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188 points by lando2319 4y ago

dsfyu404ed 4y ago
I understand that $25 may have been an introductory loss leader but $1k seems insane and short sighted given the size of the market this drug potentially has.
- boomboomsubban 4y ago
  I assume it's some kind of health insurance bullshit pricing, where they never really expect people to buy it for $1000 a month.
  - cowpig 4y ago
    The US healthcare system is systematically broken. I've sworn off doing business in that sector because the cultural attitude that insurance companies have towards payment has infected everything. You can't trust anything anyone says about how much they will pay for something. Some kind of drawn-out, adversarial process around payment collection is the expectation. Sorry for that rant I am a bit traumatized by my experiences trying to do business in the US healthcare industry.
    - alyandon 4y ago
      It is absolutely insane what insurance companies will actually pay for - mine was fulling willing to pay $1250 for a simple ultrasound procedure at a hospital facility vs $150 at a specialty clinic. I made the smart decision to have it done at the clinic but it isn't like I'm going to be rewarded for that decision by paying lower premiums.
      - moneywoes 4y ago
        How do find these prices
        alyandon 4y ago
        The hard way - I looked up the average price for the procedure and pestered them for up front pricing. When they told me what they were going to charge I walked out of the facility without another word and went to the local clinic. I also let my doctor know that I was extremely displeased about his referral to that facility when there were cheaper alternatives.
      - AdrianB1 4y ago
        The insurance companies have huge discounts, even 90% for many procedures. The price list is usually for uninsured people, not what is ever paid by insurance.
        alyandon 4y ago
        In my case - $1250 would have been the contract/discounted price to the insurance company. List price was almost 2x that amount.
- TheRealDunkirk 4y ago
  Surely there is a formula that can solve for an optimum price that will maximize revenue by making it cheap enough for a certain segment of the population to pay for out of pocket. I don't have diabetes and I'm not morbidly obese, but I have struggled with my weight, and, frankly, given the hype, I'd try it on my own if it were something like $100/mo.
  - dmurray 4y ago
    Maybe 10% of people like you would also pay for it at $1000/mo, and they're already solving for optimum profit (not revenue - presumably they have some marginal costs). Maybe they can capture the $1000/mo market first and then offer something very similar to those who are interested at $100/mo. Or they have capacity constraints where they can't scale up manufacturing to supply everyone who would buy it at $100, but they can validate their process at the higher price first.
  - wonderwonder 4y ago
    "The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit"
- wonderwonder 4y ago
  "The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit" Seems like a supply chain problem
- refurb 4y ago
  Its not a loss leader. $25 was the patient support program for diabetes. That still exists. The drug isnt approved for obesity, so they dont get access to the program. Its actually illegal for the company. This is a case of the company stopping people from doing something they shouldnt have been doing in the first place.
- matthewdgreen 4y ago
  They are currently unable to produce enough of these medications, so charging a fortune for it makes sense to them. Private enterprise is stepping in to fill the gap via US "compounding pharmacies", with all the potential safety risks that entails.
boomboomsubban 4y ago
https://archive.is/iatwu https://archive.is/iatwu
cheapliquor 4y ago
Ah yeah my favorite distro Mounjaro Linux
- testTED 4y ago
  Came here to ask the important stuff: ate their certs up to date?
deleted 4y ago
[deleted]
canadianfella 4y ago
[dead]
boomboomsubban 4y ago
The story itself doesn't mention TikTok at all, it's really strange that the headline makes it the key aspect of the article. edit now the title here has changed, but it's still strange The Independent list that as the most important part. Guess it's normal click bait tactics.
Bluecobra 4y ago
> When someone takes an anti-obesity medication like Mounjaro, the amount of fat the body wants to maintain is re-regulated, usually to a lower weight. “When you take the medication away, that defended fat mass goes back up, and weight is regained,” Jastreboff said. “In order to continue to maintain the new re-regulated defended fat mass, and weight reduction, you have to continue taking the medication.” This doesn’t seem worth it to me. I’m sure a lot of people would like to lose 25lbs but you’re making a deal with the devil to get it. It almost makes me think they design these drugs to make a recurring revenue stream instead of fixing the issue permanently.
- lm28469 4y ago
  > instead of fixing the issue permanently. That would require a major cultural shift, we're far far away from that
- kemiller2002 4y ago
