7 ms·

A new class of drugs for weight loss could end obesity

22 points by bumbledraven 4y ago

bumbledraven 4y ago
https://archive.fo/4eE2y https://archive.fo/4eE2y
bberrry 4y ago
I'd be lying if I said I wasn't excited by the discovery of semaglutide. I'm not particularly heavy (BMI of 26.5) but I would happily pay for it if it was available over the counter. I wonder how long that will take, if ever.
- exfatloss 4y ago
  Don't know about OTC but patents last 20 years. So the generics will be out then. And you could get it prescribed by your doctor w/o a big deal like blood pressure meds or something now. I got a CGM prescribed just cause I wanted one. No biggie.
_aavaa_ 4y ago
The real money quote is: "A bigger drawback, however, is that those who start taking the new drugs are likely to depend on them for life. Stop, and the weight piles back on, just as with most conventional diets."
- dsfyu404ed 4y ago
  "Like dieting but easy, just pop a pill" still seems like a huge net positive for society.
  - exfatloss 4y ago
    Not even pop a pill - take an injection weekly, at home. Zero stigma, nobody will even know you're on it.
    - thomascgalvin 4y ago
      If these drugs prove workable over the long term, pretty soon everyone will suspect you're on it, because the majority of people will be. There would be no more of a stigma about this than taking a medication for blood pressure.
      - exfatloss 4y ago
        100%. I've heard the theory that once we discover the cure for obesity, it'll be over in 2 years and nobody will miss it. What, like 40% of Americans are currently dieting at any given time? And that's with a ~0% success rate.
        _aavaa_ 4y ago
        There's nothing to discover cause it's not a secret: be more active, eat better & less food. Don't have a clear picture of what "better" mean? That's also simple. Look at what people were eating 100 years ago, and how much physical activity they were doing then. Or, look at other countries across the world today.
        legerdemain 4y ago
        WW1 military rations, from https://net.lib.byu.edu/estu/wwi/memoir/ration.html https://net.lib.byu.edu/estu/wwi/memoir/ration.html > British Daily Ration, 1914: > > 1 1/4 lb fresh or frozen meat, or 1 lb preserved or salt meat; > 1 1/4 lb bread, or 1 lb biscuit or flour; > 4 oz. bacon; > 3 oz. cheese; > 5/8 oz. tea; > 4 oz. jam; > 3 oz. sugar; > 1/2 oz salt; > 1/36 oz. pepper; > 1/20 oz. mustard; > 8 oz. fresh or 2 oz. dried vegetables; > 1/10 gill lime juice if fresh vegetables not issued; > 1/2 gill rum; > not exceeding 2 oz. tobacco per week. So, mostly meat, bread, bacon, and sugar?
        _aavaa_ 4y ago
        This is not a productive comment. Comparing military rations to what civilians eat is apples and oranges. The focus of military rations is getting enough calories and to avoid any short-medium term health issues (notice the conspicuous reference to a lime juice ration to fight scurvy). But let's take it at face value, these rations are calculated for target activity level. Any idea of what that is? Cause I'm pretty confident that it's higher than the sedentary North American lifestyle.
  - _aavaa_ 4y ago
    "like dieting" may be an improvement over nothing, but it's a far cry from "better diet". This is a technological fix to a personal (or societal problem) which doesn't address the underlying problem. At least "dieting" requires you to face the problems in what you eat and how much exercise you do, this takes even that away.
  - MagicMoonlight 4y ago
    Until it inevitably turns out you get cancer from it
- thomascgalvin 4y ago
  This is a drawback, but I'm not sure how terrible it is. If you go off the drug, you regain your weight. If you go off your diet, you also regain the weight. That, then, is a wash. These drugs currently cost a fortune, so lifelong dependence is an expensive scenario, especially since most insurances refuse to cover them. On the other hand, this is preventative medicine, which might significantly reduce costs from obesity-related health issues down the road, including heart disease, cancer, and arthritis. Compliance with a weekly injection is also likely to be higher than compliance with a long-term dietary change. Of course, since something like 95-plus percent of diets fail long-term, almost anything would have a higher compliance. I don't know that we have enough data on long-term use of these drugs to be confident about long-term side effects, either. I don't love the idea of being dependent on a medicine for the rest of my life, but there are plenty of other lifelong medicines that we just sort of accept as normal now. Insulin-dependent diabetics and people with high blood pressure are just two examples. I guess for now I'm putting these in my "cautiously optimistic" bucket.
