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The FDA will likely approve the diabetes drug tirzepatide for weight loss
- not_enoch_wise 4y agoProfitable subtext only I have the insight to call out: more people are thinner, ergo more people are horny, ergo gas station boner pill sales will increase. Get my economic insights for only $199 per month!
- jleyank 4y agoNote that weight-loss is relying of a side effect. It might be a wonder drug, or it might have issues due to how that side effect affects patients (loss of appetite, insulin levels, etc). I hope it's a clear aid for weight loss but some caution is appropriate.
- sschueller 4y agoSadly it seems that these drugs will be used for vanity without much regard for their safety.
- Buttons840 4y agoBeing overweight has risks, drugs have risks, choose your risk. Being overweight is quite a risk, so it's not impossible for a pill to be the better choice. Significant weightloss is not a vain thing.
- cptcobalt 4y agoIt still requires a prescription and, therefore, a doctor moderates usage and safety.
- robertheadley 4y agoI am currently taking this drug in an attempt to get my blood sugar level down. I have lost about 15 lbs but my insurance did not want to cover it. Thankfully, Eli Lilly has a $25 coupon to cover it.
- jmpman 4y agoI’m also on it, originally started it for weight loss, and am down 35lbs in 4 months. However I’m starting to wonder if I was diabetic or pre diabetic, as I no longer feel my blood sugar changing throughout the day. The drug has been great, with minimal side effects. Simply not interested in food, and always feel full.
- simfree 4y agoDoes the coupon make it cost $25, or just reduce the cost by $25? Any other specifics on this would be super helpful!
- e1g 4y agoI’m seeing one of the doctors quoted in the article and they say nobody knows what’s going on with pricing or what will happen next year when the drug gets approved. The coupon is from the manufacturer and brought the total cost to $25 out of pocket. However, in Oct the rules changed and now there is lots of confusion about eligibility and costs. Most pharmacies refuse to deal with this at all, and last week I paid $500 (for a monthly dose).
- MerelyMortal 4y agoAt let's say a 10 pound per month weight loss, that means losing 100 pounds would only cost $5,000. I know it doesn't quite work that way, but $500/month sounds a lot, but $5,000/100lb sounds like a bargain.
- wbarber 4y agoUnfortunately 90%+ of people need to continue taking the drug to keep the weight off. It’s an expensive drug but there is increasing competition in the drug category which will be good for consumers in the long run.
- sschueller 4y agoHere is Derek from MPMD talking about one of those diabetes 2 drugs being used for weight loss by people like Elon Musk [1] Sadly because celebrities are using these drugs I can forsee many people who are only a bit overweight taking this when just eating better and working out would be so much better for them. [1] https://youtu.be/hcNTHLdH5QE https://youtu.be/hcNTHLdH5QE
- pixl97 4y agoThe number of overweight people and diabetics far exceeds the number of celebrities out there. I think it's just demand driven by media exposure that is the issue
- toomuchtodo 4y agoEating better and working out is hard. If the medication can get you a similar outcome with minimal side effects, that seems like a prudent protocol to prescribe. If it’s determined to be safe (statistically), why not? Might only be necessary until we can inexpensively synthesize miR-1: https://news.ycombinator.com/item?id=34196488 https://news.ycombinator.com/item?id=34196488
- Steven420 4y agoUnfortunately there aren't any shortcuts to good health
- johncearls 4y agoApparently there is now.
- muldvarp 4y agoExercise and diet have positive health effects other than losing weight. Many people with normal weight according to BMI still have an unhealthy body fat percentage. That said, if this drug can keep its promise it will have an enormous positive effect on public health.
- barbariangrunge 4y ago1100-1500/month is pretty brutal. It’s a bit of a middle finger pointed at lower income people
- JamesBarney 4y agoUnfortunately it's really expensive to research and produce drugs and somebody's gotta pay for it. The rest of world isn't willing to so it looks like rich people's insurance is the one that will foot the bill which means lower income people have to wait. It sucks and it's a inefficient way to fund research but it's better than the alternative where no one funds this research and we (both rich and poor) never get the drug.
- asdff 4y agoAnother alternative is the government funding this research and/or buying the drug directly. This is what was done for the government ordering 30 billion dollars worth of covid vaccines from moderna, pfizer, and j&j.
- refurb 4y agoWhat the difference between consumers paying for drugs directly or paying taxes that pay for the drugs?
- asdff 4y agoMany. For one the government can now collectively bargain for better prices. They can also subsidize the drug such that its available for everyone who needs it, not just those who have great insurance or who can afford to pay entirely out of pocket. Keeping your working population healthy has massive second order effects on the economy, it would be an investment paying for medical care. Where does this money come from? The people in this country who make way too much money to notice any decrease in quality of life from this potential tax hit. This country is full of such whales who could front a lot of money for collective good if we thought about things in a more redistributive manner instead of the "screw you I got mine" manner that somehow got perverted into the American way.