  The real problem is not as a weight loss drug, but as a way to regulate diabetes. My girlfriend is on it, because the other medications don't work outside of insulin which has it's own difficulties. The sudden raise in price and her insurance refusing to pay for it means she either has to do it out of pocket or try and switch to something else which may or may not work. The real problem with using it as a weight loss is that it doesn't solve the underlying problem. Mounjaro makes it so that you can't eat. Eat too much and you get sick (seriously like 2 bites and you're done eating). Overeating is a psychological problem. The drug doesn't fix you wanting the food, it just makes it so that you can't eat it. Take the barrier away, and you're back to where you started.
  - diordiderot 4y ago
    > The drug doesn't fix you wanting the food Shouldn't it _eventually_ have a pavlovian effect where you associate all food with nausea?
    - cjbgkagh 4y ago
      It seems strongly linked and such links are quickly extinguished. If there is a delay and randomness on getting sick it’ll be weakly linked and more durable.
falcolas 4y ago
The company that gouges customers for life saving insulin (edit: not epipens) gouges customers for another life saving drug. Capitalism, ho! (If you accept that obesity kills, reducing obesity saves everyone’s money and lives)
- pg_bot 4y ago
  Epipens are made by Mylan, Eli Lilly makes Mounjaro.
- nordsieck 4y ago
  > (If you accept that obesity kills, reducing obesity saves everyone’s money and lives) That seems like a ... strange argument. If that is a very poorly phrased way of saying that reducing obesity will extend peoples' working lives, that's certainly true. But otherwise, everyone dies in the end. Is it really that much more expensive to die as a middle aged overweight person than a healthy weight old person?
  - wonderwonder 4y ago
    Argument doesn't really make sense. If you are trapped in a fire and the fire department kicked down your door and carried you out would you argue they really didn't save your life as you will die eventually anyway?
  - falcolas 4y ago
    Yes. It's more expensive because of several issues that happen to obese people that don't happen to healthy weight people. Specifically dramatically increased inflammation of pretty much their entire body due to decomposing fat cells. And those higher costs get socialized through insurance and taxes.
- wonderwonder 4y ago
  "The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit" Supply chain issues
- fourseventy 4y ago
smallpipe 4y ago
The obese are mad at the diabetics, the diabetics are mad at the obese, while they should be mad at their failure of politicians who won’t regulate the drug market like any other functioning democracy. It’d be funny if it wasn’t so tragic
- lm28469 4y ago
  > who won’t regulate the drug market And the food industry, the real root cause of all of this
  - Spivak 4y ago
    Saying food is the cause of obesity is boiling down the visible aggregate effect of a million different things into one big cause. I eat pretty much nothing but garbage food -- pizza, wings, burgers, subs: just salt and grease. And I went from 220 to 120 and stayed there doing it. It's a meme at this point that when we go to restaurants with friends it's the skinny people ordering apps and burgers and the overweight people get salads. The difference is that all the skinny people get full and leave half their meal on the plate. For most of my life I was dumbfounded that this could happen and they must be forcing themselves to stop or something but nope, I hit the wall same as the rest of them now. No issues with cholesterol or blood pressure either. So we 1000% should deal with the amount of crap that's in our food but I don't think it'll be the cure-all that people expect.
    - lm28469 4y ago
      The problem is that we're not talking about well educated adults making a conscious decision about eating shit food and ruining their lives. We're talking about entire generations of kids who don't know better being purposefully fed addictive food which will ruin their health. > I eat pretty much nothing but garbage food -- pizza, wings, burgers, subs: just salt and grease. And I went from 220 to 120 and stayed there doing it Fast forward 10 years later and you'll get a very concerning blood work result. (I don't wish it on you but the web is full of "fat/skinny/I only eat junk food and I was healthy until I hit 45 and discovered XYZ is 5 times over the recommended limit" stories) Also you might have a damaged thyroid or other similar health issues, I know a few people coming from an industrial region known for pollution, they have more thyroid issues than the average, as a result they can eat 6+ times a day and much more calories than you'd expect while not packing a gram of fat.
NotPavlovsDog 4y ago
Tragic to observe the typical Dallas Buyers Club dynamic at play. People are coordinating online and locally and doing border runs for the Mexico-available GLP-1 predecessors. The Mounjaro patent appears to be until '39, with no generics available at the moment. As one of the patients states in the article, obesity may very well lead them to diabetes. People will die. And with the shortage affecting current diabetics, they are dying now.
- automatic6131 4y ago
  >obesity may very well lead them to diabetes. People will die. How scary! If only there was a reliable way for patients to prevent this disease :-(
  - counttheforks 4y ago
    Like taking the drug? If you're implying people should "just eat less", that's clearly not very reliable.