  - exfatloss 4y ago
    100% agreed. I currently wouldn't take it just because it seems to have pretty drastic effects, and we don't seem to quite understand on what or how. The reported side-effects like 5% have nausea or whatever, don't seem too bad. Prices will inevitably come down if these go mainstream. Would I snap my finger like Thanos and obliterate obesity in natural ways if I had the 7 rings or whatever? Yea, but I don't. This is a decent alternative, it seems. If there are no serious long-term side-effects.
thatguy0900 4y ago
Honestly not sure how I feel about people being able to be absolute gluttons then just take a pill and have no consequences. I can't imagine a move to healthier eating or lifestyle afterwards.
- Enginerrrd 4y ago
  That's not how the pills work. They act by reducing hunger and creating satiety at lower caloric inputs. They also often have nausea and vomiting as side-effects.
- exfatloss 4y ago
  Will be interesting to see how that dynamic acts out. I'm also kind of dumbfounded. E.g. will we just make food even unhealthier and just counter it with more of these drugs? Where eventually we're just chugging soybean oil laced with high fructose corn syrup? :D I mean could the drug counteract that or is there a limit? Guess we'll find out.
- anonuser123456 4y ago
  You misunderstand the mechanism of action. You cannot be a glutton on this class of drugs. They make you not want to eat, and that’s how weight loss is achieved. Think back to a time when you had a gastroenteritis. There is a period after vomiting where you are fine pain wise, but have a mental opposition to eating. That’s the sensory feedback these drugs give to your HPA axis.
  - exfatloss 4y ago
    Haha hopefully without the disgust ;) edit: oh wait, is this why they sometimes cause vomiting? Like you literally feel sick?
    - anonuser123456 4y ago
      >is this why they sometimes cause vomiting I would speculate yes, but Im not an expert. GLP-1 seems to be the primary signal of “nutrient in the gut”. What happens when you mechanically overwhelm your gut? You throw up. What happen when you have gastroenteritis? You want to get everything out of your gut. Similarly, gastric bypass surgery directly affects GLP-1 secretion (increasing it), which has the effect of causing people to not want to eat/ feel nausea with much lower nutrient intake.
pedalpete 4y ago
It seems like we never learn. There are definitely a group of people who truly need this drug (diabetics), but the obesity epidemic is the result of poor diet and a lack of exercise. So rather than solving for the problem at the source, we're suggesting a "quick fix" which has some known side-effects, and potentially many more unknown. Historically we look at the drugs that have promised weight loss in the past, and they have all been pulled from the market, or shown to have negative consequences. Taking the drug likely still doesn't solve the other side of the obesity epidemic, which is exercise. So are we going to pop a pill that exercises for us as well? What will life look like for future generations when they can eat like gluttons, laze around with robot servants bringing us our every wish, and AI that can think for us? That's not a future I want to live in. I already see parts of it with the UberEats/DoorDash, etc - where people think they are just too busy to go and do something themselves, then I find out they are watching 3 hours of television and tiktok per day. I'm tempted to downvote myself for this rant, but I do find this a very worrying state.
- exfatloss 4y ago
  Obesity is unsolved. If you know what dietary intervention will cause significant long-term fat reduction in a majority of people, please demonstrate and you'll win the Nobel peace price. We just don't know. Trust me, this is kind of my thing. That said I am also naturally skeptical of quick fixes. The known side effects of these drugs seem meh, but I worry about hidden ones. E.g. I've heard these described as "chemical starvation" - doesn't exactly sound healthy long term to starve your body? I strongly disagree exercise has anything to do with the obesity epidemic. Exercise is great but not related to obesity. edit: let's debate this guy and not just downvote, plz?
  - pedalpete 4y ago
    I'm not saying exercise and diet is the cure for obesity. Good diet and exercise are the preventative of obesity. I didn't state that clearly in my initial comment. Please, debate (me) "this guy"!
    - 4y ago
lofaszvanitt 4y ago
I always wondered what happens when your ulcer flares up. If I would develop a drug that takes away appetite then get someone with ulcers and check what signal is sent to where and try to imitate that. Ulcers are the best when you need some weight loss.

