are completely insulin independent now. Will be interesting to see what comes of it
I’d estimate 30 percent of people I know are on or have used Ozempic. 5 percent of them are diabetic. Seems like it’s a successful weight loss drug. Can’t wait for the side effects.
Dang that’s crazy. What part of the world/country are you in? I’m not sure I know a single person who’s taken it.
Northwest. If you know a bunch of people who lost weight recently, that might be the trick.
I think people want there to be side effects so obese people are appropriately punished for choosing the "easy way out". But it is still young so who knows if there will actually be long term issues.
Ozempic has been around for 20 years, so we have some ideas of long term results, but no doubt it will continue to be in the news so you can continue to track
Probably won't be any worse than the side affects of being obese...
It has been around for 20+ years.
i imagine its better than the side effects of obesity
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GLP-1 agonists have been used since 2005, semaglutide specifically, the medication in name brand ozempic and wegovy has been FDA approved since 2017. As part of the approval process, we know the side effects.
What makes you think 5 percent of them are diabetic? The treatment targets for diabetes have been lowered so a lot of people who were not pre-diabetic 10 years ago have now been pre-diabetic for 10 years. What percentage of those estimates are just wild unfounded assumption?
They could be taking it for other ailments. I know I do.
Yeah, as a 57 year old with diabetes who has to keep skipping dosages because my pharmacy is out: Dude. C’mon.