    - pwinnski 4y ago
      Not only unreliable, but ignorant. There is so much in hormone responses and often-undiagnosed conditions that makes "just eat less" absolutely irrelevant to many people.
      - rs_rs_rs_rs_rs 4y ago
        >There is so much in hormone responses and often-undiagnosed conditions that makes "just eat less" absolutely irrelevant to many people. I agree with your that's why you see many obese people in parts of the world with food shortages.
    - automatic6131 4y ago
      [flagged]
      - 4y ago
simonw 4y ago
If you haven't heard about Mounjaro before this Wired article by Paul Ford is worth your time: https://www.wired.com/story/new-drug-switched-off-appetite-mounjaro/ https://www.wired.com/story/new-drug-switched-off-appetite-m...
anovikov 4y ago
Cynically speaking, main reason people lose weight, is looks and advantage in dating it gives (unless they are morbidly obese and at risk of severe illness or death due to that, of course). If there was a $25 a month drug that lets everyone become skinny, then what's the point? Advantage will cease to exist.
- SketchySeaBeast 4y ago
  Nearly all people can bathe regularly now but hygiene is still valued for dating and there's also the more important point regarding health than you're letting on. $25 a month is cheaper than insulin and far cheaper than open heart surgery.
- Rury 4y ago
  Perhaps some people have that mindset, but a lot of people do it for health. And I know some people may find that BS, but if you have ever lost significant amounts of weight before, you know how much better you feel and function.
  - anovikov 4y ago
    I only wanted to say that a $1000 obesity drug is better than $25 obesity drug.
bedast 4y ago
Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The ‘next Ozempic’ became a social media sensation. Then everything changed The coupon didn't go away. The coupon's terms changed. I'm using the coupon now. Because I have type 2 diabetes. The coupon changed because people were using it to get the drug for off-label use. The drug wasn't taken away from people trying to lose weight by jacking up the cost. The drug shouldn't have been dispensed in this way to begin with. Lilly is seeking to get approval of tirzepatide under a different label as a weight loss drug, similar to how Ozempic and Wegovy exist, as well as Victoza and Saxenda. If you want a GLP-1 RA (this drug class) for weight loss, go get Wegovy or Saxenda, which are a version of these drugs approved for weight loss for those with a BMI over 30, or wait for the tirzepatide version. Leave the diabetes drugs alone. And to be clear: This drug isn't helping diabetics by helping them lose weight. It helps diabetics regulate blood glucose. It slows the release of glucose from the liver as well as promotes the release of insulin from the pancreas. Weight loss due to slowed stomach emptying is a side effect.
- HDThoreaun 4y ago
  People aren’t stupid. Mounjaro is the most effective weight loss drug in existence. Better than wegovy and the other brand name semaglutides. If you think FDA approval is going to stop people from wanting and getting it you’re sorely mistaken.
  - bedast 4y ago
    Yeah, feel free to spend the $1200/mo for it then. Because that's off-label use when there are drugs in this class with on-label weight loss use. And sometime this year, tirzepatide is expected to be among them. The coupon was changed because people were abusing it. This drug is approved for diabetes, not weight loss.
    - __Parfait__ 4y ago
      Don't worry, it will be approved for the latter soon enough, perhaps under a different brand. No way to put this genie back in the bottle, sorry.
HDThoreaun 4y ago
https://astralcodexten.substack.com/p/semaglutidonomics https://astralcodexten.substack.com/p/semaglutidonomics These new weight loss medications are the solution to obesity. Imo this is one of the biggest medical advances of the century and at least in urban areas of wealthy countries, I don’t think we’ll see obese people anymore in 10 years. The pharma companies realized they’ve got something truly revolutionary so they took the old tried and true drug dealer strategy. Get ‘em hooked for free/cheap and then bump the price to capture the value. Can’t say it’s surprising, they’re just following the incentives. And as the link goes through, these drugs have the potential to be worth many billions of dollars over their lifespan.
- msrenee 4y ago
  Are they the solution to obesity? I'm curious as to whether the weight stays off long term. 10 or more years at least or else it's just another bandaid. What we need is better access to nutritious food that doesn't take up so much of folk's scant downtime and tight income. I understand there's lots of reasons people are obese that aren't just laziness, but the drug doesn't solve those either. They're still not getting the nutrition they need. It's an improvement having poor nutrition with a lower BMI rather than poor nutrition and their current BMI, but not any kind of solution in my opinion.
  - icelancer 4y ago
    People saying that you have to be on X drug forever to solve your problem as if it's some silver bullet argument think.... what exactly about Type I diabetics who need to inject insulin every day, forever, to solve their problem?
    - msrenee 4y ago