22 points by bumbledraven 4y ago

https://archive.fo/4eE2y https://archive.fo/4eE2y

I'd be lying if I said I wasn't excited by the discovery of semaglutide. I'm not particularly heavy (BMI of 26.5) but I would happily pay for it if it was available over the counter. I wonder how long that will take, if ever.

exfatloss 4y ago
Don't know about OTC but patents last 20 years. So the generics will be out then. And you could get it prescribed by your doctor w/o a big deal like blood pressure meds or something now. I got a CGM prescribed just cause I wanted one. No biggie.

_aavaa_ 4y ago

The real money quote is: "A bigger drawback, however, is that those who start taking the new drugs are likely to depend on them for life. Stop, and the weight piles back on, just as with most conventional diets."

dsfyu404ed 4y ago
"Like dieting but easy, just pop a pill" still seems like a huge net positive for society.
- exfatloss 4y ago
  Not even pop a pill - take an injection weekly, at home. Zero stigma, nobody will even know you're on it.
  - thomascgalvin 4y ago
    If these drugs prove workable over the long term, pretty soon everyone will suspect you're on it, because the majority of people will be. There would be no more of a stigma about this than taking a medication for blood pressure.
    - exfatloss 4y ago
      100%. I've heard the theory that once we discover the cure for obesity, it'll be over in 2 years and nobody will miss it. What, like 40% of Americans are currently dieting at any given time? And that's with a ~0% success rate.
      - _aavaa_ 4y ago
        There's nothing to discover cause it's not a secret: be more active, eat better & less food. Don't have a clear picture of what "better" mean? That's also simple. Look at what people were eating 100 years ago, and how much physical activity they were doing then. Or, look at other countries across the world today.
        legerdemain 4y ago
        WW1 military rations, from https://net.lib.byu.edu/estu/wwi/memoir/ration.html https://net.lib.byu.edu/estu/wwi/memoir/ration.html > British Daily Ration, 1914: > > 1 1/4 lb fresh or frozen meat, or 1 lb preserved or salt meat; > 1 1/4 lb bread, or 1 lb biscuit or flour; > 4 oz. bacon; > 3 oz. cheese; > 5/8 oz. tea; > 4 oz. jam; > 3 oz. sugar; > 1/2 oz salt; > 1/36 oz. pepper; > 1/20 oz. mustard; > 8 oz. fresh or 2 oz. dried vegetables; > 1/10 gill lime juice if fresh vegetables not issued; > 1/2 gill rum; > not exceeding 2 oz. tobacco per week. So, mostly meat, bread, bacon, and sugar?
        _aavaa_ 4y ago
        This is not a productive comment. Comparing military rations to what civilians eat is apples and oranges. The focus of military rations is getting enough calories and to avoid any short-medium term health issues (notice the conspicuous reference to a lime juice ration to fight scurvy). But let's take it at face value, these rations are calculated for target activity level. Any idea of what that is? Cause I'm pretty confident that it's higher than the sedentary North American lifestyle.
- _aavaa_ 4y ago
  "like dieting" may be an improvement over nothing, but it's a far cry from "better diet". This is a technological fix to a personal (or societal problem) which doesn't address the underlying problem. At least "dieting" requires you to face the problems in what you eat and how much exercise you do, this takes even that away.
- MagicMoonlight 4y ago
  Until it inevitably turns out you get cancer from it
thomascgalvin 4y ago
This is a drawback, but I'm not sure how terrible it is. If you go off the drug, you regain your weight. If you go off your diet, you also regain the weight. That, then, is a wash. These drugs currently cost a fortune, so lifelong dependence is an expensive scenario, especially since most insurances refuse to cover them. On the other hand, this is preventative medicine, which might significantly reduce costs from obesity-related health issues down the road, including heart disease, cancer, and arthritis. Compliance with a weekly injection is also likely to be higher than compliance with a long-term dietary change. Of course, since something like 95-plus percent of diets fail long-term, almost anything would have a higher compliance. I don't know that we have enough data on long-term use of these drugs to be confident about long-term side effects, either. I don't love the idea of being dependent on a medicine for the rest of my life, but there are plenty of other lifelong medicines that we just sort of accept as normal now. Insulin-dependent diabetics and people with high blood pressure are just two examples. I guess for now I'm putting these in my "cautiously optimistic" bucket.
- exfatloss 4y ago
  100% agreed. I currently wouldn't take it just because it seems to have pretty drastic effects, and we don't seem to quite understand on what or how. The reported side-effects like 5% have nausea or whatever, don't seem too bad. Prices will inevitably come down if these go mainstream. Would I snap my finger like Thanos and obliterate obesity in natural ways if I had the 7 rings or whatever? Yea, but I don't. This is a decent alternative, it seems. If there are no serious long-term side-effects.