- Eleison23 4y ago[dead]
- ck2 4y agoAll these new "weight loss" drugs are semaglutide peptide https://en.wikipedia.org/wiki/Semaglutide https://en.wikipedia.org/wiki/Semaglutide No way messing with insulin production doesn't have long-term delayed consequences.
- xnx 4y agoWorse consequences that excess adipose tissue?
- shlant 4y agopeople very often forget this. Even if we assume an unsubstantiated risk from the drugs, you absolutely have to factor in the reduced risk from the weight loss. These drugs aren't just providing aesthetic improvement in body composition.
- JamesBarney 4y agoThey are in the same class as semaglutide. We know being obese has long term delayed consequences. And they've been giving this drug to diabetics for a while and they seem to be fine and healthy.
- simonebrunozzi 4y ago> No way messing with insulin production doesn't have long-term delayed consequences. Not an expert, but this sounds most likely true.
- marcus0x62 4y agoSure, but being grossly overweight also has a tendency to “mess with insulin production”. That’s how type 2 diabetes works: your musculoskeletal cells become resistant to insulin and your pancreas produces more and more until it can’t keep up.
- r930 4y agoThere is some evidence that soleus push ups can induce significant insulin responses, without the need for drugs. Soleus is the muscle below the calf and normally used when walking running and jumping > All of the 600 muscles combined normally contribute only about 15% of the whole-body oxidative metabolism in the three hours after ingesting carbohydrate. Despite the fact that the soleus is only 1% the body weight, it is capable of raising its metabolic rate during SPU contractions to easily double, even sometimes triple, the whole-body carbohydrate oxidation. https://www.eurekalert.org/news-releases/965506 https://www.eurekalert.org/news-releases/965506
- DoreenMichele 4y agoPossibly related: Insulin resistance is impacted by muscle protein. https://news.ycombinator.com/item?id=14667430 https://news.ycombinator.com/item?id=14667430
- anonuser123456 4y agoYour source is like the weekly world news of medical information.
- exabrial 4y agoAll right, this is a single Data point, and of course is anecdotal evidence… if you’re into taking health advice off the Internet rather than from your doctor… well you probably will end up disappointed. OK disclaimers aside now: when I switched to clipless petals on my mountain bike, I dropped 12 lbs over the course of the summer. SPD clipless work the hell out of your calves when they are placed under the ball of your foot, especially in mountain biking applications because you spend so much time out of the saddle. There is so many lurking variables here and nothing was normalized. I just thought that was an interesting connection.
- o10449366 4y agoDrugs like Adderall don't mimic the hormones talked about in the article, right? I took Adderall XR once a day in college which completely suppressed my appetite and, combined with being a poor student that couldn't always afford lunch, I would frequently only eat one meal a day (either breakfast or dinner.) Since I graduated college many years ago, I also stopped taking Adderall but my sense of hunger has never returned. I always figured my body just got used to having my appetite suppressed and now I can go multiple days without eating and not feel any physical sensation or side-effect (including fatigue/irritation from lack of food or things like headaches.) Just the other day I went 40 hours without eating while traveling for the holidays and didn't even realize it until I went to a social dinner. I've never thought too much of this. It seems like in pop culture/science nowadays "fasting" is generally seen/understood to be beneficial. I certainly don't mind because its helped me stay at a healthy weight, but in reading about this new class of drugs for weight loss recently I am curious as to what exactly is going on in my body and whether there's a similar mechanism at play. Is there anyone who fasts regularly who's also experienced this loss of hunger sensation?
- 98codes 4y agoNot at all, nor do all prescribed users of Adderall experience any change in appetite.
- yummypaint 4y agoI'm also one of those people who finds it more convenient to eat 1 meal per day when busy. It also started in my early 20s, but I've never been on stimulants. I got in the habit of eating irregularly in grad school which made it even easier to continue. I rarely have any appetite within an hour of waking up, and ive almost never eaten during this window. Not clear to me which is the cause vs effect. I know some people who are on the opposite end and have problems functioning after missing lunch. None of them have ever intentionally fasted, though again it's hard to separate cause from effect. What is clear is that different people's bodies form very different expectations surrounding food intake, and we are mostly unaware of this collectively.
- JamesBarney 4y agoNo Adderall works via a completely different pathway.
- SamoyedFurFluff 4y agoDo we actually know if weight loss from these medications is associated with improved health outcomes in non-diabetic people? Like does it fix joints, does it fix heart disease, blood pressure, etc?