      I get where you're coming from and want to clarify that my issue is not that you may have to stay on it for the rest of your life. I'm concerned that even while on the drug, your body could get accustomed to it, and you'd end up eating the same as before taking the drug. This happens a lot with bariatric surgery. I realize that that's due to the elasticity of the stomach, but the body adapts and with many medications that have weight loss as a side effect, your body eventually sorts itself out and you start gaining weight again.
fourseventy 4y ago
Pro tip, you can lose weight for free with no drugs at all.
- ralmidani 4y ago
  I agree with you regarding the general population. I also hope we can agree that not everyone attains meaningful weight loss with just diet and exercise. The human body is incredibly complex, with a spectrum of natural compositions, metabolisms, etc. Your post dismissing these nuances risks being interpreted as “thin privilege” (my wife is a Dietitian and taught me the concept). For what it’s worth, I’m against treating drugs like this as a first line of defense against obesity; it should be seen as the last step before bariatric surgery, and only used under the direction of a competent and ethical health professional.
  - fourseventy 4y ago
    I can't take anyone seriously who uses the phrase "thin privilege".
    - toofy 4y ago
      and many of us can’t take anyone seriously who dismisses nuance in one of the most incredibly complex topics which involve: biology, psychology, economics, etc… as you did in your original post.
- bluedevilzn 4y ago
  This is equivalent to saying, you don’t need a cure for AIDS. You can just avoid getting it by not having any sex. This is easier for some people but not a solution for the general population. Similarly, eating less is easier for some people while others are genetically or psychologically predisposed to eating more than they need.
  - pessimizer 4y ago
    There's also an enjoyment asymmetry. I'm 6', 175 lb. If I were 5'2" and ate the same way I'd be fat. My structure gives me the ability to enjoy life more than a smaller person (at least tastewise), and if they eat exactly as much as I do I can tell them they lack self-discipline.
zttg 4y ago
[dead]
Overtonwindow 4y ago
Is the high cost of some of these drugs simply because they know the government will pay for it?
- jmpman 4y ago
  They’re expecting the insurance companies to pay for it. Many/?most? Insurance companies don’t pay for weight loss medication. They’re likely trying to get people to push for this coverage, which will of course drive up healthcare insurance. Regardless, I’ll pay the $1000/month out of pocket if necessary.
- walnutclosefarm 4y ago
  I think it's going to be an interesting fight. By the standards the drug companies want to use, at least 1/3 of the US population might be diagnostically suited for a GIP prescription, which, as current understood, they would have to take every month for the rest of their lives. At $1000/month, treating half that cohort would add 15% to the US health care bill. That ain't gonna happen without a fight.
6510 4y ago
One of the flaws of our culture is that we madly overrate convenience. We think everything should be as easy as possible. It is taken as self evident but if you spend some thought on it it is hard to escape how important effort and accomplishment are. If we learn how to push ourselves we can take on slightly larger goals every time. Don't take my words as some kind of expert on the topic, if anything it reminds me constantly how damn lazy I am and how much worse it got. What kind of challenge you take up or find yourself in doesn't matter, it is all the same discipline. If I'm not careful the significant other will do all the house chores, cook the food and pay for everything. Imagine how appealing that sounds! This comment could have been a very lengthy article full of good references, the kind I haven't written in a long time. For this audience it could have used programming as it's context. What if after learning to read and write we would all learn to use a cli? Anyone could learn basic SQL and if we ever get the tools sorted out we could all consume API's. Very little effort and a huge reward. In stead some of us have to fight the html forms so that a baby can make very limited use of it. Lets have them type their name and their email and their address by hand? What horrific waste of time? We already force people to go to school and in some countries you have to join the military but after that we are free to never exercise again and stuff our face with any kind of food we want the year round. If we are financially successful we will never have to use our brain. Can get drunk and stoned every day.... wonderful? You can smoke, drink coffee and watch tiktok indefinetly... at least until any kind of challenge presents it self. Then ur fucked. Not very funny in a personal context but as a society or a culture things should get rather bizarre as we pile up more and more convenience. We already have to import people to do the work. It seems cheap universal healthcare isn't as hard as it seems. Putting out a small fire and cleaning up is cheaper than letting the entire city burn down before doing anything.
ergonaught 4y ago
What we really need is more fighting and hating and blaming and corporate greed and general incivility. That’s sure to make everything better for everyone.
bradwood 4y ago
Manjaro's installer is a lot easier to use.