thatguy0900 4y ago

Honestly not sure how I feel about people being able to be absolute gluttons then just take a pill and have no consequences. I can't imagine a move to healthier eating or lifestyle afterwards.

Enginerrrd 4y ago
That's not how the pills work. They act by reducing hunger and creating satiety at lower caloric inputs. They also often have nausea and vomiting as side-effects.
exfatloss 4y ago
Will be interesting to see how that dynamic acts out. I'm also kind of dumbfounded. E.g. will we just make food even unhealthier and just counter it with more of these drugs? Where eventually we're just chugging soybean oil laced with high fructose corn syrup? :D I mean could the drug counteract that or is there a limit? Guess we'll find out.
anonuser123456 4y ago
You misunderstand the mechanism of action. You cannot be a glutton on this class of drugs. They make you not want to eat, and that’s how weight loss is achieved. Think back to a time when you had a gastroenteritis. There is a period after vomiting where you are fine pain wise, but have a mental opposition to eating. That’s the sensory feedback these drugs give to your HPA axis.
- exfatloss 4y ago
  Haha hopefully without the disgust ;) edit: oh wait, is this why they sometimes cause vomiting? Like you literally feel sick?
  - anonuser123456 4y ago
    >is this why they sometimes cause vomiting I would speculate yes, but Im not an expert. GLP-1 seems to be the primary signal of “nutrient in the gut”. What happens when you mechanically overwhelm your gut? You throw up. What happen when you have gastroenteritis? You want to get everything out of your gut. Similarly, gastric bypass surgery directly affects GLP-1 secretion (increasing it), which has the effect of causing people to not want to eat/ feel nausea with much lower nutrient intake.

pedalpete 4y ago

It seems like we never learn. There are definitely a group of people who truly need this drug (diabetics), but the obesity epidemic is the result of poor diet and a lack of exercise. So rather than solving for the problem at the source, we're suggesting a "quick fix" which has some known side-effects, and potentially many more unknown. Historically we look at the drugs that have promised weight loss in the past, and they have all been pulled from the market, or shown to have negative consequences. Taking the drug likely still doesn't solve the other side of the obesity epidemic, which is exercise. So are we going to pop a pill that exercises for us as well? What will life look like for future generations when they can eat like gluttons, laze around with robot servants bringing us our every wish, and AI that can think for us? That's not a future I want to live in. I already see parts of it with the UberEats/DoorDash, etc - where people think they are just too busy to go and do something themselves, then I find out they are watching 3 hours of television and tiktok per day. I'm tempted to downvote myself for this rant, but I do find this a very worrying state.

exfatloss 4y ago
Obesity is unsolved. If you know what dietary intervention will cause significant long-term fat reduction in a majority of people, please demonstrate and you'll win the Nobel peace price. We just don't know. Trust me, this is kind of my thing. That said I am also naturally skeptical of quick fixes. The known side effects of these drugs seem meh, but I worry about hidden ones. E.g. I've heard these described as "chemical starvation" - doesn't exactly sound healthy long term to starve your body? I strongly disagree exercise has anything to do with the obesity epidemic. Exercise is great but not related to obesity. edit: let's debate this guy and not just downvote, plz?
- pedalpete 4y ago
  I'm not saying exercise and diet is the cure for obesity. Good diet and exercise are the preventative of obesity. I didn't state that clearly in my initial comment. Please, debate (me) "this guy"!
  - 4y ago

lofaszvanitt 4y ago

I always wondered what happens when your ulcer flares up. If I would develop a drug that takes away appetite then get someone with ulcers and check what signal is sent to where and try to imitate that. Ulcers are the best when you need some weight loss.