- wbarber 4y agoVery likely so. I know of at least one study in which they are interested in determining if weight loss from semaglutide results in a similar decrease in cancer rates that they see in bariatric surgery patients. The drugs cause you to eat less and the mechanism of the drug may, in and of itself have some cardio protective effects. To get a drug approved for diabetics, you have to demonstrate it doesn’t cause cardiovascular issues because the comorbidity among diabetics is so high, and other drugs have a history of helping with blood sugars but causing cardiovascular issues. On those measures, iirc, semaglutide specifically showed my that the treatment group saw a significant reduction in cardiovascular events. I’m on mobile so can’t provide links at the moment.
- causi 4y agoAs long as it doesn't damage those things by itself, either it will help them or we're totally wrong about what causes them.
- deleted 4y ago[deleted]
- jcampbell1 4y agoDulaglutide is a drug in the same class that has been around longer there is a modest improvement for cardiovascular events. 5.4 years on the drug: https://pubmed.ncbi.nlm.nih.gov/31189511/ https://pubmed.ncbi.nlm.nih.gov/31189511/
- SamoyedFurFluff 4y agoYour link says “ in type 2 diabetes” in the title. I’m interested in non-diabetics, given this is going to be approved purely to unfat people without diabetes.
- ruskyhacker 4y agoYikes. Gogo gadget thyroid tumors, not at a great place for a tumor. https://www.drugs.com/dosage/tirzepatide.html https://www.drugs.com/dosage/tirzepatide.html
- tptacek 4y agoIt causes thyroid tumors in rats, and thyroid tumors are among the most curable cancers.
- rswail 4y agoSigh, as a T2 diabetic that's been on this for a while, the lack of supply is becoming a real problem. This is in Australia, where the drug is available on the PBS for T2 Diabetes.
- tjohns 4y agoOn the flip side, people who are overweight are already on the road to T2 diabetes. Obesity isn't just a cosmetic issue, it is a disease with very real health implications. If behavior modification doesn't work to lose weight, we shouldn't deny people effective treatment. The supply chain will adjust to meet demand.
- pknomad 4y agoDisclaimer - I'm just a mere biochem grad who've taken some grad level courses in physiology so my question is coming from curiosity and healthy dose of ignorance. I took a cursory glance at the wiki page (https://en.wikipedia.org/wiki/Tirzepatide https://en.wikipedia.org/wiki/Tirzepatide) and it seems like it's working wonders on weight loss by targeting satiety. Weight loss still occurs when calorie out exceeds calorie input so it's not fundamentally changing anything as far as I know biochemically. Why is it so popular then? Should we be concerned about needing drugs to treat obesity? My guess is that patients who lose weight this way still needs this drug to keep it off. Medical professionals/experts - please ream me or just correct me if I'm wrong here. FWIW - I also struggled with weight loss. I was 284(!!!) during peak covid but managed to get myself down to 224. I'm hoping to get it down to 174 by end of this year. I found fasting + exercise + will power to be key for weight loss but I also understand that this is an anecdote and won't work for others.
- wbarber 4y agoPatients do indeed need the drug to keep the weight off. They have proven this. But that is not an issue at all. Individuals who have gained a significant amount of weight do not produce leptin, grehlin, and other related hormones in the same way that people at a normal weight do. Once you’ve put on a significant amount of weight you can’t just expand the size of your fat cells you make new cells entirely. Even if you remove those new cells via liposuction, the body recreates them as a homeostatic response. The result is that something like 10% of obese people that lose weight have kept it off two years later. The people who keep it off have been studied extensively as a group and generally they weigh themselves daily and many of them count calories meticulously. As soon as they stop doing that, they regain the weight. It’s a path dependent outcome. Once you’ve walked the path to obesity, your body fights you walking back towards healthy. This drug adjusts some of the same hormones that get out of whack when you’ve been overweight before. Unfortunately not all of them can be safely played with (giving people leptin and leptin like hormones tends to cause cancer for example). But these seem to be both safe and effective. There really shouldn’t be a stigma associated with taking drugs like these for the rest of your life.
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- Eumenes 4y agoI'm sure this will have no long term side effects or risks! Is exercise + sound diet that difficult for people?
- pixl97 4y agoI mean what percentage of the US is overweight these days, the number is scary high and it has a massive impact in productivity and Healthcare costs.
- thehappypm 4y agoAbstinence-only education always works!
- lancesells 4y agoClearly it is in the US. I think it's a generational lack of understanding and poor habits. From my perspective each generation of an obese family seems to get bigger and bigger, and pass on those non-existent or bad habits to their kids. If your parents aren't modeling exercise and good behaviors the only avenue you have to learn from is school and that's easy to get left behind. On top of that you're marketed with the shittiest food all day, your school probably serves food where only things like pizza and burgers are palatable. It's all really a shame because exercise and eating well clear your mind and make you feel better. Even if you're a healthy weight eating shitty and sitting all day does things to your mental health.
- 015UUZn8aEvW 4y agoEmpirically, yes. Very few people who attempt to lose a substantial amount of weight via diet and exercise are able to lose the weight and keep it off over the long term. The latter part is the problem for most people.