188 points by lando2319 4y ago

I understand that $25 may have been an introductory loss leader but $1k seems insane and short sighted given the size of the market this drug potentially has.

boomboomsubban 4y ago
I assume it's some kind of health insurance bullshit pricing, where they never really expect people to buy it for $1000 a month.
- cowpig 4y ago
  The US healthcare system is systematically broken. I've sworn off doing business in that sector because the cultural attitude that insurance companies have towards payment has infected everything. You can't trust anything anyone says about how much they will pay for something. Some kind of drawn-out, adversarial process around payment collection is the expectation. Sorry for that rant I am a bit traumatized by my experiences trying to do business in the US healthcare industry.
  - alyandon 4y ago
    It is absolutely insane what insurance companies will actually pay for - mine was fulling willing to pay $1250 for a simple ultrasound procedure at a hospital facility vs $150 at a specialty clinic. I made the smart decision to have it done at the clinic but it isn't like I'm going to be rewarded for that decision by paying lower premiums.
    - moneywoes 4y ago
      How do find these prices
      - alyandon 4y ago
        The hard way - I looked up the average price for the procedure and pestered them for up front pricing. When they told me what they were going to charge I walked out of the facility without another word and went to the local clinic. I also let my doctor know that I was extremely displeased about his referral to that facility when there were cheaper alternatives.
    - AdrianB1 4y ago
      The insurance companies have huge discounts, even 90% for many procedures. The price list is usually for uninsured people, not what is ever paid by insurance.
      - alyandon 4y ago
        In my case - $1250 would have been the contract/discounted price to the insurance company. List price was almost 2x that amount.
TheRealDunkirk 4y ago
Surely there is a formula that can solve for an optimum price that will maximize revenue by making it cheap enough for a certain segment of the population to pay for out of pocket. I don't have diabetes and I'm not morbidly obese, but I have struggled with my weight, and, frankly, given the hype, I'd try it on my own if it were something like $100/mo.
- dmurray 4y ago
  Maybe 10% of people like you would also pay for it at $1000/mo, and they're already solving for optimum profit (not revenue - presumably they have some marginal costs). Maybe they can capture the $1000/mo market first and then offer something very similar to those who are interested at $100/mo. Or they have capacity constraints where they can't scale up manufacturing to supply everyone who would buy it at $100, but they can validate their process at the higher price first.
- wonderwonder 4y ago
  "The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit"
wonderwonder 4y ago
"The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit" Seems like a supply chain problem
refurb 4y ago
Its not a loss leader. $25 was the patient support program for diabetes. That still exists. The drug isnt approved for obesity, so they dont get access to the program. Its actually illegal for the company. This is a case of the company stopping people from doing something they shouldnt have been doing in the first place.
matthewdgreen 4y ago
They are currently unable to produce enough of these medications, so charging a fortune for it makes sense to them. Private enterprise is stepping in to fill the gap via US "compounding pharmacies", with all the potential safety risks that entails.

boomboomsubban 4y ago

https://archive.is/iatwu https://archive.is/iatwu

cheapliquor 4y ago

Ah yeah my favorite distro Mounjaro Linux

testTED 4y ago
Came here to ask the important stuff: ate their certs up to date?

deleted 4y ago

[deleted]

canadianfella 4y ago

[dead]

boomboomsubban 4y ago

The story itself doesn't mention TikTok at all, it's really strange that the headline makes it the key aspect of the article. edit now the title here has changed, but it's still strange The Independent list that as the most important part. Guess it's normal click bait tactics.

Bluecobra 4y ago

> When someone takes an anti-obesity medication like Mounjaro, the amount of fat the body wants to maintain is re-regulated, usually to a lower weight. “When you take the medication away, that defended fat mass goes back up, and weight is regained,” Jastreboff said. “In order to continue to maintain the new re-regulated defended fat mass, and weight reduction, you have to continue taking the medication.” This doesn’t seem worth it to me. I’m sure a lot of people would like to lose 25lbs but you’re making a deal with the devil to get it. It almost makes me think they design these drugs to make a recurring revenue stream instead of fixing the issue permanently.

lm28469 4y ago
> instead of fixing the issue permanently. That would require a major cultural shift, we're far far away from that
kemiller2002 4y ago
The real problem is not as a weight loss drug, but as a way to regulate diabetes. My girlfriend is on it, because the other medications don't work outside of insulin which has it's own difficulties. The sudden raise in price and her insurance refusing to pay for it means she either has to do it out of pocket or try and switch to something else which may or may not work. The real problem with using it as a weight loss is that it doesn't solve the underlying problem. Mounjaro makes it so that you can't eat. Eat too much and you get sick (seriously like 2 bites and you're done eating). Overeating is a psychological problem. The drug doesn't fix you wanting the food, it just makes it so that you can't eat it. Take the barrier away, and you're back to where you started.
- diordiderot 4y ago
  > The drug doesn't fix you wanting the food Shouldn't it _eventually_ have a pavlovian effect where you associate all food with nausea?
  - cjbgkagh 4y ago
    It seems strongly linked and such links are quickly extinguished. If there is a delay and randomness on getting sick it’ll be weakly linked and more durable.

falcolas 4y ago

The company that gouges customers for life saving insulin (edit: not epipens) gouges customers for another life saving drug. Capitalism, ho! (If you accept that obesity kills, reducing obesity saves everyone’s money and lives)

pg_bot 4y ago
Epipens are made by Mylan, Eli Lilly makes Mounjaro.
nordsieck 4y ago
> (If you accept that obesity kills, reducing obesity saves everyone’s money and lives) That seems like a ... strange argument. If that is a very poorly phrased way of saying that reducing obesity will extend peoples' working lives, that's certainly true. But otherwise, everyone dies in the end. Is it really that much more expensive to die as a middle aged overweight person than a healthy weight old person?
- wonderwonder 4y ago
  Argument doesn't really make sense. If you are trapped in a fire and the fire department kicked down your door and carried you out would you argue they really didn't save your life as you will die eventually anyway?
- falcolas 4y ago
  Yes. It's more expensive because of several issues that happen to obese people that don't happen to healthy weight people. Specifically dramatically increased inflammation of pretty much their entire body due to decomposing fat cells. And those higher costs get socialized through insurance and taxes.
wonderwonder 4y ago
"The conflict, which has been exacerbated by shortages of Mounjaro and two of its GLP-1 predecessors, Ozempic and Trulicit" Supply chain issues
fourseventy 4y ago

smallpipe 4y ago

The obese are mad at the diabetics, the diabetics are mad at the obese, while they should be mad at their failure of politicians who won’t regulate the drug market like any other functioning democracy. It’d be funny if it wasn’t so tragic

lm28469 4y ago
> who won’t regulate the drug market And the food industry, the real root cause of all of this
- Spivak 4y ago
  Saying food is the cause of obesity is boiling down the visible aggregate effect of a million different things into one big cause. I eat pretty much nothing but garbage food -- pizza, wings, burgers, subs: just salt and grease. And I went from 220 to 120 and stayed there doing it. It's a meme at this point that when we go to restaurants with friends it's the skinny people ordering apps and burgers and the overweight people get salads. The difference is that all the skinny people get full and leave half their meal on the plate. For most of my life I was dumbfounded that this could happen and they must be forcing themselves to stop or something but nope, I hit the wall same as the rest of them now. No issues with cholesterol or blood pressure either. So we 1000% should deal with the amount of crap that's in our food but I don't think it'll be the cure-all that people expect.
  - lm28469 4y ago
    The problem is that we're not talking about well educated adults making a conscious decision about eating shit food and ruining their lives. We're talking about entire generations of kids who don't know better being purposefully fed addictive food which will ruin their health. > I eat pretty much nothing but garbage food -- pizza, wings, burgers, subs: just salt and grease. And I went from 220 to 120 and stayed there doing it Fast forward 10 years later and you'll get a very concerning blood work result. (I don't wish it on you but the web is full of "fat/skinny/I only eat junk food and I was healthy until I hit 45 and discovered XYZ is 5 times over the recommended limit" stories) Also you might have a damaged thyroid or other similar health issues, I know a few people coming from an industrial region known for pollution, they have more thyroid issues than the average, as a result they can eat 6+ times a day and much more calories than you'd expect while not packing a gram of fat.

NotPavlovsDog 4y ago

Tragic to observe the typical Dallas Buyers Club dynamic at play. People are coordinating online and locally and doing border runs for the Mexico-available GLP-1 predecessors. The Mounjaro patent appears to be until '39, with no generics available at the moment. As one of the patients states in the article, obesity may very well lead them to diabetes. People will die. And with the shortage affecting current diabetics, they are dying now.

automatic6131 4y ago
>obesity may very well lead them to diabetes. People will die. How scary! If only there was a reliable way for patients to prevent this disease :-(
- counttheforks 4y ago
  Like taking the drug? If you're implying people should "just eat less", that's clearly not very reliable.
  - pwinnski 4y ago
    Not only unreliable, but ignorant. There is so much in hormone responses and often-undiagnosed conditions that makes "just eat less" absolutely irrelevant to many people.
    - rs_rs_rs_rs_rs 4y ago
      >There is so much in hormone responses and often-undiagnosed conditions that makes "just eat less" absolutely irrelevant to many people. I agree with your that's why you see many obese people in parts of the world with food shortages.
  - automatic6131 4y ago
    [flagged]
    - 4y ago

simonw 4y ago

If you haven't heard about Mounjaro before this Wired article by Paul Ford is worth your time: https://www.wired.com/story/new-drug-switched-off-appetite-mounjaro/ https://www.wired.com/story/new-drug-switched-off-appetite-m...

anovikov 4y ago

Cynically speaking, main reason people lose weight, is looks and advantage in dating it gives (unless they are morbidly obese and at risk of severe illness or death due to that, of course). If there was a $25 a month drug that lets everyone become skinny, then what's the point? Advantage will cease to exist.

SketchySeaBeast 4y ago
Nearly all people can bathe regularly now but hygiene is still valued for dating and there's also the more important point regarding health than you're letting on. $25 a month is cheaper than insulin and far cheaper than open heart surgery.
Rury 4y ago
Perhaps some people have that mindset, but a lot of people do it for health. And I know some people may find that BS, but if you have ever lost significant amounts of weight before, you know how much better you feel and function.
- anovikov 4y ago
  I only wanted to say that a $1000 obesity drug is better than $25 obesity drug.

bedast 4y ago

Mounjaro is not an obesity drug. It's a type 2 diabetes drug. Do not call it an obesity drug. The headline is editorialized. The linked article's headline: The ‘next Ozempic’ became a social media sensation. Then everything changed The coupon didn't go away. The coupon's terms changed. I'm using the coupon now. Because I have type 2 diabetes. The coupon changed because people were using it to get the drug for off-label use. The drug wasn't taken away from people trying to lose weight by jacking up the cost. The drug shouldn't have been dispensed in this way to begin with. Lilly is seeking to get approval of tirzepatide under a different label as a weight loss drug, similar to how Ozempic and Wegovy exist, as well as Victoza and Saxenda. If you want a GLP-1 RA (this drug class) for weight loss, go get Wegovy or Saxenda, which are a version of these drugs approved for weight loss for those with a BMI over 30, or wait for the tirzepatide version. Leave the diabetes drugs alone. And to be clear: This drug isn't helping diabetics by helping them lose weight. It helps diabetics regulate blood glucose. It slows the release of glucose from the liver as well as promotes the release of insulin from the pancreas. Weight loss due to slowed stomach emptying is a side effect.

HDThoreaun 4y ago
People aren’t stupid. Mounjaro is the most effective weight loss drug in existence. Better than wegovy and the other brand name semaglutides. If you think FDA approval is going to stop people from wanting and getting it you’re sorely mistaken.
- bedast 4y ago
  Yeah, feel free to spend the $1200/mo for it then. Because that's off-label use when there are drugs in this class with on-label weight loss use. And sometime this year, tirzepatide is expected to be among them. The coupon was changed because people were abusing it. This drug is approved for diabetes, not weight loss.
  - __Parfait__ 4y ago
    Don't worry, it will be approved for the latter soon enough, perhaps under a different brand. No way to put this genie back in the bottle, sorry.

HDThoreaun 4y ago

https://astralcodexten.substack.com/p/semaglutidonomics https://astralcodexten.substack.com/p/semaglutidonomics These new weight loss medications are the solution to obesity. Imo this is one of the biggest medical advances of the century and at least in urban areas of wealthy countries, I don’t think we’ll see obese people anymore in 10 years. The pharma companies realized they’ve got something truly revolutionary so they took the old tried and true drug dealer strategy. Get ‘em hooked for free/cheap and then bump the price to capture the value. Can’t say it’s surprising, they’re just following the incentives. And as the link goes through, these drugs have the potential to be worth many billions of dollars over their lifespan.

msrenee 4y ago
Are they the solution to obesity? I'm curious as to whether the weight stays off long term. 10 or more years at least or else it's just another bandaid. What we need is better access to nutritious food that doesn't take up so much of folk's scant downtime and tight income. I understand there's lots of reasons people are obese that aren't just laziness, but the drug doesn't solve those either. They're still not getting the nutrition they need. It's an improvement having poor nutrition with a lower BMI rather than poor nutrition and their current BMI, but not any kind of solution in my opinion.
- icelancer 4y ago
  People saying that you have to be on X drug forever to solve your problem as if it's some silver bullet argument think.... what exactly about Type I diabetics who need to inject insulin every day, forever, to solve their problem?
  - msrenee 4y ago
    I get where you're coming from and want to clarify that my issue is not that you may have to stay on it for the rest of your life. I'm concerned that even while on the drug, your body could get accustomed to it, and you'd end up eating the same as before taking the drug. This happens a lot with bariatric surgery. I realize that that's due to the elasticity of the stomach, but the body adapts and with many medications that have weight loss as a side effect, your body eventually sorts itself out and you start gaining weight again.

fourseventy 4y ago

Pro tip, you can lose weight for free with no drugs at all.

ralmidani 4y ago
I agree with you regarding the general population. I also hope we can agree that not everyone attains meaningful weight loss with just diet and exercise. The human body is incredibly complex, with a spectrum of natural compositions, metabolisms, etc. Your post dismissing these nuances risks being interpreted as “thin privilege” (my wife is a Dietitian and taught me the concept). For what it’s worth, I’m against treating drugs like this as a first line of defense against obesity; it should be seen as the last step before bariatric surgery, and only used under the direction of a competent and ethical health professional.
- fourseventy 4y ago
  I can't take anyone seriously who uses the phrase "thin privilege".
  - toofy 4y ago
    and many of us can’t take anyone seriously who dismisses nuance in one of the most incredibly complex topics which involve: biology, psychology, economics, etc… as you did in your original post.
bluedevilzn 4y ago
This is equivalent to saying, you don’t need a cure for AIDS. You can just avoid getting it by not having any sex. This is easier for some people but not a solution for the general population. Similarly, eating less is easier for some people while others are genetically or psychologically predisposed to eating more than they need.
- pessimizer 4y ago
  There's also an enjoyment asymmetry. I'm 6', 175 lb. If I were 5'2" and ate the same way I'd be fat. My structure gives me the ability to enjoy life more than a smaller person (at least tastewise), and if they eat exactly as much as I do I can tell them they lack self-discipline.

zttg 4y ago

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Overtonwindow 4y ago

Is the high cost of some of these drugs simply because they know the government will pay for it?

jmpman 4y ago
They’re expecting the insurance companies to pay for it. Many/?most? Insurance companies don’t pay for weight loss medication. They’re likely trying to get people to push for this coverage, which will of course drive up healthcare insurance. Regardless, I’ll pay the $1000/month out of pocket if necessary.
walnutclosefarm 4y ago
I think it's going to be an interesting fight. By the standards the drug companies want to use, at least 1/3 of the US population might be diagnostically suited for a GIP prescription, which, as current understood, they would have to take every month for the rest of their lives. At $1000/month, treating half that cohort would add 15% to the US health care bill. That ain't gonna happen without a fight.

6510 4y ago

One of the flaws of our culture is that we madly overrate convenience. We think everything should be as easy as possible. It is taken as self evident but if you spend some thought on it it is hard to escape how important effort and accomplishment are. If we learn how to push ourselves we can take on slightly larger goals every time. Don't take my words as some kind of expert on the topic, if anything it reminds me constantly how damn lazy I am and how much worse it got. What kind of challenge you take up or find yourself in doesn't matter, it is all the same discipline. If I'm not careful the significant other will do all the house chores, cook the food and pay for everything. Imagine how appealing that sounds! This comment could have been a very lengthy article full of good references, the kind I haven't written in a long time. For this audience it could have used programming as it's context. What if after learning to read and write we would all learn to use a cli? Anyone could learn basic SQL and if we ever get the tools sorted out we could all consume API's. Very little effort and a huge reward. In stead some of us have to fight the html forms so that a baby can make very limited use of it. Lets have them type their name and their email and their address by hand? What horrific waste of time? We already force people to go to school and in some countries you have to join the military but after that we are free to never exercise again and stuff our face with any kind of food we want the year round. If we are financially successful we will never have to use our brain. Can get drunk and stoned every day.... wonderful? You can smoke, drink coffee and watch tiktok indefinetly... at least until any kind of challenge presents it self. Then ur fucked. Not very funny in a personal context but as a society or a culture things should get rather bizarre as we pile up more and more convenience. We already have to import people to do the work. It seems cheap universal healthcare isn't as hard as it seems. Putting out a small fire and cleaning up is cheaper than letting the entire city burn down before doing anything.

ergonaught 4y ago

What we really need is more fighting and hating and blaming and corporate greed and general incivility. That’s sure to make everything better for everyone.

bradwood 4y ago

Manjaro's installer is a lot easier to use.